6/25/13

Insurance Deductable Met

WooHoo! . . . not.

For years we've been a healthy family, until now. One little mistake on my part in yoga class resulted in a torn rotator cuff, resulting in a shoulder MRI ($4000--I asked!), which will result in surgery.

--yes, I figured out what stupid A$$ thing I did to cause this problem! I'm sure the shoulder wasn't perfect to start with, but one yoga move pushed it over the edge to tear!

All it takes is one 'procedure' to put you in a financial hole. So many people live paycheck-to-paycheck, or simply live beyond their means (buying the next big 'thing', racking up credit card debt, etc.) that all it takes is one medical issue and BAM! you are in serious trouble.

Having insurance helps, but it isn't the answer to everything. Many insurances have high deductibles you have to meet, or you set your own high deductible to keep your monthly costs down, BEFORE they will pay anything you pay your deductible, and then they may pay 80% of the cost, or up to a cap limit, oh let's say $100,000.

Here's the kicker. Years go by and you're healthy so you set a high deductible, let's say $2000, so you can pay less every month. That $2000 comes out of your pocket before any insurance kicks in. AND then they only pay 80%.

For example, and this is a very broad example and probably on the cheap end of the scale, let's say you have to have surgery. The subsequent surgery/hospital stay can easily add up to $50,000, of that you will have to pay 20%, which is $10,000! PLUS the $2000 deductible = $12, 000!

That's 12K out of your pocket. Do you have that kind of money in the bank?

Probably not.

If you don't, you might want to start saving instead of spending. Medical issues add up quickly. And don't go all high and mighty on me about the cost of medicine and that doctors are overpaid--shoot, most docs are still paying off 7-years worth of medical school bills! And that isn't counting how much they pay in overhead (office, staff, electricity, etc) and insurance because people are suing them ALL THE TIME--especially OB's.

I worked in a hospital for years. It sounds ridiculous that a simple 6-test chemistry panel would cost $80.

But break it down. (the numbers are pure guessing on my part since it's been a long time since I've been in the lab and I know the actual numbers have changed)

The actual tests costs about $8, BUT you also have to pay for non-test costs
  • the computers to order the test and spit out labels
  • the equipment to draw your blood (safety needle, alcohol, cotton ball)
  • the tubes the phlebotomist used
  • the centrifuge to spin the blood down
  • the $500,000 instrument that runs your test
  • running controls on the machine used to test your blood, numerous times a day. Controls are used to check that the tests are running in the optimal narrow test range established by the company who makes the control serum.
  • calibrating the machine, once or numerous times a day, depending on the test. Calibrating runs two or more tests with exact known values, the instrument then adjusts the graph according to those results, which will effect both the controls and the patient's results. Controls, high and low MUST be run after calibrating to verify accuracy, prior to running patient specimens.
PLUS you pay for the skills and education of the phlebotomist and MT running your test. You want phlebs who are relatively painless and skilled to draw your blood. Trust me, the phlebotomist who can manage to find a rolling vein, or even find a hidden vein in an obese person is worth their weigh in gold!

Or the MT who questions a result and retests it, or questions the validity of the machine and re-calibrates it only to discover the result, which might have been abnormal, to fall back into the normal range.

So it isn't just the cost of the test you are paying for. It's everything else, including knowledge.

Think about it. Think about those people who live beyond their means and are in a financial hole. Those are the people who drive up the cost of health care. Because they don't pay their bills someone else has to foot the additional cost.

And guess who those people are--the rest of us!

It's time American's start doing what our parents did--start saving our money.

Just because the newest phone has come out doesn't mean you need to get it. Shoot, there will be another new one in 6 months! Do you really need a 75-inch TV? Pluh-leeze!

It's time to start saving money for that rainy day and teaching our children how to save money. Doing without the next big electronic gizmo isn't that much of a hardship.

Sorry, my blog rant became a little side-tracked, but I think it needed to be said . . . whether anyone reads it is a whole 'nuther thing!

Later, Peeps!

2 comments:

Marilyn said...

I realize a lot of costs are legit, but the hospitals show themselves in a bad light when they charge outrageously for really cheap stuff, which makes people leery of all their charges.

After one of my outpatient knee surgeries, I got a charge for $10.50 for two units of "patient self-administered medication." I knew I hadn't taken any medication myself, but we finally figured out what they were referring to: before I could be discharged, I had to drink and keep down 8 ounces of soda. I'd been NPO for eighteen hours; I was thirsty; when they offered me a second can, I took it.

So when they bill me ten bucks and change for "medication" also known as Sierra Mist, I have to wonder about the other charges they've listed, too.

You're so right about not needing the next new thing. My flip phone is dumber than dirt, my television is analog (and we have only one), my truck is celebrating its tenth anniversary in a few months, and my clothes dryer is 27 years old. If they work, I ain't replacing them.

Margaret Golla said...

Wow, $5 for a can of soda! That's worse than the vending machines at an expensive hotel!

I understand what you mean, when hubs had a kidney stone he had a pink basin to hold just in case he got sick. I think the $2 plastic basin cost us $20.

Again, I think this is the way they make up for the cost for those who don't pay, and by law, they have to treat people whether or not they can pay.