pay usually visit

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What is the difference between pay a visit and visit ?Feel free to just provide example sentences.

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"pay a visit" is a single visit "visit" doesn't specify whether it's a single action or a habitual/recurring one You could pluralize "pay a visit" like this: "I'll pay him a few visits over the week" "They paid him a visit every few days" (makes it habitual)

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@manad Not everyone would say it, but probably everyone has heard it in a book or movie. People that are more articulate or read/watch movies more would be more likely to use it, I think? It has a slight old-school "polite/friendly" tone. When I think of someone saying it, it's usually with an older way of speaking, at least 60 years ago, with good diction/elocution, and probably paired with other older phrases. You'll see this "nice" tone used sarcastically (or at least calmingly) in movies by - teachers telling kids to go to the school office for punishment/a talk with the principal - police officers telling disorderly drunk people they're "paying a visit to the station" (getting locked in jail)

@manad glad i could help.

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Understanding the Idiom: "pay a visit" - Meaning, Origins, and Usage

The meaning of “pay a visit”.

“Pay a visit” means to go and see someone for a short period of time. It could be to check on their well-being or simply to catch up with them. The phrase is often used when referring to visiting friends or family members, but it can also be used in professional settings such as visiting clients or colleagues.

Usage Examples

Here are some examples of how “pay a visit” can be used:

• I’m planning to pay a visit to my grandparents next weekend.
• The doctor advised me to pay a visit if my symptoms persist.
• We should pay a visit to our new neighbors and welcome them.

Origins and Historical Context of the Idiom “pay a visit”

The phrase “pay a visit” is an idiom that has been used for centuries to describe the act of visiting someone. This expression has its roots in Old English, where it was commonly used to refer to the act of paying tribute or homage to someone.

Over time, the meaning of this phrase evolved, and it began to be used more broadly to describe any type of social call or visit. Today, we use this idiom in many different contexts, from visiting friends and family members to making professional visits for business purposes.

Throughout history, paying visits has been an important part of human interaction. In ancient times, people would often travel long distances just to pay their respects or seek advice from respected leaders or scholars. As societies became more complex and interconnected over time, the practice of paying visits became even more common.

Today, we continue to value the importance of face-to-face interactions with others. Whether we are catching up with old friends or meeting new acquaintances for the first time, paying a visit remains an essential way for us to connect with one another on a personal level.

Usage and Variations of the Idiom “pay a visit”

When we want to see someone or something, we often use the idiom “pay a visit” . This phrase has many variations that can be used in different contexts. Let’s explore some of these variations and how they are commonly used.

One common variation is “make a visit” , which has the same meaning as “pay a visit”. Another variation is “drop by” or “drop in”, which implies a casual or unexpected visit. We can also say “call on” when referring to visiting someone at their home, office, or other location.

The idiom “pay a visit” is often used to describe visiting friends, family members, colleagues, or acquaintances. For example: “I’m going to pay a visit to my grandmother this weekend.” It can also be used in more formal situations such as business meetings: “The CEO paid a surprise visit to our office yesterday.”

“Drop by” and its variations are commonly used when referring to informal visits with friends or acquaintances: “I’m going to drop by Sarah’s house after work today.” Similarly, we might say: “I just wanted to drop in and say hello.”

“Call on” is typically reserved for more formal occasions such as job interviews or professional meetings: “I need to call on Mr. Smith at his office tomorrow.” However, it can also be used in everyday conversation when referring to visiting someone’s home: “We’re planning on calling on our neighbors this weekend.”

Synonyms, Antonyms, and Cultural Insights for the Idiom “pay a visit”

Instead of saying “pay a visit” , you could use phrases like “drop by”, “stop in”, or “pop in”. These expressions convey the same meaning but with different nuances. For example, if you say you’re going to “drop by” someone’s house, it implies that your visit will be brief and casual. On the other hand, if you say you’re going to “stop in”, it suggests that your visit might be longer or more formal.

Antonyms for “pay a visit” include phrases like “avoid”, “ignore”, or simply not visiting at all. Of course, these expressions have negative connotations and are not appropriate when talking about friendly visits.

Culturally speaking, paying visits is an important social custom in many countries around the world. In some cultures, such as Japan and Korea, it is customary to remove one’s shoes before entering someone’s home as a sign of respect. In other cultures, such as Italy and Spain, it is common to bring small gifts or treats when visiting friends or family members.

Practical Exercises for the Idiom “pay a visit”

Exercise 1: fill in the blanks.

