This is a post by Connie Brooks, a new mommy in Louisville, KY and a regular contributor on Blueprint for Financial Prosperity.

Having a baby is one of the most incredible experiences in the world.

There are no words to describe the moment you hold your baby in your arms for the first time. When their little eyes look up to you and you realize you made the little tyke. There are no words to describes the feeling of pride the first time you see them turn over, or when they crawl and then eventually walk.

While these memories are priceless, having a child is a very costly endeavor. Most parents expect to pay for the obvious things once the baby arrives like food, diapers, and clothes but they often don’t anticipate “the other stuff.” When we had our daughter, we expected to pay for more food and diapers, but we never planned for “the other stuff.” From the moment I found out I was pregnant though, a seemingly limitless chain of bills started showing up. We were literally supporting our baby from the moment we knew about her. It doesn’t have to be that way.

If you are thinking about having a baby any time soon, here are some of the expenses (”the other stuff”) you’ll want to plan for, even before your baby arrives:

1. Prenatal Care

As scary as it is to think about, most miscarriages happen within the first three months. Chances are your Ob-gyn will not even want to see you until you hit the three month mark because of this. After that, you can expect to go once or twice a month for the next six months, and even more frequently for the final three months.

Every time I went to my Ob/Gyn, it cost me an insurance co-pay of $30. We had hyperactive prenatal doctors so we ended up going even more often than average. Our cost for pre-natal doctors visits over nine months was around $500. Your cost will vary depending on your insurance plan.

2. Prenatal Diet

Your baby is literally depending on you for its nutrients. If you don’t have a healthy diet, then your baby will not get what they need, and that could have long term consequences.

The truth is, we weren’t eating very well when I got pregnant. We ate out once, sometimes twice a week, and ate a lot of beans, rice and eggs otherwise. Doing that kept our before baby food budget to around $300 a month.

After I found out I was pregnant, our food budget literally doubled. We stopped eating out, and I bought fresh organic fruits, vegetables and yogurt. The only food I craved when I was pregnant was steak (which was odd since I am a semi-vegetarian!). The steak was expensive too because I chose to buy only top quality grain-fed beef.

I did not care how much our food ended up costing us, I wanted my baby to have every building block she needed to grow. Over a twelve month period (I breast fed for three months afterward, so we kept our diet the same.) Our food ended up costing us $7,200. Prenatal vitamins added in another $270 over nine months.

3. Maternity Clothes

– I gained around 20 pounds while I was pregnant, so my clothes fit me for most of my pregnancy. However, by the eighth month, there was no containing my belly. I had to face facts and invest in a few good quality maternity clothes. I bought a week’s worth of clothes as cheaply as possible. I also used my husband’s shirts and bought things like hip-hugger pants that I could wear after my baby. The total cost of my maternity clothes was around $400. If you’re careful you might be able to get by cheaper, but it could easily cost more depending on your needs. Try to maximize sales whenever you can!

4. Baby Clothes & Supplies

We were very blessed because our friends and family gave us nearly everything our daughter would need for her first few months. If you don’t have a strong supportive network, then this will be a real expense.

Wal-Mart and Target have the most reasonably priced baby clothes. If I had to put a price on what we were given I would say that it amounted to easily $800 to $1000 worth of diapers, clothes, shampoo, and supplies. Again, we had an extremely generous family, who put all they had into helping us prepare for our baby. In retrospect, If I were the one paying for the items, I would have spent around $400 total on clothes and supplies for my daughter’s first few months – and that would have been plenty.

5. Nursery & Travel Items

The crib for our daughter was $500. Her mattress was $100. We bought a crib that would turn into a toddler bed, and eventually a full sized bed as she grew. Her car seat and stroller ran us about $400 – again because we bought for the long term and wanted something that would last through several children if necessary. You can definitely do this cheaper than we did! The total cost for her nursery was around $1,500 after decorations.

6. The Big Day(s): Hospital and Delivery Costs

How much this ends up costing you will depend on your insurance, how difficult your labor is, and how well everything goes.

