Category Archives: Health

On Being Sick Without Health Insurance

For one day this month (May 1), we were not covered by any insurance.  The insurance from Dad’s old job ended on April 30 (Saturday), his new insurance wouldn’t kick in until May 2 (Monday) his first day of work at the new job.  We figured that we have 45 days to sign up for COBRA, so if we needed to, we could (we hadn’t even gotten any of the papers about it yet!). Friday, April 29, Daughter Person is sent home from school with a sore throat and fever.  We decide to kind of ride it out and see if it’s just a virus or if she might have had strep.  Saturday, she’s fine other than a fever and saying her throat hurt occasionally.  We let it go.  Sunday (the day without insurance), she wakes up screaming about her throat hurting and still has a fever, but this time is having trouble breathing because her tonsils are so big. Look in her throat, and sure enough there are the typical white spots of strep. Panic!

I asked around my local mom’s group about their opinions on the two urgent care options and which would be more likely to give us a discount for paying cash up front – neither.  BUT, Walgreens/CVS have the in-house clinics that are open on Sundays, and they publish their prices!  We went to the local Walgreens, waited less than we normally do for our doctor, and get this: PAID LESS than we would have at our doctor’s office – with insurance!  We then looked up the cheapest place to get her prescription filled with the OneRX app, and were on our way.

We were charged $134 at Walgreens, and $20.44 at Rite Aid for her antibiotics (azithromycin).  When we took her in March for the same exact thing, we paid $165 for the doctor’s visit (after the insurance negotiation!) and about the same for the prescription from WalMart.  If we needed to, we still could have pulled money out of our HSA to cover it, but the charge was quite low (we thought), so that money’s still working for us.  Now, I’m wondering why exactly we bothered paying $282/mth premiums for our health insurance, it certainly wasn’t saving us anything!

Surgery with a High Deductible Plan – Part 2

We’ve now (finally) gotten all of the bills from Daughter Person’s surgery and followup.  Total damage: $2,562.97, not including the first two appointments with the specialist to determine and confirm she’ll be getting tubes (those two together were $508.90 out of our pocket) – those were in the health insurance’s estimated cost of $2600.  She’ll also be having followups every 6 months until the tubes fall out on their own, or we have to pay for another surgery to have them removed.  The first 6 month followup will be in December 2015, and will include a hearing test, so it’ll be approximately $400 (based on the previous appointment she had with a hearing test).

Despite having a high deductible, we still get the “benefits” of the health plan negotiations with the doctor and hospital – not sure it’s really worth the premiums we’re paying, if you pay cash and negotiate yourself, you can probably get similar “discounts”.  Below, you’ll see what the “actual” charge was, and then what we have to pay.  The charges from top to bottom in the image are: the 3 week followup appointment with the ENT, the hospital, the anesthesiologist, and the surgeon/doctor’s fee for surgery.

Claims Summary for Insurance

Claims Summary for Insurance

This is the first full year we’ve had a high deductible plan, and this will likely be a year that we meet our deductible.  Dad has some elective outpatient surgery he needs to take care of, so he’s scheduling that this year.  I’m making sure that any outstanding medical issues we’ve been putting off are being taken care of this year because we’re so close to the deductible.

We have over 4k in our HSA, but at this point, I’m just paying with my cash back card and adding up the amounts I’ll be able to withdraw in the future.

The best part (not really): the surgery may have not been necessary.  When they did it, they didn’t find any fluid behind her ear drums.  So, we paid almost 3k to prevent ear infections that could be resolved with a $54 doctor visit and $4 in antibiotics.  That’s over 40 ear infections. I get that doctors are cautious with kids and so on, but I’m still rather pissed about it – *he* didn’t pay 3k for basically nothing (granted, he didn’t get most of the money from it either).

Do you have a high deductible plan?  How do you handle “major” medical issues with it?

Surgery with a High Deductible Plan

We got the word yesterday that Daughter Person will be getting tubes in her ears.  The estimated cost to us out of pocket (including the followup appointment) is $2600.  Most of that is the hospital and anesthesiologist, not the doctor doing the surgery.

