Saturday, October 8, 2016

Monitoring our deductible


Our new medical insurance plan year was effective September 1. We planned ahead as much as possible:

-all known medical needs (appointments, tests, RX renewals etc) were addressed by the end of August, as we had already met last year's deductibles so costs were free to us as long as we remained in plan
-I intentionally funded 1/3 of my HSA to cover the new deductible plan. My employer (technically still employed by them) furnished 1/3, and I had 1/6 of a balance previously remaining. I intend to add the additional 1/6 come Jan 15th as there are Federal limits as to how much I can put in there. These funds, unlike a FLEX account, stay with me, I will never lose them.

That said, we've had medical expenses:
-I was put on a new RX, bought at a local pharmacy
-I subsequently mail ordered a 3 month supply, saving 1 month's worth of costs (cheap RX anyway)
-I've been to my Rhumatologist twice
-DD saw her Gastroenterologist and her Rhumatologist, soon returning to both
-DD had an $$ procedure done at the local hospital, to the tune of over $2200-that's on her, although I will pay it off, she will reimburse me. That's our arrangement
-DS # 3 has seen the Pediatritian twice, and bought 2 RX-costs are on him as well
-I had my annual physical, no cost, thankfully, as well care annual physicals are free
-2 of us have gotten flu shots at the local pharmacy, again well care, no cost
-DS has received his special therapies at the local hospital, luckily, we have resources to cover them
-I have had 2 weekly allergy shots, more to follow

We need to hit $4000 in expenses to be considered as having hit the first of 2 deductibles. During this time, we are responsible for all costs, which continue to be charged at the inplan, somewhat reduced rate, fortunately.  I anticiapte that we will hit this deductible by the end of October.

What happens next: we have a second deductible to hit: another $2000 of medical costs. This second time, however, requires that we only* pay 10% (if in plan) of costs until the $2000 in OOP costs are incurred. So instead of owing $170 per Rhumatologist visit, it will be a much more manageable $17. This also means that it will be some time before that second deductible is met, yet I do anticipate that we will meet it sometime before March 31st of 2017, as I have calculated known RX expenses, therapeutic expenses at 10% of costs charged, per month. It will take 5 months to meet that second deductible at the latest. Knowing these figures, I fully fund the maxiumum of the 2 deductibles, as I know that that is the sum I could be liable for. These are pretax dollars, set aside so my monthly budget is based on take home (althought currenlty using anticpated retirement earnings which are roughly 52 % of current income).

I do know that this is most likely going to happen much sooner: we already have 7 medical appointments scheduled within this time frame, most likely, more will be added.

So, I continue to monitor our status of the deductible. I have set aside the funds to cover meeting both deductibles, minimizing the impact on our monthly budget. The only additional medical costs I anticipate, which do not go thru insurance would be my vitamins, which are medically required not a personal choice. I am able to deduct those costs from my HSA (health savings account),where I intentionally keep a slush fund. Things like first aid supplies, topical eczyma creams etc can also be charged against it.


Florence said...

It sure adds up fast!

saraband said...

The complications of your medical system make me very thankful for our National Health Service in the UK!

CTMOM said...

Saraband, and I have "good" insurance, thru my employer.

meme said...

I dont have a deductible on my insurance plan, so I feel lucky. Appointments can be so expensive. You have a great financial plan to deal with it all.