As mentioned, we have just a few weeks left on this year's health insurance plan before the new year starts and we have met both of our deductibles to date, so everything, as long as we use in plan providers, is $0 OOP.
I recently returned to my Dermatologist for what I strongly suspected was Psoriasis. He stated that it's either Eczyma (I already was diagnosed with this years ago, mostly on my hands, feet, undeside of the upper arms)or Psoriasis-the treatment would be the same.
My Dad was plagued with Psoriasis, I actually was the one who would put his salve on, which was needed on 90% of his body. He had it so bad, he was told that he could retire under disability. Due to his work ethic/mind set, that was not an option. What I have developed on my elbows is not eczyma, I am very familiar with plaque Psoriasis, that is what I have. MD prescribed a RX cortizone, which he gave me a sample for, as well as a sample for an expensive OTC urea moisturizer cream, which he also gave to me as samples. I left the MD's office with him telling me to use the creams for 7-10 days, it'll clear right up. I actually used it 14 days, and while it helped, it is not cleared up. Again, not a surprise when dealing with Psoriasis.
I called the MD's office after the 14 days and spoke with a nurse. Per my conversation during the appointment, I was to call in for a RX, should I need more that the samples provided. I had the nurse call in a RX for the topical cortizone. They filled a generic. OOP cost to me was $0, normally I would pay $5/$25/$40 for a one month supply at the retail pharmacy. If I had ordered something thru mail order pharmacy, I'd save 1/2 a month's worth of co-pay charges, if my deductible had not yet been met, this was an incentive to use the mail order service. I can see that the RX cleared my insurance. Cost for the generic ointment: $278! Egads! So glad that I got it now.
Effective Sept 1, we pay 100% of everything (MD's, RX, test, etc) until we hit the first $4000 deductible for a combinatin of RX and medical expenses. Then, a second deductible comes in to play, with us paying 10% of Rx or medical costs if in plan and 30% if out of plan until we hit the $6000 total OOP deductible, then the insurance will cover everything at 100%. We always aim to use in plan services.
Meanwhile, I am topping up whatever RX's I can, advising the kids to do the same. Ditto any medical appointments. DD is addressing some gastro issues and will need a gastro MRI but it's only done at the local hospital (none of the ancillary MRI places do it), limiting her ability to attend to it before the new plan year. She has a date for Sept, but was told to call daily for a cancellation. I anticipate it being very costly, to the tune of over $1000. Even a $100 medical bill is hard for her to handle, as she works retail while paying off college loans. Luckily, she just finished paying off the bank of Mom for her car, increasing her disposable cash to $200 a month.