Venting....

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terestrife

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Huh, yeah, that's really confusing and I'm not sure what the difference is between the deductible and out of pocket. It almost sounds like once you meet the $1500, then the next $1500 would be taken out of the stuff you've already paid/that's been taken out of your paycheck? I mean, I would assume your biopsy would fall under that diagnostic laboratory (I could be completely wrong - it just seemed to fit best), which I see would have a $60 copay after the deductible, so would that mean each one is only $60 once you meet that $1500, and have they been charging you for the whole thing thus far in previous bills without any adjustments or insurance putting anything in? I feel like your family should be willing to put in a bit toward your medical bills if you need the help, though - it's not like it's money being spent frivolously.

Anyway, best of luck tomorrow! I hope you get good news.
Today i wasnt charged $900. Which was the charge back in may for this same test. So i am hoping that means my insurance starts helping more once i reach my deductible. I find it very confusing to be honest. :confused2: All i paid today was the co-pay. Unless they call me up later to charge me. lolol

Not the best news. My uterine lining is less thick, but it is still thick. Doctor wants to increase my medication and we discussed potentially doing the procedure i did last year. A deeper scrapping of my lining under anesthesia. We are waiting for biopsy results to see if the cells are at least changing back to normal. :frown: Feel so down now, i was hoping he would see a big improvement.

Not sure why but i found the d&c more painful than normal. With this doctor its usually not to bad, but i yelled out in pain today. :frown: Not sure what is different. Just waiting for results now, but feeling really discouraged.


Oh, your insurance looks like mine. It has a Health Savings Account that your employer pays into. That covers half your deductible. You shouldn't have to pay more than $750 toward your deductible unless you've used your Health Savings Account on other stuff (I can use it on vision and dental care, too, so that would cut into the medical deductible). After the deductible, you should only have to pay co-pays and random stuff they don't cover, and your out-of-pocket maximum is $3000, after that they cover everything. Also Women's Health is covered 100%. It's good insurance! Go to the doctor!
Here, I think this explains out-of-pocket maximums pretty well. It's good news! You'll never have to pay more than $3000 a year for your health care, even if you have to get some really complicated surgery (unless you do something that isn't covered, like IVF or elective surgery). And your co-pay for inpatient hospital care is $300, so it would take quite a lot for you to reach that $3000 maximum.

Mental health services are also pretty well covered, if you need them :).

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How much have you paid out-of-pocket so far this year? (Don't feel like you have to answer if that's too nosy, I'm just trying to see if I can help figure out how much more you have to go before coverage kicks in).
Im so confused now. I have a d&c/biopsy every 3 months. I am always charged $800-900, this time i was only charged the copay $60. so far i have spent 1265$ so i have almost reached my deductible.

Does that mean my insurance will start covering my exams more, once i reach my deductible? its just very confusing. It took me so long to pay for this same exact test that i did on May.

Took this from the article:

Out-of-Pocket Maximum vs. Deductible
An out-of-pocket maximum differs from the plan's deductible. Amounts you pay for covered services go toward your deductible first. That's the amount you must pay before your insurance kicks in.


Once you meet the deductible, you may be responsible for a percentage of covered costs (called coinsurance). These payments help you meet your out-of-pocket maximum. Once you reach that amount, the insurance plan pays for 100% of covered expenses.


I hope that means my insurance starts helping more at this point. That would be a relief that i dont have to have $3000 every single year on hand.
 

Willowy

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Yes it sounds like you reached your deductible already, if you only had to pay the co-pay. Your share of the deductible should only be $750; your employer covers the other $750. But you say you're already up to $1265 out of pocket? That shouldn't have happened. . .was it the same doctor?

Now, with this kind of insurance you do have to be careful to only use in-network providers. There should be a list on their website. But if it was the same doctor I don't know why they charged you in May but not this time.

Did your insurance send you a statement the last time? That should have broken down how much was left on your deductible, etc. You may be able to access it online too.
 

