By: rebecca.stoffer | 06-17-2016

Many of the calls and questions I get from clients is in reference to prescription drug coverage.  Sometimes, trips to the pharmacy can cause additional headaches, but there may also be some things you can do as a consumer to help make sure you are being given all of the options and get the best possible outcome.

What is the typical process when filling a script?

When your prescription is given to a pharmacy to be filled, they run your information through their systems – they look up your coverage information with the insurance company and see how the company covers that prescription on something called a formulary list.  This is why it crucial that you are giving your pharmacy your updated insurance information because each insurance company will have a different formulary list.  This formulary list is also subject to change throughout the year if the insurance company feels it necessary.  Your script goes through without a problem and the pharmacy will hand over your medication exactly as the doctor prescribed, and you’ll be told your cost share based on your plan and contract with your insurance company.  The cost share may be applied to your deductible, or coinsurance, or you may just have a prescription copay – and that’s it.  Simple right!? 

What can go wrong and what does it mean?

What happens when getting a script filled does not happen easily and the pharmacy gets an error message on their computers?  Most times, people will tell me the pharmacy relayed to them there’s no coverage for their medication.  Usually, the prescription just requires step therapy.  Step therapy means that the insurance company feels that there is another medication in the same prescription class that should be able to do the same thing but costs less than the script your physician wrote.  This isn’t the end of the story…. Once the pharmacy receives the error message that you drug requires step therapy, they should send the appropriate paperwork to your doctor to let them know.  The doctor can either tell the PHARMACY to go ahead and dispense the lower cost alternative OR the doctor can tell the INSURANCE COMPANY they want the script as they originally prescribed and to give the reasons why.  After the insurance company reviews the doctor’s request, they either approve and you get the script your doctor originally prescribed or the insurance company argues back and denies the medication.  Many times, if the doctor is adamant in their original choice of prescription, the insurance company will approve.  If you need to begin taking a medication immediately and the script requires step therapy or additional authorization, contact your doctor to see if they have samples, but if they don’t, your doctor should be able to offer a temporary solution while they take care of the insurance part.   

What questions to ask the pharmacy when something doesn’t go according to plan?

So what can you do if you are at the pharmacy and they tell you there is no coverage for your script?  Ask them, “is my prescription declined or does it require authorization?”  If they answer that it requires authorization, ask them “will you send paperwork to my physician to complete?”  If you are confused about the answer you receive and need some assistance, call our office, even while you are still at the pharmacy so that we can talk directly with the pharmacy staff if need be.

The biggest piece of advice we can offer, never be afraid to ask questions when you’re at the pharmacy – ask if there were any problems filling the script or if there is any additional information you should know.   Also, never hesitate to contact us if you need assistance getting any of the answers you need, it’s why we’re here and why you’ve trusted us to be your agent, let us know how we can help!

By: John-Mark Young | 11-05-2015

As one of Dave Ramsey’s Endorsed Local Providers we are often asked by families that have never heard of Dave or maybe have only seen his wildly popular book, “The Total Money Makeover” who is he and what does he stand for? Quite frankly Dave and his teachings have helped millions of America’s get on a written game plan (often called budget), pay off their debt and start saving for their retirement and other goals with the hope that, “if you live like no one else today, on day you can live and give like no one else”.

Dave has practiced what he preached, once building a real estate empire of about $4 million only to lose it all after his local banks had merged, lost their local leadership and made due within 90 days the loans that supported these assets. Proverbs 22:7 (ESV) says, the rich rules over the poor, and the borrower is the slave to the lender”. See what this passage means – Dave had become a millionaire but because he used debt to build this wealth he really had no control over them. He filed bankruptcy and decided next time he was going to do it God’s way – build wealth based on the Bible not what he once learned in his college finance class from his broke professor.

So here we get to his 7 Baby Steps

1. $1,000 to start an emergency fund – While not the size of an emergency fund you’re going to want when become debt free this is going to cover most emergency expenses that come about – fixing the car, minor home repair, etc. – plus it’s only a $1,000 so you can possibly get here fast by putting things on eBay, having a garage sale or just being very focused on your budget.
 

