• 13 Posts
  • 111 Comments
Joined 1 year ago
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Cake day: June 10th, 2023

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  • All very valid points and part of why American health insurance is such a joke

    I had an incident recently where my spouse had to go to the ER because of a life threatening incident. One of those fix it right now or they might die things. (They’re fine now, thank goodness.)

    We went to an in-network hospital and all doctors were also in-network. However the one who actually did the life-saving procedure was a specialist. Under our insurance plan seeing a specialist requires a referral, which of course we didn’t have time to get. So insurance tried to nope out of that doctor’s entire bill.


  • You need to know both your deductible and out of pocket maximum numbers. You’ve said your deductible is $1500. For the sake of this example let’s say your out of pocket max (OOP from now on) is $2500.

    For simplicity, we’ll go with your insurance’s negotiated rate for the procedure is $1000*. Meaning at the end of the day you and your insurance combined will pay the hospital $1000.

    Basically any bills up to $1500 for the year you pay 100%. Between $1500 and $2500 (or your OOP), insurance pays 50% and you pay 50%. Over $2500 insurance pays 100%.

    Some examples to illustrate:

    1. You’ve paid $400 this year so far. You pay the full $1000: $400 + $1000 = $1400 which is less than your deductible of $1500
    2. You’ve paid $1000 so far this year. You pay $750 and insurance pays $250: $500 gets you to the $1500 deductible limit so you have to pay all that, plus you pay 50% of the remaining $500 bill = $250.
    3. You’ve paid $1700 so far. You pay $500 and insurance pays $500. $1700 + $500 = $2200 which is less than your OOP of $2500
    4. You’ve paid $2300 so far. You pay $200 and insurance pays $800. 50% of $1000 = $500 but $500 would put you over your OOP of $2500. $2500 - $2300 = $200. You pay $200 and insurance pays the rest.
    5. You’ve paid $2500 so far. Insurance pays $1000
    • If your insurance’s negotiated rate for the procedure is $1000, this means that’s what the hospital and insurance have agreed to pay. A lot of times you’ll see the hospital “charge” a larger number and then have an insurance “discount” but ignore this. It doesn’t factor into deductible or out of pocket maximum calculations.











  • When mine was young I only gave him dry food. Then he developed kidney disease (CKD) 4 years ago. It and diabetes are fairly common in older cats.

    Now he gets dry food plus wet food in the morning and evening - 1/2 of a little can or 1/4 of a bigger can at each feeding. The dry food and wet food are in separate bowls. That plus finding a water fountain he likes has so far kept his kidney disease from getting any worse.

    Next cat I’ll give wet and dry food from the start.





  • I watch a tv show on my phone. I know it goes against all the traditional advice, blue light is bad for sleep, blah blah blah. For me, it means I can get 7 or 8 hours of sleep instead of 3.

    I don’t watch just any tv though. It has to: 1. Be a show I know well enough where I can tell which character is speaking when I’m only listening. 2. Have a good amount of seasons (8 or more) so I don’t get to where I’ve memorized the episodes and my mind starts to wander. 3. Is one I know in general what’s gonna happen with the characters (so I don’t have to stay up and find out what happens) but isn’t one I love so much that I can’t stop watching. And 4. Doesn’t have a bunch of nonverbal stuff that’s important to the plot.

    I have a sleep headband with little speakers in it so it doesn’t keep my partner up. When I’m ready for bed, I make sure my screen brightness is turned all the way down, I put on my sleep headphones, and I lay down and close my eyes to listen to the show. Usually I can fall asleep in less than an hour, as long as I keep my eyes closed. Otherwise I get caught up watching the show and before I know it I’ve watched 3 episodes and I’m still awake.