Saturday, November 16, 2013
The reality of living with a high deductible medical insurance plan and a health savings account
I also placed a call into my Allergy-Asthma-Immunologist who I saw in early October for my annual visit, and a concern over a lingering cough from a recent cold. He felt it was GERD flaring up, advised me to take a month of Prevacid, see what happens and call if the cough remains. Still coughing, and I use RX nasal sprays to combat allergies so just what is this? Calling avoids a MD visit and he simply called in a generic antibiotic, suspecting that this is a sinus infection just lingering, causing post nasal drip and therefor the cough. If the meds don't help after a week, I am to call again and see him for a visit. Fine. The bulk of my MD's follow this protocol, saving me time and ultimately $. Again, we hit the deductible, the RX cost me $0.
I also am a very compliant patient. I see some of the best MD's in the country, I am fortunate, as well as selective. I resent the practice of forcing a patient to see a PA before seeing the MD. While I understand that this can free up the MD's time to see more patients, the insurance company pays the same amount regardless of who I see in the practice. I recently had a follow up visit with an orthopedist I know very well, after having a MRI. In walks the nice PA. Great guy, well educated, personable. I politely, yet firmly, insisted on speaking with my DOCTOR who I saw just the week before. I am paying to see HIM, not the PA. Bottom line, I remain assertive when it comes to my medical care. So while the PA gave me the "update" on the MRI results as well as some possible treatments, I insisted on speaking with the orthopedist, who I am paying to consult with me on my medical care. When I called my gastro MD yesterday, I spoke with the nurse and explained that the orthopedist asked me to consult with the gastro Doc before starting the course of Advil. She got back to me a while later, told me what to do and mentioned that it's been a while since I saw gastro guy (been focusing on orthopedic issues the past few years) and would I make an appointment? Sure, she patched me through to scheduling, who insisted that I first see the PA. I explained that the last time they did that in this practice, I had to insist while at the appointment, to see my gastro MD as the advice of the PA was totally opposite what the MD had me doing. She complied, the MD came in and confirmed that I should continue doing as he had been advising me to. @@ Sigh. Apparently that PA is "no longer associated with the practice" but there is a new one. Hmmm . .I made an upcoming appointment, but have absolutely no reservations about asking to see the DOCTOR who is the one who said to come in and see HIM. Anyway . .
I am addressing medical concerns as cost effectively as possible:
-using in plan facilities, doctors
-selecting generic meds,both prescriptive as well as over the counter
-using mail order for our maintenance meds and being sure to renew them just prior to the end of June to max out this "freebie"
-making medical appointments now (before the June end of fiscal year) to address medical ailments, especially what I would characterize as "less serious/urgent" such as an appointment with the dermatologist. I do have some dermatological concerns which will be covered in full by insurance, including medications. I will also have some treatments of a more cosmetic nature. Getting costs ahead of time, and knowing what they will be, will guide my ability to use the funds in the HSA to cover these additional charges. I am able to deposit lump sums, if needed, into my HSA to cover these extra costs (up to an additional $2500/year) I will once again start July 1 with $2000 from my employer. Any charges beyond that cost for upcoming procedures/therapy/meds this Summer, will be worked out for a payment plan starting Sept.
-besides the orthopedic issues I am addressing, the next 6 months will find me at the dermatologist, dentist, gastroenterologist, a new internist (yet to be determined as my former one is now retired) for a physical, my gynocologist, as well as handling some routine medical tests such as mammography, colonosccopy now that I've hit the magic 50. I am also anticipating additional surgery on my hand, come Spring, which will be again followed by weeks of OT at the rehab center. Knowing this, I can anticipate once again, quickly maxing out the $4000 deductible in the Summer of '14, thereby placing us in the position we are in now, with medical expenses being fully covered, if in plan.
It's been an interesting ride so far, a definate adjustment but I think I've got a good handle on it.