MONEY Health Care

This Scary Retirement Expense Just Got Even Scarier

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GIPhotoStock—Getty Images/Cultura RF

The estimated tab for health care costs in retirement is huge—and getting bigger every year, according to a new study.

If you’re worried about paying for your health care in retirement, get ready to worry more.

A healthy couple retiring this year at age 65 will pay $266,589 for health care in retirement, according to the 2015 Retirement Healthcare Costs Data Report by health data provider HealthView Services. That’s a 6.5% jump from HealthView’s projections a year ago.

If medical costs continue their rapid rise, the tab will be even larger in the near future: Expected lifetime health care expenses will rise to $320,996 for a couple retiring in 10 years at age 65, the study found.

And that’s just what you’ll pay for Medicare Parts B and D, which cover routine medical care and prescription drugs, and a Medicare supplemental insurance policy, which most Medicare recipients buy to help with co-pays and deductibles. It doesn’t include all the out-of-pocket costs that traditional Medicare doesn’t cover, including dental, vision, and hearing services, and co-pays.

When you factor in those expenses, projected retirement health care costs rise to $394,954 for a couple retiring this year at age 65 and $463,849 for a couple retiring in 10 years. And those numbers don’t even count long-term care, which can add tens of thousands of dollars if you need extensive help at home or in a nursing home.

To put those costs in perspective, HealthViews estimates that a couple retiring today will spend 67% of their Social Security benefits on health care costs over their lifetimes. For a couple retiring in 10 years at age 65, medical care will suck up 90% of their Social Security income. That’s troubling considering that for many, Social Security makes up the majority of their retirement income. Even for middle income and wealthier families, Social Security accounts for about one-third of retirement income.

But Social Security benefits won’t be able to keep up with health care inflation. Social Security benefits have averaged a 2.6% annual cost of living increase over the past decade (and just 1.4% the past four years), while health care costs have risen more sharply. According to the Centers for Medicare and Medicaid, health care costs will rise 5% to 7% over the next eight years.

HealthView numbers are higher than other surveys on health care retirement costs. In Fidelity Benefits Consulting’s annual retirement health care costs report for 2014, a 65-year-old couple retiring today will need an average of $220,000 to cover medical expenses throughout retirement.

Counterintuitively, estimates of total lifetime health care costs are lower for people in poor health at retirement. HealthView’s estimates show that total retirement health care costs will be lower on average for someone with diabetes because of a shorter life expectancy. The total health care costs for a typical 55-year-old male with Type II diabetes will be approximately $118,000, compared to $223,000 for his healthy counterpart, primarily because the 55-year-old with diabetes has an expected longevity of 76, vs. 86 for a healthy male.

Of course, these are just averages. You can’t know exactly what your health will be after you retire, how much medical treatments will cost you, or how long you will live.

That said, even a rough guide can be a useful planning tool. So take a look at your insurance coverage. Consider the likelihood for each type of expense, as well as the average Medicare costs by age, to come up with an estimate of the savings you’ll need to fund these costs. Kaiser recently published a study on Medicare costs by age, which breaks down Medicare spending into its main components—hospitals, doctors, and drugs—and measures how much Americans spend on these services at different ages.

To prepare for that spending in advance, take a look at your sources of your retirement income. If you have a health savings account, do everything you can not to touch it now but let it grow tax free. It is an excellent vehicle for funding future medical expenses. Ditto for a Roth IRA, which lets your money grow tax free. For more tips on planning for retirement health care costs, check out MONEY’s stories here, here, and here.

MONEY Health Care

The Scariest Health Care Statistic of 2014

Express Scripts reports that spending on medicine surged by 13.1% in 2014.

Healthcare has no shortage of frightening statistics, but a recent review of U.S. spending on medicine last year by the pharmacy benefit manager Express Scripts EXPRESS SCRIPTS HOLDING COMPANY ESRX -0.74% contained a particularly scary revelation: Last year, Americans shelled out 13.1% more for medicine than they did in 2013. That surge in spending could put our healthcare system on a perilous path, especially given that healthcare utilization is climbing on the tailwind from aging baby boomers and healthcare reform.

Better drugs equals pricier medicine

Thanks to innovative new therapies, people are living longer, but they’re doing so at a steep cost.

A decade ago, medicines were primarily small molecule drugs that were easy to manufacture and duplicate. As a result, these drugs were less costly to prescribe and were more quickly challenged by generic alternatives once their patent protection ended.

Today, medicines are increasingly complex biologics. These biologic drugs are medicines that are developed inside living systems such as plant or animal cells. Most biologics are complicated molecules or combination molecules that aren’t easily replicated. The complexity of biologics often translates into increased efficacy over prior generation drugs, but it also makes them much more expensive to develop and manufacture. It also makes it incredibly difficult for generic drugmakers to duplicate them once their patents expire.

The ongoing shift toward these increasingly complex — and correspondingly more expensive medicines — has resulted in them accounting for an increasingly larger share of our healthcare dollars.

According to Express Scripts, despite specialty drugs like biologics representing just 1% of all annual prescriptions, they accounted for a whopping 31.8% of drug spending last year.

