It’s the beginning of a new year and the television waves are gluttonous with meal-delivery diet commercials. Each company is trying to outdo the competition by showing slim, smiling models eating calorie and fat-laden foods like pizza, cheese curls, pasta, muffins, French fries and even burgers (probably sprayed with a zero-calorie lube to make them appear greasy). The models appear so satisfied that you almost believe they had just finished chowing down on a Philly Cheesesteak instead of the low-carb version of a baked potato. In fact, the only foods missing on diet program commercials seem to be what you actually should be eating more of: fresh fruits and vegetables!

I have never tried a dieting program. In fact the closest I ever came to doing so was during college when I would sneak into “The Cove” snack shack for a Slim-Fast Meal Replacement Bar in between classes. I mistakenly thought these bars were snacks because the flavor was chocolate chip cookie dough, and also because they were just enough to hold me over until an hour or so later when I could go home and cook lunch or dinner. Thank goodness I was too busy using up energy and burning calories by doing things like taking 22 credits in one semester while working part time; otherwise these meal replacement bars probably would have contributed to the “Freshman 15”!

Despite having never tried a diet program, I am curious about the cost involved and think it is important to share my research because I know many others are trying to sift through all of the information to figure out whether or not they should try a diet program. What I have found is that there are so many options out there that it is hard to find the differences between each program. If certain programs are going to charge much more than others, I think we should all compare to find out if the extra cost is truly worth it. For the sake of this article, I established a cost for one person to be on the plan for three months because I think a person will probably need to be on a diet program for at least this length of time in order to make the lifestyle changes they need to achieve their goals.

The programs I chose to compare are listed below from the most expensive to the least expensive.

Meal Delivery Program Cost Comparison

• eDiets.com: This program allows you to choose from 15 different online meal plans with customizable menus. The food is supposed to be freshly prepared and does not include powdered, artificial, or freeze-dried meals. One week of meals (7-day plan) is $169.95 with every third week free for a total of three free weeks over a period of three months. The five day meal plan is $139.95 with a comparable free week program. Over a three month period, the total cost would be between $1,259.55-$1,529.55 (taking free weeks into account). Another option with eDiets is the Biggest Loser Meal Plan. This plan costs $178.60 ($153.65 weekly plan + $24.95 weekly shipping) for the 7-day base plan, and $144.70 ($119.75 weekly plan + $24.95 weekly shipping) for the 5-day base plan. Total cost for three months would be between and $1,616.65-$1,989.55 (this takes into account one week of free food, but you have to pay the $24.95 shipping costs for the free week). To sum, the cost for three months is between $1,259.99-$1,989.55. It should be noted that while this is the most expensive of the diet programs, unlike the other two meal delivery programs below you do not need to purchase groceries for yourself to supplement the delivered meals.
• Jenny Craig: This program offers meals as well as a partnership with a personal consultant. You pay for your food and an introductory promotional amount of money (sometimes it’s $20 for 20 lbs., and sometimes it’s $1.00 for all the weight you want to lose). While I cannot find any information on the Jenny Craig website about prices for the food and program, I found someone who has posted the Jenny Craig Price List for 2011. Someone also posted the price list on the Jenny Craig Forums, dated April 2011. How much you will actually pay is up in the air, but many sites claim it is between $14-$19 per day for food. I took the lowest costing breakfast, lunch, and dinner entrees from these price lists and found that I could pay $11.57 for one day for the following food: a Honey Oat Bar or Oatmeal Breakfast Sandwich, a Broccoli and Cheese Potato for lunch, and a Beef Chili with Beans for dinner (no snacks or desserts included). Other sites say the cost is approximately $500 per month. If we take the low end of this estimate, then over three months this would cost approximately $1,500. This does not include supplements to the diet like fresh fruits and vegetables, whole grains and reduced-fat dairy products.
• NutriSystem: This diet program offers portion-controlled meals in microwave-ready packages. Counselors are available over the phone and a guide is sent to the home; however, this program does not appear to be as hands-on and personalized as Jenny Craig’s program. On the internet people have estimated the cost to be around $11 per day for food; however, on NutriSystem commercials they are stating it is approximately $9 per day for food. A Wikipedia article states that as of July 2011, the cost per month was between $279.99 and $339.99,which does not include additional grocery items you must purchase (fruits, vegetables, dairy, meat, etc.). A three month estimate would be between $839.97 and $1019.97. At $9 per day, the cost for three months would be $810.00.

