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Money Problems: Day 9 – Health Insurance
Today, I am continuing the series, Money Problems: 30 Days to Perfect Finances. The series will consist of 30 things you can do in one setting to perfect your finances. It’s not a system to magically make your debt disappear. Instead, it is a path to understanding where you are, where you want to be, and–most importantly–how to bridge the gap.
I’m not running the series in 30 consecutive days. That’s not my schedule. Also, I think that talking about the same thing for 30 days straight will bore both of us. Instead, it will run roughly once a week. To make sure you don’t miss a post, please take a moment to subscribe, either by email or rss.
On this, Day 9, we’re going to talk about health insurance.
The first thing to understand is that there is a difference between health care and health insurance. Health care is what the doctors do. Health insurance is when the insurance companies pay for it. Or don’t. They are not the same thing. I won’t be addressing who should get care or who should be paying for insurance. That’s political and I try to avoid that here.
I won’t spend much time discussing health care as a “right”. It’s not. If a right requires somebody to actively do something for you, it’s not a right. It can’t be. The logical conclusion of requiring somebody to provide you care gets to be a intellectual exercise to be completed elsewhere. That, too, is political.
What I will discuss are the components of a health insurance plan is the U.S. and what to watch out for when planning your insurance coverage.
Premium
This is the amount you pay for your health insurance. For people with employer-sponsored insurance, this is usually paid out of each paycheck, deducted pre-tax. For those with an individual plan, it’s almost always a monthly payment. There generally isn’t much you can do to lower this much. Most employers offer, at most, 2-3 options, ranging from a good plan for a high premium to “we’ll mail you leeches if we think you’re dying” for a much smaller price.
Copay
This is a flat fee paid out of pocket when you get medical care. Depending on your plan and the type of visit, this could be $10-50 or higher. For example, with a plan I participated in recently, the copay was $15 for an office visit, $25 for urgent care, and $100 for an emergency room visit. The office visit and urgent care visit were billed the same amount to the insurance company, so the price difference was entirely arbitrary. Currently, all health insurance plans are required to pay preventative care visits at 100%, meaning there is no copay.
Coinsurance
This is the payment split between the insurance company and the insured. 80/20 is a common split for plans with coinsurance. That means the insurance company will pay just 80% of the bill, until the insured has paid the entire out-of-pocket maximum. After that, the coverage is 100%.
Deductible
This is the amount that an insurance company won’t pay. It has to be covered by the insured before the insurance company does anything. For example, if you have an insurance plan with a $25 copay, 80/20 coinsurance and a $100 deductible, and paying for an office visit costing $600 would look something like this: $25 for the copay, followed by $75 to max out the copay, leaving $500 to be split 80/20 or $400 paid by the insurance company and $100 paid by the insured. That office visit would cost $200 out-of-pocket. The next identical visit would be cheaper because the deductible is annual and doesn’t get paid per incident. That one would cost $115 out of pocket.
HSA
Health Savings Account. For people with a high-deductible plan–that is, a plan with a deductible of at least $1200 in 2011–they are eligible to open an HSA. This is a savings account dedicated to paying medical expenses, excluding OTC medication. It can be used for vision, dental, or medical care. Payroll contributions are taken pre-tax, which makes it a more affordable way to afford major medical expenses. Unfortunately, there are annual contribution limits. Currently $3050 for an individual account and $6150 for a family account. HSAs do not expire, so you can contribute now, and save the money for medical expenses after retirement.
FSA
Flexible Spending Account. This is similar to an HSA, but the contributed funds evaporate at the end of the year. It’s “use it or you’re screwed” plan.
Individual Plans
If you’re not getting health insurance through your employer or another group, you are on an individual plan. These cost more because they A) don’t benefit from the economy of scale presented by getting 50 or 100 or 1000 people on the same plan, and B) you don’t have an employer subsidizing your premium.
