Don't get sick on New Year's Eve

[IBWino]

We just visited with my wife's cousin, and she was telling us that she was admitted to a hospital on New Year's Eve, and because her stay spanned 2015/2016, she had to pay two annual deductibles ($2000 for each year) at once.

I never gave it much thought, but it makes sense that this could occur. It could present a hardship for some people.

 

[prudent_one]

Wow, never considered that possibility. What a blow to people who get seriously ill during the Christmas season.

 

[Midpack]

Wow, never thought about that. Awful, but I am sure that's how most if not all health insurance would work...

 

[athena53]

Thanks for the warning. DH and I had something a little les drastic happen after I joined my last employer in September, 2013. In October he needed an endoscopy. The new employer's plan and a $1,250 pp/$2,500 family deductible. I learned the hard way that the $2,500 deductible applied even if the other person had zero covered expenses. They wanted to do a "follow-up" and I thought it would be a doctor's office visit. They scheduled it in January. Oops. It was another endoscopy. There went $5,000 over a just a few months.


There used to be plans that counted expenses from the last 3 months of the prior year against the current year deductible (as well as the previous year's deductible). I'm sure the premium was a little higher to reflect that, but I wish we could get those policy provisions now.

 

[pb4uski]

.... I learned the hard way that the $2,500 deductible applied even if the other person had zero covered expenses. ....

That is why DW and I have separate policies, although I believe there were some changes effective January 1 that changed deductibles to stacked vs aggregate for policies covering more than one person so the situation you describe would not occur anymore.

 

[MRG]

That's what I would expect. At one time self insured Megacorp had a rule that if met your deductible in the last quarter it carried over, helped me out one year. That may have been in the last century.

 

[NW-Bound]

We just visited with my wife's cousin, and she was telling us that she was admitted to a hospital on New Year's Eve, and because her stay spanned 2015/2016, she had to pay two annual deductibles ($2000 for each year) at once...

My policy had a deductible of $10K/year. I paid that 3 years in a row, in 2012 for my son and 2013-2014 for myself. I was grateful that we stayed alive. Our separate illnesses could have taken our lives.

 

[Sunset]

But the same thing works for a person's benefit.
Have a root canal and cap put on , do first part in Dec and second part (cap) in Jan and the dental insurance pays the max $1,000 each year.

 

[IBWino]

My policy had a deductible of $10K/year. I paid that 3 years in a row, in 2012 for my son and 2013-2014 for myself. I was grateful that we stayed alive. Our separate illnesses could have taken our lives.

Glad that both of you are doing better. Money should certainly be a secondary concern during dire health events. My wife's cousin is fortunate that the deductibles were not a significant financial burden.

We also have high deductible plans ($3000 each) and I had never given this situation any thought. I only mention it here so that others might be aware and better prepared for such an event.

Regards,
Wino

 

[IBWino]

But the same thing works for a person's benefit.
Have a root canal and cap put on , do first part in Dec and second part (cap) in Jan and the dental insurance pays the max $1,000 each year.

True, but it would likely be a shock to many (most?) people when presented with this cost for a single medical event. Sure, your deductible is now covered for the remainder of the new year, but it still feels like a double hit.

 

[iac1003]

That's what I would expect. At one time self insured Megacorp had a rule that if met your deductible in the last quarter it carried over, helped me out one year. That may have been in the last century.

I believe those days are long gone. I remember them well.


Sent from my iPhone using Early Retirement Forum

 

[NW-Bound]

Glad that both of you are doing better. Money should certainly be a secondary concern during dire health events. My wife's cousin is fortunate that the deductibles were not a significant financial burden.

We also have high deductible plans ($3000 each) and I had never given this situation any thought. I only mention it here so that others might be aware and better prepared for such an event.

Regards,
Wino

Thank you.

My son's unusual infection got him a 9-day hospital stay, with a month-long at-home treatment. The total hospital bill for him was about $33K, if memory serves. For me, it was more than $130K due to major surgeries and extensive treatments.

So, considering the total cost, my $30K total deductible for the ordeals was not bad at all. By the way, I signed up for the high-deductible plan because we were healthy and used no healthcare other than the annual exams, and I often skipped even that. The money I saved on the premium was put into an HSA account, and I had built it up to more than $40K when I needed to spend it.

 

[MRG]

Glad that both of you are doing better. Money should certainly be a secondary concern during dire health events. My wife's cousin is fortunate that the deductibles were not a significant financial burden.

We also have high deductible plans ($3000 each) and I had never given this situation any thought. I only mention it here so that others might be aware and better prepared for such an event.

Regards,
Wino

+1.

A good friend was diagnosed with stage 4 glioblastoma. He's been in remission for three years. He's told me a fair amount about his experience, never once complaining about cost!