Feeling Anxious About New Year’s Costs
Last updated: December 2022
Many people seem to be swirling with purpose on New Year's Day. This feeling seems to start around the end of December and continues throughout January. I watch people make resolutions, pick a word for the year, join a gym, or try to form new habits that are good for them.
While all of this excitement is going on in the world, I'm preoccupied with wondering what our first insurance claim will be.
Instead of "New Year, new me," I find myself thinking, "New Year, new deductible." It’s been an intimidating part of my family's life for the past few years. After buying a house and having 2 kids we’ve found it harder to save up to meet our annual deductible. Our medical expenses are costly and plentiful, accumulating quickly after January 1st. It's hard to avoid feeling stressed despite having a good insurance plan.
Meeting the deductible quickly
We have a high-deductible health plan (HDHP) with my husband's company. It makes the most sense for our family. Currently, our deductible is $6,000, although each individual has a limit of $3,000.
Typically, I hit my cap of $3,000 within the first 6 weeks, which is a short amount of time to spend that much money on healthcare. Last year, one of my first expenses was filling my Cimzia prescription, which costs around $5,000 a month. We decided to pay for my portion, and just like that – I was done. We were only on the 3rd week of January, and I didn’t have to pay anything else for the remainder of the year.
The downside is that there is no payment plan for this high-cost prescription. You can get a savings card from the manufacturer that will help cover the cost of Cimzia, but it takes a while to fill out the paperwork and get everything set up. To use it, I would have had to postpone my regular injection.
Since I could pay the cost, I decided not to bother with the program as I would have risked a flare by waiting to fill my prescription. Plus, my other medical costs are high enough that I would have met my deductible quickly, regardless. For example, I have a prescription face cream that is $640 monthly (Soolantra), prescription eye drops that are $624 monthly (Restasis), medical Botox injections that run about $5,000 every 3 months, and so much more.
The other half pays out more slowly
The remaining half of the deductible is usually split up between my husband and 2 sons. Last year, my husband and older son both had procedures early in the year that could be put on payment plans. This helped us financially because we could pay relatively low payments over several months. After dumping most of our saved money into my prescription/deductible, we had a little breathing room.
This year, however, we don’t have any procedures planned. Isn’t it strange to almost wish it would work out that way again? Unfortunately, we are less prepared to pay the medical bills this time around. We could not refill our Health Savings Account (HSA) balance like we normally do each year.
The financial anxiety fades but does not disappear
Our wallets suffer significantly early in the year because of our medical expenses. However, once we meet our deductible, it’s refreshingly simple. We don’t have to think about copays or coinsurance – we have to check that everything is pre-approved and we stay in-network with our insurance.
This was helpful when our kids started preschool this fall and brought home several viruses. In a month, we had 5 urgent medical visits due to sickness in our family – and each one was nearly $400. I only know this because I looked up the claims; we didn’t have to pay a dime since we had already met our deductible. I’m grateful we can plan for the deductible and not worry about unexpected expenses after that until December 31st rolls around.
I have been thinking a lot about how we will pay the torrent of expenses headed our way. I felt anxious about this in October because we weren’t on track. It’s been a tough year, and we couldn’t save up enough for our deductible.
Thankfully, I don’t have to refill my Cimzia until February. Still, I'm worried about how we will pay for things we can't go without until that pesky deductible is once again satisfied. While we have a good healthcare plan overall and excellent medical coverage, it still comes at a significant cost. I know others are likely paying just as much, possibly more, for lower coverage healthcare.
At what point in the year do you usually meet your deductible? Do you feel stressed about your deductible starting over?
How are you most likely to respond when someone offers you unsolicited advice about your lupus?