An Open Letter to My Health Insurer and Physicians

I'm basically a free-market Republican.  My basic philosophy is that the less the government is involved in business the better.  I also believe that it is for more efficient to save insurance for the big bills and not to use it for every routine expense.  That being said, right now, I'm angry.  I feel like I've been scre*** and it is your fault--yes, both of you, and I'll blame the government too.

What happened?  Well, on March 1 I started suffering from what I thought was a rather routine illness.  I called my doctor's office and they sent me to a partner clinic across town.  No problem, I understand that I can't get instant appointments with whomever I wish whenever I wish.

My appointment was with a nurse-practitioner.  Again, no problem.  As far as I knew, this was a routine problem and I just needed someone who could write a prescription.  When I got there, they checked my insurance and collected my co-payment, as expected.  The nurse-practitioner did as expected, ordered the lab tests I expected and wrote me the prescriptions that I expected.  No problem.

Unfortunately, the test results did not come back as expected, which led to questions about what was causing my symptoms (which had resolved promptly when I took the medication).  Sensibly, the NP referred me to a specialist, as the symptoms could have been indicative of something serious.

I saw the specialist who ordered more tests, tests that I thought were very reasonable considering the possible causes of my symptoms.

I returned a few weeks later for the tests.  They were negative.  Most likely, the doctor said, the symptoms were caused by some germ that didn't show up on the first test, and that nothing was wrong.  However to be sure, we should do some more tests.  She'd get her office to get insurance company approval.

A week or so later her office called to schedule the appointment for the tests, and I agreed.  The day before the tests the patient accounts office called and told me the cost for the tests would be over $800.  When I asked for an explanation I was told that this test came under my deductible, not my co-pay.  Our local paper had just published a piece on medical prices, so I asked for the codes for the test I needed and I checked online.  The Medicare price for this procedure was $425.  I called several facilities around town and asked for the cash price for this procedure and most of them wanted about $800; one only wanted $750.  I told my doctor's office to send the orders over there, but when I called to schedule the procedure, they wanted over $800 because the orders listed my insurance.

Then the bills started coming.  It seems that my insurance had changed--and I knew that, sort of.  I knew the deductible and co-pays had increased (along with the premiums) but until this year, my co-pay covered everything that happened at the doctor's office that day, in other words, it covered the shots and the labwork.  Well, not anymore.  You'd think a change like that would have been pointed out to us.

I read medical bills for a living but I still couldn't make enough sense out of the bills I got to determine what they were charging me for and why.  All I know is that I paid the doctor's office over $200 last month and today I got a bill for another $300.  I got an EOB that said something was non-covered and I may owe the provider.

I don't live paycheck to paycheck.  Our income allows us to handle bills like this.  Even if I end up paying all of this out of pocket, we will still have dinner tomorrow, and no one is going to turn our lights off.  Still, I have a very nasty taste in my mouth.  It is nasty tastes like this that make people think that "someone" ought to "fix" the problem.  If you (doctor and insurance company) want to know why so many people are agitating for change in the way we pay for medical treatment, an experience like this is a big reason why.

First of all, I had no clue these bills were coming (except for the $800 bill).  Secondly, when I got the bill, it just gave a date of service and an amount.  There was no clue what it was for.  The EOB had more information, but even it wasn't complete.  The EOB showed a huge charge, a "discount", the amount the insurance company paid and the amount owed.  It did not explain why I owed that much, to get that information I had to call.  Medical math has to be the most complicated PhD level math course there is, and since I'm not a math person, I don't get it.

Finally, the bills do seem outrageous compared to the amount of time I was there, the complexity of the problem etc.  Maybe I'm wrong about that, maybe they really do need for me to pay that much in order for them to maintain the business and pay the employees decently--but back to that $800 charge for a test that would have cost Medicare $425--why should I pay more than Medicare?  The nice lady at the doctor's office said they could send me a financial aid packet if I needed one, and if I have to pay a little more so the poor can get treatment, I'm ok with that, but I don't see why I should pay more than the biggest payer.

With everything else I buy I am told the price before I incur the charges.  Even the mechanic gives me an estimate before he fixes the car.  Just trying to get prices over the phone requires more sophistication about medical billing that what most people have.  A friend of mine just posted on facebook that she went to an in-network ER for what was truly an emergency and was sent into surgery.  However, it seems that the assistant surgeon (who she never saw) was out-of-network and the insurance company wouldn't pay, so she was supposed to.

