Monday, October 13, 2008

Difficult Decisions

Sometimes being a grown up is hard.

I am scheduled to have surgery on October 23rd. I've done my pre-op appointment, I've got childcare lined up, and I've arranged for my own babysitters during the 24 hour surveilance period after the surgery when Ryan's at work.

I've also started looking into the financial ramifications of this surgery, and I found out a few things:
1. This is going to cost $2000 out of pocket, which happens to (coincidentally) be the maximum annual out of pocket for our new insurance
2. The new health insurance operates on a calendar year, and so even though we didn't start with this company until Oct. 1, the out of pocket restarts on Jan.1.

Because of that, and because of the fact that I use up all of my out-of-pocket costs most years, I am looking at postponing my surgery until the new year and effectively saving us $2000.

This is not a decision I want to make. That is an understatement, actually. The way I really feel about it is essentially unprintable; it involves a lot of four letter words and foot stamping and whining and the kind of crying that is really snotty.

I hate my expanders. In addition to the fact that they look terrible, and they're deformed, and my breasts are no longer on the same parallel and it's even visible when I'm fully clothed, the expanders hurt. Sometimes they're merely uncomfortable, sometimes they're painful, but they're always present in my life. They disrupt my sleep (imagine sleeping on baseballs implanted under your skin, and you've about got it), they make me uncomfortable in my own body. I hate them, and this surgery is all about getting rid of them.

So, I have a conflict. Financial concerns versus physical concerns. What kind of decision is that?! It's completely unfair to me to have to make that kind of decision, and it sucks. Yes, sucks. There is no more literary term to define it: sucks is about the only word that will suffice.

I am strongly leaning towards postponing the surgery. Our family has aquired too much debt through this process already, and we already have payment plans set up with two hospitals. We don't need to add $2000 to that pile....if I do the surgery in October, we will aquire $4000 in medical expenses between now and Dec 2009, but if I do the surgery in January, we will "only" acquire $2000 in medical expenses. (Not including copays, prescriptions, or other "not included" categories...but I won't go there for the sake of this post.)

I'm trying to be an adult about it. I'm trying to remind myself that I'm not putting off the surgery indefinately, only for a couple of months. I'm trying to remind myself that financial intelligence sometimes involves making difficult decisions, and that I'm not immune from avoiding difficulties, either. I'm trying to remember that a few years from now, a few months one way or the other won't make much of a difference, but paying interest on credit cards for that same time might still be making a difference.

I'm trying to put on my big girl panties and do what is right for my family, not just for me.

I'm trying to remember that I have dealt with much, much worse stuff in my life. I'm trying to remember that it's "only" reconstruction, and it's not a life-saving technique.

I'm trying not to focus on the fact that I'm so dreadfully tired of having surgery hanging over my head, and that I just want it over with.

I'm trying to remember that I am allowed to put myself first.

I'm trying to remember that making a decision that benefits my family will make me feel good, too.

I'm trying.

If you pray, please put in a prayer for me that I will make the right decision about this, whatever that might be. I have not decided what I should do, or what I must do, or what I can do; I have not decided if should and can are the same thing. If I postpone the surgery, I do not know how to remove the black cloud from over my head; if I have the surgery now I do not know how to avoid feeling guilty at the cost.

I would love to have an answer. Anybody have advice?


Sue said...

Kristina, I'm sorry that you're struggling with this decision. I had a similar one to make last year.

I had knee surgery 11/2 last year for a torn meniscus. I actually found out that it had torn in September, but I decided to postpone it until November due to finances. We have a flexible spending plan at work where we can put aside pre-tax medical expenses, and our year starts on 11/1. So I thought it would be helpful to wait until Nov. to have surgery, so a new year began. it's also the beginning of our insurance year. So here I am, postponing it, hobbling around in pain, thinking I'm being all frugal about my expenses. I figure I've been in pain forever, what's another month.

So it's now 2 weeks prior to surgery and I discover that yes, a new flex spending year begins 11/1, however, like you're discovering, my deductible (which hadn't been filled) would reset on January 1. I was so angry. I thought I was being good to postpone to save money, but then something else ended up coming along to screw that up. Oh, and our insurance changed as of 11/1 as well (same company, different plan), and now instead of having it covered for the deductible, it was now deductible and 10% of surgery, plus other costs I wouldn't have had if I had the surgery in October. But now it was too late to reschedule before 11/1.

I spent a lot of angry time, wondering why I try so hard to be frugal and then essentially get screwed for my efforts. Sigh.

Only you know how postponing will affect you physically, emotionally, etc. (For what it's worth, it's not noticeable to me visually that your breast repairs need to be made, but then again, I haven't spent much time inspecting. :) I guess I don't really have an answer for you - "something" always seems to come up for me, no matter how hard I try to avoid it.

One thought I did have, is that when Ryan's current consulting positition is completed, if for some reason he doesn't find another one and his time "on the bench" ends, then the insurance coverage ends (which I pray doesn't happen) - so postponing could have that ramification as well.

Sorry this is so long - I feel for you and your decision, and I'll keep you in my prayers that you make the right decision for you and can live with that decision. If I can help in any way, let me know. If nothing else, let's get together for some coffee and chat. I'm here for you.

AnnMarie said...

Sue mentioned it in passing, but I wanted to make sure you'd thought about flexible spending or whatever other options you might have for that. We have "employee reimbursement accounts" that run from Jan 1-April 15 (with the money taken out Jan 1-Dec 31 however). It's pre-tax. So if you have access to that and can wait, you'd save a lot more than $2000. On the other hand, if you have it this year and still have money to use up and you have to spend it this year, it might make sense to do it now instead.

OR, what if this surgery would put you over the 7.5% (or whatever the amount is) amount that would make it deductible on your taxes?

Best of luck with the decision. I know it's not easy....

Caley said...

I pray for your spirit of peace to be with Kristina. Heal her body, soul, and mind from all of the illness and burdens she has borne. Thank you for giving wisdom generously to all who seek it and for knowing exactly what Kristina needs right now. Be with her in this very moment and bless her with your loving kindness. May she know how much you (and others) care for her.