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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?
Save Your Family
I don’t attach much importance to dreams. They are just there to make sleepy-time less boring. Last night, I had a dream where I spent most of my time trying to prepare my wife to run our finances before telling my son that I wouldn’t be around to watch him grow up. That’s an unpleasant thought to wake up with. Lying there, trying to digest this dream, I started thinking about the transition from “I deal with the bills” to “I’m not there to deal with it”. We aren’t prepared for that transition. Last year, we started putting together our “In case of death” file, but that project fell short. The highest priorities are done. We have wills and health directives, but how would my wife pay the bills? Everything is electronic. Does she know how to log in to the bank’s billpay system? Which bills are only in my name, and will go away if I die? Is there a list of our life insurance policies?
I checked the incomplete file that contains this information. It hasn’t been updated since September. It’s time to get that finished. Procrastinating is inappropriate and denial is futile. Here’s a news flash: You are going to die. Hopefully, it won’t happen soon, but it will happen. Is your family prepared for that?
The questions are “What do I need?” and “What do I have?”
First and foremost, you need a will. If you have children and do not have a will, take a moment–right now– to slap yourself. A judge is not the best person to determine where your children should go if you die. The rest of it is minor, if you’re married. Let your next-of-kin, your spouse keep it. I don’t care. Just take care of your kids! Set up a trust to pay for the care of your children. Their new guardians will appreciate it. How hard is it to set up? I use Quicken Willmaker and have been very pleased. Of course, the true test is in probate court, and I won’t be there for it. If you are more comfortable getting an attorney, then do so. I’ve done it each way. You can cut some costs by using Willmaker, then taking it to an attorney for review.
It’s a sad fact that often, before you die, you spend some time dying. Do you have a health care directive? Does your family know, in writing, if and when you want the plug pulled? Who gets to make that decision? Have you set up a medical power of attorney, so someone can make medical decisions on your behalf if you aren’t able? Do you want, and if so, do you have a Do-Not-Resuscitate order? Willmaker will handle all of this, too.
What’s going to happen to your bank accounts? I’m personally a fan of keeping both of our names on all of our accounts. I share my life and my heart, I’d better be able to trust her with our money. If that’s not an option, for whatever reason, fill out the “Payable on Death” information for your accounts, establishing a beneficiary who can get access to your money if you die. Do you want your spouse to lose the house or the car if you die? Should your kids have to miss meals? Make sure necessary access to your money exists.
Does anybody know what you have for life insurance? Get a copy of the policy and make sure your spouse and someone else knows what company holds it and how much it is worth.
Now, it’s time to make some lists. You need to gather account numbers and contact information for everything.
- Bank accounts. List every bank and account you own. Checking, savings, CDs.
- Investment accounts. Again, every company, every account.
- Mortgage and car payment information.
- Life insurance. Get your policy numbers, contact information, beneficiaries, and amount of coverage all in one place.
- Credit card accounts. Every card, every company. If it’s just your name on the account, your spouse will need to send certified death certificates to stop collections. Otherwise, she’ll need to pay the bills.
- Utilities. Get the account number for the electric bill, the gas bill, water/sewer/garbage, cable and phones.
- Other bills. These include car/home insurance, Netflix, memberships and anything else you pay.
- I’ve included the account information for my web host, registrars and websites. Some of it is salable, some of it is income-generating.
- Car titles. Put the actual titles in the pile of lists.
- Property deeds. Keep these here, too.
Non-financial information to list:
- Online accounts. Any financial sites that would be useful, or any community sites you would like to have informed about your death. Your online presence is a part of who you are.
- Email accounts. Will your survivors need to interact with anybody potentially contacting you? They will need your username and password, or most big providers won’t let them in.
- Social media. How many networks do you participate in? Do you want to disappear, or should all of your Facebook friends know your dead?
- Blogs. Do you have a blog that needs an announcement? Does it generate income? Could it be sold?
- Contact list. Who else needs to be informed of your demise? Don’t make your loved ones hunt for the information.
Now, take all of this information and put it in a nice, fat envelope and lock it in the fireproof safe you have bolted to the floor. Make a copy and give it to someone you trust absolutely. Make sure someone knows the combination to the safe or where to find the key.
Your loved ones will appreciate it.
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?
Living in Debt: How I Sacrificed My Future
For those of you who haven’t been following along, I’m in debt. Starting 13 years ago, when I was 19, I managed to bury myself in debt, until I decided I’d had enough of that…almost 2 years ago.
Why?
It wasn’t because of college expenses, though they contributed to my debt level. I was in debt before I went to college. Heck, I was a daddy before I went to college.
It wasn’t because of major medical procedures. The only major medical procedures we’ve ever had were the births of our children, and we had two of them well after we built our shackles.