Unsustainable spending?

Across the tens of millions of health insurance members covered by Express Scripts pharmacy plans, spending on the average member climbed to $668.75 per year for traditional drugs and $311.11 for specialty medicines.

As you can see in the following table, annual spending per member increased by 6.4% year over year for traditional drugs and by 30.9% for specialty drugs. In both instances, higher drug prices were overwhelmingly behind the increases.

If left unchecked, drug spending growth of this magnitude could be unsustainable. In 2013, IMS Health reported that U.S. spending on medicine clocked in at about $329 billion.

If spending increases by 13.1% per year over the next 20 years, the amount spent annually on prescription medicine would surpass $3.8 trillion (yes, with a “t”).

Taking matters into hand

Such a surge in drug spending would undeniably put patients at risk. Medical costs are the biggest reason for personal bankruptcy, particularly among patients with diseases like HIV and cancer.

In an attempt to blunt the risk to the system posed by runaway drug costs, pharmacy benefit managers, or PBMs, like Express Scripts and CVS Health CVS HEALTH CORPORATION CVS 0.5% — the two largest PBMs — are rethinking how they pay for drugs.

In December, Express Scripts negotiated a steep discount to AbbVie’s ABBVIE INC. ABBV 0.66% new hepatitis C drug Viekira Pak by offering exclusivity. In January, CVS Health similarly orchestrated a discount for Gilead Sciences’ GILEAD SCIENCES INC. GILD -0.04% competing hepatitis C drugs, also in exchange for exclusivity. Express Scripts estimates that its deal with AbbVie will save its clients $1 billion annually.

In addition to more aggressive price contracts with drugmakers, healthcare payers are also developing programs that can increase patient adherence to medicine to lower the risk of costly future healthcare events, as well as programs to increase the use of generic alternatives.

PBM programs that increase the use of lower cost generics could prove to be critical. Despite biologics’ difficult-to-copy nature, technology advances are helping generic drugmakers develop biosimilars. While not exact copies, these biosimilars deliver similar efficacy to their brand name counterparts. So far, biosimilars have been a bigger story in Europe than in the U.S.; however, the FDA approved its first biosimilar this month when it gave Novartis’ Sandoz unit the go-ahead to begin marketing its biosimilar of the top-selling cancer drug Neupogen. That approval is likely to be the first of many over the coming years.

Looking ahead

The financial stakes are high for patients and drugmakers. If prices are too low, it could force drug developers to focus only on diseases that offer the biggest payoff. That could derail advances in a range of orphan diseases. However, if prices for medicine continue to grow at this rate, it’s unlikely that the system will be able to afford it. Clearly, a middle ground is not only necessary, but in the best interest of everyone. Finding that middle ground, however, may remain difficult.

TIME Healthcare

The Most Expensive Place in the World to Have Diabetes

A new review looks at the global impact of diabetes

The U.S. is the most expensive place to have Type 2 diabetes, with an average lifetime price tag of $283,000, according to a new study published in the journal PharmacoEconomics.

Researchers at the University of East Anglia (UEA) analyzed 109 studies on the economic impact of Type 2 diabetes and found that costs are higher in the U.S., even compared with other countries with similar income levels.

“Employment chances for women with diabetes in the U.S. are decreased by almost half,” said study author Till Seuring of UEA’s Norwich Medical School in a statement. “Women with diabetes also lose out on $21,392 in earnings per year — the highest loss due to diabetes worldwide,” In other countries, men with diabetes suffer more when it comes to employment options, the data shows.

Still, the U.S. appears to be an exception. Diabetes has the greatest economic toll for people in low- and middle-income countries, the research finds. Most new cases are appearing in countries in this economic stratum, including Mexico, India and China.

Diabetes affects over 380 million people worldwide, the researchers say. That number is expected to balloon to 592 million people by 2035.

Check out the findings in the infographic below.

University of East Anglia

Read next: What Diet Soda Does to Belly Fat

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TIME Mental Health/Psychology

20 Things You Shouldn’t Do Before Bed

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Getty Images

Having trouble sleeping? These insomnia-inducing habits could be to blame

Getting a good night’s sleep is important for your mood, your energy levels, and your overall health. It’s also dependent on what you do during the day—how much physical activity you get, what you eat and drink, and how mentally stimulated you are—especially in the hours before you crawl into bed.

“When people suffer from insomnia or other sleep issues, it’s often because of something they’re doing, probably unintentionally, when they should be preparing for rest,” says Michael Grandner, PhD, a psychiatry instructor and member of the Behavioral Sleep Medicine Program at the University of Pennsylvania. Here are 20 things you might want to avoid at night, especially if you’re suffering from a lack of shuteye.

Use an e-reader or smartphone

Several studies have suggested that using electronic devices like e-readers and smartphones, or even watching television in or before bed can disrupt sleep. Robert Rosenberg, DO, author of Sleep Soundly Every Night, Feel Fantastic Every Day, recommends avoiding any light-emitting technology for at least one hour before bedtime.

