healthcare

6 Ways Greed Is Keeping You Poor

Paul Michael — Fri, 03 Jun 2016 10:30:05 +0000

Greed is a particularly ugly sin. While there are positive characteristics of pride, or even envy, it's almost impossible to use greed in any way that isn't an insult. It conjures images of fat cat CEOs hoarding millions, while their workers earn minimum wage. But although Ebenezer Scrooge and his ilk are portrayed as misers with serious money, greed can sometimes make you poor. Here are six examples of the way greed can eat away at your pot of gold.

1. Wanting It All

Not content with their lot in life, some people look at all those things they could have that make life even better. Or so they think, anyway. The latest smartphone. The upgraded car. The bigger house. The 80 inch flat screen TV. The huge deck. The patio. The yacht. Sadly, all those expenses have to be paid, and it can lead to crippling credit card debt, loans that cannot be paid back, and the eventual loss of everything to pay back creditors. As Tyler Durden famously said in Fight Club, "the things you own end up owning you." So, be very wary of greed. Happiness from those items is fleeting anyway.

2. Living to Excess

More wine. More beer. More junk food. More everything! When greed manifests as the intense and selfish desire for food and drink, it can lead to a plethora of health problems. And as we all know, health care can be very expensive in the USA. Overeating, leading to obesity, is responsible for as much as $210 billion in healthcare costs in the United States. An obese adult spends 42% more on healthcare than someone with a healthy weight, and obesity can lead to many other illnesses.

Then there's greed that turns to alcoholism, or drug abuse. While there are definitely other factors involved, including depression and other mental health issues, greed can contribute to a whole host of health problems from drug abuse. Recovery can be costly. And then there are the other problems stemming from an excessive lifestyle, including time taken off work, a lack of drive or motivation, and the sheer expense of maintaining that kind of diet.

3. Breaking the Law

Greed can make people do some strange things, which leads to committing unlawful acts. This does not mean they go out and rob banks, or scam people out of their savings online. It's more that they see an opportunity to make a lot of money for doing something they believe is harmless, albeit illegal. And then, they get caught, and face a prison sentence and a career in ruins.

One example is Scott London, a once successful audit partner at a huge accounting firm. He was earning $900,000 a year, but it appears that wasn't enough. London decided to start selling sensitive information about some of his clients to a friend. This is known as insider trading, and it's against the law. Although he made just $70,000 from the deals (a lot for most of us, but for him, a drop in the bucket), he was caught by the FBI and sentenced to 14 months in prison.

However, for others, it may be something smaller that leads to the poor house. Cheating on taxes, even just for a few bucks, is a federal offense. And shoplifting as little as three belts, or a couple of jerseys, has landed people in prison for life.

4. Avoiding Generosity

There is a misnomer that every rich person is greedy, and every poor person is not. This is actually not true, and financial guru Robert Kiyosaki has devoted a one-hour radio show on this subject that is well worth listening to. The basic idea is this: Having a generous spirit, and giving back to the world, will pay dividends. Investing in people, and in projects that have real potential, will reap rewards. On the other hand, hoarding your possessions, never giving to charity, and stockpiling wealth is not a positive way to manage money. Being generous, and doing good, can build much greater wealth than saving every penny and watching it grow a few percent a year in a bank account.

5. Gambling Away Everything

You know the stories. You've seen the movies. Gambling can bring people great wealth in just a few seconds. But, for the vast majority, it's a losing proposition. Couple gambling with greed, and you have a recipe for tragedy just waiting to happen. Every year, millions of people try and get lucky, and for most, it's just a flutter. Win or lose, they walk away. But 2% of people who gamble get seriously addicted, and greed takes over. A win becomes an adrenaline rush. They want more. And more. They want to see the dollar signs multiply. Before they know what's happened, they have lost everything trying to win back the money they once had.

6. Finally… the Impact of Corporate Greed

Sadly, it's not personal greed, but corporate greed that is having an impact on our wallets. And in some instances, it keeps people in poverty. From the greedy politicians who take cash to vote against the public interest, to the outsourcing of jobs to other countries, America has a serious greed problem. Many of us feel it a little, here and there. But for some, it's the cause of great hardships.

One recent example comes from Wendy's. After the recent minimum wage hike, and plans to raise it to $15/hour, the fast food giant responded with automated self-service kiosks. "We continue to look at initiatives and how we work to offset any impacts of future wage inflation through technology initiatives, whether that's customer self-order kiosks, whether that's automating more in the back of the house in the restaurant," said CTO Todd Penegor (who was compensated over $3 million in 2014). The moral of this story — demand a living wage and you're out of a job.

The defenders of this say that these jobs are entry-level, but with so many manufacturing jobs going elsewhere, and the employment of low-wage workers who do it "cash in hand," it's getting harder and harder to find a decent paying job that doesn't require an education and a ton of experience; something many people never had the chance to get.

Of course, the massive financial meltdown in 2008 was also caused by massive greed, and that impacted millions of homeowners and led to bankruptcies. It's safe to say that even if you are the least greedy person on the planet, you will still be affected by greed in your day-to-day life.

Has greed cost you? Tell us about it in comments!

This article is from Paul Michael of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

4 Moves That Guarantee a Great Retirement

Damian Davila — Fri, 27 May 2016 10:00:12 +0000

Times have changed. Retirement is no exception.

Back in 1998, 60.5% of Americans said they were very satisfied with their retirement in a study conducted by the Employee Benefit Research Institute. Fast forward 14 years later, that percentage dropped to 48.6%. Even worse, the percentage of Americans not satisfied at all with their retirement situation went up from 7.9% to 10.5%.

But you can avoid that fate. Here are four ways to turn this period into the best time of your life.

1. Semi-Retire

An old retirement adage goes, "When you retire, think and act as if you were still working; when you're still working, think and act a bit as if you were already retired." There are three good reasons why this is true.

First, putting off retirement may help stave off certain maladies of aging, such as Alzheimer's disease. According to French researchers, there is a correlation between higher retirement age and lower dementia risk.

Second, later retirement allows you to make the most out of your nest egg:

While you can start receiving Social Security retirement benefits at age 62, you can wait until full retirement age to receive delayed retirement credits.
Roll over a former employer's 401K plan after you turn 70 1/2 into another plan with a current employer, and you aren't required to take required minimum distributions (RMDs) starting the second year after the rollover.
By continuing to work part-time, you can continue to contribute to a Roth IRA (up to $6,500 in 2016) after you reach age 70 1/2.

Third, 83% of U.S. retirees cited "enjoying working" as a major reason to work for pay after retirement. Among current workers who expect to work in retirement, 79% of them cite "wanting to stay active and involved" as a major reason to work for pay in retirement.

2. Take Advantage of Catch-Up Contributions

Starting age 50, you can make additional contributions on top of the regular limit to eligible plans.

Catch-up contributions of up to $6,000: 401K (other than a SIMPLE 401K), 403(b), SARSEP, and governmental 457(b).
Catch-up contributions of up to $3,000: SIMPLE IRA and SIMPLE 401K.
Catch-up contributions of up to $1,000: Traditional or Roth IRA.

Let's take a look at the power of catch-up contributions: Let's imagine that you have a 401K and you make $6,000 in catch-up contributions for 15 years. Here is how much more you would have at the end of 15 years, assuming different rates of return, in your 401K:

3% return compounded annually: $113,398.69
4% return compounded annually: $122,728.99
5% return compounded annually: $132,951.76
6% return compounded annually: $144,154.23
7% return compounded annually: $156,431.90

3. Research Adequate Health Coverage and Disability Insurance

Despite the best-laid plans, chances are circumstances will require you to make some changes along the way. Nearly one out of two Americans reported retiring earlier than expected. While some individuals have good reasons, such as accumulating sufficient financial resources or wanting to do something else, many had negative reasons. Of those that retire early, 61% of cited health reasons or disabilities, and 18% cited the need to care for a spouse or family member.

This is why getting the right health coverage and disability insurance now for your spouse and yourself is a key way to make retirement enjoyable. Plan ahead so that you don't become part of the 24% of Americans who aren't confident about paying for medical expenses in retirement. Disability insurance is essential for the main breadwinner of the household. (See also: Make These 7 Money Moves Now or You'll Regret It in 20 Years)

If you have to retire early due to health problems, the Social Security Administration suggests applying for Social Security disability benefits, which are full, unreduced retirement benefits.

