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Post-COBRA Coverage Choices: What Next? April 24, 2012

Posted by Admin in Blog Math, Healthonymous, Money.
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18 months is a long time-until the end is near. My employer-provided COBRA coverage April 30th, 2012.  I have appreciated the coverage very much, and it seems to be a relic from another time.

The main concern I used to have was how to maximize my choices in the individual insurance coverage market. Now, I am resigned to the bad choices, at least until the Supreme Court rules in June 2012. [Then it might get worse]

U.S. Supreme Court, 1998.

U.S. Supreme Court, 1998. (Photo credit: Wikipedia)

In my state there are fewer than 5 companies that offer individual coverage in my town. Not much competition there.

  • Deductibles: Used to a $250-$500 annual deductible? Kiss that one goodbye. The lowest annual deductible is $750, and that will be going up this summer to $1000. I contacted the state Insurance Commissioner and that apparently is perfectly legal. The annual deductibles go up to $10,000.
  • Monthly premiums: these range from $170 to more than $500 per month for one person. I know many people out there have more people to cover. How many folks do you know that didn’t even take COBRA, due to the cost?
  • Co-insurance or cost-share: Used to an 8o%-20% plan where you are responsible for 20% of the covered amount? Well, that is increasingly difficult to secure as well. I’ve even seen 50/50 plans. That means the insurance covers 50% of some amount and you pay the other 50%. That is after your monthly premium. Then you have to go through the calculation of whether it applies to your deductible or not.

For example, I learned yesterday that the plan I may select would cover an MRI like this: (as a cancer survivor I have had several of these in my life)

  1. Monthly premium $442
  2. Current deductible $750, in July increases to $1000
  3. Cost of MRI: about $2000
  4. Coverage pays the first $400 only
  5. The rest of the $2000 ($1600) charge would first go to my deductible of $750 if I need the MRI in the next two months.
  6. Out of pocket so far in one month $442+$750, then $850 remains. I pay 20% of that $850-$170.
  7. Total out-of-pocket that month = $1362

Whoa-Stay healthy for the rest of that month! Survive on reduced grocery budget! Other choice: go without coverage like many other Americans!

Health uninsurance rates in the United States ...


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When Employment Ends, the Appointments Begin October 11, 2010

Posted by Admin in Blog Math, Healthonymous, Money, Women.
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Since I learned that my employment would end soon, I have scheduled the following:

  1. Overnight Sleep Study (for sleep apnea)
  2. Regular Physical (mammogram, cholesterol, Pap)
  3. 2010 3 in 1 Flu Shot (no shortage this year)
  4. Visit to the Optician
  5. 2 Massages for October (lymphedema)
  6. Cancer study appts: ultrasound, plus CA 125 blood test

Here’s how it is going:

Sleep-see separate post today…

Flu shot: easy-peasy and no side effects.

Cholesterol test. Each one of these begins with a great phlebotomist. How easy is it to voluntarily submit to a blood draw, while hungry and uncaffeinated? These phlebotomists should get combat pay!

(my secret-a number 23 needle)

Results-could be better. Fewer carbs?

Mammogram: Normal (what is normal, anyway?)

Pap test. (TBD-a couple of weeks). Good news for women! New policy. If one year is clear, then you might get a three year pass until the next one! (in my home town, at least)

Note: Each appt. cost includes parking, time away from work (whoops not any more), opportunity cost then, and a $20 co-pay (except for an appt. labelled annual physical exam), in the name of prevention. No co-pay at the optician and the parking there is free.

Cost for last week: $6.00 (parking)

Week before (sleep study) $14.00 parking plus TBD

Two days before sleep study: $4.00 parking for consultation that led to sleep study

(was physician maximizing his/her revenue for September?) hmmmm.

Goodbye to 2009 January 11, 2010

Posted by Admin in Blog Math, Health Insurance, Money.
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Now I see why calculating this total was hard for me.

I had an eventful year in 2009, including unanticipated dental work (a cracked tooth that could not be saved), an age related procedure (colonoscopy), a DNA test covered under GINA, and an infection that was treated as if it was MRSA. In contemplating this post, I realized that I have postponed the next visit to my physician, due to the expense.

My expenses  since I began the blog total $$1249.81, divided by 14 weeks. That is a daunting $89.27 per week.Annualized, that is $4,642 spent on health care appointments, premiums, co-pays and out of pocket expenses.

Are there any lessons from 2009?

  • I did a good job managing my lymphedema with exercise, massage and diligent use of my compression sleeve.
  • However, in the last six months, partly since I did not do the 2009 Danskin triathlon, I really fell off the exercise wagon. You won’t read my exercise intentions here for a while (as this is not a fitness blog!) , but I do realize that returning to a regular exercise plan will provide immediate benefits as well as potentially decrease expenses…
  • As far as managing my expenses, some of my out-of-pocket costs could not have been avoided. I look forward to decreasing the other ones in 2010!

Goodbye to 2009 January 5, 2010

Posted by Admin in Blog Math, Diary, Health Insurance.
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Now I see why calculating this total was hard for me.

I had an eventful year in 2009, including unanticipated dental work (a cracked tooth that could not be saved), an age related procedure (colonoscopy), a DNA test covered under GINA, and an infection that was treated as if it was MRSA. In contemplating this post, I realized that I have postponed the next visit to my physician, due to the expense.

