How My Tiny Toe Taught Me More About Health Insurance

Foot-Medicine

I recently injured my second toe.  I’m not sure how it happened exactly, but my doctor thinks it was due to a combination of overuse and poor foot bio-mechanics.  Basically, my foot does a terrible job of spreading the load around evenly to all my toes when it hits the ground.  He diagnosed me with capsulitis (or metatarsalgia) – an inflammation of the toe joint.  The treatment involved a month of rest, an orthotic shoe insert, and a stiff dose of physical therapy.

Alex, I’ll Take Toes for $500

During this whole process, I discovered things about my medical insurance.  For one, I pay a $60 copay to see a specialist such as a podiatrist.  I also pay a $30 copay each time I make a trip to the physical therapy office.  I also had to pay $60 out of pocket for the orthotic insert that my insurance did not cover.

In all, the whole ordeal ended up costing me about $500 out of pocket.  Really not too bad considering how much a new set of tires can cost on a car; and my toe is far more important than a couple of black rubber donuts.  Don’t tell the doctor, but I’d probably be willing to pay at least twice as much to get my toe back to normal.

Deductible Blindness, Coinsurance Ignorance, and Copay Carelessness

It’s been a while since I’ve had to use my health insurance for anything more than a simple visit to the doctor.  Getting a chance to actually exercise my health insurance, I was reminded that just because I have insurance, doesn’t mean I get free healthcare.  When shopping for insurance, it’s very easy to fall into the trap I like to call deductible blindness.  You focus your attention on lowering your premiums because that’s the amount you pay every month no matter what.  But, you ignore your deductible – the amount you pay out of pocket when you get sick or hurt.

You also tend to ignore the coinsurance, or the amount you owe after the deductible has been met.  For example, it’s quite common for insurance providers to cover 80% of the bill after the deductible is met.

Copays are usually small, but they can quickly add up.  I may have been discouraged from going to physical therapy if my copay was any higher.  But, I’m glad I now I’m glad I went.

Proactive Procedure Pricing

It might not be a bad idea to find out how much common procedures like an MRI or repairing a broken bone might cost.  If you really want to be prepared for worst-case scenarios, take a look at how much major procedures like heart-bypass surgery or cancer treatments cost.  CostHelper has a great section on health where you can find out the average cost of most medical procedures.  If you want more specific numbers, contact your local hospital or insurance provider and see if they’ll give you more specific pricing.

Next Stop, the House

With all this insurance talk, I just remembered.  Our homeowner’s insurance premium just went up by about 30%.  I need to message my insurance agent and see what I can do to lower the rate.  I may end up increasing our deductible.  Mrs. Pennypacker and I have enough in savings to pay the minor claims ourselves.  It’s the big catastrophes that we still would rely on insurance to cover.

Have you had any recent insurance epiphanies that you’d like to share?

2 thoughts on “How My Tiny Toe Taught Me More About Health Insurance”

  1. Your last epiphany–the one about the homeowner’s insurance–is a good one. As Dave Ramsey put it in a video I watched of one of his presentations, “We have an emergency fund to pay for the little stuff; we get insurance to take care of the big stuff.”

    I don’t agree with everything Dave Ramsey says about insurance, but I do agree with this point.

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