Is anyone else on a deductible insurance plan?

[pantsparty]

I'm really frustrated with mine. I don't have a regular doctor and thought I found one earlier this year. I went in for a standard doctor's visit. No bloodwork or anything like that. Later on I get a bill for $140 - WTF.

So I call my insurance company and say, "How am I supposed to know what a bill is going to look like?" They tell me when I call a doctor's office, I need to ask for their billing code and tax ID and then call the insurance company back.

This sounds fucking insane to me - are they not the insurance company? They can't tell me what the cost of a standard doctor's visit looks like?

I need to go to the doctor but I've been putting it off for a long time because I don't want to go through this process.

I'm just wondering if anyone else on a deductible plan goes through this. I just really can't fathom paying $140 for each standard doctor's visit. I mean, I got a ROOT CANAL earlier this year that was about $230 out of pocket. WITAF!

[mel]

I had a high deductible plan when I started my current job 4 years ago. I HATED it. It was always a guessing game what the bill was going to be. The ONLY nice thing was the HSA associated with it. Last year, my employer offered a traditional copay plan and I couldn't jump on it fast enough. I love knowing exactly what I'm responsible for each time I go to the doctor.

[wambam]

My insurance company told me they wouldn’t know the final cost of my surgery until THE DAY OF SURGERY. I knew that it would likely be the rest of my deductible so I was prepared for that. But yeah, it’s ridiculous.

[pantsparty]

Nov 28, 2018 10:20:07 GMT -5 mel said:

I had a high deductible plan when I started my current job 4 years ago. I HATED it. It was always a guessing game what the bill was going to be. The ONLY nice thing was the HSA associated with it. Last year, my employer offered a traditional copay plan and I couldn't jump on it fast enough. I love knowing exactly what I'm responsible for each time I go to the doctor.

I do have an HSA and I like that. But the rest of it seems like utter bullshit.

[whitemerlot]

Yes. We have a HDHP and it’s always a surprise what a visit costs. It’s generally $145-$175 for an office visit, but my h paid $300 for a rheumatologist quarterly check in and that doesn’t include the labs he paid for. The next time the same appointment was $215 plus labs, so it may have been the first appointment of the calendar year was more! Who knows.

ETA: I try to go to minute clinic for minor things.

[mel]

Nov 28, 2018 10:25:58 GMT -5 pantsparty said:

Nov 28, 2018 10:20:07 GMT -5 mel said:

I had a high deductible plan when I started my current job 4 years ago. I HATED it. It was always a guessing game what the bill was going to be. The ONLY nice thing was the HSA associated with it. Last year, my employer offered a traditional copay plan and I couldn't jump on it fast enough. I love knowing exactly what I'm responsible for each time I go to the doctor.

I do have an HSA and I like that. But the rest of it seems like utter bullshit.

It is. 

[puppylove64]

Yes I had one and I actually liked it. I never go to the dr for much of anything. Preventative was supposed to be free, so I only went for annual checkup type stuff. If I was really sick, I usually go to the Kroger clinic and it isn’t too bad. Plus that is why you are putting the money in the hsa, to cover those rare pricey sick moments.

[pantsparty]

Nov 28, 2018 10:27:47 GMT -5 whitemerlot said:

Yes. We have a HDHP and it’s always a surprise what a visit costs. It’s generally $145-$175 for an office visit, but my h paid $300 for a rheumatologist quarterly check in and that doesn’t include the labs he paid for. The next time the same appointment was $215 plus labs, so it may have been the first appointment of the calendar year was more! Who knows.

ETA: I try to go to minute clinic for minor things.

I keep thinking what if we had kids? We can afford this, but I can't imagine how families afford this with how frequently kids get sick.

I've never been to a minute clinic, I will have to look those up.

[gummy]

They can't tell you because they're is literally no standard amount. Which is insane and frustrating. Office visits have a range of levels depending on the issues you present with and the level of care that goes into treating you and there is literally no way to predict how your visit will go until you're there.

