Dealing with loss

A week ago Hillary Clinton suffered a crushing defeat at the polls.  A couple of days later one of her supporters encountered Clinton out hiking near her home in Chappaqua.

20161112-hrchiking

This news caught my eye because I remember after suffering one of the most devastating losses of my adult life I took to walking almost every day for hours.  It was therapeutic, and I frankly could not think of any other way to deal with my misfortune.  And it helped me understand that taking one day (or one step) at a time was an effective way to deal with life’s adversities.

How do you deal with loss and disappointment?  Whether it’s a small setback like not getting an expected promotion or a large one like the death of a loved one, we’ve all had to find ways to handle loss.  Do you try to put it out of your mind and carry on with your regular routine?  Do you exercise?  Do you overeat or drink?  Does religion offer you comfort?  Do you turn to deep self-analysis?  Do you seek out support from close friends?  What works, and doesn’t work, for you?

 

Advertisements

68 thoughts on “Dealing with loss

  1. I don’t do well with things I cannot change. I stay in denial and anger longer than I should, I ruminate, I get stuck, I circle back over the same useless stuff again and again. The only thing that worked for me (to any degree) was also walking. Sometimes pre-dawn, when I couldn’t sleep and my brain just kept flying around in circles.

    I can’t say it fixed anything, or that I took some greater lesson from it. But I did notice that after an hour or so, the physical weight on my chest would lift and I could take a full breath, sometimes for the first time in days. So, you know, there’s that.

  2. I am not a very religious person but starting in my teens when I was upset with my appearance and felt I was on my own, I felt that the only person I could talk to was God or maybe that was just me comforting myself, don’t really know. It did and does help me feel better. I realized that marrying someone wouldn’t make me happy but I needed to take charge of my life and try to turn it around. I got the idea to come to apply to colleges in America. The few friends I told didn’t think I had any chance. I am glad I did because out of a very low period in my life came a profound change. I always encourage people to go for it, if they make it great, if they don’t they gave it their best shot.

  3. I have shared this event before, and I know I am not the only one of us regulars who have had similar experiences.

    The most devastating and memorable loss I’ve experienced was that our first child was stillborn. This occurred without any warning, completely normal pregnancy, water actually breaking on his due date, labor (I was there the whole time, and until DW delivered him there was no panic among the staff). BTW the diagnosis was sepsis.

    For the only time in my life I got close to fainting.

    This was such a shock, I remember the sadness. There was a funeral. Friends were kind, but unsure of what to say, when to say what. There were some idiotic comments “God must have a plan” and “You can start over again soon” stick out.

    Words of advice: it may sound trite, but if you’re at a loss for words just say “I’m sorry for your loss.” If you want to be there for the grieving, offer to call/come by to talk with them in a few days/week/month.

    I got thru the ordeal by being close to DW and staying busy by going to work after a point. Otherwise I know I’d just obsess. I don’t remember if I gained weight, lost weight, exercised more (or less), slept worse (or better, because of being so tired). About a month later we took a quiet driving vacation for about a week and that seemed to help.

    So for me the rest of life’s disappointments other than the death of a loved one pale. And even then, there is an “order” as I see it. Old people should die first, parents preceding children. When the younger generation dies first, it’s sadder to me. Death, other than by “natural causes” or prolonged illness, is always more shocking/hard to deal with regardless of cause / age of the deceased.

    I deal with non-death related loss/disappointment pretty well. I am not one to linger over it; I really try to ‘move on’ and mostly I do that by staying busy with work, volunteer work. It’s all part of life anyway. I’ll talk with one particular friend, best man in our wedding, if I really need a sounding board.

  4. I think I have a number of coping mechanisms. Running with girlfriends helps me work out most of the daily ups and downs. Definitely talking things over with DH helps with the bigger losses, he’s a really good person to talk to.

    Nighttime is where I struggle if something is really bothering me or I am feeling upset/feelings of loss. It can be very hard for me to turn off my brain.

