S/O What health care are you NOT getting due to costs?

[Spock]

In the other thread, many talked about being uninsured or not being able to afford the deductible. So what kinds of things are you ignoring/not getting care for because of this?

 

 

• dental care--My oldest son had his first dentist visit at Navy boot camp. I had a dental exam 2 years ago that showed I have 5 cavities, but we haven't been able to pay to have them fixed. My youngest probably has a cavity. My husband didn't get the bridge that was recommended.
  
• migraines--I just take 4-6 advil or 2 naprosyn (and sometimes sudafed or an allergy pill) and lie down in a dark, quiet room for a few hours or a day or so
  
• when I sprained my ankle 7 years ago, we waited 2 days to go to the doctor
  
• when I got a concussion 12-13 years ago, we waited 3 days to go to the doctor, who at that point did nothing more than say, "That was a concussion", so we might as well not have gone
  
• My husband sees his neurologist only once a year, instead of the recommended every 6 months (maintenance for myesthenia gravis)
  
• ADHD diagnosis and treatment for my youngest (who fits 18 out of 18 diagnostic criteria from a website I checked, when only 6 out of the 9 from either category is apparently sufficient for a diagnosis). I am considering applying for Medicaid to do something about this, because this has begun to affect his schoolwork a lot as of late last year
  
• my husband and second son do not take asthma preventive medication. [They have very mild asthma, or we would find a way to pay for it--for 3 years we did pay over $120 a month for my son's medicine. However, they don't even need albuterol more than once a year or so anymore, so we haven't been getting the Flovent or anything else for several years. It probably wouldn't even be prescribed for my son anymore.]
  
• Probable arthritis in my knee and the ankle that was sprained years ago and never completely healed.
  
• Probable need for a CPAP machine
  
• We never go to "just check it out" for anything--strange rashes that appear out of nowhere, headaches in children, new pains or swellings, etc. We only go to a doctor for things that cannot be avoided--stitches, bronchitis, etc. We always wait until it is obvious that whatever it is will not go away on its own, and that it must be treated.
  

We have not had health insurance for 15 years, and cannot afford to pay the $500-700 per month estimates (sometimes per person!) that we have been given by insurance companies. It is cheaper to pay the $75-120 per visit for doctors, and the $1000+ for emergency room visits (and even the $75 per month or so that we have been paying on my husband's hospitalization in 2001).

 

What scares me about the Obama Healthcare package is that apparently it makes it mandatory to have health insurance, or you cannot get treated by a medical professional. Since we cannot afford health insurance, and the possibility of a government health insurance which might have been possible to afford was eliminated by Congress, we will apparently no longer be able to have any sort of medical care, even self-paid. I am hoping that either I have misunderstood the plan, or that the plan will be altered before it goes into effect. At least my oldest now has access to healthcare through the Navy.

[Scuff]

A ganglion cyst removal on my wrist (that is pressing on the nerve that controls my thumb) and having something done about what I think is a hiatal hernia.

 

My dh has had to have 3 major surgeries this past year, and we are still getting bills in from various doctors and such. Add to that having two kids in braces...The non emergency stuff is getting put off.

 

I have to say that I'm grateful for the insurance we do have. If it weren't for that, we would have gone under this year.

 

Has a dr told you that you need the ganglion removed? I've had one on my wrist twice and both went away on their own. The dr said that they usually don't do anything, unless I wanted them to. It took a few years, but they did eventually go away. Hang in there.

[Tess in the Burbs]

I haven't seen an endocrinologist mostly due to getting an appt. But I know the copay will be $50.

 

I need to see someone about my shoulder, and my feet. Both would be $50 copay and whatever else that has to be paid under deductible. By the time we have the co-pays available in the budget we will be on a new year of deductible, lol.

[Princess Peach]

Braces for 2 of my kiddos. But, then again, if I thought they were truly medically necessary, I'd find a way to pay for them.

