How to save hundreds on a MRI

Hopefully you never have to get a brain or spine MRI. However if your doctor recommends one, you should know that you can save hundreds by choosing a for-profit MRI center.

I didn’t even know about low-cost MRI options until recently. Like many Americans, I would have gone to the radiology lab referred by my doctor, or at least one that is in-network with my insurance company.

That reasoning made sense in the good old days, when your insurance company co-pay would likely be the best deal. If someone has pricing amounts from 10 or so years ago, let me know!

Nowadays, many people pay through the nose even if they have employer-sponsored health insurance, especially those with high deductible plans (HDP). As the name indicates, HDP insurance plans have low premiums but high deductibles (a specified amount of money that the insured must pay before an insurance company will pay a claim). It is intended to incentivize people to compare prices for healthcare services.

One of my favorite cousins has a high deductible plan with a 30% co-insurance for most services, including MRIs. While she is young and in fairly good health, last year she experienced mysterious dizzy spells. Her doctor recommended a MRI.

My cousin called several in-network radiology labs for pricing. No one could or would give her an exact price. The cost would depend on a variety of factors: 1) Negotiated price they billed to the insurance company, which varied widely; 2) the individual’s co-insurance, co-pay and deductible; 3) medical code used; and 4) the biller’s mood that day. (#4 is kind of a joke).

When she went for a second opinion, her new doctor requested another MRI. I forget the reasoning for a 2nd scan but almost a year had passed since her first MRI.

At that point, my cousin had already paid $520 out of pocket for the first MRI and could not afford another costly scan. After some research, she found several for-profit MRI center with good online reviews that charged $200 – $250 for the same scan — basically a 50% saving!

My cousin reported that the facilities and personnel were very good. Her doctor had no issue with the MRI, which means that the quality was good.

A quick Google search for ‘low cost MRI’ pulled up a half dozen results, including Radiology Assist, Nationwide MRI and Affordable MRI. I can’t vouch for any of these so be sure to do your own research.

I wonder if other lab services, such as mammograms or biopsies, have for-profit options that cost less than insurance. As shown by my cousin’s experience, it never hurts to look for alternatives!

Who’s Afraid of Bernie Sanders?

Or An open letter to the 1%.

Dear 1%,

Imagine society as a pyramid, with you and your Super Rich cronies at the top.  The Poor make up the bottom. In between are three tiers for the Middle Class, thinly separated as Upper, truly Middle, and Lower Middle.

If I were you, I would do everything in my power to help the Middle-Class thrive.  We may not be the largest group in terms of population but we are key to the stability and economic prosperity of our society.

The Middle Class are sort of a foundation for the rich. Think about this in terms of your beloved corporations. To succeed, good leaders need a  team of dedicated, smart, and hardworking people below them.

The Middle Class are also a bridge (or buffer depending on your viewpoint) between you and the Lower classes. Those at the bottom know that the odds of leaping to the top is less than 1%. However, they do have a good chance of climbing up to middle-class, if given the right tools and circumstances.

At this point in history, due to years of inequality, compounding interest, tax shelters, inherited wealth, corporate bail outs, and other factors favoring the rich, billionaires like you could spend $1 million a day and never outspend your assets.

If/when people wake up and realize that the gap between themselves and the RICH are insurmountable, they will give up on the “American dream”. If we, the Middle Class, are decimated due to rising health care costs, unaffordable housing, and stagnant wages, what hope do those lower down the ladder have? Someday people may realize that  the entire system is rigged and following the rules is for suckers. No matter how hard they work, they will never catch up to the 1%, or even the top 20%.

Is it really asking too much to have wages that keep up with inflation? Like other Middle class chumps, my salary would be much higher if it were adjusted for inflation. Instead, I feel lucky to get a 1 – 3% raise in a good year, while cost of living increases by an average of 5% per year.

Some other things to consider:

  • The average student graduates with thousands in student loans, while their rich peers buy their way into Ivy leagues (and in-demand state schools) with legacy admission or bribery.
  • Many “glamorous” industries, such as entertainment and publishing, rely on the labor of unpaid interns and make this the best way to get a foot in the door. Guess what? Only certain classes can afford to toil for zero dollars.
  • A master degree is the new bachelors, which hurts middle- to lower- class folks who are already in debt for their bachelor degree.

Have I mentioned that wages are stagnant while housing and health costs climb at astronomical rates?