In my case, nothing was simple. I spent two days in the hospital being induced and ended up with a c-section. My daughter had a fever when she was born, so she spent a week in the hospital on antibiotics undergoing a lot of tests. (She was fine, thank God!) They kept me for four days after my surgery. I can honestly say that for a month after we came home I dreaded going to the mailbox and pulling those medical bills out!

The total cost for her delivery was nearly $4000.

7. The Paperwork

After my daughter was born, we did have to take care of some paperwork. Particularly ordering several copies of her birth certificates. This was another unexpected cost. I’m not sure why I thought that the hospital would provide us with one – they didn’t. They sent her birth records off and we had to order an official copy. Those were $10 each, and we ordered 3, so we $30 spent on her paperwork.

8. The Aftermath

In the first few months following her delivery she and I both went back to the doctor a couple of times for routine checkups. This was not a huge expense, but it was one I did not expect. The follow-up visits probably ran us around $150.

From conception to birth, our daughter cost us about $14,000. Fourteen thousand dollars. Oh, and that does not even take into account the diapers or the eventual formula costs once I went back to work. It also does not include childcare, which thankfully, we did not have to get.

If you are considering having a baby, please make sure that you get a hefty savings account going before you take the plunge. Many of these costs we had not planned for, and that made it more difficult than it had to be. When we planned out our finances before getting pregnant, we always planned out what we thought the costs would be after we had her, and we did not take into account what it would cost just to get her to delivery!

I am very sure that if I had it to do over again, I could do it for less money. I think that I went into it from the mindset of doing what I thought was right for my baby, and the finances took a backseat. That being said though, my daughter’s birth story is an excellent example of how having a baby can easily cost you a fortune – so it’s something to think about.

How about you? Do you have children? What would you say it cost you and your spouse to have your baby? Leave us a comment below!

(Photos: Baby Factory by swanksalot, Baby Booties by normanack, Baby Birth Certificate by michaelallroy)

One of the great paradoxes of our nation is that we spend far more, by a great margin, than any other country on healthcare yet we don’t live the longest. According to a report from the NCHC [PDF], which was based on other research, we spent $2.3 trillion on health care in 2007 or about $7600 per person. (that article lists a lot of other sobering statistics).

Part of the reason is because the system is so complicated and convoluted. When a doctor orders a battery of exams, it he or she motivated by expertise, fear, or greed? Is the test what is actually needed because the doctor needs to rule out a particular condition, or does the doctor fear malpractice suits so he orders every possible exam, or does the doctor need to up his pay this month because he has a vacation soon? While I’d say that most medical practitioners operate out of expertise, there is a subset that operates, if only sometimes, in the other two groups too.

That’s where Stay Healthy, Live Longer, Spend Wisely by Davis Liu comes in. It’s a guide to help you navigate the complexities and vagaries of the American healthcare system.

About Dr. Liu

Who is Dr. Davis Liu? He’s a board-certified family physician with the Permanente Medical Group in Northern California, graduate summa cum laude and Phi Beta Kappa from the Wharton School of Business and the University of Connecticut School of Medicine and has written several opinion pieces that have appear in the San Francisco Chronicle and the Sacramento Bee.

Do Your Homework, Question Everything, Pay Nothing (At First)

That’s the subheading of a section in which Dr. Liu explains how you can be a smarter consumer of medical care, specifically with respect to the billing process. He tells one story about his brother who saw a general practitioner and specialist for a throat issue. His brother confirmed with the insurance company that the visits would be covered yet was billed anyway. Fortunately, due to diligent note taking which included which representatives they spoke to, the issue was resolved and the brother didn’t have to pay anything.

The lesson here is that you should question everything, since most medical bills contain errors, and confirm with the insurance company as to whether something is covered (unless it’s a true medical emergency).