4. Consider Retiring Abroad

According to a study from a Transamerica Center for Retirement Studies, 71% of Americans say travel has helped them enjoy retired life. That's why one way to turn retirement into the best time of your life is to move abroad. Additionally, living abroad can enable you to reduce your living expenses during retirement, without forsaking quality of life. Several cities around the world offer visa pension programs, such as Malaysia's My Second Home and Panama's "pensionado" program, that offer U.S. retirees generous tax breaks and high-quality medical services at reduced costs. Of course, beautiful locales and ideal weather conditions don't hurt either! (See also: 4 Exciting World Cities You Can Afford to Retire In)

How do you plan turn retirement into the best time of your life?

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This article is from Damian Davila of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

Here's When You Should Switch to Your Partner's Health Insurance

Dan Rafter — Fri, 04 Dec 2015 18:00:05 +0000

If both you and your spouse or partner work for companies that provide health insurance plans, you have the option of getting coverage through your own employer — or signing up through your spouse's. If you're unhappy with your current coverage, it might be time to leave your employer's health insurance and switch to your spouse's.

But before making that jump, you'll need to look at six key factors.

1. Employee Contributions

Mike Schneider, managing director with NFP, an insurance broker and consultant, said that the first factor that most employees consider is the amount of money they are spending on each paycheck for health insurance.

What if the combined employee contributions would be lower if both went on the insurance plan of one spouse? Many will automatically make that jump. Saving money is good, but Schneider warns that the cost of insurance plans is not the only factor that spouses should consider.

"The easiest thing to compare are the employee contributions," Schneider said. "You are comparing the two plans directly. But you have to be careful: Sometimes the employee contributions, while important, are not the only factor you should consider. Many employees only consider the savings in their combined paychecks, but fail to look at anything else."

2. Deductibles

Employees should also consider the deductibles that they'll have to meet before insurance kicks in. Many employers are moving to high-deductible plans. This means that employees have to shell out more of their own money upfront before their insurance providers begin to cover their medical costs.

High-deductible health insurance usually comes with lower premiums, which is why many might be tempted to jump on their spouse's plan. But these plans are known as "high-deductible" insurance for a reason: You might have to pay as much as $3,000 or more out of your own pocket to meet your deductible. Before you move to your spouse's high-deductible plan, make sure that you can afford to cover that deductible should you become seriously ill.

3. Aggregate or Embedded Deductible?

The deductible question becomes even more complicated when an insurance plan is covering an entire family. That's because some plans have what is called an embedded deductible, while others offer an aggregate deductible.

Here's how an embedded deductible works: Say your insurance plan's individual deductible is $1,000 and its family deductible is $4,000. If your son has a medical procedure that costs $6,000, you will have to pay $1,000 out of your own pocket to meet the individual deductible. Your insurance will cover the remaining $5,000. However, if your daughter has a medical procedure that costs $5,000, you will again have to pay the $1,000 deductible before your insurance will kick in and cover the remaining $4,000. That's because even after your son's earlier medical procedure, there would still have been $3,000 left over in your family's overall $4,000 deductible. You won't be free of the deductible until you finally pass that $4,000 mark.

An aggregate deductible works differently. If your family has an aggregate deductible of $3,000 and your daughter undergoes a medical procedure costing $5,000, you will have to cover $3,000 before your insurance provider begins to cover your medical costs. Your entire deductible will now be met for the year.

"The type of deductible might be an incentive or disincentive," Schneider said. "Say you have one kid who is really sick. Under an aggregate plan, with just one procedure he could claim your entire deductible. With an embedded deductible, he won't."

4. Network of Doctors

Your spouse's insurance plan might come with lower premiums — but would you have access to your favored medical providers if you jump to it? That's an important question that people often ignore when tempted by lower premium costs. And it should not be assumed that, say, a HMO plan offered by Blue Cross Blue Shield on your company's insurance will provide the same medical network as the Blue Cross Blue Shield HMO plan offered by your spouse's employer.

"There is no guarantee that you will be able to see the same doctors even if your spouse's plan is being offered by the same insurance provider as yours," Schneider said. "Different plans, even if you'd think they would be similar, often offer access to different medical providers."

5. Working Spouse Surcharges

Many employers will levy an extra fee when a working spouse, who has access to their own employer-provided health insurance, signs up for coverage under a spouse's plan. This surcharge might be high enough to eliminate much of the benefit of switching to your spouse's insurance plan altogether.

6. Access to Wellness Programs

Schneider says that employees should look at their company's wellness benefits before making the jump to a spouse's insurance. Many companies today offer such healthy-living perks as reduced annual fees to local health clubs, or lower insurance premiums for employees who give up smoking or lose a certain number of pounds.

But many companies don't offer these perks to employees unless these workers are on their insurance plans, Schneider said. If you jump to your spouse's insurance? Your access to that half-price gym membership might disappear.

"I think people are getting better about doing the research before moving to their spouse's plans," Schneider said. "A lot of that is because so many companies are rolling out high-deductible plans. That is a huge shock to employees. It is hammering home the message that their health insurance decisions are important, and that they can have a big impact on their finances."

Are you on your spouse or partner's health insurance?

This article is from Dan Rafter of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

Avoid These 5 Costly Health Insurance Mistakes

Dan Rafter — Fri, 30 Oct 2015 09:15:33 +0000

How little do most consumers think about their health insurance? The 2015 Aflac Workforce Report found that 23% of adults would rather clean their toilets than research their health benefits during their employer’s open enrollment period.

This is too bad. Not researching their health insurance choices could cost them.

"Too many people get their health insurance from their employers and then never research it again," says Hector de la Torre, executive director of the Transamerica Center for Health Studies. "They don't change their plans even as their lives change. And that can cost them a lot of money. You need to monitor your health insurance over the years. Most people don't think much about their plans until they're making a co-payment or paying a bill."

Here are the five costliest mistakes consumers make when it comes to health insurance. If you want to keep more money in your pocket, you'll be sure to avoid them.

1. Not Living a Healthy Lifestyle

Dr. Sam Ho, chief medical officer with UnitedHealthcare, says that a growing number of employers are offering their employees discounts on health insurance premiums if they pursue healthier lives. Your employer might slash $400 off your annual health care premium if you don't smoke. Others might give you a discount if you lose weight.

Ho says this trend isn't going anywhere. A recent study by Fidelity Investments and the National Business Group on Health found that employers will spend an average of $693 per employee on wellness-based incentives in 2015, up from $430 five years ago.

2. Focusing on Premiums Only

Rebecca Palm, chief strategy officer of Boston-based healthcare expense management company CoPatient, says that too many consumers choose the health insurance option that comes with the lowest premium, whether or not it's the best plan for them and their families.

For example, an HMO plan might come with lower premiums than a PPO program. But that doesn't mean you'll be happier with the lower-cost HMO option, Palm explained.

"Yes, HMO premiums could be lower, but do you prefer your primary care doctor directing traffic for you, or do you want to go the PPO route, where your care is more self-directed?" Palm asked. "With a PPO plan, you won't necessarily need to ask your primary care physician for a referral before you go to see a specialist. If you see a lot of specialists, you might be happier with the PPO choice."

3. Not Understanding How Their Plan Works

Matthew Owenby, senior vice president with insurance provider Aflac, said that too many consumers never take the time to fully learn how their health insurance plan works.

Some consumers don't understand how a plan's co-pay system works until they actually show up at their doctor's office with the stomach flu. Others don't understand how high their deductibles are, or don't realize that when they have health insurance with a deductible of $1,000, that they'll actually need to have that money available before scheduling an expensive medical procedure.

"Most people don't spend enough time researching their options before making benefits decisions," Owenby says. "The reasons for that are broad. Some people think health insurance is too complicated. Often, the enrollment period offered by employers is too short. Other times, people are feeling healthy and they don't consider health insurance to be a priority."

4. Going to the Emergency Room Too Frequently

Ho said that hospitals are increasingly investing in freestanding clinics to offer patients an alternative option to the emergency room. These options are less expensive — and offer shorter waiting times, too — than do traditional emergency rooms, Ho said.

And that's just the beginning. Medical providers are increasingly offering telemedicine and online services for routine and preventive care, Ho said. By using these alternatives, consumers can keep their health insurance fees low.