“The blue light given off by computers, smartphones, tablets, and TV prevents the production of melatonin which helps the body become sleepy,” he says. If you don’t want to give up reading your Kindle Fire or using your iPad in bed, follow this advice from a 2013 Mayo Clinic study: Keep the device at least 14 inches from your face and turn down your screen’s brightness to reduce your risk of light-related sleep problems.

Take certain medications

If you take medicines or supplements on a daily basis and you’re also experiencing sleep problems, ask your doctor whether the time of day you take your dosage may be keeping you awake. “The effects may be subtle, but some medicines can make you alert for several hours after taking them,” says Grandner. For example, antidepressants can have strong effects on sleep in either direction, and some pain medications may upset your stomach and make sleep more difficult. (On the other hand, some other medicines—such as some types of blood pressure pills—have been shown to work best when taken at night; talk to your do about when to take yours.)

A sleeping pill isn’t always the answer, either: They’re generally only recommended for short-term use—over-the-counter meds, especially—so if you find yourself taking them regularly, talk to your doctor about other options. A prescription drug will be safer and more effective to use for more than a few weeks at a time, but a longer-term solution that doesn’t rely on medication is your best bet.

Read more: 27 Mistakes Healthy People Make

Text a friend

You may think a text is less disturbing late at night than a phone call, but think twice before you message a friend or family member, or get involved in a group text conversation, shortly before bed. If you sleep with your phone in or near your bed, you could be disturbed by replies after you’ve already retired or fallen asleep.

In fact, a 2011 National Sleep Foundation poll found that about 10% of kids 13 to 18 are awakened after they go to bed every night or almost every night by a phone call, text message or email, and about one in five 13- to 29-year-olds say this happens at least a few nights a week. If you are worried about getting messages late at night, put your phone in another room or mute it.

Drink coffee (maybe even decaf)

A cup of coffee contains anywhere from 80 to 120 milligrams of caffeine per cup, and you probably already know you should avoid it right before bed. But some still like the idea of a hot drink after dinner, says Grandner, and may not realize that although they’re still several hours away from turning in, their habit could disturb sleep. Truth is, caffeine can stay in the body for up to 12 hours. “Even caffeine at lunch can be too close to bedtime for some people,” says Grandner.

Perhaps even more surprising: decaf coffee may not even be a safe bet. A 2007 Consumer Reports report found that some “decaf” samples” contained up to 20 milligrams of caffeine. But there’s good news for people who love a hot cup of joe in the evenings: The new (truly) decaf Counting Sheep Coffee ($12,amazon.com) contains valerian, an herb that promotes sleep.

Drink tea

Even if you do avoid coffee, you may not be as careful about another major source of caffeine: tea. Drinks labeled as “herbal tea“—such as peppermint or chamomile varieties—are probably caffeine-free, says Grandner, but varieties that contain black, green, or white tea leaves do indeed contain the stimulant.

There may still be able to enjoy your favorite caffeinated tea at night. Dunk your teabag quickly into a cup of hot water, then dump it out and make a second cup using that same tea bag. Most of tea’s caffeine is released early on in the steeping process, explains Grandner, so this may help you enjoy the flavor and warmth without so much of the stimulant.

Read more: A Sleep Meditation for a Restful Night

Eat chocolate

Another sneaky source of caffeine is chocolate, especially dark chocolate with high cocoa contents. “People might not think about ice cream that contains chocolate or coffee as something that might potentially keep them awake, but if they’re sensitive to caffeine that could definitely do the trick,” says Grandner.

Milk chocolate bars usually have less than 10 milligrams of caffeine per serving, but a Hershey’s Special Dark Bar, for instance, contains 31—the amount in almost a whole can of Coke. Chocolate also contains the stimulant theobromine, which has been shown to increase heart rate and sleeplessness.

Skip your wind-down time

When people say they can’t shut their mind off in bed, it’s often because they haven’t given themselves adequate time to relax in the hour or so beforehand, says Grandner. “When you’re going from one distracting activity to another and not giving yourself time to sit back and reflect on your thoughts, it’s no wonder that your mind is racing when you finally climb into bed,” he says. He recommends taking at least 30 minutes before you head into your bedroom to put away anything that’s too stimulating, thought-provoking, or absorbing—anything from action-packed TV shows to work that you’ve brought home with you. Instead, focus on activities that relax you and bring closure to your evening, like making a to-do list and packing a bag for the next day.

Check your work email

Aside from the fact that a blue-light emitting device can mess with your body’s natural sleep rhythms, there are other potential problems with checking your email too close to bedtime. “Unless you’re waiting for a specific email that’s going to put you at ease and help you sleep better, I would advise against it,” says Grandner. Checking in with the office too late at night is more likely to make you nervous or agitated, or fill your mind with things you’ll need to do in the morning. In a 2014 Michigan State study, people who used their smartphones for work purposes after 9 p.m. reported being more tired and unfocused the next day.

