Tag Archives: doctor

$1000 a month on a psychologist?

I’ve written before on my concerns on over-spending on healthcare, particularly mental healthcare, as my income has ranged from $50k to $100k. Even though today I make more money than I did years ago, it still seems a bit unreasonable to spend $1000 a month on a psychologist. However, that’s how much qualified mental health costs in my neck of the woods. I just spoke with a local psychologist who sounds like he may be able to help me reduce stress and be more functional, yet he costs $235 a 45 minute session. Does it make sense to spend $1000 a month on mental health therapy when my rent is only $600?

You could argue in the long run I’ll make more money if I get appropriate mental health help. I may be able to keep my job longer… be more successful in my tasks… prove to management that I’m capable of sustained success and therefore worthy of a raise… etc. But it certainly won’t help my bottom line in the short term. And wouldn’t something like yoga (even at the really expensive studios around here) or straight-up personal training be cheaper and actually make me healthier in the long run?

Perhaps I’m just resistant to allowing therapy to work because I don’t want to believe I can pay for someone to tell me how to fix something that isn’t physically broken. That said, these days I’ve been about at my wit’s end and need help. I need help enough that I’ve started to call local psychologists. Yet, then I remember that they charge $200 a session, and that means $800-$1000 a month, or $12,000 a year. Even though my take-home pay is $4200 a month after 401k and taxes, that’s still a lot. How much should I spend on mental health?

HSA, FSA, and the Cost of Being Healthy

There are a lot of different versions of health benefits available these days. Even when you are fortunate enough to have insurance through a company plan, it seems basic healthcare costs have skyrocketed over the last decade. For instance, my co-pay to visit any sort of specialist is $50 a visit. Assuming I ever need to go to a specialist for more than one visit, which is often the case if you need to see a specialist, that adds up fast.

My last company offered an HSA plan, where instead of paying for a more expensive plan, they’d put $100 per month into your account. The deductible was high, like with all HSA plans, requiring a $3000 spend per year before additional fees would be covered at all. So it was basically a high-risk plan, with an HSA savings account that, theoretically, would be beneficial as a separate retirement account if you were healthy and didn’t need to touch the money. You could either leave the funds inside it to gain basic money market interest, or you could open an investment account where you could put the money in a handful of mutual funds available.

The good news is with HSAs, even when you no longer have the insurance plan open with them, you can still use any money put inside there for medical costs in the future. Plus, the money that goes in is tax free and as long as you use it for a qualified medical expense the money that gets spent is tax free too. But there’s a catch… Continue reading

Occupy Doctor’s Office & Health Insurance Agencies

They say the occupy movement is unfocused — it’s about all these various things we’re upset about — but a lot of the movement is about the lack of transparency in between bureaucracy and us common folk.

When I got home yesterday, I went through my mail and discovered a “explanation of benefits” mail from a recent “surgery” I had on two pilar cysts on my head. The doctor’s office never knows about costs — they don’t really care about how much you end up getting charged, as long as you pay it. Even with medical insurance from work, the two cysts removed cost me $550. Last time I had two cysts removed it was $300, so I was a little surprised that the cost went up $250. But I haven’t found a way to identify how much any medical interaction will cost in advance of the treatment… it always has to be a big surprise after the fact.

Another example… I went to a regular yearly gynecological exam a while back, which is covered by my insurance. Or is it? The gynecologist decided to do an ultrasound to check out my polycystic ovaries which — big surprise — still had cysts on them. That procedure wasn’t covered by the free annual checkup description, as it was considered diagnostic, and ended up costing me a few hundred bucks. Continue reading

Contemplating a Serious Career Change

Maybe it’s because I’m an INFP with ADHD, but I always feel the need for a career shift every couple of years. I get bored at jobs but that’s not the only reason I look for a change. There is something missing at every job I’ve had so far and what that thing is becomes clearer as I get older. That thing is feeling like I’m helping people.

