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Cutting Healthcare Costs
It’s not a secret that health care can be expensive. Many people pay two and three digit bills for their prescriptions. A visit to the doctor’s office can hurt the budget. Glasses cost hundreds of dollars? How can you cut this cost?
Drugs
If possible, go generic*. There is no difference between Trazorel and trazadone, aside from the cost. Wal-mart, Target, and many other stores offer common generic prescriptions for $4-5. When you are talking to your doctor, ask if there is an drug option that has an available generic. When you are talking to your pharmacist, ask if there is a generic alternative available.
Get the price match. The Cub Foods pharmacy near me matches the Target generic drug price, giving us $4 generics for the asking. This is often an unpublicized deal, so make sure you ask. If your pharmacy will not match nearby prices, consider going elsewhere.
See if there is a 90 day plan. Many insurance companies sponsor a 90 day prescription plan that gives you a 90 supply of drugs for the 60 costs as long as you are willing to accept the drugs by mail. For expensive prescriptions, this 33% discount can be a substantial savings.
Physician
Does your clinic offer online consultations with your doctor or nurses? Some clinics offer a chat or email option to talk to your doctor without requiring a visit that will add fees and copays to your expense sheet. Most clinics and hospitals have a free nurse line for basic questions, like “When is my baby‘s fever dangerous?” It’s a great chance to save some money. I know, from personal experience, that they won’t be shy if they feel you need to come in, but they generally won’t try to convince you to come in if aspirin will fix the problem.
Stay in-network. Check with your insurance company to make sure the doctor you want to see if in your network and therefore, available at the cheapest out-of-pocket price. If not, and you really want that doctor, ask your insurance company if they accept nominations for the network and ask your doctor if he’d be interested in being nominated.
Stay home for your cold. Don’t go to the doctor for every minor problem. The best remedy a doctor can give your for your cold will reduce it to a seven day malady. On the other hand, if you do nothing, it will go away in about a week. Why waste the money? This counts double for the emergency room and urgent care. Strep throat is not an emergency. Wait until morning and go to the clinic, paying the lower fees instead of the large ER costs. Make an appointment for a doctor visit, if possible. Urgent care is billed the same as a regular visit, but most insurance plans double or triple the copay for urgent care visits.
Cash Flow
A Health Savings Account(HSA) is a pre-tax account to save for qualifying medical expenses similar to a Flexible Savings Account(FSA). The main differences are that HSAs are only available for people with high-deductible insurance plans and do not have to be spent on medical expenses. Non-qualifying expenses move from pre-tax to post-tax, meaning you will be charged federal income tax for non-qualifying withdrawals. FSAs are “use it or lose it” plans. If you don’t use it, it will go away, usually at the end of the year. That makes December a great time to stock up on over-the-counter medicines and possibly replace your eyeglasses, as both of those are qualifying expenses. Find out if you have either option available. If you use either one, set aside a place to store every imaginable medical receipt, so you can be reimbursed. Make sure you understand the FSA-eligible expenses.
An Ounce of Prevention
Get routine checkups. The earlier you find a problem, the more options you have. This goes for everything from cancer screenings to blood tests. Get a physical every year and know what is happening with your body. We may be living in the future, but replacement parts are still hard to come by.
Maintain Your Health
It’s cheaper to be healthy. Eat right, exercise, quit smoking.
I enjoy a good meal. It’s one of my favorite things. I won’t cut rich foods out of my diet, so we reduced portions. Beyond the first few bites, the flavor isn’t nearly as enjoyable or even noticeable. There’s no more enjoyment for huge servings than small ones.
Get more exercise, even if it’s just a 2o minute walks twice a week parking on the far side of the parking lot, or taking the stairs instead of the elevator.
Vision
Go online. This one is worth a write-up all by itself. I have 6 pairs of prescription glasses–all varieties of frames and coatings–that have cost a grand total of about $150. There is no noticeable difference between my cheapies and the designer alternatives. While I work on the write-up, the best site to introduce you to the concept of online glasses is GlassyEyes. Reviews, coupons, and discount likes. They have step-by-step instructions on turning an intimidating idea into a simple and cheap solution to an expensive problem.
How do you save money on health care?
* There are no generics available on new drugs until the initial patent expires. This gives the pharmaceutical companies a change to recoup their research and development costs. Without this patent period, new private drug research would evaporate. Don’t hate the brand names, but don’t show undue loyalty.
Money Problems – Day 7: Paying Off Debt
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 7, we’re going to talk about paying off debt.
Until you pay off your debts, you are living with an anchor around your neck, keeping you from doing the things you love. Take a look at the amount you are paying to your debt-holders each month. How could you better use that money, now? A vacation, private school for your kids, a reliable car?
