tigerwillow1
Known around here
And I did not say anything other than contributing a single data point.
The Medical Industry is soooooo Broken
- Thread starter bigredfish
- Start date
Is Shingles related to hereditary? I don't know of anyone in my family tree ever getting them.
About 10 years ago, my company offered the high deductible plan which we pay nothing out of paycheck, along with adding $750/yr into our Health Savings Account, but has a 2,500.00 deductible. Which has been great, especially if you are healthy.
A few of us are now getting close to retiring and looking at Medicare. Going with the traditional Medicare with supplements ( G or N and drug plan) seems to be the best option. Vision/Dental not covered, but can get a plan outside of Medicare. I understand that they did away with the F plan and now the "F" plan is now the G plan, where anyone can switch to (from an advantage plan, like Joe Namath, Jimmy Walker, etc. push) without question, while the N plan you can only join, without having a physical, at first time applying for Medicare (otherwise you premiums may be higher due to your conditions). Note that your monthly premiums will also be adjusted based on income, look up IRMAA.
Also looking at IRA to ROTH conversions, it's considered "salary" so check the IRMAA charts if on Medicare or if say 62 and retired, look at the health care options beforehand, based on income.
About 10 years ago, my company offered the high deductible plan which we pay nothing out of paycheck, along with adding $750/yr into our Health Savings Account, but has a 2,500.00 deductible. Which has been great, especially if you are healthy.
A few of us are now getting close to retiring and looking at Medicare. Going with the traditional Medicare with supplements ( G or N and drug plan) seems to be the best option. Vision/Dental not covered, but can get a plan outside of Medicare. I understand that they did away with the F plan and now the "F" plan is now the G plan, where anyone can switch to (from an advantage plan, like Joe Namath, Jimmy Walker, etc. push) without question, while the N plan you can only join, without having a physical, at first time applying for Medicare (otherwise you premiums may be higher due to your conditions). Note that your monthly premiums will also be adjusted based on income, look up IRMAA.
Also looking at IRA to ROTH conversions, it's considered "salary" so check the IRMAA charts if on Medicare or if say 62 and retired, look at the health care options beforehand, based on income.
No.
From the Mayo Clinic:
Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. After you've had chickenpox, the virus stays in your body for the rest of your life. Years later, the virus may reactivate as shingles.
Jim I.
Getting comfortable
I'm very close to retirement as well. I have been advised that you don't want to convert your IRA to a Roth until after retirement when you will be in a lower tax bracket.
As you stated my Medicare premiums are higher due to IRMAA if you are still working and your income is over a specified amount.. After I retire they will go back down.
bigredfish
Known around here
Same with my 401K. If I convert to a Roth now Id be paying huge tax on the money. If I wait till I'm on SS next year I'll drop down to a much lower tax bracket. (most of our other retirement assets are cash/liquid and non taxable)
Parley
Known around here
...and apparently the Covid shot activates the virus in some people. This happened to a neighbor of mine.
tigerwillow1
Known around here
Be aware of what I call the social security tax trap. For anybody below the 85% social security taxation level, raising your AGI exposes more of the social security to taxation. The net effect for most in the 12% bracket is that you're being taxed at 22% marginal. The only way to avoid this is to do the roth conversions before taking social security, or have a pre-conversion AGI high enough that you're above the 85% social security level before the roth conversion. Here's a table and graph from Taxation of Social Security benefits - Bogleheads showing how the 12% bracket is taxed at 22%. It's pretty evil how this extra tax is hidden. It really shafts people making traditional IRA withdrawals or roth conversions.
Did it?
Or did they just have shingles after having a covid vaccine?
Are you familiar with the post hoc fallacy?
bigredfish
Known around here
bigredfish
Known around here
@tigerwillow1 , I dont undertand this part?
The only way to avoid this is to do the roth conversions before taking social security, - Yeah OK, but it means I eat a huge tax liability now upon conversion.
or have a pre-conversion AGI high enough that you're above the 85% social security level before the roth conversion. ?? I lost ya here
The only way to avoid this is to do the roth conversions before taking social security, - Yeah OK, but it means I eat a huge tax liability now upon conversion.
or have a pre-conversion AGI high enough that you're above the 85% social security level before the roth conversion. ?? I lost ya here
Jim I.
Getting comfortable
This is getting pretty deep. I may need to hire a CPA! lol!
Remember who voted to tax social security at 50% and then voted to tax at 85%….Wait for it….Joe Biden.
tigerwillow1
Known around here
Using MFJ brackets, anything you convert before taking social security will be taxed at 22% up to taxable income 178k, and 24% to taxable income 340k.