Meetings in Person

• Weight watchers: This program does not provide food, but rather accountability, meetings, and the PointsPlus® 2012 system. There is a registration fee as well as a weekly meeting fee (it should be noted that the $20 registration fee is being waived until March 24, 2012 in many areas). The weekly meeting cost varies by region; in Houston it is $13.00 per meeting if I pay as I go, or $11.41 per week for a 17 week pass ($194). You can also purchase a monthly pass for $42.95 that includes unlimited meetings and FREE access to eTools, the Internet weight-loss companion that has interactive tools, tips and recipes. You could also get lifetime membership status after meeting certain goals which entitles you to free meetings for as long as you maintain certain weight requirements. Approximate three month cost of this program is $128.85-$156.00.

Online Dieting Communities

• Weight Watcher’s Online: This site offers all of the materials and information for the points program online, as well as access to recipes, tracking/charting of points via a mobile phone, etc. The cost per month is $18.95. Total cost for 3 months is $56.85.
• eDiets.com: If you don’t have the money for the meal delivery program above, you can join the eDiets Online Diet Plan for $18.56 per month. This community offers personalized meal plans and shopping lists, a live dietitian for help, a fitness trainer to assist in a customized training program, recipes, etc. Total cost for 3 months is $55.68.
• South Beach Diet Online: This site offers a customized meal plan, over 1,000 recipes (here is a sampling of the recipes), tracking of your weight/phase/diet goals, and 24 hour online/community support. You can check out a review by US News. The first 7 days are free, then after that it is $5 per week. Total cost for 3 months is $55.00.
• Atkins:  Atkins offers a free online community with recipes, tips, body mass index (BMI) calculator, meal plans, etc. Total cost for 3 months is $0.00.

Even though people tend to swear by one program or another, I think you can probably succeed on any of the programs if you truly put in the effort and change your diet/exercise habits. Still, we each have to find what works best for us. Financially speaking, many of these programs are too cost prohibitive to even be an option; think about it, if you choose a meal delivery program not only do you have to purchase up to $1500 worth of food for yourself over three months, but you also need to continue to purchase normal groceries because the other people you live with will most likely not be on this diet with you (and if they are, multiply the cost by two).

Honestly, I think the meal delivery costs are staggering and have started to wonder if getting premade food sent to your home is comparable to hiring a personal chef to come to your home and cook several freshly prepared and healthy meals per week for your entire family. In Wednesday’s article I am going to discuss how to save money on diet programs and some frugal alternatives that, with some motivation and follow-through, should get you to the same destination at a fraction of the cost.

Other Articles You May Enjoy:

Online Workout Programs that Rock
My Husband Hired a Personal Trainer
Week 6 Weigh-in: I Hope My Christmas Meal Doesn’t Come Back to Haunt Me
My First Run at Thirty…Working Out Goals

I’ve been ignoring text spams on my phone for too long. It started out with just one text spam out of the blue that I quickly erased. Then I began seeing them every other month. Now I am receiving text spams about once a week. The most recent one was from Sender 42227 and read, “Official Reward Notice: claim your $1,000 Walmart gift card at www.hyprdrct.com/r/?s-1449&a=206798 Keep GAPC txt act active.txt stop 2 end”.

Aside from the nuisance of having these spam messages in my queue, the most annoying part about these spam messages is the feeling that each time I receive an unsolicited message it might be costing me money ($0.10 here, $0.20 there). I finally called my cell phone provider last week to discuss my concerns with them, and found out that there are far greater concerns than the ones my mind had conjured up.

