With the ongoing debate on ways to reform health care, I've been thinking about the routine medical care I receive in a typical year. However, living with multiple sclerosis and rheumatoid arthritis, it is not always easy to know if a particular year is going to be "typical" or not. So I examined exactly what health care services I used in one calendar year. Here is what I found:
I saw the rheumatologist three times during the year since I have routine visits scheduled every four months.
Total charge: $433 - insurance adjustment: $202 = $231
Insurance paid: $176
My copayments: $75
I saw the neurologist (or nurse practitioner) five times during the year. In addition to routine visits scheduled every three to four months, I had two extra visits related to a multiple sclerosis relapse.
Total charge: $1,269 - insurance adjustment: $780 = $489
Insurance paid: $354
My copayments: $125
I saw my primary care physician four times, which included one well care visit, two acute illness visits, and one medication visit.
Total charge: $860 - insurance adjustment: $435 = $425
Insurance paid: $325
My copayments: $100
I experienced a multiple sclerosis relapse and underwent five days of IV Solumedrol treatment. This involves going to the Infusion center daily for IV treatment.
Total charge: $3,234 - insurance adjustment: $2,656 = $578
Insurance paid: $463
My copayments: $115
Since I had the MS relapse, I also underwent an MRI of the brain and c-spine. Some MS patients do this annually, but I don't have MRIs conducted that frequently. Only when indicated by disease activity.
Total charge: $6,017 - insurance adjustment: $1,003 = $5,014
Insurance paid: $4,513
My copayments: $501
Since I turned 40, I also had a mammogram. Squish.
Total charge: $286 - insurance adjustment: $71 = $215
Insurance paid: $215
My copayments: $0
I have routine blood work completed every two months to check liver functions since I take methotrexate for RA. I also had a few non-routine tests related to urinary tract infections.
Total charge: $2,425 - insurance adjustment: $2,066 = $359
Insurance paid: $327
My copayments: $32
I began physical therapy in December and continued twice weekly sessions through March. This was probably the very best treatment for my MS, general health and well being. I'm very lucky that insurance pays for it.
Total charge: $4,821 - insurance adjustment: $1,231 = $3,590
Insurance paid: $3,211
My copayments: $379
I had some visits with a counselor to address mental health issues. I used to go weekly, but now only when I feel the need.
Total charge: $945 - insurance adjustment: $493 = $452
Insurance paid: $226
My copayments: $226
I had the yearly routine visit to the eye doctor and ordered a year's worth of contacts.
Total charge: $691
Insurance paid: $0
My payment: $691
I also had routine cleaning visits with the dentist and had a special mouth guard made, an unusual expense but highly worth it.