Layout:
Home > Category: Health Care/Insurance

Viewing the 'Health Care/Insurance' Category

Major health update on DW and Ebay update

May 21st, 2022 at 12:50 am

I haven't blogged for a few weeks with good reason. My wife ended up in the hospital on 4/23 and was there for 19 days. To keep it short, she developed a serious infection in and around her spine and related fluid in her left lung. She had major surgery on her back to clean it out and rebuild and stabilize her spine. She had a total of 3 procedures, 1 minor, 1 intermediate, and finally 1 more extensive to fix the lung issue. Spent 4 days in ICU post-op. Got 3 transfusions. Came home last week with a PICC line and IV antibiotics for a few more weeks.

As you can imagine, it was a major ordeal for all of us. On top of that whole mess, my mom got admitted during that same period for mild heart failure. Same hospital fortunately, so I was constantly going back and forth between their rooms. DW came home on Wednesday. Mom came home on Thursday. So I've been busy coordinating their home care needs since.

Anyway, both are now recovering and doing okay. Both have a visiting nurse and physical therapy at home. In a couple more weeks, DW will likly start outpatient PT for her back rehab.

Incidentally, as of now, the billing for DW's hospitalization stands at around $730,000. Insurance has already taken care of most of that but there is still some stuff that hasn't settled. It's only been a week, though, so I'm hopeful that the remainder will work its way through the system and get paid as well. We may end up owing something but we're hoping it won't be a major amount.

I put my ebay sales on vacation mode for a week when DW was first admitted. Once it became clear that she would be there quite a while, I restarted sales but only listed an item here and there so I was making and shipping sales but wasn't doing much to keep it going until after she got home. There just weren't enough hours in the day.

For the 2nd quarter so far, I have done $1,042.36 in sales and $679.42 in profit. That brings my YTD numbers to $2,657.35 in sales and $1,795.94 in profit. Considering my goal back in January was to average $200/month profit, I certainly can't complain as I'm actually averaging $359/month even with pausing for a few weeks with my wife's illness.

I haven't gotten an official end date for my part time contract at work so I'm still assuming it will be August 6. That means I've got 31 shifts left to work before I change to per diem. With the latest COVID surge hitting full force, I can't wait to cut back to 4-hour shifts. My site saw 69 patients yesterday which is a lot for us. I'm hoping this wave dies down quickly but right now there's no sign of that happening so we're all working our butts off again thanks to elimination of mask mandates and so many people just not caring anymore.

February updates

February 20th, 2022 at 12:42 am

Things are cruising along reasonably well. I've adjusted well to working part time. At first it didn't seem much different. It took me a few weeks to adjust my schedule and stop feeling like I had to cram things into the 3 days I was off since I now have a whole 4th day free. Plus 2 days a week I don't go in until 1pm so I've got those mornings free now too.

Still, I'm constantly running the numbers to see when it is reasonable for me to drop to per diem and just work when I want to. I'm thinking that if I can pick up at least enough shifts to earn what we will be spending on health insurance, that would be perfect.

I'm not sure if I mentioned this in my blog (I know I've talked about it on the forums) but my wife developed back trouble at the end of October so we've been dealing with that. She's had 3 epidural injections and is having facet joint injections on Friday. She's better than she was but still nowhere near normal. Because of that, I don't really want to switch insurance plans now, which we'd need to do if I stopped working part time. We could do COBRA but that's super expensive so not really a good option. Hopefully, things will turn around over the next few months and she'll be better so switching coverage won't be a big concern anymore.

I've been much more active on ebay, which was my intent when I started working less. I currently have 72 items listed (plus 10-20 on Marketplace). Just this morning, for the first time in a long time, I bought some stuff to resell from an estate sale. While we still have plenty of stuff in the house for me to sell, I also know that if I want ebay to become a meaningful source of retirement income, I'm going to need to buy stock. I spent $14 today on 6 items that should bring in $100 or more. We shall see.

We have a cruise booked for August so we're hoping both that COVID is under control and that DW is physically able to do it.

I'm taking our tax stuff to the CPA on Tuesday. This year is complicated as it's our normal personal return, a final return for my cousin, and an estate return. I have no idea what that will all look like, if we'll owe, if we'll get money back, or what. So I kind of feel like I'm in limbo at the moment as far as making any big financial decisions until that's all done and I know where we stand.

