Wednesday, July 17, 2013

No Money, Mo Problems

Two and a half months with the Kidney

"See Imma tell you
Like Wu told me
Cash rules everything around me
Singin dolla dolla bill, y'all
Singin dolla dolla bill, y'all"
 The one and only Wyclef Jean

I've been meaning to write a post about the cost of kidney transplants for a while.  But right now, the timing is perfect because last week I received my bill for my hospital stay, anesthesia, actual surgery, my dad's portion of the surgery, and my medications that I took during the hospital stay.  And I had been waiting for this bill, watching the mail box like a dog sitting by the storm door of a house watching cars pull out of drive ways and the wayward basketballs of bad kids bounce into our yard.  But then, at one time I thought, "Maybe it's not going to come.  Maybe they're not going to charge me for the surgery. After all, I've already paid so much money to doctors over the past year."  

Lesson #1:  It takes a while for medical bills to actually get passed on to the patient.  In this case, it took roughly two months after the surgery for the hospital to send me my bill.  During that two months, the hospital financial division drew up the numbers and exact costs of everything and negotiated with my insurance company.  My insurance company told them what it was going to pay for the surgery.  And then what was left over was sent to me.  

I had an idea of what I would have to pay, and I also had an idea of the worst case scenario.  
Lesson #2Become really well versed in what your health insurance policy dictates.  The health insurance we have through my job requires, among other things, a 10 percent coinsurance on any medical procedures like outpatient and inpatient surgery.  At the first meeting on Kidney transplants that Ben and I ever attended, we were told how much we should anticipate paying.  MATH TIME!  And yes, I'm using a calculator.  I'm a writer, not a math-er.

The entire transplant was estimated to cost $140,000.  Yep.  Staying alive is expensive!  And the sad part is, if you don't have insurance, this is pretty close to what you would have to pay.  Luckily, most hospitals have some kind of financing program and help for those who can't make the payments.

Per my insurance's coinsurance policy, 10 percent of $140,000 is $14,000.  Wow!  A new car, or a really well planned, small wedding.  

That's what added a whole other complicated layer to this whole transplant thing.  Ben and I were planning our wedding, reading up on the average costs of weddings in the D.C. area.  How much is the average wedding in the D.C. area?  $32,500.  And that total right there is for if you invite 100 people to your wedding. Ben and I invited 235 and ended up paying for 180.

"All I see is signs. All I see is dollar signs. Money on my mind. Money, money on my mind."
The good thing is that it's really hard to be concerned about bank accounts and piles and piles of money flying out the window, when your major organs are on the brink of imploding inside your body.  Now, don't get me wrong.  There were plenty of times when I turned to Ben and said "Maybe we should just not have the transplant, save the money, and travel around the world together."  Don't judge me. I was sick.  There was toxic waste floating around in my blood and it was clouding my judgment. 

So my insurance plan has the coinsurance policy, but, like most other plans, it also has an out-of-pocket maximumYour OOP max would be what a plan participant pays within a year of the plan.  For example, if your OOP max is $1000 each year, then once you pay $1000 in procedures, hospital visits, etc., you won't have to pay anymore.  Now most people, don't reach their OOP max, because most young people like me are healthy as a prize winning horse.  So if you go to the doctor only once a year, you're not going to hit your OOP max.  

But lucky for sick people like me, once I hit my max (which has either already happened or is happening in the next week due to my ER visit) I can have all the free surgeries I want!  So YAY for me!  I might just get all my organs replaced.  Like a full body tune up.  

Lesson #3If you don't have an emergency fund, start one right now.  So you want to hear something dumb and immature and idiotic and stupid?  Ben and I started our emergency fund in January.  I know....we're STUPID.  Now, that's not to say that we didn't have savings. Before I moved in with Ben two years ago, I had built up a considerable amount of savings because I lived with my parents.  They say you should have three to six months salary (or rent or living expenses depending on your school of thought) saved up in a bank account for emergencies.  Well I definitely had that.  Like I said, I lived with my parents.  But I wasn't necessarily saving all of that up for "emergencies."  I was saving it so that I could move out of my parents' house and afford security deposits, first month's rent, and maybe even some new furniture.  Then once that was taken care of, Ben and I got engaged, and I decided to use most of it to pay for our wedding.  So when all this stuff went down, and there was a strong possibility that I was going to have to go on unpaid leave for some time after my kidney transplant, Ben and I immediately started saving to cover my half of the rent and my living expenses if I had to take unpaid leave.

LUCKILY, I didn't have to take that much leave, and was paid for all of the time that I took off work.  But what if that hadn't been the case?  It's the "what ifs" that always get you.  What if...the car breaks down?  What if...I don't have enough paid leave?  What if...YOU HAVE TO HAVE A KIDNEY TRANSPLANT???  And that's where emergency funds come in.  

Lessons Learned:  Having a major surgery really rocks your mental state, emotional state, and financial state.  There are so many doctor's reports, lab results, and procedures to schedule, and then bills to pay.  And your family and friends never want you to have to think about the money because "This is your life," they always say.  You're life is more important than some money.  Please. In all honesty, when it's happening to you, and your spouse, the thought process doesn't always go like that.  Because after the surgery,  it's you who is responsible for the remaining balance.  It's you who has to figure out how to make ends meet.  It's you who has to count the zeros.  Yes, you know your life is more important than dollar signs.  But what about the rent and all those wedding vendors you promised to pay off?  

Throughout this process I've come to have a new appreciation for really good health insurance plans.  Because those plans make the difference between paying $14,000 for a kidney transplant or just paying $14.  

Ben and I have become super serious about establishing a household budget that we can live with.  Budgets can be hard because you can't have everything you want. But we think we've come of with one that still allows us to save for the future, pay down medical bills, and still invest money in the things that we love doing.  And now that the wedding is over and paid off, we are more committed than ever to building up our emergency fund.  

Lastly, more than ever I just do not understand those people who are against Obamacare.  Ben says only the opponents call it that.  I'm a supporter and I call it that just because I feel like it rolls of the tongue a little easier than "Affordable Care Act."  Something just tells me that most of those people against it are super healthy people who have never had any problems ever in their life, or just a-holes who think it's OK for sick people to not have access to insurance.

I'm gonna go with option C:  that they are just a-holes all around.