Are Spammers Allowed to Text You By Law?

In March 2005 the Federal Communications Commission (FCC) adopted rules that prohibit sending unwanted commercial email messages to wireless devices without prior permission. However, this ban is only good for messages sent to cell phones from internet domains. Short Messages (SMS), which are messages sent from one cell phone to another, are not covered by this ban. You can see where this is going—instead of a company sending you a spam text from @ronniespaintshop.com, they now are sending them to you from 48888.

Spam Texts Could Cost You Money Even with Unlimited Texting Plans

Here is where I was very surprised. I assumed that if you have an unlimited texting plan that you will not be charged extra for text spam. After all, it shouldn’t matter who is sending you texts with an unlimited plan. A Verizon Wireless representative confirmed that with unlimited text messaging plans you are, in fact, not charged per text that you receive. She clarified that if you do not have an unlimited text messaging plan then the cost for Verizon customers would be $0.20 per text.

However, the representative discussed another way that many people with unlimited text plans are charged anyway: most of these companies have you opted in to their service without any effort on your part.  Simply by receiving their text and with no further action from you, your cell phone bill will reflect this charge (typically $9.99). The representative I spoke to said that your “permission” was given somewhere along the way, but that many times it is without you knowing. Sneaky! Specifically, she said that this could be from putting your phone number on Facebook (which I have not done). The representative also explained that these types of messages where there is an option to purchase or subscribe by a third party vendor are called “Premium Messages”, and are delivered to your phone via a Short Messages (SMS). You’ll know you have received one because they look like the one sent to my phone above and are sent by Short Codes with four, five or six-digit numbers.

Fortunately for me, the representative checked my bill and I had not been charged.

How to Get the Messages to Stop

The good news is that you can stop the spam text messages from coming to your phone. The first and easiest step to take is to reply to the sender with either “stop”, “quit”, “end”, “cancel”, or “unsubscribe”. This may work; however, companies generally have more than one short code and so they may just start texting you again with another short code.

A more effective way to stop these premium messages is by calling your wireless company customer service and asking them to block premium messages with short codes from coming to your phone.  If you were charged and did not want to be, take the time during this phone call to have them deduct these charges from your bill (this is at their discretion).

Personally I think it is a bit outrageous that companies can opt you in without you doing anything to warrant this. It could be argued that you did, infact, opt-in to these companies. But if you cannot remember doing so (and the representative said that many consumers cannot remember doing so) then there is something wrong with this system. Fortunately for me I was not charged, even though my cell phone provider was more than willing to check my bill and reverse any charges.

Has this ever happened to you? Were you charged, and was your cell phone company willing to reverse the charges?  

Ever since I boarded a plane for the first time as a sixteen year old foreign exchange student headed to Burgos, Spain I have been in love with flying. Perhaps it is because there is nothing else to do once you board the cabin but to sleep, read, write, or relax. I get to turn my cell phone off for several hours, power down the laptop, and since I always choose the window seat I need only look to my left or right for one of the most splendid, majestic views in the world.

My flight to Spain was about 12 years ago, and since then, airlines have severely cut back on in-flight services. While you can still find the occasional blanket and pillow (though the H1N1 virus nixed many of those), flight-brand magazine, soda and a small packet of peanuts, finding anything else is going to cost you money.  Continental is the most recent airline to drop even the complimentary token snack with beverage, something American and US Airways have already cut (to be honest I usually do not eat the peanuts and/or cardboard-like crackers).

I fly several times a year, and have never once purchased anything from inside of an airplane. I’ll pack a granola bar, purchase a slice of pizza, or raid the convenience-type store snack aisle at the airport, but I avoid purchasing food and drinks inside of the airplane at all costs. Because of this, I thought it would be interesting to see how much it would actually cost for me to purchase drinks and food onboard, and also what quality and quantity of food I could purchase for $5.

