Benefits of Being an Employee

As a self-employed doctor in the Philippines, I did not have benefits. There was no IRA that I could invest in. But my husband and I were smart enough to save and invest some of our money in mutual funds since that was the best thing we could think of, rather than put all our money in a savings account where it will just depreciate with the inflation.

So it was totally foreign for me to be able to invest in a 401k or be receiving benefits from the company that I am working for. Since I was not yet sure about our expenditure, I chose to set aside 10% of my income to 401k. As soon as we are able to financially establish ourselves, I will increase that to 20%. Since I am still far from the retirement age of 65, I decided to invest 90% of that in stocks and 10% in bonds. Even if the stock market is not doing too well right now, eventually it will pick up. Now is the best time to invest because I can buy low and years from now, sell high. With the market plunge, there is no other way but up.

What I did not avail of, to my regret is the flexible spending account. I thought at that time that we were in a pretty good shape and the past years, we never really spent that much on health. But when I injured my back, I saw how a couple of doctors' visits could amount to a considerable amount of money. I only chose the basic health insurance for my family so my co-pay was also higher, at $40 per visit. Again, I am not so familiar with this because back in the Philippines, I don't really pay professional fees since I was a doctor myself. Either I self-prescribe or just call my friends. We do not charge PFs to our co-doctors as part of the professional oath where we treat each other as brothers and sisters. Most of my friends do not have health insurance. I decided to get one just for diagnostic coverage because that is something that will not be waived by the hospital even if we practice in that hospital. We are only given a 20% discount which is not really that much considering how expensive diagnostic work-ups can be.

Here in the US, our health insurance takes care of our bill but there is an out-of-the-pocket co-pay which can be reimbursed using the flexible spending account. In short, the FSA is a kind of health savings account. I can dictate how much I want for that, say $1,000/year. This will be deducted in my salary before tax. The advantage of having this is the immediate availability of the fund even if you have not yet contributed the full amount of $1,000. So all my co-pays for doctors' visits could have been reimbursed using the FSA. The only main drawback for the FSA is that you have to use it by the end of your eligible year or you lose whatever is left there. So it might be best if I start off with an amount close to my past year's health expenditures. I am just fortunate that my 3-week physical therapy was entirely covered by my insurance. I would have skipped it had I been required to give co-pays per visit. Then, just today, when I visited CVS to buy some stuff (not even medicine!), I saw a Flexible Spending Account Summary at the bottom of the receipt. It gave a $3.72 amount eligible for reimbursement. I can't believe how I missed out on this benefit.

But it is not too late because every year there is what you call open enrollment where you can opt to modify your benefits and health plans. So having learned my lesson, I plan to make some modifications on my benefits. I will definitely avail of the FSA and even the short-term disability so I do not need to use my paid-time offs for short term sick leaves due to disability. I just realized I am not so invincible after all. Experiencing this back injury and its initial debilitating consequences, I can never be too sure of what can happen in the future. No matter how prayerful or blessed I am, bad things can still happen because I am living in this imperfect world, inhabiting this imperfect body.

I also plan to include vision in my health benefits. Having an ophthalmologist for a husband, I thought, my family will not be needing it. Lo and behold, just early this year, we found out that my eldest daughter had an error of refraction. To think, my husband refracted her just before we left for the US last year and her eyes were perfect. Now, she's wearing glasses. We would have paid for the service of refraction if not for a very opportune moment when my husband went to a vision center in the mall and there was no optometrist on duty. My husband asked if he can use the instruments because he knows how to refract. Surprisingly, the manager allowed him. Well, he did get a customer anyway, because my husband bought my daughter's first pair of eyeglasses in that vision center. But this expense may have also been covered by an FSA if I had one.

As for our primary care provider, I like the Group Health Associates because of the MyChart feature where I can just go online and ask questions to my health provider. Just imagine having to pay $40 just to ask my rehab. doctor if I can bike or run. Rip off!

So a word of advice for new immigrants, never take your benefits for granted. Save as much as you can in your 401k, at least 10% if not 20% of your income. Get a Flexible Spending Account even if just for $500 or so, then modify during open enrollments as needed. Get a short-term disability benefit too. These are all pre-tax savings. Ask your co-employees which health plan work for them and why. For someone new to these things,the gravest sin you can commit is NOT to ask.

Amazing Technology

Once more, I am amazed at how technology has made things very easy here in the US. I recently visited my new primary care doctor. She belongs to Group Health Associates. She holds clinic which is very near our place. When I registered I was given the option to fill out the myChart feature of their health care. It enables me to have a web account with them so I can view my appointments, make new appointments or even email my doctors regarding questions. I can also ask for prescription refills through this account.

Last Thursday, I had a severe low back pain which did not respond to NSAID intake. When I went to the GHA clinic to have my blood drawn, I asked the secretary if I could make a stat appointment with my primary care doctor because I just wanted a prescription for muscle relaxant. I was informed that she was only there in the morning so the secretary typed a message for her instead. After 10 minutes, I was told that she had muscle relaxants prescribed for me and that I could pick up the medicine at Walmart pharmacy (where I usually buy my medicines). I was impressed with the network that they have even with pharmacies. When I went to Walmart, my medicines were ready for pick-up and I just paid $4.00 for co-pay.

Then this morning, I went to my rehab/physical medicine doctor for a consult. He prescribed for an MRI and the nurse made an appointment for me for this procedure at Bethesda North. Then he prescribed a steroid and asked me where I wanted the drug picked up. My husband and I decided to get it from Bigg's because it is on the way to our house. When we went to Bigg's we saw that there was actually a drive-thru where you could pick up medicines but the pharmacist informed us that it will take 15 minutes for her to process the transaction because I was a new patient for that pharmacy. So the next time that I need to pick-up a drug from them, I can use the drive-thru already. Amazing.

This reminded me of the drive-thru at the bank which was very convenient especially during winter and when you have kids with you. You simply go through the drive-thru and they have canisters which you put your deposit/withdrawal slips. The canister is sucked by a vacuum which delivers it to the bank teller who communicates with you via an intercom.

In the hospitals too, a lot of technological improvements are put into place. One hospital that I go to, no longer uses paper charting. Everything is done through the computer software Epic Hyperspace. The main advantage is that doctors see all orders at a glance, even those given by other doctors. You also see all medications that are prescribed to the patient. It makes it easier for pharmacists to see redundant medications or drug interactions. It is also easier for nurses to see what medications are due at a particular hour. The doctors are also able to access the patient's chart even when they are outside the hospital. Hopefully, all these technological advancements will result in better patient care.