Plenty of other things happening, but that's enough for now.

2021 spending

December 27th, 2021 at 01:45 am

I haven't crunched the numbers in detail but big picture, here's how our spending stacked up for the past 3 years.

2019: $81,200

2020: $70,600

2021: $88,400

There was also a large one-time expense in 2021 not included there. We paid the lawyer handling my late cousin's estate $14,500. Technically that was paid from the estate (even though I was the sole beneficiary of the estate so ultimately it was my money either way) but I certainly don't need to count that when doing future spending projections.

We had one other large expense this year spending $10,200 for a home repair. If not for that, our 2021 spending would have come in a few thousand under 2019. We're not quite back to pre-pandemic spending yet.

We have trimmed a couple of costs over the past year or so. We cut cable in November 2020. Just this past month, I dropped DW's life insurance and one of my disability insurance policies. Our daughter aged off our health insurance in October but we're now paying out of pocket for her therapy as her new plan doesn't cover it.

Overall, I'm pretty satisfied with where our numbers are at this point. I dropped to part time at the end of November so my income dropped by 1/3. That should still have me earning more than we're spending with a little to spare. That was pretty much my goal - earn enough to pay the bills and still save a bit and not have to touch the nest egg yet.

Updates: estate, job, etc.

August 7th, 2021 at 11:34 pm

It's been over a month since my last entry. Time for an update.

I did return to Florida where I spent about 2 more weeks finishing up. Donated a bunch more stuff. Got the house ready to sell. Met with the realtor. A guy who lives in the neighborhood and knew my cousin had a sister in NY interested in the house. I had her and a couple of others excluded from the realtor contract. She flew down to see the house while we were there (my wife joined me partway through) and made a cash offer for just over our asking price. We're on track to close on Tuesday as far as I know.

We rented a truck and packed up a bunch of stuff that we wanted to bring home and drove back 7/14-7/15. I returned to work on 7/17.

Work has been nuts thanks to COVID and the fact that they closed one of our 8 sites at the end of May. At my primary site, we've had several days where we've seen over 70 patients which is a lot. 50s to 60ish had been the norm. We all can't wait for COVID to settle down but this particular location is also in an area with high anti-vax sentiment and "free-dumb" folks. Even a number of the staff members are anti-vax which just drives me nuts. How can you be on the front line of the pandemic seeing COVID patients every single day and still not see the value in the vaccine? Thankfully, our job has made the vaccine mandatory. We must be fully vaccinated by September 15. A bunch of people have quit as a result, though I'm not sure where they're planning to go since most other health systems are doing the same thing, but at least I won't be stuck with them anymore.

Big news on the job front is that I officially gave notice to drop to part time. I don't have an effective date yet. My contract requires 120 days notice so it could be as late as December 1. They handle that on a case by case basis so it could be before that. I know they have per diem providers waiting for hours to open up so if they can fill my spot easily, they might let me out of the contract early.

I'll go from 36 hours to 24. I'll still have medical benefits but at a slightly higher rate (about $70/month). And I'll still have the option of picking up extra hours whenever I'd like based on availability. I'll definitely do that for a while because I owe them about 80 hours. My leave of absence used up all of my PTO but we have a couple of trips planned in the fall that I'm still taking so I have to make up that time. Also, if I pick up 4 hours a week, I'd make some extra money and still be doing 8 hours less than I had been. One nice thing, hopefully, is that I won't be working 12-hour days anymore. I requested three 8-hour shifts for my 24 hour week.

Hopefully, the house closes as scheduled on Tuesday. That will be the last big piece of the estate. Then I just have to wait for the probate process to end in early October before the funds can be distributed to me.

I've been staying active listing stuff on ebay since a lot of what came home from Florida is items I wanted to sell. I've got about a dozen listings going and have already sold several. Little by little, I'll work through it all. Once I go part time, I plan to devote more time to the sales.

I think that's about it for now.

I think I have "the number"

April 17th, 2021 at 12:57 am

In recent months, I've been doing a lot, and I do mean A LOT, of retirement planning. I've been reading and studying and educating myself on every aspect of retirement I can think of including withdrawal rates, taxes, Social Security, ACA coverage, Medicare (well not so much on that yet actually), and more. I've asked a bunch of questions on the SA forums. I joined and became quite active at Early-Retirement.org and have learned a ton of useful information there. I highly recommend the site if you are in the same boat as me.