The book has a lot more in it than I explained so here’s a listing of what’s included in each of the eight parts:

1. The Most Important Policy You Will Ever Own: This part discusses health insurance in general from how much coverage you need to what an HSA is, from COBRA to health care costs.
2. Mastering the Ten-Minute Doctor Office Visit: Every aspect of a typical visit with a physician is covered including how to be a “wise patient,” versus a typical one. It stresses the importance of knowing your medical history and making each visit count.
3. Do the Right Thing Regularly and Repeatedly: This part stresses the importance of routine checkups and preventative medicine, such as routine screening, immunizations, and age specific checks.
4. Meet Your Medical Team: Any and every medical professional you’ll meet is discussed in this chapter along with anything you may need to know about their profession. Do you know what a Rheumatologist or a Nephrologist or a Ophthalmologist is? If you said you did and you’re not one, you’re probably lying.
5. The Truth About Medications: It’s hardly a hard hitting expose on branded medicines but he discusses branded vs. generic (and points out studies of the placebo effect, a topic discussed in Predictably Irrational too) and even goes through over the counter drugs.
6. Caveat Emptor, Or “Let the Buyer Beware”: This section talks about all the unproven, untested remedies from body scans to herbal remedies. He’s a little apprehensive about them but does recognize that some provide benefits.
7. Twenty-First Century Medical Care: Dr. Liu is looking forward in this chapter, looking at new and different techniques that may play a larger role in medicine in the future.
8. Take Control: Excellent Health Pays: In this last part, he talks about how you can be proactive about your health such as using the internet for research (which can be counter productive, depending on your mentality) and being active.

Stay Healthy, Live Longer, Spend Wisely is far more comprehensive than I gave it credit for when I first opened it. I expected a book that discusses health insurance, government plans like HSAs and FSAs, and medical expense related ideas but this one really went above and beyond that. The sections discussing all the specialists, the various medications, and even looking to the future of medicine was a nice bonus. Another nice bonus was Dr. Liu’s style, I can see why he would be asked to write opinion pieces in the newspaper because he has a very easy style that likely translates into a comforting bedside manner.

If the whole world of medicine intimidates you, this book can help by giving you a good basic understanding of the whole breadth of the medical world.

We’ve made it through four of the seven deadly sins of personal finance and touched on many good topics so far. The first few were easy - have an emergency fund, don’t raid your retirement, budget, and plan and project for the future. We’re starting to get into a bit of the hazier areas of personal finance, where the answers are quite so clear cut and where much of it depends on you and your specific situation. You could argue that failing to budget isn’t so bad a sin, the reality is that math will do the budgeting for you if you decide you don’t want to. When you run out of money, you’ve hit your budget.

I doubt anyone can argue against today’s deadly sin…

Being Improperly Insured

The reality is that insurance is a very difficult subject to tackle because it provides you protection against the unknown. Since you’re protecting against the unknown, it’s difficult to know how much protection you’ll actually need. Insurance is also very temporal. When you pay the premium for the month or the year, that protection is gone once the insured period passes. I’ve been driving for nearly five years and never once made a claim. That’s five years of auto insurance premiums gone. (I’m not complaining, I consider myself very lucky!)

But you can’t look at insurance that way and many people do. Insurance is a hedge against unknown events that could potentially bankrupt you and it’s a way for you to purchase peace of mind. So, how do you ensure you have the right amount of insurance? How do you avoid getting too much coverage or too little? Sadly, it’s mostly a judgment call but here’s how I approach it.

My approach towards insurance is that it should protect against catastrophic events. Not everyone is like that and that’s certainly not the “right” or “best” way to approach it, I don’t know what the “right” or “best” way is (or if there even is one). My tolerance of risk is such that I’m comfortable with assuming some self-insurance (high deductibles) in order to pay lower premiums.

How should you approach it? I can’t answer that other than to say that you have several factors that will affect how you adjust your coverages and deductibles:

• Assess your financial situation. If you have a fully funded emergency fund, consider increasing it and self-insuring through higher deductibles. If your current automobile insurance has a deductible of $500, increase it to $1000 and put the premium savings into your emergency fund. If you work in a volatile industry or have irregular income, consider adjusting your insurance so that any negative events don’t cause extreme financial distress.
• Known your own “riskiness.” If you’re a bad driver who is prone to accidents or mishaps, lower your deductible. There’s no sense in being prideful and making the wrong financial decision by increasing deductibles or removing certain coverages. If you live in a dangerous neighborhood, lower your homeowners deductible so that you’re better covered in the event of a break-in or fire.
• Know the statistics. Some cars are burglarized more than others, some neighborhoods are rougher than others, and some ethnicities are more prone to some medical problems. Be aware of these statistics, many of which can be found online, and use them to adjust your coverages.
• Your tolerance towards risk. If peace of mind is priceless to you, adjust your insurances so that you obtain that. You can’t quantify stress and all we know about its effects are that it’s bad on the body. Paying a few extra dollars so you can sleep better at night and prevent a few gray hairs is money well spent. Frugality is important but your health is more important.

