Years ago, before my other half started his current job, we had a doctor's appointment for the kids--just your standard well-child visit. Went well, like they always did: kids healthy, growing like weeds, Imp screaming at the doctor to not touch his bits (and yes, he used the medical terms, and yes, the doctor thought that was excellent), and we were out. Went to pay at the window, and the admin assistant asked for our insurance card, and I declined, saying we'd be paying cash.
Our insurance (yes, we had it--it came out of the account right at the top of the month, and cost around half my monthly paycheck)...didn't cover doctor's visits. Just catastrophic stuff.
If they'd tried billing the insurance, it would have gotten kicked back to me, and I'd have paid $125 per kid for the office visit; as cash pay, it cost $80 per kid.
Makes sense, right?
The gal doing the billing blinked at me, and asked if I wanted the bill mailed, and I said no, and pulled out my checkbook...which shocked the crap out of her. "Uhm...you're going to pay right now?"
"Well...yes. I budget for this."
"I have never even heard of that. Why do you budget for doctor's office visits?"
"...because I know they're coming up, and know I'll need to pay y'all promptly so you can keep the doors open and the lights on?"
"Wow."
That doctor first went cash, then retired when Obamacare really came online. Odysseus has been with his current job for more than five years; I still budget for office visits (the copay, specifically).
You don't want to know how many people pay their copay with what is clearly a credit card. And bitch about the copay every time (I see a lot, especially at the endocrinologist's office).
But yes, medical is another line on the budget that needs to be...close to the top. Above "stuff I want" but below "stuff my family needs." It may not be stuff, but it is both an expense and a need.
The "expense" part will vary with age and health--you've got to figure that stuff out for yourself. But you need to figure a lot of different things into that: your insurance costs (if it doesn't come out of your paycheck before you even see it), your office copay for each visit (yes, you're going to need to do math: what's the base copay, times how many people, times how many times per year). A couple of visits to urgent care or the emergency room per person per year (you likely won't need to use it, but it's better to have it in reserve for the possibility). Your prescriptions...and a few extra bucks set aside for an "uh-oh, need a course of antibiotics" situation. Any vitamins and/or other supplements you take. Over the counter meds like NSAIDs, acetaminophen, antibiotic ointment; supplies like bandages (wraps and sticky), disinfectants (alcohol and peroxide are an absolute must, as is bleach), hygiene supplies (soap! shampoo! toothbrushes/pastes! laundry- and dish-detergent!).
Hey, how's your vision? Yeah, you're going to need to budget for that, too. And start socking away money to cover glasses--just in case--even if you don't need them currently.
A lot of this is, quite honestly, ongoing small costs. Preventative maintenance. You pay the small costs up front so you don't incur enormous ones.
Budget for them. You need a line item in your written budget for "medical." Be honest, and be thorough.
It's a lot less stressful to know you've got the money to cover those things than to not think about them and have them pop up in your face just before you've bought groceries.
Or worse, just after you've bought that thing you wanted that could have paid for the sudden, unplanned medical expense, instead.
Once upon a not that many years ago, Calmer Half and I were sitting in the ER way too late at night, and the doc was finally back with test results. Which were... off. The rise in certain things was Not Good, but it wasn't Double Plus Ungood Sky Is Falling! The doc wanted to keep Calmer Half overnight for observation and another round of tests.
ReplyDeleteCalmer Half wanted to go home, get a proper meal, and sleep in a proper bed. They both looked at me, as the mediator in this pointed dispute.
I took a deep breath, and said, "Love? When is your next cardiologist appointment scheduled? Right, that's after the first, when the deductible resets. We've already run out the deductible for this year, so at this point, all the tests are covered. I know the doc can't tell us how much they cost, but I know what the copays for those are. And given the unhappy your ticker just did, the cardiologist is going to order all the same tests. Why don't you stay for observation, get the tests, and this way, even if it's nothing, they'll be much cheaper for our pocketbook when the doc looks at them in a month-ish."
With some grumbling, Calmer Half acceded to that logic. Which is why he was in the hospital already when his ticker proved that the minor hiccup that had sent him to the ER 16 hours prior was, in fact, merely the foreshock to the Main Myocardial Event.
Which, since it wasn't his first time... I had already budgeted for. I was still thankful for the not-so-small mercy that it was after the deductible had run out for the year, though! I'm not that good!
Yikes! That's terrifying!
Delete(Both times I went in for vague symptoms of heart attack, it turned out to be low blood sodium. And we had a copay for an ED visit for each member of the family--and there are four of us--in the savings account.)