If you’ve got a ton of debt, the real cost is in missed opportunities. For example, with my son’s vision therapy being poorly covered by our insurance plan, we are planning a much smaller vacation this summer–a “staycation”–instead of a trip to the Black Hills. If we didn’t have a debt payment to worry about, we’d have a much larger savings and would have been able to absorb the cost without canceling other plans. The way it is, our poor planning and reliance on debt over the last 10 years have cost us the opportunity to go somewhere new.
The only way to regain the ability to take advantage of future opportunities is to get out of debt, which tends to be an intimidating thought. When we started on our journey out of debt, we were buried 6 figures deep, with a credit card balance that matched our mortgage. It looked like an impossible obstacle, but we’ve been making it happen. The secret is to make a plan and stick with it. Pick some kind of plan, and follow it until you are done. Don’t give up and don’t get discouraged.
What kind of plan should you pick? That’s a personal choice. What motivates you? Do you want to see quick progress or do you like seeing the effects of efficient, long-term planning? These are the most common options:
Debt Snowball
Popularized by Dave Ramsey, this is the plan with the greatest emotional effect. It’s bad math, but that doesn’t matter, if the people using it are motivated to keep at it long enough to get out of debt.
To prepare your debt snowball, take all of your debts–no matter how small–and arrange them in order of balance. Ignore the interest rate. You’re going to pay the minimum payment on each of your debts, except for the smallest balance. That one will get every spare cent you can throw at it. When the smallest debt is paid off, that payment and every spare cent you were throwing at it(your “snowball”) will go to the next smallest debt. As the smallest debts are paid off, your snowball will grow and each subsequent debt will be paid off faster that you will initially think possible. You will build up a momentum that will shrink your debts quickly.
This is the plan I am using.
Debt Avalanche
A debt avalanche is the most efficient repayment plan. It is the plan that will, in the long-term, involve paying the least amount of interest. It’s a good thing. The downside is that it may not come with the “easy wins” that you get with the debt snowball. It is the best math; you’ll get out of debt fastest using this plan, but it’s not the most emotionally motivating.
To set this one up, you’ll take all of your bills–again–and line them up, but this time, you’ll do it strictly by interest rate. You’re going to make every minimum payment, then you’ll focus on paying the bill with the highest interest rate, first, with every available penny.
DOLP
This is the plan promoted by David Bach. It stands for Done On Last Payment. With this plan, you’ll pay the minimum payment on each debt, except for bill that is scheduled to be paid off first. You calculate this by dividing the balance of each debt by the minimum payment. This gives you an estimate of the number of months it will take to pay off each debt.
This system is less efficient than the debt avalanche–by strict math–but is better than the snowball. It give you “quick wins” faster than the snowball, but will cost a bit more than the avalanche. It’s a compromise between the two, blending the emotional satisfaction of the snowball with the better math of the avalanche.
Snowflaking
For each of these plans, you can give them a little steroid injection by snowflaking. Snowflaking is the art of making some extra cash, and throwing it straight at your debt. If you hold a yard sale, use the proceeds to make an extra debt payment. Sell some movies at the pawn shop? Make an extra car payment. Every little payment you make means fewer dollars wasted on interest.
Paying interest means you are paying for everything you buy…again. Do whatever it takes to make debt go away, and you will find yourself able to take advantage of more opportunities and spend more time doing the things you want to do. Life will be less stressful and rainbows will follow you through your day. Unicorns will guard your home and leprechauns will chase away evil-doers. The sun will always shine and stoplights will never show red. Getting out of debt is powerful stuff.
Your task today is to pick a debt plan, and get on it. Whichever plan works best for you is the right one. Organize your bills, pick one to focus on, and go to it.
Assuming you are in debt, how are you paying it off?
Credit Cards: How to Pick a Winner
We live in a decidedly credit-centric culture. Whip out cash to pay for $200 in groceries and watch the funny looks from the other customers and the disgust from the clerk. It’s almost like they are upset they have to know how to count to run a cash register.
If someone doesn’t have a credit card, everyone wonders what’s wrong, and assumes they have terrible credit. That’s a lousy assumption to make, but it happens. For most of the last two years, I shunned credit cards as much as possible, preferring cash for my daily spending. Spending two years changing my spending habits has made me comfortable enough to use my cards again, both for the convenience and the rewards.
Having a decent card brings some advantages.
Credit cards legally provide fraud protection to consumers. Under U.S. federal law, you are not responsible for more than $50 of fraudulent charges. many card issuers have extended this to $0 liability, meaning you don’t pay a cent if your card is stolen. Trying getting that protection with a wallet full of cash.