Employer-Sponsored Plans
If your employer provides health insurance, you have an employer-sponsored plan. Possibly the fastest way to correct problems with the health insurance industry would be to make individual plan premiums tax-deductible, while eliminating that deduction for employers and letting insurance companies work across state lines. That would eliminate the mutated pseudo-market we have right now, and force the insurance companies to compete for your business. Honest competition is the most sure way to increase efficiency and service while reducing costs. It beats “one payer” or “socialized” care which add overhead to the process and hide the premiums in increased taxes.
Open Enrollment
Most employer-sponsored plans only allow you to make changes at a specific time of the year, unless you have a “life changing event”, like marriage, divorce, death, or children.
Explanation of Benefits
After you use your health insurance, the company will send an EOB, showing you what was billed, what they paid, and what you’ll be responsible for. It’s fascinating to see the difference between what gets billed by the doctor and what the insurance company is willing to pay, by contract. You should read this, to at least understand what you are consuming and how much is getting paid for you.
Maximum Dollar Limit
If your insured care cost more than your maximum dollar limit, or maximum annual limit, the insurance company stops paying. this was supposed to be going away under the Patient Protection and Affordable Care Fraud Act. Unfortunately, if an insurance company offers a crap plan, they have been allowed to apply for waivers based on the fact that they offer a crap plan. The deciding factor in whether the waiver is granted seems to be the amount of the political contributions the insurance company has made to the correct political entities, but maybe I’m just bitter.
Out-Of-Pocket Maximum
This is the most you will have to pay directly with coinsurance. After you pay this amount, the insurance company will cover 100% of expenses, subject to the maximum limit.
COBRA
The Consolidated Omnibus Budget Reconciliation Act of 1985 is, in short, an opportunity to continue your employer-sponsored health plan–minus the subsidy–after you have left the employer. It’s expensive, but it keeps you covered, and will eliminate issue with pre-existing conditions when you get a new plan.
Catastrophic Health Insurance
This is an extremely-high-deductible plan, typically $10,000 or more. For the people who can’t afford coverage, this is insurance-treated-as-insurance. It’s coverage when you absolutely need it, not when you feel a bit ill. $10,000 isn’t a bankruptcy-level bill, while $100,000 usually is. This plan prevent medical bankruptcy for a small monthly fee. For the people who got screwed by a PPAACFA waiver, it bridges the gap between a plan that’s useful for minor things and protection when something goes really wrong.
Things to Watch Out For When Applying For Health Insurance
Now that we’ve looked at the terms you need to understand, we’re going to talk about some things to check before deciding what coverage is right for you.
Individual, Individual + 1, Individual + Family
Do you need coverage for yourself, or yourself and your family? If you and your spouse are both working, make sure to run the math for every possible combination that will cover everyone. Is it cheaper to have one of you cover yourself and the kids, while the other just gets an individual plan?
Maximum annual coverage
It’s really easy to blow through a $3000 annual maximum. If you’ve got a low annual max, look into a supplemental catastrophic plan.
Primary and Secondary Coverage
For years, my wife paid for insurance that covered herself and the kids, while I covered myself. When we were expecting brat #3, I added her to my insurance plan, without having her cancel hers. When the bill came, my insurance plan covered the coinsurance and deductible, which saved us thousands of dollars when the baby was born.
Pre-Existing Conditions
If you’ve got a pre-existing condition, it can be difficult to get insurance if you don’t already have coverage. This makes sense. It prevents someone from corrupting the idea of insurance by waiting until something goes really wrong before getting a plan. Without this, all of the insurance companies would be bankrupt in a year. This is one of the biggest benefits of COBRA. It’s a short-term bridge plan that eliminates the idea of a pre-exisiting condition deadbeat. If you’ve got insurance, you can transfer to a different plan. If you don’t, you can’t.
Homework
Your homework today is to get a copy of the details of your health insurance and look up all of the above terms and situations. How well are you covered? Did anything surprise you?
Money Problems – Day 6: Reducing Expenses
Today, I am continuing the series, Money Problems: 30 Days to Perfect Finances. The series will consist of 30 things you can do in one setting to perfect your finances. It’s not a system to magically make your debt disappear. Instead, it is a path to understanding where you are, where you want to be, and–most importantly–how to bridge the gap.
