One of my good friends has an opportunity to work on a client engagement in London, England, and started asking me about international medical insurance options for his ladyfriend. He will have medical insurance through his employer but his ladyfriend, if she chooses to live in England while he’s on this half-year engagement, will not have any medical insurance because they aren’t married and because she’ll have left her job. So, in chatting it up with him, the question of international medical insurance came up and he asked if I, in my infinite wisdom, could do a little research on his behalf and maybe write about it.

International medical insurance, or travel medical insurance, is pretty straightforward in terms of its offering and I was surprised at how cheap it was. The first step though is to see if you qualify for an ISIC Card because it gives you access to discounts and some supplemental insurance. Also, they recommend that you purchase travel insurance because it often includes some basic medical and accident coverage. If you are “a full-time student, a teacher or are under 26 years old,” then you’re eligible for the card.

Now, onto the insurance…

Abroad-Only Coverage vs. Both

Abroad-only coverage means that you only have medical insurance coverage outside the United States. The Both option refers to medical coverage in the United States and abroad. The advantage of Abroad-only coverage is in cost because medical services abroad are often cheaper and Abroad-only coverage doesn’t not let you return to the United States for treatment. The advantage of both Abroad and Domestic coverage is that you can always return to the US to receive treatment though the coverage will always be more expensive than abroad only. One significant disadvantage of Abroad-only coverage is that it will not cover pre-existing conditions.

Abroad-Only Insurance Providers

If you already have insurance, the best option is to talk to your provider to see if they offer international coverage. If they don’t (or if you just want to review your options, there are several international insurance providers that cater to the travel and study abroad demographic. If you want the “both” option, your best bet is to use an insurance search engine to get a few names of US insurers and call them up for more information.

Cultural Insurance Services International - This program covers study abroad candidates with affordable temporary health insurance. My friend will not be studying abroad, which is one of the requirements, but if you are, this is certainly a reputable site references by many universities. (Highway to Health, Inc. is another well-regarded student insurance provider)

Gateway Plans - This is a more comprehensive medical insurance provider that isn’t restricted to only students studying abroad. In fact, Gateway offers plans for US citizens traveling abroad, internationals traveling to the US, and almost everything else in between. For my friend traveling to the UK, she’ll likely want the Gateway International plan. The Gateway International plans will cover you for a minimum of 15 days to a maximum of 180, or six months. The plan rates seems pretty straightforward, with $100,000 of coverage for only $4 a day. (Wallach & Company, Inc. is another well-regarded insurance provider)

Does anyone have any first-hand experience dealing with travel medical insurance or something similar? I’m afraid I’ve never actually purchased any so my research is based solely on Google and numerous university study abroad websites, nothing beats first hand.

It’s December 18th, I have $131.81 in my Flexible Spending Account (FSA) and I have absolutely no idea what I’m going to spend it on. This is doubly difficult because last year I smashed a year of spending in three months (only $300) as I overfunded my FSA when I started my new job and I spent down my former job’s FSA, all in about the same two or three month period. So, what can I do? I took a look at the list of eligible FSA expenses and broke them down into a bunch of categories: Procedures, Nice To Have Items, Stock-up-able Items, and Useless (And Perhaps Funny). (I pulled the list from some page I found)

Procedures

First and foremost, consider getting a general medical check-up or eye exam or dental check-up. All the out of pocket expenses related to these are covered and if you haven’t done it this year there’s certainly no reason not to. So, when you get a dental cleaning and you pay a few bucks for the co-pay, that’s covered. This should be idea #1 when spending down your FSA (as long as you haven’t procrastinated like me, but I’ve gotten all checked up earlier this year).

Nice To Have Items

These are expensive items that don’t have a daily purpose but might be nice to have around the house such as a blood pressure monitor, ear infection monitor, and other personal test kits. Some items that aren’t explicitly listed under an OTC item are heating pads and ACE bandages, but I’ve claimed them before and they had been reimbursed.

This category of items I’d look into last after stocking up on stock-up-able items.

Stock-up-able Items

This category is exactly what it sounds like, all those OTC drugs you can stock up and use for the next year. These are your pain killers, allergy medicines (antihistamines), decongestants, anti-arthritics, antacids/acid-reducers, band-aids and bandages, contact lens solutions (I stock up on this stuff, I probably have around 20 bottles!), denture adhesive, ear and eye car products, eye drops, hearing aid batteries, lactaid/lactose intolerance, hemorrhoidal products, motion sickness pills, throat pain medications, condoms (whoo hooo party!) and wart removal.

This list can go on and on with tons of products you use and is always my first bucket. The warning I have is that you shouldn’t ever buy more than a year’s worth of any one product because you’re likely going to go through the exercise against at the end of next year. It was a mistake for me to stock up on 20 bottles of contact lens solutions before I thought about it because now I have enough solution for far too long (don’t worry, I checked the expiration date and I’m safe).

Useless (And Perhaps Funny) Items

Now, these are useless to me but they may not be useless for you. What fits into this bucket will depend on your situation but all the products that need a doctor’s note or handle a situation such as obesity or smoking addiction don’t apply to me. The ones that require a doctor’s note cover very specific conditions such as joint pain, dental flouride, OTC hormone therapy, snoring cessation, and other such conditions. The ones that don’t require a note but must be “medically necessary” are weight loss pills and smoking cessation products (patches, gum, etc.)

