Dilemma...should I postpone surgery?
I need some advice...
Today I learned that my insurance benefits include a Flexible Spending account option for medical expenses. Basically, I am able to allocate a specific amount of money (pre tax) that can be used through the year for medical expenses...like my surgery copay ($3,500), prescriptions, etc. Then the money is deducted from my paycheck through the year to pay it back, with no interest.
So, my dilemma is that I am 5 months and 2 weeks into my 6 mo supervised diet required by my insurance. So, in 2 weeks I was expecting to submit for approval and get a surgery date. I have the necessary money in savings for surgery, but the pretax option without depleting 1/2 of my savings is very appealing. If I waited, I wouldnt be able to have the surgery until JUNE!!!
I just don't know what to do....
Today I learned that my insurance benefits include a Flexible Spending account option for medical expenses. Basically, I am able to allocate a specific amount of money (pre tax) that can be used through the year for medical expenses...like my surgery copay ($3,500), prescriptions, etc. Then the money is deducted from my paycheck through the year to pay it back, with no interest.
So, my dilemma is that I am 5 months and 2 weeks into my 6 mo supervised diet required by my insurance. So, in 2 weeks I was expecting to submit for approval and get a surgery date. I have the necessary money in savings for surgery, but the pretax option without depleting 1/2 of my savings is very appealing. If I waited, I wouldnt be able to have the surgery until JUNE!!!
I just don't know what to do....
(deactivated member)
on 12/27/11 4:51 pm
on 12/27/11 4:51 pm
In that 6 months you are going to make up the tax difference in the money you save on food and you are going to be that much further ahead in your weight loss journey. If it was ME, I would do it. I wouldn't have prolonged my surgery any further than I HAD to.
I don't know your financial situation though. To each their own... but me? I'd rather have the surgery, get healthy, and get a 2nd job than to stay in the body I'm in because this body right here is NO way to live. That's the point that I am at in my life.
Good luck with your decision. :)
I don't know your financial situation though. To each their own... but me? I'd rather have the surgery, get healthy, and get a 2nd job than to stay in the body I'm in because this body right here is NO way to live. That's the point that I am at in my life.
Good luck with your decision. :)
Yeah, I am sooooo on the fence about this. I have the money I need in savings. I know my health and happiness are worth more than a few thousand dollars, but I'm just a tightwad. It's really stressing me out to think that I have to withdraw a large chunk of my savings for the copay ($3500). I guess I should be grateful I have insurance coverage. I'm excited to just get this surgery over so I can stop overthinking it and get this weight off, so I will probably won't wait.
Thanks for your support :)
The expenses related to treatment received in 2012 should still be eligible. So, anything you spend in 2011 will not receive that savings, the rest of your treatments, co-pays spent in 2012 except continuation of treatment will be payable.
What you will need to find out from your medical teams office staff is what will be submitted to the insurance as separate from what you are receiving in 2011. Typically, the nutrition evaluation is separate from the surgical treatment...typically. You may not need to postpone the surgery, but the nutritional component may not be eligible since it began in 2011.
Also, you should check with your employer regarding payment submission to the benefit. It may be that in order to receive the full benefit, you will have to submit claims as your FSA accumulates. So, if $200 a month is withheld from your pay, then you can only submit reimbursements in $200 increments per month.
Also, if your spouse's employer (pardon if I presume too much) has this employer benefit, then you can have them submit claims against their account too, but only once for each receipt. Did that make sense?
What you will need to find out from your medical teams office staff is what will be submitted to the insurance as separate from what you are receiving in 2011. Typically, the nutrition evaluation is separate from the surgical treatment...typically. You may not need to postpone the surgery, but the nutritional component may not be eligible since it began in 2011.
Also, you should check with your employer regarding payment submission to the benefit. It may be that in order to receive the full benefit, you will have to submit claims as your FSA accumulates. So, if $200 a month is withheld from your pay, then you can only submit reimbursements in $200 increments per month.
