MONEY Health Care

5 Things to Know About Finding a Doctor Online

Online reviews are a great place to start looking for a new doctor or specialist. But you should dig deeper.

1. More patients are web surfing for docs.

Nearly a third of consumers have read doctor reviews, PricewaterhouseCoopers reports, while Google searches for crowdsourced MD data have doubled since 2007.

The info is now found on dozens of sites, from medically focused Healthgrades and to general review sites like Angie’s List and Yelp.

What you’ll find: an overall rating based on patient reviews, info about training, plus metrics such as time spent per patient, office wait, and customer service.

2. The sites are great for bedside manner…

Look for patterns in the reviews to get a sense of a doctor’s patient style. That’s especially useful when choosing a family practitioner, less so for a specialist.

“The narrower the doctor’s expertise, the more you need their knowledge, not their personality,” says Pamela Gallin, author of How to Survive Your Doctor’s Care. Some site extras: ZocDoc lets you book appointments via its portal; Angie’s List offers a service to help detect billing errors.

3 …But less useful for assessing quality of care

Studies have found weak correlation between health ratings and other measures of how successfully a provider treats patients. And the sites offer little data on the outcomes of procedures by specific docs. That may change because of Obamacare, which ties Medicare financial incentives to performance; that should make more data available.

4. Choosing a hospital? Get a full lowdown

“There’s much more quality and safety information available for hospitals than for physicians,” says Matt Austin, a patient-safety expert at Johns Hopkins Medicine.

Use the Hospital Compare tool at to see how readmission, complication, and death rates compare with the national averages, plus patient satisfaction data. Check for safety ratings by hospital and procedure and for state-specific data.

5. For cost info, head to your insurer’s site

As part of their doctor search tools, most health plan websites will help estimate your out-of-pocket for a particular doctor or hospital.

For in-network care, large insurers such as Cigna and Aetna will factor in your plan design, deductible, and their pricing agreements with specific practices. Such tools have become more popular as patients shoulder more of their medical bills.

Says UnitedHealthcare’s Victoria Bogatyrenko: “Consumers are more price-sensitive.”

MONEY Health Care

Help Your Parents Get the Right Home Care

Photo: Jason Hindley The right home care can make it possible for many seniors to age in place.

Your parents probably want to age in place. The right home care is the key to making it happen.

The vast majority of Americans want to live at home for as long as possible: Nearly 90% of people over the age of 65 said so in a 2010 AARP survey.

And with assisted living costing more than $40,000 a year on average, staying put can also save money. But the physical and medical problems that go hand in hand with aging can make home life difficult.

That’s why seniors — and their adult children — are increasingly hiring help to extend their time at home. Demand for these services is so strong that the Labor Department expects the number of aides to rise by 70% through 2020, making it the fastest-growing job in America.

The cost of help, though, can add up fast, averaging $21,000 a year for a typical part-time schedule, says MetLife. And more often than not, the government or insurance won’t foot the bill. Take these steps to find the right care:

Identify the need

After a hospital stay or health crisis, it’s often obvious that a parent should have help. In those cases a doctor may prescribe short-term skilled nursing care or physical therapy visits, which should be covered by Medicare.

Other times, the need is tougher to spot: dirty dishes in the usually tidy kitchen, stubble on Dad’s typically clean-shaven face.

“When you see longtime habits changing, that could be a sign,” says Kathleen Gilmartin, chief executive officer of home health franchiser Interim Healthcare.

Your own heavy caregiving load could also be the trigger: “Home health aides give family caregivers a break from the stress and let them manage their own life,” says Denise Brown, founder of online support site

The type of care varies, from health aides and nursing assistants who can help with bathing, dressing, and medication reminders to workers who’ll do light housework and fix meals. In both cases you’ll pay about $20 an hour through a home health agency, says MetLife (for live-in care, the average tab is $250 a day). By hiring directly you can pay about a third less, says Steve Horen, CEO of the home agency Koved Care.

A geriatric-care manager ($150 to $200 an hour) can do an assessment of your parents’ needs. Locate one at

Hire carefully

A geriatric-care manager or home health agency will screen candidates and conduct background checks. You can find an agency at Advertise directly, and you’ll need to do the due diligence, including checking references and credentials. Health aides and nursing assistants are generally certified by the state.

