health insurance. yes, health insurance.

Thursday, February 13, 2014

the daily muse

my coffee mug currently rests on a pile of medical bills that i was wrongfully charged coupled with detailed notes and reference numbers from our insurance carrier. at my feet sits a space heater surrounded by 80% of the hair on my head that has fallen out due to said phone conversations regarding medical bills. fun stuff!

i'm reminded of jenna's thought provoking post on health insurance a few years ago. it's something you don't give much thought to (get in, get out, pay your co-pay) until an actual problem (or worse, an emergency) arises. and what concerns me most is that no one really understands health insurance until you're in a situation that forces you to.

due to rising monthly premiums, ed and i switched to a plan with a higher deductible a few years ago. put simply-- we now pay less per month but more out of pocket should we need surgery, etc. it's a gamble no matter, but two years later i'm happy we made the switch as it's allowed us to stash money in an emergency account should we need it. doesn't it make more sense to keep money in my pocket?

if either of us worked for an employer who offered a health savings account plan, i think we'd definitely make the jump. an HSA plan gets rid of co-pays all together-- instead you pay for a doctor's visit out of pocket up until a certain amount is spent, after which everything is free. as scary as it sounds, it's sort of genius given you work for a company that generously puts money into your HSA account. correct me if i'm wrong on any of that.

that being said, this isn't a pro-high-deductible-health-insurance rant (snoozefest of the century), but rather a way to start an open discussion about the topic. so yeah, health insurance.

15 comments:

Juju said...

oh Rebecca, i hear you. luckily, i have health insurance through work but even that gets tricky. i've been wrongly charged for a routine obgyn examination by a doctor who "accepts" my insurance. after 5 or so collection letters, my insurance broker informed me that all's taken care of. but it sure is a frustrating process...

Mary Schaubert said...

I'm so sorry you're having to deal with that....so icky. My husband and I both have wonderful insurance through our jobs - mine is completely paid for, he pays a small amount out of his check for his but I believe it's under $120/month and basically everything is covered. That said, we're having a baby in June and so of course have to add her to one of our policies, and when I asked my employer about dependants they quoted me about $500/month. My eyeballs about popped out of my head, that's 50% of our RENT! Thankfully, adding her to my husband's (not quite as flexible on providers) plan was much more doable. Another thought if you have a pet you're pretty dedicated to (a la you guys and Sam Wiggins) pet health insurance??? I NEVER considered it until this year when our dog had an apparently very difficult to diagnose shoulder issue and $1000 later plus still no real diagnosis I was seriously starting to entertain the idea of one of those $30/month plans.

Jesse said...

my family and i are covered under my employer's plan but it's very expensive and we don't use it enough. but with my son, we just can't take risks. i've been very thankful we have insurance this year because atticus got the sniffles a few times and most recently a very nasty stomach bug that had me in a tizzy. still a huge cost that i would be very happy to be putting toward my son's education, paying off my credit card bills or my husband's student loans. we're hopeful that my husband's almost full-time job will turn into real full-time as then the whole family's health care would be covered for free. sigh.

rebecca said...

juju-
you pretty much summed up my exact situation!

mary-
we had pet insurance when sam was a puppy which was a lifesaver in terms of covering all his shots and neutering. considering purchasing a plan again in the near future if the monthly premium makes sense.

in dreams said...

having never known anything but free healthcare (yay canada!), i'm always perplexed and terrified by the american system. i watched john green's healthcare spending breakdown recently, and that only solidified my desire to never have to deal with it! i'm sorry you have to go through any sort of run-around to keep yourself healthy. <3

in cahoots said...

Hey lady, we have an employer high deductible plan and an HSA (which we add money into, sadly, my husband's employer does not match our contributions, though we still contribute because they're pre-tax dollars).

Yearly physicals, preventative care is fully covered by our insurance. If we get a cold or an ear infection, we pay out of pocket for the doctor's visit. I should say, we're only charged our insurance's agreed upon price with the doctor. So, had we gone to the doctor without insurance, we would have been charged $200 for the visit, but with insurance, the out of pocket cost comes to $80. Our health insurance covers zero of that visit but we get the benefit of the negotiating power they have with the doctor's office.

