My company decided to change insurance companies, effective January 1st. Treating our son and ourselves this past month has been a learning experience. Back during open enrollment times, the wife and I decided we were going to middle of the road insurance (out of three choices) where before we had chosen the best offered. The only real consequence we could see was a $100 higher deductible, and we really wanted more money coming in per pay period.
We also decided not to manage a flex spending account this year. For those not familiar, a flex account is money deducted out of your check, tax-free, that sits in an account earmarked for extra health-related items like dental work(other than cleanings), contacts and/or glasses, some over-the-counter medications like cold or allergy medicine, etc. A couple caveats: You’ve got to front the money for these things and then submit the reciepts for reimbursement. Also, any money still in the account unclaimed at the end of the year is LOST to you. USE IT OR LOSE IT.
Some companies put your flex money on a debit card; ours never did. We decided not to deal with the account this year for many reasons:
1. Healthcare reforms mean 70% of the medicines that qualified for reimbursement in 2010 would now require a doctor-issued prescription if I wanted my money back.
2. This past year I logged the amount of time spent on organizing, scanning, faxing, emailing reciepts and checking and double-checking that refunds had been posted to our checking account. The amount of hours spent doing that could have brought in enough money for new tires for my car had I spent it freelancing.
3. Last year we contributed the maximum amount, got a ton of dental work done, bought more than enough contacts and pairs of glasses, yet still found ourselves scrambling in December to spend the rest of the money. We bought even more ridiculous amounts of contact solution, “gift” medications to send to my family overseas and meds our son won’t need for another year and a half.
4. Not contributing to a Flex account PLUS choosing the slightly less awesome insurance gets us to our goal of a significant amount more take-home dollars per paycheck.
Fast forward to 2011 . . .
January 7th the wife and I needed to use a walk-in clinic when we contracted strep throat and bronchitis respectively, simultaneously. The one we’d been using now cost 5 times as much so we drove across town and went to the cheaper, crappier one. My wife is still having symptoms.
My wife has also spent 8 hours so far researching what physical therapist, private, clinic-based or otherwise, we will be able to afford now that the one we’d been seeing for 7 months has become prohibitively expensive. I still don’t understand all the details, but the first question we’ve been able to answer is: YES, this would have happened even if we’d selected the best insurance. It isn’t the level of insurance that’s the problem, its the different provider.
This new company has more than a few differences . . . has different rules with how services are billed and whether or not they’ll cover them at what amounts . . . its kind of a mess. So the irony is that the time (money) we thought we were saving by not screwing with a flex account is now being spent re-learning how to manage (not waste money on) services with this new insurance. We’re still trying to find an in-network, covered therapist that bills as an office visit rather than as outpatient services AND is close enough to our home to get there, have therapy, and get back at a time conducive to the child getting his meals and naps on a decent schedule. This whole situation just rubs me the wrong way.
At least I have new tires.