MONEY College

12 Things We Wish We’d Known When We Were 18

Girl moving off to college
Eric Raptosh Photography—Corbis

Suze Orman and other experts share their financial advice for the Class of 2018. Follow these tips to keep your college experience from becoming a major money mistake.

Prepping for freshman year at college typically includes activities like shopping for dorm essentials, reviewing orientation packets, and Googling your new roommate.

Most students don’t spend a lot of time thinking about how they’ll manage their money in this new phase of their lives.

And yet, what you do in those first few years of parental emancipation can affect you for years—or decades—to come. Students graduated last year with an average $35,200 in college-related debt, including federal, state and private loans, as well as debt owed to family and accumulated via credit cards, according to a Fidelity study. Half of those students said they were surprised by just how much debt they’d accumulated.

To make sure the class of 2018 gets off on the right foot, MONEY gathered sage advice from top financial experts about the lessons they wish they, their kids, or their friends had known before starting school.

1. Limit your loans. “Do not take out more in student loans than what you are projected to earn in your first year after college. If you only expect to make $40,000, you better not take out more than $40,000. The chances of you being able to pay it back is close to nil. If you need to take a private loan, you’re going to a college you can’t afford. Remember, going to an expensive school doesn’t guarantee success. The school never makes you, you make the school.” —Suze Orman, host of The Suze Orman Show and author of The Money Book for the Young, Fabulous & Broke

2. Finish in four. “Many kids are finishing school in five or six years. But every extra year is potentially an extra $30,000 to 40,000 in expenses. Map out your coursework and figure out exactly what you’ll need to do each semester. Be vigilant about sticking to your plan. Try to catch up on any credits by taking classes at a community college over the summer.” —Farnoosh Torabi, author of You’re So Money

3. Study money 101. “Sign up for an economics or personal finance course. This way, when you graduate, you’ll be better equipped to manage money for the rest of your life.” —Brittney Castro, CEO of Financially Wise Women

4. Leave the car at home. “Everyone feels like they need a car, but with the combination of sharing services like Uber, Lyft, Zipcar and public transport, that isn’t always the case. If you’re living in a major metropolitan center or on campus, consider leaving your car behind. It’s much cheaper to use one of these car services than it is to pay for insurance, gas, parking, car maintenance and car payments.” —Daniel Solin, author of The Smartest Money Book You’ll Ever Read

5. Lead rather than follow. “Especially in college, you’re going to be surrounded by people doing dumb things financially. You’ll see people financing their lifestyle with student loans or their parents’ money. Don’t feel bad if you can’t afford the same things as others. I knew a student who was financing his whole college experience with debt and he was always asking people to go shopping with him. If I’d tried to keep pace, I’d have ended up in the same debt-ridden place as him.”—Zac Bissonnette, author of Debt-Free U

6. Find free fun. “You can still do fun things at school, without spending a lot of money. You’re paying an activity fee in your tuition, so you ought to make sure you’re taking full advantage of whatever the school offers for free—be it concerts, trips, lectures. The school I went to provided grants to help students travel abroad and offered free plays and trips through different clubs.” —Farnoosh Torabi

7. Be purposeful with plastic. “The idea that you need to build credit in college is wildly overrated. It’s not a bad idea to build credit, but having built up a bad credit history will hurt you more than having no credit history. You don’t need to feel pressure to get a credit card. You can get by just fine with cash and a debit card; no one is expecting you to have a ton of borrowing history when you’re getting your first apartment anyway.” —Zac Bissonnette

8. Put your budget on autopilot. “Keep track of the money you’re getting in from loans and your parents, as well as your expenses. Use an app like Mint.com, which lets you link your debit and credit cards to your online account to track your spending and easily help you keep on budget.” —Daniel Solin

9. Enlist Mom and Dad. “Check in with your parents once a month and review your spending with them. Talking about this will help you to avoid what I call ‘budget creep,’ where all of a sudden you’re spending $30 a day on food and entertainment. All those little extras add up and you could be spending over a hundred a week… on what?”—Neale Godfrey, chairwoman of Children’s Financial Inc.

