The Decision

OK, so my decision isn’t as captivating and probably won’t cause as much drama as Lebron’s did earlier in the year, but I thought I’d share it anyways!

A few weeks ago I noted that our health care options came out and that none of them looked all that appealing, with our costs going up in a big way.

There were three options available to us for next year:

High Deductible Plan / HSA Compatible
Annual Premium: $2,400
Deductible (out of pocket before coverage kicks in): $3,750
Then They Cover: 80%
We Still Pay: 20%
Max Out of Pocket: $10,000

Exclusive Provider Option
Annual Premium: $6,000
Deductible: $0
Then They Cover: 90%
We Still Pay: 10%
Max Out Of Pocket: $1,500 per person max $3,750 total

Read moreThe Decision

2011 Health Care Costs Looks Bad

They sent out some preliminary information about our health care options for 2011 and I have to say, they look worse than I had even imagined.

Last week, I wrote about how I was getting nervous about our options.

From the looks of things, they are altogether canceling the option that we had, which was a PPO with no deductible as long as we stayed in network.

The PPO option that they do have is much more expensive, the coverage is reduced, co-pays are higher, and there is a $500 per person deductible.

They also have an HMO type option, but that is actually the most expensive option and doesn’t really provide all that much more coverage.  It’s obvious they don’t want people to use that.

Read more2011 Health Care Costs Looks Bad

Getting Nervous About Our Health Care

Right around now is when we typically get information about our benefits for open enrollment on our health care plan.

I’m getting a little nervous for two reasons:

  • We haven’t heard anything yet
  • The ‘promise of same’ could come to an end
  • Others working for different companies have reported changes due to ‘Obabmacare’

Let me explain:

The first point is pretty obvious.  The longer you wait on something where the costs and coverage are unknown and can be so variable, the more you start thinking that ‘No News Is Definitely NOT Good News’.

The second point has to do with our company.  Our unit was spun off into a separate company in 2008, at which point we were told that the benefits would remain largely transparent for the foreseeable future.  In 2009, they actually hadn’t finished the spin-off so we still got the exact same plan and beneifts.  In 2010 they lived up to the promise and kept the benefit levels the same (though they did switch providers).  Now that they’re over two years out from that, there is always the chance that the benefits get whacked changed.

Read moreGetting Nervous About Our Health Care

Flexible Spending Account Review

We have a flexible spending account option through my benefit plan, which allows me to have money deducted throughout the year which can be applied toward out-of-pocket medical costs.  The main benefit with such an account is that the money is deducted pre-tax, so you are avoiding the taxes on the amount you have deducted.  The main risk with such a plan is that it is a use-it-or-lose-it plan, where if you don’t use all of the money in the calendar year, you lose it.

So, as you can tell, coming up with an accurate estimate is important.  If you budget too little, you’ll end up with out-of-pocket costs that miss the tax benefits.  If you budget too much, you’ve wasted money.

I thought it would be worthwhile to do a quick review to see where we stand for the year.

Read moreFlexible Spending Account Review

Changes To Flexible Spending Accounts On the Horizon

A few months ago, the health care reform discussion was all the rage and dominated most news stories that were centered around politics.

Now that it’s been passed, I think people have moved on.  Most political discussions I hear of now seem to focus either on the upcoming elections or the government’s (lack of) response to the oil spill.

However, I thought it was noteworthy to go back to health care and point out a couple of pretty major changes to those that use flexible spending accounts to save money on health care related costs.

A flexible spending account, for those who may not be familiar, allows you to set aside pre-tax dollars that can then be spent on reimbursable health care costs, including co-pays, non-covered costs, prescriptions, and other items.  This essentially gives you a ‘discount’ equivalent to your marginal tax rate on health care costs.

Read moreChanges To Flexible Spending Accounts On the Horizon

Wisdom Of Teeth Removal

I had three of my four wisdom teeth removed last week.  I had been in discussions with my dentist about my wisdom teeth for years.  Probably 15-18 years ago, he pointed out that my wisdom teeth were in bad locations and were not ideal candidates for ‘automatic’ removal, which is the path that many dentists / oral surgeons seem to be leaning towards.  The idea behind that is that getting them out in your late teen’s or early 20’s is the most ideal time, as your body can adapt and heal the quickest.

