14 Things I Wish I Had Told My Young Adult

Our oldest has left the nest for his first real job. He has worked some part time gigs going through school but this will be his first fulltime job in his field of choice. Regardless of where your young adult is heading, there are always things you wish you had told them. You may wish you had that special last moment like parents in the past sending young adults off into the prairie, to college, to the big city, immigrating to the US, going into the military or just heading off on their own for a global adventure.  I think we all want our kids to be accountable, successful and independent. We want to see them get along with others, do well in their jobs, truly enjoy their work, and have long employment life.

Where is your path leading you?

If I could “do-over” our last special moment it would include:

  1. I’m sorry. I wish it was different but life isn’t perfect. But, life is good.
  2. Dissatisfaction can be a motivator.
  3. We encouraged you to dream. Continue to dream big.  Dream jobs do come along but it may not be your first job. That’s OK.
  4. For the most part, bosses are doing the best they can. They aren’t perfect. Figure out a way to get along.
  5. Work helps you determine what you enjoy and don’t enjoy doing. Give everything a try.
  6. Organizations are trying hard to create better work environments for their employees. But you are still ultimately responsible for finding the joy in your work.
  7. Making connections and building relationships will help you just as much if not more than education in helping your career.
  8. You have strengths but use them properly. Identify and manage the “dark side” of strengths. Your strength could be critical thinking but don’t become a critic no one wants to be around.
  9. Everyone has barriers or constraints that can prevent them from success.  Try to find a way to grow outside of your comfort zone.
  10. Be kind even when you don’t feel like it.
  11. Remember people when you make decisions. Try to see things from the other side.
  12. Balance logic with empathy.
  13. The less than perfect job can build important skills and characteristics like patience, flexibility, adaptability, and cool stuff like idea generation and creativity.
  14. Difficulties and disappointments can make you bitter or better. Choose the latter.

Hugs.

A Primer to Medical Insurance Terminology

Explaining “healthcare lingo” in “lay” terms is essential to facilitating the medical insurance conversation with your young adult. Analogies are even better but this can be challenging when there are few other industries or business products that equate to the complexity of health insurance.

With auto insurance, your rates are based on your age, gender, specs for your car, driving record and whether you are grouping your auto insurance with your homeowners and umbrella policy. Rather cut and dry compared to health insurance. In addition, with all of the payment levels of copays, deductibles, out of pocket and co-insurance, it’s easy to envision an unending stream of money flowing out of your checking account if you don’t understand the process.

There are so many products and packaging to meet a variety of consumer needs. As reimbursement strategies, benefit plans and consumer contributions to coverage have evolved over time, the consumer must stay abreast of these changes in order to purchase the best coverage.  As a baby boomer, I can only equate understanding insurance to attending an all-day social media class with no baseline computer skills or knowledge of LinkedIn, Facebook, YouTube or Twitter.

Some process things to remember:

Medical providers (physicians and healthcare institutions) determine their own charge for services.

Medicare and Medicaid determine what they will pay medical provider for services.

Insurance companies negotiate with medical providers to determine allowable amounts and allowable charges based on “group” or contracted rates.  That’s one reason why it is even more important to have insurance so you are not paying the “regular” charge for services.    

There are dozens of terms to understand for healthcare insurance. It can be overwhelming. If you have no insurance or healthcare knowledge, start small.

Below are some standard definitions.

Current Types of Plans and Services – non Medicare/Medicaid information

Fee for Service (FFS)  or indemnity plans – plans that allow the consumer the choice to go to any doctor or healthcare facility.  Generally, these plans are more expensive but do offer choice.

PPO – A health plan that is designed to encourage consumers to use a network of selected healthcare providers.  Your expenses should be lower if you use a physician or hospital in the network than if you go to providers outside of the network.

Open Access – plans that allow you to self-refer to physicians, particularly specialists without obtaining prior approval from a primary care provider.

Health Savings Account – A tax-advantaged savings account that individuals and employees in group policies can open to pay for qualified medical expenses. HSAs may only be created in conjunction with a high deductible health plan.

High Deductible Health Plan – A plan with higher deductible than a regular plan.  The plan description will define the plan as a high deductible plan. The U.S. Department of the Treasurer specifies the annual deductible requirements.

Medical Exchange – State marketplaces designed to improve the access and selection process of insurance for the consumer. MEs will calculate premium subsidies, enrollment, quality oversight, certification of qualified health plans that can be sold in the exchange.  Available in select markets and expected roll-out nationally: 2014.

There are many websites to help with more detailed information and instructions. Some of my favorites are:

http://www.fairhealthconsumer.org/glossary.aspx#H

http://www.gettingcovered.org/about/

http://www.learnvest.com/knowledge-center/i-want-to-get-health-insurance/

 

Next:

Medical Cost – Definitions and Processes

 

 

“Truisms” of Young Adult Healthcare

As I worked with my stepson on obtaining insurance quotes, I thought it would be a bit easier.  As a healthcare professional with many years of experience, I intuitively knew what he needed but I found myself grasping for words and analogies to interpret the concept of “out of pocket”, “co-insurance” and other necessary insurance terms to understand pricing and select the right product. I found all the sites we reviewed for quotes had excellent descriptions but could still be overwhelming without an initial conversation or dare I say, learning session, hopefully with a parent or guardian. I did my best, still stumbled, but we got through it and purchased a good product that met his needs at the time.

