It finally happened. Now that I’m pulling money from my investments, my ‘income’ according to the tax man surpassed the level where I need to choose a healthcare plan from the marketplace instead of defaulting to Washington State Medicaid that I basically never used.
My Previous Plan
From 2020 to 2024, I bought World Nomads Travel Insurance to cover me outside of my home state of Washington and in all the countries I’ve been visiting. However, World Nomads insurance has a requirement that you also have US insurance to buy their product.
So when I retired, since I’m still a Washington State resident, I applied for their health insurance and was placed in WA Apple Health/Medicaid because of my low income (or basically nonexistent income). The plan didn’t cost anything, which worked for me since I am rarely in my state of residence and I would basically never use it.
But now that I have more ‘income’ by pulling more money from my investments, it’s time to choose a healthcare plan for myself that will hopefully meet all my needs.
Calculating Income
But first, how did I realize my income had gotten too large to qualify for my previous plan? Interestingly, when refreshing myself on how income is calculated for US healthcare plans, I learned that calculating MAGI (what the ACA is based on) isn’t as hard as I thought. The MAGI calculation for the ACA is different than MAGI for other things. To get my MAGI, I took my AGI (from line 11 of my 1040 tax form) and just needed to add back in 3 things:
- Non-taxable Social Security Income (Line 6a-Line 6b3 on Form 1040)
- Tax-exempt Interest (Line 2a on Form 1040)
- Foreign Earned Income for Americans living abroad (Form 2555)
I don’t have any of those so my AGI = my MAGI. Easy! Once I had my MAGI, I went to my state (WA) marketplace, filled out that info and it spit out the plans I was eligible for.
WA Healthplan Finder
I learned about WA Healthplan Finder when I was funemployed in Seattle and was told to go there to get insurance after I was laid off from Company 5 (my time with them was detailed below):
It was a super helpful website for the state of Washington. It doesn’t matter what income you input – it just shows you everything easily, such as tax credits you qualify for and all the plans that are available. It also lets you filter by plans that pay for your specific prescriptions, preferred doctors, and anything else you want. It also lets you compare the details of multiple plans on one screen, which I really appreciate
A Qualifying Event In The 2024 Healthcare Marketplace
In August 2024, I updated my projected income based on my investment withdrawal, dividends and accidental income in WA Healthplan Finder and it told me that (as I suspected) I no longer qualified for my previous WA Apple Health/Medicaid plan because of my retirement ‘income’. This income change was a qualifying event that would allow (and require) me to change my plan in the middle of 2024 instead of during the enrollment period that starts in November.
Interestingly, the process of updating my income on WA Healthplan Finder was more detailed than I expected, but I appreciate the specificity. They asked for each individual type of income I had, so I took each from last year’s tax forms as an estimate for the coming year.
For me this included self-employment income, capital gains, interest, dividends and IRA distributions as well as deductions. My Mom who has experience with the healthcare marketplace’s income estimates said that they will check my tax forms next year to see if my estimates are correct and tell me if I owe them more money since this is just an estimate…greeeat 🙂 . Joking aside though, I’m not actually worried about that because I’m in control of how much ‘income’ I make based on my investment withdrawals so I can make sure my estimate is correct next year by adjusting my withdrawals accordingly.
After I filled everything out, the website said I had a $2,244.75 monthly/$26,937 annual income. At this point, I knew I was going to be out of the US and not using any US insurance for the remaining months of 2024 – so I picked a plan that was $0/month with the intention of switching to a plan that would cover everything I want during the November open enrollment period for 2025 plans.
Signing Up For A 2025 Plan
So after those few months passed, open enrollment started. Open enrollment for health insurance currently starts November 1st in the US. So on that date, I checked what plans were being offered based on my ‘income’ amount for 2025.
My overall goal was for this insurance to cover my usual medications and let me visit a doctor I like in Seattle (even though I’m rarely there and have bought prescriptions I need for literally $1 USD in México that have cost me hundreds in the US).
I’ve also had trouble in the past filling prescriptions since I’m usually in other states and US healthcare is ridiculously state-based. So I wasn’t sure getting a plan that said they would cover my prescriptions would actually do that outside of Washington state, but I decided to pick a plan that claims they would and see what happened.
Based on the prescriptions and doctors I preferred, as well as the premiums and out of pocket maximums, I chose the Ambetter Balanced Care 4 plan, which is a Silver Plan that will cost me $26.10/month in 2025.
There were other Silver Plans that looked good and were $0/month, but they didn’t cover the doctor I like in Seattle, so I paid more money to keep him as my primary care physician. I’m curious to see how that goes and how filling prescriptions across states pans out and I’ll be sure to update y’all on this blog about how it works out.
Travel Insurance: SafetyWing
Now I have to figure out what to do about my travel insurance. Over the last 4 years I paid $3,422.07 total for World Nomads Health Insurance that I’m lucky to say I’ve never used. Healthcare outside of the US is usually a lot cheaper and has better outcomes, so even when I’ve gotten healthcare services, they were minor and I didn’t feel like it was worth my time to even look into if I could get it reimbursed by World Nomads.
Just to try something new I’ve decided to sign up for a new travel insurance for the next year called SafetyWing. Feel free to sound off in the comments if there’s a different travel insurance you prefer. I’m planning to buy my first plan with them in January when my World Nomads insurance ends.
So I’m going to try SafetyWing, which is $56.28/month for my age bracket no matter where I go in the world. I’ll be sure to write a review of their service after I submit a claim or after I have significant time with the company.
Conclusion
What have you learned about health insurance lately?