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I had a reality check recently with my own medical spending. Here I am, the professional, offering advice to employers about plan designs to promote better consumer decision making through higher deductible plans (HSA’s & HRA’s), and I was irresponsible in a recent trip to the doctor. I did exactly what the insurance companies are addressing these days. I frivolously paid no attention to what the medical services actually cost.

I had been periodically experiencing a pain or cramping in my left foot for the last couple years, and so I decided that as long as I had to drive my mother to her podiatrist for an appointment, this would be a good time for me to check this out. The doctor examined my foot, asked me to describe the pain and where and when it occurred, then concluded it could be neuralgia. On the other hand, it could also be from the lack of proper food support or even as a consequence of a back issue. We talked about arch supports and she also asked whether I had back pain. She then offered that a cortisone shot in the nerve between the 3 rd & 4 th toes could be helpful if it was indeed neuralgia. I focused more on that shot in my foot than cost. After all, I had paid my $25 co-pay to see her, and how expensive can a shot be? When I got my EOB (explanation of benefits) in the mail, I was shocked to see that visit cost $375! She did spray some Novocain on the spot before giving me the cortisone, which I guess is the anesthesia, which was included on the bill. My HMO was able to discount roughly $90, but oh my gosh! If I had a HAS or HRA plan, I bet I would have asked what the costs would be for this questionable procedure (that never helped anyway). I’m sure I would have done some calculating and thinking about whether I wanted to gamble with a procedure to rule out one of several probable causes. The arch supports are only $12.95. Why no start with the simplest and cheapest first and determine results from there? If it were coming out of my medical savings account (HAS), of course I would have exercised more discretion. This experience is something for all employers to think about...

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