The “Truisms” of Young Adult Individual Healthcare Insurance (as of 2012)

Some geographical areas offer short-term medical coverage (less than six months) and ongoing medical coverage (greater than six months.)

Similar to auto insurance, you will pay a monthly premium. The premium amount may be based on your gender, age, height, weight, smoker status and at this point, pre-existing serious conditions.

Healthy, young adults generally pay less than older adults.

Costs may vary based on how much you want to pay out of pocket beyond the monthly premium throughout the year.

Costs may vary based on if you want:

1)      Basic coverage to cover you for inpatient hospitalizations and outpatient surgery in case of a major accident or serious illness

or

2)      Comprehensive coverage to cover you for doctor visits, prescriptions and preventative care.

There are many plans to choose from with variations on coverage, deductibles and out of pocket.

Generally, high deductible plans have lower monthly premiums. You are basically betting you will not need to use the insurance but you have it if you need it.

Low deductible plans have higher monthly premiums because you are basically paying more up front for the coverage. These plans are available if you have a greater need to go to a specialist or frequent a primary care physician, need preventative care, tend to have more frequent prescription needs, etc.

As you work through the plans, you will need to consider how and where you can get the extra money for out of pocket and deductibles should you become ill and use the insurance.

As a young adult working through this process, think about your medical history:

  • Over the last year, do you feel you have been relatively healthy as compared to your peers?
  • How frequently have you gone to the doctor in the past two years?
  • Have you parted with your tonsils and appendix?
  • Do you stay current with annual immunizations through other resources such as pharmacies and convenient care clinics?
  • Do you have frequent upper respiratory or stomach infections or skin conditions requiring treatment?
  • Do you participate in higher-risk recreational activities such as skiing?
  • Do you plan to travel outside the country?
  • Are you frequently around people who may be sick or are contagious with illnesses that generally need formal medical treatment?

Next! Medical Insurance Dictionary

Medical Insurance 101: As a young adult – is it necessary?

The P-YA Conversation  

We are almost empty-nesters. Almost. The youngest has moved to the West Coast and the second may well be moving to the Upper Midwest or North West soon. Not to promote any political persuasion, but it has been nice keeping both boys on our insurance until the age of 26.

But, at some point, the birds leave the nest and they need to be prepared for the world. In prepping for the world, I have asked each of them about what they plan to do when they are sick in their respective new areas. I received the following reply, “I guess I will go to the ER.”

I try not to gasp and roll the eyes. Deep breath. Think fast. Respond slowly.

As a healthcare professional and a proponent of consumer accountability and cost containment, I was shocked at the response. We had not done our job of educating the kids on the health system – except to ask the question to get an idea of what they do know. Hmm. Not much knowledge. Much to do.

How does a parent translate the complexity of the healthcare system to a young adult who has never had to deal with health benefits? Always had mom and dad help with appointments, pay for co-pays, manage the deductibles and out of pockets, and of course, premiums? Have we been hover-parents and didn’t know it?

I honestly don’t remember my parents talking to me about medical insurance. My first job provided healthcare benefits back in the days before PPOs, EPOs, HMOs, HSAs and goodness, what other acronym can we create to make the learning more difficult but perhaps the care more affordable??

So here’s how the Parent – Young Adult conversation can go:

YA: I never get sick.

P: Yes, you are right. Young adults are relatively healthy. Your greatest risk is an accident.

YA: I drive safely.

P: You are involved with other activities that could involve accidents. Example: bicycle riding or hunting. It may not your fault. It could be the person you are with.

YA: I am careful. My friends are careful. It won’t happen to me.

P: I feel comfortable that you are as careful as you can be. But things happen. If you fall off your bike and injure your leg, just an ER visit to x-ray your leg, have a doctor evaluate you, give you some antibiotics and painkillers could be as high as $5000. Do you have $5000 in your bank account?

YA: No.

P: How would you pay for the bill?

YA: I can’t right now. I guess I could ask you for help.

(Try not to gasp and roll the eyes. Deep breath. Think fast. Respond slowly.)

P: What do you think will happen between you and the ER facility?

YA: I guess I will receive a bill.

P: Yes, and more than likely for the total amount. How will you pay the bill?

YA: I’ll try to pay it. Is it like a credit card?

P: Sort of. But it will take a long time to pay off $5000 on your salary.

YA: I guess I have never thought about.

P: Well, we really haven’t had a need to talk about it but I guess we do now. Insurance is created to provide some protection against the risk of an accident or illness that could financially deplete you. With insurance, although you pay monthly premiums, in most cases you won’t receive a bill for the total. It depends on what product you purchase. Given that with your first job you are making around $25K and it does not offer you healthcare insurance, basic healthcare insurance is an investment in your financial and health future.  We can look at your budget, look at the different insurance options, and choose one that is good fit for your needs and budget. Healthcare insurance should be a line item just like your cell phone bill and groceries. The good news is you are young and healthy and the premiums can be affordable. First, let’s look at some basic insurance language that will help better understand the products.  

Coming Next:

Truisms of Young Adult Healthcare Insurance

Medical insurance dictionary

What medical insurance options are available for young adults?

Woohoo! I have my first job with benefits. What does that mean and now what to I do?