A vent (health insurance related) JAWM

[cintinative]

I know my family is blessed to even have health insurance.  All four of us have an autoimmune disease of one kind or another. Also, my husband has had cancer.  

That said, when we got our latest numbers from my husband's company for the cost of our insurance, I wanted to cry. I just feel like we are never going to be able to save the way we need to because of medical care.  Our options are basically $500 a month with an $8000 family deductible or $370 a month with an $11,000 family deductible. To give you some perspective, because of all of our health issues, we will easily spend the $8K.  I am not 100% on the $11K.  Presently we have $20 in our HSA so we are not going to be rolling over anything. The IRS only allows a certain amount to be contributed to the HSA account, and our current family deductible is $7K. I forget the IRS amount, but it is at least $1K below that.  

Anyway, I guess this is a JAWM. On the one hand, I feel like I am whining. At least we have health care insurance.  At least we are all alive and relatively healthy.  On the other hand, the way our health care costs keep increasing each year (I am not 100% on the number but the deductible has gone up on average $1K a year), I get sort of overwhelmed by it all.

I know some of  you are self-insured and are in much worse situations (or can't afford insurance at all). I don't want to belittle your experience at all. I know many of you struggle a lot with your medical bills.  My heart goes out to you. I don't know what we would do if we had no insurance at all.  We just had a discussion of how much we would have to pay for COBRA if my husband lost his job.  It's crazy.  

[fairfarmhand]

I am so sorry. My family has excellent insurance and I feel so very bad for those who have to choose between saving for the future and medical expenses. 

We recently lost a family member to prostate cancer. Partly the reasons he didn’t have it treated early was because of money. Heath care costs are awful. 

[cintinative]

3 minutes ago, Arctic Mama said:

My gut would be to go with the smaller deductible and higher monthly cost, so if you have anything big but expensive that you can shuffle off to November or December that is an option.  So far we have pushed glasses, dental, special needs equipment, hearing aids, and medical tests for me to the end of the year when our deductible is already filled and thus taken some budgetary pressure off ourselves.  If we had the lower monthly cost but higher deductible we wouldn’t have been able to do that, and an extra $150 in the budget each month would be nice but not an appreciable enough difference to offset the benefit of a lower deductible, overall, for us.

 

We sort of feel like we don't have a choice but to do the smaller deductible. I am not sure the other one works better for us from a tax perspective. Less of the total cost is tax deductible because the HSA contribution is capped.  I haven't worked it out on paper though.

Mostly what is killing us is the yearly MRIs I have to get and my husband's CTs, plus my eldest's Celiac panel.  Asthma medication is crazy expensive, but kills you bit by bit instead of all at one time.  LOL. 

[moonflower]

It is so expensive.  We don't have chronic health conditions and so have only carried catastrophic for years because the premium plus deductible on any plan is 10x what we pay just buying health care OOP through the year.  

[klmama]

I didn't realize people could still buy just catastrophic care insurance. I'm glad that's still an option.

[historically accurate]

Hugs to you! Ironically, health insurance often makes my head (and pocketbook) hurt.

 

[HS Mom in NC]

We've bought our own insurance since 2012.  I don't feel belittled by your reaction, I feel sympathetic to your situation.

[Faith-manor]

Hugs to you! I hate our system. Hate it. 

I am so sorry. 

[scholastica]

You are not alone and you are not whining. Somehow, the insurance companies got us all to agree to pay them premiums and pay for most of our own care at the same time. Just so you know, the HSA limit for a family next year is $7,000. So you should be able to put your whole deductible in there. 

[Guest]

I hear you on that, 100%. I was the one with the freak-out last year because our premium was increasing by over $700/month. Per month! And we already were paying (don’t remember precisely) around $1,700. So we managed to get in on a group and pay $1,500/mth. It is increasing 9% for the coming year, though. 

I totally understand the tension between being grateful to have it but frustrated at how it works and how much it costs. With all the cancer bills coming in, I am grateful it is there, and grateful it is a “good” coverage plan. But still...

Health insurance is the number-one reason - and there aren’t many other reasons - why I am considering going to FT employment next year. I would like to give my family the gift of health benefits without having to pay 18,000+/yr out of our small business. 

[lulalu]

I have been dealing with insurance and the clinic for 2 months now. I honestly think it would be easier to have no insurance and just make a payment plan for all the appointments dh has with his health issues. 