10. Protect your stuff. “College students may not think they have a lot of valuable possessions. But think about the value of electronic devices alone, not to mention textbooks, clothes, even that ratty futon. The good news is that renters insurance is typically inexpensive and can protect you from fires, theft and other incidents. The even better news is that students’ stuff may be covered by their parents’ homeowners insurance. Check the policy prior to hitting the books.”—Kara McGuire, author of The Teen Money Manual

11. Establish rules with roomies. “If you’re renting an apartment with friends, be sure everyone and their parents sign the lease. Try to have everyone’s name on the utilities bills as well. Kids will take advantage of other kids, and you don’t want to be the one who is stuck being responsible for everything. If you can’t attach everyone’s names to all the bills, have them prepay. Also, make sure everyone chips in for general expenses like cleaning supplies and toilet paper, so you don’t end up paying for all of that as well.” —Neale Godfrey

12. Share with discretion. “Social networks are a public record. Your future employers will look you up on your social sites and judge you based on what they see. So something that you thought was cute in college could keep you from getting the job. Know that every move you make on those sites could have a direct consequence on your ability to land a job.” —Suze Orman

 

MONEY

How to Keep Health Emergencies from Bankrupting You

Celine Dion takes a break from touring to care for her husband, who is battling cancer.
To help care for her ailing husband, Celine Dion has stepped out of the workforce for a while. Ryan Remiorz—AP

Céline Dion cancelled her tour to care for husband René Angélil, who's been fighting cancer. She doesn't have to worry about money, but most people in a similar situation do. Here's how to contain the financial damage.

Earlier today, singer Céline Dion announced that she would be canceling her tour to take care of her husband René Angélil—who has been battling cancer.

“It’s been a very difficult and stressful time for the couple as they deal with the day-to-day challenges of fighting [Angélil's] disease while trying to juggle a very active show business schedule, and raise their three young children,” a publicist was quoted as saying.

No amount of money can erase the worry and heartache associated with caring for a loved one who’s dealing with a critical illness. And of course Dion, with a net worth estimated at $500 million, doesn’t have to fret about how her family will cope financially at this difficult time. But for the average American, the economic consequences of a tough diagnosis can compound the stress. A study by Sun Life Financial found that even with health insurance, the average cancer patient faced $6,700 in out-of-pocket costs a year. Plus, a family illness can take you away from the office, potentially crimping your earnings.

Should something like this happen to you, a parent or a partner, follow these steps to keep the financial toll to a minimum:

First, maximize your insurance coverage

Dig into your health plan. “Find out if the treatments you need will be covered or if you’ll have to go out of network to see the best specialist,” says Donald Duncan, a Chicago financial planner. Check how much you could be on the hook for; note that your out-of-pocket max when you leave your network can be twice as high as for in-network care.

Appeal to your insurer. If you can successfully argue that no specialists in your network are experts in your care or that none have treated your condition frequently, your insurer may be willing to cover out-of-network care at in-network rates.

Negotiate with your doctor. Another cost-saving option is to see if an out-of-network practitioner will accept in-network rates. Get a sense of what prices doctors and insurers typically agree on at healthcarebluebook.com.

Next, Get Down to Business at Work

Make the most of open enrollment. Use the annual benefits election period to switch to better health coverage, fully fund a flexible spending account ($2,500 max), and see if you can sign up for extra life and disability insurance. For most large group plans, you don’t need a physical for life insurance during this annual event.

Protect your position. If your firm has 50 or more workers and you’ve been there a year, the Family Medical Leave Act lets you take 12 weeks of unpaid leave—for your care or a family member’s.

Work out a lighter load. Your company may very well pay all or part of your salary for a leave under the firm’s short-term disability policy. If all you want is to reduce your hours, most policies will allow for that too.

Last, Guard Against Greater Financial Damage

Get your shoebox in order. Assemble all your financial statements, insurance policies, property records, and estate plans now, not later, says Philadelphia financial planner Stephen Cohn. Add to that list online IDs and passwords.

Raise cash. Prepare for big medical bills and a potential reduction in earnings by deciding which funds you’d tap in a worst-case scenario. If you must raid your assets and you’re under 59½, tap taxable accounts first to avoid the penalties you’ll pay to cash out an IRA or 401(k) (unless you can get a hardship waiver). “Sell before you need cash so you won’t have to liquidate at a bad time,” says Cohn.