Folks, business as you are now running it is only going to make people madder as the current trend promoted by both Obamacare and Turmp is for more individual responsibility for medical bills (up to a point) in the form of deductibles and co-pays and taxes on plans that pay "too much".  All this in-network, out-of-network foolishness with those huge "discounts" was fine when we knew that at the end of the day we could easily find doctors who were "on the list" and that we were going to pay $50 for the doctor's visit.  However, if you are going to make me page huge insurance premiums and then get stuck with big medical bills too, I'm going to feel taken advantage of and people who feel taken advantage of aren't going to be happy with the status quo--and I'll give you a heads up, I'm not looking for more ways to put money in your pocket. *Part of Financially Savvy Saturdays on brokeGIRLrich.*

Getting the Most for Your Money at Disney or Universal

These days tickets to major theme parks like Walt Disney World or Universal Studios can run close to or even over $100 per day.  There is just no way you can consider spending any amount of time at such a park to be a low-cost vacation.  Having taken several trips to the Orlando theme parks, I have several suggestions for getting the most for your money.

Compare Onsite and Offisite Hotels.

I know people will disagree with me on this, and I certainly encourage you to run the numbers, but for the most part, you will find on-site hotels to be more expensive than comparable off-site properties.  While  you have to factor in the fact that you will not be paying $20 per day to park and you do get extra park hours, you also have to consider that you will probably  be eating theme-park priced food all day every day.  

However, if you fly into Orlando rather than drive, staying onsite may be less expensive as you will not need to rent a car.  While offsite hotels do advertise free shuttles, people have told me that these are inconvenient and crowded and cannot be guaranteed to get you to and from the parks on your preferred schedule. 

Walt Disney World

As I am writing this article, Disney is offering a "Summer Special".  For a family of four to stay at the All Star Resort, get four day tickets allowing entrance to one park per day (and no park twice)  and to get a dining plan allowing two counter service meals plus two snacks would cost $2849.70.  That hotel room has two double beds.

How else could we enjoy this vacation?

We could stay at the Townbridge Suites, which is only 3.2 miles from the Magic Kingdom.  Our five nights there would cost $845.79, and instead of a small hotel room with two double beds, we'd have two queen beds, a double sofa and a kitchen.  We'd also get free breakfast.  

The four day four park tickets would be $1346.16. We'd also have to pay $20 per day to park the car, so getting in the door would total $1426.16.  

Since we had our free breakfast at the hotel, we only have to budget for lunch and dinner.  A counter sevice meal and drink is going to run about $15 per person, so if you eat them in the park, that is $120 per day or $480 in meals, and we'll round it up to $500 because you'll probably want snacks too.  

While the Disney package cost $2849.70 for our family of four adults, the family that stayed offsite only spent $2771.95 and got larger accomodations.  Further, they could have saved even more on food by going back to the hotel for lunch and/or  dinner, or packing their lunch, since they have a kitchen.  

Another choice is the  Park Inn by Raddison where two queen beds and breakfast but no kitchen costs $470.00.  This hotel has a rating of 3.2 (good) on Trip Advisor.  Assuming we eat our meals in the parks, staying here (within walking distance of Animal Kingdom) would cost us about $2400.  

None of these choices are luxury hotels, but all appear conveniently located and have good or better reviews.

Universal

Universal's lowest price resort is the Cabana Bay resort, and for a room with two queen beds on the same days as I priced for Walt Disney World, plus four day three park tickets (Universal, Islands of Adventure and Volcano Bay Water Park) I would pay $2226.31.  Add on $50 per day per person for food and the total package is about $3026.31.

If I stayed down the road at the Drury Inn and Suites, in a room with two queen beds, that room plus the tickets would cost $1711.38, and if you add $20 to park per day you get $1791.38.  Add $50 per day per person for food and you get $2511.38.  

Arrive Early

I know it is your vacation and that sleeping in sounds like a better plan, but the early bird gets to skip the long lines.  If you are staying onsite, take advantage of those early admission hours where you can basically walk onto the rides.  

Based on our experience, if you are lined up to enter the park when the rope drops, you can expect to walk on to one or two headline rides with less than a five minute wait (unless the headliner you choose is a character meet and greet).  The lines are worst from about eleven until the afternoon thunder shower or about six, whichever comes first.  

I recommend a subscription to Touringplans.com which allows you to create touring plans that include the attractions you want to experience arranged so as to minimize either wait time or walking. For example, they have a pre-made plan for Universal Studios that you can edit.  If I optimize that plan for July 9 it estimates that to see the 20 listed attractions, I will spend 179 minutes in line, 316 minutes busy with the attractions, 236 minutes free and 55 minutes walking. As a comparison, if I head to the Harry Potter ride first, and then to the other activities in that area, I end up spending 317 minutes in line, 286 minutes on the attractions and 57 minutes walking.