Also, if your spouse's employer (pardon if I presume too much) has this employer benefit, then you can have them submit claims against their account too, but only once for each receipt. Did that make sense?
Hmmm...interesting info. Thanks for the response, I will follow up with my HR generalist and ask some more questions. To my understanding, the way our FSA works is that I must sign up for it during open enrollment (April), then whatever amount I have specified for medical expense is immediately available on June 1st. However, it cannot be used for anything prior to June 1st which is why I would need to postpone the surgery until after that date. It's also "use it, or lose it" by the end of the benefit year--so I would need to set aside a specific amount or a little less than I actually need so I don't actually lose money.
I am just thinking about this as an alternative to using my savings. I like to have a "nest egg".
Thanks again for the info.
I am just thinking about this as an alternative to using my savings. I like to have a "nest egg".
Thanks again for the info.
Just a thought.........if you used the flexible spending, your employer would have to deduct about $292 a month to equal the $3500 correct? Why not go ahead and have the surgery and still have them deduct the $292 to go back into your SAVINGS...no tax savings but your nest egg will be replenished in 12 months for you to use a portion on all the new clothes you will need to buy.
Not everyone's enrollment period for insurance goes January-December. Sounds like KS's coverage goes June-May, so her FSA wouldn't be available until then.
KS, my 2 cents - FSA is definitely great. I use it every year...that said, I didn't realize I would be having surgery in November 2010 when I was enrolling for my Jan-Dec 2011 coverage. So, my tax-free funds ran out about halfway through all the pre-testing (my insurance covers the surgery, but not any of the pre or post-op testing. Weird!)
Anyway, because I knew that my deductible and maximum-out-of-pocket expenses would reset at the beginning of the year, I decided to just go ahead and go for it. When submitting my 2011 taxes, I'll see if it'll be worth it to do the crazy medical worksheets to see if I can deduct anything, but think I'll just be paying for about half post-tax.
My suggestion would be to have your surgeon and PCP provide a detailed list of all the office visits, lab tests, and surgery costs as well as approximate timing. Then, talk to your local HR or insurance company to understand how much of each of those things is covered and any discounts your company may have negotiated, figure your out-of-pocket charges through May, then June and after. There are plenty of FSA calculators out there that will tell you how much you'd be saving by waiting.
I decided to go ahead, but bumped up my 2012 FSA amount to help cover all the post-op visits (3 months, 6 months, 12 months for my surgeon).
Good luck! Only you know your financial and health cir****tances well enough to decide.
KS, my 2 cents - FSA is definitely great. I use it every year...that said, I didn't realize I would be having surgery in November 2010 when I was enrolling for my Jan-Dec 2011 coverage. So, my tax-free funds ran out about halfway through all the pre-testing (my insurance covers the surgery, but not any of the pre or post-op testing. Weird!)
Anyway, because I knew that my deductible and maximum-out-of-pocket expenses would reset at the beginning of the year, I decided to just go ahead and go for it. When submitting my 2011 taxes, I'll see if it'll be worth it to do the crazy medical worksheets to see if I can deduct anything, but think I'll just be paying for about half post-tax.
My suggestion would be to have your surgeon and PCP provide a detailed list of all the office visits, lab tests, and surgery costs as well as approximate timing. Then, talk to your local HR or insurance company to understand how much of each of those things is covered and any discounts your company may have negotiated, figure your out-of-pocket charges through May, then June and after. There are plenty of FSA calculators out there that will tell you how much you'd be saving by waiting.
I decided to go ahead, but bumped up my 2012 FSA amount to help cover all the post-op visits (3 months, 6 months, 12 months for my surgeon).
Good luck! Only you know your financial and health cir****tances well enough to decide.
Thank you so much....you are a wealth of knowledge. I didn't know there were FSA calculators, so I will get right on that! This insurance, deductible, copay, FSA stuff is all foreign to me. I have always been a "healthy" person (haha...like morbid obesity is healthy) so I have never used my insurance aside from the occasional checkup/ yearly exam. Guess I am getting my feet wet. Thanks for the advice!