Same goes for Wambam's surgery. You may go in for X but once they get in there they end up doing X,Y & Z. Hospitals and clinics don't want to quote someone a price they can't guarantee.

ETA: At my old clinic we could give a range of $120-400 for the office visit alone not including any lab work, radiology or further testing.

[bittybomb]

Yes. Unless its coded as a preventative visit, we pay insanely high bills.  

I was watching CBS This Morning, and they actually did a piece on this just this morning - how ridiculous it is in our country versus elsewhere.  

[bittybomb]

Also - we contribute to an HSA and I will make payments on bigger bills using the HSA funds so its not a hit all at once.

[revolution]

I'm not a fan. We have an HSA and use it. But when the kids get sick, or we get sick, I'm kinda like.... let's see if it is viral and then decide if a dr visit is really necessary for $140.

And schools here won't excuse an absence unless there is a doctors note. SO, if I keep a kid home for a fever and viral nonsense, I send a note in that the kid was home sick, it is unexcused. WHAT?? The only way to excuse is an actual doctors note. So - pay $140 to have a dr tell me my kid has a viral infection and get a school note so it is excused and drag said sick kid out of the house into the public, or have an unexcused absense?

[kadams767]

Nov 28, 2018 10:25:58 GMT -5 pantsparty said:

Nov 28, 2018 10:20:07 GMT -5 mel said:

I had a high deductible plan when I started my current job 4 years ago. I HATED it. It was always a guessing game what the bill was going to be. The ONLY nice thing was the HSA associated with it. Last year, my employer offered a traditional copay plan and I couldn't jump on it fast enough. I love knowing exactly what I'm responsible for each time I go to the doctor.

I do have an HSA and I like that. But the rest of it seems like utter bullshit.

I don't mean to be flippant, but you kind of get used to it.  Obviously it is very situation-dependent, but in the long run having the HDHP with an HSA has worked out very well for me.  I've been on one for years, though, so I am used to paying for my visits and I know the general range I am looking at for things like a checkup, a sick visit, extra bloodwork, and my eye exam because those are things I do every year.  But yes, the office never knows the exact amount, so they have me pay a round number at the time of the visit, say $100 and then I either get a bill for the remainder or get a refund check from them for something silly like $6.51.  

The savings in monthly premium costs between this and the HMO that is offered greatly outweighs anything I've paid over the years.  

[msmerymac]

Yup! If it makes you feel better, the initial appointment is more expensive than follow up appointments.

My first appointment with a new doctor while on a high-deductible plan was about that much. When I called later for something (I think wanting to renew a prescription or something) they called back and said, "well, the doctor would really like you to come in so he can see you." Okay, but how about I don't want to because I don't want to pay for it. I asked, "Okay, well how much will that appointment be? Because I'm not thrilled with the idea of paying another $180 or whatever." They were kind of floored. The office person was like, "I have no idea. You'll have to talk to your insurance company."

So yeah. Insurance in the US. Completely ridiculous.

I actually agree with one thing the right/capitalists/Republicans have mentioned, which is more transparency with pricing up front. Never would you walk in to buy a good or service and agree to it before you actually knew how much you were going to pay in any other scenario in a capitalist society. But with insurance, first, everyone pays something different, and second, no one actually knows what that will be.

The nice thing about a high-deductible plan, though, is being able to put money for medical bills in an HSA, so that cost was a little less painful. My H's new company also puts $1k/year in his HSA for them.

[mel]

Nov 28, 2018 10:51:16 GMT -5 pantsparty said:

Nov 28, 2018 10:27:47 GMT -5 whitemerlot said:

Yes. We have a HDHP and it’s always a surprise what a visit costs. It’s generally $145-$175 for an office visit, but my h paid $300 for a rheumatologist quarterly check in and that doesn’t include the labs he paid for. The next time the same appointment was $215 plus labs, so it may have been the first appointment of the calendar year was more! Who knows.

ETA: I try to go to minute clinic for minor things.

