MONEY Health Care

5 Things to Know About Electronic Health Records

Electronic medical records should not be subject to prying by employers or insurers. illustration: Gillian Blease

More doctors and hospitals are switching from paper to electronic medical records as part of a government-initiated effort to manage patient care more effectively.

1. Chances are you have one — or will soon.

Get ready for your doctor’s office or hospital system to switch your medical record from a stack of papers to a computer file.

More than half of physicians have started keeping electronic medical records, the federal government announced this year. About 80% of hospitals have gone digital, too, with urban institutions leading the way.

Driving adoption: In 2015, clinicians’ Medicare payments will drop at least one percentage point each year that such records aren’t in place.

2. They can improve your health — and protect your wallet.

Electronic records, while not a cure-all, can help cut problems such as duplicate tests and prescription errors, says Michael Painter, a health policy advocate at the Robert Wood Johnson Foundation.

Electronic prescription forms, for example, can guard against incorrect dosages and harmful interactions with other medications. A preventable drug error during a hospital stay, one study found, added an average $8,750 in costs.

3. You’ll get a look too.

Pushed by the feds, hospitals with advanced systems will roll out online portals by October (some have already), making it easy for you to see your file. Clinicians begin in January. So start asking providers whether they have records you can view.

Potential benefits: catching mistakes and easily pulling lab results to show a specialist in another hospital network.

4. They can create new problems.

Electronic records aren’t immune to mistakes. Studies show that dropdown menus in record systems make it easy for physicians to introduce authoritative-looking errors.

Also, patients reading their doctor’s notes could be tempted to research their condition and improperly self-medicate, says Nancy Davenport-Ennis of the Patient Advocate Foundation, or suffer “undue stress” from a mention of minor abnormalities in lab results.

5. Privacy is still an issue.

Digitization doesn’t make it more likely that employers or insurers will pry, since their access rules haven’t changed. Just read release forms to see how your data might be used.

Snooping by hospital personnel, though, can be a problem; some facilities don’t have systems for checking that, says Steven Stack, a doctor and expert in health information technology. Hackers are a threat too; look up major data breaches here.

MONEY Travel

Secrets Of The Super Travelers

These four super travelers hack airline miles and hotel offers to land trips all-across the world. Here's how you can do what they do for your next vacation.

They soar above ordinary trips and perform feats of vacation derring-do, all while nailing their budget. Here are their travel tips.

  • Scott M. Lacey

5 Ways to Cut the Cost of Allergy Relief

Your health insurance is unlikely to cover an acupuncture session for treating allergies. Illustration: Gillian Blease

What you need to know about treating this common malady.

Looking for allergy relief? Prescriptions, rather than OTC remedies, are often more effective and cheaper in the long run.

1. Avoiding treatment can be costly

Nearly a third of adults have allergies. Suffer through the symptoms, and you could pay the price at work. During allergy attacks, one study found, employees lost more than two hours of productivity a day.

If you regularly take over-the-counter pills, get tested to pinpoint your allergens and fine-tune treatment.

The common skin-prick test is faster than a blood test and may save you a second office trip, says North Aurora, Ill., allergist Sakina Bajowala.

2. A prescription pays in more than one way

What your doctor prescribes may be more effective. For example, a steroidal nasal spray like Flonase beats an OTC spray, which shouldn’t be used for more than a few days because it’s habit forming, says Richard Madden, a physician in Belen, N.M.

Even when an OTC drug like Claritin or Zyrtec works fine for you, ask for a prescription anyway. That way you can pay for the pills with the pretax dollars in your flexible spending account.

3. Shots pay off over time

Your doctor may suggest immunotherapy — shots one or two times a week for up to eight months, tapering down to monthly over three to five years. A recent study in the Journal of Allergy and Clinical Immunology found that immunotherapy patients saw 38% lower treatment costs owing to fewer overall doctor visits and drugs.

“You put in your work and expense upfront and get all the benefit down the road,” says Bajowala.

