Vision therapy — Live Real, Now

music therapy — Image by emanuela franchini via Flickr

For the first time in 2 years(almost to the day), I am acquiring new debt that I can’t afford to pay off immediately. On a credit card.

Last Thursday, my son entered vision therapy. He has what is commonly known as a “lazy eye”, but is more properly called a “wandering eye”. His eyes don’t always lock on to whatever he is looking at. Instead, one of his eyes will (occasionally, but not always) drift to the side and shut off. His brain doesn’t interpret the signals from that eye.

We had two sessions of tests to diagnose the specific problems: $350.

We will have 28 weekly sessions of therapy @ $140 per session: $3920

There is an equipment fee: $85

That’s a total of $4355 over the next 7 months.

Insurance covers some of it, but the therapist is out-of-network, so it’s “pay first, get reimbursed later from the insurance company”. If we pay up front, we get 1 session free, bringing the price to $4215, minus insurance.

I have a health savings account that I have been trying to max out to cover this, to make my payments all pre-tax. I haven’t been able to get enough in there, yet. In fact, since I don’t have my kids on my insurance, my maximum HSA contribution is $3050.

Since finding out that vision therapy was going to be necessary, I have managed to save $1000 in cash, and about $1500 in my HSA. That’s $2500 of a $4215 bill, leaving $1715 that I still need to be able to cover.

Here is my plan:

We’re charging the entire $4215 at 11.9% interest on a card with a 2% travel rewards program. This will give me $84.30 worth of travel rewards good for reimbursing any travel expenses.

I will immediately pay off $1000 from cash savings.

I will also immediately file for an insurance reimbursement, which will cover 80% – $500, or $2972 minus a bit. Our insurance got a waiver on the pseudo-wonderful healthcare ~~fraud~~ act on the grounds that the plan sucks so bad that it would cost too much to comply with the law. No joke. I’m expecting about a $2500 reimbursement, and I have no idea how long that takes.

In 6 weeks, when I have maxed out my HSA contributions for the year, I will file for an HSA reimbursement for about $2500, leaving about $500 to cover some medical costs for the rest of the year. Vision therapy doesn’t count against my deductible, since my kids are on my wife’s insurance plan.

Starting in June, my debt snowball will no longer be going to max out my HSA and will instead go straight to this card, to finish paying it off as quickly as possible. That’s $750 per month.

Any money from any side work will also go towards this bill, but I don’t budget for that, because it isn’t reliable money.

The projected results:

$3215 on the credit card for 6 weeks @ 11.9% = $50 in interest payments.

After the HSA reimbursement, there will be $715 left to pay, which will be paid off in June for another $10 in interest.

When we get the insurance reimbursement, we’ll replenish the medical bill account, to start getting ready for the kid’s braces next year. We’ll drop $1500 into that account and use the remaining $1000 as a debt snowball payment.

We’ll end up paying $60 in interest to save $140 in therapy costs, so it’s good math, but I hate the idea of racking up another credit card bill. I could drop the interest costs a bit by raiding my emergency fund, but that still wouldn’t cover it all, and it would leave me with very little left for an actual emergency. I could raid the emergency fund for half of its value($700), and reduce the initial interest paid to $25 and the total interest paid to about $40, then use the $1000 leftover from the insurance reimbursement to replace my emergency fund.

: Image via Wikipedia

I’m not a bad father.

Last spring, we noticed my son had a wandering eye. One of his eyes would just drift when he was looking at something. It was happening consistently, so we brought him to the eye doctor. After an exam, we found out that his eyes were 20/100. The doctor said that getting him classes may be enough to fix the wandering eye problem. The theory was that his eye was drifting because his eyes weren’t able to focus. Bringing the world into focus could have let his eyes train themselves to work right.

Nine months with glasses later, the problem hasn’t gone away, so we went back to the eye doctor.

He’s got alternating exotropia. His eyes aren’t working well together. One eye will focus, and the other will drift. So now we’re looking into vision therapists.

A friend went through something similar with his kid, so I asked him for the name of the doctor he used. He gave it to me and told me the clinic was the best in the business, and I would be paying for that. I asked about the cost and was handed the doctor’s spiel about how sad it is that parents focus more on the cost of care than getting the best possible care.

What a load of crap.

First of all, that’s a sales pitch. Of course the doctor is going to defend his prices. If his prices are exorbitant(I don’t have a basis for comparison) and he can’t defend them, people will go elsewhere. $3000 isn’t pocket change. That’s a significant chunk of change. Refusing to look at your options is irresponsible.

Second, price does not equal quality. There are a ton of things that are overpriced garbage. Not only do scam artists abound, but some legitimate things are are horribly overpriced at one location and reasonably priced at others. To stay on the vision theme, my $10 glasses are every bit as high quality as any $400 pair I’ve ever owned. The difference between generic and brand-name drugs? The label and the price. The FDA requires they be chemically identical to be sold. If you insist on the brand name because it’s “better”, you are flushing your money down the toilet. If you live by “you get what you pay for” you are guaranteed to get ripped off.

Third, balancing cost and treatment doesn’t mean I care less. Yes, I am killing my debt as fast as I can right now. Even when I was willing to use a credit card, I wouldn’t drop $3000 without considering my options. I have an entire family to consider, not one problem that my kid doesn’t even notice. Grr. I hate getting told–implicitly or otherwise–that I am a bad parent because I don’t choose to waste my money the way other people do. I’ll check out my options first, thank you.

Now, I will pay for the best when it is warranted. My wife wants Lasik and mentioned some sale some company was having. No. The guy sticking a laser and a scalpel in my eye will not be the lowest bidder. When I left the gene pool, I went to one of the top guys in the state for the procedure. When those things screw up, it’s permanent.

Vision therapy? Not so much. If it comes to surgery, we’ll go with the best. But it’s not there, yet. My kid is going to get a series of eye exercises, no matter where we go. Even if I go to some back alley vision therapist with a degree from a Nigeria U, what’s the worst case scenario? We may have to try someone else. Since I will be doing a bit more research than that, odds are better that my kid will get exactly the same therapy regimen for 1/4 of the cost. That’s the difference between a perfectly competent doctor and a perfectly competent doctor who convinced some trade magazine to write him up as the best in the business.

What do you think? Am I neglecting my kid by wanting to save some money for his braces, too?

New Debt

Medical Costs and Choices