I keep thinking what if we had kids? We can afford this, but I can't imagine how families afford this with how frequently kids get sick.

I've never been to a minute clinic, I will have to look those up.

Kids is precisely the reason I couldn't wait to get back on a standard copay plan. And this year I had a kid in the ER for a baseball bat to the mouth (which required stitches) the other kid in the ER with a broken nose from an errant throw in baseball (which required surgery 2 weeks later). I paid just over $5,000 OOP for both of those incidents with my standard copay plan. I can't imagine what it would have been with the high deductible plan. With the high deductible plan, I felt like wrapping my kids up in bubble wrap to avoid costly ER visits.

[mel]

Nov 28, 2018 10:56:06 GMT -5 revolution said:

I'm not a fan. We have an HSA and use it. But when the kids get sick, or we get sick, I'm kinda like.... let's see if it is viral and then decide if a dr visit is really necessary for $140.

And schools here won't excuse an absence unless there is a doctors note. SO, if I keep a kid home for a fever and viral nonsense, I send a note in that the kid was home sick, it is unexcused. WHAT?? The only way to excuse is an actual doctors note. So - pay $140 to have a dr tell me my kid has a viral infection and get a school note so it is excused and drag said sick kid out of the house into the public, or have an unexcused absense?

The bolded is another reason why I hated the HD plan. 

[msmerymac]

Oh, also, for the last 2 years I was on a full PPO insurance plan, which cost me like $400/month, but I used about $100k worth of insurance. My H's high-deductible plan was like $60/month to keep me on so we were able to fully fund an HSA for the things that weren't covered, too.

Too bad that insurance ran out and maxed out their treatments. It was heaven. I'm back to using just an HDHP now.

[msmerymac]

Nov 28, 2018 10:56:06 GMT -5 revolution said:

I'm not a fan. We have an HSA and use it. But when the kids get sick, or we get sick, I'm kinda like.... let's see if it is viral and then decide if a dr visit is really necessary for $140.

And schools here won't excuse an absence unless there is a doctors note. SO, if I keep a kid home for a fever and viral nonsense, I send a note in that the kid was home sick, it is unexcused. WHAT?? The only way to excuse is an actual doctors note. So - pay $140 to have a dr tell me my kid has a viral infection and get a school note so it is excused and drag said sick kid out of the house into the public, or have an unexcused absense?

What does an unexcused absence mean? How is it different and does it really matter?

And that's also classist as eff for your school to do that. Do they seriously have no kids who are on free and reduced lunch plans? How often do they think those kids can afford a doctor's visit? Even just parents who both work can struggle to take a kid with a cold to the doctor. And sending them to school just increases everyone's exposure.

[dancelnow]

Year over year I come out way ahead on my high deductible plan, even with a kid because it saves me so much in premiums. I get a decent comparison because BF and his daughter are on the co-pay plan with the same employer as me. Have to look at big picture.

[minionkevin]

I am now and love it, but due to an error on my part we are switching to a traditional plan for 2019 and the cost is significantly more. On the flip side, I am having a baby in 2019 so I know I will pay less as an end user but I’m not quite sure the lack of tax savings (since no HSA contribution) and higher premium cost is worth it. We’ll see in May and beyond.

[af1212]

Yes we have had a HDHP for the past 6 years. I agree it sucks. But after a year or two in it you can begin to generally predict what things will cost. We always find our HsA and make all dr payments from there so at least it’s not affecting our monthly budget in an u predictable way.

[kadams767]

Nov 28, 2018 10:58:07 GMT -5 mel said:

Nov 28, 2018 10:51:16 GMT -5 pantsparty said:

I keep thinking what if we had kids? We can afford this, but I can't imagine how families afford this with how frequently kids get sick.

I've never been to a minute clinic, I will have to look those up.

Kids is precisely the reason I couldn't wait to get back on a standard copay plan. And this year I had a kid in the ER for a baseball bat to the mouth (which required stitches) the other kid in the ER with a broken nose from an errant throw in baseball (which required surgery 2 weeks later). I paid just over $5,000 OOP for both of those incidents with my standard copay plan. I can't imagine what it would have been with the high deductible plan. With the high deductible plan, I felt like wrapping my kids up in bubble wrap to avoid costly ER visits.