Eat spicy or fatty foods

Having a large meal too close to bedtime can make falling asleep uncomfortable if you’re bloated or painfully full. Spicy or fatty foods may be particularly risky because they’re associated with acid reflux, which often rears its head when a person lies down at night. Ideally, you should have dinner at least two hours before going to sleep says Grandner, to give your body enough time to begin digesting it. If you’re used to eating something right before bed, stick with sleep-promoting foods like simple carbs or a glass of milk. (And ask yourself if you really need it: If you’re not careful, late-night snacking can lead to weight gain.)

Drink booze

“Alcohol tricks you into thinking you will sleep better, because it often makes you drowsy and makes it easier to fall asleep,” says Dr. Rosenberg. “But as your body begins to metabolize the alcohol, REM sleep, the period where our sleep is most restorative, is reduced.” Impaired REM sleep often leads to waking up tired and unable to concentrate, he adds. Plus, a 2014 University of Missouri study points out that alcohol is a diuretic and may make you have to go to the bathroom through the night. Dr. Rosenberg’s advice: For most people, it’s okay to have a drink or two with dinner—but skip the nightcap or the glass of wine on the couch right before bed.

Read more: The Best Pillow for Your Sleep Style

Smoke

We could go on and on about all the ways smoking is terrible for you, including disturbing your sleep. Many people smoke to relax, says Grandner, but nicotine is a stimulant and can make insomnia worse, especially if you light up close to your bedtime. Nicotine withdrawal can also cause smokers to wake up earlier than they normally would in the morning.

“If you’re a smoker and you’re having trouble sleeping, that may be another reason you should talk to your doctor about quitting,” Grandner says. It’s not just traditional cigarettes you should avoid at night; e-cigarettes, smoking cessation patches, pipes, cigars, and chewing tobacco can all keep you up.

Chug lots of water

Staying hydrated is important, but it may not be the best strategy to drink a huge glass of water before bed or sleep with one water by your bed,” says Grandner, “unless your goal is to get up in the middle of the night to use the bathroom. Instead, he suggests, make sure you’re drinking plenty of water throughout the day—and always be sure to use the bathroom before you head to bed, even if you don’t feel like you have to.

Work out too intensely

You may have heard that exercise before bed might keep you awake at night. This belief has been largely disproven, says Grandner: “The amount of physical activity that’s required to have an affect on your sleep is pretty intense, and the vast majority of people don’t get enough exercise as it is—we don’t want people to not work out just because they think it’s too late.” In fact, getting regular exercise has been shown to actually help treat insomnia and promote good sleeping habits.

There is some evidence, though, that prolonged or very high-intensity exercise late at night may make it hard for some people to fall asleep. If you’re staying up extra late to squeeze in time at the gym, or suspect that your 9 p.m. kickboxing classes may be keeping you up, see if you sleep better after an earlier workout.

Play video games

The science on television’s effects on sleep is somewhat inconclusive; some studies show that watching TV before bed can disrupt sleep (due to its melatonin-impairing blue light, its mental stimulation, or both), while others show it has little effect. One thing that most experts do agree on, however, is that electronic media that requires a lot of interaction—like video games—can definitely wreak havoc on your slumber.

“Browsing the web or flipping through TV channels before bed may not be so bad if you’re not super sensitive to light,” says Grandner, “but anything that’s highly engaging will almost certainly keep you awake.” Dr. Rosenberg agrees: “Stimulation from these devices can activate and excite the brain, which presents a challenge when it comes to trying to fall asleep.”

Turn up the heat

Everyone’s preferences are different, but most tend to sleep best between 60 and 70 degrees. “People sleep better when it’s cooler—sometimes a little cooler than they think,” says Grandner. That’s because the body’s temperature drops during the night, and also because a lower temperature allows for people to cover up with blankets without getting too hot.

Of course, if it’s freezing in your house and you can’t fall asleep without shivering, there’s nothing wrong with bumping the heat up a degree. But know that you’ll probably sleep better at a slightly cooler temperature than your house is set at during the day.

Read more: 10 Sleep Compatibility Problems, Solved

Let your pet into bed

“Everyone with a pet knows that inviting that pet into your bed is inviting a whole lost more awakenings during the night,” says Grandner. In fact, in a recent University of Kansas study, 63% of people who shared a bed with a furry friend experienced poor sleep. “If you’re cool with that, go right ahead—but it’s definitely something to consider if it starts to affect your sleep quality,” Grandner says.

And those sleep disturbances can come from more than just your dog or cat’s movements through the night. Pet hair and dander in your bed could also contribute to allergies and breathing difficulties, which can also affect your slumber.

Take a shower

If you shower after working out at night or you are simply in the habit of bathing before bed, there’s certainly nothing wrong with it; a hot bath may even help relax you and prime your body for sleep. But if you normally rinse off in the morning and you only switch it up occasionally, bathing at night could send the wrong message to your brain.

“Showers often wake people up, so it might not be the best thing to do before bed,” says Grandner. People with long hair should be careful not to go to bed with wet hair, either; not only can it be uncomfortable and cause knots and tangles, but it can also make sheets and pillows damp, which could cause mold to grow.

