tracking medical expenses

Hi,

    I'd like suggestions on how to track the total medical expenses. Currently I have some number of categories that describe the medical expenses I pay. But I'm missing the discount and the amount my insurance pays... for example if if I have a doctor visit and the doctor bills $300 for the visit, but my insurance gets a discount of $200 and the pays the doctor $50, I end up paying the doctor $50. So it it's easy to track the amount of money I paid the doctor ($50), but I like to be able to track the gross amount of the bill and the discount and the amount the insurance paid. As it is now, I only track the amount I'm responsible for. 

   Why do I want to track this in quicken ? Currently I can track what I am paying my employer for health insurance and my employer provides via my W-2 the amount they paid, so I know the amount of the insurance cost I and my employer are paying... But according to my insurance company this year I was billed for roughly $85,000, they got a discount of roughly  $66,000 and paid roughly $12,800 leaving me with a balance to pay of roughly $6500 that I get to pay. I can track these amounts outside of quicken (total billed, amount of discount, amount insurance company paid),  but it would be nice to look at one place to get these numbers somehow. I've thought of categories, or perhaps tracking via tags.

    Any suggestions ? Thanks !      

     This is Quicken 2018-2019 for windows...

Comments

  • splashersplasher SuperUser ✭✭✭✭✭
    edited November 2018
    If I was going to do this, I'd create a separate cash account in my regular file and enter everything into it.  Notice I wrote separate, that is a Quicken designation that keeps the account from being included in any normal reports.
    -splasher  using Q since 1996 -  QW2016, 2017 & Subscription  -  Win7/Win10
    -Questions? Check out the  Quicken Windows FAQ list

  • edited January 22
    I'm interested in those numbers in my situation also.  However, they're all available and reported in quarterly and annual  summaries by my insurance co..  So I just track net out-ot-pocket (amounts actually paid less any refunds) in Quicken.  I don't have a separate account, because I pay medical expenses variously (sometimes cash, check, debit card or credit card).  Tracking gross amounts charged and discounts/disallowed charges, insurance payments, etc. in Quicken seems like just too much trouble for me.  

    BUT, IF I was going to track them in Quicken, what I imagine I would do it make an entry for each expenses net charge actually paid out and then use Split to enter the gross charge, discount, disallowed amounts, ins. payments, etc. into the successive lines in the Split box so that you end up with a total that matches the net amount you paid out.  Each line in the Split would have an appropriate Category plus possibly a Tag so that I could extract whatever data I wanted in a report.  

    Not only is that a lot of bothersome detail (especially if you have medical expenses for two Sr. citizens like we do in our household!), but, at least in our case, it involves a LOT of after-the-fact, retrospective accounting since one RARELY knows what the gross charge, discounts, etc. are going to be until well after you've made the initial payment which, with we Medicare patients anyway, is usually at or around the time of service.  It can take 4 to 8 weeks to get the rest of the information from our Medicare Advantage Plan, and then the provider's statement arrives weeks after that, if they even bother to bill you when you have a zero balance.  

    So, in my case, what I would be doing is entering a simple payment for my contribution to the charge and then, often much later, going back and expanding that register entry by entering a Split with positive and negative number is the various Categories so that the net charge paid is still the same.  Too much work for me!!

  • Rich_MRich_M SuperUser ✭✭✭✭✭
    edited November 2018

    I'm interested in those numbers in my situation also.  However, they're all available and reported in quarterly and annual  summaries by my insurance co..  So I just track net out-ot-pocket (amounts actually paid less any refunds) in Quicken.  I don't have a separate account, because I pay medical expenses variously (sometimes cash, check, debit card or credit card).  Tracking gross amounts charged and discounts/disallowed charges, insurance payments, etc. in Quicken seems like just too much trouble for me.  

    BUT, IF I was going to track them in Quicken, what I imagine I would do it make an entry for each expenses net charge actually paid out and then use Split to enter the gross charge, discount, disallowed amounts, ins. payments, etc. into the successive lines in the Split box so that you end up with a total that matches the net amount you paid out.  Each line in the Split would have an appropriate Category plus possibly a Tag so that I could extract whatever data I wanted in a report.  