Of all the jobs I’ve had so far, the moments I’ve liked most were when I felt most connected to my “NF” side. Admin? Hated data entry. Liked answering questions when people needed help. Retail? Hated “selling.” Loved helping people shop for something that fit what they wanted. PR? Hated “pitching.” Liked helping journalists get the information they need. Journalism? Liked when I got to write articles to give a voice to people in the local newspaper who otherwise wouldn’t be heard. Disliked when my whole job was getting stories first about corporate drama. Marketing? Well, it’s hard to find a lot to like here in this sense. I do enjoy the strategy end of things, but I’m lacking motivation to promote something that doesn’t benefit people in any way. Notice a trend?
This has me sitting here, wondering if I have gone the entirely wrong direction with my life. I’m “only” 26 but some jobs out there require years of training… a high GPA… and a whole lot of commitment. The worst thing is that now I am making really good money. That would be great if I loved my job, but it’s hard to stop everything and go into debt for another x number of years of school to ultimately learn less money. My secret TJ side is screaming “that’s stupid!”
One of the fields I’m tossing around is nursing. If I like helping people so much, and I like jobs that are fairly high paced, why not be a nurse? I always wanted to have a job where I could be special and different. Being a nurse is not about you at all. It’s a job just like any other job. But where I’d never get recognized by the masses, I’d be recognized for helping people every single day. Would that be enough to make me happy? Maybe.
The only thing I know is that if i keep on the route I’m on now, well, I’m looking at doing what I do best… getting fired, or laid off, or quitting, and being depressed, but too scared to change my track, and then managing to find something else that is “better” in theory (better pay, more reasonability) but worse in getting me closer to career happiness. If that exists.
There are other things I’m interested in… especially psychology… and if I’m going to be a nurse why not just go for the PsyD? Or, heck, get a postbac in premed and go to school for 12 years to become a psychiatrist? It feels too late for all of that. And I don’t want to kid myself. I’m definitely interested in psychology, but I’m also not a good test taker and I’m of average or only slightly above average intelligence and below average focus and motivation. I’m on a roll right now faking it in the field I’m in, why change? — and, granted, I don’t totally fake it – but I feel like a big phony. But… if I have one life… why give up a chance to feel like I’m helping people every day? Wouldn’t that be worth more than any salary?

To COBRA or Not to COBRA

My mom would say get your ass on COBRA asap, but she doesn’t understand the financial implications of COBRA healthcare costs when you’re unemployed.

