The never-ending headache that is health insurance

This morning I saw my pain-in-the-ass vascular surgeon about the final surgery on a stubborn varicose vein. I won’t get too much into why he’s a pain because it has nothing to  do with money…well, I guess it does because if he hadn’t pretended that he did the procedure we decided on, it would have saved me at least $100 in co-pays. Anyway, before I had the first two procedures in January 2008, I asked him once and his admin staff twice if everything was good to go with the insurance company and they all said yes. Then the bill came and because it wasn’t pre-certified, the insurance company only paid 40% instead of the 80% they would/should have. BCBS of Illinois has been giving my doctor the runaround for a year, and the admin assistant who deals with that stuff had a stack of files going back two years of billing cases with similar issues. Apparently they always pay up, but they’re counting on frustrating the hell out of accounts receivable staff to the point where they give up trying.

The doctor started off with an apology for discussing billing issues with me, but said that what the insurance company had paid so far (and might only ever pay) didn’t even cover the pre-profit overheads for the surgery. Apparently the surgery that he officially bills @ $8300 per leg gets a Blue Cross Blue Shield approved fee of about $2200, of which $950 is the barebones cost of materials and staff costs for everyone but him. Well, I can do the math for the two days per week that he does this and only this office surgery, and BCBS pays some of the lowest fees out there…so for those procedures alone, he makes a minimum personal profit of $20,000 a week. I soooo don’t feel bad for him. 

On the way out, I told the assistant to bill me for the 20% co-insurance that I owed no matter what the insurance company did about their portion of the fees. So when I go in for an ultrasound of my leg tomorrow morning, I’ll be slapped with a bill for $870 – expected, but I hate the timing. Then it also turned out that there were smaller co-pay/co-insurance bits and pieces that I’ve owed for a year and that they claim to have been sending me bills for monthly (I honestly haven’t received a single one of them), so that’s another $130 I’ll be coughing up. Add another $85 for my portion of today’s and tomorrow’s appointments, and BLECH.

Let’s harken back to my credit score of 805, where I was penalized for not having any installment payment debt (e.g. car loan, student loan). I wonder…if I arrange to pay that bill in monthly chunks, will that do the trick, or is that such an unofficial arrangement that it won’t count? I can pay the whole thing up front, but if I can get some personal benefit out of it somehow, I’ll take it.

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Business development: Networking groups?

This morning, I reconnected with a massage therapist I did some Thai training with back in 2005. She contacted me a week ago with info about a course and suggested we meet up for an exchange, but there was clearly an ulterior motive: she’s moving abroad in a few months and wants to sell her client book. I actually prevented that conversation from even starting, which made for a less awkward conversation in the long run. But still, I wouldn’t have bought it…I mean, there’s absolutely no guarantee that a single one of those clients would make the switch. When you’re using an independent massage therapist like me or her, the need for someone whose disposition/personality/etc makes you comfortable is a lot more important than when you go to a spa. She’s a spiritual vegetarian with maroon hair and funky hats, I’m a plain-jane carnivorous wiseass.

However, she did mention that for over 3 years, she has belonged to a Business Networking Int’l group, which has 40 chapters in Manhattan. I know a few people who do this sort of thing, and they swear by it. You attend a weekly breakfast meeting and give a one-minute speech about your business (what’s new, etc). One person per meeting gets the floor for a 10-minute presentation, and it’s “non-compete”, which means only one person per profession. And once you’ve been attending a while, you actually get pop-quizzed about other members (“What do they do? What’s their tag line?”) to make sure you don’t tune out. She says it represents about 30% of her business, and it works really well for personal service professions (personal trainers, hairdressers, etc) because they’re small-ticket items compared to estate lawyers and interior designers. She offered to bring me along to her next one as her guest, and I have to admit, it makes me nervous. The only people who invite you along to their “thing”, in my experience, are either born-again christians or pyramid schemers (aka network-selling like Mary Kay and Amway). What I would like to do is “dip my toe”, so to speak, since you’re only allowed a very limited number of absences before they kick you out, though you can send a substitute. I’d like to be her substitute. Heck, I’d even reimburse her that portion of her membership fee (wish I knew what that was!) to be that substitute just so that I could find out if it was worthwhile without making a pricey commitment. I can’t afford to make a mistake. And since she’s going to be moving away in a few months, there will be an opening for a massage therapist at a chapter that meets in my neighborhood (that can’t hurt!).

