Dealing With Skin Eczema In A Bitter Cold Winter

For the last couple of years, I’ve suffered from skin eczema, particularly over the winter months where the cold, dry air exposes my already vulnerable skin to a greater potential of outbreak.

In the three years it’s really affected me, this has been the coldest winter we’ve had.  I’m happy to say, though, that it’s also been the winter that has had the least impact on me.  I think I’ve finally found balance!

The first year I had problems, there was a spot next to my mouth that got very red, very raw, and very itchy.  I spent the first few weeks in denial, figuring it would just go away.  I finally went to my family doctor at the time, who gave me a cream that only seemed to aggravate the issue.  He then referred me to a dermatologist.  As it was my first time ever visiting a dermatologist, I figured maybe it was normal that it took quite a few visits to get seemingly nowhere.  He had me try two other creams (neither of which worked particularly well), he made me get skin patch testing to see if any particular chemicals might be causing it (inconclusive), and recommended that I change many of the personal hygiene products I used.

Eventually, the problem faded as the weather warmed up, but last year, the problem returned.  In addition to the problem near my mouth, I also had issues around my eye.  I tried the original dermatologist again, but eventually was unsatisfied as I felt we were going nowhere.  I went to a different dermatologist, and he was much more helpful.  He prescribed a different cream, which seemed to get me through the season.  I did have a couple of outbreaks but they weren’t as severe and didn’t last as long as they had before.  I felt we’d made progress.  He also suggested I moisturize, which is something I did now and then, but never took to seriously.

The summer came and went and this past winter hit.  Immediately, I felt like this was going to be a tough winter as I immediately had the rash around my eyes return, as well as part of one hand.  After doing some homework and talking to various people, I decided to focus this season on moisturizing.  I apply Eucerin multiple times a day over most of my face, hands, arms, and other exposed body parts.  I found that this wasn’t good around my eyes as it caused tears, so additional research had me apply Vaseline.  I have had a couple of very minor outbreaks, but nothing like in years past, and the spot near my mouth (which was the biggest problem for me because I was very self-conscious about it) has only had two minor outbreaks.  In both of those cases, I apply the cream that I was previously prescribed, put on extra applications of the moisturizer, and the problem has always gone away in less than 24 hours, whereas I’d have flare-ups that would last days and days in the past.

I think the moisturizing is key.  I wish I had thought of something so simple, and it amazes me that the original dermatologist never recommended this.  I truly believe that he was a quack in every sense of the term.

For as cold a winter as it’s been (we’ve had multiple spells where frigid temperatures last for days on end), I’ve been very happy at how I’ve been able to keep it under control.  I think that had these temperatures hit in the previous two winters (both which were much milder), I really would have been in trouble.  It gives me hope as I sort of have come to the realization that this will probably be something I have to live with moving forward.

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

Preferred Provider Option
Annual Premium: $5,500
Deductible: $500 per person
Then They Cover: 80%
We Still Pay: 20%
Max Out Of Pocket: $2,000 per person

The third option (Preferred) was thrown right out.  The ‘benefit’ here is that you get to go out-of-network if you need to and they’ll still cover your costs.  However, all of the doctors we use and all of the hospitals in the area are in-network, so we have no use for this benefit.

That narrowed it down to the High Deductible Plan (HDHP) or the Exclusive Plan.

If you’ve been reading, then you know that we’re expecting our second child next year.  That means that we will be using medical services to a pretty big tune.

Using our costs for the birth of our first (in 2008) along with other visits, I ran a bunch of scenarios comparing the two.

If everything went as well as possible, meaning that the birth was straightforward, that the new baby was healthy, and that we had a minimal amount of sick visits and other visits, the HDHP / HSA plan actually worked out to be the cheaper option by about $250.

I was leaning towards this option, but then I started looking at risk.  I’m a project manager and one of the things I do is look at risk of various points in doing projects.  So, I started looking at the risks involved here.

The biggest risks were simple: Having more medical needs outside of the minimum planned.  This could involve anything from more sick visits than planned, to ER visits, to complications involved with the baby or delivery.

If the additional needs were small, the ‘gap’ closes slightly.  If the additional needs were larger, though, then the Exclusive Plan would provide the best coverage.

I also looked at our Maximum potential costs for the year.  With the high deductible plan, this would be up to $10,000 on top of the $2,400 premiums.  This puts our maximum costs for the year at $12,400.

But, with the Exclusive Plan, even though we’re paying a lot more in premiums, we have no deductible AND our liability is limited to a maximum cost of $3,750, possibly lower if only one member of our family really ends up needing care, since each family member is capped at $1,500.  This means our maximum out-of-pocket costs are between $7,500 and $9,750 depending on how many people need care.

In normal years where a family is not anticipating needing a lot of insurance, the HDHP option would probably be $2,000 or so favorable.  At that point, it’s arguably worth the risk of having potentially higher out of pocket costs, but since we’re knowingly going to be using insurance, most of that ‘gap in our favor’ disappears, and the additional risk simply isn’t worth the $250 or so that we’d save (reminder: that’s in the best-case scenario).

So, we ended up going with the Exclusive Provider coverage.

Either way, health care this year is going to cost us over $2,200 more than we paid in either 2008 (our first baby) or 2009.  This sucks.

The 2011 payroll tax cut of 2% was bargained for by President Obama to put more money in people’s pockets and to stimulate the economy.  Not for us.  That 2% will cover a chunk of that $2,200 cost, and since we didn’t get raises, we’re still going to come up short.

One day, maybe these new healthcare laws or stimulus packages will benefit us in some way.  So far, though, our household has been anything but stimulated.

*sigh*

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.

The only remaining option is a High Deductible / HSA option.  This seems to be what companies are pushing employees to.

What really sucks is that for every single option, the biggest out of pocket increases are seen by those with families.  People getting coverage just for themselves actually see their costs go down with some plans, and with moderate increases in others.  People who are providing coverage for themselves and a spouse have moderate increases, but those of us with families look to be paying an alarming out-of-pocket cost.

My initial number crunching shows that this could be to the tune of $2,400 per year out of pocket on top of what we paid in 2010.  Not even counting that co-pays are doubled, coverage is worse, and there seem to be limits on things that there weren’t before.

Sweet.

Oh, and no raises this year.

Sweeter.

I’m reserving final judgment until they come out with the final plans, which should be in the next week or two.

Of course, the way things are looking, they’ll only make it worse between now and then.

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.

The third point is that the new health care reform could definitely change things.  Just reading people’s reactions on Facebook and such as their companies announce benefits has alerted me that the possibility exists for change because of the new legislation.  To what degree this does/could impact us, I have no idea.

Of course, anything could change, but the areas that I’m most nervous about are:

  • Higher employee contributions – We’re probably not getting raises again this year so every time they deduct more from our paycheck , it hurts a little more
  • Preventative care changes – Our plan is nice because it covers 100% of preventative care, most notably immunizations and well visits, which are both frequent and expensive for toddlers
  • Removal of the ‘no deductible’ option – Our company offers a plan where you don’t have a deductible if you use exclusively in-network providers (with the offset being that you get soaked if you use an out-of-network provider).  Since they have a very comprehensive provider list, we’ve never had an issue with this, and it’s saved us the $500 or $1000 that is fairly common with other plans.  I’m keeping my fingers crossed that they don’t decide to remove this offering.

All I know is that each passing day with no news makes me more and more nervous…..