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The whole "health care insurance" thing is confusing to EVERYONE, and I don't claim to be able to understand it, plus, I am so hostile to the whole thing that I tend to block everything on the subject. So I won't weigh in on that except to wish you the very best.
Yeah, everything IMHO points to your need to be out on your own away from all that mess. Sorry to be blunt but that's what it is. Putting your loved ones in harm's way just isn't workable IMHO. It sounds out of control and yes, an accident waiting to happen. People who aren't in control of themselves can't be trusted to make good decisions about anything. And the thing about restaurants is SO common -- people won't save, or spend on necessities, but yeah, they'll go out and/or buy frivolous stuff. That's what this society is all about. I could go on and on, but I won't. IDK what the answer is, but I pray there will be one.
 
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terestrife

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Yes it sounds like you reached your deductible already, if you only had to pay the co-pay. Your share of the deductible should only be $750; your employer covers the other $750. But you say you're already up to $1265 out of pocket? That shouldn't have happened. . .was it the same doctor?

Now, with this kind of insurance you do have to be careful to only use in-network providers. There should be a list on their website. But if it was the same doctor I don't know why they charged you in May but not this time.

Did your insurance send you a statement the last time? That should have broken down how much was left on your deductible, etc. You may be able to access it online too.
no, sorry. i just wrote out the total of the deductible. that includes the health fund given by my employer $750. My contribution should be half.

I remember i was told i owed $900 for my last procedure in may out of my pocket. I paid half and then they charged me a little bit per month to finish paying. Im not sure, its been a few months.

And yes, its the same doctor.

now that i think back. I remember calling my doctors office because i knew i still hadnt paid the complete $900 but when i called they told me i had finished paying. I wonder if my insurance realized i had reached my contribution and stepped in?

Sorry, i dont really know much about insurance. In my last job they would charge me $200 monthly, and then i would just pay a copay when i went to the doctor. Never had to have money on me and pay for things like this.



The whole "health care insurance" thing is confusing to EVERYONE, and I don't claim to be able to understand it, plus, I am so hostile to the whole thing that I tend to block everything on the subject. So I won't weigh in on that except to wish you the very best.
Yeah, everything IMHO points to your need to be out on your own away from all that mess. Sorry to be blunt but that's what it is. Putting your loved ones in harm's way just isn't workable IMHO. It sounds out of control and yes, an accident waiting to happen. People who aren't in control of themselves can't be trusted to make good decisions about anything. And the thing about restaurants is SO common -- people won't save, or spend on necessities, but yeah, they'll go out and/or buy frivolous stuff. That's what this society is all about. I could go on and on, but I won't. IDK what the answer is, but I pray there will be one.
Thank you!

My sister is telling me shes trying to get financial assistance so she can start taking care of the utilities and give me a chance to have a savings for my health issues. Who knows if that will happen, but shes at least trying to help me out.

i still dont know for certain what will happen with my health, and would feel less stressed if i had savings should anything happen. Thankfully i didnt need my savings today, so its staying there until i need it. The doctor says we will know more about the next step once we have the biopsy results.

Just feeling down today. Been resting in bed.
 

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Well, it's definitely good you only had to pay the copay now. Hopefully that will be all. I wonder if the out of pocket max is if you do end up going over $3000, then you wouldn't even have to pay the copay anymore.

It's too bad your lining isn't as thin as they want it, though hopefully since it's gone down a little that's a good sign. Fingers crossed the cells are going back to normal. :vibes: Rest up and hopefully the biopsy results come back quickly so you have answers.
 

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no, sorry. i just wrote out the total of the deductible. that includes the health fund given by my employer $750. My contribution should be half.

I remember i was told i owed $900 for my last procedure in may out of my pocket. I paid half and then they charged me a little bit per month to finish paying. Im not sure, its been a few months.

And yes, its the same doctor.

now that i think back. I remember calling my doctors office because i knew i still hadnt paid the complete $900 but when i called they told me i had finished paying. I wonder if my insurance realized i had reached my contribution and stepped in?