I’m sure there are actuaries who know insurance backwards and forwards who would disagree with me, if you are such an actuary I invite you to let us know what you think.

The following were my thoughts after Gary first sent me an email about his health and work-life balance, that email has been transformed into a two part article titled Stay Focused, Stay Balance, Stay Healthy (Part 1, Part 2).

When I first started working at my first company, there was a training class on Work-Life Balance and a panel of managers there to share their experience. The panel was quite diverse from an experience perspective, they varied in tenure from ten years to thirty and ran up and down the organizational charts. That’s when a well respected manager of 20-something years of service said to us - “I work forty hours a week, get the job done, and I don’t sacrifice my family, my life, or my health.” He said he left work at 5 PM every single day so that he could be home to see his daughters. This was his job, but this wasn’t his life.

His perspective hit us like a punch to the gut. Here we were, young bucks thinking that the company wanted hard charging workhorses to push sixty-plus hour weeks to get the job done. The reality is that you can get ahead if you do a good job and only work the standard forty hours most of the time (there will always be times when you need to work hard but that should be an exception, not the rule).

When Gary wrote me that story about his medical problems, that hit the same chord. Gary was on the work side of the work-life pendulum and it affected his health. When he tried to get back to a more balanced life, his employer probably thought he was shirking or past his prime. Perhaps he transitioned down too quickly. Whatever the case may be, he was outputting less and it affected his employer’s perception of him. But, when you’re forced through a battery of medical exams, it puts your life in perspective and I felt that perspective needed to have a voice.

You might think Gary has an axe to grind against his former employer. He doesn’t. We’ve traded nearly two dozen emails (at least!) and he never once mentioned being let go until that story. In fact, that part of the story surprised even me.

Whose fault is it? You might be surprised to hear that I think it’s my fault he was fired.

He writes about how the corporate mentality of today is to run a workhorse until they’re burned out and gone. This wasn’t the case when he first started because the employer-employee relationship has changed dramatically since then. I often write about how you aren’t dating your job and how you should look for a new job with more pay, more opportunity, or more responsibility and growth potential. Companies are forced to work their employees hard because there is little incentive to go slow and grow stars because those being groomed could easily jump ship in a heartbeat.

The moral of this tale?

If you don’t have work-life balance, you will have neither.

Thankfully Gary persevered, his health improved, and was able to share that story and the many more that will soon follow.

This is a post by Gary Bonner, a regular contributor on Blueprint for Financial Prosperity.

This is the conclusion of Stay Focused, Stay Balanced, Stay Healthy article, an article by regular BFP contributor Gary Bonner. Part one is available here.

It was during those 5 hours that I reflected on how I got myself into this health mess. The company was relentless in demanding results on the very visible, very important project that I was providing a considerable amount of shoulder to lift off the ground. This project was a transition and I had to continue doing my former duties as I developed a new project. The requirements consumed me. Even when I was home I didn’t rest because I was planning for the next day’s work in my head.

Laying there listening to the beeping monitors, in between interruptions for x-rays taken by a portable machine and the nurses checking in on me, I started thinking about my family and my loved ones. I thought about how I hadn’t paid any attention to them and had let life events pass me by in the name of “getting the job done.” Then it dawned on me. I remembered a moment twelve years ago, when I had sat on the side of my father’s bed (he was a victim of cancer) as he peacefully took his last breath. My mother, his wife of 50 years, his older son and daughter-in law, his only brother plus his nephew and wife stood next to him.

