Thursday, November 6, 2014

Open enrollment and over-sharing

The Mr got his open enrollment propaganda at work yesterday.  We're in pretty much the lowest cost insurance that pulls the least out of pocket but enough to tick you off during the year because all co-pays go toward your deductible.  But oh wait, our delightful doctor decided to drop our insurance so she's out of network now and she's not worth paying an extra $80-100/mo to be covered again.  The doctor we wanted to switch to that is highly rated is also booked out 6 months.  She's part of a conglomerate of doctors and it's like I don't want to switch to be shoveled over to another available doctor that I haven't met because I'm sick and need care now not 6 months from now.  I miss the days when you had insurance, you got sick, you paid a co-pay and everything else was covered.  It seems we have to fight for every little thing with our insurance but they've got us by the short hairs because their benefits are as good as it's going to get for the price.  GRRRR!!!

Men...avert your eyes.

Still there ladies?  I get to be on double cramp duty the next few days as monkeys swing from my Fallopian tubes for being mother nature free in New England.  (See curious dudes it didn't pay off to stick around for this paragraph now, did it?)  Did I ever tell you guys I planned my wedding around my period?  Yep...when we got engaged, I sat down with a calendar, figured out my ladies days for the next two years about 30x and picked our wedding date based on the time of month I'd be the nicest and not affected by hormones.  I was 19 at the time...no one told me that if you were on birth control you could skip your period!  Certainly not the 70 year old dude that initially gave them to me but when I was 21 and getting my annual from his significantly younger wife and I told her this she laughed, applauded my planning efforts and let me in on the secret.  She told me she'd go home and smack him for leaving that tidbit out.  Twice please.

Anyhoo...

I'm getting really tired of having to take it easy on the workout front this week.  The Mr and I are both completely screwed up muscle wise and we think it's between coming back in too hard (even though we eased back in the first week) and getting used to the new floor mats we put down.  It's a thicker mat but harder instead of cushier.  We've really only done Walk Away the Pounds on it cardio wise so it's kind of irritating trying to figure out why our muscles from head to toe are so tight.

So last night we did the Firm 30 from Leslie Sansone's Walk It Off in 30 Days with lighter weights because we were both still sore from the weight session we did the other night.  Get with it bod!

Dinner was spicy orange grilled shrimp over thai lime rice and peas.


Well, I think I'm going to brew up some hot tea, put on a little jazz, keep my mile date with Leslie and try to get a jump on a few more holiday projects.

Are you happy with your insurance?  Were your 'ladies days' a consideration when planning your wedding or was I the only one afraid of wearing a diaper with a white dress?

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19 comments:

  1. Benefits definitely aren't what they used to be. I do miss being able to just pay the premium and pretty much not have to worry about it. Now it's a crap shoot as to what you're going to have to pay for in addition to all the money you've shelled out to the insurance company already.

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    1. They definitely aren't. It's VERY frustrating and I naively thought that insurance would just always be that way. I don't condone not having insurance of some kind but given the lack of coverage these days, I can understand why people in good health roll the dice. Unfortunately it just takes one catastrophic health problem or needing surgery to bankrupt the un/underinsured. These days, even having insurance doesn't mean you won't be sidled with crippling debt. Something seriously needs overhauled.

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  2. I hate dealing with insurance. Every year the premium goes up and coverage goes down. It's a total crap shoot, and I'm sick of it. I'm already on the "get well or die" plan. The only advantage I have is that in my smaller town there aren't doctor conglomerates like that. At my doctor's office you might see a PA instead of a doctor, but if your case is serious they'll pull him in at any time. I've liked all but one PA there too over the years, and didn't dislike her - just kinda meh about her. I'm actually going to drop to a lower bracket this year and hope my health holds up. $70 a month back in my paycheck with little noticeable drop will have to be worth it. I just hope I don't need XRays or and MRI b/c I'll have to go out of town for those.

    I planned my wedding for a Saturday knowing that my period always ran Tuesday through Friday. I never had severe PMS so that wasn't an issue, but I did want to make sure that Aunt Flo didn't get invited.

    Dangit - I forgot to re-enable cookies so it took me like 50 tries to post this.

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    1. Your docs office sounds like a good one! I'd be happy to see that money back in pocket or maybe put half in a HSA so other stuff could come out of that. Still money back in your pocket but some 'just in case' savings too?