Arriving early means that you have time to take a break in the middle of the afternoon when the weather is the hottest (or when it rains).

Go During the Offseason 

Both Disney and Universal engage in load-based pricing.  If you want to be there on the busiest days of the year you will pay more than if you are there when the kids are in school.  We got lucky this year--the only person in our family who is still in school graduated from our parish school, and therefore got out a week before everyone else.  We took our vacation the week before Memorial Day and it got us a four day Universal ticket for the normal cost of a two day ticket.

Disney often offers free dining packages if you stay onsite during the offseason.  You can find bargains at local hotels during the offseason as well.  

When Practical, Skip the Theme Park Food

As noted above, a counter service meal such as a hamburger, chicken nuggets or pizza will cost about $15 per person.  If your family includes children, they may be able to split these meals as portions are generous, however, it is still basically fast food.  If you upgrade to something with vegetables, you upgrade the price as well.  

If you are staying offsite, particuarly in a room with a kitchen, if the hotel does not offer free breakfast, make or buy your own.  Many hotel rooms have small refrigerators that can hold yogurt, milk, cheese and fruit.  If your kids eat cereal at home, they can eat it at the hotel too.

If your family can be at the rope drop and last until the fireworks end, more power to you.  You probably will be eating theme park food because leaving and returning will cut into your fun..  However, if you head back to the hotel for an afteroon swim or rest, include you lunch in the break, or take sandwiches with you.  The parks allow you to bring in food and water, just no ice chests.  

Even if you can't fix food in your room, you can save money and/or get some variety in your diet by patronizing offsite restaurants.  

Shop Around for Tickets, But Be Careful

The major theme parks make it clear that multi-day tickets are for use by one person.  If I buy a four day ticket, I can't let you use one of the days.  They enforce this by scanning a bar code on the ticket (or checking the magic band) and comparing it to a fingerprint scan.  

There are people who try to sell unused days or counterfeit tickets.  All I can say is "let the buyer beware" and "if it sounds too good to be true, it probably is". 

That being said, Undercover Tourist  is a reputable ticket broker that often offers tickets at a lower cost than the parks themselves do.

When you start planning your trip, start keeping an eye on ticket prices and deals.  As I said above, the "rack rate" seems to be about $100 per park.  I say "per park" because if you buy a ticket that allows entry into more than one park per day, the price goes up subtantially, unless you buy multi-day tickets.  

As I am writing this, on the Undercover Tourist site, I can get a 1 day 1 park ticket to Universal for $132.06. If I want to make that a 1 day 2 park ticket it goes up to $175.73.  If I do a 2 day 1 park per day ticket it is $209.71.  2 day 2 park is $263.62. If I want head of the line privileges at all the major Universal attractions, another $50-60 will give you that.

Both parks offer deals of one sort or another frequently , the trick is to get the best deal for what you want to do when you want to do it. Both Disney and Universal now charge extra to hop between parks.  Disney is offering a deal right now--$79 per day, but you have to buy four day tickets and you can only visit each park once (in other words you can't skip the park you aren't sure is worth it).

We recently got four day tickets to Universal for $200 each--but the reality is we wouldn't have paid to return to either park for a second day.  Since they gave us two days "free" we did return, did pay parking, and did buy overpriced food.

If you are willing and able to dedicate part of your vacation to listening to a hard-sell sales pitch for a vacation condo, you can probably score a free ticket or two, but you will almost certainly be there for half a day or more.  

Decide What Is Important to You and Your Family, and Focus Your Spending on That

Everyone has a different idea of what is "fun" or "worth it".  For some people, an integral part of the Disney experience is staying onsite, and they absolutely would not be happy with a generic condo three miles away, even if that condo gave them more space and allowed them to cook.  For others, being trapped in a small hotel room with their kids is something worth paying to avoid.  

The theme parks try to reach adults with dining and entertainment choices that go beyond chicken strips and french fries.  While the food is not inexpensive, eating in unique restaurants can be fun for some people, while others would be better off going back to the condo and popping a Lean Cuisine in the microwave.

Ways to reduce the overall cost of a theme park vacation include making a one-day visit part of a vacation in Florida, rather than making your vacation a week-long trip to theme parks.  

Figure out your budget and figure out how to give your family the most fun for that amount of money.  

*Part of Financially Savvy Saturdays on brokeGIRLrich.*

Update on My Lending Club Portfolios

Lending Club allows you to divide your notes into "portfolios" or groups of notes and it shows you data about those portfolios.  This post is about my Lending Club portfolios--what they are, why I invested that way and what my results are.