    Not only is that a lot of bothersome detail (especially if you have medical expenses for two Sr. citizens like we do in our household!), but, at least in our case, it involves a LOT of after-the-fact, retrospective accounting since one RARELY knows what the gross charge, discounts, etc. are going to be until well after you've made the initial payment which, with we Medicare patients anyway, is usually at or around the time of service.  It can take 4 to 8 weeks to get the rest of the information from our Medicare Advantage Plan, and then the provider's statement arrives weeks after that, if they even bother to bill you when you have a zero balance.  

    So, in my case, what I would be doing is entering a simple payment for my contribution to the charge and then, often much later, going back and expanding that register entry by entering a Split with positive and negative number is the various Categories so that the net charge paid is still the same.  Too much work for me!!

    I totally agree with you, this is just a lot of complicated, unnecessary work on the part of the poster, not sure what would be accomplished by doing this.
    Quicken 2017 Premier - Windows 10
  • AndrewAndrew Member
    edited November 2018
    Exactly William Prendergast .  One other source of info is on your W-2s, you find in line 12 the code of "DD" which is how much your employer paid for medical coverage if that too is of interest to you.  I too am not sure what tracking and having all the info you would be doing would be of any value to you since it's available in so many other online places that's at least as (and probably more) accurate than you could ever help to code in Q yourself.  YMMV.

  • mrphilmrphil Member
    edited November 2018
    splasher said:

    If I was going to do this, I'd create a separate cash account in my regular file and enter everything into it.  Notice I wrote separate, that is a Quicken designation that keeps the account from being included in any normal reports.

    Hmmm... can you give me an example of what a single occurrence (say a dr visit) would look like ?  
  • SimonSezSoSimonSezSo Member ✭✭
    edited November 2018
    Just use a split transaction - 

    1.  Gross Amount      1000
    2.  Discount                 -50
    3.  Ins Pmt                 -150


    This leaves a net amount of 800, which is the resulting transaction amount and what you  paid.  It is the same principle as a paycheck, when using gross pay.

    Then reporting on these split amounts would be simple, and the detail information would always be there when you need it.

  • mrphilmrphil Member
    edited November 2018

    I'm interested in those numbers in my situation also.  However, they're all available and reported in quarterly and annual  summaries by my insurance co..  So I just track net out-ot-pocket (amounts actually paid less any refunds) in Quicken.  I don't have a separate account, because I pay medical expenses variously (sometimes cash, check, debit card or credit card).  Tracking gross amounts charged and discounts/disallowed charges, insurance payments, etc. in Quicken seems like just too much trouble for me.  

    BUT, IF I was going to track them in Quicken, what I imagine I would do it make an entry for each expenses net charge actually paid out and then use Split to enter the gross charge, discount, disallowed amounts, ins. payments, etc. into the successive lines in the Split box so that you end up with a total that matches the net amount you paid out.  Each line in the Split would have an appropriate Category plus possibly a Tag so that I could extract whatever data I wanted in a report.  

    Not only is that a lot of bothersome detail (especially if you have medical expenses for two Sr. citizens like we do in our household!), but, at least in our case, it involves a LOT of after-the-fact, retrospective accounting since one RARELY knows what the gross charge, discounts, etc. are going to be until well after you've made the initial payment which, with we Medicare patients anyway, is usually at or around the time of service.  It can take 4 to 8 weeks to get the rest of the information from our Medicare Advantage Plan, and then the provider's statement arrives weeks after that, if they even bother to bill you when you have a zero balance.  

    So, in my case, what I would be doing is entering a simple payment for my contribution to the charge and then, often much later, going back and expanding that register entry by entering a Split with positive and negative number is the various Categories so that the net charge paid is still the same.  Too much work for me!!