So, check out the stock-up-ables and stock up, then consider something “extravagant” like some blood pressure monitor or a an ear infection monitor; when thinking about how to spend down your FSA. I’m going to stock up on loratadine, the good stuff inside Claritin’s allergy medicine, some OTC drugs, and perhaps something extravagant to finish off that list little bit of cash. If you’re looking for ideas, drugstore.com has an FSA store that I sometimes search through when trying to figure out ideas.

A nonprofit organization called the Commonwealth Fund released a study in which they ranked the various states (plus Washington DC) on how good their healthcare system was. Hawaii ranked first and Mississippi and Oklahoma came in tied for dead last; they also concluded that if every state could reach the mortality rates of Hawaiians, there would be 90,000 fewer deaths each year. I personally think that if I lived in Hawaiian, I’d probably live longer too because it’s freaking nice out there.

All kidding aside, the study looked at 32 factors ranging from percentage insured to number of adults who receive preventative care; even in the best states, the performance fell “far short of optimal standards.”

Maryland came in 19th with an average rank of 24.4, 16.6 behind the leader Hawaii with an average rank of 7.8. My state of birth, New York, came in 22nd with an average rank of 25, only 17.2 behind the pace. Poor Mississipi and Oklahoma scored an average rank of 47.8, a whopping 40 off the leader. A huge chunk of states fell within the 22 to 32 range, so there isn’t much of a difference with a lot of the states in terms of average.

Source: Yahoo Finance

I was recently stumped by this recent reader question about Flexible Spending Accounts and was hoping someone here could shed some light on it.

I recently read an article dated May 10, 2005 about Flexible Spending Accounts. You stated that “If you leave the company at any time.., you aren’t required to pay back the amount you’ve already spent and your employer foots the bill.” Where did you get that information? My husband is leaving his job after 6 months and we have already used the money from his account. His company is trying to tell him that he has to pay this money back. Do you know if there is an official IRS regulation or anything else that we can site? We are afraid that they are going to take it out of his last paycheck. Can they do that? How can we stop them?

When I scoured the IRS.gov site about Flexible Spending Arrangements, I could only find the “use-it-or-lose-it” provision but not anything about paying back an FSA overspend. I could only recall from my own experience and those of people I’ve talked to about this as my backup but didn’t know if there was some codified rule out there I was just missing. The reader’s husband is leaving this Friday and was hoping to have some good ammunition to fight the company so if you know of anything, please do share either via email or in the comments below.

Thanks!

On Tuesday, during the President’s State of the Union address, President Bush is going to be discussing, among other things, three items that relate to some of the issues often discussed on personal finance blogs. Just wanted to give a heads up in case you were planning on watching the State of the Union and wanted a score card.

Health insurance deduction

In an attempt to help more Americans obtain health insurance, the President will propose a plan in which each citizen will be able to deduct $7,500 ($15,000 for families) from their taxes and employer paid medical insurance will become taxable. What this means is that everyone who doesn’t get insurance help from their employer will get that help from the government and everyone who does will now pay taxes (if their benefit exceeds the deduction) on what is now a tax-free benefit. Personally, while I may find myself owing a little more in taxes, I think it’s better for the country as a whole to have more individuals covered by medical insurance.

Making tax breaks permanent

President Bush would like to make permanent those tax breaks currently set to expire in 2010 such as the lower rates on income tax, capital gains, and dividends. I think that some of those breaks unnecessarily benefit the wealthy (not many low income earners find themselves investing in stocks, they’re investing more in groceries).

Social security shortfall… your poor ugly stepsister/brother

While there were no hints as to what they were going to do, apparently the President will ask Congress to work with him to try to solve the shortfall issue - though Democrats have called his individual accounts plan a “non-starter.”

Source: CNN Money

Ever go to a store, pick up a whole bunch of stuff, and then find out they don’t take credit cards? Yeah, I think that’s ridiculous too (but entirely their right, I would just put the stuff back and leave) Well, at hospitals, some of the specialists won’t take some of the insurance types because insurance companies are a pain in the ass to deal with (imagine how hard it is to get insurance companies to pay the people who pay them, now imagine getting them to pay you when you don’t pay them… now imagine doing that all freaking day). So, the fifth tip in CNN Money’s Fifty Ways To Cut Your Health-Care Costs is to double check with all the specialists you’ll be working with do accept the insurance that you have and that they are in your network. It’s best to do this before you get treated but when that can’t be helped, you should ask when you’re there.

Source: CNN Money

When I signed up for my new health insurance with my new job near the end of August, I elected to put $200 into my flexible spending account. Without reading the fine print, I didn’t realize that the plan year was January to January and that my election wouldn’t be prorated for the remaining three months of the year. I also didn’t realize this whenever I reviewed by first paystub either. I did realize it about a week ago, which was not enough time to schedule any doctor’s appointments but was enough time for me to go on yet another medical supplies binge - something I did about three months ago before I quit.

I have more than enough standard medical supplies (pain relievers, hydrogen peroxide) as well as some of the more exotic non-OTC drug related products like an Omron blood pressure monitor and some electric heating pads. So, what is left?

Right now, my best bet is to get some more contact lens solution (despite having so many bottles already), some first aid kits (always good to have one in the car), and maybe some more NyQuil. Anyone have any good ideas?