What was your deductible, though?  At the very least, you would know what the maximum cost would have been.  In my case, my family deductible is $5,000 and my OOP maximum is also $5,000, so if I had paid absolutely nothing towards the deductible this year, this would have been the same, except I would have been paying more towards my insurance every month and I couldn't pay the $5,000 with pretax HSA funds.  Frankly, I would be more livid about paying for a standard HMO or PPO plan and still paying $5,000 OOP on top of it all.

[af1212]

Nov 28, 2018 11:03:39 GMT -5 msmerymac said:

Nov 28, 2018 10:56:06 GMT -5 revolution said:

I'm not a fan. We have an HSA and use it. But when the kids get sick, or we get sick, I'm kinda like.... let's see if it is viral and then decide if a dr visit is really necessary for $140.

And schools here won't excuse an absence unless there is a doctors note. SO, if I keep a kid home for a fever and viral nonsense, I send a note in that the kid was home sick, it is unexcused. WHAT?? The only way to excuse is an actual doctors note. So - pay $140 to have a dr tell me my kid has a viral infection and get a school note so it is excused and drag said sick kid out of the house into the public, or have an unexcused absense?

What does an unexcused absence mean? How is it different and does it really matter?

And that's also classist as eff for your school to do that. Do they seriously have no kids who are on free and reduced lunch plans? How often do they think those kids can afford a doctor's visit? Even just parents who both work can struggle to take a kid with a cold to the doctor. And sending them to school just increases everyone's exposure.

Unless it’s a private school, attendance requirements are state mandated. The difference between unezcised and excused matters when it comes to truancy procedures. Unfortunately truancy is a big problem in many areas so many states have fairly strict rules about excusing an absence.

[konapoppy]

Nov 28, 2018 11:00:04 GMT -5 mel said:

Nov 28, 2018 10:56:06 GMT -5 revolution said:

I'm not a fan. We have an HSA and use it. But when the kids get sick, or we get sick, I'm kinda like.... let's see if it is viral and then decide if a dr visit is really necessary for $140.

And schools here won't excuse an absence unless there is a doctors note. SO, if I keep a kid home for a fever and viral nonsense, I send a note in that the kid was home sick, it is unexcused. WHAT?? The only way to excuse is an actual doctors note. So - pay $140 to have a dr tell me my kid has a viral infection and get a school note so it is excused and drag said sick kid out of the house into the public, or have an unexcused absense?

The bolded is another reason why I hated the HD plan. 

To be fair, the bolded is the purpose of high deductible plans (they want you to make smarter choices about when to go to a doctor and how cost effective the doctor is). So for healthcare in this country, which is ridiculous, it makes sense.

But I hadn’t thought about the issue of doctors notes for kids. That is really annoying.

[revolution]

Nov 28, 2018 11:03:39 GMT -5 msmerymac said:

Nov 28, 2018 10:56:06 GMT -5 revolution said:

I'm not a fan. We have an HSA and use it. But when the kids get sick, or we get sick, I'm kinda like.... let's see if it is viral and then decide if a dr visit is really necessary for $140.

And schools here won't excuse an absence unless there is a doctors note. SO, if I keep a kid home for a fever and viral nonsense, I send a note in that the kid was home sick, it is unexcused. WHAT?? The only way to excuse is an actual doctors note. So - pay $140 to have a dr tell me my kid has a viral infection and get a school note so it is excused and drag said sick kid out of the house into the public, or have an unexcused absense?

What does an unexcused absence mean? How is it different and does it really matter?

And that's also classist as eff for your school to do that. Do they seriously have no kids who are on free and reduced lunch plans? How often do they think those kids can afford a doctor's visit? Even just parents who both work can struggle to take a kid with a cold to the doctor. And sending them to school just increases everyone's exposure.