2. Pay off all debt but the house – List all your debts in order of smallest to largest. The smallest debt is going to be your number 1 priority, paying only minimum payments on everything but that smallest debt. Don’t worry about interest rates – here we are more focused on having as many wins (by paying off debts) as quickly as possible so you can feel progress and be motivated to continuing to win! Once you pay off that first debt add what you were paying on it to the next debt and start attacking it with a vengeance. The “debt snowball” has been the tool families making $50,000 have used  to pay off $60,000 in debt in 2.5 years – they see progress and not only stick with it but are motivated to work the extra job, sell the new cars for used cars. Etc.
 

3. 3 to 6 Months of Expenses in Savings – This step is all about building that emergency fund that will cover life unexpected expenses that are sure present themselves at some point in your life. How do you determine whether to put away 3 months of expenses or 6 months? Well many times that dependent on your work situation – does your job have a history of making lay-off’s? Better stick with 6 months. Do you work for a fortune 500 company in their accounting department? Probably can stick closer to the 3 months.
 

4. Invest 15% of household income into retirement – This step is all about building wealth long term. With no payments (other than a house payment possibly) and a fully funded emergency fund doing this step should be straightforward. Between your 401(k), Roth IRA and Traditional IRA you have a lot of options. Take 15% of your gross household income and invest it first into matching company 401(K) plans and then Roth IRA’s. If you company doesn't offer a retirement plan or match your contributions then go straight to the Roth.
 

5. College funding for children – This step may not be applicable for everyone however if you do have kids you don’t want college to sneak up on you and taking out college loans is never an option. Two smart ways to save for your kids college are 529 college savings funds or Coverdell ESA’s. They are both tax-advantaged savings vehicles that let save money for your kids college expenses while investing them in mutual funds.
 

6. Pay off home early – There is only one debt standing in the way of freedom from all debt and that’s paying off your home mortgage. Just imagine being done with your mortgage and not having a single payment in the world! Millions of Dave’s followers have tasted this sweet success and you can to – stay focused in this step and don’t forget to celebrate the mini wins within this step (for example getting the mortgage under $100K, getting it under $10K, etc.)
 

7. Build wealth and GIVE – this is the last step and by far the most fun! It took a lot of hard work and dedication to get here but it will all pay off – No payments in the world, retirement is on track, kids college is saved for and you can do whatever you want. I meet many families that have achieved this step and there is a freedom they have that is indescribable. The single lady at your church that can’t pay her light bill – what if you could pay it ahead for a year for her? The young couple at the restaurant that looks overwhelmed and defeated – what if you could buy their dinner and not even think twice about it? Proverbs 21:5 says, “The plans of the diligent lead surely to abundance, but everyone who is hastily comes only to poverty.” You had a plan, you were certainly diligent, now you can enjoy the abundance of your labors.

 

To wrap up, I want to answer my question in the title – How does Whitaker-Myers fit into the 7 Baby Steps as an Investing ELP – the obvious answer would be Baby Step 4, 5 & 7 however we believe in these steps so if you’re struggling with debt and just want someone to help you create a plan to get out we’d love to talk. Maybe you’ve been trying to pay off debt, save for retirement and fund your kid’s college and you just aren’t gaining any traction we’d love to talk. Reach out to us with any investing need or to talk about the 7 baby steps at 330-345-3921.

 

For more information on Dave’s Baby Steps visit his website - https://www.daveramsey.com/baby-steps

Ready to attend Financial Peace University, his nine week course on getting out of debt and taking control of your money visit http://www.daveramsey.com/fpu/home/?snid=classes.fpu-a

 

Raymond James Financial Services does not endorse and is not associated with the Dave Ramsey Endorsed Local Provider Program. Any opinions are those of your advisor and not necessarily those of RJFS or Raymond James. Expressions of opinion are as of this date and are subject to change without notice. Every investor's situation is unique and you should consider your investment goals, risk tolerance and time horizon before making any investment. Investing involves risk and you may incur a profit or loss regardless of strategy selected. Links are being provided for information purposes only. Raymond James is not affiliated with and does not endorse, authorize or sponsor any of the listed websites or their respective sponsors. Raymond James is not responsible for the content of any website or the collection or use of information regarding any website's users and/or members.

By: John-Mark Young | 10-23-2015

As one of Dave Ramsey’s Endorsed Local Providers for much of Wayne, Medina, Stark and Summit counties we typically meet clients who have heard Dave talk about putting money into a Roth IRA but may not completely understand the “why” behind that recommendation. To be clear, Dave never recommends you do any sort of investing until you complete the first 3 Baby Steps, which are (1) to build a $1,000 starter emergency fund, (2) Pay off all non-mortgage debt using the “debt snowball” and finally (3) save three to six months of expenses (note expenses, not income) in savings.