Pick a point person. Draft a durable power of attorney and health care proxy. And says Tampa financial planner Keith Amburgey, “identify who will be your trusted person through your illness.”

MONEY Autos

The Least and Most Expensive States to Drive

Car driving into the Tetons, Wyoming
At least the scenery is great in the state where drivers tend to log in the most mileage on the road, Wyoming. Rolf Richardson—Alamy

Curiously, a state with low auto insurance premiums and fairly cheap gas is named the most expensive in the nation for operating a car.

Bankrate.com released the results of a new study about the least and most expensive states to own a vehicle, and a few of the places featured at the pricey end may seem particularly puzzling. Using state-by-state data concerning driver spending on car repairs, insurance, and gas gathered from CarMD.com, GasBuddy.com, the Bureau of Labor Statistics, and the National Association of Insurance Commissioners, Bankrate researchers found:

• The Midwest dominated the least expensive end of the cost spectrum, with Illinois, Ohio, and Iowa named the three cheapest states. All averaged under $2,000 annually for the trio of car operating costs included in the study, with Iowa the cheapest of all—$1,942, 13% below the national average ($2,233).

• Drivers in North Carolina, California, Washington, D.C., and New Jersey spend the most on repairs, all averaging $390 or more annually. New Jersey has the highest average of all at $393, which is 11% higher than the national average. A few hours north in Vermont, meanwhile, drivers average just $270 in annual repairs.

• Average car insurance premiums in Washington, D.C., New Jersey, and Louisiana top $1,200 per year, which is at least $500 more than a half-dozen other states in the country.

• Several of the top five most expensive states to operate a car may come as a surprise: Wyoming is the priciest overall ($2,705), followed by Louisiana ($2,555), Florida ($2,516), Mississipi ($2,487), and New Jersey ($2,421).

The reason that Wyoming is at the top of the list pretty much boils down to how much drivers pay for gasoline. It’s not even that the state’s gas prices are all that high—drivers in Alaska, Hawaii, New York, California, and Connecticut, among other places, routinely pay more per gallon than folks in Wyoming. Instead, Wyoming drivers pay more annually for gasoline because they tend to drive so much—68% more than the average American. The data used by Bankrate indicates that folks in Wyoming spent $1,588 on gasoline last year, and $1,643 the year before that. In the 2014 study, the state where drivers spent the second highest amount on gas was Alabama, with an average of $1,237. The average driver in Washington, D.C., meanwhile, spent an average of only $618 on gasoline in a year’s time.

Drivers in D.C. don’t get off so easily in other areas, however. The average car insurance policy there runs $1,273 annually, vastly more than premiums in Iowa, Ohio, Idaho, Wisconsin, Maine, and both of the Dakotas, which all average under $700.

What’s more, D.C. drivers are subjected to many costs that aren’t factored in to the Bankrate study, and that drivers in, say, Wyoming, rarely have to worry about. Like parking. A 2014 NerdWallet report about the worst 10 U.S. cities for parking featured Washington, D.C., for its typical costs ($19 per day, $270 per month) and the total amount collected in parking fines (around $100 million each year).

For that matter, the Bankrate study, limited as it is to just three data points, leaves out quite a few of the costs involved in owning a car. Like, you know, the actual cost of the car. Once the price of buying or leasing a vehicle is adding in, along with things like depreciation, maintenance, and gas, the average sedan costs $8,876, according to the latest AAA estimates.

And hey, owning a car in Wyoming is not necessarily as expensive as the Bankrate study makes it out to be. The average driver pays more there because he is on the road much more than his counterpart in Washington, D.C., New York, New Jersey, Nevada, and Pennsylvania, where the averages in annual gas expenditures are all under $800. To some extent, Wyoming drivers are victims of their state’s geography and development—stuff there is far away, what are you gonna do? But unlike in other states, where impossible-to-get-around high auto repair and insurance costs inflate overall driving expenses, at least people in Wyoming theoretically have the power to dramatically rein in the price of having a car, provided their work schedules and personal lives allow it. Just drive less.