We’re still way under our deductible ($7500 for the family), so we’ll be paying all of it out of pocket (well, out of the HSA anyway).  Not planned, but not a huge emergency since we have about 4k in our HSA.  I would have to pull it out of investments and into the “cash” part of the HSA to use it, so I might get to play timing the market.  The surgery is on July 10, I figure we have until the end of July before the paperwork even gets through to the insurance company and we see a bill, so I’m going to try to save enough and pay it out of pocket in August without decimating our mini e-fund.  The doctor takes credit cards, so hopefully I can use this opportunity to earn some points and miles as well, and it lets me float the payment to the following month/cycle to give me more time to come up with the cash.  I’ll post an update once we have the final value.

I am grateful that we have the money available to pay for her surgery, even if it’s not in the most ideal places to pull it from.

Update on Health Goals

January is over, and I wanted to update on how my health goals are going.

I’ve not gained any weight (and lost 1.7lbs), but I’ve changed my calorie intake and my exercise.  I’ve gotten up at 5:30am for 16 days in a row now to exercise for 30 minutes in the morning before everyone else wakes up.

I’ve been doing P90x3 and enjoying most of it.  I’m on the 3rd week of block 1, and next week starts the transition week.  I’ve never stuck with anything so long before – except maybe half-marathon training.  I like being able to roll out of bed, get dressed and exercise before my shower and not have to worry about it later in the day when I’m more tired and more likely to say screw it.  It’s over and done with, and I have a decent idea of how many calories I have to “eat back” throughout the day.

I’ve increased my calorie intake to closer to my TDEE and will slowly increase it until I get to my TDEE of 1900 calories.  I’ve basically been starving myself, and I want to get my metabolism back to where it should be, so my primary goal at the moment is to maintain my weight while increasing my calories every week.  I’m up at 1600 calories/day, and still maintaining or losing.  It’ll be a long process, but I’ll be able to not eat like a bird again.

I’m not doing as well at eating a fruit or veggie every day – although I’d say I’m at about 90% compliance – we have salads almost every night for dinner, which gets me 2-3 servings of veggies (mostly lettuce).  I had an apple on each of Saturday and Sunday – mostly mindless munching of apple slices – which I should take advantage of.

How are your goals coming along?

How I’m Going to Meet my Health Goals

Just setting goals is not sufficient for me – they’re too abstract.  I also have to put behind them a task list that gives me “something to do” that will let me reach those goals.  Here, I’m going to talk about my health goals in more detail and what I’m going to do to reach them.  I’m focusing on creating “habits” rather than just doing something once and forgetting about it.  Ultimately, I want to be healthier, hopefully fix my back issues (resulting from pregnancy, not weight, so not sure I can do this) and eat better to be a better role model for Daughter Person.

Goals

  • Lose 15 lbs, with a stretch goal of 20 lbs
  • Exercise at least 3 times per week for at least 20 minutes each time
  • Eat at least 3 servings of fruits or vegetables per day – potato based foods do not count as a veggie

Losing Weight

Since I know that BMI is a poor indicator of my health, I’m focusing more on body fat percentage and how I feel than my exact weight.  I’m just hoping that the weight will follow.  My current body fat percentage is 42.2%, and pre-pregnancy, it was pretty consistently about 36%, and that was still a bit too high for me.  I’d like to shoot for 30%, which is at the higher end of the “healthy” range.  I don’t know what that will look like weight wise for me, but I’m hoping it means I can fit into smaller jeans 🙂

Losing weight is about 80% what you eat rather than what exercise you do.  You can lose weight without doing any exercise at all (been there, done that), but there are consequences, such as lost muscle tone and reduced metabolism.  And losing muscle mass is not ideal for me since I want to have a higher lean/fat ratio.  So, I’m doing a combination of reducing calories and exercising (see next goal).

I’ve joined My Fitness Pal, and I’m focusing on logging my food daily.  I’ve even set up a gympact for it – I have to record at least 3 meals per day before midnight for 5 days per week, or I lose $5/day.  MFP has me at 1200 calories per day,  which is low.  I’ve tried raising it to what would be “normal” for my weight, but I just gained weight over the last 4 weeks.  I know 1200 calories will make me lose weight.  BUT, I have to eat back any exercise calories I “earn”.  I have a fitbit, which accounts for my non-exercising calorie burn – I usually get 2-300 extra calories per day from that.