"Emergency rooms should be reserved for true emergencies," Ho says.

5. Never Questioning Their Medical Bills

Palm said that medical providers aren't perfect; they might charge consumers for a service they never provided. But most consumers simply pay their medical bills without ever reviewing them for mistakes, Palm said.

"There is a lot of complexity with medical bills," Palm says. "Consumers don't always understand what they are being billed for. They just assume that the bill is right and pay it right away. We always encourage people to make sure everything is correct on the bill and to wait to pay that bill until they are sure they are being charged correctly."

Are you monitoring your health care costs carefully?

This article is from Dan Rafter of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

The Stock Market Has Been Really Tough on These 10 Industries

Tim Lemke — Mon, 12 Oct 2015 13:00:43 +0000

There are very few stocks that performed well in August. It was pretty ugly all around, as the market endured a correction that wiped out any gains produced this year up to that point.

Some industries got hurt worse than others, however. Anything related to technology was slammed hard, and the low price of oil hurt companies in the fuel industry. While past returns aren't indicative of future performance, it can be helpful to understand why certain stocks tanked recently.

Here are the 10 worst-performing industries in August of this year.

1. Road and Rail

The S&P 500 Road and Rail Index dropped more than 11%, and it could have been worse were it not for a late-month rally. Stocks like CSX and and Norfolk Southern have had a tough year, as shipments of goods remain sluggish.

2. Household Products

Companies that manufacture the products we use every day are often some of the most stable investments, but August was not kind to them. It was a tough month for shares of the usually solid Procter and Gamble (down 7.8%) and Kimberly Clark (down 7.3%.) The S&P Composite 1500 Household Products Index fell 7% in August.

3. Paper and Forest Products

As people increasingly use email and the web for communications, paper is becoming less popular. And August was an especially bad month, with the S&P 500 Paper & Forest Products Industry Index down 9.8% during the month. Hardest hit stocks included International Paper (down nearly 10%), and Clearwater Paper Corp. (down 4.7%).

4. Chemicals

It hasn't been a great stretch for companies like Dow Chemical and BASF. The Dow Jones U.S. Chemicals Index reported a 6.5% drop during the month. BASF, the largest company in this space, saw shares fall 7.5% in August, while Dow's declined 7%.

5. Health Care Services

Health Care companies were some of the top performers in recent years, so they may have been due to come back to earth a bit. The S&P Healthcare Services Industry Index fell 5.7% in August, and September has looked even worse, with an additional 10% drop as of this writing.

6. Semiconductors and Equipment

The S&P Total Market Semiconductor Index fell more than 3.5% in August, making worse what had already been a down year for semiconductor stocks. Tech stocks haven't been particularly attractive to investors this year, so semiconductor stocks including Micron Technology and Rambus have been hammered down.

7. Software

Another industry hurt by the performance of the technology sector. Big names including Oracle (down 7%) and Microsoft (down 6.8%) had a tough time in August. The S&P Software and Services Index fell 5.5% during the month.

8. Electrical Components and Equipment

Like semiconductors and software, stocks in this space were hurt by the overall drop in tech stocks in August. The Dow Jones U.S. Electrical Components and Equipment Index reported a 5.4% drop during the month, and it's down 13% for the entire year.

9. Oil and Gas

With oil prices down, down, down, any company involved in the exploration of fuels has taken a beating, and August was especially bad. The S&P 500 Oil, Gas, and Consumable Fuels Index declined more than 5% in August, and was down as much as 15% at one point before rallying.

10. Building and Construction

August was a bad month for companies involved in building stuff. The S&P Building and Construction Industry Index dropped 3.6%, as companies including Lend Lease and Chicago Bridge & Iron Company saw double-digit drops in share growth. The bad month of August was only a precursor to an even uglier September.

Has your portfolio bounced back since August's correction?

This article is from Tim Lemke of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

9 Ways to Save on Prescriptions

Paul Michael — Mon, 07 Sep 2015 13:00:31 +0000

If you look at the hard facts on prescription drug use in the U.S., almost half of Americans are taking one pill a day, while 10% of the population pops a staggering five or more pills daily. Meanwhile, health care costs continue to rise.

So, what can you do to cut the costs of your prescription drugs? Here are nine ways to slash the bills and save money on your medicines.

1. Double the Dosage

Asking your doctor for a higher dosage can turn a 90-day supply into a 180-day stash. It does involve a little extra work on your part, and you'll need to invest in a pill splitter to do the job properly. (These are usually under $10.) However, you must make sure that you can safely and effectively split the pill. The simplest way to check is to look for the line down the center. If it has that, it is designed to be split. Capsules absolutely will not work, so don't ask.

2. Get Generic Whenever You Can

Some people are sticklers for buying brand names, and in some cases they have every right to be. From foods and electronics, to jewelry and shoes, name brands are often more favorable. But when it comes to prescription drugs, it makes little sense to pay for a brand name when a generic is available. As MedicineNet.com explains, "Generic drugs are copies of brand-name drugs that have exactly the same dosage, intended use, effects, side effects, route of administration, risks, safety, and strength as the original drug. In other words, their pharmacological effects are exactly the same as those of their brand-name counterparts."

As you don't wear prescription drugs, or taste any difference, there is no reason to pay extra for a brand name. The only exception, of course, is if the generic version of the drug is not yet available. In that case, you really do have to pay through the nose.

3. Ask Your Doctor for Alternatives

When your doctor fills out a prescription, make sure and ask about alternatives to the medication they have recommended. There may be several different types of medication that will do the job, but some could differ vastly in price — especially if one is available as a generic, and the other one isn't. Don't leave the doctor's office until you know that you have options to work with. The difference could be hundreds of dollars a year.

4. Use a Discount Program

There are many different discount programs available nationwide, for people with and without health insurance. Many stores and pharmacies have discount and loyalty programs that you should definitely take advantage of, and they're usually free to join. There are also other ways to save, such as the NACo Program, Familywize, and special savings for seniors from the AARP.

5. Order in Bulk

One of the best ways to save money on your regular prescriptions (those you take month after month, year after year) is to buy in bulk and take advantage of big savings. For instance, Cigna's online pharmacy Tel-Drug is a very handy resource that can save you a lot of money. Most of the 90-day supplies are charged at a 60-day supply rate, saving you 33% every time you place an order. Shipping is usually free, unless you need the drugs at a rush speed.

6. Use Coupons

There are coupons for almost everything these days, and prescription drugs are no exception. You will find coupons at your doctor's office, the weekly circulars, and of course, online. Do not underestimate the efficacy of these coupons; although some are for only a few dollars, they can add up over the course of the year. And if you take multiple prescription drugs, the savings can really start to snowball.

7. Get Samples

This is a tricky one. On the one hand, samples are great because they're free. However, samples are also readily handed out by doctors as a way to get you started on a brand new drug that you may, or may not, want to take. It's common practice for drug companies to slightly change the formulation of a drug that is about to go generic, give it a new name, and charge a brand fee. But, they will give out free samples to get people to try it. So, talk to your doctor about the differences between the new drug, and the one that's similar (or almost identical) at a fraction of the cost. However, if you plan on taking that pill, the samples can sometimes add up to weeks, or even months, of free drugs.

8. Look Into "Extra Help"

If you are a Medicare beneficiary, you should definitely look into the government's Extra Help program. Applicants who qualify can look forward to around $4,000 of assistance every year, but you must fall below a certain income threshold, have limited resources, and reside in one of the 50 states or the District of Columbia. If you do qualify, it could be of enormous help.

9. Finally, You Could Try Canada, But…

It's illegal. For the moment. Yes, although it can save you a lot of money, buying any kind of prescription drugs from a pharmacy outside of the United States is against federal law. However, Congress is considering new legislation to allow Americans with valid prescriptions to purchase their medications from licensed Canadian pharmacies. Of course, this could all depend on the power and persuasion, not to mention the vast amount of money, that lobbyists for the U.S. drug companies will bring to the table.

How do you control the cost of prescription drugs?

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This article is from Paul Michael of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

The 9 Best Performing Mutual Funds of the 2000s

Tim Lemke — Mon, 31 Aug 2015 13:00:24 +0000

If you're looking to supercharge your investment returns, it's often helpful to look at some of the best performing mutual funds of recent years. It's a particularly fun exercise to examine the funds that have performed best since the year 2000.

