Life

[tegan]

My mom sent me an email again saying she has another savings bond for me. It's my birthday this week, so that's probably got something to do with it. I wouldn't really need the money so bad and I don't want to meet with her again, but I'm considering seeing if I can finagle back a few possessions I left behind when I left home (namely: my rather valuable Lego and Pokémon card collections and a beloved plush toy). I know that's a stupid thing to obsess over, but still...

[Zeusthecat]

Life has kind of sucked balls lately. Don't read this post if you don't want to hear me bitching about my problems.

 

Our 3 month old came down with something 2 weeks ago and ended up having to go to the hospital last week because he was dehydrated from having so much diarrhea. We still haven't heard a definitive answer on what he had but after 3 days in the hospital they discharged him and he seems to be doing better as of today. Going through this whole ordeal has left us worried and frustrated. Since he is finally showing signs of improvement we aren't as worried now as we have been but still pretty goddamn frustrated over how all of this played out. So I'm going to vent for a bit and throw myself a pity party. Sorry if I come off as whiny.

 

First, why does this type of shit have to happen over a holiday? I know that isn't what I should be concerned with but it's just sad that he had to be in the hospital on his first Halloween. My wife still wanted me to take my daughter trick or treating so she wouldn't miss out but it is hard to enjoy that type of thing under those circumstances.

 

Second, fuck our healthcare system. This high deductible health plan (which is supposedly a good plan) is a load of shit. I hate that it discourages you from making good decisions out of fear of the exorbitant bills that come as a result of using the healthcare system. Before we were even admitted, they started hounding us to pay $2000 up front. I had to explain that we had already met certain deductibles from the birth of our child and that the bill needed to be sent to our insurance so that we don't overpay but they still insisted that I had to pay something before they would admit us. So rather than argue more, I just paid $100 so our son could be admitted. My head is still spinning from the flow of hospital bills that we are getting from the birth and now there will be a whole lot more coming in.

 

Speaking of hospital bills, I foolishly thought we would just get one bill from the hospital after the birth of our child but holy shit was I wrong. Instead, we are getting separate bills from every single surgeon, doctor, and specialist and there seems to be a lot of the right hand not talking to the left hand going on. We are supposed to have a $2400 deductible for individual, $4000 for family after which the insurance kicks in and starts covering 90% of the costs. Then we have a $5000 out of pocket max for individual and $10000 for family. We paid $2500 up front for the birth but it all got super confusing when we kept getting bills for things that weren't covered because one random doctor was out of network or they just moved certain things we expected to be under my wife to my son since he was a new person. Then, even after hitting what we thought was the $4000 deductible for family we were getting full bills for other things because it didn't register that we met our deductible because we set up a payment plan to pay off the rest since we exhausted all the funds in our HSA. Then we realized that even with the insurance covering 90% after the deductible we would still be paying thousands more because the bills totaled over $30000. Why the fuck is a 45 minute surgery and 3 days in the hospital SO FUCKING EXPENSIVE?!?! And now with these 3 days that our son was in we get to go through it all again. At least now we know that we are hitting the $10000 out of pocket max so there won't be much point in fighting specifics as long as our total bills don't add up to more than that.

 

Finally, I hate doctors. From what I can tell they aren't worth what they get paid and they are condescending assholes. We had one of the labs our pediatricians ordered come back positive for C Diff which prompted her to insist that we start antibiotics right away. Meanwhile, the pediatrician in the hospital told us that you never want to give antibiotics to a 3 month old and that C Diff occurs naturally in all infants so of course the results will come back positive. Who the fuck do we believe and why would we hear two polar opposite opinions coming from two different pediatricians. My gut is to go with the hospital doctor since I figure there is a chance our pediatrician gets some kind of kickback for prescribing certain things and might have ulterior motives. Or maybe I'm just paranoid and that kind of stuff doesn't happen. But who cares, when it's all said and done we will just be further in debt and these doctors will have done nothing more than talk to us for 5 minutes at a time, give him an IV, and take our money.

 

On the bright side, at least our son is doing better and I finally got to play some Sam and Max last night.

[SecretAsianMan]

I was wondering what happened to you Zeus.  Sorry to hear all that stuff but if it makes you feel any better, I think your plan is better than mine.  My plan has a $5000 deductible with an $11,000 out of pocket max and only 80% coverage in-network.

[dibs]

Holy crap that is some money to be laying out. I hope the little fella gets proper better soon Zeus.

[Zeusthecat]

I was wondering what happened to you Zeus.  Sorry to hear all that stuff but if it makes you feel any better, I think your plan is better than mine.  My plan has a $5000 deductible with an $11,000 out of pocket max and only 80% coverage in-network.

