Types of Auto Medical Payments Coverage

The following are types of Medical Payments (MED-PAY) Coverage that many consumers are NOT aware of. Worth the time to read and subsequently follow-up with your insurance agent. Could save thousands of dollars in the future.

"Non-reimbursable, Non-excess Med-pay" is coverage that many refer to as the last ''true med-pay", and is the type that would have been part of a "full-coverage" package many years ago. There is no repayment obligation by the consumer, and the applicability of coverage is independent of health insurance benefits. It is the most expensive of the medical payments coverage, but the added cost is not, by any means substantial. It is not uncommon for the coverage to cost $ 5-10 per $ 1,000.00 of coverage, over a six-month period. This is the type of coverage that you should have, as a consumer, and what we advise our patients to purchase.

"Reimbursable Med-pay" marks the first in the deviation from the type of Med-pay that was typically provided, and is one level lower on the scale of desired coverage. The reimbursement is described by many names, such as "Third Party Liability", "TPL", "subrogation" or "contractual reimbursement." All of these names have been used interchangeably to detail the concept that the original payor of the bills is due to receive a refund of amounts paid, from settlement or judgement against the responsible party, due to the fact that its policyholder was not at fault for the incident. The way this typically works, is that the med-pay insurer pays the bills as deemed reasonable and necessary, up to the limits of coverage. The insurer then has a claim against the settlement proceeds, or award of judgement, pertaining to the case of the policyholder. Upon settlement or judgement, the policyholder is required to pay the first funds of settlement back to the pay or of the med-pay benefits. This can cause friction between doctor and patient, and may ultimately lead to the possible destruction of the doctor-patient relationship, when it is perceived that the doctor received more money in his pocket than the patient, when the patient "was the one that was injured."

"Excess Med-pay" is the first in a series of coverage that many consumer groups feel represents illusory coverage. "Excess" refers to amounts of medical care that exceed that which the policyholder's health insurance will cover. Because of the status of the law, many carriers are refusing to consider billing above any contractual rate between the facility rendering care, and the health insurer. So, in essence, if you have health insurance and the facility is contracted with the health insurer, there cannot be excess, so therefore you have no med-pay, although you are paying for it. Most excess coverage also carries a reimbursement obligation; therefore, in the event the carrier does pay anything, they receive the amounts they paid as reimbursement. Further complicating this coverage, and giving further support for the allegations that the coverage is illusory, is the fact that without health insurance, many policies are subject to a deductible. Often times, the deductible, or "retention" is 40% of the coverage amount.

"Modified, or Coordinated Med-pay" further represents coverage which may be classified as illusory. The "Modification" or "Coordination" is between the health insurer and med-pay carrier, thus acting as excess med-pay. There is one little difference, separating the two; however, in that it pays only a percentage of the excess amounts, after the policyholder first pays a deductible. The same problems persist as with "excess" coverage, in that if there is health insurance the insurer may refuse to honor any amounts in excess of what was paid by the health insurer.

Caveats to Medical Payments Coverage

Insurance companies have been known to arbitrarily change your coverage from "Non-reimbursable" to "Reimbursable," and from "Non-excess" to "Excess." You should take the time to review any notices sent to you by your insurer, which reflect "changes to your automobile policy" and immediately reject any non-requested changes.

"Always better to have the correct coverage and not need it, than to need it and not have it."

Holiday Stress

For some people, the holidays bring unwelcome guests, stress and depression. And it's no wonder. In an effort to pull off a perfect Hallmark holiday, you might find yourself facing a dizzying array of demands, work, parties, shopping, baking, cleaning, caring for elderly parents or kids on school break, and scores of other chores. So much for peace and joy, right?

Actually, with some practical tips, you can minimize the stress and depression that often accompany the holidays. You may even end up enjoying the holidays more than you thought you would.

The trigger points of holiday stress
Holiday stress and depression are often the result of three main trigger points. Understanding these trigger points can help you plan ahead on how to accommodate them.

Here are the three areas that commonly trigger holiday stress or depression:

Relationships. Relationships can cause turmoil, conflict or stress at any time. But tensions are often heightened during the holidays. Family misunderstandings and conflict can intensify, especially if you're all thrust together for several days. Conflicts are bound to arise with so many needs and interests to accommodate. On the other hand, if you're facing the holidays without a loved one, you may find yourself especially lonely or sad.

Finances. Like your relationships, your financial situation can cause stress at any time of the year. Overspending during the holidays on gifts, travel, food and entertainment can increase stress as you try to make ends meet while ensuring that everyone on your gift list is happy.