Dh right now should be in the hospital, but with all the hassle we have had we are taking care of what we can at home. Not the first time this has happened so I kind of know what to do. Praying it all goes well. We just can't afford anymore. So yep we have insurance, but it really is of no use. 

[cintinative]

1 hour ago, scholastica said:

You are not alone and you are not whining. Somehow, the insurance companies got us all to agree to pay them premiums and pay for most of our own care at the same time. Just so you know, the HSA limit for a family next year is $7,000. So you should be able to put your whole deductible in there. 

Our deductible this year is $7K but next year if we choose the more expensive plan, it will be $8K. =(

 

[ktgrok]

I think our family deductible is 3K, and we pay over 1K a month. Ugh, I feel you. 

[J-rap]

I hear ya!  We're luck in that our monthly premium is paid for, but our family out-of-pocket deductible is still $14,000, and each member deductible is $6,500.  We always reach the family deductible because of ongoing health problems.  Ugh.

[fairfarmhand]

1 hour ago, Quill said:

I hear you on that, 100%. I was the one with the freak-out last year because our premium was increasing by over $700/month. Per month! And we already were paying (don’t remember precisely) around $1,700. So we managed to get in on a group and pay $1,500/mth. It is increasing 9% for the coming year, though. 

I totally understand the tension between being grateful to have it but frustrated at how it works and how much it costs. With all the cancer bills coming in, I am grateful it is there, and grateful it is a “good” coverage plan. But still...

Health insurance is the number-one reason - and there aren’t many other reasons - why I am considering going to FT employment next year. I would like to give my family the gift of health benefits without having to pay 18,000+/yr out of our small business. 

I know many many women in this exact same position.

[Kassia]

2 hours ago, fairfarmhand said:

 

We recently lost a family member to prostate cancer. Partly the reasons he didn’t have it treated early was because of money. Heath care costs are awful. 

 

That is so sad.  We are in a similar situation.  Last year, I avoided going to the ER when I had a life-threatening condition because I was afraid of the cost and I wasn't absolutely certain it was life-threatening.  I waited 12 hours before going and was incredibly fortunate to not have any lasting damage or worse.  I am certain DH wouldn't go to the ER or even the doctor if he suspected anything was wrong with him until it was too late because of the expense.  High deductible, high premiums - we pay a ton for medical care and are afraid to use it.  Absolutely awful.

[mommyoffive]

2 hours ago, Kassia said:

 

That is so sad.  We are in a similar situation.  Last year, I avoided going to the ER when I had a life-threatening condition because I was afraid of the cost and I wasn't absolutely certain it was life-threatening.  I waited 12 hours before going and was incredibly fortunate to not have any lasting damage or worse.  I am certain DH wouldn't go to the ER or even the doctor if he suspected anything was wrong with him until it was too late because of the expense.  High deductible, high premiums - we pay a ton for medical care and are afraid to use it.  Absolutely awful.

 

That is so horribly sad.  I do think about it too when something comes up.  Is this serious because I know the bills will be huge. 

 

I just went over this for our family and I wanted to choose the cheaper HSA version but we went with the expensive route.   It is insane that you have to decide this.  How can you see the future? 

 

 

Edited December 3, 2018 by mommyoffive

[redheadmom]

So we do this every year when our options are available... I add up the total premium and out of pocket max to see which one is the cheapest overall.    For your 2 examples the $500 a month one is around $480 a year cheaper overall.    We always max out our deductible every year due to my health conditions.  I basically only see specialists and take expensive medicine - lucky me.    I wish healthcare were a more affordable option for everyone .

[ktgrok]

Husband just got some info on a possible new job, and although the job itself isn't much better than what he has, the insurance would cost HALF as much. He may change jobs just for that. 

[Mbelle]

It is terrible.  

With auto immune issues in our own family we are also paying a ton with high deductible.  Currently it's $1750 a month and we both have to take meds which are not covered.  It is defeating.

I just looked at a part time job with the school system, but now they have outsourced to a company and you have to work for 1 year before you get insurance, and that insurance is not even as good as it used to be.  

Good news is there are 2 jobs recruiting dh and one of them has great insurance and the other is at least better than what we are doing right now.  

I feel like we make a lot of decisions about work and finances and health based on paying health insurance. 

