That’s Highly Deductible

It’s that time of year again. When the school year starts anew. And so does the high deductible on my insurance plan. Only this year, courtesy of some lovely new federal legislation that shall remain nameless, my high deductible is, well, higher. Twice as high. Which means that it will take me 4 months instead of 2 to revert to something of a more liveable co-insurance type insurance plan.

The first year my employer went with this new high deductible idea, I went to fill a couple of my prescriptions, and the pharmacy assistant ringing me up just gave me a pitying look, and asked if I wanted to look at their discount card since I didn’t have insurance. I pointed out I did. It was a new insurance plan brought to us school district employees courtesy of the ginormous enterprise in TX referred to as TRS (Texas (Teacher’s) Retirement System). And yes, we aren’t retired, but for some reason that is where the majority of the health plans for TX school districts originate.

Mind you, I actually got that pitying look a number of times since we started that plan, but not this year. I guess it has been around long enough (has it been 3, maybe 4 years?), and there are so many folks around here that work for the schools, that the pharmacies have finally registered that when September rolls around, so do the high charges for drugs.

Now there are many I know who never meet their deductible, and make reference to not going to the Doctor unless they absolutely have to since they haven’t, and it is too expensive. And I think to myself, must be nice to be able to think that way. Sure, it stinks to have to fork over about $100 to see a Doctor when you have bronchitis, but bronchitis is the least of my bills. Or my ills. My drugs cost some serious moolah. In fact, with just two of them yesterday I was 1/6th of the way towards meeting that new, even higher deductible. And one of them was just for heartburn of all things.

I might choose to live without that one, to save some money on the deductible, but it wouldn’t matter much, really. Because the deductible will be met. The drug I need to have most, the one that keeps my bladder from coming undone, and the pain from taking me out, is $800 for a 3 month supply (and that is through the discounted mail order). I am ever so grateful I am one of the 33% of Interstitial Cystitis patients who sees noticeable benefits from this drug, Elmiron. I am. But is is so darn expensive, and it gets more expensive every year. And then there are the other medications I take to help with my terrible Texas sized allergies, and with some of the other funky things that happen to a body with fibromyalgia.

My drug habit is expensive. I am a pharmaceutical dream. And I don’t even take the REALLY expensive stuff that many other chronic patients have to take, like Humira. I long for the days when I paid almost nothing for employer sponsored health insurance, and even my Elmiron only had a co-pay of $40 a month.

And yet, there is this one thing. It may be high deductible, but I do HAVE health insurance. And since it is just me (my husband has his own plan through his job), and not a family plan, we can afford it. It stinks to pay that much for drugs, but by the grace of God, we can afford it. I can afford to take my needed medications, and also have a nice house, a nice car, food,  and a few things I want. For many people with chronic illness, both those who can and can’t work, all of this would be a luxury as they tried to pay for their pills. It’s highly deductible, but it’s mine. And by Christmas, I will be back to my co-insurance payments again.

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