Pick a fight

There’s a good reason couples are told to never go to bed angry. “Stress is a major cause of insomnia,” says Dr. Rosenberg. “If a conversation is stressful, it will elevate cortisol and other stress hormones impending your ability to fall asleep.” Plus, he adds, angry people tend to ruminate, or play over thoughts again and again in their minds, which can also make falling asleep difficult.

Going to bed with unresolved issues may not be your best bet either, but Dr. Rosenberg suggests trying to hash out any problems earlier in the night, and saving important decision-making or serious conversations for days when you have more time to reflect and relax afterward. “A serious conversation before bed is not a good idea,” he adds.

Alter your routine

Doing the same thing every night before bed is one of the tenets of good sleep hygiene. Brushing your teeth, washing your face, and setting out your clothes for the morning, for example, can all send a signal to your brain that it’s time for bed—especially if you do them in the same order, at the same time every night.

But switching up that routine, by doing things out of order or earlier in the night than usual, can disrupt that mental process. “Without a consistent bedtime routine, your brain doesn’t go into sleep mode until you crawl into bed and turn out the light,” says Grandner. “You’ll fall asleep much faster if you can start that process a little bit earlier, as you’re getting ready.”

Anything that’s too exciting

Reading in bed can be a great pre-slumber activity, and if it helps you wind down and makes you tired, says Grandner, then go for it. The same goes for any routine habit that helps you get to sleep—chatting on the phone with your best friend, organizing a photo album, or knitting, for example.

But if that book or that knitting project or whatever else you’re doing draws you in too much, you may have a hard time putting it down and turning out the lights. “When I read at night, I get too absorbed in the story and the next thing I know it’s 3 a.m.,” says Grandner. If this happens to you, be careful about the activities you choose before bed, and set strict time limits for whatever you do decide to take on.

Read more: 10 Products That May Help You Sleep

This article originally appeared on Health.com.

Read next: 10 Ways To Sleep Better With Your Partner

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TIME Healthcare

Chilean 14-Year-Old With Cystic Fibrosis Asks To Be Allowed To Die

'I am tired of living with this disease'

A video of a 14-year-old Chilean girl with cystic fibrosis asking to be allowed to die has captured attention across the Spanish-speaking world and launched a debate about the right-to-die movement in a region with strong Catholic influence.

“I am asking to speak urgently to the president because I am tired of living with this disease, and she can authorize the injection to put me to sleep forever,” said a teary-eyed Valentina Maureira, addressing Chilean President Michelle Bachelet.

The video, which Spanish media outlets said had been posted to Facebook Sunday evening, shows Maureira sitting on a hospital bed speaking directly to the camera. She explained later that she was “tired of continuing to fight,” according to a translation of a BBC interview. Cystic fibrosis—a genetic disorder that causes problems in the respiratory, digestive and reproductive systems—is a terminal illness that typically results in death in a person’s 30s. In Chile, one in 8,000 newborns has been diagnosed with the disease in recent years, the BBC reported.

Fredy Maureira, Valentina’s father, told radio station Bío Bío Chile that the video had come as a surprise to him, though he said he knew that his daughter had been unhappy in recent months.

“I told her: ‘Daughter, if you want to fight, we will fight. You know how your disease is,'” he told the BBC.

It seems unlikely that Bachelet could authorize the procedure. Presidential spokesperson Alvaro Elizalde said that euthanasia violates Chilean law. Instead, he said, the government would provide Maureira with medical and mental health resources.

“We have to be completely clear, the current norm, the current law in Chile does not allow the government to agree to a request of this nature,” he said, according to Reuters.

The story had spread throughout the Spanish-speaking world by Thursday, with major Spanish language outlets on three continents covering the news, and inspired thousands of Facebook likes.

“I did not think it would get so high,” she told the BBC. “I liked it because [it] motivates people. And this [disease] is a reality.”

MONEY privacy

Your Embarrassing Online Searches About Health Problems Aren’t Private

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Thomas Jackson—Getty Images

A new study found that 91% of health-related web pages reveal potentially sensitive information to third parties like data brokers and online advertisers.

Hypochondriacs beware: That Google search for “STD symptoms” could go into your digital dossier.

A new study has found that health-related web pages often leak information about you and the information you access to third parties, raising concerns about online privacy.

To conduct the study, University of Pennsylvania PhD student Timothy Libert analyzed the top 50 search results for 1,986 common diseases, some 80,000 web pages. He found that on 91% of the pages, third parties like social networks, advertisers, and data brokers could access information about who was viewing the page, like the user’s IP address. On 70% of the pages, those third parties could see information about specific “conditions, treatments and diseases” viewed.

Altogether, 78% of the health-related web pages sent information about you to Google, 31% sent information to Facebook, and 5% sent information to Experian, a credit bureau and data broker.

What’s the big deal? Libert has two major concerns about these practices. The first is that the third parties could match you with your medical search results, a problem he calls “personal identification.” This isn’t a totally imaginary scenario—data brokers routinely collect information about you from your online activity, shopping habits, and public records, then turn around and sell that information to advertisers. That already includes sensitive medical information: One data broker was caught hawking lists of “rape sufferers,” “domestic abuse victims” and “HIV/AIDS patients.”