    While it is work, this way I have information in one place, not trying to chase it down from the insurance company, the pharmacy company, if I want to see the values from from last year or two or three years ago or find the PDFs for a period. Also the insurance company does not keep this information around for more than a year or two. It doesn't seem to be more work than tracking paychecks, investments, etc.  
  • SimonSezSoSimonSezSo Member ✭✭
    edited November 2018
    If you need to create a group for your medical expenses, why not use a tag?  That make it easy to create a report for all medical expenses, by type, location, etc.  The tag also shows up in split transactions (if you enable it) and will add flexibility to what you want to do.
  • NotACPANotACPA SuperUser ✭✭✭✭✭
    edited November 2018
    @mrphil,
    Search the web and see if you can find a copy of "Quicken Medical Expense Manager".  Intuit/Quicken discontinued the product a number of years ago ... but I still use it (on Win10) and it works great.

    Also, it covers all of your requested features.  Only shortcoming is that it doesn't interact/connect with Quicken.

    After you find and install it, but before you use it, download V2 of the product from here: http://www.quicknperlwiz.com/quicken-med-expenses.html
    You can't get that download from Q anymore ... but I worked with QuickNPerlWiz to get it uploaded to his website.

    I've tried multiple other products ... but I always return to QMEM.
    Q user since DOS version 5
    Now running Quicken Windows Subscription
    Retired "Certified Information Systems Auditor"
  • WannabeWannabe Member
    edited November 2018

    @mrphil,
    Search the web and see if you can find a copy of "Quicken Medical Expense Manager".  Intuit/Quicken discontinued the product a number of years ago ... but I still use it (on Win10) and it works great.

    Also, it covers all of your requested features.  Only shortcoming is that it doesn't interact/connect with Quicken.

    After you find and install it, but before you use it, download V2 of the product from here: http://www.quicknperlwiz.com/quicken-med-expenses.html
    You can't get that download from Q anymore ... but I worked with QuickNPerlWiz to get it uploaded to his website.

    I've tried multiple other products ... but I always return to QMEM.

    I just use a spreadsheet, with appropriate column headings and formulas.

    There are multitudes of Excel and Numbers templates for medical expenses that are free on the web.  Find one that you like and adapt it to your use.  Or create one for yourself.  Took me maybe an hour to setup.  Probably less.  And I'm not that proficient in spreadsheets. 
  • mrphilmrphil Member
    edited November 2018
    Thanks for all comments and suggestions. I'll try them out and see what works. Got QMEM installed and it seems like it will be something to consider.  
  • DouglasDrakeDouglasDrake Member
    edited November 2018
    I'm now living in Canada, so don't have this problem !  

    But when I was in the US, I created several categories...

    Medical Expense ( The Full undiscounted price)
    Insurance Coverage-Inc( Amount paid by one or more carriers)
    Insurance Discount-Inc (the amount discounted by the provider--this was not reported separately but I would subtract the amount paid from the full price to calculate)

    No, while some taxes are higher, I don't see any bills from hospitals or medical providers !!


  • edited December 2018
    One potential pitfall to using a Split transaction with the various lines for original charge, discount, ins. payment, balance due, etc. (as I suggested above and as illustrated by SimonSezSo), is the transaction DATING.  That is because of the long time lapse to resolve the transaction from a single medical visit.

    For example, you make your co-pay on the day of the visit.  At that point, and even when you leave after the encounter is completed, neither you nor the provider may know exactly WHAT the total charges, let alone payments, will be for that encounter.  But the co-pay is the first entry in a series of entries that will take place over the next 3 to sometimes 12 weeks before the payment process is complete for that encounter and its service charge.   

    If you enter your co-pay transaction in Quicken on or close to the day of the service, then, when insurance "EOBs" and provider statements start to roll in, you're faced with a problem.  Due to the fact that Quicken transactions are editable after entry, you CAN go back and create a Split transaction for that date of service entry and add the various lines with + & - contributions so that you have one entry that reflects each total charge and every adjustment.  BUT you can't enter different dates for your split lines.  In "real", double-entry bookkeeping of course, "editing" an entry is a no-no.  Corrections have to be entered as separate entries, dated when they're made.  

