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Being Well: Paying Medical Bills the Smart Way

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A health savings account may be used to pay for costs not covered by most traditional

insurance plans. The accounts must be set up long before your retirement years, says

James Gandolfo, one of the nation’s foremost experts on HSAs.

Photograph by Tom Nutter

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You are covered by a high-deductible health insurance plan, so you’re daunted by the escalating cost of health care. Not sure how to handle it?

A health savings account is one solution. HSAs, authorized in December 2003 by the federal Medicare Drug Prescription Improvement and Modernization Act, allow some people to make untaxed contributions to a special fund, which can then be withdrawn tax-free to cover medical expenses that are not covered under their health insurance plans. In that way, they work much like a self-directed individual retirement account, but the money is available for use immediately.

“Consumer-directed health care and related HSAs engage the consumer in his own healthcare decision-making process,” says James Gandolfo, senior director and vice president of global business development-HSAs for PFPC, a member of PNC Financial Services Group, Inc. One of the foremost experts on HSAs in the nation, Gandolfo began a term as chairman of the HSA Council with the American Bankers Association on July 1.

To qualify for an HSA, you must have a deductible of $1,100 per year for an individual health insurance plan and $2,200 per year for a family plan. If so, you can contribute up to $2,850 to an individual HSA in 2007 or up to $5,650 to a family HSA. Deductions may be used to pay for health-related expenses such as eye exams, prescription eye wear, physical therapy sessions and other costs not covered by most traditional insurance plans.

Individuals can use their health savings to pay for medical expenses as they occur, save the receipts, then withdraw the money to reimburse themselves at a time that’s convenient for them, Gandolfo says. “HSAs give the consumer choice and control.”

HSAs are also great for retirees, who often end up withdrawing money from their 401(k) plans to pay for medical expenses, which is then taxed.

“However, HSAs must be set up long before the retirement years, since the key factor of the HSA’s eligibility is the ownership of a high-deductible health care plan,” Gandolfo says.

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Doggone Good Vacation Homes

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While making plans for that great summer vacation, don’t forget to make plans for Fido and Bells.

Weeks before setting out, it is important to find out what boarding facilities are near your home or destination and whether they can accommodate your pet. Facilities may be full during peak times such as the winter holidays and the week of July 4. If the kennel can accommodate your pet, make an appointment to visit beforehand.

“Making sure you have a proper boarding facility for your pet should be your No. 1 concern,” says veterinarian Andrea Richter. Richter and her husband, vet Robert Pedigo, own Savannah Animal Hospital and Savannah Animal Hotel in Lewes. “Families and individuals should go on these preview visits armed with questions. They should look for cleanliness and good ventilation for the animal. And they should note whether the animals are exercised regularly and are handled with compassion and affection.”

You should have a list of questions to ask on your preview visit: What type of food are the animals fed? When are they exercised? Do they have free access to water? Do they get interactive play time? What would happen if the animal should need veterinary care while the owner is away?

“Dogs must be taken out to be exercised and to go to the bathroom at least three times a day,” Richter says. At Savannah, dogs are exercised four times daily. Cats and exotic guests are exercised twice a day. Savannah Animal Hotel also offers additional playtime, socialization or attention such as brushing through its Special Attention Service.

For cats, make sure their primary enclosures are large enough to stretch and move in, and that they contain litter boxes that are cleaned regularly.

You must provide a vaccination record for any boarding stay, and shots must be up to date. If you supply toys for your pet, make sure they include the animal’s name, as well as your own. You may also supply your pet’s food if it’s not what the facility serves. “It will lessen the likelihood of gastroenteritis or colitis in the animal,” Richter says.

Boarding can be stressful for your pet, partly because of temporary separation anxiety. To ease your pet’s transition, make sure you leave ample time to check in. “The animals should never be in a rushed situation,” Richter says. So fill out all paperwork ahead of time, not on the way out of town at the start of vacation.Ê

If the pet travels with the family, it’s important to have copies of the animal’s rabies certificate and vaccinations, and it is important to know ahead of time if there are facilities nearby, in case of emergency. Be aware that your pet might come down with motion sickness.

“Some pets love to travel. Some find it stressful and become anxious,” Richter says. Consult a veterinarian for medications to minimize your pet’s stress during the trip.

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Turning up the Heat for Athletes

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Highly trained, Olympic-class athletes are better equipped physically to deal with heat when they exercise, but we normal folks and weekend warriors need to be careful. Exercising in the heat can lead to serious health conditions—even death.

So how do you avoid danger? Dan Wagner, lead exercise specialist at Bayhealth’s Lifestyle Fitness Center in Dover, says to pick exercise times carefully. It’s best to avoid exercising outdoors between 11 a.m. and 3 p.m., when the combination of high heat and high humidity put you at risk of heat exhaustion and heat stroke.

A person with heat exhaustion sweats profusely. He also experiences dizziness, high heart rate, confusion and loss of strength. Heat exhaustion can lead to heat stroke, a possibly fatal condition characterized by dry skin and loss of consciousness. When humidity approaches 50 percent or greater outdoors, the risk of such conditions begins to increase.

“Trained athletes have little problem with outdoor conditions, but even they take precautions,” says Wagner.

For one, dress in cool, light-colored clothing. (Dark colors absorb light, which increases heat.) Many items on the market today are designed to keep you cool during strenuous activity.

Second, drink 5 to 10 ounces of water every 15 minutes while exercising. Also, weigh yourself before you work out, then weigh yourself afterward. For every pound of weight lost during activity, drink 1.5 times as much fluid.

“If an individual loses 2 pounds during an hour-long activity, he or she should drink 48 ounces of cold liquid, preferably water, within an hour after the exercise has been completed,” Wagner says.

Cold fluids are better to drink than warm ones because your body absorbs them faster, thus cooling your body sooner. Be aware that your body can only absorb about a liter of fluid an hour.

Individuals who are just starting an exercise program should take great care during the summer, especially if they are overweight. Women are at greater risk of trouble because they generally have more body fat than men.

When possible, exercise indoors during those midday hours. If you venture outside, go in the morning or late in the afternoon, when it’s cooler. “It takes 10 to 14 days to get acclimated to the heat when exercising outdoors,” Wagner says. “It’s a good idea to have a back-up plan on those hot days. Stay inside and work out in the gym or go walk inside the mall.”

One last word of advice for exercising outdoors: Wear sunscreen. “A sunburn decreases the body’s ability to cool itself,” Wagner says—not to mention the risk of skin cancer.

And if you’re watching an athletic event instead of participating in one, remember to keep the fluids going. Spectators at outdoor events may be at greater risk of heat exhaustion and heat stroke than the athletes themselves.Ê

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