Insurance Claims: Timing is everything

I ran into an interesting financial faux pas a few months ago, when Mrs. C8j decided she needed new glasses (her eyes are deteriorating at a high rate it seems). I checked my insurance to see and yes she was allowed to buy glasses this year, so she went out and bought a nice new pair.

Optical Device Glasses

I have replaced these glasses since this photo

Mrs. C8j has her own insurance (which is nice for a full part-time job), so she first submitted her glasses claim to her insurance provider and was told, “No, we won’t pay for these because you already had new glasses, in this time period”. I believe the obscenity yelled by me was similar to #WTF! , I was not well pleased, but from this I learned that timing is everything when it comes to Optical Device Insurance Claims.

The interesting point is that both Insurance Companies claim you can purchase glasses every two years and they will cover an amount for the glasses (with a bunch of riders about styles, types of lenses etc.,) up to a maximum of about $250 (not the real number). In theory then, if Mrs. C8j went and bought $600 worth of glasses, the arithmetic should end up:

  • Insurance Company #1 pays about $250
  • Insurance Company #2 pays about $250
  • We are $100 out-of-pocket on the glasses

Fine and dandy, and that was the (flawed) assumption we went forward with, but the mistake we made was how each insurance company computes 2 years.

How can this be? I will try to elaborate

  • My Insurance company computes two years as a calendar event. If I buy glass on January 1, 2012 or on December 31st, 2012 I can then buy a new set on January 1st 2014. This is a nice way of calculating two years (and it was what I was used to with insurance).
  • My Wife’s insurance computes two years, as two years from the day you last bought glasses. Mrs. C8j had bought glasses in September of 2012, thus she wouldn’t be allowed to buy another pair until September 2014, and that is where the problem arose.

This is where the consternation on my part arose, Mrs. C8j purchased new glasses in March, thus we ended up only being reimbursed by my insurance company for their “cut” of the glasses pay out, only.

I don’t think anyone is “at fault” here except myself for not checking closely with BOTH insurance companies before telling Mrs. C8j about when the insurance might pay out, but remember with Insurance (and all things financial) check dates, riders, provisos, and the fine print closely before acting!

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Men’s Health

It’s been a bit of a busy week so here is an important post I did a while ago about why men are idiots (about men’s health) when it comes to doctors and how Viagra might save a few men in spite of this.

More studies are coming out that are pointing out that thanks to Erectile Dysfunction medications (like Viagra) men seem to be getting healthier.

I said it, I meant it.

Men's health

Viagra

Think about it, most men go to the Doctor when their arm falls off or their skin turns purple (i.e. never). “I’ll just walk it off”, or “Nothing to worry about”, are typical excuses by men, who believe that going to the doctor is a sign of being a Wuss.

I don’t remember who wrote this, but she was female, and she pointed out that if men poop’ed blood, they’d simply go to the bathroom with the lights off, so they wouldn’t have to see it (a very true statement about men’s health).

Then the MIRACLE of E.D. medications arrived. All those men who felt that somehow their virility was not what it should be, now started to flock to their Doctors to get themselves a “little blue pill” (or whatever the other pills look like).

How did this stunted (if not weird) conversation go between patient and Doctor?

Patient: Hey Doc.
Doctor: Hey Mr. X haven’t seen you since you stepped on that board with the rusty nail and got gangrene in your foot, what was that like 10 years ago?
Patient: Yeh Doc, I’ve been kind of busy, but I wanted to talk to you about a problem I’ve been having.
Doctor: Really Mr. X? What kind of problem might that be…..
{fill in your favorite uncomfortable explanation about how Mr. X.’s plumbing does not work the same as it did when he was 18}
Doctor: Well, I think we can do something for you, but I’ll have to give you a complete physical first.
Patient: What for?
Doctor: Well, if you have heart problems, or high blood pressure and I give you this medication you might die.
Patient: I guess so Doc, if I might die…

That is why Men may start living longer, because they want to have the ability to bang a nail in without a hammer. Their view that their partners will not love them unless they can do something for 4 hours, that most folks don’t do for more than 3 minutes.

An entire industry is now created around men wanting the ability to hang their hats without a nail, and due to this, men’s health has improved (in spite of themselves). Yes, we men are a very complicated species to understand, but at least now we know what might motivate us to go to the Doctor more than once every 20 years (aside from our Doctor’s having a stunningly beautiful receptionist).

Health is more important than wealth, but most men don’t figure that out until they are very unhealthy (and can’t get back to healthy easily either). Work on your wealth, but remember without health, all you are doing is making sure your estate has lots of money for your kids.

Go see your Doctor, if you haven’t seen him (or her) in more than 5 years.

If they could figure out this kind of association for Financial Health, just think where we might be?

 Oh and to add a financial spin on this, I own stock in Pfizer as well (for full disclosure). 

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Losing Sleep and Money

Would you rather have a good night’s sleep or be financially sound?

Sorry that is a trick question, because in my case, if I was financially sound, I would sleep better. My sleep patterns are not ideal, I am a classic worrier (I believe it is genetic), so I have had many sleepless nights, but at the end of it most of the time it has been directly or indirectly due to money (and the lack thereof).