I'm trying to figure all of this out.  We've only been in the district for a month, so I'm not quite sure of what the difference is.  Our old school, there was a difference between excused/unexcused.  BUT, they also let a parent note qualify as excused.

[definitelyO]

I've been on a HDHP plan for probably 10 years.

Initially it is shocking when you're used to spending $20 and get a bill for $140. We put the premium savings from moving to the HDHP in the HSA and my employer contributes as well.

I'm willing to bet that your insurance company has cost estimator tools online that will tell you the cost of the visit (as long as nothing changing during your visit to get it coded differently). I know that Aetna, Kaiser and UHC all have these tools online.

we do a cost comparison each year and the savings in premium vs. deductible and OOP max almost always makes the HDHP more appealing. At my company - the premium for the family PPO (copay plan) was $5,500 MORE than the HDHP premium. If someone moved from the PPO plan to the HDHP and put the $5,500 "savings" into their HSA they would have saved enough to meet their out of pocket maximum.

[af1212]

Nov 28, 2018 11:10:23 GMT -5 kadams767 said:

Nov 28, 2018 10:58:07 GMT -5 mel said:

Kids is precisely the reason I couldn't wait to get back on a standard copay plan. And this year I had a kid in the ER for a baseball bat to the mouth (which required stitches) the other kid in the ER with a broken nose from an errant throw in baseball (which required surgery 2 weeks later). I paid just over $5,000 OOP for both of those incidents with my standard copay plan. I can't imagine what it would have been with the high deductible plan. With the high deductible plan, I felt like wrapping my kids up in bubble wrap to avoid costly ER visits.

What was your deductible, though?  At the very least, you would know what the maximum cost would have been.  In my case, my family deductible is $5,000 and my OOP maximum is also $5,000, so if I had paid absolutely nothing towards the deductible this year, this would have been the same, except I would have been paying more towards my insurance every month and I couldn't pay the $5,000 with pretax HSA funds.  Frankly, I would be more livid about paying for a standard HMO or PPO plan and still paying $5,000 OOP on top of it all.

That’s awesome that your OOP max and deductible are the same!! My deductible is 6500 but OOP Max is 12,000 😩

[definitelyO]

Oh and I'd look into telemedicine. again depending on your plan you can "call a doctor". They can video chat/face time, etc.. and write Rx and call them into 24 hour pharmacies, etc... it's so much more than a nurse line and on the plans I've seen - they're a LOT cheaper than a doctor visit and WAY cheaper than an ER/Urgent care for emergencies.

obviously won't work when you need stiches, but for rash, flu, pink eye, ear infection, etc.. works great!

[af1212]

Nov 28, 2018 11:11:45 GMT -5 revolution said:

Nov 28, 2018 11:03:39 GMT -5 msmerymac said:

What does an unexcused absence mean? How is it different and does it really matter?

And that's also classist as eff for your school to do that. Do they seriously have no kids who are on free and reduced lunch plans? How often do they think those kids can afford a doctor's visit? Even just parents who both work can struggle to take a kid with a cold to the doctor. And sending them to school just increases everyone's exposure.

I'm trying to figure all of this out.  We've only been in the district for a month, so I'm not quite sure of what the difference is.  Our old school, there was a difference between excused/unexcused.  BUT, they also let a parent note qualify as excused.

I would look into this - I have taught in two different states and in both a parent note was fine up to a certain number of absences per semester. It was only after those were used up that a doctor note became necessary. So for a chronically absent kid they would need a dr note after their first x absences but for your average kid who just gets sick a few times per semester you wouldn’t run into the need for a dr note.

If you want to send me your state I can maybe help you decipher it.

[isabel]

Welcome to insurance in America.

We fucking suck at healthcare. So much.

There is literally no other service provided where you receive service with literally no idea what the cost will be. And this is why I very, very rarely go to the doctor. I can’t trust what doctors and insurance reps tell me, so I only go when I absolutely have to or when I am certain the visit is fully covered as preventative care.