The 1%, government fat cats, and corporations are blinded by greed. Top CEOs don’t need to earn 1000x above their lowest paying employees. If CEO and top management earn 100x above their lowest paying employees, they could still live in luxury and never outspend their assets.

Perhaps I need to put this in a context that you understand:

A strong Middle Class means higher consumer spending, which means money in the bank for you.

No matter how rich he is, Mike Bloomberg can only own one iPhone (maybe two?). In contrast, the mass of middle income folk can buy thousands of iPhones, clothing and other stuff that keep the economy pumping.

To your advantage so far, we Middle Class have been fairly conservative in our actions.  We have regular jobs, own stocks and mutual funds, and are more reluctant to join mass protests. In general, we have positive views of entrepreneurs and business people…at least up to a certain point.

With adequate government oversight and business cooperation, we could work together within the current system and build a “capitalist” society that doesn’t reward a handful at the top and destroy the environment.

sliced apple pie on brown surface
Give us a piece of the pie. Photo by Valeria Boltneva on Pexels.com

However, the top 1% need to give us a bone and make changes to give the middle class, especially those in the lower tiers, a fighting chance to climb up the economic ladder. Maybe we had that chance 20 years ago, when college tuition were reasonable, companies didn’t lay off employees to pump up the bottom line and please stockholders, and healthcare/housing were more affordable.

Today, the reality is that the Middle Class are one step away from falling down the ladder. And instead of supporting the Middle Class, the 1% continue to act in short-sighted and greedy ways, with their insatiable desire for more and more….

If you are still unconvinced, take a look at history. A weak middle class could result in a revolution. See French Revolution, Communist revolutions in China or Russia

How long do you think the middle-class (and lower-classes) will support this system before we wake up?

Financial Goals: The Long, Short & Middle Of It

I’ve been inspired by this post to list out our/my financial goals. I like the idea of planning out savings the same way you would plan out paying off debts using the Dave Ramsey snowball method.

Hopefully I will remember to refer to this and update as the years go by.

Short Term Goals (anything that needs attention in the next year):

Name: Maintain Emergency Fund
Life Reason: To give us the freedom to undergo hardship without stress
Terminal Amount: $40K (Source: Savings)
When goal needs to be met: Already met

Name: Car Replacement
Life Reason: We have 2 old cars but one is likely to die soon or cost too much to repair.
Terminal Amount: $25K
When goal needs to be met: September 2016

Once a short term goal is funded, you can immediately spend the funds, or save that money toward mid-term goals

Worthy Midterm Goals (anything that needs attention in between one year from and when we retire):

Name: House Down Payment
Life Reason: I would like to own a house that can be left to kids. However I firmly believe that most houses are not investments.
Terminal Amount: $200K
When goal needs to be met: 2017

Name: Life Insurance
Life Reason: We have a special needs child who will need financial help after we’re gone.
Terminal Amount: $100K*
When goal needs to be met: 2037-ish
* Truthfully I don’t know how much we need in this account. Several people have told me that the government programs will suffice, yet these are the same people who tend to favor budget cuts in government programs (which would include any program helping the disabled).

Long Term Goals:
Name: Retire
Life Reason: We want a comfortable retirement with ability to leave enough to our kids.
Terminal Amount: $1.5M indexed to inflation
When goal needs to be met: 2037-ish

While we’re okay in terms of emergency savings and our car goal, it seems highly unlikely that we can meet the 2 biggest goals — house down payment and retirement.  I am assuming that the house value will have to be a part of retirement or inheritance for kids.

There Will NOT Be A Revolution

Despite the title of this blog, I want to assure the upper-classes that the middle-class are highly unlikely of ever staging a rebellion.

Here’s Why:

French revolution

French revolution

1) We middle-class would very much like to join you in the upper-classes.  Some of us don’t even care how we get up there.

2) We don’t want to get our Khaki pants dirty.

3) We don’t like to protest unless we can do it from the comfort of our homes, preferably behind a computer or an anonymous blog!

4) We still believe in upward mobility even if stats tell otherwise.

5) We have good credit.

6) If you throw us a stick once in a while, like a 1-3% raise, we’ll be happy.

7) We still think that we can afford to own a home.

Russian Revolution

Russian Revolution

8) We are too busy and tired from trying to stay afloat on stagnant salaries.

9) We naively believe that if we pay for more lessons, SAT prep courses, and private school, our middle-class kids catch up to your kids, who get even more lessons, prep courses and go to more elite private schools.