This list was compiled using historical data on annual average returns from Morningstar and Fidelity. It is heavy on biotechnology and health funds, driven by some of the biggest gainers in the stock market over the last 15 years.

It's worth noting that there are several funds that could be on this list, but are now closed to new investors. There are also other funds that have done exceptionally well in the last 10 years, but did not make the list because of bad performance between 2000 and 2005.

Here's to hoping these funds can give your portfolio a boost. Just remember that past performance does not guarantee future returns.

1. Prudential Jennison Health Sciences Fund Z [PHSZX]

It's hard to complain about an 18% average annual return over the last 15 years. A $10,000 investment at the start of 2000 would be worth more than $130,000 now. Top holdings are Biomarin Pharmaceutical, Shire, and Allergan.

2. Rydex Basic Biotechnology Fund Class A [RYBOX]

Founded in 2004, here's a fund that has ridden the wave of hot biotech stocks. This fund would have netted $57,000 from a $10,000 investment at the start. It boasts a 17% average annual return over the last decade, and a more than 50% return over the last year. Gilead, Amgen, and Celgene are the top holdings in this fund.

3. ProFunds BioTechnology UltraSector Fund Investor Class [BIPIX]

This fund is not for the faint of heart. It has high fees and a high minimum investment ($15,000), and uses leverage to maximize returns. But that risk has paid off for investors with an average annual 9% return since being founded in June of 2000. It's recorded a 21% average annual return in the last decade and a 63% average annual return in the last three years. Its holdings include some of the biggest names in biotech, including Gilead Sciences, Amgen, and Alexion Pharmaceuticals.

4. Fidelity Select Biotechnology [FBIOX]

This fund has been a solid performer for more than a decade, with an average annual return of more than 14% since the start of 2000, and more than 19% since 2005. Investors should be especially pleased with the 64% return in the past year. Anyone who invested $10,000 into this fund back in 2000 would have about $45,000 today.

5. Rydex Dynamic NASDAQ-100 2x Strategy Class A [RYVLX]

This is another fund that should probably come with a bottle of ulcer medication. Investors tough enough to endure a brutal 2008 will have seen this mutual fund rebound nicely. This fund has a 16% average annual return since being founded in 2004, and a 50% annual return since the bottom in early 2009. The goal of this fund is to double the performance of the NASDAQ-100. Top holdings include Apple, Amazon, Google, and Facebook.

6. Fidelity Select Pharmaceuticals Portfolio [FPHAX]

It took a while for investors to make money from this fund, but there were solid gains between 2005 and 2007, and super performance in the last six years. We like a 9.8% annual return since its founding date in 2001, and more than 15% in average annual returns in the last 10 years.

7. Fidelity Select Health Care Portfolio [FSPHX]

Ronald Reagan was in his second year as president when this fund first came into being. It's been a solid performer all its life, and has generated an average annual return of 12% in the last 15 years. Current top holdings include Allergan, Medtronic, and Boston Scientific Corp.

8. Fidelity Select IT Services Portfolio [FBSOX]

This fund was once known as "Business Services and Outsourcing," but now invests about 80% of its holdings in the information technology sector. Whatever the focus, the fund has been good to investors. An average annual return of about 11% makes this one of the best performers of the last 15 years. Top holdings include Visa, Mastercard, and IBM.

9. Janus Global Life Sciences Fund [JAGLX]

Here's a funny thing about this fund: If you bought right at the start of 2000, you'd have been rewarded with a 70% return on your investment within two months. But if you bought in March of that year, you'd have been forced to wait 11 years to see any positive return at all. Patient investors, however will have seen an average annual return of between 11% and 12%, and a 41% average annual return over the last three years.

Are you invested in any of these nine best performing mutual funds of this century?

This article is from Tim Lemke of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

7 Places to Get Vaccinated for Cheap or Free

Damian Davila — Thu, 27 Aug 2015 11:00:15 +0000

Less than half of Americans were vaccinated against the flu during the 2013–2014 season.

The statistics for other types of immunizations are even more discouraging:

21% of adults with high-risk conditions have received a pneumococcal vaccination;
24% of adults over age 60 have received a shingles vaccination; and
17% of adults have received a Tdap (tetanus, diphtheria, and pertussis) vaccine in the last 8 years.

While there may be many reasons why people aren't getting vaccinated, cost shouldn't be one of them. Here are seven places to get immunized for cheap or free.

1. "Stop Flu at School" Programs

During the fall, most state Departments of Health in the country offer free flu vaccine programs at participating public, private, and parochial schools. For example, the Hawaii State Department of Health provides flu shots to over 65,000 students statewide every year through its Stop Flu at School program.

Participation in school vaccinations is voluntary and requires permission of a child's parent or legal guardian. Check with your school whether or not it's participating in a flu vaccination program and inquire about more details, such as necessary consent forms and available methods of vaccine delivery.

2. Your Workplace

Every year, nearly 111 million U.S. workers get sick with the flu, costing about $7 billion per year in sick days and lost productivity. Even more troubling is that adults ages 18 to 64 account for about 35% to 40% of flu hospitalizations. If you're the main breadwinner at your home, you need to take action to protect yourself and your loved ones against preventable diseases and potential financial strains.

This is why many businesses are offering free flu shots and other types of immunizations to their employees. The larger the organization that you work for, the higher the chances that your workplace offers at least one type of immunization for free. Check with your HR department for more details.

3. County Health Department Programs

Many county health departments offer immunization services that have lower prices than private pharmacy service providers.

For example, the cost of a hepatitis A/B (Twinrix) vaccine at the Washoe County Health District is $63, while the cost of the same vaccine at Costco is $109.97. Another example is the State of Hawaii, Department of Health, which offers free or low cost vaccinations for persons without health insurance.

Keep in mind that most county health departments require an appointment and walk-ins often result in long waiting times. Check with your local county health department for more details.

4. Participating Locations Through the Health Insurance Marketplace

Thanks, Obama.

Per the Affordable Care Act, all health care plans sold through the health insurance marketplaces must cover certain preventative services, such as immunizations, without charging you a copayment or coinsurance.

Here is a list of the covered immunization vaccines for children and adults:

Hepatitis A
Hepatitis B
Herpes zoster
Human papillomavirus
Influenza (flu shot)
Measles, mumps, rubella
Meningococcal
Pneumococcal
Tetanus, diphtheria, pertussis
Varicella

Check with your insurance provider for details about where you can receive immunizations for free. To get a list of locations near your zip code that may accept your insurance plan, you can also use the vaccine finder offered by Vaccines.gov.

5. Costco

Assuming that you have no health insurance, you need a flu shot right this minute, and are ready to pay out-of-pocket, your best bet is to visit a Costco Pharmacy. At $14.99, Costco offers the most affordable flu shot (influenza) to anybody that doesn't have insurance and is ready to pay out-of-pocket. Costco also offers types of vaccines, such as pneumonia and shingles.

No Costco membership? No problem. Immunization services are one of the seven things non-members can get at Costco.

6. Target

If a Target offering flu shots happens to be more convenient for you than the nearest Costco warehouse, then you can take advantage of Target's price match guarantee to lower the cost of your immunization.

Bring proof of the listed price for a flu shot at a nearby Costco and Target will lower the price of its original flu shot from $23.99 to $14.99. Call your nearby Target location for more details and a list of available immunizations for children and adults. (Note: Target stores in Hawaii and Alaska are excluded from the price match program.)

7. Sam's Club

Neither a Costco or Target nearby? Head to the nearest Sam's Club that offers pharmacy services. Non-members don't need a Sam's Club membership to buy pharmaceuticals and Sam's Club doesn't charge extra for those purchases.

If you do have an insurance plan, it may entitle you to a free flu shot at qualifying Sam's Club locations. The cost of a flu shot is at Sam's Club is $15. The big box retailer also offers other types of immunizations.

Where do you get immunized for cheap or free?

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This article is from Damian Davila of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

Ouch! 5 Ways to Make Paying for the Dentist Less Painful

Mikey Rox — Tue, 18 Aug 2015 21:00:40 +0000

A trip to the dentist might not hurt your pocket if you have dental insurance. All you have to do is flash your insurance card, cover your co-pay, and be on your merry way. But without dental insurance, a routine visit might be more than you bargained for. Not only is there the agony of dealing with all that noisy scraping, sucking, and drilling, but you can get hit with a hefty fee for services.