The chart below is based on flying economy class on a domestic flight (typically including Hawaii and Caribbean). My research shows that most airlines (excluding Southwest) offer an array of expensive and ‘inexpensive’ food offerings (remember you are thousands of feet in the air), and that American Airlines and Continental/United offer more expensive options than others. Wine and cocktails are most expensive on Delta, American Airlines, and Continental, while AirTran even charges for water, milk and premium juices (these are offered as complimentary on other airlines).

In order to compare the airline pricing further, I decided to see which airline would give me the most value for my $5 (please note that the products listed below are only offered on certain flights and at certain times of the day). What I found is that I certainly will not get full from any of the airline’s menus if I only want to spend $5. Also, for $5 there are very few healthy snack options (other than nuts, cheese, and dried fruit).

Do you purchase in-flight food and drinks?

Part of the Yakezie Carnival: Goals Edition.

Have you ever made a purchase that was either useless, something you could have gotten for a lot cheaper and perhaps didn’t know it at the time, or deemed worthless some other way and your window of opportunity for a refund had passed?

This list encompasses those purchases where, if you had been around me, I exclaimed a Homer Simpson “D’oh!” after making them. In fact, while you are reading this list go ahead and make that “D’oh!” sound after each in your own head; it’ll add to the experience.

1. Two car tows in the City of Houston. Cost: $400.00
2. Lug nut replacement after stripping it when Paul changed our two flat tires (we could have replaced it ourselves for much cheaper, as the part only cost $5.00). Cost: $29.99
3. Two plastic birdfeeders that the birds/squirrels ate large chunks out of. Cost: $20.00
4. 4 new stovetop things (they were ruined within a month of purchase): Cost $12.99
5. Several pieces of PVC piping (hooking up our own plumbing in the laundry room sink we replaced). Cost: $20.00
6. Phillip’s Sonicare Toothbrush (Paul purchased this without coupons, ExtraCare Bucks, sales, etc.; we could have gotten it a lot cheaper). Cost: $127.00
7. Cancel fee after the volcano erupted and we couldn’t go on our honeymoon: Cost: $122.
8. A shirt specifically for the bridal party fun that I literally lost in all of the happy chaos of a wedding (still have not found it to this day). Cost $8.00.

Total: $739.98

What is the great news about all of this? In my first ever “Stupid Money Spent” list I made in 2009, I wasted a huge total of $1,132.39. This year, I managed to waste much less.

Is there any money you wasted in 2010?

In a nutshell, Austria was expensive. We truly enjoyed our time there (photos are up on my Frugal Confessions blog), and most importantly, our time together, but some of the costs incurred were quite surprising. I’d like to share them with you here in case you are planning a trip abroad.

1. Luggage Fees: Perhaps I should not be surprised by these, but since I always fly Southwest, it was particularly off-putting to pay $100 in checked bags fees ($50 each way). Ouch.
2. Mandatory Cloak Room Fee: At both of the concerts we attended, we were forced to check our coats and backpack. You would think this would be a free service since we did not have a choice, but in fact we were charged €1 for each piece.
3. Airport Storage Fees: When we arrived in NYC and were faced with an eight hour layover, we decided that we would store our luggage in lockers and head into the city. The only luggage storage available was through a service company and we ended up paying $30 for 5 hours.
4. Internet: At our first hotel the internet cost €3 per half hour. A great reason to stay off of it…Thankfully it was free of charge in the conference room at our second hotel.
5. Charge to Use the Bathroom: At one of the Christmas Markets, we were charged €0.50! By the way, I detest charges to use the bathroom.
6. Excessive Taxes: One of the restaurants that we ate at actually broke down the taxes at the bottom of the receipt. There were three of them; two were for 20% each, and one was for 10%.
7. ATM Fees: Our bank actually charged us $3 per transaction at a foreign bank instead of the normal $2.00. Yuck.
8. Post Handling Charge: It was great when we found out that our second hotel had a mail service. Unfortunately, on top of the postage fee, there was an extra €10 fee. Instead of spending this, Paul found a post office and mailed everything off for us.
9. Water: Every restaurant brought us bottled water in glass bottles instead of just tap water. I suppose the tap water was not good enough to drink? (This is for mineral water, not sparkling). Nevertheless, we shelled out an extra €3 per meal for one bottle of water. And what a waste of bottles (though I am sure they recycle them).