Sorry, i dont really know much about insurance. In my last job they would charge me $200 monthly, and then i would just pay a copay when i went to the doctor. Never had to have money on me and pay for things like this.





Thank you!

My sister is telling me shes trying to get financial assistance so she can start taking care of the utilities and give me a chance to have a savings for my health issues. Who knows if that will happen, but shes at least trying to help me out.

i still dont know for certain what will happen with my health, and would feel less stressed if i had savings should anything happen. Thankfully i didnt need my savings today, so its staying there until i need it. The doctor says we will know more about the next step once we have the biopsy results.

Just feeling down today. Been resting in bed.
Good idea. Recharge, relax and recuperate! Get plenty of C.A.T (Cat-Assisted Therapy) :cloud9::catlove:
 
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terestrife

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I never have either. It all goes to insurance, they decide what they pay, and then send a bill for my portion. It's weird the doctor's office expected immediate payment. Hopefully they won't do that again.
They have done it twice that they ask for at least half and then put me on a payment plan. Im guessing they call in the insurance and then decide if they should charge me.

Well, it's definitely good you only had to pay the copay now. Hopefully that will be all. I wonder if the out of pocket max is if you do end up going over $3000, then you wouldn't even have to pay the copay anymore.

It's too bad your lining isn't as thin as they want it, though hopefully since it's gone down a little that's a good sign. Fingers crossed the cells are going back to normal. :vibes: Rest up and hopefully the biopsy results come back quickly so you have answers.
Its such a relief to only need to pay copay. Hopefully it really stays that way. i think you might be right about how my insurance works. so hopefully i wont need to have $3000 in my bank every year.

Been resting the past few days. This last d&c was painful. i thought i had gotten used to them at this point. lol i think the doctor might have forgotten the shot that numbs the area. Not a horrible pain, but the scrapping is always unpleasant, and got light headed this time.


Good idea. Recharge, relax and recuperate! Get plenty of C.A.T (Cat-Assisted Therapy) :cloud9::catlove:
Been resting the past few days. Feeling a bit better. Still have some pain and cramping, but not too bad. :heartshape:

Yep that's what it means.
Thank you for taking the time to help! I had been losing sleep worrying that i would need $3000 on hand every year.
 

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They have done it twice that they ask for at least half and then put me on a payment plan. Im guessing they call in the insurance and then decide if they should charge me.



Its such a relief to only need to pay copay. Hopefully it really stays that way. i think you might be right about how my insurance works. so hopefully i wont need to have $3000 in my bank every year.

Been resting the past few days. This last d&c was painful. i thought i had gotten used to them at this point. lol i think the doctor might have forgotten the shot that numbs the area. Not a horrible pain, but the scrapping is always unpleasant, and got light headed this time.




Been resting the past few days. Feeling a bit better. Still have some pain and cramping, but not too bad. :heartshape:



Thank you for taking the time to help! I had been losing sleep worrying that i would need $3000 on hand every year.
Something that could possibly help with stress and is very gentle is the Bach Flower Remedies. Have you tried Rescue Remedy?
 
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terestrife

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I'm glad you've been able to rest! I wish it had been less painful. Still hoping for good news on your biopsy. :hugs:
Thank you! :heartshape: I hope so too, i need the good news. :sigh:

Something that could possibly help with stress and is very gentle is the Bach Flower Remedies. Have you tried Rescue Remedy?
How interesting, the website says its safe for humans and pets. I have never tried it before. Is it something you have tried? I was looking at the website and theres a lot of options.
 

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Thank you! :heartshape: I hope so too, i need the good news. :sigh:



How interesting, the website says its safe for humans and pets. I have never tried it before. Is it something you have tried? I was looking at the website and theres a lot of options.
Yes, I have it. I very rarely take anything for anything, except aspirin for headaches, which I've gotten for the past 2 days with the heat and the fires here. Last night I used the Rescue Remedy before bedtime. I'm an insomniac, and pretty stressed with all of this and more, but I did get some sleep even with having to keep all the doors and windows closed. I recommend it.
 