 

[cintinative]

1 hour ago, Ktgrok said:

Husband just got some info on a possible new job, and although the job itself isn't much better than what he has, the insurance would cost HALF as much. He may change jobs just for that. 

 

My husband sent an email to his boss asking if he realized that the premium employees will be paying for this coming year is 63% higher than the current year.  They subcontract out their HR and they used a benefits broker. I am not sure how aware the company leadership is of the change because in the benefits meeting the increase was not mentioned and last year's numbers were not provided for reference. They have lost a number of employees lately for other reasons--I wonder what impact this will have.

Edited December 3, 2018 by cintinative

[cintinative]

11 minutes ago, Mbelle said:

It is terrible.  

With auto immune issues in our own family we are also paying a ton with high deductible.  Currently it's $1750 a month and we both have to take meds which are not covered.  It is defeating.

 

 

I am so sorry.  The meds part is scary to me--for awhile they thought I might have MS and I know some people who have had to fight to get their medication covered for MS. It's tens of thousands of dollars.  My husband's autoimmune(s?) don't appear to be active right now. I can't imagine what our bills will be like when they are active. 

I hope you don't mind me asking--do you bother to itemize your additional medical costs (over and above insurance) on your taxes? I know it has to be over a certain percentage of your gross income. When we looked at it before about five years ago, it didn't seem possible to reach it, but now it sort of does. 

[fairfarmhand]

1 hour ago, Ktgrok said:

Husband just got some info on a possible new job, and although the job itself isn't much better than what he has, the insurance would cost HALF as much. He may change jobs just for that. 

My dh works at a much lower paying job but the insurance more than makes up for the gap in what private sector could pay.

[zimom]

I am so sorry and totally understand.  Just opened up a bill for over $2000 for anesthesia alone for my second surgery of the year.  This is after we paid our deductible as they are 'out of network'.  I see many phone calls in my future.   

[Mbelle]

19 hours ago, cintinative said:

 

I am so sorry.  The meds part is scary to me--for awhile they thought I might have MS and I know some people who have had to fight to get their medication covered for MS. It's tens of thousands of dollars.  My husband's autoimmune(s?) don't appear to be active right now. I can't imagine what our bills will be like when they are active. 

I hope you don't mind me asking--do you bother to itemize your additional medical costs (over and above insurance) on your taxes? I know it has to be over a certain percentage of your gross income. When we looked at it before about five years ago, it didn't seem possible to reach it, but now it sort of does. 

We have not done it in the past, but may be doing that this year.  It hasn't seemed possible to reach ii before, but like you now it sort of does.

Looking at an outpatient surgery this week.  Complications and side effect of dh autoimmune. 

Edited December 4, 2018 by Mbelle

[cintinative]

18 minutes ago, HeighHo said:

 

Have you re-evaluated the need for the MRI and CTs?  I have found some providers have more experience than others, and can show the data to me as far as the determination of frequency of the need and the time frame the need might be expected.  No need to share anything personally, just pointing out that there may be an update that a local physician is unaware of, but a big city specialist may be aware of.   

Also, price varies a lot for MRI and CT. Sometimes its worth it to travel overnight.

 

That makes sense.

In a few years, I will not need the MRIs anymore. 

We live in a big city, and the specialists are ordering the MRIs and CTs. 😃  We might be able to postpone the MRIs but cannot cancel them--the condition I have is relatively newly understood and they don't have a lot of clinical data for the first five years. 

My husband must have the CTs as part of his cancer follow up and to check on his Sarcoidosis. Probably in a couple years both of us will be on a much reduced schedule for these. We just got hit with medical stuff at the same time.  😃 

[cintinative]

2 hours ago, HeighHo said:

 

Cancer is one condition where CTs must be questioned as to necessity and frequency.  Some of the cancers will show up with other symptoms well before they are big enough to show on a CT scan.  Again, no need to get personal...just get that second opinion if you already hit your oop max for this year.

 

I'm not familiar with the standards for other cancers. Our particular scenario is kidney cancer. They wouldn't have found it at all if it hadn't been for an MRI of his abdomen to find out what was causing pain. They saw something on the kidney and decided to remove it to be safe, and it turned out to be cancer. Kidney cancer is one that doesn't usually show up (symptom-wise) until it is advanced stage. The pain wasn't related to the cancer at all (we still don't know the cause actually).  So we were very blessed they found it when they did.  Unfortunately that also means we are not in a scenario where CTs are not medically necessary.  If they had removed the entire kidney, perhaps, but they didn't think it was cancer so they only removed part of his kidney. The margin wasn't clear, so there is a very small chance that it will come back.  