Second, advertisers could discriminate against you based on your medical searches, regardless of whether your search results are ever connected to you personally. That’s called “blind discrimination.” In other words, advertisers could serve you certain ads and offer you certain promotions based on the websites you read. Again, this practice can be innocuous, but it can also have a dark side. “It’s like any other form of discrimination,” Libert says. “If you’re going to extend a favorable offer to somebody, your best client probably isn’t somebody with terminal cancer.”

The tech-savvy might think their searches are private because they delete cookies or use a private browser, like Google Chrome’s “incognito mode.” Sorry, but no.

That’s because of the way websites work. Libert explains that a web page is like a recipe. The code says, “display an image from this file” or “play this video from Youtube.” To pull in content from another website’s server—like a video from Youtube—your server makes a “request” to that third-party server, and reveals information about you in the process. For example, the third party can see the name of the webpage you’re visiting, which may sound harmless, but can reveal a lot. You might not, for example, want advertisers and data brokers to know that you recently read “www.cdc.gov/hiv”.

“Even if you’re using incognito mode or something, the HTTP requests, at the very basic level, are still being made,” Libert says.

And you usually don’t even know it’s happening. While you can see evidence of some third-party requests, like Youtube videos and Facebook “like” buttons, Libert says most requests are bits of code invisible to the non-programmer’s eye.

Legally, this is all aboveboard. The HIPAA law protecting medical privacy only applies to medical services like insurance claims, not other businesses.

So while Libert wants lawmakers to beef up online privacy protections, he says in the meantime, your best bet is to install a browser extension like Ghostery or Adblock Plus.

“They don’t catch everything, but they catch a lot,” Libert says.

MONEY salary

500,000 Walmart Workers Are Getting a Raise. Here’s How You Can Get One, Too

Walmart raise minimum wage $1.75
Gunnar Rathbun—Invision for Walmart

These 5 moves can help you make sure you get what you deserve.

Two corporate giants have made headlines recently for perking up their workers’ paychecks.

Last month, health insurance provider Aetna announced it would be raising the lowest wage it pays to $16 an hour, effectively giving raises to 5,700 of the company’s workers. On Thursday, Walmart followed Aetna’s lead, revealing it would be giving 500,000 associates a salary bump of at least $1.75 above the federal minimum wage.

While across-the-board wage increases such as these are unusual, other corporations are also expected to be more generous with pay this year. Among mid- and large-sized employers, the average increase in base pay is expected to be 3.0% in 2015, up from 2.9% in 2014 and 2.8% in 2013, according to HR consulting firm Mercer.

You can help your chances of boosting your pay with these five tips:

1. Ask at the Right Time

Choosing the optimal time to approach your boss about a raise will significantly increase your chances of success. Stay on top of your own industry’s salary trends and consider whether your company and division are doing well enough to afford what you’re asking for. It’s also a good idea to ask for a raise a few months before performance reviews so that salaries aren’t already set.

Read more: How to Tell if Now Is a Good Time to Ask for a Raise

2. Know What Others are Getting

Before you ask for a raise, you’re going to need to know what kind of raise is reasonable. Check sites like PayScale.com and GlassDoor.com to get an idea of the industry standard for your position, then consult your colleagues to see what the story is internally. For women, that means making sure to check with your male mentors as well. As MONEY’s Margaret Magnarelli writes, female employees tend to be underpaid relative to their male counterparts, and often remain unfairly compensated because they compare salaries with female colleagues who are also underpaid. Gathering a broad cross section of salary data can help break through the ceiling.

Read more: The Foolproof Way to Make Sure You Land a Big Raise This Year

3. Be Able to Prove You’re Better than Average

The 3% average bump that Mercer projects isn’t bad, but being better than the norm can be very lucrative. In 2014, Mercer said the highest-performing employees received a 4.8% raise—more than 2 percentage points higher than the average for that year. How do you show you’re the best of the best? Gather a portfolio of past endorsements and ask satisfied clients to write testimonials. Then do your best to quantify your accomplishments so that your boss has the hard numbers as well.

Read more: 5 Ways to Get a Big Raise Now

4. Identify Your Added Value

Think about what you do that no one else at the office can do—either where you’ve particularly excelled or what highly marketable skill you bring to the table—and then frame your ask around this added value. Jim Hopkinson of SalaryTutor.com suggests framing your requests as follows: “Not only do I have [all the standard requirements that everyone else has] + but I also possess [the following unique traits that make me worth more money].”

Read more: The Secret Formula that Will Set You Apart in a Salary Negotiation

5. Just Ask!

As Wayne Gretzky said, you miss you 100% of the shots you don’t take. According to CareerBuilder, 56% of workers have never asked for a raise, which is a shame because 44% of those who did ask got the amount they asked for, and 31% still got some kind of salary boost. It might seem daunting to ask for more money with the economy still in recovery mode, but job openings are the highest they’ve been in a decade, almost three-quarters of employers say they’re worried about losing talented workers, and raises are gradually getting larger. Being assertive can be scary, but don’t let fear stand in the way of a bigger salary.