4. An alternative treatment is on you

Acupuncture, biofeedback, hypnosis, and even eating local honey are touted as treatments, but there’s little clinical data to prove widespread effectiveness over the long term. While your insurance may pay for a $100 acupuncture session for back pain, allergies are less likely to be covered.

One homebrew that gets a thumbs-up from doctors: nasal irrigation. No need to spring for a $100 contraption — a $20 drugstore variety with distilled water is fine for most.

5. For gear, there’s no need to splurge

The best air purifier is your air conditioner, says Gaithersburg, Md., allergist Jacqueline Eghrari-Sabet. Just add a HEPA filter to trap pollen, dust, and mold spores. With no AC, a basic $50 HEPA air purifier works fine, especially in small rooms.

When you’re allergic to heavier allergens that settle quickly — like dust mites and cat hair — air purifiers may not help much, though. Get a HEPA filter for your vacuum and clean often.

MONEY health

DNA Testing: Crack Open Your Genetic Code

Genetic testing is getting cheaper and easier. What you should know before you use it.

For as little as $100, here are some secrets you can unlock from your DNA: Whether you could have inherited a risk factor for certain kinds of cancer. Or how much of your genetic makeup comes from Neanderthals.

You might also learn whether your genes raise your chances of getting diabetes — but your doctor will still probably be more interested in other, more obvious risk factors, such as your family history and diet.

In short, although technology is quickly making it cheaper and easier to get data about yourself, it’s not always clear which information is worth getting and which isn’t.

Here’s a guide to using, and paying for, genetic tests.

What you can find out — and what you’ll pay

Roughly, two kinds of tests are available.

The first is ordered by a doctor and will often involve finding all the variations in specific genes. Research has found some variations that point to a higher risk of diseases, including breast cancer and a kind of colon cancer.

A doctor might recommend a screen based on risk factors like family history or ethnic background. Other tests, says David Fleming, an internist and health ethicist at the University of Missouri, can provide clues to how you’ll respond to certain drugs or treatments.

The tests can cost $300 to $3,500. If your doctor recommends it, insurance will generally cover it like any other test. But call your insurer first: Some might require an advance letter from your doctor or a visit to a genetic counselor, a professional trained to help people use genetic information to manage their health.

The second kind of test is a home kit that lets you mail in a saliva sample and log on to a website to get results. It’s generally not covered by insurance. (The Food and Drug Administration has said it’s concerned about unregulated consumer tests but allowed companies to keep them on the market if they began the process of getting approval; none are yet FDA approved.)

One big player, 23andMe, has made a publicity splash by cutting its price to $99 for a report on up to 250 indicators, from that Neanderthal DNA to markers of health risk. This test may differ from one your doctor would order; it won’t read all the variations in a gene but looks for common markers.

For concerns about a specific disease, use a doctor, not a kit.

Why you shouldn’t face the serious stuff alone

Experts caution that the results of tests can be difficult to interpret on your own. That’s fine if you are looking for fun info on your ancestry. But discuss with a counselor or doctor in advance whether you should do a screen for a disease, and what a positive or negative result would mean.

You also need to think about what you’ll do if you get a worrying result.

A test can find markers of an elevated risk for late-onset Alzheimer’s, for example, but you can have them and never get the disease. And since there’s little to do now to prevent Alzheimer’s, you may feel better off not knowing.

Other screens, such as those for cancer, could leave you with difficult choices about how aggressively to respond. “The issue is when we make decisions based on fear rather than what we know,” says Fleming.

You’ll want professional help to sort through the facts. Visits to genetic counselors are often covered by insurers and billed like doctor’s visits. You can find a counselor at

What tests don’t tell you

With some diseases, such as diabetes, it may be more accurate to simply look at your own family history, says Michael Dougherty, director of education at the American Society of Human Genetics. What’s more, he adds, “the genetic test doesn’t take into consideration all of the environmental factors.”

So it’s a good idea to eat right and exercise no matter what the result.

How safe are your records?