MONEY Health Care

Here’s One Thing That’s Cheaper in the City, and It Will Help You Live Longer

New York City Cityscape
Hint: It's not rent. Charles Taylor Crothers—GalleryStock

In some states, rural residents are paying far more for health insurance. Here's why—and why that might change next year.

By many measures, city living is a racket: skyrocketing rents, expensive food, and pricy entertainment options can make for a high cost of living. But a new study from the Robert Wood Johnson Foundation finds that city residents have the slight edge on one metric: this year they had access to cheaper individual health insurance plans on the state and federal exchanges that were created under Obamacare.

Nationally, rural residents pay only slightly more: A 50-year-old nonsmoker from a rural county is spending $387 a month on average for a mid-tier silver plan in 2014, while a city denizens pay $369 for the same kind of plan, the study found. But in some states the gap is much wider.

In Nevada, for example, residents of rural counties must spend an average of $554 a month for a silver plan—57% more than their urban peers. In eight other states, country consumers are charged at least $50 a month more for the same healthcare coverage.

A chief reason for higher premiums, researchers believe, is a lack of competition. Rural areas are home to fewer doctors, which makes it hard for insurers to score discounts for their policyholders. And rural residents have fewer health insurance options. This year, on average, urban health-care shoppers had their pick of five insurers on the exchanges, the study found; those who live in rural areas had only 3.8 options. Also, urban shoppers were able to choose from one of 17 plans on average, while rural consumers saw an average of 14.2 plan options.

Another problem is that insurance is sold on a state-by-state basis, says Janet Weiner, associate director for health policy at the Leonard Davis Institute of Health Economics. Take Nevada. In a few rural counties bordering Utah and California, there aren’t that many doctors and hospitals, and many of the closest ones are out-of-state. “The insurers do not sell multi-state plans, and so even if there are more providers close by, but across state lines, they cannot expand their provider networks,” Weiner says. “This limits the ability of insurers to drive discounts and keep costs down.”

The potential good news? Rural residents could see some relief in 2015 as more insurers join the exchanges (open enrollment starts on Nov. 15). While some states, including Florida and California, have already announced premium hikes for next year, new insurers could inject some much-needed competition into the marketplaces. For instance, both Cigna and Aetna have announced plans to expand into Georgia, a state where rural customers currently pay 24% more than urban customers do for the same kind of plan. UnitedHealthcare, the nations’ largest insurer, has announced that it will sell policies on far more state exchanges next year. “If insurers see a business opportunity, rural areas may be in luck,” Weiner says.

Read more about the impact of health reform:

 

TIME Saving & Spending

5 Super Simple Secrets to Save Your on Car Insurance

5 Secrets to Save Your Teen Car Insurance
Jane Sob—Yellowdog Productions

Experts say many people aren’t taking advantage of steps to ease the costs of car insurance when their teens get behind the wheel

fortunelogo-blue
This post is in partnership with Fortune, which offers the latest business and finance news. Read the article below originally published at Fortune.com.

If you’re anything like me, you anticipated the birthday at which your teen was eligible for his (or her) road test with a combination of glee and dread. Glee because – finally – he could get himself to the tutor; she could pick up her little sister; your days as a chauffeur were coming to an end. Dread because you weren’t sure exactly how much adding this new driver to the family policy was going to cost, but you were sure it was going to be a lot.

I’ve been through the experience now twice. And I can tell you that you’re right on both counts. It is incredibly liberating to have another driver in the family. It is also tres expensive! Car insurance costs an average 79% more when a married couple adds a teenage driver to the family policy, according to a new report from InsureQuotes.com. Boys, as you’ve heard, boost costs more than girls – by 92% compared to 67%, respectively. And costs vary widely depending where you live. In New Hampshire, Maine and Rhode Island, premiums jump by more than 100%, while in New York and Michigan the increases are relatively reasonable at about 55%.

Say it with me: Ouch!

For the rest of the story, go to Fortune.com.

MONEY health

Raising an Autistic Child: Coping With the Costs

A new study pegs the lifetime cost of caring for a child with autism at $1.4 million. For parents, there are no easy solutions.

When Linda Mercier’s son Sam was around two years old, she knew something wasn’t right.