There isn't much you can do to make the actual appointment more enjoyable, but there are ways to ease the financial pain of paying for a dental visit. Take a look at these five tips on how to make paying the best part of your dental appointment.

1. Save Big With a Dental Discount Plan

If dental insurance isn't offered through your employer and you can't afford monthly premiums on your own, purchase a discount dental plan.

These plans vary depending on the plan provider, but are significantly cheaper than dental insurance. For example, the Careington Care 500 Series discount dental plan costs about $159 a year for a family plan, and offers discounts of 20% to 60% for most dental procedures. Instead of paying a usual fee of $57 for a routine six-month checkup, the discounted fee for plan members is $15 — a savings of 74%. The plan also covers other dental procedures, such as X-rays, fillings, crowns, root canals, tooth replacements, and tooth removals, as well as cosmetic dentistry and orthodontics care for adults and children.

If you're interested in these discount dental plans, DentalPlans can help you find the perfect plan for your needs and budget. The site allows users to search, compare, and select from more than 30 discount dental plans that offer savings of 10% to 60% off most dental procedures.

2. Don't Skip Regular Examinations

Going to the dentist might not be the highlight of your day, but skipping regular examinations could end up costing you more in the long run.

Regular six-month examinations are crucial for good oral hygiene. Your dentist can identify dental problems early and treat a small issue before it worsens and becomes an expensive one. If you have a small cavity, your dentist might be able to fill the cavity at a small expense. On the other hand, if you ignore a cavity and the decay worsens, fixing the tooth might require more than a conventional filling, and you might need a dental crown. The more extensive a dental procedure, the more you'll pay out-of-pocket.

Make sure you visit the dentist at least twice a year for a professional cleaning. And if you experience toothaches, bleeding gums, or other oral problems, let your dentist know sooner rather than later.

3. Negotiate a Cash Discount

If you don't have a dental discount plan or insurance, speak with your dentist's office in advance to see if you can get a discount for paying cash. Some dentists prefer cash payments directly from patients because they don't have to deal with insurance claims. Never underestimate the power of negotiation. If the dentist knows you don't have insurance, he might surprise you and knock money off your bill.

"Many dentists will offer around 5% off if you pay cash up front," says Dr. Lawrence Wallace, CEO of Larell Surgical Consultants, a California company that evaluates claims for insurers.

Also, it doesn't hurt to ask dentists to charge you the same rate they charge insurance companies, which is usually 10% to 15% off a regular office visit or procedure. This may not work out, but it's worth a shot.

4. Go to a Dental School

Before a dental student can graduate and start working in a dental office, she needs to practice on real people. This is where you come in. Going to a dental school for routine dental procedures, such as cleanings, fillings, and root canals can result is a cheaper dental bill. To give you an idea of the potential savings, the Indiana University School of Dentistry charges "about half what a dentist might charge for preventative care like a cleaning."

The thought of a student working on your mouth might sound scary. However, these students only perform services on patients as they near graduation, and always under the supervision of an instructor. You can check the American Dental Association's website for a list of accredited dental schools in your area. Personally, I went to a dental school to have my wisdom teeth removed after college when I didn't have insurance. Everything went according to plan, and they got me sufficiently high on gas before the procedure. All things considered, that was the best part of my day.

5. Barter for Free or Cheap Dental Care

If you don't have a lot of cash to pay for dental care, consider bartering for discounted or free services. Maybe you have a skill that can benefit the dentist, such as web design, office cleaning, or marketing skills. Contact the office manager and leave a message for the dentist asking to trade services in exchange for dental care.

Do you have other ideas on how to save money on dental appointments? Let me know in the comments below.

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This article is from Mikey Rox of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

Follow These 5 Steps to Full Health Care Coverage in Retirement

Carrie Kirby — Thu, 14 May 2015 15:00:09 +0000

Are you sure you'll be able to afford healthcare in retirement? Positive?

Consider this: A recent report analyzing the rising out-of-pocket Medicare costs estimated that people retiring 10 years from now will spend $9 of every $10 they receive from Social Security on health care, in the form of copays, supplemental insurance premiums, prescription drugs, and things not covered by Medicare such as visits to the dentist.

This means that the cost of medical care is something everyone should factor into their retirement saving plan. But this is no ordinary expense — there are specific strategies for saving for health care that can put you in a much better position in your golden years.

1. Maximize Your Social Security Benefits

"The number one thing people should do — most people aren't aware of this — is optimize Social Security," says Ron Mastrogiovanni, founder of HealthView Services, which issued the alarming report.

The main way to maximize benefits is to wait as long as possible to start receiving Social Security. A couple retiring 10 years from now at age 65 will receive $142,000 less in lifetime benefits than they would if they worked until age 67, he said.

"If you're capable of working, why would you throw away $142,000?" Mastrogiovanni says.

2. Start a Roth IRA

"Under Medicare, they have something called means testing; the more you earn, the more you pay," Mastrogiovanni says. "Here's the kicker: Those income brackets are not indexed to inflation." That means that if the government doesn't adjust the income at which retirees are considered affluent, many middle earners of today will end up paying more once they retire.

But not all retirement income is counted in this calculation. Money drawn from a traditional 401(k) counts, but money drawn from a Roth IRA or a Roth 401(k) doesn't. So if your regular 401(k) is building up towards a high income in retirement, you might want to divert some of your contributions to a Roth, or convert the account to a Roth, to keep your income below the level where you'll be considered an affluent retiree.

3. Consider a Health Savings Account

Health savings accounts are not generally considered a retirement savings vehicle — they are meant to help people pay high medical care deductibles with certain insurance plans. But Medicare expert Katy Votava advocates saving excess contributions to HSAs for retirement health care needs.

"You can put in significant money and it grows tax free. Most people don't need to spend their full health savings account every year to meet their full health insurance needs," Votava says.

4. Consider Long-Term Care Insurance

The high out-of-pocket costs outlined in the HealthView report do not include the cost of nursing homes or other long-term care, but those are obviously a major concern when looking at lifetime health care costs. Some advisors recommend purchasing insurance that would protect your savings if you go to a nursing home, while others warn against it. This Wall Street Journal report explores both sides of the long-term care insurance issue.

5. Purchase the Right Supplemental Plan

Your parents or grandparents may not have had to pay anything out of pocket once they qualified for Medicare, but people retiring now and in the future need supplemental insurance to cover the copayments, coinsurance, and deductibles that Medicare doesn't cover. You'll also have to pay for a prescription drug plan. Choosing the right plan can be so complicated that many people turn to consultants like Votava to help them figure out which to pick. Before signing up for a plan, make sure it covers your doctors and your medications, because not all plans cover everything, Votava warns.

What are you doing to ensure sufficient health care coverage in retirement?

This article is from Carrie Kirby of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

Don't Miss These 7 Great Tax Deductions for Parents and Caretakers

Christa Avampato — Thu, 26 Mar 2015 13:00:11 +0000

April 15th will forever be synonymous with an-often dreaded American obligation: filing our income taxes. It can, and often is, a tedious process that we put off for as long as possible. As you wade through a sea of W-2s, 1099s, and deduction paperwork, parents and caretakers should be aware of the following deductions and claim them if and when they apply.

1. Home Modifications

Certain health challenges require home modifications, such as making a bathroom accessible or adding ramps in place of stairs. These expensive modifications can often be deducted from your taxes if without them you wouldn't be able to care for your dependents.

2. Basic Living Expenses

Provided that basic living expenses such as specialized food, housing, and clothing are medically necessary for your dependents, you may be able to take them as deductions. It's important to note that these expenses are not tax-deductible based on personal preferences. They must be substantiated as required expenses by medical professionals. Make sure that you have paperwork in your files that proves this to be the case in the event that you are audited.

3. Health Care

Once health care costs exceed a certain percentage of your income, it can be taken as a deduction. This includes your own personal health care costs, as well as those of your dependents.

