Friday, March 28, 2008

Accessing Healthcare: Part 2

They pulled my pin last Friday, so I now sport a new cast (they cut the old one off) and another follow-up appointment. The pain is gone, although I'm beginning to understand what folks with arthritis go through when the weather changes.
The EOB, or Explanation of Benefits [ed: a copy of which is available here], has finally arrived, and we now begin the process of paying for my slippery feet. The good news, one supposes, is that I met my annual deductible early. On the other hand, I still have quite a way to go with regard to the potential maximum out-of-pocket. Still, between the amount with which my wife's employer "seeded" the account and what we've put in (not to mention our premium savings), it's not too bad. Yes, I can certainly think of more entertaining uses for the $2,400. Still, things could have been much worse.
How's that, you ask?
Well, let's take the typical co-pay (non-HSA) plan: $25 for office visits, maybe $1,000 deductible for big ticket items, followed by the ubiquitous "80/20" (plan pays 80% of the next $10,000, insured pays 20%). Between the ER, the ortho and the radiologist, the bills total out to just over $3,400. None of these were "office visits," so they all go to the deductible and co-insurance.
So, the first $1,000 would be mine (deductible), and another $480 for the co-insurance, for a total of about $1,500. Add in my premium savings of some $1,600, and my net out-of-pocket would have been $3,100 (not to mention giving up that $800 HSA "seed money"). So, I'm ahead by about $700 ($3,100 less $2,400).
Not too hateful.
I still have some follow-up and, of course, therapy, so I'll need to keep a running total on those. Once the final bill's been paid, I'll post a recap. Stay tuned.
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