    On DS not making the team he wanted – that was hard to watch. In our town we have competitive basketball and rec league basketball. He wanted to do competitive. For the past month he has been out practicing for no fewer than 2 hours/day, doing drills and practicing shots. The team took 11 kids. 8 of them absolutely needed to be on the team. Another kid is terrible but very, very tall. The remaining 2 kids were definitely worse than DS, but had played for the coach before, whereas our DS had not. That was very hard for him to swallow over the weekend. But, he went to school on Monday and came home telling us that his entire grade (middle school) was shocked he didn’t make it, told him he should have – essentially gave him a real ego boost. So he is going to do the rec league, and try again next year to make the team. He’s asked if he can go this summer to the UNC basketball camp (WHY YES YOU CAN SON I WILL SIGN YOU UP RIGHT NOW).

    It’s been 100% a good life lesson, as Risley noted, and he’s reacted very maturely. I do think these setbacks are good to have. But it’s hard to watch it happen. I was a little bit worried he would internalize a message of “what was the point of working so hard if I can’t make it,” but I think his classmates’ reaction dispelled that feeling.

  5. Lark, that’s great that he’s reacting to the disappointment in such a mature way. My 12 year old recently didn’t get into a special thing he’d auditioned for and his reaction was “I think I’ll quit chorus next year.” (It wasn’t the people running his chorus who were judging the audition tapes.) We had a chat about how people of character react to setbacks. So you can be proud that on his own he’s viewing it as a reason to keep practicing and try again next time.

  6. Louise, when I first wrote this post I left out any mention of religion, probably because I am not part of any organized church. Then I realized that religion was probably a very important way for many people to deal with loss and so i put it in. I grew up in a very religious environment but basically I left the church in my teens. However, even into my 20s I still found comfort in prayer and going to church when I encountered serious adversities.. What do they say, there are no atheists in foxholes?

    Lark, I’m so proud of your son. What a wonderful outcome.

  7. I have tried all of the above with varying success. “This too shall pass” was always true even if not what I wanted to hear.

  8. I have never had a professional loss of Clintonesque magnitude, maybe because I simply never reach for the stars like that. I did have a big disappointment a few years ago. It was the year of the sequester. I had submitted a major NSF proposal, and it had sat under review for almost a year, which is a Good Thing (proposals that clearly aren’t going to make it usually get kicked back in 4 to 6 months). At a conference, I ran into the program director, who told me that the proposal was “on the bubble” and they were waiting to see what happened with the sequester. Alas, the sequester was passed and my proposal got denied. I can’t say I was really upset because I know how competitive those things are, but I also have to admit I haven’t submitted since. It was just so much work, and so disappointingly close.

    My biggest personal loss was when my mother died unexpectedly (she was only 61) right after my first kid was born. I was very close with her, and she was so excited about the baby. I did exactly what the OP described – I walked and walked. It helped soothe the baby anyway, and I couldn’t think of what else to do. It was such a conflicted time – happiness with a new baby and deep sorrow too.

  9. I would just echo Fred’s last two paragraphs.
    Losing near and dear ones is my biggest fear. I have a hard time even thinking about it. Also, I really concur with order of things. When my younger brother suffered a blow to his health at a young age, I was devastated and very angry. I was angry with God and angry with the universe. I questioned the very existence of a higher power. Some particular religious hymns and philosophy helped me come to terms with what happened and again believe in God. Thankfully my brother is doing well now.

    For all other stuff, working hard, exercising, spending time with my kid and really just controlling things I can seems to help. Since I am a naturally optimistic person, that helps too. Unfortunately DH is pessimistic and deals with stuff in completely different way than me. So there is that.

  10. HM – is it all-state or similar? Those judges know nothing – I didn’t make all-state 2 out of 4 years when I was in HS (including my senior year!). Hope he can bounce back!

    Lark, that is great that your son is looking forward to the next opportunity!

  11. Lark: How awesome. Kudos to your DS.

    Regarding loss–death and illness have a way of prioritizing everything else in your life. When I have a professional or personal challenge now, I say to myself “Well, at least everyone is healthy.”

    I also try and focus on what’s going on *right now*. What is the next step? How can I make things better today? It really takes away worries about the future, which is my main source of consternation.

  12. Lark – in soccer here it is acceptable to play rec if you don’t make it to competitive.
    I have heard of a few kids totally dropping out because they didn’t make competitive. Well, one is dropping out of rec because the team is not winning as much. I was sad to hear this because at this point even in rec, kids and their parents have been part of the team for a long time.

