I've just come from the gym. My arms are so spent I can barely type. My glutes are killing me as I sit on my wooden chair. I am guzzling ice water and still sweating a little. An hour of concentrated exercise with a trainer -- part of my gym memberships -- has left me feeling both exhausted and accomplished. I love my gym.

My gym membership costs us $158.46 per month. I can hear the gasps of horror from the frugal corner: that's 1,901.52 a year! Over the next 10 years, that's almost $20K I could be putting into my Roth IRA. That's $5,704.56 we could be putting into the 529 college account for our second child (you remember him, the one we call Hope He Gets A Soccer Scholarship)! I could use that to open a stock investment account and invest in electronic-traded funds. I could purchase corporate bonds!

The recent uproar over the cost of EpiPens, the life saving self-injection device that contains epinephrine, a chemical that narrows blood vessels and opens airways in the lungs to offset an allergic reaction, has garnered tremendous media attention and consumer outrage. Through massive marketing and outreach efforts by the manufacturer, Mylan, EpiPen has become to the go-to device for anyone facing a potentially serious or life-threatening allergic reaction. It is a brand that has “become” the device, like Kleenex has “become” tissues, and Jet Ski has become the catch-all for personal watercraft.
The EpiPen price has been raised 17 times in 11 years. When Mylan bought the device from Merck KgAA, a German company, in 2007, it cost $124 for a two-pack. Today, a two-pack costs more than $600. And there is no real competitor in the market, as Auvi-Q, a similar product launched in 2013 by Sanofi, was withdrawn in 2015 because of dosing issues. Mylan controls 94% of this market.
Under fire from all sides for the last few weeks, Mylan announced it would rapidly bring to market a generic, but is unclear how much impact this will have.

A complicated scenario

Here's what I learned when I was researching this issue: while Mylan does control the price of the product, it does not control the price to consumers — health insurance companies do. According to an article published recently by Ronny Gal, Ph.D., a senior analyst at the investment bank Sanford C. Bernstein & Co. (I found it on a fascinating website called drugchannels.net), in the wake of Sanofi pulling its drug, “Mylan was in a position to price up Epipen, which they did — by 15% in November and by another 15% in May. … The (insurance) payors got mad and raised the pain level on patients — raising copays and toughening medical policies (this is important, Mylan does not determine price to consumers, payors do). As Epipen is broadly purchased ahead of the new school year, the pain became acute for many families over the past month. There were lots of posts on mother's networks, the media caught wind of the story and now we have multiple politicians jumping on the bandwagon.”
This got me thinking about the cost of prescriptions in general. Way, way back in the good old days of the mid-1980s, when I first entered the working world, I had a $5 co-pay on my prescriptions. Over the years, as insurance plans have morphed and HMOs were invented and employers began searching for ways to save money, we had a tiered prescription plan that started at $5 for basic generic drugs and ended at $50 for really important stuff.
Today, under my husband's company's insurance plan, we have a $3,000 annual deductible we have to meet. Until we hit that $3K, we pay out of pocket for EVERYTHING. This has ended up being quite an education, especially since we are at the age now where there are daily medications for things like blood pressure and prostate. Luckily (or unluckily), we have had a run of bad health and met the deductible for the first time, about halfway through the year.
It is these broad-deductible types of plans (which I think more and more of us are opting for as a way to save up front on the premiums taken out of the paycheck) that are making many of us painfully aware of the full cost of prescription drugs.
As Matthew Herper recently noted in an article on forbes.com, “If a customer is paying a $73 co-payment on a $600 device, this is a good deal. But a lot of consumers no longer simply have a co-pay on their drug purchases. They have a large deductible — an amount of money they must spend before their insurance kicks in. A Kaiser Family Foundation survey last September found 24% of consumers had high-deductible plans. ObamaCare is one reason for the rise, but another is that employers are turning to these plans more frequently.” Remember, too, that is the insurers who are determining the costs to the consumers by manipulating copays, discounts and rebates, not Mylan.
And in multiple interviews, Mylan chief executive Heather Bresch has made it a point to note that Mylan “only” gets $275 of the $608 list price for two EpiPens.

Hunting for affordable medications

The high cost of his prescriptions led my husband on a mission to figure out the lowest-cost way we could deal with it. Because even generics — if there are any — aren't cheap anymore. He discovered a website called GoodRX, which not only showed him the price of his medications at all our area pharmacies, but also offered a big-discount coupon. So my husband now gets his medications at WalMart, which is considerably cheaper than other pharmacies in our area, and uses the coupons. There are other similar websites out there.
Another smart strategy is to always ask your doctor for samples and coupons. They have closets FULL of samples. Our son has acne, and when we went to the doctor to have it looked at, he prescribed two medications, one being Epiduo. This is $300-$400 for 1 small tube and it's not covered by most Medicare and insurance plans (including ours). Now, acne is not life-threatening, but for a 15-year-old boy, it might feel like it.
Luckily, our doctor loaded me up with samples and also gave me a one-time coupon. We filled it once, using that coupon (cost to us $45). Since then we have just used the samples. His prescription for clindamycin phosphate was almost as expensive, but I discovered there are over the counter creams that have the same ingredient, and with pharmacy coupons I can get it cheaper than it would be with prescription discounts.
Hunting for discounts, rebates and coupons, asking your doctor for as many samples as they will spare, shopping from pharmacy to pharmacy to get the best price (the disparity among stores is shocking as well), and making sure you understand your insurance coverage and are getting the most out of it — these are all keys to helping to manage the cost of your medications. Needless to say, I am not looking forward to those golden years, when our medications increase and our ability to pay goes down.
How about you? What tips do you have for managing the cost of your prescriptions? Tell us here in the comments or on our Facebook page!

