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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 ...


Risk: Relative vs. Absolute November 22, 2009

Posted by Admin in Cancer, Health Insurance, huh?.
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What is the risk of getting cancer? There are two types of risk, absolute and relative.

If you are over 35, try out the breast cancer risk assessment tool at cancer.gov. There are also tools for colorectal cancer and melanoma.

Also from cancer.gov:

Absolute risk is the number of people who will get the disease within a certain time period. Absolute risk gives an actual number of people with that risk factor who will get the condition. You also may see this expressed as, for example, “10 out of 100 people.”

Relative risk compares the chance that a person with a certain risk factor will get cancer to the chance that a person without the same risk factor will get cancer. When you hear that someone is at “high” risk or “low” risk of getting cancer, it is referring to that person’s relative risk.

Relative risk is usually shown as a percent or ratio. The ratio is based around the value of 1. A value above 1 means a higher risk; a value below 1 means a lower risk.

There are different kinds of risk factors, they include genetic (I have a second degree relative with a cancer history-2 generations away), environmental (secondhand smoke exposure and sun), biological (gender, age, race, skin complexion), or behavioral (what I eat and drink, how much exercise I get).

When I was diagnosed with cancer, I had no risk factors. No first degree relatives, (in fact I didn’t know that I had any relatives with cancer until I was asked the family history question for the first time), no second-hand smoke exposure-unless you count flying in the 70’s) , didn’t come from an ethnic group at higher risk etc. Regular readers will recall that I do not have the BRCA 1 or BRCA 2 mutations either. Cancer was a (more…)

Affordable Health Care for America No Longer “Optional” November 8, 2009

Posted by Admin in Health Insurance, Healthonymous, Money.
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Yesterday, HR 3962, the Affordable Health Care for America Act, passed the House of Representatives with a slim 5 vote margin to make history in America. The sweeping bill includes a public option-so the public option government health care plan is no longer “optional”. If you would like to hear the bill read out loud, visit this website HearTheBill.org .

Yours truly was glued to C-SPAN for most of the day. It was fascinating to look at cspan.org last night, and check out the member speeches the choose to post on their site.  I stood amazed (well, sat on my couch actually)

  • at the breadth of stories (both true and false) told on the floor,
  • the mind numbing use of repetitive phrases,
  • the patience of Rep. Dingell and each subsequent presiding member as they politely requested that members “heed the gavel” and that visitors in the galleries ” were guests of the House” and had to adhere to House rules,
  • the utter lack of interest in Rep. Wally Herger’s floor speech (D-CA District 2) from his colleagues seated nearby-presumably from his own party
  • Speaker Pelosi’s floor speech where she reminded her colleagues that HR 3962 would not treat being female as a reason to deny coverage for a “pre-existing condition”.
  • Speeches by Rep. Waxman, Rep. McDermott (WA) , Rep. Miller (CA), Rep. Velasquez, Rep. Slaughter, Rep. Meek
  • The lifelong commitment of Rep. Dingell and his family before him to providing health care for all Americans,
  • The surprising inclusion of the Stupak amendment, the most restrictive amendment since the Hyde Amendment on abortion rights
  • The misused, recurring call of “parliamentary inquiry” to the chair
  • The various descriptions of the weight of the bill and the number of pages (Jon Stewart summarizes it well)

No matter if you approve or disapprove, this day has been a long time coming-since the time of President Roosevelt or even President Truman-no bill has gotten this far. The next few weeks will still be crucial, especially with the “poison pill” of the Stupak amendment now contained within the bill, sort of like an odd political pregnancy.

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

September Blog Math October 1, 2009

Posted by Admin in Blog Math, Diary, Money.
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Yesterday was the end of the month.   This blog is not yet one month old, so the numbers for September will not include the days prior to the First Post.

Expenses this week: Massage (for lymphedema) co-pay $30.00

Expenses for the life of the blog(less than 30 days): $680.68

Cost of worry, uncertainty, and bill-juggling (to paraphrase a national commercial) : Priceless!

Percentage of monthly income: Not  a single digit number!

Prediction for next month: Flat (did you know flat is the new up?)

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