  13. Fred – how fortunate you are that you and your wife were able to support each other in dealing with your loss. One of the most difficult things I faced when my father passed away was the increased isolation from my family. My mother was in no condition to offer comfort to her children for many years. It took a massive argument over a holiday for her to realize that we, her children, also suffered a deep loss. It would seem that this is obvious but it was not. She was so wrapped in her own loss. She was so angry and depressed that efforts to comfort her were fruitless or rebuffed. As a family our typical response to any difficult situation is to talk less, isolate ourselves more. My siblings and I each dealt with our grief on our own, My siblings were married then, I was not, so they turned to their spouses. I sought therapy and sleeping aids, threw myself into my work and turned inward. I moved abroad a short time afterwards.

  14. “Regarding loss–death and illness have a way of prioritizing everything else in your life. When I have a professional or personal challenge now, I say to myself “Well, at least everyone is healthy.”

    +1000
    “It’s not cancer” puts things in perspective for me, even though I was convinced while going through it that I would never anguish over more minor issues again.

    Looking back, my faith was a rock, but at the time I could not see it. Well-meaning people who told me that God would heal my depression if only I had enough faith were lucky that I was too physically weak to kill them.

    Also agree with Fred that a simple “I’m very sorry for your loss” in the case of death and “I’m so sorry that this is happening to you” in the case of most other crises are always a good option if you don’t know what to say.

  15. “I’m very sorry for your loss””

    Beats “don’t blame yourself” hands down. Really, people say the stupidest things at funerals.

  16. With ‘professional’ losses (getting fired), I had a hard time in the moment and always cried. I hope I am more of an ice queen now and wouldn’t do the same; OTOH I am more secure in this job than I was in the others.

    With deaths in the family, I agree that “I’m so sorry for your loss” is always the best thing to say. Scarlett, I have also said “I’m so sorry” in the continuing crisis situations and people seem to take that well, esp when coupled with sympathetic noises if you are on the phone.

  17. L, it was national honor choir. He’s just generally a little pissed at the world for not letting him laze around watching tv all day and then get all the accolades for nothing. I keep reminding myself that the other two got through this stage and he will too.

  18. “My mother was in no condition to offer comfort to her children for many years. It took a massive argument over a holiday for her to realize that we, her children, also suffered a deep loss. It would seem that this is obvious but it was not.”

    Yeah, this. I remember about 3 mos. after my stepdad died almost having a meltdown at his memorial. Not because my mom was selfish — she really wasn’t. She just needed so much. And I was right there and the only one to help (trained lawyer to boot = useful for Social Security, estate stuff, you name it). And it just seemed natural to automatically prioritize her needs over my own (husband more important than stepdad). And of course I did the same with my stepsibs on an emotional level (because dad more important than stepdad). All of which resulted in several months basically piling three other people’s grief on top of my own, until I was completely exhausted and the slightest little thing just seemed overwhelming.

    In retrospect, the “wandering for hours at 4 AM” makes so much more sense.

    And then my stepsister (trained family therapist, hallelujah) made some comment about how much my mom seemed to need and said something like “your grief/loss is important, too — how are *you* doing?” Somehow I hadn’t that I even realized what I was doing until she asked such a simple question (so much for self-aware). That, in turn, allowed me to give myself the space that I needed for myself — even when that included basically running away from the “mingling” part of the memorial — and things improved pretty dramatically from there.

  19. “He’s just generally a little pissed at the world for not letting him laze around watching tv all day and then get all the accolades for nothing.”

    Well, to be fair, I’m still a little pissed about that, too.

  20. I haven’t really got a coping mechanism – I just don’t sleep.

    On the bright side, I’m running so much in an effort to sleep that I now have really great calf muscles. So there’s that! :)

  21. Like Fred, delivering the baby that died, and the decisions around that, has been rock bottom for me so far. And I know it was hard on our parents too- my MIL commented that my FIL (who was almost-simultaneously diagnosed with the cancer from which he died a few months later) cried more and suffered more emotionally about our loss than his own grief.

