Health Insurance, School, and Money

Our new healthcare plan rolled out and I’m totally screwed.  Both of my doctors will now be out of network.  The deductible for out of network providers is $2500 per person $5000 for the family.  Once I hit that number, they only cover 60% of each visit.  My therapist charges about $170 for an hour so that’s $340 a month right there before the deductible gets met.  Then I have my med doctor and I haven’t asked her what she charges yet.

Then there’s my medication.  Abilify will still run me a whopping $150 a month.  Most of my medications will now classify as maintenance medication and will be 100% covered so that saves me about $25 a month.  My Adderall isn’t covered so that’s $10.  My Xanex isn’t covered so that’s another $10.

On top of my crazy, there’s my migraines.  My shots cost $200.  My pills cost $150.  My doctor for that is in network at least and will be covered at 80% after meeting at $1500 deductible for each individual or $3000 for family.

My rough estimates put us at somewhere between $12,000-$16,000 next year in health care costs between the actual cost of the insurance, doctor visits, medication, and a few potential ER visits that happen every year.  If anything major happens that number will skyrocket.

I honestly dont’t know how we can afford over $1000/m in healthcare.  That’s ridiculous.  How can they get away with charging people that?!  If I don’t take my meds I can’t function.  If I don’t go to the doctor I can function, but not as well.  It’s imperative that I stay on track but damn if they don’t try to make it impossible.

I found a clause that’s called “transition of care” that says if you have a major medical condition and your provider will no longer be in network that they could offer in network benefits for a certain timeframe due to the change over.  I spent THREE hours on the phone with the insurance company and my HR department in regards to this.  The insurance company was fairly helpful but said they would not have full details until next month.  They said to contact my HR department since my benefits enrollment was now to see what could be done.

I called HR who said they didn’t know what I was talking about and to find another doctor.  My hatred for my HR never ceases.  I had to walk them through their own website to show them the clause.  They got their supervisor who proceeded to also say to get another doctor and was I sure I double checked both healthcare options to make sure they weren’t in network on one of them.  I got quite pissy and read them the page word for word and gave them the checklist of why exactly I qualified and asked them why they weren’t willing to provide benefits in accordance with their policy.  They said they’d have to research it and get back to me.  *SIGH*

In light of the crazy increase in my healthcare alongside with my husband’s company’s lack of work and sending him home early – we are officially broke and likely will continue to be so for some time to come.  Registration for spring semester is coming up and I have a big old $0 available for tuition.  I can’t get a loan from anyone and my mom has officially decided she will neither sign nor give me funds.  So at this point, going to school next semester is a no go.

I don’t much care for wasting time and energy.  Both are resources that are limited and precious to me.  Giving them up causes me stress and exhaustion.  The way I figure, if I can’t go to school, I might as well drop this semester as well.  Why bother spending all the time if it doesn’t amount to anything?  I’m stressed as hell lately, depressed, overwhelmed, just…ugh.

Mom says she is willing to pay for me to go back not this coming semester but the next if I take one or two classes at a time as the cost will be lower and then take breaks when money is low.  So she says I should finish this semester because then that’s four less classes I’ll need to take should I be able to go back.

At this point though I’m so tired and exhausted I’m just done with it.  If I go back I’ll just take the classes again.  I only started in late August so it was only a waste of about two months.  Classes don’t end until end of December and I don’t think I can do three more months of this right now.  I need some time to collect myself.  Work and health insurance has me done in.

Now my mom is pissed with me as usual because she thinks I should at least take two classes and only drop two.  I have an all or nothing attitude (which she hates).  I’m either gonna finish all of them or just drop until I can afford to go back.  She keeps yelling at me and saying I don’t listen to reason and that I’ve wasted money etc.  She always makes me feel like shit.  I know she doesn’t intend to, but that’s what she does.

I don’t know what to do because I don’t want to piss her off but I don’t want to finish the semester either.  I tried to get an appointment with my therapist today but she was on vacation.  I discovered today that I am unable to make big decisions without my therapist to tell me what to do.  Well, walk me through to coming to a decision.  On my own I just make mushy decisions that I can’t quite commit to.

I’ve already pretty much screwed myself if I decide to stay in for the semester because I had a math test tonight and decided to say screw it and didn’t take it.  So yeah.  I’m just done with it all.

Just for good measure once more – screw shitty health insurance for putting me in this predicament.

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About Kira

How do you say "I hate the about me section" without sounding cliche? I haven't found a way yet, so instead you'll now be subjected to random bits of info so you at least know what the blog is about. I'm a 26 year old wife and fairly new mom trying to make a life for myself and my family. These things should be run of the mill, but alas, I have Bipolar (amongst other diagnoses that I have long since lost track of). So here I am, trying to juggle a professional career, marriage, motherhood...and my own general crazy. All the rest of the "about me" sordid details will have to come in time, but the bottom line is that I need somewhere to vent that makes me feel like I'm being heard (even if no one ever reads this) and if along the way I can help another person or two then all the better. **Full Disclaimer** For the record, Kira is not my real name. Pretty much everyone I know is aware of all of my issues, but I do have a career and such and need to keep some level of privacy due to that. And, well, I'm paranoid. View all posts by Kira

One response to “Health Insurance, School, and Money

  • fishrobber69

    I’m sorry to hear all this. I had to go through a similar situation a couple years ago, so I understand the stress and frustration. Insurance reform is what I wanted from the health care law, but that didn’t happen. Insurance companies are Satan… I’m actually buying my Abilify from a Canada mail-order for about $100 for 3 months supply, so that saves a little. There are many more generics available through this site. Mail me if you want the site I use.

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