10) Did I mention that we would really like to join the upper class?

Note: You probably should look out for the lower classes though.

A Week In The Life Of Special Needs Parenting

Every week, my spouse and I face a mountain-load of paperwork related to managing a special-needs household.  Below is a sampling.


Monday

Spouse handles medical appointment for one kid.

I schedule extra service hours for this Wednesday.

Tuesday

I take a day off from work.

I attend 3-hour parent training seminar required by Regional Center

I pick up dental referral form for one kid

I email back and forth with Service Provider re; insurance denial for one of kid’s services

Spouse and I participate in a therapy session with kid.

I fix a mistake that I made earlier in one of our service provider’s schedule.

Spouse sends in medical supply order and questions to service provider

Wednesday

Spouse brings kid to hospital for check-up.

I research and complete paperwork for a government program.  I hope I get all the necessary forms!

I call Insurance about a denied claim.  Hear a message saying they’re too busy and to call back another day. Search for most recent approval paperwork!

Spouse completes paperwork for IHSS.

I discuss upcoming vacation time with a therapist.

I notice a possible error in schedule for next week and note to bring this up with provider.

I print and save copies of lab results for one kid.

Thursday

Spouse discusses parent training schedule with consultant

I TRY to submit information online for a government program. I get an error message and contact the agency for help. I would have submitted the old-fashioned way but I cannot find a paper application anywhere on their site.  During this research, I also notice that there are a few additional supporting documentation on their site that were not required in the online application.

I email important documents to kid’s doctor for his signature.

I email insurance about the denied claim.

I call provider about services that is supposed to start for one of my sons in April.

Friday

I email Regional Center about services that is supposed to start for one of my sons in April.

Weekend

We realize that we have 3 special needs related meetings next week.

Add stuff to the To-Do List:

  • Get ready for IEP by reviewing progress reports and decide strategy.
  • Get paperwork ready for foundation meeting.
  • Set a schedule for weekly parent training for both of us
  • Email provider about not being happy with one of the therapists.
  • Find out if one of our recent appointments qualify for a claim with AFLAC.
  • Note to self: Research if we should continue paying for AFLAC insurance.
  • Must follow-up (again) with IHSS
  • Must follow up with kid’s doctor about completing form.

Some weeks are definitely more hectic than others.  It was a fairly slow week at work so I was able to tackle multiple projects.  Many times, I’m just too busy at work to do much else. Unfortunately, it’s not uncommon for it to take-up 2-3 weeks for me to follow-up.

All of the above must be taken care of while we manage a household with two young kids, freelance career and a full-time job! We could not do this without local family support (thanks Mom!)

News: Free Tax Help For The Middle Class

The IRS has a Volunteer Income Tax Assistance (VITA) program that offers free tax help to people who make $53,000 or less, persons with disabilities, the elderly and limited English speaking taxpayers who need assistance in preparing their own tax returns. IRS-certified volunteers provide free basic income tax return preparation with electronic filing to qualified individual.  Although I wish the income limit was higher, $53,000 or less certainly qualifies as middle-class!

To find a location near you, do a search with the word “VITA” or use the IRS website.

Note: This is not an April Fool’s joke. The suffering Middle-Class do not play jokes…

HTSMC: Work The System

It’s hard to write about government assistance programs without getting into a debate whether there should be a societal safety net or not.  Many people view all welfare programs in a negative light — as inefficient bureaucracy at best or assistance for the undeserving poor at worst.

From my observations, it seems that most liberals / Democrats believe that the government should help all of its citizens. Most of my Republics/ conservatives friends and family members put their faith in the American Dream of “pulling yourself (and your family) up by your own bootstraps”.  They tend to support a program or service only if they know someone who benefits from it.

Many states offer home buying assistance for first time buyers and/or for low- to middle-income households.  I did not end up using this type of program but I learned many national and state government program are available even for middle-income people.

Before I get into details, I want to “out” myself up-front as someone who has benefited greatly from receiving support during tougher times.  I also admit that we were not the poorest of the poor.  We had a little family help, too.  Without the myriad of government-sponsored programs, however, I know we would be much worse-off today.*

Here is a quick run-down of government services that I’m thankful for:

1. Disability Insurance – In California, disability tax is taken out of every pay check. It’s not a larger amount.  Should you ever become disable, you can tap into these funds and get approximately 55% of your regular paycheck. This short-term benefit made it much easier for us when I had to quit earlier than expected for a difficult pregnancy.

