durham_lad

I also thought I was stupidly healthy but decided to take out supplemental private health insurance when we moved back. In 2017 at age 62 (me) and 61 (DW) it cost £90/month for both of us including dental and vision. The plan only kicks in if the NHS waiting list is longer than 6 weeks. By the summer of 2017 I am diagnosed with Atrial Fibrillation, apparently pretty common among athletes. Fortunately we live close to a regional heart center and after lots of tests and visits over the coming year I am told that I am a good candidate for cryoablation, an outpatient procedure, if I'm interested. My Afib was not the permanent kind it was paroxysmal, often many days between episodes which lasted from 10 minutes to a couple of hours, but every time I had an episode I would feel a little dizzy and woozy and would be out of breath climbing steep hills, which happened from time to time. I was put on the waiting list and 6 weeks later had the procedure in October 2018. No private insurance needed and I have been extremely pleased with the treatment at the hospital. (The actual procedure worked a charm).

In 2020 I developed a bad knee problem which greatly reduced my ability to walk and hike, which during the Covid lockdowns was a real pain. The insurance includes 5 same day GP video appointments per year so I took a photograph of my knee, booked an appointment and uploaded the picture plus description of the symptoms. The GP talked to me for about 10 minutes and said he would refer me to a specialist. 10 minutes later a PDF of the referral came through. I called the insurance who said that of course the waiting list was more than 6 weeks so I booked an appointment with a specialist at our local private hospital and saw him a week or so later. MRI same day of appointment and a call next day confirming that it was a badly torn cartilage that he could fix with day surgery. The surgery was done a few weeks later (Covid delays) plus follow-up appointments. Didn't receive an EOB from the insurance company until after the last follow up appointment and it was unbelievably simply and easy to understand, one line item for the hospital costs including MRI and one line item for the surgeon's cost and that was it. Paid my £500 excess and that was it.

In 2019 my wife needed cataract surgery, again she simply called the insurance company and since it was more than a 6 week waiting list got to see an eye surgeon immediately. He was absolutely brilliant and was actually the senior consultant of our local NHS hospital's eye department. She had various complications so he had lots of tests done including at the hospital which had much better equipment. After he did one eye he told her that with her permission he would switch her onto the NHS as she needed a customized toric lens and the insurance company would not cover but the NHS would since her astigmatism was so bad it couldn't be corrected by glasses. Also he was concerned she might need a follow-up procedure if the lens didn't sit right the first time and he didn't want to subject us to excessive cost. It all worked out superbly well, and once again the EOB for the first procedure was ridiculously simple. That year she also needed multiple sets of glasses as the prescription kept changing and the insurance paid up in full every time.

In our case our decision to take out supplemental insurance has been well worth it. 5 years on and it is up to £130/month so no great hikes due to the procedures we have done.

destone

I’m sorry to hear! Have you been running that led up to this? I gave up running this summer as my knees were starting to hurt and it wasn’t worth the risk for me. My knees are fine now but I am not running.

durham_lad

Not running but soccer, then soccer referee and singles tennis up until age 60 when my knees and back convinced me to give it up. I then switched to aerobic exercise in the gym including High Intensity Interval Training. Always pleased to see resting heart rate in the 40s.

Lion in Winter

Do you mind sharing which insurance company you are using? I love the NHS service but the waiting times at the moment are quite worrying. I can put up with waiting for non-essential stuff, but if I come down with something that requires speedy treatment I would be worried. Much as I hate encouraging privatisation, I may have to.

durham_lad

We chose Aviva after doing a free consultation with the folks below. I must say that Aviva have been great, very easy to deal with and very easy to use. For dental and vision in particular which we use regularly then it is simply a case of making copies of the invoices and receipts and uploading them when making a claim, and the refunds go directly into our bank. I tried Active Quote again but they said now that I have a heart condition Aviva is the best option. So pleased to have taken out insurance a year before the heart issues even though I have not needed to use the insurance specifically for that.


https://www.activequote.com/

Lion in Winter

Thanks for the info. Do they do two separate policies for a couple, or a joint? Perhaps we would be better off with two separate policies since I'm still in good nick but OH has a thing or two?

durham_lad

Our policy is a joint policy but for privacy regulations we have our own accounts to make claims under. I log on under my wife's name to submit the claims for her but should we need to talk to them then she has to do the talking and the agent will ask if it is okay for me to be in the room talking with them as well.

I would contact Active Quote and discuss with them. As I say I thought they were excellent and will explain all the jargon and discuss your needs such as being willing to only use them if there is a 6 weeks wait, deductibles you want to pay on all 3 items (health, vision and dental). Higher deductibles (aka excess) means lower premiums.