Sam was becoming withdrawn, not speaking or playing with other kids, and focused on specific tasks like lining up his toys. Eventually the mystery was solved: He was diagnosed with an Autism Spectrum Disorder, or ASD.

That was the beginning of a very long road, one that has involved significant time, effort — and money, plenty of it. Hundreds of thousands of dollars so far, Mercier estimates, on tutors, therapists and lost wages.

The good news: Same is now high-functioning, and in many respects a completely normal 13-year-old. The downside: The price tag to get to this point has been massive.

“Only a parent of a child with special needs can ever understand the struggles, and the financial commitment, of raising and recovering an autistic child,” says Mercier, a business owner from Winnipeg, Canada. “It’s an endless battle — and an expensive one.”

Indeed: A new study in the medical journal JAMA Pediatrics has pegged the total lifetime cost of supporting an individual with an ASD at an astonishing $1.4 million in the United States. If there is also intellectual disability, the total rises even more, to $2.4 million.

RELATED: Paying for My Special-Needs Child

Such costs typically include an ongoing mix of special education programs, medical care and lost wages. After all, many parents of autistic children reduce their work hours, or even quit their jobs altogether, to help their child full-time.

The study is the most recent to tabulate just how crushing these figures really are.

“I can believe it,” says Mercier, when told of the million-dollar-plus price tag. “Easy.”

Even the study’s lead author admits to being taken aback by the final number.

“I was really surprised,” said Dr. David Mandell, director of the Center for Mental Health Policy and Services Research at the University of Pennsylvania. “The old estimates were from 8 or 9 years ago, and at first I was skeptical they needed updating.”

New studies are providing more current cost estimates. “What we found was shocking,” Mandell said. “This is a huge hit on families.”

Journalist Ron Suskind knows about that financial hit first-hand. His son Owen, now 23, was diagnosed as being on the autism spectrum about 20 years ago, a journey Suskind has recounted in the book “Life, Animated.”

Owen has made remarkable strides, thanks to what Suskind calls “affinity therapy,” or tailoring treatment depending on the child’s particular way of understanding the world.

In Owen’s case, his preferred frame of reference is Disney movies. Using that template, Suskind and his wife got to work unlocking Owen’s full potential. But it did not come cheaply.

The organization Autism Speaks estimates that it takes around $60,000 a year to support someone with an ASD, Suskind says, adding that treatment for Owen cost about $90,000 a year.

“When we first got the diagnosis, the doctor asked me what I did for a living, and I said ‘newspaper reporter.’ He said, ‘I’m so sorry to hear that. You know, private equity is a nice way to go.'”

MOVING FOR SERVICES

The costs are so prohibitive that many affected families actually pick up and move to states that offer a superior array of therapeutic services. Suskind calls it a “Grapes of Wrath”-style migration, of families ultimately headed for locales like New York or Massachusetts. (To choose the right place for your family, check out Autism Speaks’ state-by-state resource guide.)

There is also a measure before Congress that aims to mitigate the financial burden for families: So-called ABLE accounts would be patterned after 529 college-savings plans, but specifically geared toward those with disabilities. The tax-advantaged savings could be put toward expenses like education, housing, therapy and rehab.

RELATED: Paying for My Special-Needs Child

One piece of advice from Mandell: Don’t automatically think that you have to drop out of the workforce in order to manage your child’s case full-time.

It’s the natural human instinct to want to do so, of course. No one knows your child and his or her needs like you do, and navigating multiple layers of city, state and federal services can indeed be a full-time job.

But when one parent drops out of the workforce, just as out-of-pocket expenses start to mount up, “it can become very financially difficult,” Mandell says.

He urges families to take a long-term view of caregiving. “In some cases it might be better for the mother to stay in the workforce, and then hire additional support to provide case-management services,” he says.

For Linda Mercier, the towering costs hit her family budget every single day. It meant cutting back wherever possible, taking second jobs and foregoing trips to visit family. All well worth it, of course, since Sam has been such an inspiring success story.

But there’s no question that raising a child with an ASD is a sobering financial reality.

“I would tell other parents of special-needs children that there is hope,” says Mercier. “It can get a lot better, and it does. But it takes a whole lot of money to get there.”