Then the thought just crystallized from somewhere deep inside: “No one lays on their deathbed wishing they had spent more time at the office.” And here I was. I had crossed the Rubicon with Caesar back into Roman territory. I would never look at corporate life the same. I would do what I had to do but I wouldn’t, couldn’t, bite off more than I could chew ever again.

Over the next several months I underwent a series of stress tests, special echo cardiograms, and finally an angiogram. This procedure runs a tube, with a camera at the end, through your groin muscle through your body cavity to look at the arteries of your heart. You are awake but your body is “knocked down” by a Valium I-V. If there had been blockage, the doctor would have inserted a stent to insure good blood flow. Fortunately the cardiologist, a doctor of world wide respect in his field, announced that there was no blockage and that I had one of the strongest heart muscles he had ever seen.

I wish that was the end of the story.

That was in November 2004.

When I returned to work nothing had changed, the attitude of management had become more unrelenting. I withdrew from the new project to return to my old job. I steadily refused to put in extra effort and felt the heat turn up on me. Timid to fight back because I wasn’t feeling well and didn’t want to get fired and lose my medical benefits, I operated in a world of conflict between my personal health needs and, from my viewpoint, the demands of a high pressure job. My health broke again. I wound up back in the Emergency Room 3 times between 2005 and 2007.

The last time I said to my doctor who had wheeled me to the ER, “You know, my ticket book from the ambulance company doesn’t only contain round trip tickets. There is a black one that says ‘one way’. I am tired of playing Russian Roulette with my health.”

He agreed.

I needed a lot of rest to stabilize and restore my health. While out on disability the company terminated my employment. (As of this writing I am exploring to see if I have any legal remedies for their action)

I lost out on an opportunity for a lump sum retirement payment and will have to accept a monthly annuity that will be modest at best. Why? Because I demonstrated to the company that I had the capacity and ability to accomplish results with a good work ethic. I gained a reputation as a “go to guy” if you were faced with a hard problem.

One of the rules of business is “if you find someone who can get something done right the first time, give him more to do.” In the 20th century, management took care of their workhorses by grooming, feeding and taking care of productive people. Now, in the 21st century, things are done differently. If a company rides a workhorse until it breaks down, managers just pull their pistol and shoot the horse. They’ll get another one.

Our world runs at lighting speed and is faster than the one I joined thirty-five years ago as a “go-getter.” People now hitting their stride in the work world are quicker, better informed and very energetic. The same was said of my generation by my parents. It is important to know that the fastest and best workhorse today will one day be eclipsed by a younger and faster one. How you use your resources now will determine how long you will stay “in the harness” and how much you will enjoy life. At some point “overtime” will mean something much different than it does today. I found out the hard way.

There are much easier ways: stay focused, stay balanced, stay healthy.

This afternoon, I’ll share with you the thoughts I had when Gary first emailed me this story (we had never intended for this to become a post, it was just a conversation between two people that I felt told a powerful story) and why I asked him to share it with everyone.

This is a post by Gary Bonner, a regular contributor on Blueprint for Financial Prosperity.

I came up with “no one ever laid on their death bed and wished they had spent more time at the office” out of personal experience. After putting in a marathon 21 days straight of 12-14 grueling hours at my desk, my health broke. I was in a meeting with 2 people who both questioned me “are you alright?” Not wanting to take a break I said I was okay. They both gave me skeptical looks and even asked again. Reassuring them I was okay we finished the meeting. That night I didn’t sleep very well and woke up exhausted.

The next morning I got to work early and worked on my “to do” list. A “floor meeting” was called where people stand around aisles of cubicles because you can’t get everyone into one room to listen to a manager speak. I felt a sharp sting down my left side. I waved off my manager and walked down three flights of stairs to the parking garage and drove five miles in freeway traffic to my doctor’s office.

The receptionist took one look at me, crinkled her forehead and said “You need to see the doctor right now don’t you Gary” … I nodded and walked past a waiting room of patients who had appointments. The nurse took my blood pressure and left the room. The doctor came in and took my blood pressure again. I had been a patient of his for a few years. He is a great doctor and we have a very warm friendship.

He said, “Hang on, I need to make a phone call.”