I've made all kinds of charts and run through countless calculations and projections, played with FireCalc a bunch, and posted a "Can I Retire?" thread at ER with all of our details and I got a bunch of helpful responses.

Based on a number of things I've learned, I've made numerous changes to our portfolio to better position our holdings (more stocks in Roths, more bonds in taxable accounts, for example). I've done a number of things to consolidate our holdings and try to simplify some stuff (rolled over DW's old 401k and 403b, moved an outside MF into our Vanguard account, donated some appreciated stock to our synagogue, eliminated some duplication in our portfolio and got the total number of funds we own down from 16 or more to 11, which is still a lot but it's much better.

Anyway, the bottom line and the point of the title of this post is that no matter how I work the numbers and do the projections, I keep arriving at the same result: the amount we need to have saved for me to retire keeps coming out to be right around $2,500,000. I've become more and more confident in that number.

So what does that mean? Right now, today, we are a bit over $1,700,000. However, I will unfortunately be receiving an inheritance most likely within a year. The estate is currently valued right around $1,200,000 with minimal debt (less than 50K). There will be some expenses involved in settling everything, funeral costs, selling the house, travel, taking a leave from work, etc. I'm guessing that 200K should cover all of that which should leave me with roughly $900,000 as my inheritance. That would put us at $2,600,000 based on our current portfolio. If the market remains at least reasonably stable, even if it doesn't keep climbing like it's been doing, we'd likely have another 100-200K over the next year anyway and be at $1.9 million before the inheritance meaning we could potentially be at $2.8 million or even more when everything is done.

Assuming nothing crops up to make me question the $2.5 million figure, I should be at the point where retirement will work, even if the inheritance turns out to be 100K or so less than estimated.

That's both exciting and scary to be honest.

My plan right now is to beef up our cash holdings to create a nice big cushion to have in place when I do retire. My expense projection has us paying full price for ACA coverage but there's a reasonably good chance we can manage our taxable income to qualify for the subsidy which would make our numbers even better. I'm planning to meet with our CPA after tax season to really drill into a bunch of retirement tax issues including that one.

So yeah, that's how I've been spending way too much of my free time.

Got my COVID vaccine today!

December 19th, 2020 at 01:11 am

I was fortunate to get the first dose (of two) of my COVID vaccine today. Dose two is in 3 weeks so January 8.

I see COVID patients every day at work so this will certainly make me more comfortable about the potential exposure I face every day. Certainly, I will still take all precautions and wear my PPE at work and my mask outside of work, but at least I know I'm far less likely to get ill if I do get exposed to the virus.

General updates

October 25th, 2017 at 04:16 pm

I'm a lousy blogger Smile. It's been a couple of months since I posted so here's an update.

My original plan to leave my private practice and work part time plus per diem hours at urgent care wasn't going to work. After discussing it with the medical director, he felt that the days of nearly unlimited per diem shift availability were going to start drying up. So I decided to switch to full time (36 hours/week) to guarantee my hours and income. I will officially be full time as of 11/5.

My last day in my practice was 9/28 so this month I've still been part time. It worked out well as we were on vacation from 11/7-11/16. The last 2 weeks of the month I kept my schedule kind of light, 28 and 32 hours.

We did open our HELOC and immediately drew out $14,700 for the malpractice policy I needed to take out when I left my practice. Right now, I'm just making small payments on that (I paid $250 last month and will do the same this month). Once the last college tuition payment is made in December, I'll start attacking the HELOC more aggressively.

As for college, we do have one more payment of $15,135 due in December. Right now, I've got about $9,000 set aside plus some surplus in our checking account. I'm not quite sure if we'll have the full 15K by December, but if we need to draw a couple thousand from the HELOC, I'm fine with that.

Once I'm full time, my income will increase and our health insurance costs will drop by over $300/month so there will be additional money to throw at the HELOC. We'll have it paid off within a year.

So everything is on track and doing well financially speaking.

Report on the new job and a family emergency to deal with

June 5th, 2016 at 01:19 am

I realized I never posted anything after my first day at the new job.