2. Paid Family Leave – I also took advantage of paid family leave benefits after my children were born.

3. Regional Center – I have a special needs child and we’re fortunate that the state offers services for people with developmental abilities such as Autism, Epilepsy, and Cerebral Palsy. Services provided include speech therapy, occupational therapy, respite and much more. They do require that you first try to get services paid by private insurance and Medi-Cal, which is fair.  If private insurance approves services for your child, that means you are responsible for co-pays.  Our ABA therapy alone adds up to approximately $480 per month!  Luckily the Regional Center is able to help us with these co-payments.

baby

4. Medi-Cal – There is a special Medi-Cal program for individuals with disabilities. First, it’s been a great relief to know that my child would get medical coverage even if I were to lose my job. (It may be different now with Obamacare but I haven’t looked into it.)  This program has helped my family by filling in gaps in insurance coverage.  When my child needed an expensive specialty formula, prescribed by the doctor but not covered by most private insurances, we were able to get the formula through Medi-cal.

5. In-home Supportive Services (IHSS) – This is a lesser-known program that works with families to keep a developmentally disabled individual in a home setting (versus being institutionalized).

In all cases, our income was documented to ensure that we qualified for services.  We had to submit financial information and send them a copy of our tax return every year.  I’m not saying fraud is impossible but we were rejected for two other government programs for having a little too much savings. There is also a lot of follow-up by case workers in order to prevent abuse.

It can be intimidating, confusing and frustrating to navigate the system to get government services.  Government resources are limited and you have to act as an advocate to get enough services. We’ve been lucky to have a few good Case Managers at the Regional Center who have helped us navigate the process. However, I do most of the legwork and research on my own and follow up a lot (phone, email, fax, mail, you name it).

As with private insurance dealings, you’ve got to be very persistent and know your rights. Nice but firm gets better results. Tell them about worse-case scenarios.  Do as much as you can IN WRITING. Make copies. Follow up, follow up, follow up.

* I would like to add that funding cuts have greatly affected the quality and quantity of government services available.  It’s a lot of people fighting for a small slice of pie.


This is one in a sporadic series of tips/ideas to help you stay middle-class.  Whether you consider yourself on the lower- or higher-end of the spectrum, you can probably find some useful tips to help you stay there and find save more for retirement even as wages stay stagnant.

How To Stay Middle-Class: Government Help?

This is one in a sporadic series of tips/ideas to help you stay middle-class (HTSMC).  Whether you consider yourself on the lower- or higher-end of the spectrum, you can probably find some useful tips to help you stay there and find save more for retirement even as wages stay stagnant.

Work the System*

Most government programs help lower-income households.  However, even if you’re solidly middle-class, there may be times — due to disability, unemployment, under-employment or circumstance — that you may actually qualify for some assistance.   It is important that you keep abreast of new programs and policy changes that can help you and your family.  I’ve had mixed experiences but during tougher times, the government has actually been a lifeline for me.

The first step is to check your state and local government websites.  There are tons of resources out there and it can be confusing.  However, take the time to familiarize you with different aid programs.  In addition to widely-known programs like food stamps and disability benefits, there are other programs that have more wiggle room in terms of qualification requirements.

For example, when my husband and I were first looking to buy a house, we found out about a first-time home buyer program.  Operated by the Southern California Home Financing Authority (SCHFA), this program provides low interest loans and closing cost assistance in Los Angeles and Orange Counties.

Maximum Income Limits – Los Angeles County

Type of
Construction – New and Existing
One or Two
Person Households
Three or More
Person Households
 Up to $99,360  Up to $115,920

As you can see from the above, a family or three or more could make over $100,000 per year and still qualify.  That is not luxury-level living in Los Angeles but the cut-off is more generous than many other government programs.  Another option in California is CalHFA, which requires first-time home buyers to take a home buyer education course.

A quick Google search for “first time home buyer [your city/county]” will pull up results pertinent to your area.

The bottom line is that there are programs out there to help the average middle-class Joe/Jane. You just have to look for these and once you find one that works for you, be persistent and ask a lot of questions. More to come…

* I realize that the term “work the system” has negative connotations. I’m not advocating doing anything dishonest.  However, I believe that you need to be the squeakiest wheel (and very informed) in order to get services.