Last time I had the opportunity to go on COBRA after losing a job, I had been on a PPO plan (a really good one) so I was looking at $405 a month for continued healthcare coverage (not counting all the extra copays and such I’d actually have to spend if I ever went to a doctor.) I denied my COBRA coverage — that time I didn’t even have unemployment since I was talked into “resigning” my a boss who was otherwise going to fire me (I just didn’t have the chops to be a full-time journalist-blogger, go figure) so COBRA coverage, which cost half my rent, wasn’t much of an option. At the time I also thought I’d be able to find cheaper high-deductible insurance for just-in-case problems for less. And soon I discovered that my health history of having irregular periods and treatment for depression disqualified me from being able to get any sort of health coverage without lying on my application. So eventually I lied and spent $150 a month on healthcare with a $5000 deductible which could be revoked at any time if they found out that my periods were in fact irregular or that I sought treatment for being depressed. Which made me EVEN MORE depressed.
This time, I thought maybe since I was in a high-deductible plan at work my COBRA coverage wouldn’t be as expensive. It was a decent plan, but only due to my company putting in an extra $150 a month into our HSA accounts. So the plan, which has a $2000 deductible, wasn’t a bad deal. Now, on COBRA, it’s going to cost me about $300 a month to stick with this plan. So that’s an extra $3600 per year which… only covers freak accidents that would otherwise cost my life savings. Worth it? Not so sure. Possibly. Especially since I won’t be able to get other, more affordable coverage which most people would recommend to a girl in her 20s. Because my periods are irregular. And I’m sad on occasion.
I wish Obama could get his act together on healthcare. I’m not sure what a person like me should have to pay for healthcare, but these costs just seem prohibitively high. More so, I feel it is unfair for the health care system to kick me out just because my ovaries are not perfect and I actually sought help for my depression so I could get back to being a productive member of society. I learned my lesson then to NEVER pay for mental health care using health insurance (even if the booklet they send out makes you think it’s a good idea.) At least with an HSA plan it really doesn’t matter a whole lot if you pay through insurance because ultimately you can use your HSA money for therapy, and if you pay with insurance you’ll basically have to pay the whole fee anyway, it will just go on record. It may cost a little less since the few therapists who take insurance these days are forced to charge a fee which is lower than what they’d want to charge, but then you’re also extremely limited to which therapists you can see. So for now I am seeing a woman who is an intern in a psych program who is letting me see her for $20 a session. I don’t think she’s the best therapist ever, but right now, having someone to talk to weekly so I don’t jump of a bridge is important, and I can afford $80 a month for that. $300 a month for basically nothing but insurance is a little hard to shell out when after taxes your unemployment income is maybe $1500 a month. If I ever get the unemployment income, I’m still working on figuring out if I’m eligible, etc.
This all limits the otherwise decent option of seeking out contract work. I know a few people were angry at me at my post where I asked… should I do contract jobs while getting unemployment (since doing work lessens your unemployment pay) but in reality you’d make more doing NOTHING because contract jobs require you to pay 15.3% more in taxes just because you’re considered self-employed. Unemployment pay, as far as I know, doesn’t require you to pay the extra 15.3%. I agree that I should not be lazy and mooch off the government, but it seems silly to do work to make less then I’d make by instead spending my time job hunting and even teaching myself new skills. And my current contract job is not going to lead to a full-time anything, it’s just a freelance blogging gig where I can make up to $500 a month, I’ve been doing it for over a year now, and it was nice extra income when I had a job, but now it’s the question of doing that and making less than I would on unemployment or just going the unemployment route. And I’m not sure what to do…
For now, I need to figure out if I’m going to go COBRA or without healthcare again. What do you think I should do?

high deductible health insurance sucks (TMI post)

I’ve been having these pains in my stomach for the last month, and as they haven’t gone away, I want to go see a gastrologist about it. I already spent $65 + $25 to see a gynecologist for a UTI I had earlier + antibiotics, and I’m not even sure my UTI has gone away. Meanwhile, this pain is getting worse. Yesterday, I took laxatives to see if it would help. Maybe I just have IBS and the doctor will say “eat more fiber, stop eating sugar” and that will solve everything. I had the worst pains ever after taking that stimulent laxative and was up all night grabbing at my stomach.

I don’t think my problem is constipation. There wasn’t much to get out (sorry, TMI, I warned you in the title.) So what IS my problem? It’s not gassiness, it’s not dihareea, it’s probably not constipation. But there’s still a pain, that seems to go back and forth between my lower left abdomen and my upper left abdomen. Occassionally, the chest area on the left side also hurts, I get a burning sensation, so maybe that’s heartburn. The pain in my chest is rare, but the weird tight aching feeling in my left abdomen is constant.

So my boyfriend convinced me it’s time to go to a doc. I called and made an appointment. I can’t even see the actual doc because he doesn’t have an opening until Sept 24. So I made an appointment with a nurse practitioner. The lady in the billing department convinced me she’s just as good as the doctor. We’ll see about that.

So the nurse practictioner costs just as much to see as the doctor does. It’s about $300 for the appointment. Well, it might be $150 at the lowest, but they can’t tell me until after the appointment. If it turns out it seems serious (which, for the sake of getting my monies worth, I almost hope it does) then they’ll prob have to do a more thorough exam, which will cost the $300. But with that, they’ll need to do tests, and lab work, and I have a feeling it won’t be long before I reach my $3000 deductible.

I really need a job with health insurance. 🙁

The Costs of Being a Girl… Without Health Insurance

(First of all, I want to apologize for being so behind on updating this blog. My life has gotten quite busy, which is a good thing, but I definitely haven’t updated this site as often as I should, or as often as I’ve wanted to. I do hope you’ll bare with me until I can make more frequent updates.)