To give a quick review, I'm a family practice doctor. I've been in private practice for 23 years, 16 at my current job. For various reasons, I decided it was time to start exploring other options and Urgent Care centers are popping up like weeds and in desperate need of doctors to staff them all. I interviewed with a couple and signed on to work per diem with one chain of centers connected to a big local hospital group. They currently have 5 centers, a 6th one not far from my house will open next month, and 1 or 2 more should open by the end of the year. So they are expanding rapidly and that just means more and more shifts to fill.

I did my first shift a week ago Thursday evening 5-9pm. It actually went pretty well I think. It got a bit hectic in the last hour or so and I was still muddling my way through the computer system but I managed (with the help of my one-on-one IT support person who was with me the whole time).

My next shift wasn't scheduled until 6/16 but I decided I needed to work before that to keep up on the learning curve so I picked up an open shift last night, also 5-9pm. That went much more smoothly than last week. I felt a lot more comfortable and confident in what I was doing. My IT guy was with me again and I made sure to work with him to clarify some specific workflow routines on the computer and I took good notes of the processes so that on future shifts when he isn't there anymore, I'll be able to know what I'm doing.

Right now, the 6/16 shift is the next one I've got booked. I was going to possibly pick up more but we got some bad news this morning as a very close relative was just diagnosed with colon cancer. He's in the hospital now getting worked up and will likely have surgery in the next few days. My wife and mother plan to fly down to Florida to be with him. My daughter and I will stay home. I don't want to commit to any more shifts until I have a better idea of what's going on with him. If not for that, I'm all set to jump into the new position on a regular basis.

The question now becomes what to do with my existing job. I'm still working full time there. My partner and I have already talked about me possibly reducing my office hours so that I can split my time more with the Urgent Care. Part of me really hates to leave the practice as I like what I do for the most part, but personally, professionally, and financially for sure, the new job has a lot of advantages. I don't think I'm going to make any decision for at least a couple of months but I've got a lot to think about. So for now, it's just a side gig and some nice extra money.

Surprise check in the mail today

December 17th, 2009 at 07:38 pm

We got a nice surprise today. Before my wife's first surgery on 10/23, the office required us to make an upfront payment of $316 which I assume represented the percentage of the bill they anticipated wouldn't be covered by insurance.

Today, my wife got the mail and saw what she thought was another bill from the practice and wondered why because she thought we had paid everything. It turned out to be a check refunding the $316 because insurance had covered everything.

Today is her birthday so that was a nice little bonus gift.

Medical expenses on the horizon

October 10th, 2009 at 12:58 pm

And things were rolling along so well this year...

My wife has been having some gynecological issues which her doctor has been trying to correct with medication without success. So she is going in on Tuesday for a D&C/Hysteroscopy. Once that is done, they will be scheduling her for a total hysterectomy in the near future.

Obviously, my first concern is that she get better soon as she really has been miserable lately, but there will be a significant financial impact to her surgery, too. We have insurance but there is a deductible and co-insurance to deal with. Her gallbladder surgery a few years back cost us about $3,000 as I recall. I suspect this ordeal will run more than that between the 2 procedures. I'm guessing about $5,000. She is supposed to get a discount of some sort because she works for the hospital but I don't know what that will amount to.

Then there are lost wages. I'll probably lose about $1,500 in income from taking off. She will probably lose another $1,000-$1,500 depending on how long she has to be out of work.

So all together, we're probably looking at about $8,000 in unexpected costs. We have the money, fortunately, but it is still a lot, not that you can put a price on your health.

Places we could cut spending

January 23rd, 2008 at 07:55 pm

Even though I'm pretty good at giving financial advice and talking about what we all "should" be doing, I'm often as guilty as the next guy about not actually taking action and doing those things we talk about.

This has been on my mind a lot recently. DW isn't thrilled with her job and may decide to go back to SAHM status at some point. Even though most of her income goes to savings, some of it still comes home and gets spent. We already took a big cut when she went from her last job to this one without really changing much but losing the current income will eventually have some impact.

A year or so ago, I met with my insurance broker and he ran quotes for me and showed that we could lower our life insurance premiums by switching companies, but I never followed through so have maintained the more expensive policies.

Then a couple of months ago, I got an online quote from another auto insurance company that would have saved us about $36/month, but never did anything with that either.

Now, we've had the discussions in the forum about mortgage rates falling and we will probably benefit from refinancing again if rates fall a bit more in the coming months. Maybe by summertime, it will make sense and save us somewhere around $50/month.

