by Ashley
Have you ever opened the mail and found an unanticipated bill that just made the blood drain out of your face and you feel sick to your stomach?
I have. Lord knows, I have.
It’s what happens when you know you don’t have the money to pay it. You weren’t expecting it or didn’t anticipate the large amount and, knowing that you owe it, you feel scared/sick/sad/panicked.
I’ve been there. Shortly before I started blogging here in March 2014, hubs suffered a serious medical illness. I’ve written about it before but just as a quick recap, hubs was stricken with some strange neurological disease. He was in-and-out of hospitals, admitted for 10 days here, 3 days there, several other single day trips. He also had to see pricey specialists, have batteries of tests run, and went to the Mayo Clinic for consultation. On top of this, he was the main provider for our family at the time (I only worked part-time making minuscule money compared to my current income), and he was out of work for 2 full months. Being self-employed, he had no paid time off or vacation or anything of that nature. We’re very thankful that he made a full recovery (his final diagnosis was “atypical meningitis” – because he had incredibly high levels of infection in his spinal fluid, but tested negative repeatedly for all the known forms of meningitis.). Even so, the event devastated our family financially. We’re still paying it back even now (it’s the medical bill that is referenced in our debt updates).
Although that was a very extreme example, we’ve had countless other similar incidents (though with smaller price tags attached) for things like an unexpected $1,000 root canal or $700 car repair work.
So you might think that I experienced a similar sensation when I opened up an unexpected bill from our girls’ pediatrician. They recently went for their 4-year well-child check-up. Those things are supposed to be free, right? Why then did I receive a bill for just over $800!?
Well, I switched our insurance for 2016 and this was one of the byproducts. I changed our plan to one with a low monthly payment and relatively low deductible. The “catch” is that we have to pay for 100% of our healthcare costs in full until our deductible is met. But at that point, the plan pays for everything minus our copays (no 80%-20% or whatever – they pay for it all as long as we’re in-network). Apparently I was mistaken in thinking that the well child check-up was covered under preventative care because, with our new insurance, we pay ALL of those costs until the deductible is met. And it hasn’t been met yet.
So did I panic at the sight of an $800 bill?
Nope.
Not in the slightest.
I picked up the phone, called the pediatrician’s office, asked to speak to the business manager, and provided payment information in the very same day.
Say what???
When I switched our insurance plan, I also enrolled in a Flexible Spending Account for healthcare (I have a separate FSA for childcare, too). My employer has been taking pre-tax money from my paycheck every single pay day since the beginning of January and, at this point, I’ve built up a little pot just shy of $2,500 that’s just sitting there waiting to be used on medical expenses.
I can’t even express how GREAT it feels to finally be on a budget and a plan that allows me to have these unexpected expenses pop up and NOT break out in a cold sweat with clammy palms!
I’m so thankful for a full-time job that allows me to pay for ALL KINDS of things with pre-tax money (childcare, healthcare, my dang parking permit for crying out loud). It just comes right out of my check so I never miss it (I never even have it to begin with) and it’s just sitting there waiting for me when I need it. I know I could do the same thing on my own (and, though YNAB, I’ve developed my own savings categories for things like vehicle repairs or gift-giving, which is truly helpful). But it’s so much easier when I never even have to see the money and it’s just done automatically like this for me.
Now that I’ve decided to start going to therapy and whatnot, this plan might not be the best option anymore. It really works best to pay 100% out-of-pocket when you don’t have lots of doctors’ appointments, etc. But I’ve got it at least through the duration of 2016 and it’s nice to know that the money is sitting there waiting should we need it.
Also, kind of as a side note since I mentioned hubs’ surprise root canal as one of our previous financial emergencies…. hubs’ teeth are FINALLY all up-to-date. He’s had some recent dental work with cavities and an additional root canal (over the past couple months – things have been crazy and I just haven’t mentioned it). But now he’s finally got his oral hygiene in check after years of catch up. The dentist said that the only remaining problems are cosmetic: he has two teeth that are out of place and could benefit from braces, and he could use a teeth whitening. We’re going to sit on our little pot of medical FSA money for awhile, but we’ve already discussed the possibility of starting the braces process later this year. Our health care FSA can be used for approved dental and I believe braces qualify (I have to double-check). The FSA is use-it-or-lose-it and we want to wait a bit to make sure there are no other health crises that pop up. But if we get around October-ish and we’ve still got money burning a hole in our pocket, then we may move forward with some orthodontics for hubs! Crazy and exciting at the same time!
