Here is a great recent story…wife sold her business and we had to look for new insurance. Her business was paying an absurd amount for both of us…I’m 59, she’s 62. If we kept that coverage going, a lower level Silver plan we would be paying near 36K per year. Because we are spending more time outside the US, we found an international plan that covers us for up to 6 mos in the states, and anywhere else in the world, for under 7K. So basically we gain nearly 30K by STAYING OUT OF THE US most of the time. (It’s basically more catastrophic coverage, but we are healthy + plus we get some travel coverage)