Wednesday, October 29, 2014

Medical update


Living with a high deductible, health insurance plan has been an interesting ride. As of Sept 1, we are now in year 2 of a 3 year contract. Due to life events, we quickly blew through our family deductible of $4000 in 3 weeks. So from now until Aug 31st 2015, all of our in network expenses will be paid at 100% and out of network at 80% of reasonable and customary. Phew! So as the EOB's come finally rolling in (had to complain thru my Union that the ins company was no acting on any charges since the end of Aug, leaving all charges for this new plan year, unpaid with bills coming home), we can let the dust settle and figure out how to pay off these expenses. Luckily, my employer puts in $2000 into my HSA, and bi-monthly I add $150, planning on having $5000 total there this year, along with the monies that carried over from last year. My experience has been that hospitals will work out a payment plan with you, at no charge. Dr's can be a different story. Having a cushion already in my HSA helps us to quickly address any outstanding charges that we are financially responsible for.

So, this past week, once the new charges (for these past 2 months) were processed, I was then able to submit our maintenance medications thru mail order drug, purchase DD's RX at CVS-all at no charge to us. I also have made some additional medical appointments with a list of more calls to made for even more in the near future to addresss some concerns. One item: getting a new MRI on the right shoulder that I had repaired from a bad fall almost a year ago (the fall) and surgery at the end of Jan, 2014. My shoulder "clicks" which isn't right. I am not in pain, but then again, I have a high pain tolerance. So, to rule things out-the surgeon agreed that this is prudent. I have a MRI scheduled for tomorrow, and will see my surgeon on Mon to review results. In Jan, he was supposed to repair part of my bicept but decided not to, once he got in there. As I told my surgeon, "Medicine is both an art and a science. "  He is an awesome Dr, I am very happy with his treatment, this is what it is, and I'm pursuing this issue. He suspects that I'll need what is called a tenodesis  ( At this point, he says that there is no rush. I am hopeful to wait until Summer, should surgery be required.

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