Add to that the fact that the last payment on DD's braces is in May and we'll have an extra $150/month free from that.

So if I get off my butt and redo the life and auto insurance, refi the mortgage and add in the braces money, we could see over $200/month extra in our budget. So I guess that's my goal for this year.

Shopping at Whole Foods

October 15th, 2007 at 01:35 am

DW and I agree that we haven't been eating all that healthy lately and need to get back on track with diet and exercise. I decided to take a trip to Whole Foods today and spend some time exploring some different options, particularly looking for some healthier snack options since that is often our downfall.

I picked up a number of new things to try, a couple of which we already sampled tonight and liked. I was mainly focused on items with little to no saturated fat, no trans fat and no high fructose corn syrup.

The one problem with those things is, of course, that they are more expensive than the crappy versions, but I'm willing to spend a little more for good health. Also, we are working to get back to cooking at home more and eating out less which will save a lot of money. I'd rather spend it on better quality groceries than on high calorie meals out.

Top 10 Reasons for an Annual Physical

May 23rd, 2007 at 08:19 pm

Top 10 Reasons for an Annual Physical

“I feel fine.”
“I only go to the doctor when I’m sick.”
“Doctors only recommend physicals to make more money.”

People have all kinds of excuses for not getting regular check-ups. Here are 10 reasons why you should. For the record, I’m a board certified family practice physician in practice for 14 years.

1. High blood pressure: Often called “the silent killer”, high blood pressure usually causes no symptoms at all but greatly increases your risk of having a heart attack, a stroke, kidney damage and other serious health problems. Millions of people have high blood pressure and don’t know it until something bad happens. Seeing your doctor annually and getting your BP checked can identify the problem before it harms you.

2. Diabetes: Like high blood pressure, high blood sugar can have no symptoms until it is severe, but will still be damaging your body even though you can’t feel it. An annual sugar test can identify this hidden disease. This is especially important if you have a family history of diabetes or you are overweight. Women who had elevated sugar during pregnancy are also at higher risk of developing diabetes later in life and should be regularly screened.

3. Cholesterol: Same story. No symptoms. Unless you get a simple blood test, you don’t know your cholesterol is high and hard at work clogging your arteries and setting you up for a heart attack or stroke.

4. Cancer screening: Many common cancers can be checked for with simple tests as part of your annual physical. In the office, we can screen for breast, colon, skin, cervical and prostate cancers by exam, blood test, Pap smear and sending you for a mammogram. Patients 50 and older should also get a colonoscopy.

5. Vision: It never fails to amaze me how many patients come for physicals and can barely read the eye chart. I wonder how many auto accidents are due to drivers who just can’t see what is happening around them.

6. Vaccines: You aren’t all done with shots once you turn 5 years old. Adults need shots, too. Tetanus boosters, flu shots, pneumonia vaccines, pertussis boosters, hepatitis B, etc. This is particularly important if you are planning any foreign travel, but even if you aren’t. Speaking of travel, you should always check with your doctor well in advance of a trip to see if any special vaccines are needed (typhoid, yellow fever, malaria medication, etc.).

7. Obesity: Many people never step on a scale outside of their doctor’s office. As a result, a lot of folks seem truly surprised when they come in, get weighed, and see how many pounds they’ve gained. Often, just seeing that number motivates them to make some changes, start eating better and get back to their exercise routine. Plus, it gives me an opportunity to discuss their weight and make suggestions about how to address it.

8. Smoking: Studies have shown that patients whose doctors counsel them to quit are more likely to quit. If you smoke, hopefully your doctor will raise the subject during your annual exam and talk to you about quitting. There are various methods to help you quit that your doctor can prescribe if you are ready and willing to make a quitting attempt.

9. Thyroid disease: This is a common problem, particularly in women. There are symptoms, but many of them are very general and people attribute them to other things: fatigue, weight gain, dry skin, changes in the menstrual cycle. This is another case where a simple blood test can identify the true cause of those symptoms and your doctor can prescribe medication to correct the problem.

10. Anemia: Again, something like thyroid disease that has symptoms that people often attribute to something else. Fatigue, decreased exercise endurance, headaches – all things that many of us feel from time to time. That annual blood test can determine if the underlying cause is a low blood count. If so, your doctor can work with you to find out why you are anemic. The cause could be something simple and benign or something much more serious. Catching it early could make a big difference in the outcome.