The fraud protection makes it easier to shop online, which more people are doing every day. At this point, there is no product you can buy in person that you can’t get online, often cheaper. How would you order something without a credit card? Even the prepaid cards you can buy and fill at a store will often fail during an online transaction because there is no actual person or account associated with the card. The “name as it appears on the card” is a protective feature for the credit card processors and they dislike accepting cards without it.
If you’re going to use a credit card, you need to make a good choice on which credit card to get. There are a few things to check before you apply for a card.
Annual fee. Generally, I am opposed to getting any card with an annual fee, but sometimes, it’s worth it. If, for example, a card provides travel discounts and roadside assistance with its $65 annual fee, you can cancel AAA and save $75 per year. A good rewards plan can balance out the fee, too. I’m using a travel rewards card that has a 2% rewards plan. That’s 2% on every dollar spent, plus discounts on some travel purchases. In a few months, I’ve accumulated $500 of travel rewards for the $65 fee that was waived for the first year. The math works. A card that charges an annual fee without providing services worth several times that fee isn’t worth getting.
Interest rate. This should be a non-issue. You should be paying off you card completely every month. In a perfect world. In the real world, sometimes things come up. In my case, I was surprised with a medical bill for my son that was 4 times larger than my emergency fund. It went on the card. So far, I’ve only had to pay one month’s interest, and I don’t see the balance surviving another month, but it’s nice that I’m not paying a 20% interest rate. Unfortunately, as a response the CARD Act, the days of fixed rate 9.9% cards seems to be over.
Grace period. This is the amount of time you have when the credit card company isn’t charging you interest. Most cards offer a 20-25 day grace period, but still bill monthly. That means that you’ll be paying interest, even if you pay your bill on time. To be safe, you’ll need to either find a card that has a 30 day grace period, or pay your balance off every 15-20 days. Some of the horrible cards don’t offer a grace period of any length. Avoid those.
Activation fees. Avoid these. Always. There’s no card that charges an activation fee that’s worth getting. An activation fee is an early warning sign that you’ll be paying a $200 annual fee and 30% interest in addition to the $150 activation fee.
Other fees. What else does the card charge for? International transactions? ATM fees? Know what you’ll be paying.
Service. Some cards provide some stellar services, include concierge service, roadside assistance, and free travel services. Some of that can more than balance out the fees they charge. My card adds a year to the warranty of any electronics I buy with it, which is great.
Credit cards aren’t always evil, if you use them responsibly. Just be sure you know what you’re paying and what you’re getting.
What’s in your wallet?
2011 Goals
It’s that time of the year when people make public promises to themselves that last almost as long as the hangover most of them are going to earn tonight, otherwise known as New Year’s Resolutions.
Not a fan.
I am, however a fan of planning out some concrete goals and doing my best to meet them. I do this through a series of 30 day projects. I set a goal that can be reached in 30 days, and push for it. I tend to make my goals fairly aggressive, and I tend to meet them.
Here were my goals and results for 2010:
- January: Wake up at 5am AND read to my kids every night before bed. These were easy goals to meet. A year later, I am still getting up much earlier than I ever have, even if it’s not 5AM. I write better late at night than I do early in the morning, anyway. I’m not still reading to my kids every night, but we are making progress on teaching my four-year-old to read.
- February: Do 100 push-ups at one time by the end of the month. I accomplished this in 22 days. I also had a secret project that involved doing something sweet for my wife every day. By the end of the month, she was convinced I had done something horrible that I was trying to make up for.
- March: Do 100 sit-ups at one time by the end of the month. It took me a week, but I found out how bad sit-ups are for your back. Pure failure.
- April: Spring Cleaning. I will declutter every room in my house this month. We missed one room and one closet, but made a lot of charities happy.
- May: Have a sit-down dinner with my family, at the dining room table at least 3 times per week. We managed this one and enjoyed it, but we haven’t managed to keep it up. I’ll have to try this again.
- June: No computer use, while anyone else in the family is awake, except for household necessities, such as bills. This one worked well and improved the quality of our interaction. I’m not quite this strict about it, but my computer use has gone down dramatically while my family is awake.
- July: Write fiction every day. I don’t think I wrote more than a few pages of fiction, but I did write every day.
- August: Buy nothing new this month. We came very close to doing this one perfectly. It wasn’t easy.
- September: Attempt to learn a new language. Total bomb. I never even got started.
- October: No yelling at the kids. Have you ever thought about trying this with a a two-year-old and a four-year-old? We never got started.
- November: No complaining. Not at home, not at work. I didn’t make this an actual month, but I’ve been trying to complain much less. I think it’s been working.
- December: I will have done 14 projects this year. December is a month off. As planned, I took December off.
So I missed 4 months of projects. This year, I’m going to modify my overall plan and only do 6 projects, every other month. That will give me a month off to either relax or incorporate the goal into my ongoing habits without any stress.
