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gerisullivanWhen last we left our heroine, she was facing a $1,776 annual increase in the cost of her health insurance and frothing at the mouth at her current provider's refusal to reveal the cost of ultrasound and lab procedures received in recent months. This particular medical roller coaster had an unanticipated loop in the middle of the track as well as the expected miles and miles of research. I'm glad to report that I've found a couple of somewhat more tolerable options and appear to be nearing what I hope proves to be a reasonable decision.
I visited the clinic where I currently see my doctor, both to see what other insurance plans they accept and also as part of the previously-reported effort to learn what my care costs. While there, I learned that my doctor is leaving the clinic at the end of May. Yikes! So much for my idea that I'd stick it out where I am for the coming year and give myself more time to investigate and evaluate other options.
Knowing I would be getting a new doctor if I stay where I am makes it easier to change doctors and clinics in order to get a lower-priced plan with my current insurance company. Yes, I'd rather receive care closer to home -- my usual 15-minute drive to a doctor's appointment will be a 40-minute drive to the new place -- but I usually only see my doctor a couple of times a year and I can make the longer drive in order to save $600-750 on the annual cost of coverage. There is another option that's only 30 minutes away, but the hospital those doctors are affiliated with doesn't fill me with confidence or otherwise seem in any way appealing. And the closer clinic is family practice only, while I'd prefer an internal medicine doc myself at this point. (That isn't an absolute requirement, but I certainly lean that way.)
I still need to actually visit the new clinic and make sure it doesn't make my skin crawl. Online reports indicate four of their doctors are currently accepting new patients -- two of the doctors look absolutely fine in electrons (schooling, lack of complaints or sanctions, just the basics). The two others are probably fine, but I'd want to talk with them first to confirm that I'm comfortable communicating with them and learning a little more about their backgrounds. Alas, it looks like I'm not going to end up with Dr. Devine -- he's at a different clinic, and he's not accepting new patients, either. Too bad, really. It would be way too much fun, especially given that my dentist's name is Dr. Gross.
I was going to visit the new clinic yesterday, but then changes came in on a project so I stayed home and made money to help pay for visits to the new clinic instead. Maybe tomorrow.
Today, I tried the in-person approach with the medical center in Palmer. I was already in town --![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
kip_w and I checked out The Library Loft, a friendly, well-organized used bookstore affiliated with the Palmer Library. Then we had lunch at the Steaming Tender restaurant, which is inside the gorgeous Palmer train station. It's a Romanesque building designed by Henry Hobson Richardson -- he also designed Sever Hall, where Vericon is held, and the Marshall Field building in Chicago. Oh, yes, and Trinity Church in Boston. Among other landmarks.
Anyway, yes, I was already in Palmer. So I headed on over to the billing department and was soon talking with Patty, a delightfully helpful customer service rep. She pulled my records up on her computer and quickly scanned through various procedures I've had done, telling me the total cost, what the insurance company paid, and how much the medical center then wrote off. Yes, that's exactly what I needed to know.
I'm gobsmacked that each of the three ultrasounds I've had in the last 12 months cost considerably more -- $1300-1770 a pop -- than the $1,000 colonoscopy I had a couple of years ago. I still need to call my insurance company and find out if they're considered in the same camp as the less expensive "diagnostic" services listed (lab work, x-rays, EKGs, etc) or the more expensive "imaging" services (CAT & PET scans, MRIs) before making an informed guess between two plans -- one will cost a bit more up front, the other charges twice the co-pay on some services.
I'm glad my in-person visit resulted in getting the cost information I needed -- it's utterly clear that the couple hundred dollars I could save in premiums by choosing a deductible plan would result in my total costs being several hundred to $1,000 higher given that I already know I need at least one more ultrasound this fall.
The bottom line? By changing doctors and trading the risks of no prescription drug coverage for the risk of increased co-pays on some services I know I'll need and others I might need, my costs will increase $600-750/year rather than $1,776. No, I can't afford that, either, but it's a lot easier to imagine coming up with an extra $50-60/month than it is to come up with an extra $150/month. I lucked out on the risk front these last three years and will be happy to have Rx coverage in the future. I'll be even happier if my annual prescription costs remain under $200, even though I'll be paying an extra $700/year for the privilege of being in compliance with the Rx requirement being added to the Massachusetts health care coverage law.
I visited the clinic where I currently see my doctor, both to see what other insurance plans they accept and also as part of the previously-reported effort to learn what my care costs. While there, I learned that my doctor is leaving the clinic at the end of May. Yikes! So much for my idea that I'd stick it out where I am for the coming year and give myself more time to investigate and evaluate other options.
Knowing I would be getting a new doctor if I stay where I am makes it easier to change doctors and clinics in order to get a lower-priced plan with my current insurance company. Yes, I'd rather receive care closer to home -- my usual 15-minute drive to a doctor's appointment will be a 40-minute drive to the new place -- but I usually only see my doctor a couple of times a year and I can make the longer drive in order to save $600-750 on the annual cost of coverage. There is another option that's only 30 minutes away, but the hospital those doctors are affiliated with doesn't fill me with confidence or otherwise seem in any way appealing. And the closer clinic is family practice only, while I'd prefer an internal medicine doc myself at this point. (That isn't an absolute requirement, but I certainly lean that way.)
