EFFECTIVE PERSPECTIVE | SPRING 2010 EFFECTWhen Leftover HRA Money Is a Good Problem
by Matt FugateFor years I resisted establishing a health care reimbursement account (HRA). It was the “use it or lose it” part of the system that gave me pause. I couldn’t shake the fear that by the middle of the following December, I’d still have money left over, and would have to scramble to spend it. I’d have to combine this with my Christmas shopping (last-minute, naturally), and I just couldn’t see stuffing stockings with prescription eyewear.
I found myself repeating the mantra of the procrastinator, one that I have employed in most situations requiring that I plan for my short- and long-term future: “What if I do it wrong?”
However, over time it slowly dawned on me that responsible actions like keeping an HRA are a lot like flossing—you might not be doing it perfectly, but it’s still better to do a bad job than to do nothing at all.
When I first started my reimbursement account, I was very conservative with my elections. I still couldn’t shake the nagging anxiety over the possibility that I had overestimated my health needs for the year. My situation changed significantly when I was diagnosed with multiple sclerosis.
I won’t bore you with details or make this column all about my Heroic Struggle, but I do feel the need to put your mind at ease. My MS is classified as “relapsing-remitting,” which means I can go years without experiencing symptoms. It was also caught very early, and treatment has kept the symptoms extremely minimal. Most days I don’t even think about it. When friends ask about my health, it takes me a minute to remember they’re probably referring to my chronic neurological condition and not the sniffles I kicked last week.
I do think about my MS every four weeks though, because that’s when I fill my prescription for the medication that, so far, keeps the disease from worsening. Because it’s a “specialty prescription,” my co-pay is $200. Yes, you read that right: $200. At the pharmacy counter, I can always tell when the pharmacist is new because of the double take at the charge. Something in the eyes says, “Wait a minute—that can’t be right.” I know the feeling.
The medication was merely deadening the superpowers that will surely come.
I always feel strange when I swipe my credit card in the reader, and hit the OK button when the total comes up. Is $200 really “OK”? Am I not only providing authorization for the charge to my card, but also endorsing the cost in a larger sense?
I know I shouldn’t grouse, since this medication is keeping me healthy in a way that wasn’t possible before the turn of this century. I just find it annoying that when I was first diagnosed, the co-pay was only $35. To be fair, that was in 2006 dollars. Why, a candy bar was only 60 cents back then!
I am trying to be optimistic about the future of my health care. Maybe it will just end up getting cheaper on its own, like DVD players and flat screen TVs. For all I know, by the time I retire, we will have largely eliminated the need for clinics and pharmacies, and the bulk of my medical needs will be served by stepping into a booth in my bedroom. Now, I’m not saying I’ll have the state-of-the-art model—I won’t bother getting the “extra digits on demand” option until it’s a standard feature. As a matter of fact, eventually, I’ll even have old models gathering dust in my garage, waiting for the next yard sale. Yes, there will still be yard sales. I’m talking about the future, not Mars.
Until that day, however, I have to live with the current, expensive health care model. At least I have the dubious comfort of not worrying about having any money left over in my HRA at year-end. No, now I fantasize about the prospect of my doctor calling me into her clinic and telling me the tests were wrong. Not only was the tingling in my legs not multiple sclerosis, it was instead the initial effects of having been bitten by a radioactive spider, and the medication was merely deadening the superpowers that will surely come. In that case, my HRA money can go to waste.
On the other hand, I may yet find a way to spend the money. For one thing, I'll probably still need glasses—a superhero has a secret identity to maintain, after all.