Here are my goals:
- January: I’m going to do Tim Ferriss’s Slow-Carb diet. Yes, it’s a fad diet, but it beats the constant stream of garbage I eat now. The basic plan is to avoid anything white; no bread, pasta, rice, potatoes, or sugar. That’s accompanied by a targeted supplement regimen and a timed exercise plan to manipulate my metabolism. I’m not adding any aerobic exercise to my day, because I want this to be as controlled an experiment as possible. If it’s working at the end of the month, I will keep it going. It’s time to not be fat anymore.
- March: In February, I managed to get myself able to do 100 pushups in a single set. In March, I hurt my back trying to do the same with sit-ups and that killed my workout habit. This March, I’m going to do the 100 pushups challenge again, but this time, I’m going for perfect pushups. Last year, they got sloppy after about 80. This year, that won’t be good enough.
- May: I’m going to do at least 30 days of the Couch to 5k running program. It’s a 9 week program. As a 30 day project, it’s designed to establish the habit. When I tried picking up running last year, my knees were causing problems. Hopefully, my January project will mitigate that this year.
- July: I’m going to pick up a new language. This is the failed plan from September 2010. I’ve narrowed it down to either Spanish, Swedish, or Italian. One is useful, one is a part of my heritage, and one is for fun. At the moment, I’m undecided.
- September: Undecided. I am leaning towards a “nice” month. 30 days of doing something nice, for someone, somewhere. If I go this route, I’ve got 9 months to plan, because that’s a lot of things to do.
- November: Absolutely undecided. Any suggestions?
That’s my plan for the new year. Six specific goals, each lasting 30 days. I could definitely use some help for September and November. Please give me some suggestions in the comments.
Fall From Grace
When you accumulate a certain level of debt, it feels like you’re wading through an eyeball-deep pool of poo, dancing on your tiptoes just to keep breathing. Ask me how I really feel.
It shouldn’t be a surprise that I’m in debt. We have gone over this before. The story isn’t one of my proudest, so I’ve never talked much about how it happened.
Our debt was entirely our fault. We messed up and dug our own poo-pool. There were no major medical bills, no extended unemployment, just a strong consumer urge and an apparent need for instant gratification. Delayed gratification wasn’t a skill I’d considered learning. The idea of it was a thoroughly foreign concept. Why wait when every store we visited offered no payments/no interest for a year? We didn’t give much thought to what would happen when the year was up.
We got married young. We bought our house young. We started our family young. We did all of that over the course of two years, well before we were financially ready. Twenty years old, we had excellent credit and gave our credit reports a workout. Credit was so easy to get. By the time I was 22, we had a total credit limit more than twice our annual income. We fought so hard to keep up with the Joneses. A new pickup, a remodel on our house. Within a month of paying off the truck, I got a significant raise and rushed out to buy a new car.
Every penny that hit the table was caught in a net of lifestyle expansion. I was bouncing on my tiptoes.
Four months into my new car payment, I was laid off. There’s me, hoping for a snorkel. A week later, we found out our son was going to be a big brother. Our pool had developed a tide.
We killed the cable and cut back on everything else and…managed. Money was tight, but we got by. I got a new job, but had we learned any lessons? Of course not. We got a satellite dish, started shopping the way we always had. Times were good, and could never be bad. We had such short memories.
Fast forward a couple of years. Baby #3 is on the way while baby #2 is still in diapers. Daycare was about to double. Daddy started to panic. I built a rudimentary budget and realized there was no way to make ends meet. There just wasn’t enough cash coming in to cover expenses. That’s when I made my first frugal decision: I quit smoking. That cut the expenses right to the level of our income. It was tight, but doable.
There was still one serious problem. Neither one of us could control our impulse shopping. For a time, I was getting packages delivered almost every day. It was never anything expensive, but it was always something. Little things add up quickly.
Last spring, I realized we couldn’t keep going like that. I started looking into bankruptcy. Somehow, we managed to toss ourselves into the deep end of the pool. We had near-perfect credit and no way to maintain it.
While researching bankruptcy, I found our life preserver. We put together a budget. We cut and…it hurt. It’s taken a year, but every bill we have is finally being tracked. We have an emergency fund and we are working towards our savings goals. It hasn’t been an easy year, but we are making progress. We’ve eliminated 15% of our debt and opened out budget to include some “blow money” and an occasional date night. We are always looking for ways to decrease our bottom line and increase the top line. Most important, we are actually working together to keep all of our expenses under control, with no hurt feelings when we remind ourselves to stay on track.
We are finally standing flat-footed, head and shoulders above the poo.
Update: This post has been included in the Carnival of Personal Finance.
