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Old Jan 13, 2017, 03:02 PM
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bioChE bioChE is offline
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Member Since: Aug 2016
Location: New York
Posts: 2,075
Good Friday afternoon, everyone. Due to the recent discussions around healthcare, I was curious to know what your personal costs are vs. the benefits you get from your insurance or government healthcare. If you care to share your numbers, I think it would be really interesting.

During the 2016/2017 years I've changed plans so my numbers will look different this year. However, here's my best estimate at a retrospective of 2016 costs and benefits, as well as some 2017 projections. My numbers below are specifically related to mental health; I didn't really feel like tallying up other services as the overwhelming amount of my spending is due to MH. I've been using a high-deductible plan for a few years including 2016, but due to the cost of Latuda I changed to a PPO in 2017.

2016 Insurance premiums:
Payroll Deduction: $3,432
Employer: $14,400
Total: $17,832

Deductibles: $5,600

Doctor: $267 (co-pays) $1,068 (insurance)

Medications: $4,703 (co-pay) $11,800 (insurance)

The total of my care cost $17,838 for doctor visits and medications. I paid $14,002 out of pocket, and my employer kicked in another $14,400 for a total of $28,402.

Overall, that's a lot of scratch. I found this analysis interesting because my assumption has always been that I've been paying in less to the system than the benefits I've been receiving. This has definitely been the case in years where I've needed to be hospitalized to the tune of about $20k/visit, but last year that wasn't needed.

Next year it should hopefully look something like this [assuming no hospitalization, and a stable med cocktail]:

2017 Insurance premiums:
Payroll Deduction: $5,304
Employer: $16,800
Total: $22,104

Deductibles: $1,000

Doctor: $240 (co-pays) $1,095 (insurance) [assuming doctor rates stay the same, which they won't but I don't know what they'll be so I'm using 2016 rates]

Medications: $1,032 (co-pay) $14,933 (insurance)

That makes a total out of pocket $7,576, with my employer kicking in $16,800 for a total spend of $24,376. That's interesting from a couple of angles, but I'm itching to post this and am not going to slice and dice it right now. I think I made the right choice by taking the higher-price plan for 2017, simply because my total out of pocket will be roughly $7k less year-over-year. It makes sense that since I use a lot of services it makes more sense to pay into the higher-cost plan.

All I can say is holy crap my meds are expensive.

Anyone else feel like giving a run-down of your costs and benefits? This got to be a much longer post than I intended it to be and I'm not looking for the long analysis from anyone else - but I really do think it would be interesting to hear from anyone else regarding out of pocket costs vs. benefits realized.

Thanks for making it through this really long post!
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Meds: Latuda, Lamictal XR, Vyvanse, Seroquel, Klonopin

Supplements: Monster Energy replacement. Also DLPA, tyrosine, glutamine, and tryptophan

Last edited by bioChE; Jan 13, 2017 at 03:20 PM. Reason: Correcting some math