Hopefully, if Chef or I have any accidents, we’ll have them before December 31, 2010. That’s because we’ve met our deductible for the year!
Our insurance deductible is $1500.00. Our responsibility for the surgeon’s bill was $858.87, all of which went toward the deductible. For the surgery center, $641.13 went toward our deductible, which brought us up to $1500.00. After we’ve met the deductible, insurance pays 80% and we pay 20%. We had an additional $240.25 that we needed to pay the surgery center for our co-insurance, which brought that bill to $881.38. We’ve already paid those two bills.
Based on our Explanation of Benefits (EOB) from the insurance, we also expect a bill from the anesthesiologist in the amount of $274.56, and a bill for radiology and the post-op shoe in the amount of $12.00.
We also paid about $12.50 for the pain meds I was prescribed after surgery.
Therefore, the total cost for this surgery, assuming there are no other bills that I’m missing, is $2039.31.
Since the other surgery will be done in December, before a new deductible period starts, our costs should be less next time. If I’m doing the math right, we should have to pay only $814.81. First, we’ll need to pay only 20% of what we paid in deductible this time. Also, I won’t need to purchase the post-op shoe because the one I have can be used on either foot, so I’ll just use the same one. Also, I won’t need to get new prescriptions because I didn’t take all the medication last time, and I intend to hang onto what I’ve got in order to avoid paying another co-pay.
One of my co-workers often complains that we don’t have very good insurance. I’m not sure if she’s dissatisfied with the amount of the deductible, or the items that the insurance chooses to cover. But I’m just thankful we’ve got insurance. We went a number of years without it, and while we managed okay, it sure is nice to have reduced out of pocket costs. My employer pays my entire premium (up to $500/month per employee is paid, and my premium is lower than that), so all I have to pay is the deductible and co-insurance.
Someday, I won’t be working full time anymore, and we’ll have to say goodbye to company-paid health insurance. At that time, Chef and I will probably need to look into other options. Unfortunately, since he is self-employed, it’s harder to find affordable insurance. Several years ago we had looked into it and couldn’t find a plan that was worth the cost, especially since we’re both relatively healthy people who don’t use the insurance that often. (This year has been an exception with all my chiropractor appointments and this surgery. But we decided to do the surgery now specifically because we do have insurance.)
I’m not sure how the new Health Care Bill will affect us, because I don’t really understand what’s in the bill. (Does anyone??) And we’ve got at least another year to see what happens (what changes are made, and whether the bill even stays in effect what with talk of repealing it). But as my time as an insurance-covered employee comes to a close, I’ll start doing research on other plans to see what’s available and affordable.
Are there any self-employed Americans reading? What do you do for health insurance?
Any readers with company-paid insurance? What’s your deductible? Also, would you ever decide to stay in a job just for the insurance coverage?