First things first, so what is a Roth IRA? A Roth IRA is a personal retirement savings plan that offers certain tax benefits to encourage retirement savings. What are those tax benefits? Unlike a Traditional IRA where you are putting in pre-tax dollars a Roth IRA has the individual contribute after tax dollars. Like a Traditional IRA the investments inside of Roth IRA grow tax deferred, but unlike a Traditional IRA, if certain conditions are met, distributions (including both contributions and investment earnings) will be completely tax free at the Federal level.

That’s where the fun comes in – let’s assume, our friend, Johnny Client, who is 30 years old has worked the Baby Steps and is now on Baby Steps 4, 5 and 6, thus he is saving 15% of his household income into retirement. Johnny’s income is $50,000 and through his company provided 401(K) Plan he’s eligible to receive a 5% match on all contributions. Thus Johnny contributes the 5% (which is $2,500 per year plus another $2,500 in company match) and to round out his Baby Step 4 he’ll be investing 10% (to get to our total of 15% of household income) or $5,000 in his Roth IRA. Johnny decides he’ll be retiring at age 60 and over his 30 year career he would have contributed $150,000 to his Roth IRA, however based on an 8% rate of return, the account value is $566,416.06. That means Johnny has earned $416,416.06 that he has never and will never pay any federal taxes on.

There are certain rules that you must meet to be eligible to contribute to a Roth IRA, including

You must have received taxable compensation during the year (or your spouse if married filing jointly)
You must be under certain income limitations (if your modified AGI is $131,000 or greater as a single tax filer or $193,000 as a married filing jointly filer you’ll be unable to contribute)
You must not have already contributed the annual maximum to your Traditional IRA.

Other strengths not discussed include:

1. Fewer restrictions on making withdrawals prior to retirement.
2. You can contribute to a Roth IRA after age 70 ½ (not possible with a Traditional IRA)
3. Your funds can stay in a Roth IRA longer than a Traditional IRA (no required minimum distributions)
4. You can contribute even if covered by an employer-sponsored retirement plan (401K)
5. Investment choices are broad and diverse
6. When you die, your beneficiaries may pay no income tax on proceeds
7. Contributions are discretionary (up to IRS annual dollar limits)
8. “Catch-up” contributions are allowed if you’re at least 50
9. You may qualify for a tax credit (certain low and middle income taxpayers can claim a partial, nonrefundable income tax credit for amount contributed to a Roth IRA.)

 

Raymond James Financial Services does not endorse and is not associated with the Dave Ramsey Endorsed Local ProviderProgram. This is a hypothetical illustration and is not intended to reflect the actual performance of any particularsecurity. Future performance cannot be guaranteed and investment yields will fluctuate with market conditions. Theinformation has been obtained from sources considered to be reliable, but we do not guarantee that the foregoing material isaccurate or complete. Any information is not a complete summary or statement of all available data necessary for making aninvestment decision and does not constitute a recommendation. Any opinions are those of [FA NAME] and not necessarilythose of RJFS or Raymond James. Unless certain criteria are met, Roth IRA owners must be 59½ or older and have held theIRA for five years before tax-free withdrawals are permitted.

By: Whitaker-Myers | 09-16-2015

The first few weeks of college football have already blown bye.  For those of us with students away at college, there are tears, fears, and lots of excitement that go along with the beginning of fall classes.  Unfortunately, some families don't talk to their independent insurance agent before sending their child off to college.  The implications can be too much OR not enough coverage for your student's liability and their stuff.  During a season when costs are already soaring, it makes little sense to be paying for more coverage than you ought.  On the other hand, uncovered losses during this financially tight time can hit you hard, like being blindsided by a linebacker running through the backfield.  Check out some helpful insurance considerations for college bound families in this article from Grange Insurance. Click Here.  If you would like to speak to an agent about right-sizing your insurance coverage for the college years, contact us today!

By: Whitaker-Myers | 09-09-2015

Whitaker-Myers Group is proud to support Christian Children's Home of Ohio and their annual 5k event! If you or someone you know would like to run, you can pick up a registration form at our office, or go to http://www.ccho.org/c4c5k.html