• Robert Papalia, 74, retired early to care for his ailing wife, Marie.

• The couple’s $5,000 monthly pre-tax retirement income is strained by medical bills and taxes.

• Many Americans face similar financial struggles, relying on Social Security amid high medical costs.

Robert Papalia, 74, had to retire earlier than he planned after his wife Marie, 71, started getting sicker. After working more than 30 years at a telephone company, he retired at 60 — five years before he intended — to care for her.

The couple, who live in Burlington, New Jersey, have struggled financially over the past few years. Though they bring in about $5,000 a month in retirement income before taxes, much of that goes toward medical bills, high property taxes, and costly insurance payments. They’re left with little at the end of each month, though Papalia said they weren’t in dire straits.

“Do we have money in the bank? Yes. Is it a lot of money? No,” Papalia told Business Insider.

Many Americans have told BI they’ve struggled to prepare financially for the unexpected, such as a sudden health emergency or death in the family. As Americans increasingly rely on Social Security and other retirement income to get by, high medical expenses could throw years of retirement planning out of balance.

Retiring early to be his wife’s caretaker

Papalia had a goal to retire in 2015 at age 65 so he could receive Social Security benefits and have enough saved that money wouldn’t be a huge issue. In 2010, however, he retired to care for his wife full time, taking a buyout from his company that lasted until 2014.

Marie, a lifelong diabetic, had dealt with medical issues throughout her life, including vision loss in her right eye, static hypertension, and low blood sugar. She received a prosthetic eye after she experienced retinal damage.

Marie’s medical care was expensive, and the couple also cared for two dogs, both of whom had costly medical issues.

Marie needed around-the-clock care, and Papalia felt it was worth the financial sacrifice of retiring early to spend every hour with her to ensure she’d stay as healthy as possible. She had a heart attack in 2012 that forced them to pause their plans to sell their New Jersey house to move to an area in Pennsylvania with a lower cost of living.

In 2014, Marie underwent open heart surgery after doctors discovered a 95% blockage of her heart’s main artery. Papalia said that year was when finances became much tighter — he added that Marie took eight or nine prescriptions each day. She’s struggled to walk over the past few years and has relied on a wheelchair.

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“I know for a fact that when I look at my wallet at the end of the day now, it’s a difference between night and day,” Papalia said, comparing his financial situation with that in 2010.

Scraping by and making sacrifices

Papalia receives $2,132 a month in Social Security before taxes and insurance and $1,900 from his pension, while Marie gets $1,113 a month from Social Security. Papalia said that though they stayed afloat, some months were particularly tight.

Medications could cost $60 to $70 each week, and hospital bills add up to a few hundred dollars every few months, meaning well over 10% of their income goes toward Marie’s medical costs. Papalia said his health was stable, though he has acid reflux, neuropathy, and an irregular heartbeat, for which he takes some medications.

“Without insurance, I’d be living underneath a bridge,” Papalia said. “If you don’t have insurance, you’re playing with fire.”

They shifted their grocery shopping to essentials at cheaper stores, and with food inflation over the past few years, they’ve been even more methodical about purchases. Papalia estimated they were spending under $100 on groceries weekly, though they occasionally order takeout. He said pandemic-era stimulus checks helped them afford necessities.

“We’re constantly going to doctors for everything you might imagine: clogged arteries, eye surgery, a situation where she lost toes off her left foot,” Papalia said, noting that though they get Medicare, the cost of deductibles and copays adds up.

They pay more than $10,000 in property taxes each year, and they anticipate that will continue increasing. Their heating bill runs them nearly $300 monthly, while they pay upward of $40 monthly on life insurance. They also pay nearly $300 a month for car and homeowners insurance.

Papalia said it’s only a matter of time before something goes wrong with the house, driving them into the red. A few years ago, he was given an estimate of $11,000 to fix his roof, but because the original roofing wasn’t up to building codes, it became a $36,000 payment that they won’t pay off until 2030.

“It’s a struggle every day, and something’s going to pop,” Papalia said.

Finances were so tight, he said, that he took out a reverse mortgage on the house, a loan for older Americans to borrow money against their home’s equity and supplement their Social Security.

He said they rotate between 30 credit cards for various purchases to limit their budget, get rewards, and keep balances on each card low to maintain their credit.

Papalia said he’d looked into getting a part-time job, but he could rarely leave the house given Marie’s conditions. Hiring a caretaker would be too expensive, he added.

“We’re just taking it one day at a time,” Papalia said. “We’re worrying about today and letting tomorrow take care of itself.”

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