If you're caring for a loved one who is ill, these costs can be steep, and you should investigate whether they meet the deduction threshold. This includes out-of-pocket costs for hospitalization, copays, medications, dental care, deductibles, ambulances, bandages, eyeglasses, long-term care costs, alternative medicine, adaptors for TVs and telephones for hearing impairment, smoking cessation, weight loss programs, and wigs that compensate for hair loss. Remember, these costs must be medically necessary or caused by a medical condition, and not just a matter of convenience or preference.

4. In-Home Care for the Disabled

If the care of your loved one requires live-in help or a day- or night-time aide, then the cost of that help may be deductible. It depends upon your income, the cost of the care, and your other dependent care expenses. This credit would be bucketed under the "child and dependent care expenses" deductible. This is a very defined term when it comes to taxes, and there are specific disability criteria you must meet to take this deduction.

5. Child Care

If your dependent is under 13 years old and you paid for a daycare center, summer camp, or babysitter, a portion of those costs may be deducted on your taxes. There are stipulations around your employment status, the expenses you incur, and how many children you have that dictate if and how much you may deduct child care expenses.

6. Student Loan Interest

If you paid interest on the student loans of your dependents, that interest may be tax-deductible. You can take this deduction if your income is below a certain dollar amount, even if you don't itemize your taxes. The IRS provides a complete and thorough explanation of student loan interest deductions on its website.

7. Transportation

When you are caring for a loved one, transportation can also be a deductible expense. Like many of the other things listed above, these transportation costs must be medically necessary to serve as deductions.

Whenever caregiving is involved, I always encourage people to seek the advice and assistance of a tax professional, such as an accountant. These laws and guidelines are complicated, and in the event that you are audited, it's important to have all of the paperwork to prove and justify these expenses. With the filing deadline less than a month away, now is the time to get everything in order.

Which deductions for parents or caretakers will you be using?

This article is from Christa Avampato of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

Healthcare Paperwork That Doesn't Require Paper or Work

Alaina Tweddale — Thu, 25 Dec 2014 16:00:11 +0000

This post is brought to you by Humana. Click here to learn more.

Insured Americans are more likely to face healthcare paperwork overload than any other industrialized nations, according to a recent report by The Commonwealth Fund, a private foundation whose mission includes various improvements to the U.S. healthcare system. In fact, a staggering one in three American adults reported spending "a lot of time" managing their insurance paperwork, where only 25 percent of Swiss, 19 percent of Dutch, and 17 percent of German respondents claimed the same.

Healthcare giant Humana is making strides to tackle the healthcare industry's paperwork problem. The company recognizes the frustration that comes with filling out, figuring out, and following up on healthcare insurance forms. Through use of its online dashboard, MyHumana, the company has created a secure, easy-to-use portal that makes it easy to navigate your health information from anywhere you are. All you have to do is log on through your computer, tablet, or smartphone. The online portal cuts the annoying paperwork right out of the equation.

With MyHumana, all your information is in the same place. There's no need to go back through your plan paperwork or check your personal medical history files to get answers to current healthcare questions. It's all available through the portal, just a mouse click away.

Check Your Deductibles

Know exactly what your deductibles are for medical, dental, vision, and prescription coverage. The portal also shows you how much money has gone toward each deductible during the plan year, including how much you have remaining before your annual deductible is met. If you're not sure of your member ID number, group ID, plan type, or start date, it's all right there, in the portal, for easy access.

Review Your Claims

If you're not sure if you owe money for a recent doctor's visit, you can easily log on and check it out. The portal displays each claim number, the date of the claim, the amount paid, and the amount due. You even see the original amount billed, any discounts applied, and how much was paid by your plan (versus by you). In the event you have a question that's not answered through the portal and are logged in from your smartphone app, there's an easy-to-use phone icon that can automatically connect you with a Humana associate.

Find a Doctor

You won't have to wonder whether a doctor is under your planned. The online search will help find one that's covered through your plan. Before you schedule your next office visit, you can quickly check the portal to find an in network provider. You can look for doctors, dentists, hospitals, pharmacies, and urgent care centers. You can choose to look a provider up by name. Or, if you don't have a specific specialist or other professional in mind, you can search for in network providers in your area. All contact information including phone, street address, and even distance from you are quick and easy to view. With just one click, your smartphone will automatically dial the provider of your choice.

Compare Prescription Costs

The portal can be used to find what your new prescription will cost or just to research cheaper, generic alternatives before you get to the pharmacy counter. Right from the portal you can input your drug and dosage. MyHumana will automatically compare the cost of your prescription from both local and mail order pharmacies, highlighting the least expensive option. Once your prescription is in the system, you can set up a text alert to remind you when it's time to refill, if your benefits change, or if the prescription becomes available somewhere else for a lower cost. You can even set up clinical pharmacy alerts, which let you know if any potential problems arise with the medicine you're prescribed.

Access HumanaVitality

HumanVitality is a wellness app that allows you to seamlessly transfer your workouts from your heart rate monitor, pedometer, or other fitness tracking device. The program also allows participants to earn points for completing health-related tasks like getting a flu shot, completing an online health assessment, getting First Aid certified, or going for a bike ride. Accumulated points can be traded in for prizes like movie tickets, a heart rate monitor, or even a digital camera.

Thanks to Humana's online portal, navigating your health and insurance information doesn't have to be complicated. Now Humana members can safely file their healthcare paperwork away, knowing that most of what they need can be found with the swipe of a finger. Good-bye paperwork. Hello MyHumana.

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This article is from Alaina Tweddale of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

How to Take Advantage of Obamacare for Less Financial Risk and More Freedom

Philip Brewer — Wed, 25 Sep 2013 11:24:09 +0000

In the US, buying health insurance has been a gamble: If you got sick, you were locked into whatever policy you bought when you were healthy. Once Obamacare goes into effect, that will no longer be true. This reduces your risk and increases your freedom. (See also: Freedom From the Day Job)

This post isn't on the specifics of the reforms. (See Wise Bread's post on how the Affordable Care Act's Health Insurance Exchanges work for that.)

This post is on tactics and strategies for taking advantage of the new circumstances: Using them to reduce your risk and increase your freedom.

Less Risk

In the United States, choosing a life-path that didn't include employment with a large firm has been a huge gamble, and the biggest piece of the gamble was health insurance.

In particular, choosing a life-path where you needed to buy an individual policy put your whole family's finances — and your life — in danger. If you became seriously ill, your policy would cover your expenses this year, but then you'd never be able to get a new policy, because insurers only wrote health insurance policies for people without preexisting conditions. Your premiums for your current plan would go up each year to cover the costs of your care (and others on the plan who had also gotten sick that year), and healthy people would drop the plan for new, cheaper, policies. Your insurance costs would spiral out of control, until they became unaffordable for anyone who wasn't wealthy.

Basically, buying an individual policy before 2014 was a gamble that you'd only ever get seriously ill once.

Starting next year, that's no longer true. Your rates won't go up. Thanks to community rating, you'll pay the same rate as everyone else in your age group, even if you get sick: Less risk.

A related issue for the non-wealthy was that health insurance — good health insurance, that actually protected your finances from serious illness or injury — was expensive. That prompted people to go with minimalist policies that didn't actually provide much coverage. Worse, it prompted insurance companies to create crappy "insurance" policies that might look like they provided pretty good coverage (if you didn't know how to read an insurance policy), but actually covered even less than a legit minimalist policy.

Under the new law you can get stripped-down coverage — a Bronze policy — that has lower premiums (and higher copays and deductibles). But even a Bronze plan has to cover all the same care that the better policies have to cover. You have real insurance: Less risk.

One other aspect to this is that you're guaranteed to be able to change your policy every year, if you want to.

That was true before — but only if you weren't sick. If you got sick, you were stuck with whatever policy you had. If you were worried that you might get sick, you had a strong incentive to pay up for pretty good insurance, so the policy that you were stuck with would be a pretty good policy.

The new situation enables an option that wasn't safe before. While you're young and healthy you can choose a Bronze-level policy. If you get sick, you'll have to pay the higher deductibles and copays this year, but you won't be stuck with the policy for the rest of your life. You can choose to stick with a cheap policy as long as you're healthy, without losing the chance to upgrade if you start needing more expensive care: Less risk.

Strategies and Tactics

With all that in mind, here's a few tactics and strategies for using your new individual health insurance options to help you live large on a small budget.