    Going through that helped me understand my mom better during her battle with cancer- we grew apart after my grief because she told me she would have just ignored the situation, and I couldn’t understand that viewpoint until she was diagnosed with terminal cancer and ignored the situation. My Dad made all the decisions about her medical care and kept track of everything. Six weeks before she died, my brother wanted to have his family visit her and she asked them not to come, because she had a weak immune system and one of the kids might give her a bug. Since she said she wanted to live to see her grandchildren, this made no sense to us kids, but I did some reading and came to somewhat understand that denial is one healthy way of dealing with an intractable problem. I probably wasn’t a very good support to my Dad after my Mom died- and I’m not sure he is “supportable”- but his new wife and friends from church were a support, and my Dad isn’t the type of person who wants to receive support from his already-overwhelmed kids and their families.

    Before kids, I destressed by singing hymns, reading Anne of Green Gables and similar familiar books and walking. I’ve never had my faith shaken by bad things, because I’ve always figured 1) Better people have suffered far worse and 2) I’ve never asked “Why me?” but always “Why not me?” This is the advantage to being melancholic. :) After kids, I never have bandwidth to focus on my emotional self.

    I wish the professional world were different than it is, but that isn’t something that causes me emotional angst. I stressed some over schoolwork in college, but was usually able to remind myself that I could retake a class or switch majors as a “worst case scenario.” So far, my kids have been healthy and, since they are little, they still have little problems. (As the saying goes, “Little kids, little problems. Big kids, big problems.”

  22. I like that picture of Hilary. Not easy to be seen in public after a hard loss like that.

    Looking back, therapy would have been useful for me. But it wasn’t and still isn’t an option for most people there.

  23. “She was so angry and depressed that efforts to comfort her were fruitless or rebuffed. As a family our typical response to any difficult situation is to talk less, isolate ourselves more.”

    I’m guilty of that. My first inclination is almost always to isolate myself, even from the ones who love me the most. I’ve learned to move on from isolation to accepting attempts to console and help, but really sometimes I’d rather just go off by myself to lick my wounds. I’m still not sure if that’s healthy, at least not for my relationships with others.

  24. “I like that picture of Hilary. Not easy to be seen in public after a hard loss like that.”

    I read accusations that it was actually a staged photo, but I don’t think many people care at this point. However, I do wonder how much interest in the Clinton family the public will continue to have as time goes on.

  25. I remember a picture of Mitt Romney in Costco shortly after the 2012 election, and he looked relaxed. But everyone was psychoanalyzing it because it was close enough to the election that people were still in campaign mode. Eventually the world’s attention moves on to other things.

  26. I have never suffered the kind of devastation Fred has shared with us. I know this would never be his intention, but after reading his post, I realized I had little to offer on this subject. I have no idea how well I would deal with something like that.

    My relatively minuscule issues have been manageable, at different speeds depending on the specifics, through a combination of long (and sometimes repeated) talks with DH and good friends, exercise and “extreme self care” — I.e., taking it easy by sleeping in or taking time off, etc.

  27. Fred, I can only imagine how difficult that was. It must put everything else in perspective.

    We had a dear friend die not that long ago after a long and brutal battle with cancer. Only in his 40s – so so awful for so many reasons. I had a hard time having sympathy for people who were sad about their elderly relatives who died for awhile after that – kind of a “Are you kidding me, he got 40 more years than my friend!” that was the anger. I’m better with that now.

    I walk, I eat and I’m a turtle. I pull in and sort it out – I deeply resent people who try to come in to my sadness even if it is well intended. Probably should work on that.

    Lark, good lesson for your boy. It is hard to watch character being built.

  28. “He’s just generally a little pissed at the world for not letting him laze around watching tv all day and then get all the accolades for nothing.”

    HM — I think we might share the same 12-year-old son.

    I definitely internalize disappointment and grief. Very much like Moxie’s image of the turtle. This can be a challenge in my relationship with DH, since he is very much someone who wants and needs to share disappointment, grief, and other strong emotions with talk and more talk. I continually have to work on being there for him as a good, active listener when he is dealing with something, and he continually has to work on not taking it as a personal rejection when I want to be alone with my feelings when I am dealing with something.

  29. “sometimes I’d rather just go off by myself to lick my wounds. I’m still not sure if that’s healthy, at least not for my relationships with others”

    It can totally be healthy, especially for your relationships with others, if during those times you might do things that hurt the feelings of those you care about and thus damage those relationships.

  30. “He’s just generally a little pissed at the world for not letting him laze around watching tv all day and then get all the accolades for nothing.”