I’m not running the series in 30 consecutive days. That’s not my schedule. Also, I think that talking about the same thing for 30 days straight will bore both of us. Instead, it will run roughly once a week. To make sure you don’t miss a post, please take a moment to subscribe, either by email or rss.
On this, Day 6, we’re going to talk about cutting your expenses.
Once you free up some income, you’ll get a lot of leeway in how you’re able to spend your money, but also important–possibly more important–is to cut out the crap you just don’t need. Eliminate the expenses that aren’t providing any value in your life. What you need to do is take a look at every individual piece of your budget, every line item, every expense you have and see what you can cut. Some of it, you really don’t need. Do you need a paid subscription to AmishDatingConnect.com?
If you need to keep an expense, you can just try to lower it. For example, cable companies regularly have promotions for new customers that will lower the cost to $19 a month for high-speed internet. Now, if you call up the cable company and ask for the retention department, tell them you are going to switch to a dish. Ask, “What are you willing to do to keep my business?” There is an incredibly good chance that they will offer you the same deal–$20 a month–for the next three or four months. Poof, you save money. You can call every bill you’ve got to ask them how you can save money.
I called my electric company and my gas company to get on their budget plans. This doesn’t actually save me money but it does provide me with a consistent budget all year long, so instead of getting a $300 gas bill in the depths of January’s hellish cold, I pay $60 a month. It is averaged out over the course of the year. It feels like less and it lets me get a stable budget. Other bills are similar. You can call your credit card companies and tell them everything you take your business to another card that gave you an offer of 5% under what ever you are currently paying. It doesn’t even have to be a real offer. Just call them up and say you are going to transfer your balance away unless they can meet or beat the new interest rate. If you’ve been making on-time payments for any length of time–even six months or a year–they’re going to lower the interest rate business, no problem. Start out by asking for at least a 5% drop. In fact, demand no more than 9.9%.
Once you’ve gone through every single one of your bills, you’ll be surprised by how much money you’re no longer paying, whether it’s because somebody lowered the bill for you or you scratched it off the list completely.
Karate Guess So
“Walk on road, hm? Walk left side, safe. Walk right side, safe. Walk middle, sooner or later, [makes squish gesture] get squish just like grape. Here, karate, same thing. Either you karate do “yes”, or karate do “no”. You karate do “guess so”, [makes squish gesture] just like grape. Understand?” -Mr. Miyagi
It occurred to me that lately, I’ve changed my day-to-day cash flow plans a couple of times.
A year ago, I was running on a fairly strict cash-only plan.
A month ago, I was running on a strict budget, but doing it entirely out of my checking account.
Now, I’m loosening the budget reins, and moving all of my payments and day-to-day spending to a credit card, including a new balance that I can’t immediately pay off.
The thing is, changing plans too often scares me. Like the quote at the beginning of this post, I start worrying about being squished like a grape.
The simple fact is that any plan will work.
If you want to get out of debt, just pick a plan and run with it. If that means you follow Dave Ramsey and do the low-balance-first debt snowball, good for you. Do it. If you follow Suze Ormann and do a high-interest first repayment plan, great. Do it. If you follow Bach and pay based on a complicated DOLP formula to repay in the quickest manner, wonderful! Do it!
Just don’t switch plans every month. If you do that, you’ll lose momentum and motivation. Squish like grape! Just pick a plan and go. It really, truly does not matter which plan you are following as long as you are following through.
This applies to other parts of your life, too. For example, there are a thousand fad diets out there. Here’s a secret: they all work. Every single one of them, whether it’s Weight Watchers, slow carb, or the beer-only diet. The only thing that matters is that you stick to the diet. If you manage that, you will lose weight on any diet out there. Except for the jelly bean and lard diet. That one will make you extra soft.
Another secret: the productivity gurus are right. Every single one of them. David Allen, Stephen Covey, Steve Pavlina, and the rest. They all have the One True Secret to getting the most out of your day. Really. Pick a guru and go! But don’t try to Get Things Done in the morning and do 7 Habits at night. Changing systems, changing plans, changing your mind will make you sabotage yourself.