Lion in Winter

Sounds good, thank you.

Steerpike

As many people have pointed out, you can't really do a blanket 'USA / UK' comparison; you need to specify locations at both ends. At least come up with a few samples for discussion. My brother lives in a nice small house in a pleasant area of rural Yorkshire, near Leeds, and most things are dirt cheap; my niece lives in a desirable suburb of Manchester, and things are considerably more expensive, and a good friend lives in Wimbledon, where everything is very expensive. Here in the US, I've lived in Arizona, where most things are very affordable, and also in the SF Bay Area, where things are generally very expensive.

According to this website - https://worldpopulationreview.com/st...index-by-state - Mississippi has the lowest cost of living - 83.3 index, while Hawaii has the highest cost of living - 193.3. But it also says "Despite the high cost of living, however, Hawaii has one of the country's lowest poverty rates. While the living wage for a Hawaiian family is $107,702 a year, the median income for a family of four is $118,223". So your income is obviously another key factor, and you are typically going to make a lot more money in the higher cost states.

As several folks have commented, Healthcare can be a huge factor. I used to work for a great company and paid virtually nothing for the insurance, and had really low out-of-pocket expenses. Then I retired early, and had to pay my own way for insurance on the 'exchanges', and my upcoming premium for 2023 is something like $1,200/mo (and my maximum out of pocket is a horrendous $8,000) - but, since I'm retired and have income around $50k, I get a government subsidy of circa $1,000 so my actual monthly premium is about $200. Soon, I'll be 65 years old and will therefore qualify for 'Medicare', which is a great deal; I can pay anywhere from nothing to a few hundred, depending on how I want to handle things like deductibles, copays, etc, and get good coverage. Most employee packages (referred to as 'group coverage') these days cover the employee quite well, but expect the employee to pay the full freight for family members, and for those, the premiums can be high.

So tell us where you are currently in the UK, and where you are considering moving to, and we can give you more appropriate info.

My own personal experience, FWIW, was that my income shot up so high when I came here, that even with the high cost of living (esp. housing) in the Bay Area, I came out ahead. I was living in central London before I came here, so I was accustomed to really expensive housing. Plus, I've been blessed with perfect health, so no encounters with the healthcare system. Now that I'm retired, and health issues are starting to creep in, a whole new set of factors come into play.

tdrinker

In the UK, the biggest regional cost differential is housing - renting or buying. Many costs are more or less the same regardless of location - utilities, retail or online shopping, council tax, holidays. Services (buying someone's time) is more expensive in high wage locations, which tend to be those with high housing costs. But some things are cheaper in these locations, e.g. public transport in London. It's easier to live without a car in locations with good public transport.

I'm less familiar with the US, but believe that in addition to housing costs, taxes can differ by location.

As people have noted, high wage locations generally have higher living / housing costs. If you're retired with a passive income, you can move to a cheaper location and maintain the same income. If you're working, moving to a cheaper location often involves a reduced income (salary). Not always of course, salaries in the public sector are less variable by region than in the private sector in the UK, and there are WFH (work from home) jobs that can be done in any location for the same salary.

tdrinker

£400/month for a nice apartment is an amazing deal in any part of the UK, even cheaper areas. Anything like that on Rightmove would be snapped up in a heartbeat.

I'm surprised taxes are lower in the UK, unless you are referring to property taxes rather than income (and perhaps capital gains) taxes.

durham_lad

I mean that UK taxes have been less than our US Taxes plus Health insurance. At the time we moved back in 2016 our health insurance was $856/month ($10,272/year) plus copays and deductibles which had plenty off in the 3 years immediately prior to moving. Sorry if my post was not clear.

robin1234

I just got to England for a three month stay in our flat in Norfolk. Was chatting to my son who lives in Los Angeles about wine. He opined that you wouldn’t expect a drinkable bottle in LA for less than $12. That would pretty much be my experience in New York, too. I got a lovely bottle of Sicilian red in Tesco’s for £4.25 yesterday - and there were plenty of other good choices there at the £3.50-£6.00 price point, too.

Coffee. $10 to $20 a pound for decent quality coffee in NY or LA. £2.65 for 275gm here.

No contest.

Lion in Winter

Which Tesco's Sicilian red please? Taking notes here...

robin1234

Jancis Robinson would probably not approve but I liked it a lot. Maybe it was the jet lag speaking, though. (That’s the Tesco Clubcard price.)