 

The other thing our insurance doesn't cover is a neuropsych eval for DS8 for suspected dyslexia. This, we will pay out of pocket for if we feel it's necessary in the future. Right now, he is coping well and his reading is progressing. Just a little rant: our insurance won't cover the eval because they say dyslexia is an educational issue, not a medical one. This, of course, is a bunch of hooey. Schools cannot diagnose dyslexia and DS did not qualify for an IEP. So if we feel he needs a 504, we'll have to get a diagnosis. /rant

 

Otherwise, we have excellent medical/dental/vision insurance and I'm very thankful for it.

[MrsBear]

 

What scares me about the Obama Healthcare package is that apparently it makes it mandatory to have health insurance, or you cannot get treated by a medical professional. Since we cannot afford health insurance, and the possibility of a government health insurance which might have been possible to afford was eliminated by Congress, we will apparently no longer be able to have any sort of medical care, even self-paid. I am hoping that either I have misunderstood the plan, or that the plan will be altered before it goes into effect. At least my oldest now has access to healthcare through the Navy.

 

While something along those lines may be a longer term goal, there is nothing in the legislation at the moment that I'm aware of that says you can't see a doctor and pay for it yourself.

[mommymilkies]

I have 2 wisdom teeth which are abcessed and need removed, I haven't had a teeth cleaning in 5 years.

[Mommyfaithe]

In the other thread, many talked about being uninsured or not being able to afford the deductible. So what kinds of things are you ignoring/not getting care for because of this?

 

My own dental care.

 

I only have the kids teeth cleaned once a year, not twice...too expensive.

 

Eyeglasses only get replaced every 3-4 years

 

Can't afford adjustments except in emergency or twice a year.

 

Can not fill my pain meds, anxiety meds, etc. Because we do not have script coverage. I do buy whatever the kids need...even the more expensive inhalers for my asthmatic kid....she needs them, so I scrimp in other areas.

[Spock]

 

If DS does need to go to the doctor for some reason, we generally go to the ER. I know that sounds stupid, but the hospital is always willing to work payments/discounts with you. I've never found a pediatrician's office here that will do the same.

 

Pro-Med and similar places will do care for less than the emergency room, and less than a pediatrician. We found an urgent care place in a nearby town that will treat uninsured patients for $75 a visit (but extra for any labs/tests). The places in our city cost $125 per visit for uninsured. The emergency room here costs $1000 and up, even for something simple like stitches.

 

And, the pediatricians mostly won't see anyone with no insurance, but the ones who will want $150-200 per visit, and keep mailing a bill a few weeks later for charges that weren't mentioned at the original visit.

 

Also, most doctors won't spend time with uninsured patients. I had a doctor schedule my appointment at the same time as someone else (who had insurance), and see her first. (I heard the other patient checking in, which is how I know she had an appointment for the same doctor at the same time, and had insurance. She was called back to see the doctor first.) Then, once I was put in the exam room, I was ignored for almost an hour. When she finally saw me, she rushed the exam and didn't listen. It was a follow-up for a sprained instep, and she didn't listen when I said it still hurt. She kept giving instructions for exercises to prevent a recurrence, and ignored me when I said I couldn't do them. Then, she was surprised to see I was still limping when I left the office. We no longer visit that practice (which is also one of the more expensive ones for uninsured patients).

[Spock]

All of it. Pigby is finally caught up on his vaccines, but that's because the school required them. Digby and Chuck are behind.

 

At least around here, the county health department does free vaccines. That's where all of mine have had theirs.

[elegantlion]

We finally have insurance, but no money to pay for deductible or non-covered issues.

 

I did get new eyeglasses after 7 years. My co-pay was 10.00.

 

I need dental work, ds may need braces, but we can't afford any out of pocket expenses, so we don't go.

 

Forget anything medical, I would rather go to the dentist for 3 months straight than do one visit at the regular doctor's office. Plus I only go if I'm really, really sick.

[LisaKinVA]

I still have to come up with $11,000 more dollars to finish the reconstruction of my upper jaw/teeth. FTR, I have already spent over $50,000 OOP. 100% has been declined (even though the procedures were supposedly covered). Our only option at this point is to hire a lawyer... extremely frustrating. All I have left are the crowns -- which *should* be covered at 80% by the insurance, but they've found a way to weasel out of everything else, why should this be any different? Oh, and my problem is congential (and yeah, I was told "pre-existing" condition to THAT, too).