My guess is if I was single, I might not worry about money as much, because having a family and dependants makes money issues magnify in significance 10 fold (at least). It’s funny that money can play that big a role in someone’s life, but in my case it most certainly does (when I was a teenager I never thought I’d get a girl and if you’d told me I was going to be making what I am, I’d have said, “Bring it on!”. interesting how the table has turned).

Given the effect worrying has on most folks health (for those that don’t worry (and I don’t believe you don’t worry) you’ll have to imagine this), makes me start wondering about whether insurance companies are going to start asking financial health questions when you apply for health insurance or life insurance? This may sound far-fetched but is it really?

Medical studies are showing conclusively that worry and stress shortens people’s lives and can cause major health issues, so why wouldn’t insurance companies take that into consideration? In the 1960’s whether you smoked was not a question on your life insurance application, but it most certainly is now. Obesity and weight may not have been an issue before, but it most definitely is part of applications for life insurance. So why is stressful money such a stretch?

A few ideas that I could see causing insurance companies to put up a red flag on someone applying for insurance might be:

  • Over a certain age (say 35) and still owing more than 1/2 of your mortgage principle.
  • No retirement savings in place (and no pension either)
  • At Credit Card maximum rates
  • Applied for a Credit Limit increase and been refused
The list could be quite long, so watch out folks, your financial lifestyle may spill over into your health directly and indirectly too.

 

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The $6 Million Man?


Our friends over at PBS News Hour (the best news program out there (sorry Daily Show)), had a very off topic but interesting piece on the work towards bionic body part replacement that is going on in the medical world. This topic is dear to my heart because of my Dad and other folks in my family dealing with disabilities and me constantly wondering, isn’t there some way to help them with these disabilities.

Are we heading towards the $6 Million Man? No, not yet, but with more understanding of how the brain actually works, and our ability to hook into the outputs from the brain, and finally our ability to understand the mechanisms of our body (let me tell you a knee is a complicated little system), and recreate that system synthetically.

Some of this is science fiction, but then again, without the ideas of science fiction, will we move forward? The other issue (which does have something to do with money) is who is going to fund this work? How will this all fit into the already crippling health costs out there? Another interesting question to answer.

http://video.pbs.org/video/2030369120/

Watch the full episode. See more PBS NewsHour.

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Disaster Planning or the Worst Case Scenario

End of Year Financial Ideas

Any financial planning you may be doing for next year, needs to include a Disaster Recovery plan. I have had a few folks tell me that this is morbid, but as a Project Manager I have learned that you are being naive if you do not have some kind of disaster recovery plan in place, to deal with unexpected events in your life, in general, and in your financial life, in specific.

What kind of catastrophic financial events? Some simple examples might be:

  • Bread winner loses job, if your household’s main income earner loses their job, what might happen? If you don’t have a plan in place for that, and an emergency fund to deal with this, you are asking for trouble. I used to think I couldn’t lose my job, but it eventually happened, and luckily I was taken care of, but I was not prepared, and it could have been much worse. Different experts suggest 3-6 months pay in reserve, I’d say a year’s pay is your ultimate goal, having lived through it. If you think you don’t need an emergency fund because your company pays severance, that is what I thought, but then I saw what happened to my Co-Workers when Nortel went very south.
  • Bread Winner passes away, again, if you have a family and don’t have Life Insurance, or a big packet of money hidden somewhere, you are living on the edge. Does your loved ones know whether you have life insurance and what to do should you die? They need to know (as well). As soon as you get married, get life insurance (Term in my opinion), yes it’s an expense, but you need it. Is there an up to date will? Hope there is, or there could be a big mess financially to follow.
  • Bread Winner disabled, disability insurance is a tricky topic with me. I have it through work, and bought it at my former employer, and my opinion is that you should get it, if you don’t have it, but I have seen compeling arguments that simply building up savings enough is just as good a way to deal with this contingency (I don’t agree, but it is another option). What about a power of attorney? Once someone is disabled mentally getting a power of attorney is a lot harder to put in place.
  • Stuff Gets Broke, a generic topic covering stuff like Home Insurance, Car Insurance and the like. Again, you need this insurance if you care about your stuff, and in most instances in a lot of places you must have these insurances (Car Insurance at least). If your house is paid off do you need Home Insurance? I think so, if just for the liability side of things, but for unforeseen things like fire and such as well.

Why Have These Stop Gaps?

Having these financial stop gaps in place you are protecting yourself and your family’s interests, but it is worthwhile doing a plan about each of these scenarios, to see how things might work. You don’t need to go into gross detail, but if you walk through the scenario you might learn the importance of:

  • Keeping your loved ones informed on where things are. If your spouse doesn’t know about your banking, or where your insurance is with, how will he or she find out? Where is your will or power of attorney? Again, are they up to date?
  • Are you sure you have enough insurance coverage? If you run through a scenario you might realize that you need both spouses incomes, and thus you might need to have the same coverage on each spouse.
  • If you go through the scenarios and feel confident you are prepared, you then have given yourself the great present of peace of mind, and that is important.

Saying that you did this 10 years ago and it was fine is asking for trouble as well, many things change over 10 years, review it and make sure your plans are still up to date and current.

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