 

Ouch man! And I thought mine was bad. It's crazy to think that these are considered good health care plans these days.

 

And thanks for the encouragement guys.

[Dewar]

I'll save the gorey details, but my father in law had spinal surgery a couple of weeks ago. The actual doctor doing the surgery maybe talked to him for 5 minutes and told him "recovery time for these things varies greatly. He could be good to go in a couple of days or a couple of weeks." They also told us he should be ready to go home after a one night stay. After the surgery he was in extreme pain, stayed for three nights, and then they perscribed him some Vicadin and sent him home. few days later he had to go to the emergency room because he was in pain again and was already taking the maximum dose of pain killer. The nurse and doctor there let us know that:

 

1) Recovery time is almost always at least a month

2) Pain after the surgery is often worse than the pain that the surgery was supposed to be fixing (no mention of this at all at the first hospital)

3) They were shocked that he didn't get some stronger pain killers (they gave us a perscription for percaset) and an anti-inflamitory to help his spinal cord inflamation go down

 

So yeah, I don't blame you Zeus, trust in doctors shaken. The entire experience at the first hospital was lousy in a lot of ways I don't even feel like going into.

[Ucantalas]

Wow. I always feel awful hearing about the trouble people have paying for healthcare in the US. Those sound like ridiculously high fees.

I really hope your little guy gets better soon Zeus, I can't imagine the stress and worry of having a sick child.

[SignorSuperdouche]

My plan has a $5000 deductible with an $11,000 out of pocket max and only 80% coverage in-network.

 

I get $11,000 out of pocket max, but what the heck does the rest of this mean?

 

Anyway I wanted to share the following ticket I picked up at work today

 

 

My line manager marked it Priority: Major. Goddamn right.

[osmosisch]

Sorry about your troubles Zeus. It's a shitty system.

[elmuerte]

The workflow seems flawed. You can go to "open" or "in progress"!? How are those mutually exclusive?

[Frenetic Pony]

Zeus catman, so C. Diff is not often bad, water is recommended basically if symptoms appear at all. It CAN get bad, rarely. Colitis is bad. But a lot of people often have a variant of C. Diff in them already, and symptoms often only appear after an overpopulation of the bacteria due to usage of antibiotics in the first place killing off other bacteria common to our bodies. Otherwise having C. Diff can mean, nothing at all really. I wouldn't worry so much about it.

 

As for the bills, call your insurance company over EVERYTHING. Odds are they may actually cover a lot of it, medical billing is a clusterfuck to begin with and you can often get doctors just sending you bills without bothering to check if you even had insurance.

[Dewar]

I get $11,000 out of pocket max, but what the heck does the rest of this mean?

 

Anyway I wanted to share the following ticket I picked up at work today

 

My line manager marked it Priority: Major. Goddamn right.

 

Deductable is the amount you have to pay before you get any coverage at all (with exceptions for preventative care and other types of services depending on your insurance carrier)

% Coverage is the the percentage of the total bill your insurance covers after the deductible has been paid by you buy before you've hit the out-of-pocket max.

All of this is complicated by whether a specific provider is "in network" which is the dumbest concept ever.

[SecretAsianMan]

I get $11,000 out of pocket max, but what the heck does the rest of this mean?

 

The deductible is the amount you have to pay before insurance will cover anything.  So if I have $6000 worth of medical expenses, I have to pay the first $5000 with my own money, then insurance will cover 80% of the remaining $1000, assuming the doctor or whoever is in my healthcare network.  This means my total costs are $5200.  In Zeus' case, he would have to pay $4200 under those same conditions.  The one nice thing about my plan (and Zeus' too it would seem) is the Health Savings Account (HSA), which is basically a savings account that can only be used for medical expenses.  The good part of an HSA is the money that's put into it isn't taxed and can be carried over from year to year or from plan to plan in most cases.

 

Edit: Looks like Dewar be me to an answer by a few seconds.

[Zeusthecat]

The deductible is the amount you have to pay before insurance will cover anything.  So if I have $6000 worth of medical expenses, I have to pay the first $5000 with my own money, then insurance will cover 80% of the remaining $1000, assuming the doctor or whoever is in my healthcare network.  This means my total costs are $5200.  In Zeus' case, he would have to pay $4200 under those same conditions.  The one nice thing about my plan (and Zeus' too it would seem) is the Health Savings Account (HSA), which is basically a savings account that can only be used for medical expenses.  The good part of an HSA is the money that's put into it isn't taxed and can be carried over from year to year or from plan to plan in most cases.

 

Edit: Looks like Dewar be me to an answer by a few seconds.