    Totally ignorant question, mainly for L and WCE, but for anyone else who can add anything:

    What do vocalists practice to become better vocalists? I know that there’s an aspect of strengthening, that it’s hard to go out and sing 3 hour gigs without working up to it, and there’s developing of your ear for pitch, but beyond that, what do you work on?

    I’m familiar with the instrumentalist approach, which has a lot in common with sports practice– there are physical technics that you develop, and then practice over and over to commit to muscle memory. For brass players, I know there’s a muscle development aspect as well, not unlike weight training.

    I suppose my ignorance is one reason I’ve never been a good singer. Perhaps in retirement I should consider vocal training.

  31. “With deaths in the family, I agree that “I’m so sorry for your loss” is always the best thing to say. ”

    Sometimes it’s best not to say anything.

    When I was about 10, a same aged friend who lived 4 houses away lost his dad, which hit him very hard. His cousin, also a good friend of mine the same age as us, told me that they whole family was trying to get his mind off his dad, and one day they’d succeeded, and he was laughing and playing until a well-meaning visitor said that to him. I remember my friend (the cousin, not the one who’d lost his dad; remember that we were all about 10 years old) was just beside himself telling that story, wondering how an adult could be so thoughtless.

  32. “I definitely internalize disappointment and grief. Very much like Moxie’s image of the turtle. This can be a challenge in my relationship with DH, since he is very much someone who wants and needs to share disappointment, grief, and other strong emotions with talk and more talk.”

    Man, this discussion is bringing all this stuff back. I do remember at one point — I forget whether it was after a miscarriage, or after my stepdad died — when my SIL informed me that she was worried about me, because I was bottling all this stuff inside, and I just needed to talk and let it out. And I distinctly remember wanting to hit her. Hard. Because, (a) I am dealing with some serious shit, and I reallyReallyREALLY don’t need a lecture in how I am doing it wrong. And (b) I need to go inside for a while before I even *have* words that I can say to another human being. After my second miscarriage, I was filled with such a white hot rage that I, the English major who writes for a living, literally could not come up with words that even remotely described my feelings. Someone would ask me how I was feeling, and it was like every nightmare you’ve ever had about oversleeping an exam and running to class and looking at a paper that is filled with calculations you have never seen before because you just realized you forgot to go to class all semester. Just, nothing — total blank, coupled with momentary panic at the blankness, knowing you’re completely socially inappropriate but frozen, unable to form and mouth words that mean anything. I needed time in my own head to work through all of that before I could even start to “let it out” with another human person, even one who loved me and wished me the best.

  33. LfB, you are lucky to have a SIL to spot such “support and commiseration” needs in you. No one asked me when I went through my own miscarriages. Maybe I need to look into getting a therapist for all the hurt and anger that has been bottled up.

  34. I’m so sorry for everyone’s losses.

    I’m a lot like LfB – I spend a lot of time trying to process things internally before I can talk about them. And I get stuck on things for way too long.

    I agree that you can’t say anything to someone who is grieving beyond “I’m very sorry” without risking offending them. People say what they would find comforting, but everyone finds comfort in different things. Some people genuinely believe when someone dies that they really are in a better place. Many people don’t believe that.

  35. Dell, therapy is the best! One hour with someone who’s job is to listen to you and not judge. Cannot recommend it enough. A good one can change everything!

  36. How people grieve can be so different that I’m generally at a loss of words because I don’t want to offend. “I’m sorry for your loss” was offensive to my MIL. She hated when people told her that. And in the same family, my BIL hated it when no one acknowledged the loss of his child in the second trimester. It is a damned if you do, damned if you don’t situation. I don’t know what the right response is. My SIL was very open about her grief of losing a baby and was not afraid to say that there was a reason that she suffered the loss and one day she would find out. Two years later my DD received the same diagnoses that was the cause of death of her baby. Without my niece having that medical diagnoses it would probably have been years before DD was diagnosed. Those events solidified my belief that death can have a reason. But I understand that not everyone believes that.