 

The first thing on our list is to take our 5yo to a developmental optometrist. That is $275 OOP. We do have an FSA account (like an HSA), but it reimburses, so I have to come up with the $275 FIRST.

 

I'm praying I can finish up, and get my crowns before my birthday... but that's going to depend upon my job. I've been working on this for 13 years, 5 surgeries, and am finally in the home stretch. But, I still have to come up with $11k. :tongue_smilie:

[*********]

This thread has made me think a couple things:

 

I'm so grateful for our insurance, and I'll try not to complain about the deductible anymore.

 

I seriously need to send my mom a 'thank you' for taking us to the dentist when I was a kid. My folks were (and still are) VERY poor. We never had dental insurance. But they still took us once a year for cleanings. Thankfully all us kids had good teeth, so very few problems. But still, paying out of pocket for three kids to get cleanings must've been HARD for them.

[SKL]

I would just say most of these are also not done by people who have insurance but not time (e.g., everyone old enough to drive works full-time), nor by insured people who prefer to use "conventional" medical intervention only as an absolute last resort. I think the bigger difference is that those of us with insurance do not have to worry about the really bad stuff - stuff that "probably" will never happen, but "could."

 

My dd had an odd raised/discolored patch on her skin and, after the GP's prescription (mostly out of pocket cost) did nothing, she was referred to a dermotologist, who prescribed a new med (again mostly OOP) with each visit. The derm copay was $50 per visit. The allowed amount per the insurance company was about $53, meaning they paid about $3 each time I paid $50. We did not go for follow-ups after the first two visits. In retrospect, I really should have gone to Dr. Google first and tried OTC moisturizers. Live and learn.

 

Vision: theoretically some of it is covered, but I had to pay 100% for most of my kid's ophthalmologist visits, 100% of her two pairs of glasses in two years, and 100% of vision therapy (eval and therapy sessions). The VT and glasses were worth it, though. Most definitely saved me more in daycare, remediation, etc. since my kid is now accelerated instead of behind. Wish I'd done the VT eval sooner instead of the follow-up ophth visits.

 

Dental: I do not buy dental insurance for my kids (who are 5). They don't go to the dentist routinely. One of my kids had to go one time for a tooth injury (which cost $60) but that's it. I'll start taking them to the dentist when they are older. As for me, I went for several years knowing I had cavities because I didn't want to pay. I got caught up last year. I still will not go often. I have wisdoms that never erupted (I'm 45) but I'm going to let that sleeping dog lie.

 

I don't go to the doctor unless I have a specific concern, which is rare. The kids have had to go for a well visit annually in order to be allowed in preschool, but I assume their grade school won't require annual visits. I don't take them to the doctor otherwise unless I'm pretty sure they have something "bad" that responds to antibiotics, like strep. I did take my kid once for swelling around her eye after a spider bite, but that was more because I didn't want their daycare calling CPS on me for being such an unconcerned parent. (It looked like she'd been punched, so I figured CYA was in order.)

[joannqn]

I've got to figure out what to do about contraception because my pills went up again. Oh, and dental here, too.

 

No kidding. The one my doctor wanted me to try is $57 a month. We're trying to treat PMS, and this one seems to be the most promising one so we're paying for it. We consider it essential because it affects the entire family.

 

What scares me about the Obama Healthcare package is that apparently it makes it mandatory to have health insurance, or you cannot get treated by a medical professional. Since we cannot afford health insurance, and the possibility of a government health insurance which might have been possible to afford was eliminated by Congress, we will apparently no longer be able to have any sort of medical care, even self-paid. I am hoping that either I have misunderstood the plan, or that the plan will be altered before it goes into effect. At least my oldest now has access to healthcare through the Navy.

 

You will still be able to see a doctor but you'll have to pay annual fines if you don't buy insurance. By 2016, that penalty for individuals will rise to $695 or 2.5% of income, whichever is greater. The penalty for families is $2,085.

[Scuff]

Which is crazy. I don't understand how they get away with that and people don't see it as screwing the poor. If you can't afford health insurance, how can you afford the fine?

 

Like Bethany, I'm grateful for our insurance. It was better before. Our copays are now quite high. We don't go to the dr either unless it proves to truely be a need.