No matter where you get the names, interview at least three potential hires. Look for a pro who has experience taking care of someone with your parents’ particular needs. “If your father is grumpy and doesn’t like to eat in the morning, ask the caregiver how she would handle that,” says Jody Gastfriend, vice president of senior-care services at

When you hire through an agency, the company acts as the employer, withholding taxes and paying unemployment and workers’ comp insurance. While many people who hire direct pay cash, by law you must contribute to Social Security and Medicare on the caregiver’s behalf. A service like or will handle taxes and insurance for $700 to $800 a year.

Once you’ve found someone you like, make him or her feel valued and comfortable. These jobs don’t pay great, so try to be flexible about scheduling. And, adds Gastfriend, “express thanks for the often challenging work they do.”

Investigate aid

Some 70% of home health bills are paid out of pocket, according to the market research firm Home Care Pulse. Still, don’t overlook any aid options.

Most long-term care insurance policies cover visits when a person cannot perform two to three “activities of daily living,” such as meal prep or bathing. Medicare pays only for doctor-ordered, skilled nursing care. If your parents have very little in assets, Medicaid usually covers part-time help. Check for eligibility and find local services at

MONEY Workplace

Work from Home and Still be a Part of the Office

Love your commute-free workday away from the glare of fluorescent lights?

Just don’t get too comfortable. A recent study in the MIT Sloan Management Review found that bosses are more likely to attribute traits like “responsible” and “dependable” to in-office workers than those who work from home.

“This leads to lower performance evaluations for telecommuters,” says Kimberly Elsbach, an author of the study and a professor at the University of California at Davis.

If you’re among the 13 million U.S. employees who work remotely at least once a week, try these moves to seem as present as those who appear in the office every day.

Communicate constantly

Return calls as well as emails ASAP and make it easier for people to reach you by forwarding your office phone to a dedicated home-office line.

When you have to be out, make sure colleagues know in advance, and put an automatic reply on your email that says when you’ll be reachable again.

“Telecommuters need to overcompensate for being out of sight,” says Lynn Taylor, author of Tame Your Terrible Office Tyrant.

Also, don’t be shy about self-promotion. Make a habit of sending your supervisor a weekly update summarizing recent accomplishments.

Working hard on a project? Send some late-day emails to show that you aren’t checking out at 5 p.m.

Get personal

When colleagues think of you as an integral part of the crew, they’re more likely to praise your efforts on a past project or suggest your participation in a future one.

So carve out some time on phone calls to talk to your co-workers about nonwork stuff like family or weekend plans.

“You want to build relationships the same way you would if you saw them in the hallway every day,” says Sara Sutton Fell, CEO of FlexJobs.

These chats can also serve as your virtual water cooler, giving you the inside scoop on office sentiment and clueing you in on potential new opportunities.

Know when to show up

A flexible deal can be an advantage when you want to prove your loyalty.

In the face of a major deadline, however, turn up at the office and show your boss that you’re willing to make an extra effort to get the job done, even when it’s inconvenient for you.

Coming in for important meetings is also key, since your physical presence will make your contribution more memorable than participation by speakerphone.

Whatever your arrangement, if the company should hit a rough patch or you start to hear layoff rumors, haul your keister into the office as much as possible.

Says New York City executive recruiter Stephen Viscusi: “No matter what your performance level, it’s a lot easier for a boss to let go of someone that he doesn’t see on a regular basis.”

MONEY retirement planning

Danger of retiring with credit card debt

(C) 2007 Thinkstock Take steps to eliminate high-cost debt before you retire.

This story is part of Money magazine’s special Dream big, act now: Six secrets of retirement, which lays out the key drivers of retirement happiness — including your investments, health, career, family, midlife changes and debt — and what you can do about them.


The secret: Burn the credit card, not the mortgage.

Even longtime savers sometimes retire in the red, perhaps after getting pinched by a job loss or a health problem.

An Ameriprise survey of older workers with at least $100,000 in assets found that 22% weren’t on track to pay off their credit cards by retirement.

High-cost debt is especially dangerous in retirement because you are likely to see your income go down, and if you draw heavily on your nest egg to keep up with payments, you’re more vulnerable to outliving your money.

Well before 65, have a plan to wind down those obligations.