Another thing to come out of our catch-up chat…she’s doing the same number of massages per week that I am, and it’s unsustainably scary. We talked about requests from new clients for lower rates and other things that are really hard to discuss with anyone who doesn’t work like we do – neither one of us is willing to back down on our pricing, my argument being that I’d have to cut mine by about 30% in order to generate more business, and rates that low are guaranteed to attract men who think I’m leaving room to upsell them to the naughty stuff. I’m already at the low end of the Manhattan scale – she’s got room to negotiate though, because she’s closer to the top. Anyway, I appreciated her input a lot, because I doubt it’s tainted with fear of “competition” – she’s winding things down, leaving both the city and the profession, and in any case works out of two offices in neighborhoods that don’t overlap with mine.

Sorry for rambling… but I really would like to know if any of my readers have any info to share about experiences (first or second-hand) with organized networking groups. I’m completely out of my depth with this.

I couldn’t let $5 go to waste

The magic red spit machines at CVS dished out a bunch of $5-off-$15 purchase this past weekend that expired today. Even though the deals in the Manhattan stores are non-existent this week, I could not let free money go to waste and I had one left. So at 11pm tonight, I hustled out to use it and picked up 2.5 gallons of milk, 3 dozen eggs, and two bags of gummy bears. It was like buying the milk and candy, and getting the eggs for free. I’m keeping the 1/2 gallon of milk and 1 dozen eggs (completely out of both), and the rest will be carted to the homeless teen shelter this week in my little wheelie bag along with the free cereal deal my mom did for me at ShopRite. She cracks me up – with instructions to pick up 12 boxes, she had a little fun with the actual selection. When asked why in the world she would choose High School Musical cereal for a post-tween crowd, she asked, “Didn’t you say most of the kids were gay? I thought they’d get a kick out of that one!”

No, really, I’m not jealous

My brother, “Six Figures”, is buying his first home, and it closes on Friday. By waiting a year at the advice of me and the aunt who would have been my guarantor, he got a wide 4-story new-build row house with a private parking pen in central Baltimore instead of a narrow 3-story old one with street parking. And he locked in his 30-year FHA mortgage at 4.35%!!! 

My best friend asked me how I felt about my 3-years-younger brother buying a place before I did (birth order and the trappings of success are a big deal in her family). Well, because I’ve chosen to live in wayyy overpriced Manhattan  and I’m self-employed, it’s never been on my radar. I started with “I’m happy that someone I love is able to take advantage of this opportunity of a lifetime” and finished with “If my business continues to tank, I’ll have a very nice place to couchsurf”. 

The only thing I find a bit disturbing about all this:  he only had to stump up a 3% deposit. I thought we’d done away with that foolishness?? He’s literally a few bucks from being “upside down” on it! He also has no plans to use any part of his enormous bonus (due in 2 months, when the sale of his company is finalized) towards the principle. That makes me so sad, because I know none of it will be saved or invested.

Yet another successful rebate: Walgreens

I kind of avoided Walgreens because my first forays produced zip zero nada on the sales front – meaning that all of their monthly free-after-rebate products were sold out and never restocked. That was February and you know what? They still haven’t restocked one of the items. However, before I drew this conclusion, I bought the one product they had in stock – a cold remedy for $7.99 that I had a $2 coupon for and, today, got my rebate gift card in the mail for $8.79 (if you opt for a rebate rather than a check, you get a 10% bonus). In coupon-speak, that’s called a “moneymaker”.

While waiting for the rebate to arrive and feeling generally ambivalent about Walgreens, I got sucked back in last week with their monthly Dove deal – buy 8 items, get a $10 Register Reward (instant store credit, like the CVS Extra Care Bucks). Turns out it applied to single bars of soap, so I basically got 16 bars free…keeping half, donating half. And I managed to find two of the monthly rebate freebies. Then I went today to work a deal and they actually had most of my list in stock — I wasn’t really expecting them to have the Fusion Gamer razor because no other store offering a special on it this month ever had it in stock either. No biggie, that razor has the most expensive replacement cartridges on the market.

So I picked up a 30ct box of Sambucol, 2 Pledge All-Surface cleaner, 2 packs of Peanut M&Ms, 1 Theraflu and 1 Right Guard Clinical for…free. The total was about $35, minus $20 in coupons, a $10 Register Reward from the Dove soap, and $5 off the rebate gift card. I earned $10 in rebates (+ 10% bonus). I’m kind of pleased with myself about that especially since half of those items are things I use. I could get used to this drug store game too!

