Who wants to critique my post-debt budget?

[disneysteve]

surely you don't believe you are "very unlikely" to meet your deductible?

I was really curious about your comment and wondered if maybe my view was totally off base. So I posted a poll to the early retirement forum asking folks how often they typically meet their deductible.

So far, 64 people have answered.
45.3% said Never
28.1% said 1-50% of the time
3.1% said 51-99% of the time

Only 23.4% said Every year, like you

So meeting one's deductible does seem to be pretty uncommon based on this very unscientific poll. Obviously you need to be financially prepared to cover that cost if it happens, but in any given year it is quite unlikely that it will for most people.

[riverwed070707]

Different interpretation... 26.5% said they hit their deductible more than half the time. That's a substantial number, even if its not most. Also a bit hard to interpret given that the deductibles vary so dramatically even just from what's available on ACA marketplace. Your deductible could be $1000/yr with $400/mo premiums or $15,000 with $250/mo premiums. One is much less likely to hit their deductible, but also are going to pay a lot more out of pocket every time they need care.

I'm also baffled (in a good way!) at how little your fam has been to the ER. Torn between whether that is a difference in access to medical care between where we live or because you have a doc in your home who can likely pretty quickly take care of minor emergencies and/or be more discerning about what's severe enough to warrant emergency care vs being able to wait until facilities are open. If I need a doctor between 8 am and 7 p.m. I might be able to find an open urgent care. Our regular doc offices here don't even take sick patient appointments because everything needs to be booked 1-3 weeks in advance. After 7 pm weekdays or 4 pm weekends, the ER is the only option.

I was really curious about your comment and wondered if maybe my view was totally off base. So I posted a poll to the early retirement forum asking folks how often they typically meet their deductible.

So far, 64 people have answered.
45.3% said Never
28.1% said 1-50% of the time
3.1% said 51-99% of the time

Only 23.4% said Every year, like you

So meeting one's deductible does seem to be pretty uncommon based on this very unscientific poll. Obviously you need to be financially prepared to cover that cost if it happens, but in any given year it is quite unlikely that it will for most people.

[disneysteve]

Different interpretation... 26.5% said they hit their deductible more than half the time. That's a substantial number, even if its not most. Also a bit hard to interpret given that the deductibles vary so dramatically even just from what's available on ACA marketplace. Your deductible could be $1000/yr with $400/mo premiums or $15,000 with $250/mo premiums. One is much less likely to hit their deductible, but also are going to pay a lot more out of pocket every time they need care.

I'm also baffled (in a good way!) at how little your fam has been to the ER. Torn between whether that is a difference in access to medical care between where we live or because you have a doc in your home who can likely pretty quickly take care of minor emergencies and/or be more discerning about what's severe enough to warrant emergency care vs being able to wait until facilities are open. If I need a doctor between 8 am and 7 p.m. I might be able to find an open urgent care. Our regular doc offices here don't even take sick patient appointments because everything needs to be booked 1-3 weeks in advance. After 7 pm weekdays or 4 pm weekends, the ER is the only option.

Many studies over the years have found that greater than 90% of ER visits are for non-emergent issues. Fewer than 10% of patients walking into the ER actually need to be there. I saw this every day when I was in training working in ERs. All but a handful of patients who walked in had no business being there. And now with widespread availability of urgent care centers, going to the ER should be an exceedingly rare event. Call your PCP. If they can't see you promptly but feel care is warranted, they can direct you to either telehealth, urgent care, or, if necessary, the ER.

Your point about access to care certainly may play a part, though. If you live in a medically under-served community, that can impact things for sure. We probably have a dozen urgent care centers within 15 minutes of our house, our PCPs are just a text, phone call, or email away, and then there is telehealth. Something has to be very serious to head to the ER. Just as you're baffled at how little we go to the ER, I'm shocked that someone in your family has a life-threatening medical emergency every 2-3 years.

As for the deductible question, the answers on the ER forum were skewed by a number of people having Medicare. The 2025 Medicare deductible was only $250 so lots of people have met that. But if you read through the comments, most said that prior to going on Medicare they never or very, very rarely met their deductible. It's just not that common to do. There have now been 128 responses to the poll and the percentages have remained almost exactly the same. 23.4% said always. 43.8% said never. 28.9% said less than 50% of the time. Nearly 73% rarely or never meet their deductible. Remove the folks referencing meeting the Medicare deductible and it's probably closer to 90%.

[riverwed070707]

Many studies over the years have found that greater than 90% of ER visits are for non-emergent issues. Fewer than 10% of patients walking into the ER actually need to be there. I saw this every day when I was in training working in ERs. All but a handful of patients who walked in had no business being there. And now with widespread availability of urgent care centers, going to the ER should be an exceedingly rare event. Call your PCP. If they can't see you promptly but feel care is warranted, they can direct you to either telehealth, urgent care, or, if necessary, the ER.