1. Get Insurance

There's no good reason not to. If you're living near poverty, you can get substantial subsidies to help with the cost. (If you're very poor, you can get Medicaid for free in most states. Some states are turning down free money from the federal government to support the expanded Medicaid. If you live in one of those states, you might want to move.) (See also: How to Leave Town Fast)

2. Get Your Preventative Care

It'll be free — and if you're young and healthy it won't cost you much in time or discomfort either. But if it catches some serious problem early, it could save your life. (You can't live large if you're dead.)

3. Figure Out If You Can Get a Subsidy

Everybody is pointing at the Kaiser Family Foundation's calculator. It'll take your income and your family size and figure out what subsidy you'll get, if any.

The subsidy is sized to make a Silver-level plan affordable, but you don't have to spend it on a Silver plan if you don't want to. It can make a Bronze-level plan quite cheap, or bring a Gold-level plan more within reach.

If you qualify for a subsidy, be sure to buy your policy on the public exchange — it's the only way to get the subsidy.

4. Choose a Metal Level

If you're young and healthy, consider getting a Bronze plan. If you get sick or injured, you'll have to pay a big chunk of the cost of your care, but you'll still be protected by the out-of-pocket maximum, which caps your health care expense at $6,350 for the year.

In addition to people who are young and healthy, this may be appealing to people who are middle-aged and healthy. In fact, it's particularly attractive for someone who has accumulated a chunk of capital. For example, someone who's saving hard with an eye toward early retirement might well be able to take a risk that they'd get hit with $6,350 in medical expenses, if the payoff was hundreds of dollars a year that they could add to their savings.

On the other hand, if you're in the bottom half of the low-income group getting a subsidy, consider getting a Silver plan. People with incomes between 133% and 250% of the poverty level who have a Silver plan get a further subsidy in the form of reduced deductibles and copays.

On yet another hand, if you have some chronic medical condition with a high level of ongoing expenses for health care, consider a Gold or Platinum plan. (See also: What to Do If You Have a Huge Medical Bill)

5. Reevaluate Annually

Many people will be able to stick with roughly the same plan year after year. But as circumstances change, it may make sense to make some changes.

As your income changes, your subsidy will change. (Even if your income doesn't change, the thresholds for the subsidy will change as the poverty line changes.)

As your health status changes, it may make sense to change your metal level.

You're locked in for a year at a time — but that's nothing compared to being locked in for a lifetime, the way people who get sick have been.

More Freedom

As I said when the Affordable Care Act passed, Obamacare is going to be good for people like me. It's likely to save me money — although I'm very healthy, I'm getting older, and the cost of my individual policy has started to climb, simply because of age. That will stop. But that's not the big win.

The big win is that I'm no longer risking my family's finances on the gamble that I'll only ever get sick once in my whole life. And that doesn't apply only to me.

A lot of people are drawn to some lifestyle where an individual policy is the way to go. Maybe, like me, they want to be writers — or pursue some other creative career, like musician, composer, actor, dancer, painter, sculptor, or a dozen others. Maybe they want to be entrepreneurs and start small businesses. Maybe they want to be subsistence farmers on a small plot of land. There are a lot of people like that, who are willing — even eager — to accept the lower standard of living and the risk of failure that comes with taking the leap away from working for a big company, but who have hesitated to take the additional gamble that injury or illness will bankrupt them.

This less risky version of the health insurance market is going to enable them to choose to take those other risks — the risk that their book won't sell, that their play is a flop, that they never make more than $50 a week as a musician, that their business will go bust, that their crops will fail — without adding on the risk that illness will bankrupt them. (See also: Make Your Dream Career a Reality for Under $100)

This is going to enable a whole lot of freedom — and unleash a whole lot of productivity and creativity that has been sitting idle in cubicles, on factory floors, in back offices, and behind service counters.

All that because individual health insurance policies are going to be less risky.

Are you ready for the opening of the ACA medical insurance exchanges? Will you be purchasing insurance via the exchange?

This article is from Philip Brewer of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

9 Frugal Ways to Treat the Common Cold

Michael Kling — Fri, 04 Jan 2013 11:24:30 +0000

It's winter again, and the common cold will be very, well, common. Fortunately, frugal ways to treat the common cold are readily available so you don't have to spend a fortune on doctor visits and over-the-counter medication.

Many frugal cold remedies are healthier than cold medicines that only cover up symptoms instead of actually curing your cold. Plus, many cold medications have unwelcome side effects, and they're rarely inexpensive.

The next time a cold lays you low, try one or more of these nine frugal remedies to put you back on your feet again. (See also: 25 Ways to Feel Better Fast)

1. Steam

Steam can ease sore throats and clear nasal congestion. Indoor heating systems frequently make indoor air too dry, which is probably a factor in spreading winter colds. Put a humidifier in your bedroom overnight or living room during the day. Or, if you don't want to spend money on a humidifier, sit in the bathroom with the door closed while running a hot shower or stand over a pot of boiling water.

2. Saline Nasal Drops and Sprays

Frequent drops or sprays of saline solution in the nose can help encourage decongestion. Saline drops are cheap and available over the counter, and they're different from medicated nasal drops or sprays, which can prompt cold symptoms to worsen if used more than several days. You can also make your own saline solution with a teaspoon of salt and a pinch of baking soda in a pint of warm water, and apply it with a child-size medicine dropper.

3. Salt Water Gargle

Gargle with a quarter- to half-a-teaspoon of salt dissolved in an eight-ounce glass of warm water. Gargle for several seconds, then spit it out. It can soothe sore throats by drawing out excess fluid from inflamed tissue and loosening mucus. If you disdain salt water, you can gargle with warm water spiked with lemon and honey instead.

4. Rest

And plenty of it. Resting helps restore your energy and strengthens your body's immune defenses, helping avoid complications like bronchitis and pneumonia.

5. Drinking Liquids

Drinking water, juice, clear broth, or warm lemon water with honey helps loosen mucus and aids your immune defenses. Warm liquids, like broth or herbal teas, help soothe sore throats and loosen mucus, which eases congestion. Natural herbs can be added to hot water for teas.

6. Chicken Soup

Your grandmother was right. Chicken soup is easily digestible, and its warmth can help loosen mucus and relieve sore throats. It speeds up movement of mucus, possibly helps relieve congestion, and helps reduce inflammation.

7. Vitamin C

Many people swear by vitamin C, although scientific evidence has yet to prove that it cures colds; it's more likely that it can help you avoid catching colds. But if it works for you, placebo effect or not, reasonable doses won't hurt.

8. Healthy Diet

Fruits and vegetables rich in antioxidants and vitamins A and C, such as sweet potatoes, spinach, and broccoli for vitamin A; and oranges, kiwi, and tomatoes for vitamin C, help improve your immune system, although a year-round healthy diet is best before you catch a cold. Avoid caffeine and sugar.

9. Herbs

Elder (also called elderberry), eucalyptus, goldenseal, licorice, and marshmallow are some of the many plants used to treat colds, coughs, and sore throats. You can find these herbs in your local market or health food store; teas made from these herbs are also widely available. If you live in the right area you might be able to grow these herbs in your backyard or find them around your neighborhood.

Cold sufferers should research which herbs to use, as the list of possible herbal treatments is quite long, and the best options vary by person, symptom, and stage of the cold. Keep in mind that scientific evidence on their effectiveness is inconclusive, and women who are pregnant or breastfeeding and people with health conditions should talk to a doctor before using herbal remedies.

The best way to fight colds may be to avoid them in the first place. You've probably heard about eating right, exercising, and washing your hands especially after being out of the house and touching doorknobs, shopping cart handles, and shaking hands at parties. You might not have heard that reducing stress through yoga, tai chi, or meditation can also help reduce chances of catching colds, too.

This article is from Michael Kling of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread:

How to Choose a Health Insurance Plan

Julie Rains — Wed, 08 Aug 2012 10:24:41 +0000

Your health insurance plan can impact your physical, mental, and financial health. Choosing the right one can benefit your peace of mind, help you navigate the healthcare system, control costs, and, in some cases, put extra cash in your pocket.

