Tag Archives: health insurance

Do I Choose to be Stressed?

A friend of mine, a stay-at-home mother who is married to an engineer who is likely earning over $200k a year, has told me to stop making choices that make me so stressed. I should go to a mindfulness class, she says, as this helped her resolve the majority of her own anxieties. They aren’t rich by any means for this area, but they do have a small condo that the husband’s parents purchased and they are renting the unit from them. I agree with her that I put myself in stressful situations and even when I don’t I have a tendency to stress about every little thing, but it’s hard to have a conversation with her about the stress I feel about money and the ability to live a comfortable life. I hear my mother’s voice, someone who doesn’t really want to understand money or retirement savings, but who just assumes it will all work out. And maybe it will for her. And maybe it will for me. But maybe not.

In the case of my life, I just don’t see it all magically working out. I have to make it work. And,  yes, that is stressful. I am literally making the choice between jobs that will pay over $150k and jobs that would pay $60k — and the crazy thing is it’s easier to get hired in the former right now. Those well-paid jobs come with a heaping dose of responsibility and the corresponding stress.

Here I am, one month from turning 32, and — this is the year I’ll get married and when I want to try to have children. I know having children will be challenging due to my health issues, and I also know that stress can contribute to infertility and miscarriages. I need to focus on being healthy and stress-free right now, but that’s hard to do when I am staring down these startup jobs that I’ll always feel under-qualified for and incapable of any sustained success. And just logistically these companies don’t have paid leave for maternity or anything, so I’d basically have to quit when I have a kid, if I have a kid. Which really sucks since I’m currently the breadwinner (well, at least prior to getting the axe!) I don’t know how I can make this work. It works FINE now – living in a one bedroom apartment and being ok with having to move if our rent goes up too much… but I can’t do this with kids. I mean, people DO do this with kids. But if I’m stressed now… then I can’t imagine how I’d feel then. And I don’t want to be a stressed out mother around my future children.

Today, I’m trying to decide whether to do COBRA for health insurance or to purchase it on my own. Neither option is great. For $550 a month I can have a $1500 deductible plan… or I can buy my own and do something like $350 a month for a $5000 deductible. In either case, it’s just a catastrophic plan and any other health needs… like… pregnancy stuff… wouldn’t be covered (well, it would go towards that impossibly high deductible or not at all.) My fiance doesn’t have insurance through work so it’s not like I’ll be better off when married. We’ll just be paying more in tax (if we’re both working) as our big reward for tying the knot.

I know I’m fortunate to even have these problems… but the next few years of my life are legitimately terrifying. These are the years when I either become a mother OR become a woman who never has kids. Either is a major, major life-defining situation. I want kids, even though I’ll never feel ready. I don’t want to watch my 30s go by and have just let work become the only thing that matters in life. And I’m the type of person that is all or nothing — it’s so hard for me to be just enough, but not too much, especially when in the startup world the general unspoken agreement is that you should work 14 hours a day, 7 days a week (give or take.)

Becoming a contractor would be ideal – for the flexibility – but then I’ll really have to deal with the health insurance situation… I mean, after rent, health insurance, and car insurance … that’s about $1800 a month right now. I just don’t think I can – for the long term – do the consultant thing. I think, even though the stability kills my drive, I need it. I just don’t know WHAT to do. It’s not like I can bring up the whole “hey… so I may get pregnant in the next year or two… and also, I may need to take crazy hormones and take time off of work in order to get pregnant because my body doesn’t work so can I negotiate some of flexibility into this contract or you know what just go hire some woman who doesn’t want kids or who already has them at least or just someone who probably won’t have substantial medical issues trying to get pregnant.”

My friend would tell me that I shouldn’t be stressing over this. But, I guess, I would want to ask her if she’d be stressed if she didn’t have a stable place to live and a husband with such a well-paid, high-stress career. She says she doesn’t care about money but I know she likes nice things — she has good taste — and I know she says she doesn’t really care about money because that would be too stressful, but that’s because at this point, perhaps, she doesn’t have to care, or she chooses not to think about it or be involved in her financial future.

There really isn’t anyone I know who is in a similar situation either — my friends here (the female ones) are either married and stay-at-home mothers or part-time self-employed types with husbands who have high-paid tech jobs, or they’re in a situation where they’re making about the same as their significant others and will probably leave the area since their careers don’t provide the salaries needed to last here. I don’t relate to (or have any friends to people who are) powerful women who have high-paid jobs. I mean, I’m not that type, I’m just faking it… for now. I really want to just tell these companies I’m interviewing for all the reasons they shouldn’t hire me… because I’m so tired of being a good interviewer but then feeling like I just don’t know what to do or how to do it when I start – or especially after I get through the few things I know how to do… and am left with a whole bunch of “figure it out” that never goes so well when I’m in charge.

 

 

 

 

 

 

 

 

Mental Health Care: Expensive even with insurance

If you’ve been reading this blog for a while, you know I suffer with a mishmash of mental illnesses. For those who don’t — my list of diagnosed errors of the brain includes major depression, bipolar (II) disorder, generalized anxiety, ADHD, social anxiety, narcissistic personality disorder, among other, non-diagnosed yet still symptomatic crazies. Despite wanting to get through life without help for years, I’ve been in and out of therapy. Also, due to these illnesses and disorders, I’ve been in and out of jobs – which makes spending a ton on mental health treatment not the wisest.

This year I thought I had the good fortune of health coverage that would actually cover a reasonable amount of my weekly psychotherapy sessions. It would still be expensive, mind you, but after hitting the $500 deductible (that’s less than a month of weekly sessions) my outpatient therapist would cost just 30% of her total billing rate. Except, it turns out, that’s not true at all. It would be impossible to know this in advance of submitting a claim based on the way the health insurance benefits are explained. Apparently only $77 is considered a reasonable cost for a therapist visit, and the other $53 per appointment doesn’t even count towards the deductible. 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

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?

My 2009 Health Spending and HSA Account Report

This was the first year I had an HSA Account along with a high deductible health insurance plan. It’s worked out ok, though to be honest I’m still unsure if I’m doing this all right. I made some last-minute transfers from my account to reimburse myself for medical spending and glad I did it today, because I found out that I can only transfer $500 per day and I needed to take out the same $2000 that I just transfered in.

The biggest stumble with my HSA this year was my accidental over contribution (excess contribution), as I transferred $2000 into the account completely forgetting that my work would be putting in another $100 before year end, putting my account $100 over the legal limit for the year. Oops.

I’m still not sure how that is going to pan out… I’ll probably just be extra taxed on that $100 which sucks but it will be a few bucks (hopefully) and I know better for next year.

My medical expenses this year beyond what was covered by insurance were pretty costly…

Vision

$134.95 eye exam

$429 13 month supply of contacts

Dentist

$761 deep cleaning 4 quadrants and oral cancer screen

Mental Health

$710 — group therapy 1 month, one psychiatrist appointment, one career counselor appointment, 2 individual therapy (group screening) appointments

Acupuncture

$250 — 2 visits and herbs

Gynecologist

$200? — ultrasound to see that yes, I still have many cysts on my ovaries and office visit to discuss this (all during my supposedly “free” yearly checkup

Foot Problems

$195 — this was either for my one visit to the podiatrist or the xrays, I’m unclear which but I probably owe more.

Monthly Health Deduction: $20 (x 12 = $240)

Total Health Costs this Year: $2919.95

– $1200 (employer contribution to HSA)

My Approx 2009 Health Expenses: $1719.95

Reimbursing my HSA Account Before Dec 30

This is my first year with an HSA account and I’ve yet to use it properly. The basic premise of the HSA is that you can pay for medical expenses (including dental, vision, and even acupuncture and herbalists) with pre-tax dollars. Or, well, they’re post tax and then untaxed dollars, depending on how you do it.

The limit this year for an HSA account is $3000. Since I don’t have a 401k and I max out my Roth IRA, it seems like the next logical step would be to max out my HSA. My company puts in a bit of money each month so I have $2000 left that’s on me for the year. My plan now is to transfer $2000 into my HSA account before the end of the month. Nothing like waiting until the last minute.

I’m currently awaiting my HSA account to hook up with my bank account. They need to do that take out a few cents from your account so we know you’re legit and you can tell us what happened on your account thing before connecting with my checking account. Hopefully that won’t take too long.

Then I have to transfer $2000 to the HSA account, which I’m told can take up to 5 days. Then I have to, right away, transfer most of that $2000 BACK to my checking account to reimburse myself for all the medical expenses that I’ve had this year. I think there might still be a nickel or so left in my HSA account by the time I’m done with all the reimbursements.

How much am I really going to save on this? Well, I guess that $2000 extra income is shielded from federal tax (as long as I use it for a qualified medical expense). Since I’m probably in the 25% tax bracket this year, I’ll save $500? I think? Because California is a douche, that money still has to be taxed via the state’s 9% (?) rate. I’m extremely confused what that is going to look like come tax time. I’m guessing I have to pay 9% on $3000, or $270. I guess I’ll find out when I get on my Turbo Tax account and see what they have to tell me about my HSA account. I’m hoping I’ll understand it a bit more for next year.

Have any of you used an HSA account before? Is it a total hassle come tax time?

Economy and Jobs: California 3rd Worst. (How are you faring?)

Yesterday, the state of California posted an 8.4 percent jobless rate, the third highest in the U.S. According to The Los Angeles Times, The state lost a net 41,700 jobs in November. The rate is at its highest level since 1994 and puts the state behind only Michigan and Rhode Island.

Last month, U.S. employers slashed 533,000 jobs – the most in 34 years – as unemployment rose to a 15-year high of 6.7 percent, reports the San Francisco Chronicle. With the high rates of job loss in my state and elsewhere, everyone is watching their piggy bank. Closely. For workers who lose their jobs, health insurance options are limited. The San Francisco Chronicle reports that (As most of you know, I’m fortunately employed, but as a freelance worker with pre-existing health conditions, my options for health insurance are fairly non-existent.)

It isn’t helping matters that in California, the state’s financial crisis means that traditional safety-net options, such as public health programs and clinics, are being cut back or threatened by the state and national budget crisis. It’s true California’s estimated $41.8 billion budget deficit needs to be fixed somehow, but with the current state of the economy and rates of job loss in Cali, it’s a tough time to go cutting public health programs.