Co-Pays…Deductibles….Out of Pocket…..

March 20, 2015

When it comes to insurance, I’m an idiot, and I admit it. I’m an idiot actually on a lot of topics, but this one is right up there at the top of all of the top topics!!

Why can’t an office visit or a pill or a procedure just cost X amount of dollars. whether you have insurance or not.

Why is the insurance company billed a different amount for a procedure than what they claim the procedure actually cost?

Deductibles? We make a huge monthly payment….. Where’d that go?? Put THAT towards my deductible!!

Co-Pay? But I already Co-Paid when I made my monthly payment! Now YOU pay, Mr. Insurance Company!

Out of Pocket??? Who came up with that phrase? I pay. Insurance pays. Can we just call it what it is?

Okay…….I went for my MRI yesterday. I’ve had shoulder issues for over two years now. The right one needed rotator cuff surgery, and that whole process was so expensive, I’ve put off taking care of my left shoulder for too long. I’ve finally decided to bite the bullet.

My co-pay for my MRI……are you ready for it? $600. No joke. The cost for the MRI at the imaging center that I was at…..are you ready for that? $450. The very nice lady at the desk was appalled at my co-pay amount and said that she and her co-workers have never seen a co-pay that high before. Oh, and……our monthly premium would make a really really nice car payment!!

It was less expensive to just pay cash! However….if you pay cash, that doesn’t go towards your deductible, so are you doing yourself any favors for later if you pay cash now? Like, what the heck???

For the amount that we pay each month to HAVE insurance, we could just be putting that in a savings account and paying out of pocket for procedures!! But no one can tell you how much a procedure is because it varies from place to place, and then the insurance companies decide how much of it they will cover!!! Seriously…..I just don’t understand how it all works and why it’s all so damned expensive and complicated.

Yes, I do know that I have options, and I may be shopping around for an individual policy, but I remember when having insurance through work (or through your spouses work) was a benefit, not a ridiculous expense that really didn’t do much good for some of the small stuff. I also understand that if we had any MAJOR health concerns or cost, I would be happy we had insurance, but I needed to vent…..and now I’ll start shopping. Of course, now with a history of shoulder issues, I’m sure a policy will cost more than it would have had I not had any shoulder issues. AHHHHH……..still venting.

When I was first added to my husbands insurance, I thought the cost was crazy high, so I did shop for a policy, only to discover, since I was OBESE according to the BMI chart (They didn’t even weigh me, I was just honest about my weight!), my monthly premium was crazy high anyhow, so out of frustration in that situation, I stopped shopping around.

So, all of  that being said, I am truly thankful to have insurance, but I feel completely taken advantage of and I find our whole health care/medical/insurance business a gigantic financial mess!!

If I were smart, I would start my own health insurance company……and doctor’s office……..and imaging center……and physical therapy office……..and a dentist office………it would be fair, and friendly, and pretty, and people from all over the country would come there for fair and reasonable health care!!!

The End.

(I wrote this post yesterday immediately after coming home from the doctor’s office. Can you tell? I know I sound like an idiot.)

 

Breakfast

Blueberry Pancakes

Frothy Coffee

4 PPV

IMG_0141

 

Lunch

Taco Salad

3.5 oz Taco Meat, 14 g Reduced Fat Cheddar

1 White Corn Taco Shell

Romaine, Tomatoes, Salsa

6 PPV

I will now forever weigh out my cheese! I’m a bit of numbers girl, so I actually like to track, and although I do a lot of guessing on points when necessary, I prefer knowing exactly how many points I am eating. I’ve kinda always guessed on the shredded cheese and I have no idea why it took me so long to weigh it instead of filling up a measuring cup and wondering???

IMG_0142

  

Snack

Pear, 1 T. Almond Butter

3 PPV

IMG_0143

 

Dinner

Un-Pictured Wine, Appetizers with these Girls!

23 PPV

 photo

Weight Watcher’s Points Plus

I can eat 26 PPV a day.

I can earn Activity Points by doing exercise, and eat them if I choose.

I have an allowance of 49 extra points that I can dip into throughout the week if I choose.

I should drink a minimum of 6 (8 oz) glasses of water each day.

My Weight Watcher Week Begins on Friday’s

 

Breakfast = Pancakes and Frothy Coffee (4)

Lunch =  Taco Salad (6)

Snack = Pear and Almond Butter (3)

Dinner = Wine and Appetizers Bites (23)

Total = 36

Exercise = none. Damn it.

Activity Points Earned for the Day = 0

Activity Points Earned This Week = 9

Activity Points Remaining This Week = 9

How many ounces of water I drank for the day = 60

Remaining points from my 49 Points Allowance = 28

 

This is What I Will Accomplish in 2015

  1. I will choose one occasion per month for Social Drinking (this is a work in progress….)
  2. I will go no more than two days in a row without exercise. (unless I’m sick..or break a bone!!)
  3. I will track every single day for the entire year. No matter what. I’ll track if I eat 26 points, I’ll track if I eat 76 points.
  4. I will RUN in a minimum of six 5K’s

 girlfriends

 

“love the life you live, live the life you love”

julesfarm@yahoo.com

Posts

8 responses to Co-Pays…Deductibles….Out of Pocket…..

  1. julesfarm@yahoo.com March 21, 2015 at 1:16 pm

    I’m sorry you have to deal with that on a regular basis, Nancy, and I certainly hope you can keep both your job and your insurance!

    Looks like sunny and nice here today too! I love Saturday’s too!

    🙂

    Julie

  2. julesfarm@yahoo.com March 21, 2015 at 1:13 pm

    If you click on the words “Frothy Coffee” in the post, it will take you to a page that shows how I make it. You can do the same thing with the Blueberry Pancakes.

    But I can tell you here too! 🙂 I bought an electric frother at Target for about $40. You simply add your milk to it (I like skim milk) and turn it on. It heats and froth’s the milk! I love flavored coffees and Stevia drops that are flavored. I’ve found the Stevia drops at Whole Foods, and also at a few other grocery stores in the Health Food area of the store. I hope this was helpful!

    Have a great weekend!

  3. julesfarm@yahoo.com March 21, 2015 at 1:09 pm

    Yikes! I hope your daughter’s recovery went well.

    It really is a crazy mess! I do like to try to find the positive in a situation, so I am glad to have nothing major happening with my health, and I am glad that I have insurance.

    But dang!!

    Let’s try for a Healthy Happy Weekend!

  4. I have a vascular bandage (called an unaboot) on my left leg for a wound. My co-pays are $25 and I have gone every week since October 30. I worry constantly about losing my job and health insurance. I have lymphedema and there is no cure for it.
    I maybe headed up north with you!!!!
    But here today it is going to be 65 and sunny, and I love my Saturdays.

  5. Hi Julie,
    Would you share with me what frothy coffee is?
    Thank you
    Cindy

  6. My daughter had her gallbladder out in January, $2,500 deductible! And that doesn’t count the two $500 co-pays to the ER! It’s ridiculous!

  7. julesfarm@yahoo.com March 20, 2015 at 5:20 pm

    I’m considering moving!!

    🙂

  8. This is one of the reasons I am happy to live in Canada ☺.