One other surprise with finances was the lack of credit card acceptance. Many places did not accept them but kindly showed us where to find an ATM (hence all those $3 fees). The places that did accept them would deny you credit card use if you spent less than €10. We left many a shop and restaurant because they would not accept credit cards. While I can understand that these stores and merchants did not want to pay the high credit card fees, it was quite the nuisance for us as we had not adequately prepared for this (the tour books all said that most places would accept credit cards).

Featured as a Carnival of Money Story.

We don’t own many clothes. While this may be clear to others upon first entering our sparse walk-in closets, I only recently realized this while packing for our 12 day trip abroad. Turns out that I don’t just enjoy doing laundry like clockwork on Friday mornings, but I actually need to do laundry on the same day weekly, lest we be without clean clothes! We are not dire when it comes to clothes, but this issue was certainly exacerbated by the fact that we live in Houston and so we don’t have vast winter wardrobes; if it had been a trip to the Caribbean, we could have probably gotten through a week and a half without laundry machines.

By Thursday of the first week in Vienna, just six days into our trip, it became painfully obvious that we would need to do some laundry. Fortune had it that our hotel offered a laundry service which was perfectly convenient as we were getting ready to go onto the second leg of our trip for a five-night stay in Salzburg and we wanted to have everything sorted out beforehand. I figured we’d pay $20-$30 for the service, and had mentally made peace with that amount. When Paul came back with the cost sheet broken down by piece of clothing, I was shocked. I was so shocked, in fact, that I decided to go through our mound of laundry to tag and categorize each piece and figure out how much our tab would be if we had been stupid enough to take advantage of this service. And let me tell you, it was staggering enough to bring even the most exquisite Vienna Christmas Market to a screeching halt.

To give you some perspective on how terribly off my estimate was—and how crazy our hotel was—my bras alone would have cost us €18 ($23.73).

The total for everything? €229.80, or approximately $303.03 U.S. Dollars. Even on our honeymoon, we simply could not justify this cost (we could purchase our own washer and a rope for drying for that amount).

Instead, Paul shoved our dirty clothes into his suitcase and walked about three blocks away where he paid (and this is still shocking) €19 or $25.05 for two loads of laundry.

Needless to say, we have a new appreciation for our washer and dryer at home and for US Laundromats in general.

Charities have taken quite a hit in the last few years. As American’s wallets became more and more pinched, donating to the Salvation Army at Christmas time or to the food bank became a luxury item. What is the result? While alcohol consumption remained largely unchanged throughout the recession, charitable donations decreased by 3.6%. On top of this reduction in donations, demand has spiked.

Nonprofit organizations and charities are in quite the pickle. And just like the airline industry has people working ‘round the clock to figure out ways to squeeze money out of us in every possible way (like playing a movie and then charging $2 for the only type of headphones that fit in the oddly shaped socket), I am getting the feeling that charities are doing the same in order to survive.

Enter the “forced donation”. A donation by definition is something that you willingly and voluntarily give to an organization, a cause, or a person. But what happens when in order to make a purchase, you must donate money? Can it really be called a “donation” anymore?  Let me give you an example. Several months back several organizations within Houston sponsored an event where you could purchase a composter or rain barrel for half the price of what you could find on the market. You had to come downtown and stand in line, and it was for as long as supplies lasted. The good news was that you could order one ahead of time and be guaranteed whichever you wanted; however, the organization that gave this service added a $10 donation to the tab. I called the organization, which referred me to the city of Houston, which referred me to the mayor’s office…and there was no way around the $10 donation (not sure why they referred me to the Mayor’s office…I am sure she has much more important things to worry about). In this case, the organization was offering a service to me that they could have legitimately charged for. However, they chose to call it a donation without giving me the option to opt-out.