Paying off pricey debt is the only good reason to save less. Just make sure to put away enough to get any employer match.

Use these rules of thumb for college debt. It’s tempting to take big loans to pay for a kid’s dream school. Have your child look into Stafford loans first (borrowing over four years no more than his projected first-year salary), and then consider Parent Plus loans or co-signing on a private loan.

The rules: Don’t borrow more for all of your children than your annual salary. And be sure you can pay it off in 10 years or by the time you retire, whichever is first, says Mark Kantrowitz of

There’s less rush to pay off a mortgage. With today’s rates and favorable tax treatment of mortgage interest, you may be paying less than 4%. Eliminating the mortgage can make sense, since it lowers your expenses.

If you can afford the payments, however, you can hang on to the loan to leave more of your money in a diversified portfolio, says Kimberly Foss of Empyrion Wealth Management.

If most of your assets are in a tax-deferred account, then by not cashing out, you’re also deferring taxes as your investments continue to grow.

More secrets to a dream retirement:





Midlife changes

MONEY retirement planning

Rebuild Your Nest Egg After Divorce

Kevin Frayer—AP Afghan men stand next to an auto rickshaw near farmer's fields

This story is part of Money magazine’s special Dream big, act now: Six secrets of retirement, which lays out the key drivers of retirement happiness — including your investments, health, career, family, midlife changes and debt — and what you can do about them.


The secret: Forget the house, go for the pension.

Retirement plans often go by the wayside when your marital status changes.

“As a married couple, you have this vision of riding off into the sunset together when you retire. When the marriage ends, you have to create a new vision of your retirement,” says Raleigh, N.C., financial planner Steve Gaito.

Divorce or having a spouse die young saps income and assets, making it much harder to continue saving the same way you did as a married couple.

A recent survey by ING found that the average divorced person had $10,000 less in retirement savings than the average married person, even though the divorced respondents were typically five years older.

Women often find themselves especially pressed: Household income drops 41% for women after a divorce and 37% in widowhood, compared with under 25% in both cases for men, according to a report by the Government Accountability Office.

Although family changes put a lot of immediate worries on your plate, it’s crucial to keep one eye on your long-term plan.


Don’t make 401(k) and pension plans an afterthought as you split up assets. While your first impulse might be to go for the family house, weigh the benefits of doing so if it means getting less of the retirement accounts you and your spouse built up together.

“The spouse who gets the retirement plan assets may be in much better shape for retirement than the one who got the house,” says RegentAtlantic investment adviser Chris Cordaro. Houses are illiquid and have carrying costs that may be difficult to maintain on a single person’s income.

Sometimes the best strategy for both parties is to sell the house, split the equity, and downsize.

Next, take control of your portfolio choices. If you get a portion of your spouse’s workplace retirement accounts, the court will sign off on a qualified domestic relations order.

With a traditional pension, this allows your spouse’s plan to create a separate account in your name. If it’s a 401(k), the money could either go into an IRA or be kept in your name with your spouse’s plan administrator, with a choice to roll over later. Converting to the IRA is usually best, as this will give you a wider choice of investment options and more control over the fees you pay.

Keep the investing part simple. Since in many couples just one spouse handles the chore of managing investments, you might feel like you suddenly have to climb a steep learning curve to run your retirement funds.

An easy start: Put the money in a target-date fund, which gives you a premixed, diversified portfolio appropriate for your age, at least until you’ve had a chance to consider other investments. The target funds from T. Rowe Price and Vanguard are on the MONEY 70 list.

If you remarry, you can keep the money separate, but don’t let it be a secret. Prenuptial agreements are more common in second marriages, particularly if spouses want to preserve their assets for their own children. That doesn’t mean you shouldn’t be working together toward your goals.

“Individuals can keep things legally separate, but mentally they need to manage everything as if it’s one,” says financial planner Jacob Gold of Scottsdale.

When facing a spouse’s early death, give yourself a financial cooling-off period. You may suddenly have a lot of money — from life insurance or retirement accounts — to deal with at all once.

And that means you’ll soon hear from people, whether it’s a well-meaning family member or an agent or broker, with ideas for how to invest it.

Park the money somewhere safe for the short-term. If you let six months or a year pass while you deal with the emotional impact of the loss, you can make financial decisions with a clearer head.