Unmarried Couples Finance: Borrowing/Lending

Over at The Debt Chronicles, Sunflowers describes how she went about borrowing the money to pay off her consumer debt from her Significant Other — and how inferior it’s making her feel despite all her efforts to do right by him. About 5 years ago, I helped my debt-ridden sister (aka Bridezilla) through this exact situation. She and her then-boyfriend came to an agreement, not sure if anything was signed, but I thought it was perfect. I got involved only as the Excel “expert” who could set up a spreadsheet to calculate and track her payments.

Here are a few points to consider, from both legal/tax angles as well as emotional ones…

Tax implications

Feel free to chime in and correct me, because I’m working from a memory of a conversation with my CPA maybe 3 years ago when discussing loans to family. I’m not qualified to give advice on this – but hopefully I can help anyone in this position figure out what questions they should be asking….

  • As the recipient of an interest-free loan, there’s a tax implication for that sweet deal, but I don’t remember how it’s classified. Would be great if it could be considered a gift, but I don’t really know.
  • If you pay interest on a loan, the lender is supposed to pay tax on that as interest income.
  • Since I was dealing with immediate family members and the amount was below the non-taxable gift limit ($12K or $13K these days), my CPA cleverly phrased a suggestion that we define it that way to avoid a lot of annoying nickel-and-diming.
  • I think, legally and taxwise, it is viewed quite differently if the person making the loan directly pays the borrower’s credit card companies. Like maybe it doesn’t count towards the maximum tax-free gift limit or something (strangely, I recall this from an episode of Divorce Court, which I used to watch on the personal TVs at the gym for lack of any other 10am viewing options…it was either that or who’s-yer-daddy Maury or Rachel Ray, and I can’t stand her voice).
  • If the occasion arises for me to loan money to a Significant Other, I’d draw something up and get it notarized to protect myself…and then hopefully not have to use it. It would be more of a back-up plan.
  • In Sunflower’s position, she and M have a joint account. I think that would make it very easy to make repayments in the form of transfers out of the joint account and into his personal one.

The Psychological Backlash

My sister and her then-boyfriend agreed on an interest rate of 5%. That was WAY below the 18-25% she was paying, which would allow her to pay off the debt really fast. For him, it was about the same rate he could get on a CD. I thought this was a great way to handle the financial imbalance in the relationship because it cost him nothing in the short term to improve their long-term situation (had there been one). My sister, however, was unable to see it as fair to him in any way because she was getting all the benefit while he just broke even on the deal. I tried so hard to help her see that it wasn’t costing him a penny to help her like this, but she had been under the burden of about $20K consumer debt for so long that she couldn’t overcome her “loser” feelings. FYI, this was not the underlying reason why their relationship didn’t work out.

Currently, she has an outstanding car loan with me, at an agreed-upon interest rate of 6%. She’s had the loan for 3 years and only paid 15% of it back in the beginning and nothing since, and she feels really bad about it. Two years ago, I told her that I considered it an investment in my old age, because without a car, she wouldn’t have been able to go to nursing school. I’m not going to have any kids to look after me when I’m old, so it will be extremely advantageous to have a sister wired into the medical community – and used to changing old lady diapers. I recently informed her that she doesn’t start accumulating interest until June, giving her an additional 6 months’ grace period after graduating. Like a student loan, which it really was in a sense. I made her okay with this by pointing out that I would have had all that money in the market and lost at least half of it in the last few months. I actually thanked her for saving a significant chunk of my savings from the Diving Dow — that really got through to her.

Conclusions

  • As a lender to family members, I swear to you I’m perfectly happy getting interest equal to market value.
  • As a borrower, ALWAYS offer – or even insist on! – interest because it’s proof that you’ve thought through your need for a loan, understand the impact on the lender, and truly care about fairness.

Anything I’ve missed?
Anything I got ass-backwards?
Any caveats of your own to throw in?
Please let me know with a Comment!

Wow, another successful rebate!

It looked like a piece of junk mail – just a postcard, really – and had the look of those sneaky marketing ploys whereby you cash the check and are automatically enrolled in some overpriced program.  I reckon Rite Aid counts on people treating it like junk mail too. Well not me – I’m delighted with my $19.97 repayment! And since some of the deals last month were especially good, I did them, ahem, on behalf of my mother and both sisters. I quickly texted my sisters and called my mother to warn them about the junky looking check, because that’s another $30 or so owed back to me. And I want it!