A law passed in 2008 prevents health insurers from using genetic information against you. Employers can’t use it either. But federal law doesn’t offer the same protection on long-term-care, life, and disability coverage. (Some states have stricter rules.)

“The concern is the insurance company could require you to show certain medical records,” says Harvard Medical School geneticist Robert Green. Or even just ask if you’ve been tested. It doesn’t appear to be happening yet, but it’s one more thing to keep in mind as you weigh whether you want to see what’s written in your DNA.


Money Leaks and How to Plug Them

Plug those money leaks. See which of these money leaks apply to you and start saving. Illustration: Robert Samuel Hanson

You keep a sharp eye on your budget. You buy ultra-low-cost index funds instead of actively managed ones, and you know that, unless you’re behind the wheel of a Maserati, you can skip the premium gas.

Still, you may be missing some “money leaks,” those small expenses that you hardly notice but that add up over time.

Some are costs you forgot you’re shouldering. Others are regular bills you’ve been meaning to review for years. Yet another group is expenses you could save on if you took the time to check out cheaper options.

Total up which of these leaks apply to you, and start savings hundreds — even thousands — a year.


What was perfect for you five years ago may be costing you too much today.

What to do if you’re forgetting…

…you still have cash in your money-market fund earning 0.01%

The leak: Up to $94 on $10,000 in savings

The plug: Money funds are paying an anemic 0.01% on average, yet savers still have $2.6 trillion sitting in them, says the Investment Company Institute. Why!? Move your cash into an online savings account, such as those offered by Ally Bank (0.95%) or Discover (0.8%).

…to audition new car insurance companies

The leak: About $170 annually on a typical $900-a-year policy

The plug: About 75% of policyholders automatically renew without getting a new quote, a recent J.D. Power and Associates study found.

Related: Why is Saving Money So Hard?

Yet according to the Texas Office of Public Insurance Counsel, drivers who have stayed with the same insurer for more than eight years could save 19% by switching. Robert Hunter, director of insurance for the Consumer Federation of America, recommends getting annual quotes from at least four companies with low complaint ratios on

…you’ve already paid for your home alarm system

The leak: $360 a year

The plug: The first few years you have a security system, the monthly fee often covers the cost of equipment. After that, you can pay for monitoring only and cut a $55 charge down to $25.

Don’t count on the security company to automatically adjust your rate. Call and ask, says Stan Martin, executive director of the Security Industry Alarm Coalition.

…how little your car is worth 10 years off the lot

The leak: $170 a year

The plug: Once your car is 10 years old, the cost of repairing it after an accident could be more than the car is worth, says Philip Reed of

Dropping collision coverage for your wheels and covering just injury and property damage could save up to 40%.

…the landline phone gathering dust in your kitchen

The leak:$50 or so per month, once you add in those unavoidable fees

The plug: If you have spotty cell service or are worried about your minutes, use an Internet calling service like Skype ($60 adapter and $8 a month) or a VoIP option like magicJack Plus, which plugs into your phone — allowing you to make calls over the Internet without a computer.

The $70 device includes a year of free calls within the U.S. and Canada ($30 a year thereafter).

…how much you used to pay your hairdresser

The leak: That $80 cut used to be $60. There goes $120 a year.

The plug: If your hairstylist, lawn guy, or other service pro gets too expensive, say so, leaving him room to lower the price, says Jodyne Speyer, author of Dump ‘Em: How to Break Up With Anyone From Your Best Friend to Your Hairdresser. If he doesn’t, let him know you’re moving on.


You do your research, but sometimes you miss a less expensive choice.

What you miss when you pay for…

…stuff you’ll use once or twice

The leak: $605, if you buy a high-end camera for a family reunion rather than rent it for $95 a week

The plug: Consider how often you’ll use a big-ticket item and run the numbers for buying vs. renting. An online search should turn up a rental site for what you’re after.