Your point about access to care certainly may play a part, though. If you live in a medically under-served community, that can impact things for sure. We probably have a dozen urgent care centers within 15 minutes of our house, our PCPs are just a text, phone call, or email away, and then there is telehealth. Something has to be very serious to head to the ER. Just as you're baffled at how little we go to the ER, I'm shocked that someone in your family has a life-threatening medical emergency every 2-3 years.

As for the deductible question, the answers on the ER forum were skewed by a number of people having Medicare. The 2025 Medicare deductible was only $250 so lots of people have met that. But if you read through the comments, most said that prior to going on Medicare they never or very, very rarely met their deductible. It's just not that common to do. There have now been 128 responses to the poll and the percentages have remained almost exactly the same. 23.4% said always. 43.8% said never. 28.9% said less than 50% of the time. Nearly 73% rarely or never meet their deductible. Remove the folks referencing meeting the Medicare deductible and it's probably closer to 90%.

Definitely not experiencing a life threatening medical emergency every 2-3 years. My experience has been that there are few things they actually treat at urgent care and you're typically referred to the ER for anything more than antibiotics or a few sutures AND that's if the situation arises during operating hours. Part of it may be not knowing if a situation can wait or is serious enough to need seen ASAP. Some examples from our family in the last 5 years:
- DD broke her toe. Went to urgent care, they sent us to the ER for X-rays and a specialist referral (which was also located at the hospital) to have a pin placed to reset it.
- I was in a car accident on the interstate. Sent me to the ER for concussion exam.
- I was traveling for work and having trouble breathing, was having pain in my chest, and had an elevated heartrate due to the pain. Urgent care sent me to the ER. Ended up being low iron.
- DD was experiencing sore throat and fever, went to urgent care for a strep test, put her on penicillin. She broke out in rashes all over her body. Took her back to urgent care and they diagnosed her with scarlet fever and sent us to the ER. Turns out she was just allergic to penicillin.

I don't know that any of these were necessary ER visits, I wouldn't consider any of them life threatening, but it's what we were directed to do during those situations and I'm not a doctor so who am I to argue and say it can wait or be addressed with telehealth? Medical situations are scary and when a professional tells you you need to go to the ER, disregarding their advice feels negligent.

[disneysteve]

Some examples from our family in the last 5 years:
- DD broke her toe. Went to urgent care, they sent us to the ER for X-rays and a specialist referral (which was also located at the hospital) to have a pin placed to reset it.

A fracture serious enough to require surgical repair is beyond an urgent care, though at ours, we would have done the x-ray and then referred you to the podiatrist. I can't say if an ER would have been necessary unless the situation warranted surgery on an emergent basis.

- I was in a car accident on the interstate. Sent me to the ER for concussion exam.

Totally appropriate ER usage.

- I was traveling for work and having trouble breathing, was having pain in my chest, and had an elevated heartrate due to the pain. Urgent care sent me to the ER.

Also totally appropriate ER usage.

- DD was experiencing sore throat and fever, went to urgent care for a strep test, put her on penicillin. She broke out in rashes all over her body. Took her back to urgent care and they diagnosed her with scarlet fever and sent us to the ER. Turns out she was just allergic to penicillin.

Sounds like an incompetent urgent care staff in that case but if you were referred to the ER, you were certainly right to follow those directions.

it's what we were directed to do during those situations and I'm not a doctor so who am I to argue and say it can wait or be addressed with telehealth? Medical situations are scary and when a professional tells you you need to go to the ER, disregarding their advice feels negligent.

I agree with you 100%. If a medical provider says, "Go to the ER" you had better proceed directly to the ER.

[riverwed070707]

Thanks for that validation. Genuinely. This convo had me thinking we were throwing money away with excessive, unnecessary ER visits. Maybe just a string of bad luck and we won't need to go back for many years

[disneysteve]

Thanks for that validation. Genuinely. This convo had me thinking we were throwing money away with excessive, unnecessary ER visits. Maybe just a string of bad luck and we won't need to go back for many years

I certainly hope your string of ER visits doesn't continue.

[LivingAlmostLarge]

Somehow I also hit our deductible but I think it's mostly my one kid with expensive medical prescription. Rinvoq and dupixent were the two that were out of control. And then i've had medicines and DH got hit by a car. With long term medicines and preexisiting conditions we'd be uninsurable if it wasn't for ACA. i'm glad to even be fortunate enough to be allowed to buy insurance. When consider before 2012 we couldn't have been sold it. Now i shudder.