 

I remember being a kid and our dr prescribng allergy meds in such a way that we could share a huge bottle to save copays. Our copay was $2. That's a dream now.

[CalicoKat]

Certain medications that my doctor prescribes but my health insurance won't pay for.

 

They don't like my coumadin, actoplus met (for diabetes), or celebrex & enbrel (for my arthritis).

 

Can I live without these? Yes. But for how long?

[WistfulRidge]

Uhh... everything. I haven't been to the doctor for myself in 6 years. I haven't really had any dental care in that long either (except for when I had them pull a tooth about 2 years ago...). I do see a midwife while I'm pregnant, but I do a lot of my own basic prenatal care (though this is more of a choice than a must). DH hasn't been to a doctor or dentist in almost a decade.

 

Oh, and glasses. I've needed to get my eyes checked for years, but haven't and DH really needs a new pair of glasses...

 

DS1 & 2 get in for well child check ups, but that's about it. Thankfully between the two of them we've only ever had to go in once for illness. DS1 is probably getting to the age where he should have dental care but that's something we can't afford either.

 

I'm not a big "run in and see a doctor" person... odds are if I don't feel like I'm dying then I'm not likely to go. Still, it would be nice to have the option.

Edited April 18, 2012 by theAmbitiousHousewife

[txmom23]

We have a high deductible I pay the first $10,000 for the whole family, then they pay 100%. The premium is $416/mo.

 

I'm putting off an endoscopy of upper digestive system and a HIDA scan on the gallbladder.

 

I've been pretty sick since Thanksgiving. I needed expensive lab work and an abdominal u/s. When I called to schedule these, I told them I had crappy, high deductible insurance. That I would self-pay. The lab and radiology both gave me a 90% discount!! My labs were $200 and the u/s $120. They would have billed the ins. co. over $3000 for these services. The HIDA scan I need is $1650. That's the self pay price. In both instances I saw the paper with the itemized list of prices.

 

If you are uninsured or under insured, ask for BOTH prices. You might be surprised.

 

ETA: My son recently had a 7 hour ER visit. Because I discussed this when he was admitted, I got a 40% discount off the bill.

Edited April 18, 2012 by txmom23

[MrsBear]

 

I've been pretty sick since Thanksgiving. I needed expensive lab work and an abdominal u/s. When I called to schedule these, I told them I had crappy, high deductible insurance. That I would self-pay. The lab and radiology both gave me a 90% discount!! My labs were $200 and the u/s $120. They would have billed the ins. co. over $3000 for these services. The HIDA scan I need is $1650. That's the self pay price. In both instances I saw the paper with the itemized list of prices.

 

 

What they bill the insurance isn't what the insurance reimburses, what you would pay that counts toward your deductible. If they'd billed $3,000, they probably would have been reimbursed what you paid OOP with nothing counting toward your deductible because they can't charge less than they accept for insurance reimbursement except in very rare cases that need to be documented to justify the larger discount. That's part of insurance contracts with doctors and facilities - when they have a patient rate chart, it's usually just a touch above or at their reimbursement rates from insurance companies and/or medicare if they're a medicare provider too.

 

For the HIDA scan, call your insurance company to see what they'll reimburse (or what you'll owe since you need to pay the deductible first before they'll cover the rest 100%)....you'll pay their contract reimbursement rate, not the billed rate or the difference between billed and contract rate!

[mommaduck]

No kidding. The one my doctor wanted me to try is $57 a month. We're trying to treat PMS, and this one seems to be the most promising one so we're paying for it. We consider it essential because it affects the entire family.

 

 

 

You will still be able to see a doctor but you'll have to pay annual fines if you don't buy insurance. By 2016, that penalty for individuals will rise to $695 or 2.5% of income, whichever is greater. The penalty for families is $2,085.

When and how are these fines supposed to take place? We live in an area where there are many people that are opposed to health insurance and pay out of pocket. Happens all the time here, both with Anabaptists and others (like us). We don't have money to pay for insurance, we certainly don't have money to pay fines. BTW, the fine is lower than paying for insurance...so I guess a lot of people are going to be paying the government in fines instead of the ins co. in premiums. Basically, this is just another way for the government to screw us over something that people can't control.