That’s all. It’s just such a freeing feeling. And a very new feeling for us, too. We still have so much debt to contend with. But when stuff like this pops up and we have the money just to cover it with no worries, it feels like financial peace. I can’t wait to have that feeling every day once we’re debt-free!!!!
What was your most recent financial emergency and how did you resolve it?
Hi, I’m Ashley! Arizonan on paper, Texan at heart. Lover of running, blogging, and all things cheeeeese. Freshly 40, married mother of two, working in academia. Trying to finally (finally!) pay off that ridiculous 6-digit student loan debt!
It’s a great feeling – glad you’re benefiting from the reduced stress the comes from budgeting.
As for the FSA – I know it used to be a use-it-or-lose-it account where you had to spend it all before the end of the year. Do you know if this is the case for yours? Would hate to see you build up the account and then have to lose the $$ for not spending it. (We use an HSA, which builds up and is never forfeited.)
I’ll double check to be sure, but I’m almost positive our FSA is use-it-or-lose it. I’ve already reached my annual max (the cap is $2,500) and I’m pretty sure we’ll run through it between the kids’ appointments, my well-woman exam coming up soon, and hubs – who has finally agreed to get a vasectomy!!!!! But, if not, we’re going to make sure we spend it on orthodontics stuff for hubs. So one way or another, we’ll make sure the money gets spent on health-related stuff and doesn’t get forfeited.
I did use FSA monies for my braces a few years back so do look into it. I was a dental expense and actually listed on the reimbursement form under dental.
I’m more blown away by the fact that a well-child visit for a 4-year-old is $400! It’s been awhile since I’ve had a little one. Is that really the going rate?? Glad you were able to pay it without a second thought.
After reading comments I double-checked everything and even called to verify with our insurance company directly. I guess it’s accurate that they DO charge for well-child checks, but the majority of the $800 was actually from immunizations (not from the “well child check-up”).
I would double check that your insurance shouldn’t have covered the check up. Preventive care should be covered by all insurance plans since ACA went into effect. Maybe the provider coded it wrong when they submitted to insurance.
I’d also suggest the same. I’d look at the EOB from the insurance company very carefully to check if they actually applied it towards your deductible and also ask the doctor’s office about what response they got from the insurance company.
Also, I know, sometimes the Dr office will send the bill in advance, even when the claim is pending with the insurance.
You should definitely check with the insurance company first and/or make sure that the pediatrician billed the correct insurance plan, especially if you switched at the beginning of the year. If the insurance plan is through an employer, preventive care is required to be covered and not subject to the deductible. Sometimes however, the doctor’s office doesn’t put in the correct preventive care billing code or doesn’t bill the correct insurance. Then, sometimes the insurance company processes the claim incorrectly. So you should always double check both before paying.
I have a love/hate relationship with FSA accounts. About 18 months ago my husband changed jobs and we enrolled in an FSA, when he separated from the company we were told we needed to use the funds by the last day of the month (he quit mid-month) or lose it. Fortunately, I knew of the FSA store, and thanks to Swagbucks was able to spend the funds and earn Swagbucks. He then switched to a new employer and again we enrolled in an FSA, however despite searching the providers website and numerous calls to the company I was unable to know how ours were set up, resulting in a $500 loss at year end 2015 of unused funds. There was NO communication from the company letting us know this. On the flip side we did sign up to contribute $200/month in 2016. In March I broke my ankle and needed surgery. Even though we only ended up contributing $600 total in 2016 ( My husband switched jobs in April – he was paid monthly at the end of the month so we did not make an April contribution), we were able to use the full $2400 to cover deductibles and co-pays. In that instance it certainly benefitted us to have the FSA account.
Oh man! I kinda feel the love-hate thing, too. I like the idea of having this pot of pre-tax money sitting there at the ready, but it’s already been quite a hassle to deal with, upload appropriate receipts in a timely manner, etc.
Paying for a well check for small children when you have insurance is very rare. I would check the EOB and ask at the office to check the coding. And look at your Claims/Benefits disclosure-well checks are preventative. If, indeed, you have to pay for it. You should ask for the cash rate versus the insurance rate. They are generally very different.