  37. Finn – in general vocal training will help you (1) breathe correctly; (2) breathe correctly; (3) breathe correctly; and (4) place your vocal production correctly in your body, so that you are producing the sound from your diaphragm and not putting undue stress on your vocal cords or other muscles. But IME it is mostly about relearning how to breathe, and as part of that relearning the correct posture in which to sit and stand, like small children who breathe very naturally and hold their bodies very naturally in the correct posture.

  38. @Dell — I am sorry. Honestly, I still struggle with it all. Second the suggestion for therapy, because it is soooo easy to get caught in a mental loop and get stuck.

    The only thing that worked for me — and I say this knowing it may not work for you or anyone else — was one day I just suddenly thought, well, why NOT me? And I found myself listing all the reasons why it was so much better that the sucky all the MC were happening to me than to others — I had the resources (financial/emotional/access) for medical treatment; I could adopt and knew from my cousin’s story that you can create a wonderful family that way; I had never been one of those girls whose whole life revolved around the dream of having kids, so even if we never managed it, I had other dreams to follow; etc. etc. etc.

    I honestly cannot tell you what made that shift in my head. Don’t get me wrong; I am still angry at times, and the whole struggle changed my faith and my perception of things in fundamental ways (not the least of which was spending the ensuing decade waiting for the other shoe to drop). But that one thought that one day — “well, why NOT me?” — got me out of my unspeakable rage and helped me begin to process and work through the worst of it.

  39. I generally expect bad things to happen. My oldest not only lived but has done so much better than what we were told to expect. I feel like I owe the universe for this and it will come back to get me to even everything out. So, the best thing I have found is to just take everything one day a time and to stay busy. And to appreciate what I have right now. Who knows when it all goes to shit.

  40. “I generally expect bad things to happen.”

    I have to concede that’s my attitude, also. Low expectations and all . . .

  41. L, is breathing for singing different than breathing to play a wind instrument, i.e., with the diaphragm?

    Well, perhaps the reason I’m not a good singer is that I don’t have much singing talent, not that I haven’t been trained.

  42. Finn, in addition to the physical part of singing, there’s also matching pitch and reading music. If I were to improve, ear training would be my #1 area of focus, because pitch and harmony are hardest for me.

  43. Finn – I haven’t played a wind instrument, but yes, you do want to breathe through the diaphragm.

    WCE – true, but I find I have less difficulty with pitch when I am breathing correctly. Sight reading I just kind of take for granted, my bad. ;)

  44. WCE, I know how to read music (I’m a great page turner for accompanists), and going through violin lessons and practices with the kids has helped my pitch.

    My problem is knowing what note I want to sing, and when, but not being able to sing it.

  45. Finn – sounds like you might need some pitch matching exercises then. Can you sing along to songs on the radio?

  46. L, yeah, as long as the range matches mine, which is not very often.

    It’s like I’ve got a gap between my normal voice range and falsetto range.

  47. Finn, that is normal, esp if you are a baritone or bass. Tenors can often go up fairly seamlessly and have their full voice range overlap their falsetto range, but if you are a baritone who can sing full voice up to middle C, for example, your falsetto may not produce easily below an F above middle C. You can (up to a point) train the full voice to produce a few notes higher and the falsetto lower.

  48. L, I have no idea if I’m a baritone or tenor or what, although I don’t think I’m a bass. My normal speaking voice isn’t very low, but my non-falsetto singing voice is lower.

    When everyone at the school assemblies sings a song together at the end, or when we sing Happy Birthday, I’m often singing an octave lower than almost everybody else because otherwise I can’t hit the higher notes, but singing an octave lower, I can’t always hit the lower notes. It’s kinda like my ideal range is about half an octave lower than what most others want to sing.

    It’s also like I just have a limited range.

  49. L, what really bugs me is when I hear someone with a great voice– full tone, good range– try to sing, but out of tune and with no sense of rhythm or timing.

    I guess the combination of a great voice and the musical ability to use it well is quite a gift.

  50. Finn, I’m a second alto who can also sing first tenor- I can hit pitches down to the E below middle C. This was useful when church choir had no tenors, so a baritone engineering professor and I shared the tenor part. He could hit everything below middle C and had little problem covering the low C’s and D’s I couldn’t hit.

  51. Personally I do the same, I walk our I garden, either clears my mind and cleanses me. The fresh air, time to think and just keeping busy with things that bring life and not take out away helps me

  52. “I can hit pitches down to the E below middle C.”