More secrets to a dream retirement:






MONEY retirement planning

Supporting your family while saving for retirement

Kevin Frayer—AP Afghans play soccer

This story is part of Money magazine’s retirement special Dream big, act now: Six secrets of retirement, which lays out the key drivers of retirement happiness — including your investments, health, career, family, midlife changes and debt — and what you can do about them.


The secret: Know when to say no to the kids. The plan was to speed up on retirement saving once your kids were out of school. Then your son lost his job and moved back home — and Nana is becoming frail and needs help too.

A new survey by Pew Research found that 48% of middle-aged adults with grown children gave them financial support in 2012. Some 21% with a parent age 65 or older gave financially. Others gave time, which has its own costs; over 60% of those providing care are saving less for retirement as a result, says a survey by the National Alliance for Caregiving. And 15% in the Pew survey helped both adult kids and parents. “When it’s both, it gets overwhelming,” says Milwaukee financial planner Alan Moore.

Related: Tips for talking retirement with your spouse

By identifying early on what you can pay — and what you don’t have to — you can save yourself both money and angst.


With your kid, draw the lines upfront. One of Moore’s clients ended up buying his son, who hadn’t moved out, a house. “He told me, ‘I just wanted my house back,’ ” says Moore. “I’m not sure he could really afford it.” Even if things haven’t gone that far and your kids are on their own, you may still be chipping in for health care insurance or cellphone bills. However you pitch in, “set clear expectations upfront — even put it in writing,” says Theresa Wan, a financial planner in Dumont, N.J.

Ask: What specific help does she need? If she’s living with you, what rent will she pay, and for how long? (You could deposit “rent” into a fund she can use for future costs after she moves out.) Distinguish between investments in her future, such as a career counselor or job-related courses, and extras that should be her responsibility, like concert tickets.

Get a clear view of your parents’ finances. That’s often a tough conversation, but you can ease tension by enlisting a third party, such as a financial planner. If you know what Mom or Dad can afford when a problem arises, you can take steps together with them to avoid unnecessarily damaging your own finances. For example, it might become clear that if your parents downsize to a smaller condo, it would free up some money for paying a home health aide, perhaps forestalling a costlier nursing home stay.

Tap senior services. Government and nonprofit agencies offer a range of help for the elderly, says Louise Schroeder, a financial planner in Stillwater, Okla. Services include adult day care and in-home aid, and may be low cost or free. To find help in your area, go to

You’ll face a time drain, but you can get a hand. Having to provide aid to a parent gets in the way of your career and leaves little time left over for getting on top of your own financial planning. A geriatric care manager can help oversee your parents’ home and health services, says Schroeder. Search for one at; expect to pay $150 to $200 an hour.

Don’t miss tax breaks. You may be able to claim adult relatives you help as dependents. For them to qualify you must provide more than half their financial support, says CCH tax analyst Mark Luscombe. Their gross income for the year, excluding Social Security, must also be less than $3,900, as of 2013.


MONEY Health Care

Healthy Living: Key to a Happy Retirement

This story is part of Money magazine’s retirement special Dream Big, Act Now: Six Secrets of Retirement, which lays out the key drivers of retirement happiness — including your investments, health, career, family, midlife changes and debt — and what you can do about them.


The secret: A greasy burger is worse than a bear market.

When it comes to retirement, good health cuts both ways. As any financial calculator will tell you, living longer actually means you’ll need a bigger nest egg. But the healthier you are leading up to retirement, the easier it is to build up the savings you’ll need.

A recent National Bureau of Economic Research study by James Poterba, Steven Venti, and David Wise found that people who were among the healthiest 20% in their fifties retired with three times the assets of the least healthy. And the healthy also spent down their wealth more slowly.

Poterba says that’s because the impact of health on your finances begins well before you quit working.

“People in good health have lower health care costs, so they have less of a drain on their resources,” he says. Also, other research shows that about half of people who retire earlier than they planned cite health as the reason. Staying healthy gives you more power to save for longer.


Know your numbers. According to the U.S. Agency for Healthcare Research and Quality, one-third of adults with diabetes don’t know it, and 20% of adults with high blood pressure are unaware. If you haven’t been checked for a few years, do so now. Make sure your spouse does too.