Read more: New Study Reveals the Odds You’ll Actually Get the Raise You Ask For

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How to Balance Spending and Safety in Retirement

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4 Ways to Hit Your Money Goals

TIME Aging

Famed Scientist Oliver Sacks Reveals He Has Terminal Cancer in Soulful Op-Ed

The Music Has Power Awards Benefit
Brad Barket—Getty Images Dr. Oliver Sacks speaks at the Music Has Power Awards Benefit in the Allen Room at the Frederick P. Rose Hall, Home of Jazz at Lincoln Center on Nov. 6, 2006 in New York City.

The neurologist and author writes in the New York Times that he feels "intensely alive" in the face of death

Oliver Sacks, one of the leading public intellectuals of the last half-century, says terminal cancer of the liver has left him with only months to live.

Sacks, a neurologist and author of books like Awakenings and The Man Who Mistook his Wife for a Hat, revealed his condition in an article about facing death that was published in the New York Times on Thursday.

“It is up to me now to choose how to live out the months that remain to me,” Sacks, 81, writes in the Times. “I have to live in the richest, deepest, most productive way I can.”

He says he will shun politics and nightly news to focus instead on himself, his friends, and his work–an autobiography is set to come out in the spring, and he says he has “several” other books in the works. He writes:

This is not indifference but detachment — I still care deeply about the Middle East, about global warming, about growing inequality, but these are no longer my business; they belong to the future. I rejoice when I meet gifted young people — even the one who biopsied and diagnosed my metastases. I feel the future is in good hands.

I have been increasingly conscious, for the last 10 years or so, of deaths among my contemporaries. My generation is on the way out, and each death I have felt as an abruption, a tearing away of part of myself. There will be no one like us when we are gone, but then there is no one like anyone else, ever. When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.

Born in the U.K., Sacks has spent most of his career in the United States, where his prolific writing has blended science and literature to best-selling success. Outside of work, he’s been nearly as active. A one-time weightlifting champion with a stint riding with Hell’s Angel’s—according to a 1995 profile in TIME—he says he still swims a mile a day.

The removal of a tumor in his eye left him blind in one eye nine years ago and led to his 2010 book ‘The Mind’s Eye’ that deals in part with his experience with cancer and his inability to recognize faces. But the tumor metastasized, and the author now says the cancer’s spread cannot be stopped.

“I feel intensely alive, and I want and hope in the time that remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have the strength, to achieve new levels of understanding and insight,” he writes.

Read Oliver Sacks’s story in the New York Times.

Read next: The Secret of Abraham Lincoln’s Success as a Writer?

Listen to the most important stories of the day.

TIME Research

Scientists Say Aggressive New HIV Strain Discovered in Cuba

Reports of people in Cuba infected by new strain developing AIDS in less than three years

A recently-discovered form of HIV in Cuba has been found to progress into AIDS some three times faster than the most common strains of the virus, according to a recent study.

The study, conducted by researchers from the University of Leuven in Belgium, followed several reports of HIV-infected people in Cuba developing AIDS in less than three years, far faster than the usual 10 years it typically takes. All patients infected with CRF19, a recently-discovered strain of the HIV virus, had higher levels of it in their body.

They were also more likely to have developed AIDS within three years, the study published in the journal EBioMedicine found. The researchers, who looked at 95 patients at various stages of infection, concluded that the strain must be “particularly fit.”

Approximately 35 million people worldwide are living with HIV or AIDS, and nearly 40 million have died of the disease since the 1980s. Drugs exist to keep the worst effects of the disease at bay, but this new strand threatens to take a toll on patients before they realize they need treatment.

MONEY Health Care

What to Know About Obamacare Open Enrollment This Year

150209_FF_ObamacareDeadline
Jeffrey Coolidge—Getty Images

The Obamacare deadline to sign up for a policy is February 15. Here's what you need to do to make sure you're covered.

Update: The Obama administration has announced a special open enrollment period for people who did not realize they would need to pay a tax this year. So you have one more shot to get insurance for 2015, from March 15 to April 30. Here are our tips from February.

Time is running out. The open enrollment period for buying individual health insurance for 2015 ends February 15. Miss this important deadline, and you could remain uninsured all year—and face a steep tax penalty.

As of early February, about 9.9 million Americans had purchased or re-enrolled in private health insurance through the federal and state insurance exchanges created by Obamacare. But an estimated 29 million Americans remained uninsured as of the end 2014, according to the Commonwealth Fund.

Anne Filipic, president of Enroll America, a non-profit that educates Americans about health insurance, says too many people still don’t know that they can get financial assistance if they are struggling to pay for coverage.

“There has been a lot of confusion and misinformation,” Filipic says. “For a lot of people, they’ve heard of the ACA or Obamacare, but they don’t know what it means for them.”

Here’s what next week’s deadline means and what you need to know about getting covered in time.

1. February 15 is a hard deadline.

The window to buy individual health insurance for 2015 runs from November 15, 2014 to February 15, 2015. After that, you won’t be able to buy a policy this year unless you have extenuating circumstances. You may have to remain uninsured until 2016 (open enrollment for 2016 coverage doesn’t begin until next October).