I was feeling pretty woozy and after a few moments the door opened. The doctor unfolded a wheelchair and said “Come on and sit down, I’m going to take you over to the Emergency Room and get some tests done”.

I looked at him and asked, “Why the chair?”

He replied, “It’s okay, I do this a few times a month for patients. And besides, they have the equipment over there that I need to run the tests”.

I sat down, he wheeled me through his bulging room of patients with appointments and pushed me to the elevator and went down to street level. The Emergency Room was about four city blocks from the doctor’s building in a large medical complex covering acres of ground. Visualize a slightly built man about 5′ 7″ and 165 pounds pushing a 5′ 10″ guy weighing about 215 pounds down an open street that distance. If it hadn’t been serious, the image would have been laughable.

It was about 10:30 in the morning when we entered the Emergency Room. It was absolutely quiet, as if everyone was on a coffee break. The doctor said “Mr. Bonner needs to have some tests run.” The whole Emergency Room staff jumped like bunch of scared cats. They put me into an emergency bay where I laid on a gurney after stripping off my clothes and donning a hospital gown. Then, they brought in every conceivable instrument of modern science like the machines were coming off an assembly line.

Four registered nurses (RN) and a doctor started sticking needles in me, setting up an I-V drip and strapping on monitoring equipment. I craned my head around and saw the blood pressure reading: 233 over 130. Not good. Normal is 120 over 70. They pumped me full of drugs and even put an external heart rhythm equalizer on my chest. It emits electronic impulses directly to my heart. I couldn’t figure out why they were using it since the monitor showed I was in sinus rhythm but the RN said it was for “precaution”. Then they left me alone to let the drugs do their work.

I stared up at the ceiling and muttered “Well Lord, is this it?”

There is an old saying there is a “sting” at death. Although I didn’t feel that big a sting, I definitely was stung really hard.

The nurses checked on me every 15 minutes. At one point I asked one, “Where are we in the process here?”.

She answered, “We are about halfway between determining if we can release you or if we will admit you overnight for observation.” At roughly 3 pm, five hours after the doctor had wheeled me into the Emergency Room, I was released to go home. A friend picked me up and the doctor signed me out on disability for a month. I didn’t have a heart attack or a stroke, but I came as close as one can without sliding over the edge.

This is only part one of this poignant saga, continue to part two.

When it comes to insurance, my approach is that insurance protects you against catastrophic events that would otherwise leave you broke. It’s for covering your car against being totaled, covering your home against that one big earthquake or fire or tornado that’ll level it, and for covering the unforeseen medical emergency where your life depends on you pulling out all the medical stops. It’s like the backstop or net at a baseball game. The ball has to get past the batter, catcher, and umpire before it’ll hit the backstop. In most games it’ll never gets that far, but for the one time it does, I bet those fans are glad that net is there.

How does this affect my insurance policy decisions? High deductibles. The deductible on our cars is $1000 (eagle eyed readers will note that my own car has no deductible because I don’t carry comprehensive or collision insurance). The deductible on our house is $2,500 the value of the home, the maximum allowed based on the value of the home (in the state of Maryland). This doesn’t really affect our medical insurance though, but I’d raise the deductible on those if it proved to be cost beneficial.

This isn’t a good approach for everyone. For example, if I lived in the city of Baltimore I would have comprehensive insurance on my car. The incident of vehicle theft and vehicle break-ins is significantly higher in Baltimore than it is out in the suburbs. That’s not to say we live in a peaceful, crime-free, idyllic utopia but it’s, in general, safer out in the suburbs (fewer people spread farther out is one contributing factor). The actuaries know this, of course, because the premiums for comprehensive coverage in Baltimore are more expensive than out in the suburbs, but you are buying peace of mind.

This also forces us to boost our emergency fund. The standard advice for emergency funds, which can range from 3 months of expenses to a year, exists for the standard situation. If you plan on self-insuring, which is what you’re doing with a high deductible, you need to account for the added risk. If you shifted your auto insurance deductible from $500 to $1000, pad your emergency fund with an extra $500. One good way start is with your insurance premium savings.