RELATED: Paying for My Special-Needs Child

TIME Hong Kong

‘Racist’ Insurance Commercial Draws Outrage in Hong Kong

Hong Kong's Domestic Help System Under Scrutiny Following Recent Cases Of Abuse
Indonesian domestic workers protest in the streets of Causeway Bay to demand better working conditions in Hong Kong on Jan. 26, 2014 Jessica Hromas—Getty Images

An insurance commercial in Hong Kong has been deemed as racist by advocates of domestic workers and prompted outrage on social media

An insurance commercial in Hong Kong that features a male Chinese actor who impersonates a clumsy Filipina maid has been deemed as racist by domestic-worker advocates and prompted outrage on social media — reminding many Hong Kong residents of the unfair treatment of foreign domestic workers.

The advertisement for domestic-helper insurance by Malaysia’s Hong Leong Bank shows the Chinese actor as “Maria” while wearing a curly wig and covered in dark orange makeup. Foreign maids who are mostly from Indonesia, the Philippines and Thailand have become a common fixture in Hong Kong since the booming of the economy in the mid-1970s.

Along with the immigration of more than 300,000 domestic workers to Hong Kong have come horror stories of their unjust treatment by employers. Recent high-profile cases like the hospitalization of Erwiana Sulistyaningsih, an Indonesian maid who was allegedly beaten by her employer for eight months, have brought to light the abuse of foreign domestic workers in Hong Kong and prompted many of them to speak up. During the One Billion Rising event in February, a global campaign to end the abuse of women, hundreds of domestic workers there joined together to demand fairer treatment.

Erwiana’s employer, Law Wan-tung, is currently on trial and has pleaded not guilty to charges of withholding payment, criminal intimidation and causing bodily harm.

An Amnesty International report in 2013 stated that Indonesian women trafficked as domestic workers face “slavery-like conditions” in Hong Kong and that both the Hong Kong and Indonesian governments turn a blind eye to the “widespread abuse and exploitation” that foreign workers endure.

The controversial commercial comes only a few weeks after pictures from textbooks that feature racial stereotypes went viral on social media in Hong Kong. One exercise in the book invited students to match job descriptions with nationalities, prompting children to associate domestic work with a seemingly Filipina figure.

Advocates for domestic workers say the recent outpourings of racial discrimination are only a fragment of the mistreatment that domestic workers have experienced for years. Eni Lestari, spokeswoman for the Asian Migrants’ Coordinating Body, told AFP the commercial lampooned an entire community by dressing the Chinese actor up in blackface instead of hiring an Indonesian or Filipina woman to play the role. Although it was supposed to be funny to Chinese residents, Lestari added, “what they don’t realize is what’s funny is actually racist.”

[AFP]

MONEY Health Care

Rx Relief: How to Save Up to 80% on Prescription Drugs

Five strategies to help you leave the pharmacy without having to swallow a bitter pill.

The average American filled 12 prescriptions last year, according to the IMS Institute for Healthcare Informatics, and as a result the pharmaceutical industry grossed $329 billion. (You’re welcome, Pfizer.)

Minimize your pain at the pharmacy counter by taking these steps when your next script is written:

1. Use coupons. For expensive prescriptions, you can save 50% or more this way. There are a lot of ways to get your hands on prescription coupons, but start by asking your pharmacist. Call ahead or ask at the counter; the pharmacist may have some on hand or be able to tell you where to find them—most likely online. If you want to search yourself, try the drug company’s website first, then check the website of your pharmacy.

2. Try mail order. Mail-order pharmacies save you money by skipping the bricks-and-mortar middleman and sending the drug directly to you, typically in 90-day quantities. Your health insurer may work with a specific mail-order house, and often you’ll get better pricing by going this route. Alternately, your prescribing doctor’s office may have a preferred pharmacy they work with regularly, so inquire when the prescription is written.

3. Ask your doctor about pill splitting Most drugs come in more than one dosage, but aren’t priced on the same scale as the dosages. This means that, per milligram, higher dosages of the same drug are often cheaper—and you could save money by purchasing double doses of your prescriptions and halving them. Not every drug should be split, so consult with your doctor first. If you’re given the go-ahead, make sure to purchase a pill splitter from a drug store to ensure consistent and equal dosing.

