Wednesday, June 14, 2017

Cutting Expenses -- When You Think You Can't. Part V: Necessary Evils (Insurance, etc.)

     I haven't forgotten about the ongoing series on cutting expenses -- other issues had to be dealt with for a while. (Like packing. Clean underwear. Meals. Earning a living. Stuff like that.) 

You'll find the other parts here, starting with Part I -- the basics.  (Links to the other parts are included on the bottom of the post.)

Now on to the grim necessities we inevitably have to deal with, at one time or another --

                 Our health.
                        Insurance.
                              Dealing with medical costs. 

Obviously, first and foremost:
     The healthier you can stay, the less you have to worry about medical costs. Eating a reasonably good diet and exercising will do a world of good in this department. (I'm preaching to the choir here -- but looking at the roll of belly fat around my middle, I realize I don't always listen.)
     This does not mean jumping on the latest bandwagon. Or shoveling down special pills. Take the example of going 'gluten-free.' That's just plain healthy, right?
     Actually, no.

     Only a small percentage of the population actually needs to do this,  due to celiac disease or allergies/sensitivities, according to Dr. Sheila Crowe of the National Gastroenterological Association. According to Crowe, there is little direct evidence that sticking to a gluten-free diet will give you better health. (Are you listening, manufacturers who crank out 'gluten-free' items at outrageous prices? Of course not.)

     The key, in this humble blogger's opinion:  balance. Find the combination of foods that give you strength and energy, and make them the mainstay of your diet. It may be largely protein and veggies, with just a few carbs. Or minimal amounts of the food you do take. Or straight vegetarian, with or without dairy products, eggs and fish. (Seafood doesn't 'count' for some vegetarians.) There are all sorts of diets out there.The point is balance: some fats for good health. Some proteins. Some veggies and some fruit. Even some carbs.
     Experiment to find the right mix for yourself and your family...you can figure it out.




Next:  insurance. 

Thanks to Obamacare (which is still on the rolls, despite the screaming, yelling and posturing pro and con), everyone is eligible for insurance.  (If you don't get it, you'll be penalized.)

     The problem: it may not cover much. 

Our insurance plan is very reasonably priced: about $150/mo for both of us. On the other hand, it covers pretty much nothing, except for something catastrophic. The first $12,000 of medical expenses comes right out of our collective pockets. (If you count both of us, the total is $20,000.)
     I'd gripe even more about this -- except the plan we had while the Brick was employed, and afterwards as a retiree, had nearly the same coverage, for 'only' $400 or more a month.
     When the Brick's liver began failing, the majority of his stay in intensive care was covered...but we still owed more than $10,000 by the time he came home. When I called the hospital business office to arrange a payment plan, the representative said incredulously, "You still owe this much...and you've got insurance?!?"   Sadly, yes.

What has helped us:

*An HSA /FSA account. Set this up -- often your employer will do it for you -- and you can pay for medical costs before taxes, rather than afterwards. Be warned, though: you generally have a deadline for using the funds -- and if you don't, they may disappear. (One of my readers says this has changed, and the money stays. I wonder if different states do it differently. Not sure.) Estimate your costs, based on previous years, and you'll be safer.
     (Update:  Reader Virginia (see comments) points out:

you have HSA in your post which is Health Savings Account, you can set one of these up if you have a qualifying insurance policy. There is a limit to how much you can put in them per year but you can take the money and earnings out, tax free, to pay for health costs and you get a deduction on your tax return for putting money in. And you never lose the money, it rolls over until you need it.

The description you have in the post however sounds like you were talking about FSA which is a Flexible Spending Account which is thru your employer, pre-tax money and if you have not used all the money within the tax year plus a couple of months, you will lose it (it goes back to your employer). 


    She's right. We currently have an HSA account (because the Brick is retired, and no longer has an employer). But we used to have an FSA account. Apologies for mixing the two together.)

*Use a clinic, rather than a doctor's office. Many of the grocery chains, like King Soopers and Safeway, now have medical areas for minor things like flu, bumps & bruises, etc. And they're generally a lot cheaper.

*Pay cash. The Brick's last visit to our regular GP cost $75 -- versus the usual $150 -- because he offered to pay cash. (Would that we had known this the past four or so years we've been going to this medical center.)

*DON'T use the emergency room, unless it's absolutely, positively necessary. If you don't need to be admitted to the hospital, you'll pay for all sorts of tests -- and depending on the night, get only basic care. We've been to the emergency room four times in the past three decades -- twice for the Brick, twice for Daughters. We've gotten soaked every single visit.

     If you do end up in the hospital:

*Pay attention. If at all possible, have a healthy family member by your side as much as possible, asking questions and requesting explanations. Probably you'll be in no condition to completely understand what's going on -- but they will. (These tips should come in handy for them.  Try these, too.)

