Doctors’ Offices Overcharging for Co-Pays

In the past few years, I’ve had interesting experiences at the numerous doctors’ offices I’ve visited while managing my and my daughter’s health. I’ve discovered that a number of times, we’ve been charged too much for a co-pay, or charged the co-pay in instances when one wasn’t necessary at that visit.

For us, a primary care visit merits a $20 co-pay; a specialist visit is usually $40. So If I see my primary care physician, it’s likely I have to cough up the 20 bucks; if it’s the endocrinologist, it’s $40.

Our health insurance company sends statements via mail every time it processes a claim, and it shows when a co-pay should — or shouldn’t — be charged for each particular visit. Thanks to these statements, I’d previously learned that my ob-gyn annual checkup is considered well-care, meaning there’s no co-pay payment required. And any other visits to the ob-gyn are only $20. But I’d been told to pay $40 per visit to this doctor, each time (excepting prenatal visits).

A few days ago, Baby Frugalista’s pediatric ophthalmologist sent us a check to return our last $40 co-pay — the follow-up visit didn’t necessitate another co-pay. Bless them — $40 is nothing to sneeze at! But I had to show my ob-gyn’s office staff that my visits there should only rate a $20 co-pay. They finally switched it, but I didn’t get a refund for overpaying a few times.

Don’t get me wrong — I’m grateful that we have good health insurance coverage at a (fairly) reasonable price. But you’d think the front-end staff would know when a co-pay applies, and when it doesn’t. Especially since we have a major health insurance carrier (Blue Cross Blue Shield).

Have you ever taken a look at your health insurance statements to see if you’re being overcharged for your co-pays?

Saving Money on Prescriptions

Yes, another medical-related post today. Such is my life nowadays, unfortunately!

I went to my endocrinologist last week for my postpartum bloodwork and checkup, to monitor my Hashimoto’s thyroiditis and see if my dose needed adjusting. Most women find they become MORE hypothyroid after having a baby, but amazingly, my thyroid function has actually improved. This means I can take a lower dose of my prescription medicine, Synthroid.

Back in August, I wrote about how my endocrinologist really prefers his patients to be on the name-brand Synthroid. I explained that our insurance plan has a $30 monthly co-pay for name-brand prescriptions ($90 for a 90-day supply), but the out-of-pocket cost is only $80, so that’s what I pay. Our insurance co-pay is $10 for generics, which is a lot easier to swallow, especially now that we have a child and our budget is much tighter than it used to be.

Then I discovered that Target has a generic medications program where I could get my 90-day supply of thyroid medication for not $90, not $80, not $30 — just 10 BUCKS. $10!!!

Seems like a no-brainer, except I forgot to talk to the endocrinologist about allowing me to go back on the generic version of Synthroid, called levothyroxine. So my prescription, which I have yet to fill, says “no substitutions.”

I’ve left a message for the endocrinologist, and I really hope he lets me get the generic Synthroid in order to save money. His concern is that some studies showed that the generic version may have slightly varying amounts of the main drug in it. But I feel that since my Hashimoto’s is well-controlled, and I’m not pregnant anymore, I should be able to use the super-cheap levothyroxine.

I’ll keep you posted on that conversation after I speak to the doctor.

UPDATE: The doctor will let me take the generic — all I have to do is have the pharmacy call his office to confirm. Hooray!

Little Bites: Tax Filing Time & Other Chores

Holy crap, it’s March. The past month has been a blur of unexpectedly early motherhood and all the sleepless nights, diaper changes and constant feedings that come with it — and it’s been wonderful. We were caught fairly unprepared when Baby Frugalista arrived five weeks early, but thanks to family and friends, we were able to get our home ready for our new addition. They came through with meals, clothes, diapers and assorted little things that we had yet to pick up.

Now we’re settled into a routine — or as much of a routine as possible with a premature newborn. She’s gaining a lot of weight and growing at a good pace. One thing I’ve found is that our normal budget has been turned upside down. We have to factor in diapers and formula, and I’ve found that my $200 monthly grocery budget has increased to reflect that.