4. Opt for generics If there’s a generic version of your brand-name drug available and you’re not taking it, you could be wasting a lot of money—on average, generics are 80% to 85% cheaper than their brand-name counterparts. Contrary to the myth that generic drugs are held to different standards than brand-name drugs, there is no significant difference between them. Generic drugs are allowed to differ from brand-name drugs only insofar as appearance and inactive ingredients. By law, medication dose, safety, quality and instructions must be the same. Stores have gotten into price wars over generic drugs: Target now charges $4 for hundreds of medicines, for example, and Meijer and Publix are among those that offer some drugs gratis, which is why you may want to…

5. Compare pharmacies. Drug prices can vary widely between pharmacies, even locally, so you may want to shop around before simply going to the nearest drug store. Websites like GoodRx and LowestMed compare pharmacies within zip codes for specific medications, and even offer coupons and drug information. You may be surprised to find that some drugs vary by $50 or more for the same supply and dosage. In that case, the cost of convenience may just be too high.

 

More stories from NerdWallet Health:

So You’re Pregnant? Here’s What You Need to Know About Your Maternity Coverage and Benefits

How to Save On Asthma Medications

Patient Advocates: Your New Best Friend for Managing Your Health Care Experience

TIME energy

Earthquake Insurance Becomes Boom Industry in Oklahoma

Chad Devereaux
Chad Devereaux examines bricks that fell from three sides of his in-laws' home in Sparks, Okla., on Nov. 6, 2011, following two earthquakes that hit the area. Sue Ogrocki—AP

At least one industry is benefiting from the recent epidemic of tremors in the Sooner State

Just a few years ago, earthquake insurance wasn’t something many thought much about in Oklahoma. That’s changed with the outbreak of tremors that has rattled the state in recent years, which many blame on increased oil- and gas-drilling activity.

“Every time there’s a decent-size earthquake, there’s a spike in interest,” says Matthew Ramirez, an agent for Farmer’s Insurance in Edmond, which has been affected by many of the recent quakes. So far in 2014, Oklahoma has seen 200 earthquakes of magnitude 3.0 or stronger.

Standard homeowner policies generally don’t cover damage caused directly by earthquakes (to a building’s foundation, for instance), though they usually do cover the damage that earthquakes can cause, such as burst pipes or fire. Before November 2011, Ramirez insured “three or four homes” for earthquake coverage, “including mine,” he says. On Nov. 6, that all changed. A magnitude-5.6 earthquake — the largest ever recorded in Oklahoma — destroyed 14 homes and injured two people. “In the days that followed, we were flooded with earthquake calls, about 20 per day for two weeks,” Ramirez says.

Roughly 1% of the homes Ramirez insured in October 2011 had earthquake insurance. Today, he says, more than 40% of the homes he insures are covered for earthquake damage. Statewide, according to the Insurance Information Institute, the total premiums on earthquake insurance policies in Oklahoma more than doubled between 2009 and 2013, to $12,407.

According to Amberlee Darold, a seismologist with the Oklahoma Geological Survey, it’s no longer a matter of debate that hydraulic fracturing of oil and gas wells, or fracking, causes earthquakes. “It’s known that fracking can cause earthquakes and has caused earthquakes,” she says. Whether or not the injection of fracking wastewater into old wells for storage leads to earthquakes is a matter still up for debate, she says, but “there’s no question with fracking.”

Fracking, due to the nature of setting off underground explosions, is by its nature a seismic event, and the American Petroleum Institute (API) does not dispute that fracking can contribute to small-scale seismic activity. But the industry group rejects the idea that fracking causes earthquakes of a strength that can lead to a damaged home, for example. “A review of published research shows no cases of injuries or damage as a result of the very low level of seismicity related to this well-completion technique, which has been used in more than one million applications,” says an API report on the question.

Attributing any single seismic event to fracking is tricky, in the same way that attributing any single weather event to climate change is problematic. But taken on the whole, it’s hard not to link the notable increase in earthquake activity in Oklahoma with the boom in oil and gas drilling driven by advances in fracking technology. That boom shows no sign of slowing down, which may mean more earthquakes — and for the people selling earthquake insurance, more sales.