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terestrife

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Yes, I have it. I very rarely take anything for anything, except aspirin for headaches, which I've gotten for the past 2 days with the heat and the fires here. Last night I used the Rescue Remedy before bedtime. I'm an insomniac, and pretty stressed with all of this and more, but I did get some sleep even with having to keep all the doors and windows closed. I recommend it.
Ok, I will try to buy it soon. Thank you! :heartshape:

How come there are fires there? Is it a forest fire? I've heard those can last a while, or they even create them on purpose. I don't know much about it tho. I hope everything's ok over there. :sigh:

Since i live with my niece I unfortunately need to hear their arguments and petty dramas. I'm inexperienced in relationships. Is it normal to need to video chat to confirm where your partner is? Lol I ask because she sometimes texts to check if he's home to see if he's lying. I had enough with her today. She texted me to check if he's outside drinking. And I simply told her I didn't want to spy on him. Lol. She got annoyed and said "omg whatever. "

I have my own stuff to deal with i genuinely do not care what he does or where he goes. Is this normal? She even has all his logins to spy on him.

Maybe it's my personality but I can't imagine being with someone that I don't at least trust. Hopefully she doesn't get an attitude. She loves saying no to people but hates hearing it.
 

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It sounds like she doesn't trust him and that's not normal in a healthy relationship, I don't think. The only time I've checked in with my husband to "see where he is" is when he's traveled somewhere without me and I want to make sure he got there safe, which I assume is fairly normal. Has he lied to her a lot? Has she been cheated on before (not necessarily by him, just in general)? She seems very insecure.
 
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terestrife

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It sounds like she doesn't trust him and that's not normal in a healthy relationship, I don't think. The only time I've checked in with my husband to "see where he is" is when he's traveled somewhere without me and I want to make sure he got there safe, which I assume is fairly normal. Has he lied to her a lot? Has she been cheated on before (not necessarily by him, just in general)? She seems very insecure.
Even though she's my niece, we weren't close until we moved in together. I don't know if she's ever been cheated on. I do know that her current bf has lied to her.

My sister loves complaining to me about him whenever she can. Her and her husband cannot stand him. My niece used to drive to check if her bf was actually at his friend's house drinking (she asked to borrow my car that day.) He would spend hours not answering the phone.

I don't know much but the example you gave seems normal. I just don't want to be involved, their screaming matches get annoying. I think it stems from the horrible father she has.
 

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No, it's not normal. It sounds like jealousy with maybe a bit of paranoia, though it's not always unwarranted depending on what the other person is like. Then again if it's someone where it's not entirely out of place it's not going to be a very healthy relationship.
 
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terestrife

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No, it's not normal. It sounds like jealousy with maybe a bit of paranoia, though it's not always unwarranted depending on what the other person is like. Then again if it's someone where it's not entirely out of place it's not going to be a very healthy relationship.
He has his weird issues. He drinks a lot and isn't honest about where he is sometimes. If she goes out he comes home extremely late. I don't think he's cheating (I don't like accusing without proof) I think he's just drinking. It's scary because he drinks and drives.

I've told my niece how dangerous that is but he doesn't listen to her. She's constantly saying she wants to leave him but I doubt she will. Don't really know much else about what's going on. I had to ask everyone to stop involving me. Even my sisters husband tried to gossip with me about their issues. Creeped me out.

My niece has a lot of issues with her father that speaks volumes on why she does what she does. I won't get into detail but hes an awful human being. Even so she can't cut ties with him.
 
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terestrife

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Good call. You've got your own crap to deal with, some of it directly because of other people.
I just had to. I rarely talk to my sister on the phone anymore. My family gets way too involved in each other's problems. I find it's easier on my mental health when I avoid dealing with family drama.
 
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