It wasn’t because we bought more house than we could afford. We own a modest house that we bought before the bubble started.
Then what was it? Why did we do the things we did that have financially crippled us for so long?
It was a combination of things, crowned by a glorious lack of financial sophistication. As I wrote in No Brakes, neither of us had the early training to really understand our financial decisions. We knew bills need to be paid, but what was the difference if the money came from a credit card versus our checking account? Why did it matter if we carried a balance on the cards, as long as we could make the payments? What’s wrong with just making the minimum payment?
Naïve. Unsophisticated.
That day-to-day lack of sophistication was only part of the problem, and it wasn’t the biggest part. We made a lot mistakes, but they were all small. Before 2001, I think our total was about $5000. Too much, but not painful.
Between the fall of 2001 and the winter of 2002, we took our naïve decision-making process and ran with it. It was a full-scale mistake marathon.
That year, we built an addition on our house, because a full dining room and a bigger kitchen would make our house so much more livable and it was cheaper than buying a home, new. Oh, and since the difference between the mandatory crawlspace and a full basement room was just a few rows of concrete blocks, let’s expand it. Wait, don’t bedrooms require walls, sheetrock, windows, closets, paint, furniture, and electricity?
That was also the year that the car companies all jumped on the 0% loan fad. In case you don’t remember, that was the program that meant you could get a 0% loan on a new car if you picked up a 3 year term on your loan. At 22, making maybe $45,000 combined, we decided that buying a $35,000 truck was a good idea. To save money. Rationalization is wonderful. Or at least, effective.
That summer, we got married. We did a phenomenal job getting married on the cheap. We had about 100 guests, a park to get married in, flowers, food, and a hall to eat and dance in, for about $3000. The problem was, we didn’t have $3000. We didn’t have the $1500 + activities for our 10 day honeymoon on a Caribbean cruise, either, though I still plan on returning to St. Thomas.
None of those individual payments were terrible. The biggest problem was that we piled them all so close together that we never had time to absorb their impact before taking on the next obligation. When we did realize how much we had to pay, we made up for it by only buying big things that came with a “0% for a year” deal, like our living room set, our carpet, and our dining room table.
Then, when we finally did pay something off, or came into more money, we’d immediately expand our lifestyle to fill the void. The month we paid off our truck, I got a significant raise. Did we use it to pay off some other debt? Of course not, we bought a new car on a six year term.
We had so many opportunities to make bad decisions with our money, and I think we took them all and have suffered for it, since.
If you’re in debt, what made you decide to get that way?
Budget Lesson, Part 6
It’s been a month since I’ve written a post for the budget series, so I’ll be continuing that today. See these posts for the history of this series.
This time, I’ll be reviewing my non-monthly bills. These are the bills that have to be paid, but aren’t due on a monthly basis. Some are annual, some are quarterly.
- School Lunch – This could be cut by sending a bag lunch. We pay about $1.25 per day for school lunch. At that price, I don’t think I can beat the nutrition, let alone the convenience of the meal. We pay this whenever the account gets below $10.
- Property Taxes – We pay this semi-annually. This bill goes up every year due to the ****** ***-******* ******-******* who don’t care about their constituents making ends meet. ******* ***** ******* *******. Huh. Who knew WordPress came with a censor? I could move, but I’d have to get out of commuting distance to get this down much.
- Life insurance – I’ve got two quarterly life insurance policies. I can’t get these much cheaper, but I should be able to next year. The questions asked if I’ve smoked in the last three years, and that will be up on Halloween.
- AAA – It’s only been recently that I’ve owned vehicles reliable enough to avoid paying my AAA dues for me. I could cancel this, but for $80 per year, the hotel discounts make it a wash. One vacation per year comes close to making the difference.
- Vehicle Registration – The only way to cut this would be to get rid of a vehicle. I don’t think that’s possible for us. We work in opposite directions and, for at least one quarter per year, spend too much time chasing around for activities.
- Daycare – We’ve been using our current daycare provider since my oldest(10) was one. When my youngest turns 2 in June, our costs will go down. Without one of us quitting our job, this bill can only go down as the kids grow up.
- City Bill – This bill combines our garbage, water, and sewer. With three adults, three kids, and 5 animals in the house, reducing our garbage level is difficult. We do try to manage our water usage in the summer, to keep that down.
- Web host – I have a few domain names and a hosting package to handle my side hustles and miscellaneous projects. This is a deductible expense. I have been allowing my domain names to expire if the project isn’t being actively pursued.
- Memberships – I have annual dues to two organizations. I’m making payments on lifetime memberships, so these will be going away in about 18 months.
Reviewing this list, there doesn’t seem to be too much I can cut and accomplish any meaningful savings. Am I missing something?