Focus on what you can control. Just because you have a family history of a health condition doesn’t mean you’ll get it as well.

“DNA isn’t your destiny,” says Laura Carstensen of the Stanford Center on Longevity. “Research shows a very small number of factors make a big difference.” Those probably won’t come as a surprise: whether you smoke, how much you drink, your weight, and your exercise routine (you’ve got one, right?).

Any smoking is bad, but how much alcohol or weight is too much? Here’s the scoop: No more than seven drinks a week for women or 14 for men, according to the National Institute of Alcohol Abuse and Alcoholism. For weight, check your body mass index at to see if you are in the healthy range.

You don’t have to become a triathlete. Just 2½ hours of moderate exercise a week can make the difference, according to the Centers for Disease Control.

Need some extra motivation to hit the treadmill? People who are fit in middle age battle fewer chronic ailments in the last five years of life, so they get to enjoy more of their retirement being active and feeling good.

More secrets to a dream retirement:




Midlife changes


MONEY retirement planning

Six secrets of retirement

Photo: Travis Rathbone

Retiring the way you want, when you want, takes more than just saving every month. A guide to the key drivers of post-work happiness you may not have considered—and what you can do about them.

To get the dream retirement, you need to save money and the markets need to give you a decent payback for your effort. No secrets there.

Hiding in plain view, however, are other keys to post-work bliss that are at least as important as savings rates and stock returns. Especially from your mid-forties, say, to your early sixties, you’ll make money-related decisions that have clear implications for the near term but that require some imagination for you to see their critical impact on how you’ll live 10, 20, or 30 years down the road.

After consulting retirement experts and poring over the latest academic research, MONEY has identified five of these secrets and, as a sixth, found a new twist on that admonition to save, save, save.

This story will lay out these hidden retirement drivers — including your investments, health, career, family, midlife changes and debt — and help you make use of them in your planning. You’ll also see how they could affect your finances in the years after you call it a career, based on numbers crunched by Jack VanDerhei at the Employee Benefit Research Institute, whose computer model simulates 100,000 possible market paths.


The secret: 16.6% is the magic number.

How much do you need to save to retire? It’s a vexing question because different generations of savers have different luck.

Some feel the market winds at their back during their careers, while others trudge through with low returns. Wade Pfau, professor of retirement income at the American College, which trains financial planners, has crunched the numbers to find a safe level of saving that would have worked in every historical market stretch going back to periods beginning in the 19th century.

He found that setting aside 16.6% of income and putting it in a diversified portfolio of stocks and bonds did the trick every time. (Good news: Employer matches count toward that savings rate.) That’s if you’re consistent about saving over 30 years.

A slow starter must ramp up higher — a 45-year-old with two times salary saved would have to go for 20%. “During some boom times, workers could get away with saving less, but you can’t count on above-average returns,” says Pfau.

That’s a useful warning right now because investors face some real challenges in the coming decade. Part of the problem is basic math: The 10-year Treasury bond yields less than 2%, and the Federal Reserve gives every indication that rates will stay low for years. “Current yields are a good predictor of bond returns,” says David Blanchett, head of retirement income at Morningstar Investment Management.

Stocks are less predictable — but risks today include a wobbly global economy and an aging population who may prefer holding bonds to stocks. The more you can save, the less you have to worry about this stuff.

Take action

Do more than the max. For higher earners, “maxing out” your 401(k), as satisfying as it feels, might be a trap. Within your 401(k) you can save $17,500 in 2013. Those 50 and older can save an additional $5,500.

Because of IRS rules that prevent plans from benefiting mainly higher-income workers, some plans limit the contributions you can make even more, says Rick Meigs, president of Step up savings by adding to a Roth IRA, where after-tax money can grow tax-free. You may not be able to invest directly in a Roth if your salary is above income limits. (Starting at $178,000 for married couples filing jointly in 2013, the amount you can contribute begins to phase out.) Fortunately there’s a backdoor: Save in a nondeductible IRA, which you can then convert to a Roth.

Buy cheap funds — it’s like saving more, but easier. One wrinkle of Pfau’s study: He didn’t include investing expenses in his returns. If you pay a management fee of 1% a year on your funds, says Pfau, the safe savings rate jumps to over 22%. You have one advantage over past investors who enjoyed more bullish times, though. You can buy index funds and ETFs that cost 0.10% or less.