    What key are voices? E.g., you have B flat clarinets, E flat alto saxes, flutes are usually C instruments, F horns, B flat and C trumpets, etc. I think pianos are C instruments, as are violins.

  53. It’s that time of year again, so can savvy totebaggers just confirm for me that if at least one member of a family has high annual medical costs ($25k or so per year) a high deductible/HSA type of health plan is usually not the best choice? (Other options include lower deductible plans with yearly caps on out-of-pocket spending.)

  54. ^ I guess checking that the difference in premiums doesn’t tip the balance in favor of one or the other would be main consideration.

  55. ET,

    Have you run the numbers? Usually, the high deductible plans are not the best option for those who have expensive and ongoing chronic medical problems.

  56. ET – in my experience (annual medical costs with the insurance rate taken into account is over $30k) the HSA is not saving us any money. It does depend on what your annual maximum out of pocket is. For me, I can’t save enough HSA dollars to bank any to roll into following years (so the idea that this money is an investment vehicle doesn’t work). The former PPO plan was significantly cheaper on an annual basis. If we didn’t have high medical usage the HSA would be fine.

  57. In general, a Cadillac plan works well if you have frequent appts and or expensive medicines . Co-pays are much lower, tier 3 and up drugs cheaper, and the deductible clears quickly. It usually covers many more providers at favorable rates. As an individual over 55, I never hit the 2k deductible on my plan and could set aside 4200 in the so that was a no brainer for me.

  58. It does depend on what your annual maximum out of pocket is.

    This, and the cost of the premiums. We usually have very high expenses, so I do the calculation of the out of pocket max plus the premium cost, and the high deductible plan always comes out as the cheapest. I use an HSA just to “launder” money for the tax deduction, because our expenses exceed the maximum contribution.

  59. The HSA works well for us, but in reading what some of you have for premiums and o-o-p maxes I can see why going with the more traditional higher premium, lower co-pay/deductible might work out for you.

    (to refresh and understand my viewpoint: for 2017 my HSA monthly premium is $28 with a $2600 in-network – and everyone is in-network around here – family deductible; $6000 annual o-o-p max. The other option is $384/month with a $1000 in-network family deductible; $5000 o-o-p max.) So if I max out the HSA = $6336 and the other plan = $9608. Seems like a no-brainer. I just contribute the difference in the monthly premiums to my HSA.

  60. These discussions always remind me how lucky I am — I have full coverage for myself scott-free in a PPO with many local participating providers, a $20 copay, and full prescription drug coverage (though some of the drug copays have increased over the past few years). DH has Kaiser for himself and the kids for, IDK, $700-800/mo?? But again, cheap copays, seamless coverage; I think DD’s foot surgery cost us $40, and DS’s broken finger should be the same.

  61. I’m thinking that a high-deductible plan is best suited for someone or some family with a history of good health and low medical expenditures, and is more like true insurance against an expensive, unforeseen issue.

    For those with chronic, expensive conditions, whatever plan they get would seem to be less of an insurance plan and more of a health care financing plan.

  62. For those of you with high deductible options, I’m curious if any of them is something like a PPO that gives you in-network access at negotiated rates even when you don’t hit your deductible.

    I’m also curious if out of network payments count directly against your deductible. A plan that had this feature might make sense for someone like Mooshi, who’s having a hard time finding a provider for a specific issue who takes insurance.

  63. Finn, our HD plan is a PPO and we pay the negotiated rates at all times. My understanding is that is how they all work, but I could be wrong. And we have an out-of-network deductible and out-of-pocket max that are separate and higher than the in-network ones, but there is still a cap.

  64. “I’m also curious if out of network payments count directly against your deductible. A plan that had this feature might make sense for someone like Mooshi, who’s having a hard time finding a provider for a specific issue who takes insurance..”

    The problem I’ve seen is that those out of network specialists charge fees way beyond the “usual and customary” fees used by the insurance companies calculating deductibles. For instance, a o-o-n elite doc may charge $500 for an office visit that the insurance company will only pay a max of $100. So that extra $400 is totally on the patient, and will not be used to figure deductibles.

  65. “So that extra $400 is totally on the patient, and will not be used to figure deductibles.”

    Can HSA funds be used to cover that extra $400?

Comments are closed.