      I'm glad to hear I'm not the only one who thought that way! I didn't want to end up like Ginny on Sixteen Candles. "We don't want to announce to everyone that she's got her PERIOD!!!"

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    2. She was totally on my mind. We had to push our date out a few weeks from what we wanted due to the availability of the church & minister - but it HAD to be a Saturday so that was ok.

      The money is going to my son's Christmas in December, but after that it'll go straight to savings.

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  3. Don't get me started on insurance. After our third trip to Cancer Treatment Center of America (CTCA) near Chicago, they decided NOT to pay the resulting $40,000 bill. Talk about stressful. They had paid the entire tab for Du's first two trips in 2013 (both of which were nearly $40,000). This last bill was from our visit there in April this year, and I have spent the seven months since then, appealing, fighting, filling out forms, researching diagnosis codes, making phone calls, and crying. I finally got the bill whittled down to about $350. that we owe CTCA. With Du's Stage Four cancer, we didn't need this added stress. However, the fear that our insurance wouldn't pay his bills for his every-6-month visits to CTCA, made us cancel our visit back there in October and find a local oncologist instead. CTCA is more expensive than local doctors, and I have a feeling our insurance thought this would be a good way to get us to quit going there. Du's care is not as good now, nor as thorough, but at least insurance doesn't balk at paying for it. I hate insurance, but with bills like that, you certainly can't be without it. I worry about the day when Du can no longer work, and we won't have that insurance anymore, even though they annoy the hell out of me. I don't know what the Affordable Care Act will be able to figure out for us, but I have a feeling the cost will be astronomical and the coverage will be minimal. Maybe we should all move to Canada???

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    1. That is ridiculous after paying for it twice that they wouldn't pay for it again and you shouldn't have to go through all of that to get the bill whittled down either. The cost of insurance (COBRA) is like friggin' insane too. I would at least start researching the Affordable Care Act now so you don't have any surprises when you have to think of switching. Better to be prepared and possibly have a smoother transition if you can.

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  4. That shrimp looks so good. Homemade spicy orange sauce?

    *not yet married. but never thought to plan around "the date". duh, right?! I will keep that in mind!

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    1. Yep, 2 tbsp of light butter, 1 tbsp orange marmalade and heat it up, reduce it and drizzle over the shrimp. DELISH!

      Well if you're on the pill you don't have to. You just take the pills the week you would be on the inactive pills and boom, period gone that month. *face palm*

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  5. Health insurance is becoming ridiculous. I work for a staffing agency and the benefits are horrible, especially if you want to cover anyone in addition to yourself. This year, the premiums for the PPO sky-rocketed, in order to try to get everyone to convert to the HSA, which still has pretty high premiums. My hubby has pretty good insurance, but can't cover me because I'm offered benefits through my employer. He also can't cover our kids because of the "birthday rule". The spouse whose birthday falls first in the calendar year must cover the kids, or he can cover them and a pay a penalty of a few thousands dollars. We have gone that route the past couple of years and our premiums have still been about $7,000 a year. I think this year I will cover the kids and we will go the route of HSA. Our premiums will be about $6,000. I still haven't mentioned the higher deductibles. It makes me sick to my stomach just thinking about everything.
    I'm pregnant and due at the beginning of February and have started to think of the advantages of preterm labor because I have already met my deductible for 2014. Sad, but true. I also think I should bypass the epidural in order to save on medical bills.

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    1. Oh my gosh, I am so sorry you even have to THINK about enduring full on labor pain because of medical bills!! What the hell is wrong with this country that you should even have to think of these things and that "birthday rule" is a new one on me. LUDICROUS!

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  6. When I hear about health insurance in the US I'm happy I live in Canada! We are covered for doctor visits, hospital stays, surgery, x-rays, and treatment for cancer and other life-threatening illnesses. We do grumble about having to pay for prescription drugs, paramedical treatment, dentist, vision care, but some employers offer benefit plans that include coverage for all that and we just pay a small co-pay. For example, my work health plan covers me for physio, chiro, therapeutic massage, up to $750 per year for each. We do pay 13% sales tax on practically everything we buy, except groceries, and we pay a high income tax rate, but it's well worth it to me to know that if I need to see a doctor, I don't need to worry about paying for it. And if I need surgery, it will be done. I was visiting Portsmouth a couple of years ago, and struck up a conversation with the desk clerk. I was telling her how great it was that there was no sales tax there, as I was planning to do a lot of shopping. She said she'd rather pay sales tax and have health care, and that we were so lucky we had it. It did make me appreciate our health care system.