Edited April 18, 2012 by mommaduck

[mommaduck]

In 2014, everyone must purchase health insurance or face a $695 annual fine. There are some exceptions for low-income people.

http://www.cbsnews.com/8301-503544_162-20000846-503544.html (I know it's old)

 

What are the exceptions for low-income people?

[mommaduck]

Finally found it http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=14

 

• Residents must confirm on their state income tax forms that they have insurance, unless their incomes are such that they are deemed unable to obtain "affordable" coverage. The affordability levels are set each year by a newly created, independent, quasi-governmental agency called the Commonwealth Health Insurance Connector. People with incomes below 150 percent of the federal poverty guideline (FPG), or $16,245 for a single individual in 2010, are considered to be unable to contribute anything towards premiums, so no penalty is imposed if they do not obtain coverage. A person whose income is 450 percent of poverty, or $54,600, is deemed to be able to afford an annual premium of $4,104 -- about 8 percent of income. Hardship waivers are available for people whose income is sufficient to pay for coverage but who have other pressing financial needs.

[goldberry]

I also understood that before the penalities go into effect, other provisions come into effect like allowing insurances exchanges to cross state lines. That is supposed to bring down the cost of the plans. The individual mandate should also bring down plan costs, because more people would be sharing in the pool.

 

It's not supposed to be just forcing you to purchase insurance at the CURRENT PRICES. It has several aspects that are meant to work together. Which is why if any part of it gets disallowed, the rest of it won't really work.

[LizzyBee]

The biggest thing we've foregone for the past 20 years is my dh's dental work. He's had maintenance appts and that's been a high priority due to the sorry state of his teeth, but he really needed major work that he says he wouldn't bother with now even if we could afford it.

[goldberry]

Finally found it http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=14

 

MommaD, I think the paragraph you quoted refers to the Massachusetts plan, not the federal plan.

[Cindy in FL.]

I was supposed to have an electrophysiology study done, but the cost was too high. I worry about it since it is heart related.

 

Cindy

[mama2cntrykids]

For my dh: Vascectomy:glare:. I really wish he could have it done, but right now, it is not going to work out. I am really done with having more kids and I don't want to have to worry about another anytime we're intimate. Other bc options don't work for us for various reasons.

 

For myself: Dental work. 'Nuff said:001_smile:.

[frugalmama]

Finally found it http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=14

 

And what are they going to do with those of us who don't FILE taxes? I'm unemployed, and don't make enough from odd jobs yearly to file.

 

For my dh: Vascectomy:glare:. I really wish he could have it done, but right now, it is not going to work out. I am really done with having more kids and I don't want to have to worry about another anytime we're intimate. Other bc options don't work for us for various reasons.

 

For myself: Dental work. 'Nuff said:001_smile:.

 

Check with your state programs - many will pay for a Vascectomy at no cost to you.

[goldberry]

Check with your state programs - many will pay for a Vascectomy at no cost to you.

 

DH had the V from a county health grant program. We normally wouldn't have qualified for the income guidelines, but they said no one was applying and they were easing the guidelines in order to award the money. (It was for male or female reproductive health.) They often have grant money for mammograms as well.

[mommaduck]

And what are they going to do with those of us who don't FILE taxes? I'm unemployed, and don't make enough from odd jobs yearly to file.

 

 

 

Check with your state programs - many will pay for a Vascectomy at no cost to you.

Our state has a women's health program where women can get a tubal if they need or want it.

[Mommy22alyns]

I need a root canal in one tooth. I also have some kind of rash on my legs that I can't get looked at. We're uninsured. I don't even remember the last time we had insurance. :sad:

[kroe1]

Many primary care physicians are offering concierge medicine. It seemed like a luxury, but we did the math anyway. By going with a very high deductible ($15,000) for private health insurance, and then paying for the concierge physician out of pocket, we saved a lot of money. I'm not sure this will work for everyone, but it is something to check into. We did make sure the concierge physician provided in-hospital care also which is included in the monthly fee.

 

We could be out a lot for lab or radiological costs if we ever need them. And, of course, a specialist is not covered until the high deductible is met. Nonetheless, we'll take our chances there.