And this is not only occurring within organizations; what about the homeless man on the corner with his bucket of water and squeegee who washes my window whether or not I want him to? The idea is not that I am donating money to him, but rather that he has rendered a service and I now owe him money. After all, my windshield is clean.

If I purchase something at a normal price and some of the proceeds happen to go to a charitable organization, then that is a win-win-win transaction—for the consumer who purchased the product they wanted, for the nonprofit which received a donation, and for the store which moves inventory. This occurred last summer when I took Paul out for a birthday dinner at a fancy restaurant which was taking part in a citywide night for charity. Not only was part of the proceeds from our dinner going to help the Houston Food Bank, but the restaurant further enticed customers by offering a three-course meal at a discounted price. This also occurs for National Breast Cancer pink products where the products are typically normal cost, and so I choose products in the pink packaging versus their normal packaging. But if I wish to purchase something and there is a forced additional fee that goes directly to a charity, then I feel I am being forced to donate.

Here’s the thing: I am very supportive of charities and greatly appreciate the social work that they do and the need that they fill. But I want to be in the position to choose who I give my money to without feeling guilty, intimidated, or otherwise put into a situation where I am being forced to make a donation.

Are there times when you have been forced into making a donation, perhaps literally, or because you have felt obligated or strong-armed into it?

Articles Around the Web You May Enjoy:

Donation Requests at the Checkout Counter Annoy Me
Donate? Humbug! 8 Reasons Why My Favorite Charity is Me
Why You Should Donate More Money to Charity
One Casualty of the Recession: Charities
How to Donate Your Used Car
Make Your Charitable Contributions Before Year End

I am a pretty decent tipper at restaurants. When I do go out (admittedly not often) I tip 20% so long as the service is decent. If the service is subpar—really subpart—I might go 10-15%. But the other night I walked away from a transaction with a slightly sour taste in my mouth, and I’d like some opinions on the matter.

While my family was in town Paul and I wanted to take them out to a really nice restaurant. After two days of putzing around the city we were exhausted, and so when dinnertime came we decided to get takeout from the restaurant where we were originally going to eat. I put the order in over the phone, and it came to a total of around (brace yourself) $130.00.

About 25 minutes after ordering I was on the road to pick up the food, my mind racing back and forth about what to do with tipping. Still undecided, I pulled into the takeout area in the parking lot and put my vehicle in park. About ten minutes later a hostess came out and I gave her my credit card, smiling. After she ran it through her machine inside and came out with the receipt, I sheepishly asked her, “So do people normally tip you 20% like they had actually eaten in the restaurant?”

She replied, “Yes, they do. But you can tip whatever you would like.” Well, at that point I felt the pressure and with a quick signature I tacked on 20% to the bill. She put the food into the back of my car for me, and I drove away.

So what do you think? Technically the hostess provided the following services (someone else took the actual order when I called it in):

• Took my credit card from me and paid inside so that I wouldn’t have to get out of my car
• Brought my food to my car and put it in the back seat
• I’m sure she coordinated with the kitchen

Does that warrant a $26 tip? Perhaps she split the tip with the guys in the kitchen who, admittedly, deserve it much more for actually cooking the meal. Did anyone here work in the restaurant industry, and if so, how would you have handled this situation?

Other Tipping Posts You May Enjoy:
Are You Familiar with Tipping Etiquette?
Don’t Feel Guilty About Tipping Your Server 15%
Deep Thoughts on Tipping

Amanda’s Note: Do not shop around if you have an emergency. Shopping around is a luxury for procedures where you have a few days to a week at least to do some investigative work. Your health is your number one asset in life, so please be responsible with it.

                In the beginning of August my sister went into the hospital for severe pain. She thought she had gallstones—my mother is a nurse and the two of them settled on this diagnosis from the symptoms—and tests at the hospital confirmed this. Her gall bladder needed to be removed through surgery. The only problem is that she didn’t have health insurance, and she hadn’t had it for over two years. The tragic side to this is that she just recently had enough hours at work to be able to sign up for her employer’s health plan, and her benefits and coverage period were set to begin…on September 1, 2010.

