Thursday, October 28, 2010

All Rolled Into One

First, let’s start with the obvious that I don’t think anyone reads this blog anymore so that’s why I haven’t been writing. This will probably become a monthly or quarterly thing now just to write down some thoughts. No use shouting at the rain.

Second, what’s going on around here? Well, lots to be honest. Overall, Clara has been really good. The nap scheduling at home has been horrendous; I am not going to lie. For some reason she will.not.nap at home. I have tried everything I can think of to get it done with failing results. She was so utterly exhausted this past weekend I had to have Ray drive her around in the car until she finally passed out. Gah.

But let me tell you why I am pissed off though. If you remember my last post about Clara’s VCUG you will notice that I didn’t mention our insurance. Why? Because we have an HSA. While this is not ideal it is/was better than the horrible PPO my company was offering last year and way, way better than Ray’s PPO last year. So, yeah, lesser of three evils I guess. Anywho, the whole deal with the HSA is that you basically pay out of pocket for medical expenses except you pay with a non-taxable savings account that can only be used for medical purposes. I know it sounds terrible but actually it’s not that bad. However, in order to determine exactly how much you will have to pay for one thing or another the best way is to call the place that will be doing the procedures (for doctor’s appointments and the like the cost is minimal so it’s not necessary but for larger procedures that require radiology work it’s best to call). So I DID call Hopkins and chatted with a very nice insurance specialist who assured me that my bill for all of Clara’s radiology stuff would be give or take $220. Yeah, fat chance, it was actually well over $1300 after doctor’s fees (which I specifically asked about), lab testing (which I specifically asked about) and additional facilities fees (like the use of the actual machinery, which I SPECIFICALLY ASKED ABOUT-you get the point). So naturally, I am really annoyed.

Our insurance company footed $24.00 of this bill while we paid the other $1200+ out of the HSA. I guess to be fair the entire amount we paid went to our deductible (which btw is a ridiculous $2500). And I am not so pissed off about having to pay the bill itself as I am that I was duped into believing that our bill would only be $220. I mean really you call yourself an insurance specialist what the HELL where you lookin’ at lady? Luckily for me and Ray we hardly ever get sick (knock on wood) and Clara has only been to the doctor for non-well baby stuff three times this year (a total blessing). Most of what comes out of our HSA is for my birth control pills (at $60 bucks a month because I am on YAZ for the PCOS) and her medication for the VUR (which is like $13 every 3 months or so). There was (and still is) plenty of money in the account but had I known that it was going to be this much we would have done her VCUG/ultrasound a bit sooner. Why? Because we would have satisfied the deductible that much sooner and all our subsequent bills would be mostly paid out of the “PPO” portion of the medical insurance at an 80/20 split which includes my birth control pills. I am convinced that insurance companies are the devil. Sadly I work for one (but again to be fair it’s not major med).

The whole insurance thing has put a bit of kink into our baby #2 plans. While the HSA works fine for people who don’t often get sick and require few, if any, medical procedures during the year (us, most of the time), it sees pregnancy as sickness for which all doctor’s visits are charged separately and admittance to the hospital comes under the deductible (the doc visits would also go towards satisfying the deductible). Additionally, any fertility treatments that I would require (and I would, of this there can be no doubt) I would also have to pay basically out of pocket for (again it would go towards the deductible). Now, Ray’s current PPO has really decent maternity coverage- you pay a $10 co-pay once for the doctor and then never again- all doctor’s visits are fully covered. The hospital stay is still subject to the deductible but the deductible is only $1300 ($1200 less than my HSA). Moreover, I keep any money in the HSA from year to year at the end of this year our HSA will have (with no additional contributions from me) about $1300. Sounds good right? Except for that pesky infertility which is covered under Ray’s insurance at $50 bucks a visit, all lab testing and monitoring may be subject to the deductible and there is a limit of $3500. What this all means is that instead of starting/trying for baby #2 in February/March of this year (when my bc prescription runs out) I will be asking my doc for a 6 month refill and we’ll be trying closer to next September/October of next year. This will allow me to build funds in the HSA over the coming year for the fertility treatments I’ll need but it will also us to switch to Ray’s PPO with the better maternity benefits at the start of 2012. And after discussion we also decided we wanted a little more alone time with Clara. If it all goes to plan she’ll be closer to 4 when baby #2 arrives which means only a year of paying for two in daycare, not to mention a child nearly out of college before the next one goes in- a bonus.

Ancillary to all that stuff going on-Ray and I are preparing for our first real trip sans baby. In April I went to Napa with my sister and mother for a little “girl’s getaway” which stranded me in California nearly an extra day. That was for a total of 4 nights. That’s the longest I’ve been away from Clara. However, over the last year Ray hasn’t spent more than two nights away from Clara. I am both excited and nervous about going. I made sure I told my sister where all the information for our life insurance is and I made sure to write down who gets custody of Clara in the event of our untimely deaths (morbid as it is- but shit does happen). Moreover, I prepared an authorization for medical treatment in case my mom and sister have to make decisions on our behalf. I think my biggest issue is that I won’t have a good time because I’ll be missing Clara too much. When I was in Napa I called Ray every day to check in on her (sometimes twice a day) and got daily pictures of her. While in Mexico it will be much more limited so I won’t really know what’s going on. I can say with complete confidence that I trust my mother and sister so I know Clara is in good hands. I would never have let anyone else watch her for that length of time. I don’t trust anyone else to do what’s best and make decisions for her in our stead without putting their own personal shit behind it *ahem* Ray’s parents *ahem.*

So that's about it from here. Let me know if you are still reading, maybe I'll update more.

3 comments:

marylandmel said...

I'm still reading!

When is your trip?

Ann M. said...

I'm still here too :)

erin said...

I've been reading, too! (and the other blog, as well.)