
Reader response to columns I recently wrote on early retirement was strong and overwhelmingly positive.
But amid all the praise for these folks who shucked their shackles early, many of you had the same query:
"What do they do about health insurance?"
It's a good question. Americans typically can't get Medicare until they're 65. Most employers don't provide health benefits to retirees, particularly those who duck out in their 40s.
Getting insurance on your own, though, can be expensive -- the average annual premium for a family is now more than $12,000. And that's if you can get coverage at all. Most states don't force insurers to cover individuals outside employer or group plans, so even relatively minor health problems can make it hard to get coverage in many states.

Liz Weston
(While health care reforms signed into law in 2010 include changes that lower the costs of buying insurance on your own, that piece of the legislation hasn't taken effect yet.)
Going without insurance is risking financial ruin. A single accident or illness can result in six-figure bills and easily wipe out the nest egg you hoped would carry you through retirement.
Stay healthy and take a big deductible
Many of the early retirees I interviewed were fortunate: They're in good health, so they were able to purchase high-deductible insurance policies on their own. This coverage requires them to pay most health-care costs out of pocket, but it protects against catastrophic expenses.
Some combine a high-deductible policy with a health savings account, which allows them to put aside pretax money to pay medical costs.
When I last spoke with them, Fred Ecks and Ann Haebig, of South San Francisco, Calif., each had individual policies with a $4,000 deductible. Ecks was paying $104 a month for coverage that excluded dental coverage while Haebig was paying $131 for a plan that included dental services.
Both said they believe in the importance of prevention. They boasted of eating organic food and working out regularly. Ecks, who was once 100 pounds overweight, became an ultramarathon runner. Haebig said she felt a lot healthier since she switched from full-time to part-time work.
"I'm less stressed generally, which I think also helps," Haebig said.
The Bennett family of Purcellville, Va., told me they had a $10,000 deductible as well as a higher monthly premium: $700. The policy included maternity benefits, which some high-deductible policies don't, and the coverage came in handy during Mary Bennett's pregnancy with her younger son when complications required her hospitalization.
"On the one occasion when we faced a true emergency," said Rob Bennett, "the insurance covered what we couldn't cover on our own."
If your health isn't perfect . . .
The Bolons of Cedar City, Utah, had a rougher time finding adequate insurance. For the first two years of their early retirement, insurers refused to cover Brad because of a previous bout with cancer.
After Brad had been cancer-free for seven years, the Bolons were able to get a family high-deductible plan -- but the annual premiums were more than $14,000, the deductible ran to $8,000, and many of Brad's health issues were specifically excluded from coverage.
"We have coverage for the family, with major, gaping holes," said Janine Bolon, adding that the family has tried to keep health expenses down by negotiating discounts with providers for paying cash.