Exercising More

I started this at the end of last year.  I’m waking up early every other day to exercise in my living room.  I started with 20-30 minutes videos, but I’ve found I prefer the 1hour long videos.  Because I’m waking up before Daughter Person (and thus guessing at when she’s going to wake up), I’m shooting for at least 20 minutes for each workout.  I know I’m waking up early enough to fit that in, and possibly a whole hour.  I’ve been doing random DVDs I happen to have around, most are circuit training, so they’re working both cardio and muscles.  Any calories I burn here will go into MFP and I get to “eat them back”.  A heart rate monitor is on its way to me so I can get a pretty accurate measurement of the number of calories burned.

Eating Better

I’m a horrible eater.  I rarely eat fruit, and green things are generally “yucky” tasting to me.  I avoid all bitter foods, which means spinach, kale, and pretty much anything leafy green.  I do eat butter lettuce (green or red leaf) as long as it’s got some dressing on it.  My mom was not a great cook growing up, and I’ve since learned many things I thought I didn’t like, I didn’t like because of the way my mom prepared them.  Dad has introduced me to several vegetables that I will now eat – squash being the biggest one.  Daughter Person eats more things than I do – she *loves* fruit, I can’t stand the fibrous strands in almost all fruit.  I do eat apples – as long as they’re Honeycrisp, Pink Ladies or a similarly hard crisp apple. No wonder I thought I didn’t like apples when you compare the more common red delicious apples with the pink ladies!  Luckily, Pink Lady apples are a “storage” apple, and can hang around and stay fresh for a *long* time – like 4-5 months long in the fridge.  My goal is to increase how many fruits and vegetables I eat.  I’m likely to stick with the ones I know I like, but Dad has agreed to help me cook things in different ways to see if something else is enjoyable (I’ve heard roasted broccoli is good for people who don’t like bitter tastes).

My plan is to have a salad with dinner – which is one serving of vegetables (probably 2 given how much lettuce I put in mine), and have one serving of vegetables with dinner.  Then either a vegetable or fruit for lunch.  That gets me 3 servings per day.  And I hope to slowly increase that number throughout the year, but 3 is a starting point.

Have you mapped out how you plan to meet your goals for the year?

Looking Forward to 2014

With 2014 here, I wanted to evaluate my goals for the upcoming year.  And actually write them down this year.  I’ve split my goals into three categories, and three goals in each category.

Health Goals

I’m overweight – borderline obese (although you wouldn’t know it by looking at me, I’m one of the people BMI just does NOT work for), and I’d like to get close to a “normal” weight, which for me is between 115 (hah!) and 154 lbs.  I’ve never been 115 in my adult life, and even 150 is hard for me to maintain for longer than about a month.  I also look like I’m terminally ill below about 145. 15lbs isn’t going to get me to “healthy”, but it’s a start.  I’m more focused on my body fat percentage and jeans size than actual weight.

  • Lose 15 lbs, with a stretch goal of 20 lbs
  • Exercise at least 3 times per week for at least 20 minutes each time
  • Eat at least 3 servings of fruits or vegetables per day – potato based foods do not count as a veggie

Financial Goals

I know I mentioned wanting to pay off all non-mortgage debt this year, and we could likely do it, but with our car payment at 0%, we’re going to pay the student loans down, then increase our retirement contributions to the maximum allowed (and maybe qualify for a Roth?).  It will slow down our car repayment, but since it’s not “costing” us anything, I’d rather put the money to work for us.

  • Pay off all non-mortgage debt that carries interest
  • Get to 650k in Net Worth, with a stretch goal of 700k
  • Increase our assets to 1.2 million (conservative to account for market fluctuations)

Household/Parenting Goals

These are random goals around the house that I want to complete this year.  These are the big ones, although I have smaller ones in mind already.

  • Get rid of diapers!
  • Get rid of another 365 things in 365 days
  • Finish the tile in our basement project

Biking with a trailer

We are now the proud owners of a (used) bike trailer.  I scored one on Craigslist for about 1/4th the price of retail – and it’s been barely used.  About the only thing “wrong” with it is a snap is missing for the cover (easy to fix since I have a snap tool), and it’s covered in spider eggs since it was in storage – both very easy and cheap fixes.   Our bikes are now in the shop getting a professional once over since they haven’t been used in about 3 years – I stopped riding when my pregnant belly couldn’t bend enough to use the drop handles anymore.  I replaced the tires (dry rot!) and inner tubes, but every time I try to repair brakes or shifters, I break them, so I know when to take it to a professional*.