I’m not advocating any particular approach to insurance. We each have our own risk tolerances and varied life situations. In our particular situation, given our financial picture, a high deductible self-insuring plan works for us. Perhaps in a few years that will change.

What’s your insurance philosophy? Are you more of a “stop the headaches and the heart-attacks” kind of person that relies on insurance for the small and the large? Or you in my camp of high deductibles?

(Photo: branditressler)

The first company I worked for had a dedicated department, of maybe two or three employees, focused entirely on “employee wellness.” They offered services like body fat analysis but didn’t go as far as this company in requiring them. Personally, I think the motivations are good but I can see how people would think that’s invasive.

My company didn’t require you to participate in their programs but they did provide incentives for doing so. The medical insurance provider was called Lumenos and they offered a program in which you were given $1,500 a year to cover your medical costs. If you didn’t use the funds, it was rolled over into the next year. If you did and your costs exceeded $1,500, you covered the costs up to $2,000 (an additional $500), and then traditional health insurance would kick in (10% co-pays, etc.) beyond $2,000. It worked fantastically well for young professionals who, in general, have little in the way of medical costs. They incentivized participation in wellness programs by offering medical coverage money. Fill out a health survey and get $20. Participate in this program, get $25. It wasn’t required, you didn’t really get “paid,” but it boosted participation and got people thinking about wellness.

I think requiring it would’ve caused a backlash.

Either way, wellness programs are boosting the bottom lines at businesses by cutting medical costs. Everyone knows preventative care is cheaper than treating illnesses or conditions on the other end, everyone including prescription drug and treatment companies (fire away!). This was the topic of a Marketplace segment a couple weeks ago and they found that at Gilsbar, costs are lowered when you introduce preventative care measures. Here’s a quote from the segment:

Doug Layman (executive VP at Gilsbar): Our health plan costs are 6 percent lower than they were five years ago. Our prescription drug costs, which everybody complains about, is 45 percent lower than they were five years ago. And 85 percent say their benefits package is better today than it was five years ago. Yet we’re paying less, and we have happier, more productive people.

That’s one of the reasons why countries with nationally subsidized health care programs pay far less than we do - preventing something is cheaper than curing something. It’s a big joke that Americans pay the most for health care yet don’t find themselves with the best care (in fairness, I’ve heard the argument against that is that our best of the best is far superior to other countries but the “average” care received any one member of the population is below other countries).

Getting back to the wellness programs, does your company offer something like this? If so, do they require anything or is everything optional? What would you think about being forced to do a body fat analysis? What if you had to pay more based on the status of your health?

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.

One of the things I’ve been looking at lately, given the upcoming wedding, was how to optimize our insurance policies because, as we all know, multi-policy discounts are one of the best ways to get a discount. Two auto insurance policies with one insurer generally costs less than two separate auto insurance policies with two different insurers. In actuality, only the medical and auto insurance policies can be optimized because you don’t really share any others. Anyway, I was taking a look at our options and here’s what I came up with.

Auto insurance
This one will probably yield the biggest savings. When you decide to combine two auto insurance policies onto one, you get savings because of two reasons: You are statistically less risky because you’re married and the multiple policy discount. When you do optimize your auto insurance, you should do more than just add coverage to your policy (or add coverage to your spouse’s policy). You should start the whole auto insurance purchasing process over again and get multiple quotes so that you can compare. Two of those quotes should be adding you to your spouse’s policy and you adding your spouse to your own policy.

Medical insurance
Theoretically, given no prior negative medical history, one of you will simply go on the other’s policy for some quick savings. For example, my fiancee right now gets free health insurance and would also get free insurance for me if she were to add me to her policy after we are married. That’s clearly the easiest way to go… but there is another option available. If she were to add me to her policy and I were to add her to my policy, we’d get double the coverage. How is this valuable? This is most valuable if you expect to use your insurance a lot because it increases your lifetime limits. In such a strategy, I would submit claims against my insurer first and if they exceeded the lifetime or annual limits, I’d start all over with her insurance plan. The same would work in the reverse.

Are there other insurance policies you can optimize after marriage? Those were the only two I could think of.

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