Today’s post is brought to you by The American Health Care System. Due to failures in the system, this post is vastly underfunded, but luckily I’ve got plastic to pay it off…

One you’ve started bleeding (down there) or having sex (down there) – if you’re a girl – which I am – you’re supposed to go to the gynecologist once a year to get the basic test. Swab in, swab out. Needle prick. No sir you have no STDs, thanks for coming. The whole nine.

Prior to getting super-high deductible health insurance (with a $3000 deductible, so I count that as no insurance at all), I didn’t think twice about scheduling my yearly paps. The co-pays for the appointment, tests and pills were a bit annoying, but nothing that set me back any large sums. I barely went to the doctor anyway, so this wasn’t a huge deal.

Then came contract life. It took me forever to get accepted for any health insurance at all. Finally, I got accepted to a high deductible program. That sounded like a good idea. I’m young. Somewhat healthy. Well, I know what’s wrong with me, PCOS – ie, polycystic ovary syndrome – and the likelihood of my falling to the floor in pain due to anything other than a ruptured cyst is near zilch. That’s what the high-risk insurance is for. Accidents. Not day to day, or year to year stuff. That’s all out of pocket.

So my yearly health insurance, which covers nothing except a hospital visit (after I pay $3000), costs me, oh, $1600 or something like that. $1600 in case I fall down and break myself. That’s important to have.

But it’s not going to help me make sure I don’t have cancer or any other life-threatening illness. It’s not at all about prevention. It’s about post-intervention.

Ok, so I’m really sensitive to screening before things happen right now because my dad was just diagnosed with prostate cancer. And while I know that I’ll never have prostate cancer, I’m still very concerned about being at high risk for ovarian and uterian cancers due to PCOS and having, like, 2-3 periods a year (sans bc pills).

I want to be “good” and get tested yearly. I’m 24, nothing should be wrong, but it’s good to be safe. Plus, I like to have STD screenings every once in a while, just in case an earlier one was wrong. It takes like 6 months for some of those diseases to show up on tests. And sometimes tests lie.

Anyway, today I was scheduled for my annual pap and checkup with a gynocologyst I had seen about a year ago when my cyst ruptured and I felt like death. She did an ultrasound on me then, and perscribed me – tylenol. At the time, it was cheaper to perscribe me it because I had good health insurance and I got a cheaper price to buy it under the cover as opposed to over. Those days are, apparently, long gone.

Although a few weeks ago I had a very, very painful period and pre-period period, and felt little alien slugs were attacking my innerds, I opted to avoid spending $200 on another ultrasound that would likely end with the words “take tylenol.” Instead, I figured it made sense to schedule my annual pap with the doc, and then to ask her what was wrong with me then, or at least inquire as to what could be wrong with me given my symptoms, and go from there.

When I called up the gyno’s office, they told me the annual appointment, sans insurance, would be $180. Ok, so $180 isn’t a big deal. I mean, it is, but when you consider the cost to get better insurance that would actually cover that sort of thing would cost me about $180 A MONTH more, it wasn’t so bad.

But when I got to the office today – I was running late – it turned out I missed the appointment with the doc. Which actually was a good thing, because I was soon informed that the $180 for the appointment did not include any costs of labwork. Umm… isn’t that THE POINT of having a pap? Let’s just scrape my cervix for fun, why don’t we? Use the swabby stick as a paintbrush and have a little creative fun on the wax paper I’d be sitting on, sounds like a plan. Totally worth $180.

No one could really tell me how much the tests would cost. I guess they’re not used to seeing people without insurance. Or with crappy insurance, like my insurance. I got such mixed answers today. The lady at the front desk said 100s, and then the nurse pratictioner who I finally went in to see said the basic pap test would be only like $35 – $50. I don’t trust ranges.

What I really needed today, urgently, was treatment for my likely UTI. Yup, I have and have had a full-blown, painful urinary tract infection for over two weeks now. (TMI? Sorry.) I knew I needed antibiotics. I know when I have UTI. I get them all the time. This one was caused by drinking about 6 large glasses of iced tea and promptly getting on public transportation for about an hour. Lets just say my bladder was not a happy camper, and it made me pay for what I did to it.