[Pawz4me]

1 hour ago, cintinative said:

 

I'm not familiar with the standards for other cancers. Our particular scenario is kidney cancer. They wouldn't have found it at all if it hadn't been for an MRI of his abdomen to find out what was causing pain. They saw something on the kidney and decided to remove it to be safe, and it turned out to be cancer. Kidney cancer is one that doesn't usually show up (symptom-wise) until it is advanced stage. The pain wasn't related to the cancer at all (we still don't know the cause actually).  So we were very blessed they found it when they did.  Unfortunately that also means we are not in a scenario where CTs are not medically necessary.  If they had removed the entire kidney, perhaps, but they didn't think it was cancer so they only removed part of his kidney. The margin wasn't clear, so there is a very small chance that it will come back.  

My DH's kidney cancer had already spread before he developed symptoms and then it was found on a CT scan. So unfortunately we can only wish that he'd had a reason to have a scan earlier. I'm so glad it was a different scenario for your DH, and I hope he continues to get clean scans!

While I agree that one should discuss the timing of scans (or any other tests) with ones own doctor . . . in general I think it's absolutely horrific to randomly advise that cancer patients *must* question the frequency/need for scans. It kind of boggles my mind that anyone would have the hubris to do that.

Edited December 5, 2018 by Pawz4me

[SamanthaCarter]

With some of you saying monthly premiums are costing you over $1,000/mo, I don’t know how you can save for retirement. We pay a lot less and we cannot save for retirement. There’s just nothing left. It takes everything to get to the next paycheck. 

[Mbelle]

25 minutes ago, SamanthaCarter said:

With some of you saying monthly premiums are costing you over $1,000/mo, I don’t know how you can save for retirement. We pay a lot less and we cannot save for retirement. There’s just nothing left. It takes everything to get to the next paycheck. 

Right now we can not.

Currently dh is looking for a job with good insurance.  Hopefully he somewhat likes the job.  

edited: dh does a side business, but the business has ups and downs, so we save that money for overflow.

Edited December 5, 2018 by Mbelle

[cintinative]

52 minutes ago, Pawz4me said:

My DH's kidney cancer had already spread before he developed symptoms and then it was found on a CT scan. So unfortunately we can only wish that he'd had a reason to have a scan earlier. I'm so glad it was a different scenario for your DH, and I hope he continues to get clean scans!

 

I'm so sorry about your dh! Were they able to treat his cancer effectively?  

[Pawz4me]

2 minutes ago, cintinative said:

 

I'm so sorry about your dh! Were they able to treat his cancer effectively?  

He's stage IV, so he'll be on some sort of treatment for . . as long as he can. So far he's only been on one drug (a TKI/targeted drug) and it's kept him stable for a year. When he needs to move on to something else we'll probably go with one of the immuno-therapy combos. It's a bad cancer to have since it doesn't respond to chemo or radiation, but there's been an explosion of new treatments approved just in the last year, and quite a few more are in the pipeline. The immuno-therapy he'd probably move to--which is now pretty much the standard first line treatment--wasn't even an approved treatment this time last year. So . . we try to take things one day at at time and hope for the best, knowing he has lots of possible lines of treatment.

[cintinative]

23 minutes ago, Pawz4me said:

He's stage IV, so he'll be on some sort of treatment for . . as long as he can. So far he's only been on one drug (a TKI/targeted drug) and it's kept him stable for a year. When he needs to move on to something else we'll probably go with one of the immuno-therapy combos. It's a bad cancer to have since it doesn't respond to chemo or radiation, but there's been an explosion of new treatments approved just in the last year, and quite a few more are in the pipeline. The immuno-therapy he'd probably move to--which is now pretty much the standard first line treatment--wasn't even an approved treatment this time last year. So . . we try to take things one day at at time and hope for the best, knowing he has lots of possible lines of treatment.

Oh, I am SO sorry. What a hard road you are on.  I wish you all didn't have to carry such a burden. Prayers for you.