Insurance/HSA question

Sunshine99

I'm not sure where to post this.  Open enrollment is coming up in November for my husband's insurance.  Last year I was "lucky" to be diagnosed just before open enrollment, so we set aside $5,000 for out of pocket medical expenses.

So here I come to my one year anniversary and am wondering how much this is going to cost me next year.  I won't have any more chemo (unless the cancer comes back - which is always in the back of my mind).  But maybe there will be more tests, etc. 

I don't want to over pay.  I'm not sure who to talk to.  Last year when this all started I went into the cancer center of the hospital where I'm being treated.  My main contact person (breast ca services coordinator) was out so the receptionist asked the social worker if he could help me.  He sat behind his desk and said "I don't have time for this"!!!!  I left in tears - can't stand the sight of him.  I was so upset, I couldn't think of anything to say.

Thanks, everyone!

vhqh

The best thing I can suggest is to look at what the coinsurance/deductible is and what the copays are.  Then make a list of what drugs you are still on and what tests you know you will be having in the coming year and start attaching costs to each one.  I am stage IV so I know that I will hit the max on my coinsurance, I am also on some ongoing meds, some cheap enough I wouldn't bother with it but just started one that has a $75 copay, and that is per month.  My open enrollment ended today, I really wanted to bump up what I withheld to cover the new copay but I reacted to the drug and can't guarantee I'll stay on it. 

You could also try to call the services coordinator, see if they can help you as far as what tests you'll need, I would also be sure to let them know just how obnoxious the so called social worker was.

Alicia70598

I like vhqh's advice. Some benefits sites have calculators for this purpose. For 2009, I put in the maximum out-of-pocket amount into my FSA because I will have reconstructive surgery that's covered at 80%. Tamoxifen is also not cheap. But I'm like you, Sunshine. I like to err on the side of caution and put in too little rather than too much. 

Good luck with this! 

jdg1

Alicia,

I am not sure were you live, but I am in California and I get my Tamoxifen for $8.00 a month at Target.  I know Walmart also is arond the same price.  If you have either of these pharmacies available to you you might want to look into it. 

 June

jdg1

As far as your HSA account question:

Take Advantage of Tax Benefits While You Save for Medical Expenses

A Health Savings Account (HSA) gives you more flexibility and control over your health care costs. If you have a high deductible health plan (in 2008 at least $1,100 for an individual, $2,200 for a family), your employer can make pre-tax contributions on your behalf. Any other contributions you make are tax deductible. You will enjoy these benefits once your account is started:

This is over and above your deductible.  Because it is a savings account like an IRA they regulate how much you can add. 

 I just recently started an HSA as well.  We have a $1,500.00 deductible and then after that deductible has been me I believe we are then covered at 100%.  To be sure look at your policy to see what your deductible is and what is covered.  We were very fortunate to get a low HSA account. 

June

Alicia70598

For JDG, thanks for the tip. I live 3 blocks from a Wal-Mart and a Target! I didn't realize that Tamoxifen was offered in a generic. 

Re HSAs (I think Sunshine was actually taking about a Flexible Spending Account, or FSA): Health Savings Accounts are a mixed bag. Sounds like jdg got a good deal from her employer. Often they are best for young healthy people or sole proprietors, but there are exceptions. Here's the info about HSAs from the US gov.

To find out what medical/health expenses are FSA eligible, Drugstore.com is a great site. Some vitamins are eligible with a prescription. When I had to use up FSA money before changing jobs once, I got my gynecologist to write a prescription for calcium. 

Mahomet_mom

I also have a Medical Flex Spending Acct. I live in Central Illinois. Travel (mileage, parking receipts) if you need to travel a distance for follow-up care are possible deductions.  We went to Mayo Clinic in Rochester last winter for diagnosis and surgery.  Hotel costs ($50 for self and another $50 for spouse per night was allowed) so that was a sizable expense for ten days.

I also figure my husband and son's medical care, drugs, dental and eyeglasses.  I always hope that I will have some money 'left' at the end of the year to buy prescription sunglasses but it hasn't worked out in years...  Also any counselling you or your family get to help with coping is another option. In recent years things have changed so that non-prescription expenses can be used.  Items like band-aids, antibiotic cream, Tums, aspirin, and the like are okay.  See the IRS guide or ask your employer for a list.  Of course wigs are covered as well.     Take care.