Now that I’m out of work on maternity leave for 6 months to spend as much time with my little girl as possible — and only getting disability and family leave payments for 3 of those — we really need to watch our spending. I’d prepared for the 3 months without income by amping up my freelance gigs while pregnant (because I’m nuts), but that doesn’t mean we should burn through that reserve. Gas prices are headed toward uncharted territory — again — and I’m happy I don’t have commuting costs for the next few months. I just filled up the gas tank the other day, and I’m sure I won’t have to refill it for a day or two. I only bought lunch at work maybe once or twice a month, but that’s a little bit of savings, too.

We’re going to do our taxes this weekend and we’re expecting a nice refund thanks to the mortgage interest and property tax deductions. I’d like to change our withholding status on our W-4 forms at work from “O” to “1” or “2” — it’s better that we get that money put back in our paychecks, rather than get it in a large tax refund.

Other things we’re working on:

Medical Coverage — We’ve added the baby to our health insurance, provided by Mr. NSF’s employer. The pre-tax cost has increased two-fold just to add one little person. Amazing, right? So instead of $220 per month in paycheck deductions, the cost will be $440 monthly.

Will — We do not have a will as of yet, and this is something I’m going to look into. There are advantages and disadvantages to wills (enough for a separate blog post), but there are other options, too, such as payable-on-death designations on accounts.

Life Insurance — Although we have some life insurance coverage through our employers, we’ll lose it if we change jobs. I’ll have to see if getting our own policies is advantageous, in case the unthinkable happens to one of us. We want to make sure our daughter is provided for and that we could keep our home in the event something happens to one of us.

I’m sure there are other things we need to consider, but I think this is a pretty good list to start with.

One Day, $110 in Prescriptions — With Insurance

Saturday was a very expensive day at the pharmacy. Not only did I have to refill my 90-day supply of prenatal vitamin, but I also had to get another 90 days worth of my thyroid medication, Synthroid. As I’ve mentioned in the past, it actually costs LESS to pay for the Synthroid outright than it would be with my co-pay. Every 30-day supply has a $30 co-pay, so 90 days would equal $90. However, it’s “only” $80 retail for that same amount, so they charge me the lesser price. After the baby comes, I may press to go back on the generic version in order to save $20/month on that prescription.

The prenatal vitamin would also cost $90 for a 90-day supply if I didn’t get the generic version. But I’m happy to pay $30 total. Again, after the baby arrives, I’ll be more than happy to go back to my Centrum multivitamin, which costs $6 or less (on sale with coupons) for 130 tablets.

Other than that, I had a wonderful dinner meetup with two fantastic ladies. Even better? We went to a cheap Mexican restaurant where the bill for three people was… drumroll please$16 plus tip!

However, Monday promises to be a doozy of an expensive day, as I have to bring my car to the mechanic to fix a wheel sensor problem that’s messing with the traction control and anti-lock brakes. I told him that while the tires are off as he tries to figure out which wheel has the wonky sensor, to see if a tire (or two) has a slow leak, look at the brake pads and rotate the tires, if necessary. I’m going to prematurely estimate the wheel sensor repair (which involves disassembling the wheel hub) at $500. This comes on the heels of my last major car repair, the fuel pump replacement that set me back $600. Other than these two issues this year, I can’t complain about my almost-7-year-old vehicle. I haven’t had to do anything other than change the oil and get new brakes and tires on occasion.

I Screwed Up — A Cautionary Tale About Insurance Policies

Boy, am I ashamed to admit this faux pas.

When we moved into our new home together last June, we got the requisite homeowners insurance policy through the same company that we had our renter’s insurance on. On the renter’s insurance, we had a rider for my engagement & wedding rings, my only real ‘bling.’ So when I called back to turn that renter’s policy into a homeowner’s policy, I thought that rider transferred with it.

Apparently, I was wrong.

In early June, we received the notice about the renewal, which our mortgage company pays out of our escrow account each year. I had made a note to call the insurance company to make sure the policy still had the jewelry rider attached.

In case you haven’t looked at the calendar, it’s now mid-August — and I *just* got around to calling to ask the question.

The verdict? The jewelry rider never transferred! So I’ve gone more than a year without insurance coverage on my rings. D’oh.

The insurance rep is going to call me back tomorrow to tell me whether the rider can be transferred from the old renter’s insurance policy, or if I have to reapply for coverage.

MORAL OF THE STORY: Always check your declarations page on your insurance policies to ensure you have the coverage you need. If I’d done that, I would have noticed that the jewelry rider didn’t make it over to the new homeowner’s policy.