The main reason that he recommended holding off is because my bottom wisdom teeth were in very close proximity to a nerve, and he thought the likelihood of damage outweighed the benefit of taking them out without cause.

So, I was fine for years and years, but then a few months ago, the area around one of the teeth started to hurt.  I went to the dentist, and was told that I had an infection and that once a wisdom tooth started getting infections, it should come out.  We gambled on leaving them in, but unfortunately it didn’t pay off.

I was referred to an oral surgeon. Upon exam, he actually recommended taking three of my four teeth.  He recommended the one on the bottom that was getting infected as well as the two on the top, which had shown progression that would lead to decay of other teeth within a few years. He actually pointed out that the surgery would not be easy.  The bottom teeth, in addition to being close to the nerve, were embedded in my jaw.  The upper teeth would need to be cut out, cracked, and removed in pieces to avoid damaging the roots of the nearby teeth.

He recommended that I get knocked out during the surgery.  I stopped him and said that I wanted to get knocked out just for hearing any more details about the extraction!

The day of the surgery came and things went well. The knocking out portion was the easiest.  They hooked up an IV, and I asked “Did you guys start the medicine yet?”  The nurse answered, “Yes, we just did.”  I said, “That’s what I thought because things started….”

And next thing I know, they were waking me up having extracted all three teeth.

All three of the removals were as complex as could possibly be.  The bottom removal required a bone graft in my jaw.  While they didn’t know if any nerve damage occurred, the graft would reduce the chances of any damage being permanent, as well as reduce the time for the bone to heal, which would minimize my chances for future infections.  The upper teeth both were discovered to be extremely close to my sinus walls.  In some cases, the removal actually breaches the sinus wall, in which case secondary surgery is often necessary to close the sinus cavity.  Luckily, mine wasn’t breached, but because the hole from the tooth was so close, I have to take extra medicine and additional precautions to minimize the risk of blowing open my sinus cavity during the healing process.  This meant trying to avoid any sinus pressure, so I was on medicine to reduce that, as well as not holding in sneezes.

So far, my recovery has had it’s ups and downs.  I am still not eating solid foods.  The fact that they had to do so many cuts and go up so deep into my tissue has made it difficult than a simple yank.  I was also concerned that I was still getting occasional bleeding as late as yesterday (4 days after the surgery) but was told that this is normal given the complexity.

On a positive note, the complications seem to *knock on wood* have been minimal.  If I’d had nerve damage, I would have spots on or around my lips where I would have little or no feeling.  So far, I think I’m in the clear.  I also haven’t had any problems with my sinuses, where if I’d have had any bloody noses or undue pressure, there could have been complications.

If I can get away with the short term pain and not being able to eat solids for a week or so, I’ll take that as long as I don’t have any major complications.

The other fun part will be in dealing with the insurance and financial aspect.  I actually went to a different oral surgeon than my dentist referred me to, for the reason that I wanted to go to an in-network facility.  They were great with working with me, and even had me pre-pay a certain amount knowing my dental coverage.  There will be a little bit extra cost on the dental side because my maximum claim limit for the calendar year was exhausted.  That I’m cool with.  What I also expect to be fun is the bone graft side of it.  That gets billed to my medical insurance.

I had previously called my medical insurance provider to make sure that they covered it, and that the oral surgeon was in network.  Both were confirmed.  The submitted claim price for this was $900, so if everything went according to the way it should work, the most I should have to pay is $90, since my insurance covers 90% of such procedures.  It could be less if they have a ‘negotiated’ price on services, which would be nice.

However, things with the insurance company are never easy, so I expect it will not be as easy as just writing a check for $90 to cover that.  It never is.

All in all, I’m on the mend.  Today is the first day that I’ve felt halfway normal, and I’m hoping to be eating somewhat solid foods by the weekend.  It’s so nice to have goals!