There are exceptions. If you marry, divorce, have a baby, move to another state, lose your employer health insurance, or experience another “qualifying life event,” you can sign up for health insurance any time. You have 60 days after the event to enroll in a new health plan.

2. You have choices where to shop.

Under the Affordable Care Act, aka Obamacare, you can buy private insurance through government-run shopping websites, also called exchanges or the marketplace. Some states run their own sites; others use the federal government’s site. You can find the option for your state at Healthcare.gov, where you’ll also be able to see if you qualify for financial help with your premiums.

You don’t have to shop on a government-run exchange. You can also get insurance from web brokers, such as getinsured.com, gohealth.com, or ehealthinsurance.com. But if you qualify for a premium subsidy, make sure you get a plan that is sold on the government marketplace.

3. If you can’t afford insurance, you may qualify for help.

Almost half of uninsured Americans say they didn’t sign up for Obamacare because they thought they couldn’t afford it, according to a Kaiser Family Foundation poll. Generally, that shouldn’t be the case. The government will pay for part of your health insurance if you earn between 100% and 400% of the poverty level.

The poverty level varies based on your family size. A single person earning between $11,670 and $46,680 this year is eligible for a tax credit. So is a family of four earning between $23,850 and $95,400. With a tax credit, your health insurance will cost between 2.01% and 9.56% of your total income.

The Department of Health and Human Services found that 87% of the people who bought a health plan on the exchanges got financial help, and those people paid an average of just $82 a month. “This is a little known fact for many people,” Filipic says.

And if you earn less than the poverty line? The plan was for households making less than 138% of the poverty line to enroll in Medicaid, a state-administered health care program for low-income Americans. Here’s the catch: The Supreme Court ruled that the federal government could not force states to expand their Medicaid programs.

As a result, some people in the 21 states that did not expand Medicaid may earn too much to qualify for Medicaid but earn too little to qualify for an Obamacare tax credit. The Kaiser Family Foundation estimates that 18% of uninsured Americans fall in this so-called “coverage gap.” Fortunately, about 30% of uninsured Americans are eligible for tax credits to buy private insurance. Another 18% are eligible for Medicaid.

4. If you’re not covered, the penalty is going up.

Another reason not to miss this deadline: Under Obamacare, most Americans are required to have a qualified health insurance plan, or pay a fine.

If you went without health insurance for more than three months in 2014, you could owe the IRS up to $95 per person in your household (capped at $285 for large families), or 1% of your income, whichever is higher. And if you go without health insurance this year, the penalty increases to $325 per person (capped at $975) or 2% of your income. The penalty increases again in 2016.

However, you can qualify for an exemption, including for financial hardship. “Most people who are uninsured will qualify for an exemption because there’s a lot of exemptions,” says Karen Pollitz, senior fellow at the Kaiser Family Foundation. You can apply for most exemptions right on the tax return; you can apply for other hardship exemptions using this form.

5. You can ask an expert to help you enroll.

Still confused? Get help. All across the country, there are thousands of experts, sometimes called “navigators,” who can assist you in-person, for free.

Getting help is especially valuable if you aren’t sure if you are eligible for financial help, Pollitz says. Oftentimes, assisters work year-round for free clinics or other public agencies, so if you’re in the Medicaid “coverage gap,” an assister might be able to connect you with other resources, such as nutrition assistance or free community health services. Plus an ACA navigator or another adviser could help you tally up your income and see if you can claim a tax credit.

You can find an assister near you on the government’s site, localhelp.healthcare.gov. Or sign up for an appointment online using Enroll America’s connector tool at getcoveredamerica.org/connector. There are about 65,000 appointments available before February 15 at some 4,000 locations, and Enroll America offers contact information for another 11,000 locations. “There’s help out there waiting for you,” Filipic says.

6. Even if you bought health insurance last year, you should shop again.

If you bought health insurance on the exchanges last year and then did nothing, you’ve been auto-enrolled in that plan or a similar plan from the same insurer. But you can still switch plans until February 15.

Take a minute to see if that’s still the best deal, especially if you chose the least expensive plan in the first go-round. Last year’s cheapest plans have gotten 9.5% more expensive, on average, according to an analysis by the New York Times. You may be able to lower your monthly premiums by switching.

And your benefits can change too, including your deductible and out-of-pocket maximums.

Another reason to re-enroll is to see if you qualify for a bigger tax credit. “Your tax credit from last year was also automatically renewed, but it may or may not be the right amount,” Pollitz says. “Even if your income didn’t change at all, you probably qualify for a little more tax credit just because you got older. It’s based on a benchmark plan for someone your age.”

And while you’re at it, think about how you liked your health coverage in 2014. “Are you satisfied with the network? Were you able to get in to seeing the doctors you wanted to see? Were there a lot of hassles getting your claims paid?” Pollitz says. “Now is a good time to see what your options are.”

This article was updated to clarify that you can claim most tax penalty exemptions on your tax return, and premium subsidies are only available for plans sold on the government marketplace.

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