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Employee costs up; Employer rate increase less in 2013 October 17, 2013

Posted by Admin in Healthonymous, Money.
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The good news is that employer rate increases for large group plans increased by only 3.3% for 2013. The 2012 rate increase was 4.9% and 8.5% in 2011.

The bad news is that the employee share of costs have increased from $2,011 in 2004 to an expected $4, 969 in 2014, according to AON Hewitt.  Remember, while expensive, an employer’s cost-share of health coverage costs is tax-deductible, while not usually to individuals and families. (Want to know more about why our health care is tied to employment?)

AON Hewitt released its’ annual analysis of health coverage costs on October 17, 2013.

President Barack Obama listens to Safeway Pres...

President Barack Obama listens to Safeway President and Chief Executive Officer Steve Burd during a meeting with business leaders in the Roosevelt Room of the White House to discuss employer health care costs. (Photo credit: Wikipedia)

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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 ...


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!

Health Care “Providers” and the $30 Co-Pay December 13, 2009

Posted by Admin in Cancer, Diary, Healthonymous, Money.
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In my life, I have had many more health care “providers” than I ever dreamed that I would. In addition to the two excellent surgeons that I had for my cancer surgeries, I have seen people with titles such as dosimetrist, audiologist,  and a gynecological oncologist. I even see phlebotomists regularly (oops, just recalled I need to redo my latest CA 125 blood test-the number was slightly elevated last time).

But the health care job title of the person I enjoy visiting most is that of licensed massage therapist! Regular readers know that I have a prescription for massage to treat my lymphedema. My arm always feels better after and it is usually easier to put my compression sleeve back on too. Yes, after ten years, I still wear mine.

This week’s only expense was my $30 co-pay for my every other week massage. It is very helpful to have someone knowledgeable about manual lymphatic drainage look after me, plus they have two hands to minister with and I feel like a on-armed paper hanger sometimes trying to address my own needs. Ever try to kiss your elbow? Sometimes doing your own lymph massage is just that frustrating.

Tantalizing close, but definitely out of reach!

Expenses out of pocket for week ending December 12th: $30.00


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.

GINA, Coverage and Me Update November 5, 2009

Posted by Admin in Cancer, Health Insurance, Money.
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Wow! I opened an innocuous, slim envelope from my insurance company yesterday-an Explanation of Benefits or EOB. My DNA test from September to discern whether I have the  (Breast Cancer) BRCA mutations is covered in full! No more funds out of pocket! (search under DNA or GINA for previous posts)

I could have been liable for up to $350, and the blood test bill was  $3120. After a provider “adjustment”, the insurance company will pay them $2964.00.

No deductible, no co-insurance, only the two co-pays for the office visits of $40.

If you are going to have a system that keeps cancer patients alive long enough to be survivors, then these follow-up procedures should be covered (with appropriate privacy for the patient) in order to practice further early detection and possibly even prevention.

[picapp src=”3/9/1/1/Rep_Hoyer_hosts_7c52.JPG?adImageId=7129555&imageId=6278902″ width=”234″ height=”388″ /]

I waited eleven years for this test.

Relief is spelled GINA!

October Expenses-Scary! October 31, 2009

Posted by Admin in Blog Math, Cancer, Diary, Health Insurance, Money.
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  • ER visit week of 10-5-09:   co-pay before entering the treatment room $100, Dr. fee $266-my percentage of 20% after “negotiated adjustment” =  $34.02, IV drugs ?
  • Co-pays for 2 Office visits for cellulitis and 1 for DNA Test results: $60
  • Flu shot (regular)-no separate bill yet (I think)
  • Plus antibiotics (2 different types), extra pain meds (neither of which worked) $40
  • DNA test-not yet paid by insurance company $3100 (my maximum will be $350) but I haven’t been billed yet because the insurance company is hassling the lab that performed the service (the one that said they had my back). Classify this one as: “hanging over my head”
  • Regular Rx renewals $39.91 (for three months each)
  • Office visits for Ovarian Cancer research study: annual ultrasound of ovaries and CA 125 blood Test : FREE (classify this one to rule things out). More on the CA 125 test in a future post.
  • Bill for September dentist (annual exam, X-rays and cleaning) $45.40 out of pocket (insurance paid $181.60)
  • Co-pays for two therapeutic lymphedema massages: $60

Scary total: $513.00

Weekly Expenses and Musing About Procedures October 24, 2009

Posted by Admin in Blog Math, Diary, Healthonymous, Money.
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Money, Money, Money. This week some of the ER expenses came in from my visit on Oct. 5th (see blog post)-the fee for the examining physician there  was $266).  Plus I was billed for mail order meds-a prescription I take daily. I don’t think I am saving much money. $23.31 for three months for pills picked up in person and now $19.91 for meds in the mail. A savings of about 14%-ok maybe that is some savings! Plus not going to a pharmacy three times is a timesaver.

(One thing I hate about keeping up with these bills is the paperwork):

  • first the papers from the office visit and the receipts for parking etc.
  • the EOB’s or Explanation of Benefits (sometimes it feels like Exclusion of Benefits). These are the gross numbers (pun intended)
  • finally the provider and facility charges giving you the net due.
  • File, burn or shred?

However, this diary is helping me keep track of things in a way that I haven’t before and that is– what could I and the medical establishment have done differently? Should I expect better from them and from myself?

  • Should I have gone to the ER at all?
  • Why did I receive medical advice from 5 different providers in one week for one problem (either staph caused MRSA suspected cellulitis or shingles)
  • How does that affect continuity of care?
  • Will there be translation errors (on my side or theirs) like the old game of Telephone with so many people involved?
  • What if I wasn’t a persistent person and didn’t have a person to fetch my meds and drive me around?
  • What if I didn’t have paid sick leave?

Prescription meds: $19.91, my four visits the week of Oct 5th were billed at $1001-before the negotiated discounts, less my co-pays of $160. Net bill TBD

Keep reading for more thoughts on the issues. Maybe not all the answers, but I can sure ask a lot of questions!

Weekly total: $19.91

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