Do you have FSA funds left in your Flexible Spending Arrangement? If you overestimated your medical expenses for the year, you might lose that money under the use-it-or-lose-it rule. That means you have to spend all your FSA money by Dec. 31 unless your plan allows you to carry over a small amount into the next year.

The maximum you could have put toward a flexible spending arrangement is $2,550 for 2016, the same amount as 2015. The FSA maximum amount for 2017 is expected to rise $50 to $2,600.

It used to be really easy to do until a couple of years ago. In January 2011, a sweeping change made to FSAs went into effect which made it a lot more difficult to spend FSA dollars in a pinch. As a result, many FSA users have become a lot more careful about the amount they put into their account.

Have you started shopping yet? No, I'm not talking about shopping for the holidays; I'm talking about something more important — your health insurance.

It's that time of year when many employers have their open-enrollment period and the federal and state health insurance marketplaces are open for business. Open enrollment is your annual opportunity to review and make changes to your health insurance plan so you end up with the best plan for your needs. Continue reading...

When the oral surgeon recommended that our daughter have her wisdom teeth removed, we thought we knew what to expect both medically and financially. Morgan's two sisters underwent this procedure in the past, and we adopted a brave “Let's get this over with!” attitude as we scheduled her operation.

We expected the least painful part of the procedure to be the surgery bill because the girls are covered under both their parent's dental insurance. It was an unpleasant surprise to learn from the oral surgeon's billing manager, “After checking with your insurance, we estimate that your daughter's surgery will cost you about $1,200 out-of-pocket since she has exhausted nearly all of her benefits this year.”

Something was wrong!

According to the United States Department of Labor (DOL) website, "The Family and Medical Leave Act ("FMLA") provides certain employees with up to 12 workweeks of unpaid, job-protected leave a year, and requires group health benefits to be maintained during the leave as if employees continued to work instead of taking leave." The whole point of FMLA is to promote work-life balance by taking a reasonable amount of leave to deal with personal or family issues.

Because many situations requiring use of FMLA are health-related, the law also requires that your health insurance be maintained as if you continued to work. The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows employees to stay on a former employer's health plan for a limited time after job separation, provided they pay the full premium (employer share and employee share). Unlike COBRA, if you are on FMLA, then your employer still pays their share of the premium for your health plan, even if you are not being paid a salary during your leave.

Eligibility for FMLA

There are some criteria that must be met to be eligible for FMLA. First, you must work for an organization that is required by law to offer FMLA benefits. Fortunately, most employers fall under the requirements. For example, all public -- state, local and federal -- employers as well as schools must offer FMLA benefits. Additionally, FMLA benefits must also be offered by "private sector employers who employ 50 or more employees for at least 20 workweeks in the current or preceding calendar year," according to the DOL.

According to the U.S. Department of Health and Human Services, around 108 million Americans go without dental insurance during any given year. And since paying the full weight of dental care is often out of the question for those living on low incomes, many people simply choose to go without or get by with as few cleanings and check-ups as they possibly can.

However, if you do have out-of-pocket funds with which to pay, you already know how quickly cleanings, fillings, and basic dental care can take a bite out of your budget. After all, a typical dental filling can cost anywhere from $100 to $200, a cleaning can cost upwards of $200, braces can cost $5,000 to $6,000, and so on.

Obviously, one of the easiest ways to save on dental care is to have a dental insurance policy for your family. The bad news is, many employers don't offer dental coverage to their employees, even at a cost, and the dental plans commonly sold on the open insurance market can be of questionable value.

Recently, my sister and I were discussing our love/hate relationships with exercise when she told me something that struck me as funny. Apparently, she has trouble convincing herself to jog as long as she should, so she devised a plan.

"When I know I'm not very motivated, I'll have my husband get in the car and drop me off a few miles from home," she said with a snicker.

Once dropped off, she had no choice but to push through whatever issues she was trying to overcome that day, she explained.

Though our family has already had one sneak peek, cold and flu season is about ready to really get started.

Because I would like avoid as many sick visits to the doctor as I possibly can, I decided to check out our medicine cabinet and make sure it is ready for this winter -- and beyond.

What you should include in your medicine cabinet

Obviously, what you should include in your medicine cabinet depends on your needs, but here is a list to get you started. Oh, and I am not a doctor. Obviously. Read the labels. Use common sense.

A few months ago, I shared about how to survive without health insurance. To recap, I belong to a healthcare sharing ministry (HSM) called Christian Healthcare Ministries (CHM), just one of several ministries that are ACA-approved alternatives to health insurance. But I also want to share about my experiences with alternative health insurance to Obamacare.

What we belong to is not healthcare insurance; therefore, we don't pay a premium (although we pay a "gift" each month or what amounts to a deductible, except it's called a "personal responsibilty"). We chose this option because neither my husband nor I have access to an employer-sponsored plan. The most important consideration for us was cost, followed by coverage options. We opted for the most expensive level, which means that we have a $500 personal responsibility for each medical event that each of our family members experience on an annual basis.

Family of Five Pays $450 per Month for Health Insurance

At the time of the previous article, I was the only member of my family to belong, and I paid $150 per month. Now our entire family of five belongs for $450 per month. Even if our family size were to double, that is the maximum monthly contribution we'd have to make.