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2025 FIRE Health Insurance Expected Value (EV) Calculator

The Data-Driven Way to Choose Between the ACA Marketplace and Healthshare Ministries

For the Financial Independence (FIRE) community, healthcare is the ultimate “X-factor.” Whether you are planning your withdrawal rate or already living the early retirement dream, picking the wrong health coverage can cost you thousands in missed subsidies or unexpected medical bills.

Please note that this app is in BETA – please email Scott@biggerpocketsmoney.com with any feedback.

This is a modeling tool built specifically for early retirees. This tool calculates the Expected Value (EV) of your 2025 options by factoring in:

  • Real-time ACA Subsidies: Estimated for your specific 2025 zip code and income.
  • Actuarial Risk Modeling: Weighted costs for routine, challenging, and catastrophic health years.
  • The “Subsidy Cliff” Analysis: See how your costs change if the current enhanced subsidies expire.

How to Interpret Your Results

Why “Expected Value” Wins Over “Lowest Premium”

In the world of FIRE, we obsess over math. Most people pick health insurance based on the monthly premium, but that’s like picking a stock based only on its price per share.

Expected Value (EV) is the sum of all possible financial outcomes multiplied by their probability. Our model doesn’t just look at what you pay today; it looks at the 1% chance of a $250,000 hospital stay and the 5% chance of a claim denial.

  • A Low EV means the plan is mathematically the most efficient use of your dollars over the long run.
  • The Catastrophic Risk Cost accounts for the “hidden” danger in Healthshare ministries (non-sharing risk) and ACA plans (denial risk).

Navigating the 2025 “Subsidy Cliff”

The current enhanced subsidies that make ACA plans so affordable for high-income FIRE households are currently scheduled to expire on December 31, 2025.

If Congress does not extend these enhancements, many early retirees will see their premiums skyrocket. Our Cliff Analysis (visible in Step 2) shows you exactly how much your “Safe Withdrawal Rate” needs to buffer for this potential change.

ACA Silver Loading: The Pro Strategy

In many states (like Texas, Alabama, and Pennsylvania), insurers “load” the cost of federal subsidies onto Silver plans. This often creates an actuarial anomaly where Gold plans provide better coverage for a lower premium than Silver plans. If our calculator highlights a Gold plan in green, the math suggests you are benefiting from this specific state-level “Silver Loading” strategy.

Is a Healthshare Ministry Right for You?

Healthshares are not insurance, but for a generally healthy early retiree with a massive “Cash Emergency Fund,” they can offer a lower monthly fixed cost. However, the Risk Cost in our model is higher for Healthshares because they lack the legal guarantees and consumer protections of the Affordable Care Act. Use this tool to see if the monthly savings are worth the increased catastrophic risk.