The new forums will be named Coin Return (based on the most recent vote)! You can check on the status and timeline of the transition to the new forums here.
The Guiding Principles and New Rules document is now in effect.
Out of pocket maximums
minirhyder
BerlinRegistered User regular
BerlinRegistered User regular
Hello,
I've had a couple of medical procedures done over the last few months, with another one coming up this week. After it's done, I will have reached my out of pocket maximum. At that point I should be done with the medical procedures I need.
Since everything will be covered once I reach my out of pocket maximums, I kinda want to spend spend spend on healthcare because why not. I was thinking of seeing a cardiologist and a neurologist, just to check on my organs and such.
Is this a stupid idea? Should I just continue living my life and not worry about getting all the possible healthcare before the end of the year since it'll be free?
I've had a couple of medical procedures done over the last few months, with another one coming up this week. After it's done, I will have reached my out of pocket maximum. At that point I should be done with the medical procedures I need.
Since everything will be covered once I reach my out of pocket maximums, I kinda want to spend spend spend on healthcare because why not. I was thinking of seeing a cardiologist and a neurologist, just to check on my organs and such.
Is this a stupid idea? Should I just continue living my life and not worry about getting all the possible healthcare before the end of the year since it'll be free?
0
Posts
That really sounds like a discussion to have with your primary doctor. Most of them will completely understand your situation and help you figure out what would be worthwhile. If they don't understand why the insurance structure means you want to do this....well I would find a different doctor.
Thought those were out for most silver level and above plans, at least for actual health insurance. They're a thing in other, less regulated, insurances like dental or vision.
They're illegal for legit medical care you need. But if you just hit your OOP max for the year and decide to "top yourself off" you can hit those other limits.
https://www.healthcare.gov/health-care-law-protections/lifetime-and-yearly-limits/
If your insurance doesn't think you needed it (ie, you don't have a referral from your PCP/GP) they can tack it onto your lifetime limits. Though that only applies to non-essential services in general. They may not though.
I'm not sure how you can see a neurologist and it be covered unless you actually have a problem that requires it. And even if it's free, I'm not sure why you'd want radiation shot into your head if you aren't presenting issues.
I wouldn't try to milk an out-of-pocket maximum situation for anything more than health check situations. Visiting either a cardiologist or neurologist is not a normal health check situation; there is usually a referring doctor or some immediate presentation of symptoms that justify the visit.
Most plans will not cover genetic testing at all without what they consider to be a valid reason for getting the test. I don't think hitting your out-of-pocket max will help you when the bill comes due in that situation.
If I gave you a full body CT/MRI, I can pretty much guarantee I will find something "wrong". Maybe a bulging disc. A renal cyst. Colonic diverticuli. Mildly enlarged lateral cerebral ventricles. Etc. All of these are common and can be completely benign, especially in the absence of symptoms. But once we know we have "something wrong" we feel compelled to do "something" about it. This leads to unnecessary intervention with risks of side effects and complications.
I realize you feel like you have a bit of a blank check and don't want to lose the opportunity. My suggestion is to echo previous responses and talk to your PCP. Make sure you are up to date (age appropriate) with all your vaccinations, annual exam, blood work, PAP, colonoscopy, etc.
Dermatology is a great screening recommendation, if you are at risk. Most people are: Have you ever had a single blistering sun burn? Used a tanning bed? Have more than a couple moles? If you answered yes to any of those questions, congrats: You are at increased risk for developing melanoma and should have skin checks by a physician regularly.
Unfortunately, you might have a hard time getting in to see a dermatologist as a new patient before the end of the year. Many offices are booked our months in advance, especially toward the end of the year, for the same reason as you. It doesn't hurt to call though.
TL;DR - Stick to recommended healthcare surveillance timelines unless you are having a problem. Then get seen sooner, for that problem only.
I've already been to all the "standard" doctors for checkups (ob/gyn, pcp, GI, dermatologist), so I'm all good there.
I guess I'll just let it be and be grateful for being pretty healthy (barring any scary results from the genetic test).
Thanks all!
BF3 Battlelog | Twitter | World of Warships | World of Tanks | Wishlist