high cost of insurance – Life on the Farmlet

If you live here in the states and have had to rely on the Affordable Care Act (ACA) I would truly like to know how you are managing, or if not, how you are faring. If you wanted it, then are you getting what you thought you were getting? I’m not trying to be flip, I just really am interested to know if you are getting the help you need through this program.

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When Bob’s previous job realized that they were going to have to give up their current coverage due to the insurance changes, they began paying him a bit extra to help defray the cost. It wasn’t enough.

When he was then a victim of downsizing, he was out of work for months. We had to change our ACA coverage to reflect that he had no income other than unemployment wages. This still cost us about $400 a month and incurred a mammoth deductible for each of us. (About $5,400 total).

We got sick. Very sick. Both of us. The bills piled up, we became overwhelmed and had to take money from our retirement savings to help cover costs. Irritatingly, I had a TSA that had matured and was worth almost $25,000.00 at the end of the year, but we had to wait to cash it out because we didn’t want to end up owing back all the subsidy money for the ACA coverage we relied on… By the time I cashed it out in January, it had dropped in value to $18,000.00 due to the stock market crash.

Bob finished the taxes today.

Bob: You don’t want to know how much I am hating Obama care right now.

Me: What? We don’t get anything back?

Bob: I really don’t want to tell you.

Me: We owe some?

Bob: Sigh… We have to pay all of the subsidy back and we don’t get anything from the Federal at all!

Me: How much?!

Bob: $8,000.00!

He explained that in the midst of trying to make ends meet and paying the regular bills and necessities, plus the ACA payments, plus the deductibles, plus the co-pays, plus being out of work and being sick, we managed to make about $1,500.00 too much (remember that was the money we socked away for retirement!) and now they want all the subsidy monies back.

In the past week we have sprung a leak in the roof and need a new roof. The roofer has patched us up and it stopped the rain from running down the stove-pipe, into my cupboards and out onto my stove and counter tops, but the roof needs replacing. $8,600.00. He found hail damage and we are waiting to see if the insurance company will cover the new roof…

Are you keeping count? We need $16,600.00 to pay for it all. There goes the left over from my TSA monies and Bob’s IRA ++++++

After our talk, I felt awful. I wanted to cry, but couldn’t. I felt sick to my stomach and just wanted to crawl into bed and pull the covers up. I wouldn’t. After I calmed down some and began to feel better I suddenly flashed on a scene from my favorite movie of all time:

My Man Godfry

It is one of those madcap BW comedies from 1936, staring William Powel and Carole Lombard. If you haven’t seen it you must, and if you do want to see it , well look up the copy from the Criterion Collection (<— link to synopsis, etc) because it has a missing scene that makes the whole thing make sense!!!

Here is the scene I remembered and which gave me a chuckle in spite of it all!

In the meantime I am grateful to God that we are once again in better health. Feeling better makes it easier to take things in stride, although it doesn’t preclude the changes we will need to make over the next year. We are talking it out, and thinking about our options, but we don’t have a definite plan as yet.

I’ll tell more when we figure it all out.

The following has been hard to deal with, much less talk about…

This is what has been going on:

First the good news ~ We managed to afford get into a medical plan that did not have a $10,000 dollar deductible (this would have been for each of us, BTW!). Our deductible for this plan is $2,400. each. Payments to the primary care are up by $10 per visit. Payments to specialists are supposed to be $55 but we are being charged $65 because the specialists want a physical piece of paper as a referral from our primary care physician. Our primary care physician was under the idea that her request via computer system to the specialist WAS a written referral. After all, the specialist agreed to see me when she asked them to, didn’t they? She doesn’t even HAVE a paper referral, never needed one before! It is a mess. Now $10 a visit doesn’t seem like much until you add up all the visits we have been going to lately! 😦 Oh yes, and once we have met our deductible we have $300.00 copay each for the ER, the hospital, and any procedures we have done.

Bob got sick and collapsed at the end of June. We managed to get him inside and checked his blood sugar and his blood pressure. Blood sugar was OK, but blood pressure was 60 over 30! We called the paramedics because Bob kept blacking out. When they arrived they recommended that he go to the hospital. That is a 20 mile ride. It cost $700.00. The insurance wouldn’t pay any of it!

While he was at the hospital they checked him from his big toe to the last hair on his head and all points in-between. Anyone who entered the room and said “HAY!” has sent us a bill for their services. Once they stabilized his blood pressure they wanted to send him home, only every time he got up his BP fell through the floor again. They admitted him. He spent the night and all of the next day and evening in the hospital. Anyone who entered the room and said “HAY!” has sent us a bill for their services.

Eventually, they sent him home with instructions to not go to work for two days and to see his primary care physician. She referred him out for blood work and other testing, and to a heart specialist to make sure his heart isn’t the problem. The heart specialist took more blood, x-rays, an ultrasound and a stress test. When the Doctor got done with him he said his heart is very strong, and that Bob has a very minor heart murmur. He never knew that!

The primary also sent him to the Dermatologist to get a mole on his neck checked out. The verdict? Basal Cell Carcinoma. You can read about it HERE. It is one of the most common skin cancers and apparently likes to grow under the surface with roots leading out into the surrounding tissue. In order to get all the cancer, and to take out the least good tissue, the Dermatologist has him scheduled to go to his Decatur office to have it removed. The process will be performed using a technique called Mohs Surgery You can read about that HERE.

The bills for all of this are still rolling in. I believe that Bob has now met, or is close to meeting his $2,400.00 copay.

We still don’t know what caused his blood pressure to bottom out.

At this point, as we have met our deductibles for the year, I am now going to schedule my vein surgery on my legs. I was putting it off because it was so expensive but there really is no reason for me to wait. Besides, if I wait till next year I will have to start over on that nasty deductible!

Favorite Bobism from his hospital stay…

After being served a dinner of spaghetti, mashed potatoes, over-cooked cauliflower, and a nasty banana pudding, he quipped:

“I think they’re trying to starch me from the inside out.”

Seriously? Spaghetti and mashed potatoes? 😛

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Oh yes, and my colony of bees has collapsed.

Zip

Zilch

Nada one left.

I went out to check on them and they were all laying in a pile in front of the hive. It was in the late spring. So my guess is that they got dosed by a crop sprayer. I will try again next year.