The real secret to accomplishing great things, whether it’s paying off $100,000 of debt, dropping 40 pounds in 3 months, or tripling your productivity is to do it. Just get started and, once you’ve started, don’t stop. If you keep going and stay consistent, you’ll accomplish more than anyone who hops from system to system every few weeks.
5 Steps to Save
- Image by BitHead via Flickr
“Saving is too hard.”
“I don’t know where to start.”
“How much should I save?”
“Who the heck are you to tell me what to do with my money?”
“Shut up, Jason.”
These are the things I hear when I start talking about getting a good strategy in place to save some money. Financial matters are intimidating to a lot of people. They’d rather not think about their money any more than they absolutely need to, if that much. Here, I’m breaking it down to some simple steps to make saving easy.
1. Get motivated. Why do you want to save some money? Are you trying to make a secure future, or do you just want to buy a new toy? These are the kind of questions you have to ask yourself. Nobody else can tell you why you want to make changes to your lifestyle, and nobody else’s reasons matter in the least. Saving money is something you have to do for you.
2. Figure out how much you can save. Generally, you’re going to need a budget so you can figure out what you can afford to save, but not always. If you are making ends meet, then you get a raise, you can obviously afford to bank the difference. If you do that, you’ll never even notice the missing money. If you try to save so much your mortgage goes unpaid, you’re plan is doomed to failure.
3. Open an account at a new bank. The biggest problem I used to have when I was trying to save was that it was too easy to get the money. Every time I checked the balance of my checking account, I saw the balance in the savings account. Worse, it took seconds to transfer that money from my savings account to my attached checking account. Every time I wanted to see if I could afford whatever toy I was looking at, I’d see money that wasn’t earmarked for anything in particular. Naturally, that money got spent more often that it was ignored and allowed to grow. Now, I can completely forget about the money.
4. Automate. I’ve automated everything I can. All of my bills are paid automatically, except for one company that insists on quarterly paper invoices. I’ve got $665(neighbor of the beast!) automatically transferred to my INGDirect account, to get divided between my various savings goals, including a fund for my semi-annual property tax payments and a fund to pay for the braces we haven’t actually had to buy yet, but will in a couple of years. The money disappears into a bank I don’t use for my day-to-day expenses and grows completely out of sight. Every once in a while, I look at the account and get surprised by how much has accumulated.
5. Get rich. Once you’ve got the other four steps in place, all you’ve got to do is let it work. Over time, you will build wealth in a way that may surprise you. Your goal at this point is to do nothing new. Every once in a while, you can pull out some money and tuck it into an investment account to get some real growth going for you.
“Thank you.”
“You’re the best.”
“What would I do without you?”
“How can I show you my appreciation? <wink><wink>”
“What the heck are you doing with my wife?”
These are the things I always hope to hear after sharing my strategies to save money.
Toxic People
You should never be in the company of anyone with whom you would not want to die.
-Duncan Idaho, from God-Emperor of Dune
Some people suck the life out of everyone they encounter. Whether it be through lies, unreasonable demands, emotional abuse or manipulation, or just a vile personalty, the people they meet are worse off for the encounter. The people they interact with every day are screwed.
My time is too precious to waste any of it unnecessarily on people who remove value from it. I like being with people who enrich my life, instead.
Unfortunately, since I’m not an advocate for the use of hitmen, not every toxic person is easy to eliminate from your life.
Toxic people come in 3 basic varieties: professional, personal, and family. There is some overlap between the categories.
The personal category is easiest to deal with. These people aren’t relatives or coworkers, so you won’t see them at family gatherings or at work. I’ve dealt with these people in two ways.
First, there is the direct approach. One former friend, who was really only a friend when it was convenient for him(a pure leech), got told that he wasn’t invited to one of our parties because I was inviting his ex-wife, instead. That was the last time he called me.
The second option is far more passive. I set up a contact group in my phone called “Life’s too short”. At first, I set it up with a fairly insulting ring tone, but I later switched it to no ring at all. I don’t know they’ve called until I check my voicemail. It’s far less direct, but also far easier than the direct approach.
