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Health coverage that encourages non-use

January 25th, 2017 at 07:57 pm

Health coverage that encourages non-use is really nothing new, but this is a good example of how even deductibles that would be considered modest by most people can discourage people from getting proper healthcare.

I decided yesterday I should see my neurologist as I've been experiencing some low level sensory symptoms related to my MS, and since it's been over 10 years since my last MRI, I was thinking it wouldn't be a bad idea to have another one now, to see whether this is just a flare-up of old symptoms or possibly new disease activity, which might mean reassessing my current medication.

I was able to get an appointment to see the doc today and while he didn't say it was absolutely necessary, he agreed it wouldn't be a bad idea to get the MRI, which would be of both brain and spine. He said sometimes significant changes in your sleeping patterns or stress could bring on flare-ups. I sleep pretty well and I don't feel stressed, although the job situation is a concern.

He went to the trouble of calling the imaging center where I had my last MRI done; we weren't sure they'd have the film since legally they're only required to keep the records for 7 years. Luckily, they did, so I stopped over to pick them up on CD on my way home from doctor's; I would bring this to the imaging place so the radiologist there could compare the old and new films.

When I got home I called insurance company to double-check on the copay, which I was guessing would be about $200. Alas, because I have a $500 deductible which I'd forgotten about, my cost for the 2 MRIs would be about $625.

I don't want to spend that kind of money, especially when I'm not working. Getting the MRIs could have given me some peace of mind if they showed, as they did over 10 years ago, very little change, although they could also trigger further discussion with doc if it indicated a big change for the worse. None of the MS drugs are 100%, so you can't expect no issues at all.

So the question is, are my symptoms a flare-up of old disease activity, or something new? I'm guessing it's the former, since I've always been affected on the right side of my body and these symptoms similar to what I've had before. Plus, my symptoms are on and off and don't last 24 hours, which is what technically constitutes a relapse.

Unless they suddenly worsen, I'll just watch and monitor. If at some point I have another need to pay for the $500 annual deductible, then I could more easily consider going back and getting the MRI done in the same year.

So I did waste the $40 copay for seeing the doctor today, because seeing if he'd agree with me about the MRI and telling him about my symptoms was the sole reason for my visit.

5 Responses to “Health coverage that encourages non-use”

  1. creditcardfree Says:
    1485377982

    I don't think you wasted any money, if you find that it gave you some piece of mind. It could have been something worse and your doctor would have advised you differently. And you ended up with a copy of your MRI ten years ago in hand. I don't think you would be wasting $625 either for those two MRIs. Which for out of pocket cost seems pretty reasonable to me. And you do have the funds. A baseline every ten years seems pretty reasonable too. Maybe you could think of it as $62.50 per year. That is assuming you wouldn't need another one in the next ten years.

  2. Wink Says:
    1485382421

    I agree with ccf. If it were me I would have the MRI done. I understand wanting to be very careful with your money while you aren't working, but you can afford it. Maybe you can look at it as an investment in your health and not just an expenditure.

  3. rob62521 Says:
    1485382951

    Personally, I don't think you wasted any money. Sometimes you need validation and that is worthwhile. I agree with CCF and say spending the money for the MRI would be a waste either, but that is your decision and you know your circumstances. I said a prayer for you for peace.

  4. fern Says:
    1485383419

    Thanks for your feedback..now you have me rethinking my decision not to get them. I know to others who don't have MS the whole circumstances may seem alarming, which it can be, but keep in mind I've lived with MS for nearly 30 years, so dare I say I'm used to the kinds of things that can happen.

    I agree it would be an investment in my health, which is the most important thing of all; it's just that it comes at a bad time, when I'm not working. But I am still reconsidering...i figure i have at least a month to get it done and i do have a written prescription for it, so I have some time.

    I guess also in the back of my mind is the knowledge that this spring I plan on getting central air here, to protect my mother's art. I found mold or mildew on the backs of a few of them and i think restoration would be very expensive. Some of the others had foam core backing that was warped by excessive humidity of the last 2 summers in my house. So I'm guessing it could be $12 to $15K for this.

    Of course I want central air for my own comfort too, and have wanted it for years, but the damage to my mother's art made me decide to do it now.

  5. fern Says:
    1485383479

    Yes, I know my health is more important than even mom's art, but I'm just sayin'....

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