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Today, I said goodbye to an auld acquaintance, and promptly followed it with "good riddance."
As of late last week, the three of us have rejoined the realm of the medically insured. Well, more the sort-of-insured. We signed up for a plan that costs considerably less than continuing Eleanor's ex-employer's would have on a direct bill basis, but the catch is, it has a very high deductible that we have to be prepared to pay out-of-pocket for most things until we hit a certain level of up-front payment. Even if we burn that entire deductible, the whole shebang will cost us less in 2009 than Eleanor's plan cost us (at under 100 percent of a cost that was about 20 percent lower than it now is) for 2008. To limit the risk of people Not Going To The Doctor Because That's Expensive (the plan I was on growing up), most preventive and diagnostic services are covered in full without even co-pays.
You couple this plan with a tax-deferred cousin of retirement vehicles like IRAs and 401ks. Essentially, it allows us to pay the entire amount of that deductible, plus other medical costs not covered by the plan (most significantly for us, dental) with pre-tax dollars. Until this year, we always had to pay our co-pays and whatnots with after-tax dollars that couldn't be deducted from income tax unless they exceeded 7.5 percent of our combined income for the entire year, which they never did.
These "health savings account" programs are nicely designed to get you to try to comparison-shop and consider the entire cost of your medical services, rather than just focusing on the co-pays. They are also far better than their earlier evil cousin, the "flexible spending account," which we had for a year, for which year we were driven crazy by the paperwork requirements to get reimbursed for co-pays. Plus, FSA's are "use it or lose it" each calendar year, whereas HSAs encourage you not to spend all your nut on a year's medical expenses.
----
So we've paid for three months of Not Much Coverage through the high-deductible plan, and made the initial HSA deposit to cover what we hope will be our regular level of need for a month. Em has one prescription- a generic, now costing us 20 bucks when it used to be free. I have one- a brand-name not going generic for at least a year, and a sizeable hit each month until then. Eleanor's got one of those herself, plus several others which are on most of these Wally World-style four-dollar-generic programs. We filled Em's yesterday, then I went today to Walgreens, where my one scrip has been since half past forever, to fill the last one on the current authorization. I plan on shopping for a better price in the coming weeks, but at this point I just wanted to get it filled.
I've had issues with this particular pharmacy in the past- mostly involving its pharmacists' miniscule exertion of cerebral function. Today, though, their pharmacist was perfectly nice and intelligent. Rather, the stupidity lay in the news she was delivering, courtesy of Blue Cross Blue Shield.
Me: I'd like to refill this. Here's my new insurance card.
Her: ::clickety-clack:: We don't accept this insurance.
Me: What's to accept? It's a full-pay plan, so I pay the whole thing. You're not BILLING them anything.
Her: I know. But it'll still be considered out-of-network and it won't be counted against your deductible.
Me: And how much is that?
Her: ::quotes a rather obscene price in the low three figures:: But if you purchase it in-network, it will count toward your deductible, and the price will probably be lower.
She rattled off a number of names of approved providers. One is where Em got hers filled yesterday, so I know they take it and that we can pay with a check from the health savings account. The Walgreens pharmacist was very gracious about transferring the scrip over the phone, and the new people were very nice about filling it (Eleanor's picking it up, so I don't know whether we got it under the Mendoza line or not). So while I appreciate the assistance from this one kind soul today, I am still rather pissed at a place which charges uninsured people even MORE than it does insured ones, and I will not miss them, or their robocalls or email spam, one little bit.
Whatever's left after that adventure goes to pay the dentist for last month's fun and games. This is taking some getting used to. And unless Obama gets around the rabid opposition of many I-got-mine players to come up with a workable single payer system, chances are that this is what you'll be getting used to before much longer, too.
As of late last week, the three of us have rejoined the realm of the medically insured. Well, more the sort-of-insured. We signed up for a plan that costs considerably less than continuing Eleanor's ex-employer's would have on a direct bill basis, but the catch is, it has a very high deductible that we have to be prepared to pay out-of-pocket for most things until we hit a certain level of up-front payment. Even if we burn that entire deductible, the whole shebang will cost us less in 2009 than Eleanor's plan cost us (at under 100 percent of a cost that was about 20 percent lower than it now is) for 2008. To limit the risk of people Not Going To The Doctor Because That's Expensive (the plan I was on growing up), most preventive and diagnostic services are covered in full without even co-pays.
You couple this plan with a tax-deferred cousin of retirement vehicles like IRAs and 401ks. Essentially, it allows us to pay the entire amount of that deductible, plus other medical costs not covered by the plan (most significantly for us, dental) with pre-tax dollars. Until this year, we always had to pay our co-pays and whatnots with after-tax dollars that couldn't be deducted from income tax unless they exceeded 7.5 percent of our combined income for the entire year, which they never did.
These "health savings account" programs are nicely designed to get you to try to comparison-shop and consider the entire cost of your medical services, rather than just focusing on the co-pays. They are also far better than their earlier evil cousin, the "flexible spending account," which we had for a year, for which year we were driven crazy by the paperwork requirements to get reimbursed for co-pays. Plus, FSA's are "use it or lose it" each calendar year, whereas HSAs encourage you not to spend all your nut on a year's medical expenses.
----
So we've paid for three months of Not Much Coverage through the high-deductible plan, and made the initial HSA deposit to cover what we hope will be our regular level of need for a month. Em has one prescription- a generic, now costing us 20 bucks when it used to be free. I have one- a brand-name not going generic for at least a year, and a sizeable hit each month until then. Eleanor's got one of those herself, plus several others which are on most of these Wally World-style four-dollar-generic programs. We filled Em's yesterday, then I went today to Walgreens, where my one scrip has been since half past forever, to fill the last one on the current authorization. I plan on shopping for a better price in the coming weeks, but at this point I just wanted to get it filled.
I've had issues with this particular pharmacy in the past- mostly involving its pharmacists' miniscule exertion of cerebral function. Today, though, their pharmacist was perfectly nice and intelligent. Rather, the stupidity lay in the news she was delivering, courtesy of Blue Cross Blue Shield.
Me: I'd like to refill this. Here's my new insurance card.
Her: ::clickety-clack:: We don't accept this insurance.
Me: What's to accept? It's a full-pay plan, so I pay the whole thing. You're not BILLING them anything.
Her: I know. But it'll still be considered out-of-network and it won't be counted against your deductible.
Me: And how much is that?
Her: ::quotes a rather obscene price in the low three figures:: But if you purchase it in-network, it will count toward your deductible, and the price will probably be lower.
She rattled off a number of names of approved providers. One is where Em got hers filled yesterday, so I know they take it and that we can pay with a check from the health savings account. The Walgreens pharmacist was very gracious about transferring the scrip over the phone, and the new people were very nice about filling it (Eleanor's picking it up, so I don't know whether we got it under the Mendoza line or not). So while I appreciate the assistance from this one kind soul today, I am still rather pissed at a place which charges uninsured people even MORE than it does insured ones, and I will not miss them, or their robocalls or email spam, one little bit.
Whatever's left after that adventure goes to pay the dentist for last month's fun and games. This is taking some getting used to. And unless Obama gets around the rabid opposition of many I-got-mine players to come up with a workable single payer system, chances are that this is what you'll be getting used to before much longer, too.