 

It all gets much more complicated when you have multiple people under the same plan. So my wife hits the $2400 deductible then the insurance kicks in to cover 90% of the costs after that up to the $5000 out of pocket max for her. However, if charges are incurred under anyone but my wife at this point, none of it is covered until we fork over another $1600 ($4000 family deductible = $2400 individual deductible + $1600 for other individuals). But where it gets super confusing is when my wife is getting bills where the insurance covered 90% after the $2400 but then we get bills where the insurance didn't cover anything for my son until the $4000 was met. Then I guess they are both covered 90% until I have paid $10000 (or she is covered 100% after her bills reach $5000 and he is covered 90%) at which point everything is 100% covered. But due to crazy high medical costs, 90% coverage still leaves us with huge bills and the whole thing resets in January for us to pay even more.

 

The HSA is nice and the company I work for gives decent contributions to it. Unfortunately there is a federal limit of around $6000 per year you can contribute to these plans for the size of family we have so even if I dumped all my money into it I would be limited by this cap and still have to fork over an extra $4000 of my taxed income to cover the difference. But really, I'll just be making monthly payments for years to come so hopefully over the next few years we have $0 in medical costs so I can use the contributions each year to continue paying off these bills. Fuck this shit.

[Dewar]

I'm still not sold on the HSA/high deductable insurance concept. Of course you only hear about the bad stuff, but I've known a few people that got hit with major medical expenses right when starting up their HSA, and not having enough money to cover.

[SecretAsianMan]

It all gets much more complicated when you have multiple people under the same plan. So my wife hits the $2400 deductible then the insurance kicks in to cover 90% of the costs after that up to the $5000 out of pocket max for her. However, if charges are incurred under anyone but my wife at this point, none of it is covered until we fork over another $1600 ($4000 family deductible = $2400 individual deductible + $1600 for other individuals). But where it gets super confusing is when my wife is getting bills where the insurance covered 90% after the $2400 but then we get bills where the insurance didn't cover anything for my son until the $4000 was met. Then I guess they are both covered 90% until I have paid $10000 (or she is covered 100% after her bills reach $5000 and he is covered 90%) at which point everything is 100% covered. But due to crazy high medical costs, 90% coverage still leaves us with huge bills and the whole thing resets in January for us to pay even more.

 

The HSA is nice and the company I work for gives decent contributions to it. Unfortunately there is a federal limit of around $6000 per year you can contribute to these plans for the size of family we have so even if I dumped all my money into it I would be limited by this cap and still have to fork over an extra $4000 of my taxed income to cover the difference. But really, I'll just be making monthly payments for years to come so hopefully over the next few years we have $0 in medical costs so I can use the contributions each year to continue paying off these bills. Fuck this shit.

 

I wasn't going to get into it that much but yeah, shit's complicated.  Another way your plan is better than mine, our company doesn't do HSA contributions at all.

[Zeusthecat]

I wasn't going to get into it that much but yeah, shit's complicated.  Another way your plan is better than mine, our company doesn't do HSA contributions at all.

 

That sucks, I prefer to think my plan is just "less shitty". To think that one of these HDHP's is better than another is just depressing. I hope your company at least picks up the premium costs so you can just focus on putting your money into your HSA. For companies that are self insured (like the company I work for), switching to these kinds of plans are like a fucking goldmine. Especially if the workforce is young and healthy.

[SecretAsianMan]

Yeah the reason I choose the plan I have is that there's no premium, so if I don't need to see the doctor for anything at all, I pay nothing.  The next plan has a lower deductible, but if you add in the cost of the premium, I'd only end up saving a few hundred dollars.  For that amount I'll take the chance of not needing to see the doctor at all and pay nothing.

[dibs]

How much do you pay monthly for such cover Zeus?

[Zeusthecat]

How much do you pay monthly for such cover Zeus?

 

$65 per month for the premium and then I put $85 per month into my HSA to get the maximum match from the company I work for. It can be a great plan and is super cheap if you don't actually use it for anything besides preventitive care.

[Dewar]

Ah, my premiums are something like $245 a month for two of us, so I definitely pay for the lower deductable, but I just don't want to have to stress about it.

[syntheticgerbil]

Well, that seals it, I'm never having a kid.

 

Also I guess if I get cancer or some other major illness, it seems much cheaper to just die.

[Ucantalas]

Well, that seals it, I'm never having a kid.

 

Also I guess if I get cancer or some other major illness, it seems much cheaper to just die.

Might as well cook meth. If you're gonna die, make it interesting.

[miffy495]

Move to Canada? It's pretty sweet up here, guys...

[toblix]

So how much of this is healthcare.gov going to fix?