Dealing with the toxic people in your family is more complicated. You’ll see them at holiday gatherings, or hear about them during unrelated visits. You probably have a lot of memories growing up with them, and may feel some level of obligation–deserved or not–to maintain contact. It’s hard to break a tie that you’ve had your entire life.
Can you fix their behavior? It’s worth trying to have a frank discussion about how they are treating you, or the things they are doing. If the problem is that they are constantly bringing over their methhead boyfriends, banning the drug addicts from your home, while still welcoming the relative may be an acceptable fix. If the problem is a constant need to belittle you, demanding they stop may work. If the problem is a lifetime of emotional abuse, it probably isn’t fixable.
Is banishment an option? Can you put that creepy cousin on the Life’s Too Short list? You’ll still have to deal with him at family gatherings, but you can always leave the room when he comes in, right? Don’t engage, don’t participate in any conversation beyond a polite greeting, and don’t offer any encouragement towards regular contact.
It’s possible that it won’t be possible to fix their behavior and that you won’t want to banish the offender. If, for example, the offender is your mother (Not you, Mom!), you may feel a sense of obligation to maintain contact, or even be a primary caregiver at times. This is a line nobody else can draw for you. At some point, the current bad behavior could overwhelm the past obligations. When that happens are you prepared for it? That can be a traumatic break.
The other option, as cold as it sounds, is to wait it out. Nature will take its course, eventually. Can you wait that long, while maintaining your sanity and emotional equilibrium?
Professional toxic people include customers, vendors, and coworkers, none of whom are easy to get rid of.
If you own the business, you can fire your problem customers if the hassle outweighs the benefits you get from the relationship. You can find a new vendor, and you can fire the problem employees.
What happens if you are an employee?
If the problem is your boss, your options are to suck it up, talk to his boss, or find a new job. If the first is intolerable, and the second is impossible, it’s time to polish your resume.
If the problem is a vendor, you’ve got some options. Document the problems, first. Does he make inappropriate jokes, or badmouth you to your customers? Then, research the alternatives. Does one of his competitors offer an equivalent product or service? Take the documentation and research to your boss, or whoever makes that decision, and see if you can get your company to make the switch. The other option, is to request someone new to deal with at the vendor’s company, but that may not always be possible.
Finally, we come to the problem of toxic coworkers.
Some coworkers have the same problems as a toxic boss. Is the company vice-president the boss’s baby brother? You’re probably not going to find a win there. You’ll have to suck it up or move on.
Is the problem person working in an unrelated department doing unrelated tasks? It may be possible to start taking breaks at different times and leave him where he belongs: in the past.
Is the difficult individual sharing an office with you, demanding everything be done his way, and throwing daily tantrums? This is the one that has to be dealt with. He’s the one sucking the life out of you every single day.
First, start making use of a voice recorder. If you’ve got a smartphone, you’ve probably already got one. Otherwise, drop the $20 to buy one. This lets you document the evil. When his behavior goes hinky, record it.
Second, stand up for yourself. If he’s making unreasonable demands, tell him it’s inappropriate. He’s a bully, and bullies tend to back down when they are confronted.
Third, make sure the boss knows about the behavior. Yes, this is tattling. Get over it. If he wasn’t acting like he was a spoiled 4 year old, you wouldn’t have to tell the boss that he was. If the boss doesn’t know there’s a problem, he can’t deal with it.
Fourth, for any problem that isn’t directly aimed at you, ignore it. If he makes a habit of throwing a tantrum because somebody emptied the coffee pot, or because the company switched health plans, let him. Only get in the way if it’s directed at you. Over time, the tantrums will get more noticeable and out of hand, forcing the boss to deal with it, preferably by handing him a pink slip.
Your goal is documentation, awareness, and avoidance. Make the worst of it go elsewhere so you can be as productive as possible, document what you can, and let the boss become aware of the situation and how bad it has become. And be patient. This isn’t an overnight fix.
How do you deal with the toxic people in your life?