Need a dress for your nephew’s wedding? Buy one for $180, or borrow it from Rent the Runway for $35. Try a store like New York City’s Adorama for camera equipment, Home Depot for tools, REI for outdoor gear, and Sport Chalet for athletic goods.

…monthly trips to the dog groomer

The leak: $400 or more a year

The plug: It’s fine to clip just every three months — provided you’re willing to do some maintenance, says Wendy Booth of the National Dog Groomers Association of America. Brush and comb your dog at least twice a week, untangling mats or trimming them with clippers ($75 and up).

Another option: Ask your vet to suggest a grooming school that offers student discounts, which typically run 20% to 40%.

…high-turnover mutual funds

The leak: Larger trading costs that eat into your returns

The plug: The funds that replace their holdings the most frequently have only a 31% chance of outperforming the market, says Russel Kinnel, director of mutual fund research at Morningstar: “You’re better off steering clear.”

Related: Money 50: Best Mutual Funds and ETFs

The brokerage and other costs that managers ring up by moving in and out of stocks on a regular basis don’t show up in the expense ratio. So check your fund’s turnover rate at or in the prospectus. If the entire fund turns over 1 1/2 times (150%) or more a year, it’s too much.


Cutting costs has a way of falling to the bottom of your to-do list.

You keep meaning to…

…see whether you could pay less for home insurance

The leak: If you’ve updated your alarm system, you could knock $132 off the typical bill.

The plug: A new alarm or sprinkler system could reduce your cost by up to 15%, while a bigger overhaul, like revamping your electrical, plumbing, and heating and cooling systems, could mean a discount of 40% or more, according to State Farm.

Related: Homeowners Insurance: Covered? Don’t Be So Sure

Update your insurer whenever you make a significant change to get your discount.

…stop using the post office to pay bills

The leak: Let’s say you pay 10 bills via the mail every month. At 45¢ a pop, plus 25¢ or so per check, that’s $84 a year.

The plug: Pay bills through the company website, or sign up for online bill paying through your bank. Both are free — and save you the trip to buy stamps.

…quit spending so much money on lunch

The leak: The typical worker spends nearly $2,000 a year on lunch, according to a study by staffing company Accounting Principals.

The plug: Okay, so you’re never going to brown bag it every day. Here’s a more realistic option: Pick up a jumbo pack of snacks and drinks and tote a week’s worth into the office every Monday. You’ll save $10 to $15 a week (or $460 to $690 a year).

…figure out why you feel a draft in the living room

The leak: Your fireplace’s flue damper could be open, allowing hot air to — literally — leak up the chimney.

The plug: More than 60% of homeowners leave the damper open routinely, says Joe Pate, president of Enviro Energy International, which could cost $200 a year in lost heat.

If your damper is broken or just not stopping the draft, insert an inflatable flue seal ($50), or add glass doors to your fireplace ($250 and up).

…start grocery-shopping with a list

The leak: The typical American throws out $28 to $43 worth of food each month, says the Natural Resources Defense Council.

The plug: Use an app like Shopping List for iPhone (free) to plan your weekly grocery trip. To use up what you already have, plug ingredients into a website like

…take care of that annoying leaky faucet

The leak: Sealing leaks will trim $80 or more off the typical family’s annual water bill.

The plug: A single home can leak 10,000 gallons a year, according to the EPA, adding at least 10% to your water bill. Replace worn faucet washers and gaskets regularly. Investing $200 in a water-sense toilet can save you about $2,000 over 30 years.

…see whether your favorite restaurant ever offers coupons

The leak: Sites like Groupon and LivingSocial offer restaurant deals of up to 50% per meal. Using a coupon on one $60 meal a month will save you $360 a year.

The plug: Recent LivingSocial deals include half off at a high-end D.C. sushi spot and a discounted prix fixe with a Food Network star in Philadelphia.

Of course, spotting the most appealing offers can mean wading through a lot of deal emails, so sign up for an aggregator like Yipit to see the daily offers in one click.