MONEY Kids and Money

How to Get a Grip on Your Child’s Therapy Bills

Parent and journalist Beth Pinsker explains how to get your kid the mental health treatment he or she needs without breaking the bank.

When I signed up my kids for therapy after my divorce, I made some financial mistakes. The biggest was choosing an out-of-network provider, over one who takes my insurance.

Instead of a simple $20 co-pay, I spent $150 out of pocket and get 70 percent of it reimbursed, which works out to about $1,000 more over a school year. In contrast, I have a friend whose child’s therapy sessions require no co-pays at all.

In this way, mental health coverage has a lot in common with airline pricing, where seats on the same plane may sell at many different price points.

Overall, Americans spend about $2,100 per child for healthcare, according to the Health Care Cost Institute’s report for 2007-2010. During that period, HCCI says, the use of mental health services by children jumped 24 percent.

At the same time, nearly half of all psychiatrists no longer take insurance, according to JAMA Psychiatry, with a similar portion of psychologists now only accepting private payment.

Add to that an overall shortage of providers – there are 8,700 child and adolescent psychiatrists, compared to about 50,000 for adults, according to Dr. Paramjit Joshi, division chief of psychiatry and psychology at Children’s National Health System – and you have a supply and demand problem that makes cost a real issue for parents.

Stay in-network

Finding a provider in your area may be easy enough, but finding one whose availability suits your child’s schedule could be downright impossible.

That’s why I went the private-pay route. My area of Brooklyn has no shortage of doctors on my plan, but after calling a dozen and finding that an after-school slot would entail a months-long wait, I went with a personal recommendation.

To avoid the appointment runaround, lean on your plan’s customer service department to make calls for you, says Dr. Ian Shaffer, executive medical director for behavioral health for Healthfirst, a New York health plan.

Need a therapist with a specialty? You may be able to get that provider covered if you ask, Shaffer says.

He cited a case where the family wanted a therapist who shared their ethnic heritage, and had been recommended someone who charged an eye-popping $350 a visit. Healthfirst found them another therapist with the same credentials, and covered the visits.

Reduce co-pays

My friend with the zero co-pay has insurance through the state’s child health plan, but enrolment in the plan is possible only if you don’t have access to other coverage.

Most people who are on health plans through their workplace don’t have payment wiggle room, but you can ask individual providers what they can do to help, especially if you have a high deductible.

Many private-pay therapists have sliding scales based on income; others have lower fees if you work with a trainee. Since the latter are supervised grad students, “it’s like getting two doctors for the price of one, says Clair Mellenthin, director of child and adolescent services at Wasatch Family Therapy in Salt Lake City, Utah.

Also check state resources to help pay for therapy, especially if treatment is needed for some kind of trauma following a crime. Many states have victim funds, says Mellenthin.

Mark progress

Therapy can seem like an endless process, so parents need to make sure it’s staying on track, says Mitchell Prinstein, a professor of psychology at the University of North Carolina at Chapel Hill.

After the initial evaluation, make sure you have a clear treatment plan and markers to help you figure out if your child is making progress. If there’s little improvement, get a second opinion, Prinstein says. And don’t feel bad about moving on if the therapist is not the right fit.

Fight for your rights

For ongoing treatment, it’s important to make sure the insurance company is not crimping your coverage.

Even though parity clauses in the new healthcare laws say you should get as many sessions as you need, that’s not always the case.

After a while, insurers may start saying the sessions are no longer medically necessary. This is especially true if your child has a serious ongoing problem, says Alan Nessman, senior special counsel for the American Psychological Association.

Any denial of coverage can be costly.

Joe Hoyle’s bill for one month of his daughter’s treatment for a serious illness was $125,000 after his insurance company denied the claim (he negotiated a lower payment with the hospital directly). To obtain ongoing coverage, Hoyle and his wife, who live in Virginia, got her on Medicaid.

“They say they cover things, but then they get to decide when things are ‘stable,'” he says.

Hoyle urges parents to get care early for their children to try to head off bigger problems.

“You can go along for 10 or 12 years and think your kid is just quirky, then almost literally overnight, it can go to full-blown mental illness,” he says. “You hate to talk about it, but people need to know because state governments need to do more to help people out.”

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