 

It is very disheartening reading this thread. :001_huh:

 

:)

[JFSinIL]

New glasses. Five of the six of us wear glasses and/or contacts and our insurances does not cover exams or eye wear.

[SweetMissMagnolia]

not for cost really but for the hassle of it all....I need to find a new dentist-the lady who does the cleaning part of the dental visit where I've been going just gets on my nerves-she's rough and it seems like when I let her know it she gets more rough! :glare: so I stopped going in regularly (bad I know)......and I need to have a colonoscopy scope done but I just don't want to deal with that either....need to get it done by the end of the year.....a sister had colon cancer (removed-treated) and they want all the siblings to have scopes done.....UGH I don't wanna! :glare:

[Amy in NH]

 

I have difficult pregnancies but the waiting list means I don't get in to see my OB until around 18 weeks, sometimes later.

 

My experience has been that OBs in the US usually don't see patients until around 18 weeks.

[Amy in NH]

not for cost really but for the hassle of it all....I need to find a new dentist-the lady who does the cleaning part of the dental visit where I've been going just gets on my nerves-she's rough and it seems like when I let her know it she gets more rough! :glare: so I stopped going in regularly (bad I know)......and I need to have a colonoscopy scope done but I just don't want to deal with that either....need to get it done by the end of the year.....a sister had colon cancer (removed-treated) and they want all the siblings to have scopes done.....UGH I don't wanna! :glare:

 

Oh what a terrible problem - to have access to healthcare but just don't feel like dealing with it. :glare:

[frugalmama]

My experience has been that OBs in the US usually don't see patients until around 18 weeks.

 

Really? I was seen at 6 weeks with my dd

[momma2three]

My experience has been that OBs in the US usually don't see patients until around 18 weeks.

 

Wow, I don't think so. Most see you at 6-9 weeks.

[momma2three]

My insurance wants me to pay $1000 for an IUD.

[VeganCupcake]

My insurance wants me to pay $1000 for an IUD.

 

You can get a prescription for one from your doctor and order it from a Canadian mail order pharmacy for a lot less, and then have your doctor insert it--assuming your doctor would be willing to do that. Mine was.

[Julie Smith]

My experience has been that OBs in the US usually don't see patients until around 18 weeks.

 

I'm Canadian, (but a different province then the person who posted about trouble getting in to see a OB)

 

If I remember correctly I was always seen for the first time around 6 weeks. I can't remember now for sure. But I know it was way before 18 weeks.

[HappyCrazyMama]

We have decent medical but no dental or vision. I haven't been to the dentist for about 6 years, last time it had been two years and I was chastised because of my gum issues.:glare: The kids get dental and vision from the state so they are able to get their regular check-ups.

[LizzyBee]

My experience has been that OBs in the US usually don't see patients until around 18 weeks.

 

I was seen much earlier than that with all 3 of mine. IME the OB wants the first appt by about 8 wks.

[Bluegoat]

I'm Canadian, (but a different province then the person who posted about trouble getting in to see a OB)

 

If I remember correctly I was always seen for the first time around 6 weeks. I can't remember now for sure. But I know it was way before 18 weeks.

 

I'm in NS. The doctors I saw during pregnancy - who were GPs - would have seen me at nine weeks but said it really wasn't necessary until 15 or so unless there was a problem.

 

It is really just a matter of where there are shortages of particular kinds of doctors, and that isn't a particularly Canadian thing. IIRC it is very difficult to see a neurosurgeon in Florida because the insurance rates for them to practice there are very expensive, and there are a lot of old people who need brain surgery.

 

Wait times for doctors aren't always about funding - there are a lot of other factors involved.

[PeacefulChaos]

My experience has been that OBs in the US usually don't see patients until around 18 weeks.

 

No way. 6-10 weeks for everyone I can think of - all different areas of the US.

[housedress]

Dental for myself and husband and I only take the kids once a year.

[*lifeoftheparty*]

My experience has been that OBs in the US usually don't see patients until around 18 weeks.

 

Mine sees patients when they are 8-10 weeks and every 4 weeks or so after that. Then as you get closer it's every two weeks, then every week, etc.