Get in touch with the future you. Behavioral finance research suggests that saving is easier if you spend a moment thinking about your future self. Look at an age-morphed photo of your face, and you are likely to put away more, says NYU researcher Hal Hershfield. You can get a glimpse of your older self via a mobile app, such as Aging Booth (IOS, 99¢; Android, free).

Know when to dial down risk. Five years before retirement, zero in on how much you’ll need to pay essential expenses, says financial adviser Harold Evensky of Coral Gables, Fla. Shift the equivalent of one year of expenses to cash or short-term bonds so that if stocks plunge when your quitting date is in sight, you’ll know you’ll have some extra time for markets to recover. This cushion will help keep you from selling in a panic.



Reverse Mortgage: Is It Too Risky?

photo: adam voorhes Considering a reverse mortgage to drum up retirement cash? Don't tap your home's equity too hard.

If you’re 62 or older, you’ve probably started getting reverse-mortgage solicitations in the mail, and it’s hard to miss the aging actors singing the loans’ praises on TV (hey, it’s the Fonz!).

The pitch may sound appealing, especially if you’re among the 83% of boomers who plan to stay in their home through retirement: Tap your home’s equity now and receive a monthly payment, line of credit, or lump sum, regardless of your credit score or income.

The mortgage will start accruing interest immediately, but you won’t need to pay back a dime until you move out or die — at which point you or your heirs must repay the bank in full.

Indeed, reverse mortgages can be a good option for seniors age 70 or older who are committed to staying in their homes and don’t have the savings to cover their expenses, says elder-law attorney Janet Colliton of West Chester, Pa.

However, she adds that recent trends are making the loans a riskier proposition. For one, borrowers are younger: Last year 47% were in their sixties, more than double the percentage from 2001. A growing number (69%) are also taking their payout in a lump sum rather than a steady stream. And reports say predatory lenders have been pushing these mortgages on folks who can’t afford them.

The result: Borrowers who take the loan too soon, or spend the payout too quickly, could end up without a source of equity to fall back on — and might even lose their homes.

If you or someone you love is thinking about a reverse mortgage, consider these questions. If you answer yes to even one, this type of loan is probably the wrong option for you.

Are you in your sixties?

You want to put off a reverse mortgage as long as possible. The amount you can borrow is based on the current interest rate (you can borrow more when it’s lower), your home equity, and the age of the younger spouse. The older he or she is, the more you get.

On a $300,000 house with a $100,000 mortgage, for instance, a 75-year-old might receive a $574 monthly payment, while a 65-year-old would get just $411. (See for a calculator.)

Related: Your Pension: Lump Sum or Lifetime Payments?

Younger borrowers also face more years of compound interest, which can quickly ratchet up the amount you owe.

There’s also a greater chance that you’ll run into unexpected medical bills or other expenses as you age, sapping your payout more quickly than you anticipated.

Will the costs be more than you can afford?

Reverse mortgages are a notoriously expensive way to tap equity.

For that borrower with the $300,000 home, fees would include $6,000 in upfront mortgage insurance, a $2,500 origination fee, and about $3,400 in traditional closing costs — and that’s before you get to the monthly mortgage insurance premium of 1.25% of the loan balance.

Plus, you’ll still need to cover regular housing expenses such as taxes and maintenance.

Don’t commit to the loan until you’ve met with an independent financial adviser to go over the total cost and discuss alternatives, says Steve Weisman, author of A Guide to Elder Planning.

Is there a better option?

Before turning to a reverse mortgage, homeowners should explore bolstering their finances by downsizing or working longer.

Those with good credit might also consider a traditional refinance or a home-equity line of credit (HELOC), where you draw only the funds you need and pay off interest as you go, says Waterford, Conn., financial planner Nancy Butler.

It’s also a good idea to get your heirs involved — particularly since they’ll be responsible for paying off (or selling your house to pay off) the loan after your death. They may be able to provide a private reverse mortgage or become a part owner of the house now.

Ultimately, people should think very carefully before draining their home equity, says Margot Saunders, counsel at the National Consumer Law Center: “Once it’s gone, it’s gone.”

Your browser is out of date. Please update your browser at