    There are a number of work-arounds I can think of that solve this problem to one degree or another in Quicken.  The one thing I can think of that would probably give the most flexibility would be to have a separate "Medical Expenses Cash Account" and do all your transaction recording there.  My problem of various payment sources from different accounts would be taken care of by showing payments as transfers from my payment source account to the Med. Exp. Cash Acct..  

    But, as I said originally, this is just a theoretical exercise for me because I'm only interested in tracking actual, "out-of-pocket" payments (and refunds) for medical care.  I'm content to let the insurance co. track the rest of it.  I do download their yearly reports with totals, at the end of every year, for tax purposes.  For me, that's enough medical accounting!  
  • rickdiukrickdiuk Member
    edited December 2018
    So I have set up a liability account called. "Medical Bills" then I also set up a category called "Tracking."

    Now say on Nov 1st I get a doctor/dentist/whatever bill in the mail for $30.00.  I go into  my Medical Bills account and log the bill, the date I received it. account number under memo, category tracking, and charge the account and scan in the bill. 

    Bill day comes around:  I go to pay the bill out of my checking and but instead of categorizing it as a transfer from checking I put in as the category it should be: quicken defaults (Health & Fitness: Doctor)

    Now I go back into my Medical Bill account and make the payment, category: Tracking,  This will causes the Tracking Category to Zero out eventually. If and only IF I have paid the entire bill off I will mark both the Charge and the Payment as Reconciled under the Clr column.  

    Now you could use a [Transfer] from Checking to Medical Bills if you want, however at any given time I can just run a report on the Tracking Category and if its not $0.00 or matches my expectations of balances left to pay then I know I have a problem.  Plus this way say if I have a $15000.00 medical bill and I only pay off $12000.00 in 2018.  My Medical Bills account is tracking the $3000.00 and when I run a 2018 Where did my money go chart, since the $3000.00 wasn't really spent my Health & Fitness Category will not show it.   And that is good. 

    Now I just "tag" the payments.  Self, Employer, Insurance, Good Will, Charity. etc. 
  • mrphilmrphil Member
    edited December 2018
    Interesting all the different ways to track this. While all of these involve some amount of work, I guess it's really not that much work once you get this setup one way or another and get used to doing this.

    Part of what I want to see out of all of this is what is the gross amount for medical expenses (i.e the amount billed to the insurance) While this is relatively easy to get for medical and dental expenses, for Rx expenses that's a different matter as there is the retail price of the prescription vs the amount amount my managed pharmacy plan says the price is (and what they pay) vs what I actually pay.

    Or to put it another way, if I didn't have any insurance  what would be the cost for all of these; then since I have insurance what does that do to lower the price to (discounts, insurance payments) and what did I pay for all of this (what I paid for insurance through my employer plus what my employer contributed, plus what I paid out of pocket).      

    I'll be trying most of the of the suggestions to see what gives me what I'm looking for. 

    Thanks for all the ideas. 
  • NotACPANotACPA SuperUser ✭✭✭✭✭
    edited December 2018
    Part of what I want to see out of all of this is what is the gross amount for medical expenses
    QMEM
    Q user since DOS version 5
    Now running Quicken Windows Subscription
    Retired "Certified Information Systems Auditor"
  • mrphilmrphil Member
    edited December 2018
    Yes, that (QMEM) was one of the things I was looking at seriously.
  • psobilopsobilo Member ✭✭
    I chose to set up expenses by category/subcategory so I can track insurance, out-of-pocket, etc. for doctors, hospital/clinic, prescriptions, etc.  I also account for any refunds ( I pay upfront, then get reimbursed), When I set up the subcategories, I also made sure to associate them with the appropriate tax lines.  When I then run the Tax Schedule report and sort by category, I have all the numbers to plug into TurboTax, i.e. Doctors, Hospital/Clinic, Prescriptions without having to worry and account for any reimbursements because they're already addressed in my totals.

    The majority of expenses are charged.  When the bills and EOB's come in, I just enter the data as splits.
This discussion has been closed.