I'm known for not explaining things clearly, especially the first time. It's hard to give exact numbers because the percentage of the social security income that gets taxed is based on the ratio of non-ss vs. ss income. At a certain point, the ss income gets taxed at the maximum of 85%. When the total of all your income gets into the 100-125k ballpark (for MFJ), you hit the point where the ss earnings are taxed at 85%, Any income above that doesn't cause the ss to be taxed at a higher percentage, Depending on the ss to non-ss income ratio, you hit 85% ss taxation and transition from the 12% to 22% marginal bracket at about the same income level. Stating another way, if you're planning on being in the 12% marginal bracket and also collecting social security, your roth conversion will be taxed at 22%, possibly the same as doing it now. If you plan to be in the 22% bracket, the roth conversion will be taxed at 22%, possibly the same as doing it now.
If you're looking at the 24% tax bracket, you have to watch out for phaseouts and IRRMA, which raises your medicare premium. You have to worry about this a couple of years before starting medicare because they use the AGI from a year or two prior to hit you with IRRMA. I'm spreading out the roth conversions over a lot of years to minimize the total tax. I built a spreadsheet to do brainstorming. An easier way is to use the previous year tax program, plug in numbers, and see what happens. I was taken off guard the first time I saw added income increase the tax due by 22% while in the 12% bracket. Did I already say the tax code is evil and deceptive?
tigerwillow1
Known around here
(Guilty for thread creep). On the subject of roth conversions, if you're planning on making future charitable contributions, it's a great tax saving to leave enough funds in your traditional IRA to cover the contributions for as long as you expect to be alive, then pay the charities using Qualified Charitable Distributions (QCDs). The payments come out of the IRA tax free. If you take the standard deduction, it's the rough equivalent of being able to take the standard deduction and charitable deduction together. Even if you're itemizing, it's better because the QCDs don't add to your pre-tax income, potentially increasing social security taxation and pushing you into phaseouts. And as a bonus, the QCDs count toward your RMD. The QCD money has to flow directly from the financial institution to the charity without touching your dirty little fingers. Many institutions make it a pain to do this. One example that makes it easy is Fidelity. You get checks for your traditional IRA account, then simply use these to pay the charities.
Having enough funds to live on during the 4 years between 66-70, do Roth conversions and take SS at 70. One friend worked 1/2 time for two years, doing conversions and retired at 62, he will continue to do conversions based at a level not to effect his market place health care cost until 65 (take IRMAA in consideration), then take SS at 70.
bigredfish
Known around here
There is currently a major shortage of important Chemo drugs. CHEMO DRUGS. Guess which ones-- those that have gone off-patent and generics are available, or Were available.
A major one is Carboplatin...
www.nbcnews.com
And there is this... which sounds a bit like a "death panel" to me...
www.wesa.fm
My wife was saved by Carboplatin about 5 & a half years ago.
Ten (??) different therapies later and 5 years later, and we were told we should start to think about hospice as the best new chemo drugs and aromatase/kinase inhibitors have not been successful (REALLY expensive shit-- up to $50k ~$70k every 3 weeks). I mentioned we should do Carboplain again-- it kicked ass 5 years ago. The oncologist went from his "bad news" face to excited enthusiam about this idea and got it going. Gee--- a month later and the "cheap" generic is kicking ass again-- and now we may be facing a shortage and some death panel would consider her a terminal case. Well fuck, on a long enough timeline, I'm pretty sure we're all terminal.
A major one is Carboplatin...
As cancer drug shortages grow, some doctors are forced to ration doses or delay care
Fourteen cancer drugs are in shortage, according to the Food and Drug Administration.
And there is this... which sounds a bit like a "death panel" to me...
National drug shortage impacting cancer care at UPMC
While Pennsylvania’s largest medical system appears to be feeling the most immediate consequences of supply chain disruptions, Allegheny Health Network and other regional and national cancer centers will likely face difficult choices in the coming weeks and months.
www.wesa.fm
My wife was saved by Carboplatin about 5 & a half years ago.
Ten (??) different therapies later and 5 years later, and we were told we should start to think about hospice as the best new chemo drugs and aromatase/kinase inhibitors have not been successful (REALLY expensive shit-- up to $50k ~$70k every 3 weeks). I mentioned we should do Carboplain again-- it kicked ass 5 years ago. The oncologist went from his "bad news" face to excited enthusiam about this idea and got it going. Gee--- a month later and the "cheap" generic is kicking ass again-- and now we may be facing a shortage and some death panel would consider her a terminal case. Well fuck, on a long enough timeline, I'm pretty sure we're all terminal.
I actually did this very thing after my wife passed away from cancer. My accountant is the one who actually told me to do it. I didn't lie to the hospital, but explained to them that I lost a large portion of my income because of the death of my wife. She was a career woman. The hospital asked me for a few bank statements, etc and then dropped my bill to $0.00. Apparently there are generous people who donate money to the hospital to help out in situations like mine.