Anyhow, thank you for this post. It motivated me to look into the supplemental stuff, like Aflac. Hopefully in the long run, premiums will go down as well as deductibles. A girl can dream, no?

rebecca said...

in cahoots-
thanks for the clarification. i know this type of plan isn't right for everyone, but i think it's a motivator in lowering healthcare costs as doctors are forced to compete with other doctors in terms of their pricing. in some instances the out of pocket negotiated rate (for an office visit) isn't significantly higher than your co-pay would have been in the first place.

i appreciate your insight.

janinejackson said...

I feel so sorry for you poor Americans. In Australia, we have Medicare which means that all basic doctor and hospital costs are free (covered by the Government). You only have to pay for elective surgery. Meaning knee replacements, hip replacement, etc.

Jenny said...

@incahoots My plan works the exact same way. I pay out of pocket for the doc because I know I wont meet my deductible unless I have an emergency. The HSA is really cool, but doesnt work like becca describes that I know of. Its almost like a normal savings account that you can put pre tax money into and use for any medical expenses(I use mine at Walgreens all the time),,,and also I think once you hit 60 or 65 it loses its restrictions and you can use it for anything, so its a pretty cool way to stash some money and/or save up for that medical procedure that you need.

tk said...

My family is covered under a high deductible plan w/ HSA through Kaiser. The deductible is less than paying the monthly premium of a co-pay plan, so we felt pretty good about signing up for it. Similar to what "cahoots" said, we pay a discounted fee for services that may cost an uninsured more. However, we had to go to an outside provider for an emergency and we had to pay the outside provider's fee for service which was 5 times higher than Kaiser! The kicker was that had I been uninsured it would have cost me less! Evidently large providers (this was Sutter) will give uninsured patients up to a 40% discount. Now I am inclined to weigh the cost between traveling longer to get to a Kaiser facility rather than get immediate care, which is totally wrong! I guess you get insurance for illness or chronic care as opposed to emergencies, but it still makes me mad!!

A Crimson Kiss said...

Ugrrgghhh, health insurance. I had a minor but long-last health scare a few years ago, and the costs were simply astronomical. But you really can't be a good advocate for yourself when you need care, which is what makes the whole system so terribly toxic. I only wish I had some ingenious solution!

Laura said...

I carry our family's health insurance thru my job. (I'm a teacher from Nashville.) It used to be free, now we pay a little over $250 a month for pretty decent insurance. For almost 20 years of marriage we never went to the doctor and it seemed like such a waste to even have it. (The $ in the pocket thing and we don't have kids.) But then, 3 years ago, I got diagnosed with MS and my meds are $10,000 every 3 months-FREE on my insurance. Then my husband was in a head on collision wreck this past June and has had all kinds of surgeries/rehab since. So, that said, YAY insurance premiums!!!! Without it, between both of us plus medical bills, we'd have lost our house.

Laura said...

To clarify, I say it used to be free, but that was when it was just me, not me+1. One of the few benefits of being a teacher anywhere these days (especially in TN where all government officials hate us and blame us for everything that is wrong with kids) is fairly cheap /good insurance.

JULIA said...

Conversations like this always make me feel so priveledged to live in a country with universal healthcare (Canada). The comfort knowing that my province will take care of me should I need it is priceless. And while people who don't have this type of system knock it for its wait times, let me assure you that as soon as something pressing arises, you're taken care of ASAP.

sumslay said...

I work for a company that offers HSA, and they chip in an additional $1K yearly (more if you have dependents). I looove it! I haven't hit my deductible in years, and i do try to hoard the money in case something arises. There was one year that I hit my deductible ($2K) by January 8th, so you know, it can happen. Once you hit the deductible, we just pay 10% of the price, up to $4K out of pocket. Like someone else mentioned, yearly appointments (except for vision for some reason) are covered, so there's very little I have to use it for.

However, it still doesn't even occur to me to go to the doctor just because I'm sick. This is because I didn't have insurance until I got my first "real" job at 24. My parents were self-employed, so whatever insurance they did have was for "near death only - like a car wreck" i was told. I remember they'd negotiate with the dentist/orthodontic with rates, so they weren't out of pocket too much (also it was a small town). Then there were the times something happened, but I couldn't go to the doctor. When i was bitten by a brown recluse and my ankle turned black and swelled to 3x it's size: "Put some Campho Phenique on it and keep it elevated!" I survived. Then in 7th grade, i had bronchitis that turned into pneumonia. It lasted 3 months, and I was preeeeetty certain I'd never know what not coughing felt like again, but I survived. However, I still have scar tissue in my lungs from that that always shows up on X-rays. :\ So, yeaaaah, i'm for universal healthcare. My parents, for some reason, are still against it.

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