*Don't just agree wholesale to procedures or 'just in case' medications, no matter what. Some of those tests (like those in the emergency room) may not actually be necessary -- the doctor is just covering his bases. (I know this from hard experience. Sometimes, the side effects of the new meds are worse than the original symptoms, too. Ask a LOT of questions.)

*If you used an item -- take it home. You'll be charged for it -- and it gets thrown out, otherwise. But:

*Check your bill carefully. Hospitals are big, complicated places -- and it's very easy for them to charge for all sorts of interesting things -- including procedures and medications you never actually received. (Prices for items like kleenex and aspirin are heavily jacked-up, too.)


The Mama, during heart surgery a few years ago.

*Don't pay your medical bills. Right away, that is. For one thing, you need to let insurance companies, who generally move at the rate of a slow glacier, get the bills and process the claim. For another, you need to check the bill. If your income is miniscule, this pause gives time to explore what programs may be available for low income individuals. (The hospital will generally not tell you about these up-front. After all, it's in their interest to get every penny you're willing to pay. Unless the rep generously tells you about a program, you'll have to be the one to ask.)
      You may also be able to negotiate that final cost down. More than a few places will give a discount if you pay in cash -- or in full. Others will, after you've paid regularly for months or a few years, be willing to write off the rest of the debt. The key, though, even if you can only afford to pay a small amount every month, is to make that payment faithfully. It marks you as a person of integrity who follows through, and makes them more willing to work with you.  It took us years to clear away the Brick's hospital bill -- but we did it. (We're still working on the dental payments for his and my crowns -- but they're almost done. Just a few more months.)

     *You must look for the best prescription deals yourself . No one's going to do it for you -- not even your insurance company, even if they may end up paying less because of it. Go to this post for several helpful programs, like the '$4 plan' from Walmart and RiteAid's $9.99 generic offers. But beware: Wal-Mart will offer certain sizes at the $4 price -- and the same pills, slightly larger or in different amounts, at much higher prices. We found this out the hard way when I needed antibiotics to combat a abcessed tooth. The doctor prescribed one size of pill -- which Wal-Mart filled as specified. When I questioned why the cost was triple what I'd expected, the truth came out. Ask your doctor to double-check the plan before prescribing.
     Another option that's saved us money:  order from Canada.  The same prescription, same brand and everything can cost less. Why? I'm not sure -- only that we've paid hundreds less on some of the Brick's essential meds.





     I don't have space in this post to cover dental costs and care -- but the basics still apply. Keep your teeth and mouth healthy, don't authorize unnecessary procedures, and ask about discounts and payment plans. (Take advantage of new patient specials, too.)

Kiplinger's came up with 50 ways to cut medical costs -- other sites have suggestions, as well.


          Stay calm. Rest and get better, so you can deal with this. 
                     It may take time...but you will get through it.


Please note: I am not a doctor, medical or insurance professional. (I don't even play one on TV!) You are responsible for your own decisions and actions -- just like we are. I'm merely giving advice on what's helped us and others.




Next time:  Necessary Evils (continued) -- long-term care insurance, nursing homes, hospice, end-of-life...and funerals

3 comments:

Melody said...

May I also add that pharmaceutical companies have assistance programs. My new insurance refused to pay for my Lyrica, which I have been on since 2009. I applied for and was approved to receive the medication for free. Income levels apply as do a few other criteria however the process was pretty easy and is saving us $600 a mo.

Virginia Berger said...

Just a note: you have HSA in your post which is Health Savings Account, you can set one of these up if you have a qualifying insurance policy. There is a limit to how much you can put in them per year but you can take the money and earnings out, tax free, to pay for health costs and you get a deduction on your tax return for putting money in. And you never lose the money, it rolls over until you need it.

The description you have in the post however sounds like you were talking about FSA which is a Flexible Spending Account which is thru your employer, pre-tax money and if you have not used all the money within the tax year plus a couple of months, you will lose it (it goes back to your employer).

I'm a big advocate for questioning your doctor. At the end of my chemo treatments, my oncologist wanted me to have a cat scan ever three months. When I pointed out to her that my fairly sucky insurance would only pay for one a year, she agreed that one a year was sufficient. Also when I wanted to have my port taken out, the surgeon's nurse called and started talking about scheduling this for the operating room at the hospital! When I told her that I would have to pay for that and that I thought it was unnecessary to be in the surgical suite, he agreed to do it in his office and it cost me $75.

Cindy Brick said...

Virginia, you're right -- I was actually talking about both. (We had a FSA account before, and an HSA now.) I'll fix this discrepancy shortly...and will quote you. (Thanks so much.)

And Melody, you're right -- I'm grateful that some companies offer this. It means all the world to people who couldn't afford their meds, otherwise.

Thanks so much, both of you, for writing.

Mousey News...And Updates

     I don't know if it's because of the heat -- or the bushel basket of appraisals and gigs I've had this month -- but I am re...