I still need to actually visit the new clinic and make sure it doesn't make my skin crawl. Online reports indicate four of their doctors are currently accepting new patients -- two of the doctors look absolutely fine in electrons (schooling, lack of complaints or sanctions, just the basics). The two others are probably fine, but I'd want to talk with them first to confirm that I'm comfortable communicating with them and learning a little more about their backgrounds. Alas, it looks like I'm not going to end up with Dr. Devine -- he's at a different clinic, and he's not accepting new patients, either. Too bad, really. It would be way too much fun, especially given that my dentist's name is Dr. Gross.
I was going to visit the new clinic yesterday, but then changes came in on a project so I stayed home and made money to help pay for visits to the new clinic instead. Maybe tomorrow.
Today, I tried the in-person approach with the medical center in Palmer. I was already in town --
kip_w and I checked out The Library Loft, a friendly, well-organized used bookstore affiliated with the Palmer Library. Then we had lunch at the Steaming Tender restaurant, which is inside the gorgeous Palmer train station. It's a Romanesque building designed by Henry Hobson Richardson -- he also designed Sever Hall, where Vericon is held, and the Marshall Field building in Chicago. Oh, yes, and Trinity Church in Boston. Among other landmarks.Anyway, yes, I was already in Palmer. So I headed on over to the billing department and was soon talking with Patty, a delightfully helpful customer service rep. She pulled my records up on her computer and quickly scanned through various procedures I've had done, telling me the total cost, what the insurance company paid, and how much the medical center then wrote off. Yes, that's exactly what I needed to know.
I'm gobsmacked that each of the three ultrasounds I've had in the last 12 months cost considerably more -- $1300-1770 a pop -- than the $1,000 colonoscopy I had a couple of years ago. I still need to call my insurance company and find out if they're considered in the same camp as the less expensive "diagnostic" services listed (lab work, x-rays, EKGs, etc) or the more expensive "imaging" services (CAT & PET scans, MRIs) before making an informed guess between two plans -- one will cost a bit more up front, the other charges twice the co-pay on some services.
I'm glad my in-person visit resulted in getting the cost information I needed -- it's utterly clear that the couple hundred dollars I could save in premiums by choosing a deductible plan would result in my total costs being several hundred to $1,000 higher given that I already know I need at least one more ultrasound this fall.
The bottom line? By changing doctors and trading the risks of no prescription drug coverage for the risk of increased co-pays on some services I know I'll need and others I might need, my costs will increase $600-750/year rather than $1,776. No, I can't afford that, either, but it's a lot easier to imagine coming up with an extra $50-60/month than it is to come up with an extra $150/month. I lucked out on the risk front these last three years and will be happy to have Rx coverage in the future. I'll be even happier if my annual prescription costs remain under $200, even though I'll be paying an extra $700/year for the privilege of being in compliance with the Rx requirement being added to the Massachusetts health care coverage law.
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no subject
Date: 2008-03-13 03:16 am (UTC)tales in capability
Date: 2008-03-13 03:31 am (UTC)And you do it all with such ... aplomb. You're amazing and wonderful.
Re: tales in capability
Date: 2008-03-13 03:46 am (UTC)I think you're pretty darned amazing and wonderful yourself, you know.
Re: tales in capability
Date: 2008-03-18 01:35 am (UTC)Aplomb is persistence with a good write-up. And we know you're a good writer. So it all fits...
We're currentlly just praying for good health
Date: 2008-03-13 03:37 am (UTC)no subject
Date: 2008-03-13 04:34 am (UTC)no subject
Date: 2008-03-13 06:30 am (UTC)K.
no subject
Date: 2008-03-13 08:23 am (UTC)I hope I manage to convert my good intentions into actual action. Thanks for the helpful noodge.
no subject
Date: 2008-03-13 07:15 am (UTC)We so need a complete reworking of our health care system...
no subject
Date: 2008-03-13 08:58 am (UTC)I have friends and loved ones whose monthly prescription costs number in thousands rather than hundreds. Until 3 years ago, my total prescription costs for the previous 25 years were, um, probably over $200, but certainly less than $300. Total. I can darned near remember each of the prescriptions; they numbered in the single digits. I've been phenomenally lucky in that regard. Even now, I take one 41 cent pill a day. My dad has eye drops that cost over $150/bottle. And a pill that costs more that $50 each. (Fortunately, it's of the once a month variety rather than the 3 times a day sort.
no subject
Date: 2008-03-14 12:30 am (UTC)I would like to find the person who came up with the stupidity of the donut hole and smack them upside the head. Repeatedly. Along with the brainiacs at AARP who decided to endorse it.
And it's appalling that the democratic congress hasn't fixed it yet.
Okay, I'll stop ranting now...
no subject
Date: 2008-03-14 12:31 am (UTC)no subject
Date: 2008-03-13 12:17 pm (UTC)