At the doctor’s office, I ended up getting a “talking” appointment with the nurse practicioner because she happened to have a cancellation. They had me pee in a cup to test my urine for the UTI. Again, no one told me how much this would cost me. I was told – well, the doctor will look at your pee, then decide if we need to send it out. And sending it out – would be a lab fee. Ok, how much am I looking at? $50? $100? More? Can’t someone just give me antibiotics? I’ve been having UTIs all my life, I know I have a god damn UTI, I can tell you exactly how it happened. I can even reproduce the situation. Got any iced tea???

Well, I went into the examining room, and the nurse practioner came in to talk. She was really nice, but I could tell that she didn’t exactly love that I was wasting her time. Well, I wasn’t wasting her time, because she ended up charging me $65 for the appointment, but at least I left with a perscription for some generic antibiotics. Not sure how much those will cost me, but she said they’re and old brand and should be cheap. Right now I’ll pay anything for antibiotics, as that’s what I really, really need.

However, this doc told me that it prob makes sense for me to go to Planned Parenthood for my pap and checkup, since it’ll likely be cheaper. I was thinking of calling Planned Parenthood but I figured my income bracket would prob be too high for getting treated there. But this nurse gyno lady convinced me it might be best, and since I’ve never had an abnormal pap before, she didn’t seem to think there was any urgent need for me to get the test done.

Maybe she’s right. I’m 24, I have cysts on my ovaries, I get a period once in a blue polka-dotted moon and a UTI when the moon is full and white. What else is there to know?

Still, I want to get tested. So I left the doctor’s office $65 poorer with perscription in hand.

… a few minutes ago I called up Planned Parenthood to schedule an appointment. I was told by a friend that it’s better to tell them you have no insurance if you have high deductible insurance so they will see you. As, again, my insurance has such a high deductible it’s pretty much no insurance, I didn’t feel like that was much of a lie.

So I called and asked for the appointment. They proceeded to survey me about my age, ethnicity, and income. When they asked how much I make, I didn’t know what to say. The truth would surely be too high for any sort of affordable care. But I kind of did tell the truth. I told them I’m a contractor. Which is true. They asked how much I make per month. I said, well it ranges. She asked what the low end was. I picked a number out of the air. $2500, I said. The truth is the low end is like $400 when I don’t have a job and the high end is like $5000 when I do have a job. So I averaged it. What’s $2500 a month? $30k a year? Not quite poverty, I guess, but the only way to get reasonably costed checkups in this country is to be poor, apparently. Not that I’d wish for that, but when I was making less than $30k, I had health insurance, like real health insurance. And now… well, you know… not so much.

So I figured on a sliding scale, $2500 a month income might get me some discount on all the tests. I was told, by someone else, that she basically got free care at planned parenthood. And she had money, it’s just that she wasn’t making any money. She was a grad student, but she had money, somehow. Anyway…

I was told I didn’t qualify for a discount. So their pap would cost $300 (which, I think, includes lab services) which is MORE than what I was going to pay at the doctor’s office this morning… she was going to do the exam for $165 plus lab fees. Well, she said the lab fees were “$35-50” – whatever that means. Maybe it’d be about the same. Still, so much for finding cheaper care.

Meanwhile, I found out that at Planned Parenthood, you could get birth control pills without a full exam. It’d just be $30 for an appointment and $22+ for the pills, depending on which ones you want. I guess most of planned parenthood’s funding is really about not making babies, not, not having cancer (which makes sense. It’s not Planned Ovarian Health Org). And the cost of a full STD screening at my “level of income?” $150.