We live a little over 2 miles from the grocery store, but Dad’s not thrilled with the idea of me riding my bike to the store and back – especially with Daughter Person in tow (construction and rather dangerous intersection during construction).  I think I can convince him to let me go myself at least.  I just need to remember my lock’s combination and do it.

*: I understand the concepts of shifter repair, but I have a triple crank and the shifters are sensitive enough that getting them adjusted properly for the front gears is more than I can handle apparently – I have considered switching to a double crank or getting new shifters, but I haven’t had a compelling reason to yet, and I used to use all three gears when cycling long distances.

I Have Post-Partum Depression

In honor of Mental Health Awareness Week, I’m speaking out about my disease and how it has affected me and my family.

Postpartum Progress Warrior Mom

I had no history of depression in my life (I’m adopted, so I don’t know about my birth parents’ medical history), and most people would have called me outgoing, extremely cheerful, and anything *except* depressed.  But about 5 months after Daughter Person was born, I was diagnosed with post-partum depression – a “major depressive disorder”.  Looking back on my pregnancy, it was very likely that I had antenatal depression as well, although never diagnosed.

Continue reading

Been quiet lately

I’ve been pretty quiet lately, but that’s just because I’ve been really busy and the whole family has been really sick.

In the sick department:
I got pink eye at the end of last week, which either was from or turned into a sinus infection putting me in bed for a day. Then Daughter Person woke up with a fever on Sunday, prompting us to cancel her birthday party. Grandma was already in town, so we had cake anyway, and then Grandma stayed to help babysit on Monday. Monday, her fever got worse and we took her to the doc suspecting a sore throat and maybe strep. It was *just* a virus (not strep, and not flu), but the doc said something’s been going around that takes about a week to get over. Dad and I have been taking turns taking care of Daughter Person, so that we can each get some work in each day. She finally went back to daycare on Thursday, with no fever. But now Dad and I are sick. I really started coughing and lost my voice yesterday – I at least feel halfway decent, even if I can’t talk. Dad started coughing and feeling bad last night. We’re just trying to avoid passing it back to Daughter Person.

In the non-sick department:
We got an IRS audit notice earlier in the month – and the examination appointment was yesterday: the recommendation is “no change” – which means we had all of the receipts and documentation to show our expenses (it was related to a rental property we sold in 2011). It has to get passed up the management chain and be signed off on before it’s final though – up to 30 days. We paid a CPA $3k to represent us – which was *way* less than our refund last year, but it still rankles us that we paid to have the taxes done (they were quite complicated), and then pay *again* to show the IRS that no, really, we’re right. On the plus side, only about 1 in 32 returns that are audited are in favor of the taxpayer, so we were lucky in that respect.
I’ve also been taking a cake decorating class, and getting ready for Daughter Person’s birthday party. And we were cooking all of this food at the same time too. The last two weeks have just been exhausting.

Despite my lack of voice, I feel pretty decent and am starting to get other things done (like taxes for 2012). On the plus side, my weight has dropped slowly – not as quickly as I’d like (I blame the cake class…), but it’s going.

2013 goals

It’s the new year – and everyone’s making resolutions.  I’m avoiding the gym for two reasons: 1) until I feel better, and 2) until the January hubbub dies down.

I have several goals for 2013, none of which are really “resolutions”, because I’ve been working on them for a while, I’m just continuing to work on them in 2013.

  • Lose the final 25-ish pounds I need to lose to be at a “healthy” BMI. If I keep going as I’m going, that’ll be somewhere around November; if I really focus on it, it might be this summer.
  • Pay off 3 of our debts: the line of credit, and two of my three student loans. As a reach goal, I hope to also pay off my remaining Chase credit card. With no emergencies, it can be done, but there’s a lot that can happen in a year.
  • Get rid of 365 things – one for each day of the year. Not necessarily one each day, but 365 total. The games/DVDs I have listed on Amazon and eBay won’t count, since I already made the decision to get rid of them.

I’m sure that I’ll decide to have another goal somewhere in the middle of the year – it almost always happens, but these are the three big things I want to focus on.