My expenses  since I began the blog total $$1249.81, divided by 14 weeks. That is a daunting $89.27 per week. Annualized, that is $4,642 spent on health care appointments, premiums, co-pays and out of pocket expenses.

Are there any lessons from 2009?

  • I did a good job managing my lymphedema with exercise, massage and diligent use of my compression sleeve.
  • However, in the last six months, partly since I did not do the 2009 Danskin triathlon, I really fell off the exercise wagon. You won’t read my exercise intentions here for a while (as this is not a fitness blog!) , but I do realize that returning to a regular exercise plan will provide immediate benefits as well as potentially decrease expenses…
  • As far as managing my expenses, some of my out-of-pocket costs could not have been avoided. I look forward to decreasing the other ones in 2010!

No Out of Pocket This Week-Expenses 0 December 5, 2009

Posted by Admin in Blog Math, Diary, Money, Women.
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Another record week-no out-of-pocket health expenses. No bills paid. That is not because I don’t have them, I am just waiting until payday. I am sure that others are in this boat as well. It has been an expensive fall-health-wise for me.

  • Having a colonoscopy,
  • a suspected MRSA cellulitis-complete with an ER visit,
  • and my first ever DNA test was actually not part of the third quarter plan.

I guess I could have waited to get the colonoscopy-I have several friends of a certain age who have not had theirs yet.  December will  be a month to catch up on the bills, get some exercise and make a plan for health in 2010. I had dental work to get done this year, to maximize the insurance coverage and it will just have to wait. Is that thinking about the money too much? Or a smart use of resources?

By the end of December,  I plan to share with you a list of health priorities for next year and their financial impact.

November Expenses-Summary December 1, 2009

Posted by Admin in Blog Math, Diary, Health Insurance.
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These diary entries are to help me keep track of my out-of-pocket expenses and to illustrate some of the regular expenses of a cancer survivor. Does your bill-paying center look like this desk below? Mine sure doesn’t!

[picapp align=”center” wrap=”false” link=”term=paperwork&iid=3080820″ src=”4/1/1/5/b3.JPG?adImageId=7974890&imageId=3080820″ width=”380″ height=”570″ /]

Total of November weeks: $209.09

Plus health care premiums of $86.68

(medical, dental and vision)

Grand Total $295.77

September/October 2009 Total: $690.68

+86.68 October premiums =

$777.36

For the life of the blog: $1073.13 for ten weeks.

Massage for Lymphedema November 29, 2009

Posted by Admin in Blog Math, Cancer, Diary, Humor, Money.
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[picapp align=”center” wrap=”false” link=”term=health+massage&iid=1134532″ src=”6/0/f/b/Massage_bfe8.jpg?adImageId=7903797&imageId=1134532″ width=”380″ height=”283″ /]

And that method did what?

I could ask my licensed massage therapist to hand me a glass now and then however!

Last week’s expenses: $30 co-pay for massage. Too bad my insurance coverage next year will not take my ICD9 code into consideration for treatment. Monthly totals tomorrow.

Total for Week ending November 27: $30.00

Weekly Expenses-ER bill November 20, 2009

Posted by Admin in Blog Math, Diary, Health Insurance, Money.
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The other shoe finally dropped. Remember my visit to the emergency room (ER)  in October?  Yesterday I received three actual envelopes in my mail-two out of the three were health care related. You can tell that the health care business is important to the Postal Service.

[picapp align=”center” wrap=”false” link=”term=mail+delivery&iid=5672705″ src=”b/4/6/c/The_Expected_Budget_87b9.jpg?adImageId=7691531&imageId=5672705″ width=”380″ height=”260″ /]

One envelope was the Explanation of Benefits (EOB) for the hospital charges from my 3-4 hour visit to receive IV antibiotics for an infection (cellulitis), treated as if it was MRSA. This was the balance of the charges.

The bill (before the PPO adjustments) was $1282.13. This is in addition to the charge (previously noted) for the physician.  This was for the second visit in one day for a cellulitis (skin infection) that was treated as if it was MRSA. I was in intense pain, which probably was nerve pain from the inflammation.

Part of my bill was .23 for pharmacy services. I do not recall what that was. I may spend more than .23 in someone’s time and query the company as to what that was for.

I think that if the burning, sharp, recurrent pain in my head had been described differently by me, (and interpreted differently by the physician) that I might not have needed to go back to the ER, because it would have been treated correctly on the first visit-7 hours before.

My share of the bill is $149.09 (after the $100 ER co-pay).

Weekly Expenses: $149.09

Weekly Expenses November 14, 2009

Posted by Admin in Blog Math, Cancer, Diary, Money.
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I have a doctor’s prescription that allows me to have insurance coverage for my every other weekly massages. Because I have lymphedema, as a result of my mastectomy and lymph node removal, the massage is extremely helpful.

Insurance coverage for anything to do with “complications from a mastectomy” is required by the Women’s Health and Cancer Rights Act of 1998 (see the Department of Labor website  for more information)

This week’s expenses: one $30 co-pay for a massage appointment.

Weekly total: $30

Month to date: $30

By the way, check your coverage changes this month: In 2010, my company coverage for massages and chiropractic care will decrease to 24 sessions a year (“in line with the market”). Never mind the diagnosis or the ICD9 code.

Weekly Expenses — a First! November 6, 2009

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For the first time since beginning this blog, my weekly health care expenses are zero, nada, zilch, nothing.

My budget can use a break-how long will  this last?

Weekly expenses $00.00

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