I think all of this has me rethinking my career. I love my job. It’s wonderful. But I just need REAL health insurance. So maybe I’ll start looking for a job that provides that. I hate to do that. My company seems to have health insurance for “full time employees” (not contractors who work 40 hours a week) but even their health insurance, I think, is high deductible. I’m not sure, I haven’t really looked into it, but it sounds like they all have HSA plans which means they must be high deductibles, I think. They’re a small 8ish person startup, so they can’t afford good health insurance. Can’t blame them for that. But I don’t even get that. Everything comes out of pocket. And my pretty good contract rate starts looking less and less good…

It’s just hard to figure out the total cost of everything when it comes to healthcare. And in this case, the comparision between a year of being on crappy healthcare at $140 a month and having to pay for all health costs out of pocket and working as a contractor where I can work from home on some days and save on gas money, versus getting a “real job” with a salary and benefits, and having to go in every day and spend money on gas and extra travel time and being miserable and needing to spend money on a therapist.

It’s impossible to really compare that. Maybe I should just pay $300 something a month for an HMO. I can’t decifer if it’s worth it. I have an HSA plan but haven’t even opened an HSA account yet because that kind of seems like a joke. They charge you a fee to open the account, and to maintain it. It’s basically another RothIRA, but I go for index funds, and then I have limited choice in investments, and – the kicker is it’s not even tax-free in California. So…

blah.

My Father is Sick, My Mother Doesn’t Even Know How to Pay the Bills

Far across the country, my father is lying in bed, fighting off illness, and my mother is fretting that the lights are going to turn off because the electric bill hasn’t been paid.

My dad is in his late 50s and has been suffering from diabetes and obesity for years. He has refused to treat his condition properly, and has not taken the insulin prescribed to him because he said that it was impossible to lose weight on it. Of course, the way he eats with no exercise, it’s not possible to lose weight in a healthy way.

He’s supposed to go to the doctor to get checkups every few months but he hadn’t been to the doctor in over a year. That is, until this past week, when his health quickly deteriorated and has left him bed ridden.

But, being the stubborn guy that he is, he’s still telling my mom to bring him the bills to pay. He can’t even get out of the bed, yet he won’t let her pay the bills.

The saddest thing of all might be the fact that my mother doesn’t even know how to pay the bills to begin with. I mean, she could pay them, but she has no idea how much money my dad has in his accounts, or how much is saved for their future. If any credit card bills don’t get paid, it’s on her credit history as much as it is his.

My father finally went to the doctor. It sounds like there are more problems than just the discomforting illness that sent him into the doctor in the first place. They did some blood work and determined that there’s something wrong with his prostate. It’s either an infection or cancer, apparently. They’re giving him antibiotics to try to clear up the infection but if that doesn’t work it might be malignant.

Given that my dad hasn’t been to the doctor in forever, he’s probably waited too long to treat any sort of cancer if that indeed is his infliction.

My father and I don’t have a close relationship, but I’m still scared for him, and for my mom. I’ve accepted for a long time that he could just die and be gone any day, the way he takes care of himself. Still, I don’t want it to happen, obviously.

My mom said he hasn’t said he’s scared, but he at the very least admitted to her that she was right – that he should have gone to the doctor sooner. For anyone who knows my dad, him admitting to my mom that she was right says a lot about his view on his condition at this point.

He’s been in the hospital before, but it wasn’t enough to scare him to get healthy. He doesn’t seem to believe he can, or he doesn’t care to do it.

I want him to grow old and be around to be the grandparent of my children one day. He’s not the best guy in the world, he has his issues, he was abusive to me when I was a kid, and he’s emotional abusive and somewhat physically abusive to my mother at times. Still, deep down inside of him, there’s a good guy there. And I want that good guy to grow old and be around for a while.

And then, logistically, there’s the real concern of what would happen now if he did pass away. My mother wouldn’t know what to do with the money at all. I have a feeling my dad has a decent amount saved in 401ks, etc, but if my mom knew just how much they had she’d go and spend it all. Of course I wouldn’t let her do that – and she’d listen to me. She admits she knows nothing about managing the household money. I’d have to step in and take charge of all of that, probably – from figuring out my sister’s potential college education to the cost of my mom supporting herself, etc, etc.

I’ve always figured it would happen – some day – but I’m not ready for it to happen quite yet.

Maybe I’m thinking too far ahead of myself. My dad could just have an infection and he could get better soon. And if that’s the case things will just go on as they’ve been… he’ll continue to be stubborn and my mom will continue to be clueless.