…switch to a credit card without foreign-transaction fees

The leak: If you ring up $3,000 in credit card charges in another country once a year, you’ll add $90 to your vacation bill.

The plug: Credit card foreign-transaction fees are about 3% of your purchase, says Anisha Sekar, vice president of credit and debit products at

Try a fee-free card from Capital One, or go with a credit union, which typically charges a less painful 1%. If you travel enough to justify the annual cost, rewards cards like the BankAmericard Privileges with Travel Rewards ($75) also waive transaction fees.


Cut the cost of daily splurges

We’ve done a lot of the usual trimming back on services, but still had a taste for the ‘luxury’ of grinding coffee beans for a great pot of coffee every day. When prices of beans kept going up, we found we could roast our own coffee, using green beans we buy online and a popcorn popper. We can buy green beans (including shipping charges) for about $6.50 a pound — less than half of what we paid before — and roast as needed, so it’s fresher than store-bought.– George Reed, Geyserville, Calif.

Sign up for auto-pay options

I was able to cut a $12.95 monthly banking fee from Wells Fargo by having my Wells Fargo Mortgage payment paid each month under an auto pay plan. — Terry Doroff, via Facebook

Make the most of your memberships

I’m a technology professional and member of several professional societies and organizations. I called my car insurance company to see if they had any partnerships with these organizations that would mean a better rate — and they did! Now I get a significant discount, thanks to an group I was already a part of. — Ryan Ferguson, Tampa, Fla.

Get rid of any excess plastic that carries an annual fee

When I looked at my American Express card statements for the past two years and realized that the only charge to the card was the annual fee, I knew it was time to get rid of it after 40 years of membership. Savings: $55 a year. — John Strachan, Ballston Spa, N.Y.

Go paperless

I opted to receive quarterly statements via email from my mutual fund company to avoid a $10.00 annual maintenance fee. — Marc Hardekopf, via Facebook


Expert Advice on Saving Money

Plugging small money leaks adds up to big savings. (c) Stockbyte

Plug those money leaks and put an end to those small money drains that add up.

Three experts weigh in with their best advice to help you save hundreds — or even thousands — of dollars a year. Plus, tips from readers.

Three ways to stop leaks at the source (You)

Expert advice from George Loewenstein, professor of economics and psychology at Carnegie Mellon University

Admit your mistakes: You may hesitate to drop, say, a gym membership you never use because cutting it off acknowledges that you made a mistake — and that you’re not getting back the money you’ve already lost. Waiting doesn’t fix that. Cut the cord.

Know what you’re missing: Rather than wonder whether your daily Starbucks is worth the splurge, compare it with another indulgence. Drop the one that gives you less pleasure.

Sock it away, right away: People feel less guilt about spending their paycheck than they do their savings. Avoid temptation: Divert more of your pay straight into savings.

How to channel a penny-pincher

Expert advice from Jeff Yeager, author of – How to Retire the Cheapskate Way.

Go on a fiscal fast: Do your essential shopping, then try to go a week without spending any additional money (cash, credit, or debit). You may be surprised at the places where you don’t feel the pinch.

Conduct a “What was I thinking?” audit: A post-mortem is better than a budget, because you see how you actually spent your money—not how you wish you did. Comb through your bank and credit card statements annually.

Related: Money Leaks and How to Plug Them

Do a trash-can autopsy: It may sound gross, but looking through your trash (and recycling) can tell you a lot about what you waste. Are there certain foods you always end up tossing? How much did you spend on stuff from all those catalogues?

Prevent leaks when you shop

Expert advice from Sheri Bridges, faculty director of the Center for Retail Innovation at Wake Forest University

Get in and get out:About 40% of purchases are impulse buys, so stores are designed to keep you as long as possible, often by creating a pleasant atmosphere or by being tough to navigate (think Ikea, where the typical customer spends around three hours). Don’t fall for it—shop with purpose.

Beware of “free”: Buy-one-get-one and other freebie offers almost always lead you to spend more than planned. On average, people spend 36% more if they get free shipping.