                Her initial reaction was to live through the pain and hold off on the surgery until her coverage was set to kick-in—just 26 precious days away—but a few days after the initial hospital trip her skin turned jaundice and she began to have more complications. She ended up back in the hospital, and thank goodness she had enough sense to do so: a rather large gallstone was blocking her bile duct to her liver, causing her liver to stop functioning. The first surgery was to remove the large gallstone, and the second surgery was to remove her gall bladder. She is now healed and waiting on the arrival of her medical bill.

                We’ve all seen those news stories in the last year or so when the newscasters compare pricing at hospitals for various surgeries. I watched these stories and was shocked to learn that rates for things like surgeries and giving birth vary from doctor to doctor and hospital to hospital; I thought that the going rate for a broken leg was set by some random standard, regulation, or hospital agreement. I was also initially horrified at the idea of shopping around for a surgery like price shopping for salami. And then something happened to me. I went to a new dentist here in Texas and since I have never been to a dentist in Texas, by state law I had to have two consultations before they were able to do a cleaning. The first came with a $35 copay, and I assumed the second would be the same. During the second visit, the woman behind the glass said “$75”, and I winced in pain. I asked why she had not informed me that my second consultation’s copay would be so much more. And then something shocking happened—she said “I can take the price down to $50, but that’s as low as I can go”. I thanked her, closed my mouth, and got out my check book.

                 In light of my sister’s plight and my recent experience of being offered a lower price at a doctor’s office, I decided to try shopping around for surgeries for myself and see if it is worth it. I do not have a Inguinal hernia (nor can I pronounce it), but I wanted to choose a symptom that was benign enough to not excite people on the other end of the phone (I had visions of nurses screaming into the phone to get into an ambulance and get to the hospital right now while I was trying to price out a ruptured spleen or a burst appendix), and that was common enough that I could do the research.  

All of the prices below are based on the same type of surgery: laparoscopic inguinal hernia repair. But as you will quickly see, the prices vary greatly.

Comparison Prices in Houston

The Houston Hernia Center offers a low cost option for people without health insurance on the following hernia operations: Inguinal, Umbilical, Epigastric or Incisional Hernias. The cost is $3,900-4,900 per hernia with no complications. This price covers the surgeon’s fee, anesthesiologist fee, a State Certified Ambulatory Surgical center, mesh materials and the outpatient fee. At Riverside General Hospital, the same surgery (groin or abdominal) comes in at $16,100, and at the Kelsey-seybold ASC, the same surgical procedure is just $5,400. At Park Plaza Hospital the procedure will cost you $8,500. (Prices above are estimates provided by New Choice Health and/or phone conversations).

The most interesting conversation I had was with a financial counselor at Memorial Hermann Hospital, who said that the contracted rate for this surgery with my health insurance company, Blue Cross Blue Shield, was $1,991. If I were paying for the surgery on my own and paid in full the day of, the cost would be $3,800. If I did not pay in full, the cost would be $8,900. I was shocked! I asked this woman why on earth they would charge so much more to an individual with no health insurance than to a health insurance company, and basically she said it’s because that is what the health insurance company was willing to pay. And can you imagine the law that allows a hospital to tack on $5100 if you choose to finance? Most furniture stores that I’ve seen commercials for offer 0% financing for the first year on the agreed upon price that you leave the store with…could you imagine coming home with new leather sofas and finding out right after you child dropped juice on them that now they will cost you an extra $3,000?  

Hernia Operation Abroad: Medical Tourism

Would you consider having an operation done in Poland? I would probably pass. However…what about Belgium? According to healism.com, a hernia repair in Belgium within the next 1-3 months would cost me between $410-$500. The same surgery in Mexico goes for about $340-$410. For a top-notch Bumrungrad hospital in Thailand, the cost is between $3,616 and $5,397. You will also have to add in the cost of travel, food, and hotel rooms for this option.

