Tuesday, November 13, 2007

lucky

Steve's company was recently purchased by a company in Florida, which means we will be on another health insurance plan beginning in January. And it sucks. We took a look at the details this weekend. Whereas our current plan gives us each a deductible of $500 (for a total of $1,500), next year's deductible will be $3,000. Whereas our current plan will pay for any expenses we incur over $2,000 (more on that later), the new plan caps us at $6,000. So, knowing we're going to be having a baby in 2008 (not to mention a number of CAT scans for me), we're going to have to come up with an extra $4,000 to set aside for medical expenses.

It sucks. It really does, and Steve and I are looking at each other wondering where we're going to find the money and what we'll have to cut out. Home projects. Travel, certainly. We won't be able to take as many trips as we usually do, especially with the new baby — not that we took very many this year, but I don't see, for example, a long jaunt down the California coast in the cards. Other stuff we might not think twice about ... I'm on Craig's List these days, looking for a good double stroller because I don't want to think about shelling out $500-plus for a brand-new one.

But as the medical bills for my cancer surgery come in, and the checks go out, I am just breathing a sigh of relief that we have insurance at all. The total cost for just my five nights in my hospital room, I discovered today, was more than $49,000. Yikes. And that's not for the surgery itself, the anesthesia, the MRI, etc., which amounted to thousands more, maybe tens of thousands. Yet because we've easily hit our $2,000 cap, we won't be getting that hospital bill. I don't know how people without health insurance would survive something like what I went through. Maybe many wouldn't.

So in the end, I feel like we're lucky (or blessed, or however we want to see it). Lucky that Steve has a job that provides health insurance. (I don't know why having a job has to be a prerequisite for what I believe is a basic human right, but that's a whole new rant.) Lucky that we can afford to pay up to the $2,000 cap. Lucky that we will probably be able to eke out the $6,000 cap next year, though God only knows how we're going to manage that. Lucky that we have a rainy day fund. Lucky (or smart) that we don't have an unmanageable mortgage that squeezes us or tempts us to take out a home equity loan to afford major expenses. We're not rich, but when we stand back and think about it, we're actually doing pretty well.

5 comments:

Anonymous said...

Oh my God, Emilie, I can totally relate to what you're saying.

I was especially grapped by your comment, stated in paranthesis, about how health insurance, and health care in general, is a basic human right. Had I never had cancer myself, I probably would never have realized all this.

It is horrendous, I feel, that people have to severly compremise their financial well being, all for an illness they did not choose to get. As if the emotional and physical ramifications of cancer aren't bad enough, and then on top of that, the financial...

And yeah, one could say "but how else can it be done?" Well, I feel the docs are excrusciatingly overpaid, but that's another rant, as you said...

Kim in KCK said...

Does Steve's employer have a pretax medical spending plan aka cafeteria plan? I think the current limit is $3000 that can be put away pretax. It is a deduction from each paycheck, but the full amount can be used at any time during the year. It would be worth him asking his HR department.

Anonymous said...

Emilie, I think you are SMART, not lucky. How many people look at their insurance carefully in advance of big change? Very few, indeed. Because of your foresight, you'll be just fine. The baby is better than the CA coastline by far, anyhow! For vacations, hit up your friends with cabins, like us!

--Laura d'ECFE

Ellen said...

My plan is changing next year too, to something similar to yours. My peeve is that emergency and non-emergency office visits are no longer covered by co-pays alone. We pay out-of-pocket for ALL visits until you reach the deductible, and we have three different plans to choose from, all with different deductibles. The most expensive (single) plan has a $250 deductible, and I would pay each month about the same as what I pay now. But get this..."preventive" care visits are free. Covered. But I never do those. I guess the plan isn't that bad, but I usually visit when I have a persistent sore throat or ear aches. So I'll have to come up with more $ (on a single plan) just to get checked and be told to rest and drink more fluids. If I don't walk out of the office with at least a prescription for antibiotics, I'll be pissed!!!
The cheapest (single) plan we can get is a $10 per month premium, but a $3,000 deductible. So our company is really pushing this "cafeteria" plan and making it sound like it's the best thing since sliced bread. And I'm thinking, no, I just want my co-pays back.
Em, thanks for bringing up this issue. I'm sorry to hear what kind of financial struggles you and Steve are facing. You are right, those who have taken out loans and splurged on things they cannot afford (because the credit system told them they could) are up a creek without a paddle. I have read about cancer patients or those with other illnesses and accidents who have no other choice but to file for bankruptcy. What else can you do, if you never could afford to go to Harvard but your medical bills are worth four years of tuition there?

Jamie said...

Em, I know just what you are saying. I remember being SO thankful when I got cancer that I was on my parents insurance as a student. I still got the bills and I was stunned that it cost about $5,000 per night to be in the hospital, and I didn't have a private room. It's stunning.

For people without insurance, when things like this happen it's horrible. My brother didn't have insurance when he got into his car accident this summer, and he has had to fight to get MN Care to cover it, even though he is going to be disabled until at least January and unable to work. Now other doctors won't see him because he's a "welfare case", so he can't get into his dentist, eye doctor, etc. It's terrible.

You and Steve will make this work, but I totally understand what you are saying. Even though it will be ok, I'm still sorry you have to do this :(