Start by familiarizing yourself with the types of health insurance plans to get an understanding of general plan designs and features. Scrutinize the plans that are available to you. These may include employer-sponsored (or work-based) plans associated with your job or your spouse's or parent's job (for those who are married or are under 26 years) and private insurance plans. Look at costs and coverage as well as features that make the plan easy to use. Then, make a choice that best fits with your needs, preferences, and financial goals. (See also: How to Find Free (or Cheap) Health Resources)

Evaluate Financial Aspects of Plans

Understand the cost structure of the plans that you are considering. Evaluate how the plan design will affect your finances.

Look at the Provider Network

Your selection of medical providers (either in or out of the plan's network) plays a major role in your health expenses. Typically, copays (flat fees for visits) and coinsurance amounts (fee percentages of list prices) will be the least expensive for in-network providers. Charges toward deductibles and out-of-pocket limits are applied differently between in-network and out-of-network providers, with a lower threshold for network usage. HMO and EPO plans, in particular, pick up most of the tab when you see an in-network provider, but you might have to pay the entire bill for out-of-network visits (except for emergency situations).

Look at the provider list offered by the insurance company; request the listing if it’s not made available to you automatically. Check if your primary care physician is in the network and see if others you use or might use (such as labs, pharmacies, hospitals, and specialists) are included.

Kim Lankford of Kiplinger’s Personal Finance tells me that sticker shock associated with out-of-network providers is one of the biggest surprises people have in regard to healthcare costs. In many cases, consumers don’t choose to go outside the network intentionally but receive a referral from an in-network primary care physician to an out-of-network specialist.

Review Coverage

What does the health insurance plan cover? A priority for most people is preventive care, but that can mean different things to different people (and different insurance companies).

I asked Kim what was considered preventive under the Affordable Care Act, and she pointed me to Healthcare.gov, which lists services for all adults, women and pregnant women, and children. For new plans or insurance policies (created after September 2010), preventive care must be covered “without your having to pay a copayment or co-insurance or meet your deductible,” but this rule applies “only when these services are delivered by a network provider.”

Check whatever plan you are considering to see what’s covered for preventive services. Also review coverage for pre-existing conditions, mental health services, and maternity care, especially if you think you may need such coverage in the next year or so.

Compare Expected Costs

Look at fixed and variable costs of comprehensive health insurance plans. Your fixed cost is your monthly premium, the amount you’ll pay no matter what just to have insurance coverage. The variable costs are your usage costs, such as copays for office visits that you’ll incur only if you actually use products or services.

Your monthly premium should stay the same during the plan year. But copayments and coinsurance might vary based on:

The type of healthcare service you use
Whether you have met the annual deductible (per person and family)
Whether you use in-network or out-of-network providers

It’s impossible to predict your healthcare needs with complete accuracy, year after year. But you can consider how often you visit the doctor and try to predict what services you may need in the upcoming year to get a general idea of expected costs.

Consider Worst-Case Scenarios

When comparing plans, look not only at expected costs, but also consider worst-case scenarios.

The numbers that are relevant to this evaluation are:

Annual per person and family deductibles
Annual out-of-pocket (OOP) limits
Annual maximum limits
Lifetime maximums aka lifetime caps

Deductibles and OOP limits apply to you and your family, and help control your costs. Lower numbers are better. After you reach the deductible, you’ll pay a lower percentage of medical fees. And, generally, after you reach the OOP limit, you won’t have to pay any more during that plan year. The exceptions are the situations when payouts for annual maximums and lifetime maximums are reached.

Annual maximum limits and lifetime caps control costs for insurance companies. Higher numbers (or unlimited) are better for you. Though catastrophic medical events are uncommon, they can be financially devastating if your maximums are set too low.

Note that The Affordable Care Act raises these limits in 2012 and 2013, and eliminates them (for covered expenses) by 2014. Kim points to Lifetime & Annual Limits on Healthcare.gov as a resource for this information. However, grandfathered plans and plans with waivers may still have limits, so you should ask about maximums.

Look at Plan Perks

There may be some less obvious benefits to certain plans, especially those offered by your employer. Kim mentions a few features that can lower your overall costs:

HSA eligibility and funding
Wellness incentives, paid directly to you
Employer contributions to health accounts

When comparing plans, consider the potential impact of these features on your bottom line. Contributions to a Health Savings Account (HSA) can lower your tax bracket and reduce your tax liability while allowing you to save money on future medical expenses and build wealth over a working lifetime. Wellness incentives may be available if you achieve, maintain, or show improvement in certain indicators (BMI or blood pressure, for example); or you may get discounts associated with joining a gym or participating in a fitness program.

Finally, your employer may make a contribution to your health account, helping you to pay for healthcare costs. Kim points to a report from AHIP citing a 2011 Kaiser Family Foundation study showing that "69% of employees with employer-sponsored HSA/HDHPs received contributions to the accounts from their employers."

Consider Intangible Aspects of Plans

Beyond financial benefits, there are intangible aspects of health insurance plans that you should consider when choosing a plan. These areas can impact your overall wellness.

Consider the Quality of Providers

Figure out whether you will be happy and healthy with the network providers, consisting of physicians, hospitals, surgical centers, labs, pharmacies, etc. Consider their credentials, accessibility, and professional reputations. Talk to friends, family members, co-workers, and neighbors to assess whether they have had positive outcomes with these providers.

Measure Freedom and Simplicity

Consumer-directed health plans (CDHPs, aka high deductible health plans or HDHPs) generally give you a lot of freedom in making healthcare decisions. You can choose any medical provider, schedule an appointment with a specialist (that is, if the specialty physician accepts self-referrals), get screening tests, etc. based on what you think is appropriate. Greater freedom often means greater responsibility, though, for making decisions and more accountability for controlling lifestyle-based health risks.

More restrictive HMO and EPO plans limit what’s available to you in terms of provider choices and other aspects of your medical care. Such plans typically involve less decision making on your part, making things simpler for you (which may useful if you do not have health problems).

Simplicity can also be measured in terms of handling details. Anticipate how much effort you may need to expend for the purpose of locating the right provider, arranging appointments, obtaining pre-certifications, and filing insurance claims, all based on plan designs.

Choose the Best Option for You

Ideally, you want to pay as little as possible and get the highest quality and easiest-to-use health insurance plan. There may be a clear winner in your evaluation — a comprehensive plan that has low monthly premiums, deductibles, and OOP along with a variety of choices and unlimited maximums from the insurance company. But, in many cases, you'll have to decide what's best for you even if you can't get all that you want.

Rank Your Financial Priorities

Consider what's most important to you:

Would you rather pay a higher fixed monthly cost (higher premiums with lower usage costs) for budgeting purposes?
Does the opportunity to pay as little as possible (through a low monthly premium but high deductible) seem attractive?
Are you concerned about potential risk associated with an accident or health crisis?
Would you like to reduce your tax liability with an HSA?

Determine your priorities; then figure out how plan designs fit with your financial goals.

Think About Personal Priorities

You may really enjoy having lots of freedom in accessing healthcare services; or, at the other end of the spectrum, you'd rather keep things simple.

If you are relatively healthy, the type of health plan may have little impact on your lifestyle. But if you have a chronic condition or unusual risks, then more freedom could allow you to get diagnostic and treatment services more readily. Though you can't foresee everything that will happen to you in the future, you can gauge what you may need based on past experiences. So, think about how the plan helps you deal with health concerns.

Consider Special Scenarios

You may have a situation that warrants special consideration. A few that I discussed with Kim:

If you are a young adult (under age 26), the least expensive option may be your parent’s health insurance plan. However, Kim cautions that you need to consider whether network providers are available in your town, if you happen to live in a different city than your parents.
If you are unemployed, you may think about buying a temporary policy to get coverage from now until you get a job and obtain a work-based policy. Kim recommends getting a regular policy now and dropping the policy after you have landed a job (and become eligible for employer-based coverage). In this way, you don’t have to worry about the temporary policy lapsing.
Employer-sponsored health insurance policies may cover pre-existing conditions and high-risk situations. However, if you are having difficulty getting coverage or the price is unusually high, you may be able to find a policy using state resources (high risk pools or state-based insurance exchanges).

After you get a handle on the options and think about what's important to you, choosing a plan should be straightforward. Hopefully, there will be an obvious choice, and one that you can live with.

Are health insurance plans easy for you to understand? What is the most important factor in making the right choice for you?

This article is from Julie Rains of Wise Bread, an award-winning personal finance and credit card comparison website. Read more great articles from Wise Bread: