Go to the Doctor… or Wait Until January 1? A case of a restarting high deductible.

Following a sore throat-turned-larigiytus, I had a five day period of optimal health, then started sneezing out of no where, bringing on my current quite bad chest cold. It’s rare for me to get this sick, and this often – but for a pregnant woman apparently it’s normal to have a drop in immunity (to not reject baby) and thus you’re susceptible for a whole host of ills. Fun!

Colds, as anyone who has been to the doctor knows, cannot be helped by medical intervention. They just check your breathing and tell you to rest and drink lots of fluids. This is why, unlike my mother and sister – who manage to get antibiotics every time they so much as sneeze – I tend to avoid the doctor in the case of sniffling or coughing.

All of that doctor avoidance caught up with me a few years ago when I came down with  pneumonia. When my chest started rattling when I tried to breathe, I knew it was time to visit the doctor. A quick Xray later and I was told I had pneumonia. Even with that, there wasn’t much they could do but tell me to rest and come back if it got worse, not better. I did get an inhaler which helped tremendously in terms of breathing, and I have to say my lung health has never been the same since that case of pneumonia.

Today, it’s not pneumonia — I don’t even have a fever — but it is a bad chest cold that could very well be acute bronchitis. Again, nothing the doctor can do about that if it’s viral.

If a doctor’s visit was going to be $100, I’d just go. But last time I went to the doctor, it cost me about $400 to get my arm pain checked out for 10 minutes. This wouldn’t even be a huge issue (I have healthcare costs set aside for the year) beyond looking at how expensive this year has been from an insurance perspective due to a constantly resetting deductible:

The really bothersome part of my healthcare this year was leaving my job in June, going onto COBRA, and no one notifying me that the plan had changed Aug 1 to a higher deductible — so all of my August therapy appointments and medical appointments were going to be $1000+ instead of basically free with a small co-pay. Luckily, I had enough in savings to cover that, but given I was laid off from my job in June, the last thing I needed was a surprise deductible increase mid year. Yes, I should have checked before going to those doctors appointments in August — but I honestly didn’t realize that they could change plans mid year and assumed the annual deductible would have to hold for the rest of the year as long as I paid for COBRA – which, was $560 a month. Wrong.

When I talked to the health insurance company, they did say my prior deductible should apply to the new plan — that $1500 existing deductible would go towards the $2600 deductible. Except they never actually fixed that on my records. I think I ended up paying like $2700, so if I get around to it next week I’ll spend hours on the phone again trying to get Anthem to pay me back about $80. It’s not worth the time at this point, but it’s the principle of it. And that, on the phone they had already told me, about 20 times, that the deductible would be applied to the new policy since the policy was a mid-year change by the same company – only the deductible was allowed to increase by that much.

That brings me to today. Or, to October. In October I started a new job and with that new job came new health insurance. With my COBRA coverage lasting to the end of November, I had a choice — pick the low deductible insurance for 2 months and have no access to an HSA and the company HSA contribution— or — try to make up for some of the awfulness in my healthcare situation this year but going with the high deductible plan, putting money into the HSA (prorated for the 2 months of the year I’m eligible), and just not going to the doctor except for an emergency for two months. What’s two months?

Except that decision was before I found out that I was pregnant. And before I managed to come down with two very bad colds. I don’t want to be stupid about this — if I broke my arm I wouldn’t be waiting two weeks to go to the doctor. But – next year, I switch to Kaiser (for the first time in my life) and while I’m concerned about quality of care based on some of the things I’ve ready, I can’t say I’ll miss the confusing billing policies of a PPO. We opted for Kaiser this year because their prenatal and labor fees are extremely low compared to other options, while they are actually rated fairly highly for prenatal care and birth. My husband was born at Kaiser and went there throughout his life, and has high opinions of them, so I thought it will be worth trying it out for my first baby — we can use the extra cash for feeding/clothing/keeping that baby alive.

This cold only started on Sunday night. It’s Wednesday morning and I think it’s progressing, despite being unpleasant. My nose and sinuses are much less clogged, and all of the clogging has moved on to my chest. I’m not coughing up mucus (which is a bronchitis thing), but I do have this hacking cough that won’t stop, and an occasional sneeze which, after thinking the sneezes are done and dried out, opens up the fountains. Beautiful picture, I know.

It’s only 11 more days before I have access to my new health plan. This is only a cold and not working spending $300+ on an appointment to find out it’s only a cold. If anything, they’ll probably say come back in 1-2 weeks if it hasn’t gone away, and at that point I might as well have just waited…

But, I am also starting to think if this doesn’t go away by Friday (I wrote this post on Wed), perhaps I should be checked out by a doctor, just to be safe – even if it costs me $300+.

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