Physical demands. The strain of shopping, attending social gatherings and preparing holiday meals can wipe you out. Feeling exhausted increases your stress, creating a vicious cycle. Exercise and sleep, good antidotes for stress and fatigue, may take a back seat to chores and errands. High demands, stress, lack of exercise, and overindulgence in food and drink, these are all ingredients for holiday illness.

12 preemptive strategies for holiday stress
When stress is at its peak, it's hard to stop and regroup. Take steps to help prevent normal holiday depression from progressing into chronic depression. Try these tips:

• Acknowledge your feelings. If a loved one has recently died or you aren't near your loved ones, realize that it's normal to feel sadness or grief. It's OK now and then to take time just to cry or express your feelings. You can't force yourself to be happy just because it's the holiday season.

• Seek support. If you feel isolated or down, seek out family members and friends, or community, religious or social services. They can offer support and companionship. Consider volunteering at a community or religious function.

• Getting involved and helping others can lift your spirits and broaden your social circle. Also, enlist support for organizing holiday gatherings, as well as meal preparation and cleanup. You don't have to go it alone. Don't be a martyr.

• Be realistic. As families change and grow, traditions often change as well. Hold on to those you can and want to. But understand in some cases that may no longer be possible. Perhaps your entire extended family can't gather together at your house. Instead, find new ways to celebrate together from afar, such as sharing pictures, e-mails or videotapes.

• Set differences aside. Try to accept family members and friends as they are, even if they don't live up to all your expectations. Set aside grievances until a more appropriate time for discussion. With stress and activity levels high, the holidays might not be conducive to making quality time for relationships. And be understanding if others get upset or distressed when something goes awry. Chances are, they're feeling the effects of holiday stress, too.

• Stick to a budget. Before you go shopping, decide how much money you can afford to spend on gifts and other items. Then be sure to stick to your budget. If you don't, you could feel anxious and tense for months afterward as you struggle to pay the bills. Don't try to buy happiness with an avalanche of gifts. Donate to a charity in someone's name, give homemade gifts or start a family gift exchange.

• Plan ahead. Set aside specific days for shopping, baking, visiting friends and other activities. Plan your menus and then make one big food-shopping trip. That'll help prevent a last-minute scramble to buy forgotten ingredients — and you'll have time to make another pie, if the first one's a flop. Allow extra time for travel so that delays won't worsen your stress.

• Learn to say no. Believe it or not, people will understand if you can't do certain projects or activities. If you say yes only to what you really want to do, you'll avoid feeling resentful and overwhelmed. If it's really not possible to say no when your boss asks you to work overtime, try to remove something else from your agenda to make up for the lost time.

• Don't abandon healthy habits. Don't let the holidays become a dietary free-for-all. Some indulgence is OK, but overindulgence only adds to your stress and guilt. Have a healthy snack before holiday parties so that you don't go overboard on sweets, cheese or drinks. Continue to get plenty of sleep and schedule time for physical activity.

• Take a breather. Make some time for yourself. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Steal away to a quiet place, even if it's the bathroom, for a few moments of solitude. Take a walk at night and stargaze. Listen to soothing music. Find something that clears your mind, slows your breathing and restores your calm.

• Rethink resolutions. Resolutions can set you up for failure if they're unrealistic. Don't resolve to change your whole life to make up for past excess. Instead, try to return to basic, healthy lifestyle routines. Set smaller, more specific goals with a reasonable time frame. Choose only those resolutions that help you feel valuable and provide more than only fleeting moments of happiness.

• Forget about perfection. Holiday TV specials are filled with happy endings. But in real life, people don't usually resolve problems within an hour or two. Something always comes up. You may get stuck late at the office and miss your daughter's school play, your sister may dredge up an old argument, you may forget to put nuts in the cake, and your mother may criticize how you and your partner are raising the kids. All in the same day. Expect and accept imperfections.

• Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last for several weeks, talk to your doctor or a mental health professional. You may have depression.

Have it both ways
Remember, one key to minimizing holiday stress and depression is knowing that the holidays can trigger stress and depression. Accept that things aren't always going to go as planned. Then take active steps to manage stress and depression during the holidays. You may actually enjoy the holidays this year more than you thought you could.

Gum And Your Teeth

Is chewing gum good for your teeth? The medical answer is quite simple.

When you chew gum, you produce more saliva. If you chew gum after you eat, the extra saliva can neutralize and wash away the acid that's produced when food breaks down in your mouth. This can help prevent tooth decay. The minerals in the extra saliva can even strengthen the hard, outer surface of your teeth (enamel).

It's important to choose gum carefully, however. The American Dental Association (ADA) recommends sugarless gum. In fact, several types of sugarless gum even bear the ADA Seal of Acceptance.

Sugared gum also increases saliva production, but the sugar in the gum may contribute to tooth decay.

"Being successful is about professionalism, and chewing gum is unprofessional."