    I planned my wedding around my monthly visitor as well, wouldn't have been fair to unleash the beast on my wedding guests!

    Been following you for almost a year now I think, and I want you to know I so look forward to hearing my phone go "ding" to let me know your post is up! We are very similar, you and I, I have Christmas shopping almost done, wrapping started, menus planned, grocery list started, dates for decorating and baking picked out...drives my family nuts but they love it too.

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    1. Definitely appreciate that great healthy care you guys have. I have heard so many wonderful things about it and I don't know why our country can't get their crap together to provide the same thing. Problem is (I think), the almighty dollar. Drug companies want you sick so they can make you pay $80 per pill to save your life. I don't feel like cures for things are being pushed as hard as they could be because again, drug companies, insurance and medical industry all being in cahoots to drain us of our money. So yes, appreciate whatcha got! :-)

      LOL, I know, I couldn't have unleashed on my guests either! Especially the ones who would've gladly stood up had we left in the "if anyone sees just cause why these two should not be joined in marriage part." I'm not stupid...we instructed the pastor to leave it out. HA!

      Aww, thank you so much! Good on ya for being on top of the Christmas game! I think it just allows us to enjoy things so much more when you can be ahead on the smaller things. I already have my menus planned too even if my family doesn't know it yet. HA!

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  7. Our insurance changed this year - back to what insurance was like when I was a child. No more copays, now we pay our deductible then the co-insurance kicks in. Our plan covers well visits for kids, adults, and women and also covers a well visit to the cardiologist and a mammogram all at no charge. The deductible is not what I remember from childhood though!
    Regarding the wedding planning, I take the active pills all the time and skip taking the inactive pills so I plan when I want to have a period, usually every 3 to 4 months. I've been doing this for more than 15 years and it is wonderful.

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    1. Sounds like a good plan! I think all preventatives are covered on ours (mammies grammied and such), it's those extras like needing to go to urgent care, x-rays, biopsies, etc that they're like "nope" or "we're gonna see how hard you fight this." Jerks. Yeah the low deductibles are gone. I think they figure out just how much people pay in co-pays and such in a normal year and set it there.

      My gynie said I could do that and I'm kind of from the school that I have a period every month for a reason so it kind of scares me. I think what scares me more is how bad it would be when you do have them. Like, if you don't mind my asking, is it painful or feel like "damn, I'm unleashing 3-4 months of back up!" I know that sounds stupid but I'm considering it and wanted an honest opinion should you swing back by.

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  8. I've been on depo for over a decade and haven't had a period except when I was out of the country for a summer and was late with my shot. It wasn't more severe than any other time. I know the depo will probably give me osteoporosis or cancer in 30 years but totally worth it imo :)

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    1. Wow! That sounds dreamy! (Well except for the osteo and cancer part but yeah the no period is super appealing!) I'm glad its worked for you...I know THREE Depo babies and that was enough to make me turn tail on that form of BC! :-)

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  9. The insurance through the hub's work is really good and they have a lot of flexibility, so I really can't complain. He doesn't have to pay any premiums which is unheard of (and that includes spouses and kids). I can tell you though that if I had to get insurance through my work (now mind you I'm in healthcare) it'd be $350 a month out of my paycheck AND a $2500 deductible before anything would be covered. Their insurance is HORRIBLE and the employee portion tripled from one year to the next. I seriously don't know how people with kids do it because that monthly premium was over $600 -- and the pay in the health system is atrocious. I work with the obamacare crap every day and it's a giant cluster.

    I don't recall anything with my period from my wedding or honeymoon (which was a week later). I don't think I had it but I honestly can't remember. I think because I've had so many issues with the plumbing that's all I can recall! LOL!

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  10. That shrimp looks amazing!!! I don't get to have shrimp very often as the man doesn't care for it much and the girls are allergic to it. So when I come visit, you can make it for me. ;-) hehehehe

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