Insurance Considerations

I also called my personal insurance company to get the lowdown on pricing and my part of the bill. My healthcare is Blue Cross Blue Shield, and my copayment would $150 per day (if the surgery is inpatient), as well as 20% of the bill. You can quickly see why it would be in the favor of someone with insurance to shop around as well; 20% of $16,100 ($3,220) is a lot more than 20% of $5,400 ($1080).

In Conclusion: Shop Around

From what I gathered while doing the research for this article, it is not common for patients to ask pricing in advance. Yet it is in your favor to do so as the price differentials can be startling. If you have an upcoming surgery—inpatient or outpatient—that you would like to price, start by visiting New Choice Health to get some estimates. Call around to several hospitals, clinics, or centers and ask to speak with the billing department or a financial counselor to get some cold, hard dollar amounts. If you have health insurance, you will then want to speak with a rep from your health insurance company to find out what your copay and coinsurance rates will be. For those without health insurance, you can work with hospital financial counselors and bill payment centers to set up a payment schedule, and/or apply for Care Credit. In fact, it may be in your favor to have a loan through Care Credit (0% financing) before having the surgery so that you can pay in full the day of and substantially reduce your bill. Emergency insurance applications are available as well—talk with the hospital that you are having the emergency surgery at.

             A final thought: my health insurance rep informed me that health care surgeries and procedures are cheaper outside of city limits, which is something you may wish to keep in mind when trying to save money.

Read the original Timeshare Story, as well as Timeshare Part 1 posted earlier this week.

Talking with the agent from Casablanca Express was a little like the folk story of Stone Soup. Here’s the synopsis: a hungry foreigner comes upon a village with only a pot and no one will share their food with him. So in order to feed himself, he declares that he will make the most delicious soup from water and a large stone. One by one a villager passes by, and he declares that the soup tastes fantastic, but needs something else…like garnish, seasoning, onions, etc. And one by one the villagers give him the ingredients, mostly because they are curious at the foreigner’s ability to make soup out of a stone. This goes on and on and on until he has a complete vegetable soup…with a stone in the bottom. Everything was supplied by the townspeople and nothing but a stone and water was supplied by the foreigner…and yet the people walk away amazed just the same.

                Let me tell you, once I figured out that I was helping the Casablanca woman make a stone and some water into vegetable soup, I put a stop to her shenanigans. I was particularly impressed with all of the sneaky ways she and Casablanca Express had concocted to get me to basically pay for the trip myself while simultaneously trying to make me believe that we were getting a free deal. In a moment of true spite, I almost accepted the original deal (option # 1) just to make them pay for everything and to show them that I was not like other people (who supposedly 99% of the time turned it down once they saw what they were getting). Hey, it would have made a great article, right—truck stop gambling extraordinaire?  

My Initial Decision         

I decided to pay for our own airfare and get the upgrade to a hotel on the strip. It still didn’t feel right to me, but Paul’s birthday was coming up and I had to make a decision. I just so happened to have a free airfare reward with Southwest anyway, so I would just be paying for his ticket. The rep booked us for the Riviera on the strip, gave us a Las Vegas discount  card (which accounts for all the buy one get one free offers on restaurants she had told me about—undoubtedly a free promotion they have with a partner), and said that we would get an $82 refund from our $100 upon checking in at the hotel.

Our Final Decision          

But then…I looked at the hotel we would be staying at and found that during the weekdays any person could book it for just $27 a night. I looked up the discount card and found that it was super cheap as well. I had just let these people get away with paying something ridiculously cheap like $70 for our 3 days 2 nights all expense trip to Las Vegas. I felt shammed!

Paul’s birthday was on August 6^th, so I gave Paul his gifts. One of them would have included the Las Vegas trip, except that he kept pestering me with the details of the trip leading up to his birthday and when I finally broke down and told him everything he said “get our money back, babers!”

I called the woman back from Casablanca and asked for a full refund of our $100. She obliged. Case closed. Las Vegas we will see you another time.