Don’t be a points junkie: Shoppers often spend more just to get reward points. Before you cash them in for a reward, ask yourself if it’s something you really need or will use.


Ask for a discount

I’ve been using Comcast cable, Internet, and phone service for years, and my bill kept going up. Finally I called to ask for a reduction. They gave me a $35-a-month discount — saving over $400 a year. – Armand D. Bouchard, Harpswell, Maine

Don’t pay for shows you don’t watch

We realized we needed cable only for watching our favorite NBA team, so we sign up at the beginning of the NBA season and cancel it after the playoffs, saving at least $400 a year. Plus, for the six months we have cable, we put our Netflix membership on hold. — Robbyn Scribner, Orem, Utah

Don’t pay for Internet service on a tablet

My wife and I quit the AT&T Internet plan for our iPad, which was costing us $15 a month. We have wireless at home, and there are very few places you travel anymore where you can’t find free Internet. Even then, I’d rather pay the $5 or $10 one-time fee than $15 each month. – Chris Spence, Tyler, Texas

Nab discounts for prepaying

Our gym gives us a 15% discount for prepaying three years of membership dues in one lump sum, which saves $90 a year. The gym offers this program every time we renew and grandfathers us in at our initial rate. — Bart Astor, Reston, Va.

Buy only the cellphone minutes you need

We were paying $60 a month for our phones until we tracked our minutes and discovered that we each used less than 100 per month. We switched to T-Mobile’s by-the-minute plan, and now buy 1,000 minutes a year for $100, taking our annual cost from $720 to $200. — Rick and Judy Etchells, Richmond, Texas

Stamp out costly “vampire electronics”

We put our cable box and TV on a power strip, which we turn on when we start dinner and off before we go to bed. Over the last year, this has saved us almost $10 a month on our electric bill — hard to believe! — Pam Summers, Livingston, N.J.


Know Your Flier’s Rights

Did you know: U.S. airlines are not obligated to compensate you for a delayed flight. Illustration: Peter Oumanski

Whoever dubbed the holidays the most wonderful time of year must not have needed to fly home.

Still, there are things you can do to protect yourself in case of a major travel disruption, whether caused by an overbooked plane or the next Superstorm Sandy. Here’s a look at some commonplace travel setbacks, and how to cope with them.

You get bumped: When you’re bumped involuntarily, you don’t have to take a voucher, says Alexander Anolik, a California lawyer who specializes in travel.

On U.S. routes, the law entitles you to a cash payment of 200% of the one-way fare, up to $650, if your new flight will arrive one to two hours later than the original.

More than two hours and you get 400%, up to $1,300. If the fare isn’t on your ticket, the sum is based on the cheapest ticket sold.

Your bags are lost: When an airline loses your bag on a U.S. flight, it must refund bag fees and reimburse you up to $3,300.

You’ll need to establish how much your stuff is worth, though, so photograph valuables, hold on to any receipts for new items, and file a loss complaint with the airline, also e-mailing the DOT at

Your flight is delayed: U.S. airlines are not obligated to compensate you when you’re delayed — though if you’re stuck on the tarmac for more than two hours, they must provide snacks and water.

Take an international flight, however, and you may be better off.

People flying into the EU on a European carrier (or out of an EU airport on any airline) get meal reimbursements and, for delays of more than five hours, a refund.

Keep the trip on track

Flying isn’t the only place you could run into problems. Try these strategies for resolving other common travel tough spots:

A missed cruise: Missed the boat because of an airline delay?

Unless you booked your flight through the cruise line, the line is not required to compensate you. Carolyn Spencer Brown of suggests flying in a day early or getting an insurance policy that covers weather problems (most start at 5% of the trip cost).

An overbooked hotel: When a hotel can’t honor your confirmed reservation, it’s responsible for rebooking you elsewhere to avoid a contract violation.

Typically, if the new room is more expensive, your original hotel will cover the difference. If no better or equivalent room can be found, try asking for a credit for a future stay or another perk.

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