In this exercise, you will need to fill in the blanks with appropriate words from the given options:

• It’s been a while since I last _______ my grandparents.
• We decided to _______ our friends who live across town.
• I’m planning to _______ my old school teacher next week.

Exercise 2: Create sentences

In this exercise, you will need to create sentences using “pay a visit” in different contexts:

• Create a sentence using “pay a visit” when talking about visiting someone at their workplace.
• Create a sentence using “pay a visit” when talking about visiting someone who is sick or unwell.
• Create a sentence using “pay a visit” when talking about visiting an unfamiliar place for sightseeing purposes.

Exercise 3: Role-play activity

In this exercise, you will need to role-play different scenarios where you would use the idiom “pay a visit” . This could include situations such as visiting family members during holidays or dropping by someone’s house unexpectedly. You can practice with friends or family members and try out different variations of the idiom based on context and tone of conversation.

By practicing these exercises regularly, you’ll soon become more confident in using the idiom “pay a visit” in your everyday conversations.

Common Mistakes to Avoid When Using the Idiom “pay a visit”

When using idiomatic expressions, it’s important to understand their meaning and usage in context. The idiom “pay a visit” is commonly used to describe visiting someone or somewhere, but there are some common mistakes that people make when using this expression.

Using the Wrong Preposition

One of the most common mistakes when using “pay a visit” is using the wrong preposition. The correct preposition to use with this idiom is “to”. For example, you can say “I’m going to pay a visit to my grandmother.” Using other prepositions like “at” or “in” would be incorrect and sound unnatural.

Misusing the Word Order

Another mistake people make with this idiom is misusing the word order. The correct order should be subject + verb + object. For example, you can say “I’m going to pay a visit to my friend.” Incorrectly saying something like “To my friend I’m going to pay a visit” would be grammatically incorrect and confusing.

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pay (someone) a visit

Definition of pay (someone) a visit

Examples of pay (someone) a visit in a sentence.

These examples are programmatically compiled from various online sources to illustrate current usage of the word 'pay (someone) a visit.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples.

Dictionary Entries Near pay (someone) a visit

pay (someone) a compliment

pay someone no mind

Cite this Entry

“Pay (someone) a visit.” Merriam-Webster.com Dictionary , Merriam-Webster, https://www.merriam-webster.com/dictionary/pay%20%28someone%29%20a%20visit. Accessed 26 Jul. 2024.

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pay a visit

collocation pattern: verb + noun

to visit someone or something

For example

• You should pay your lawyer a visit and get some advice.
• If you have time, pay a visit to the science museum while you're here.

Paying a visit to someone always

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pay a visit

• Thread starter januska
• Start date Feb 18, 2009
• Feb 18, 2009

Can anyone please tell me if there is a phrase in English that one could use for saying to someone who has paid you a visit and invited you to visit them that you would be happy to visit them back? In Slovenian, we say something like "I would be happy to return you the visit" (literally). Thanks!  

Senior Member

If the person has invited you to visit, you could simply say, "I would be happy to" or "I would be glad to", or even simply "Gladly" or "Happily". Or, more informally, "I'd love to".  

januska said: Thanks for replying! I am more interested in the second part of the sentence...for example: You visit me in Slovenia and before you leave you invite me to visit you in (wherever). I say Thank you, I would be happy/glad/whatever to "visit you back", "pay the visit back". In Slovenian, it's the same concept as in "return a favour"... Does it make any sense? Click to expand...

I'm troubled by the suggested answers. They involve the idea that by visiting me you were doing me a favour, paying me a compliment. I could just about manage to cope with that idea. But then I, by accepting your invitation to visit you, am doing you a favour, paying you a compliment. It may be cultural, but I can't cope with that at all. If you invite me to your home you are doing me a favour.  

I see Panjandrum's conundrum on this. If I invite someone to my home I thank them for coming. They are paying me a tribute by fulfilling my invitation. If I invite someone to my home and they respond by saying, "No thanks," then that is a slap in my face, an insult. Both parties have a benefit. The guest gets (presumably) some refreshments or a clean bed to sleep in. The host gets the company of the guest. Unlike a hotel where the guest only benefits the hotel by payment in funds, a host gets "payment" in the pleasure of conversation and interaction. In most cases (in my experience) this is considered a fair transaction. Both parties gain equally from the experience (though the host may have some out of pocket expenses). When my brother-in-law visits I always look forward to the visit. I don't know how he feels about my visits to his home, but since we continue the practice I would think it is an "even" swap.  

• May 9, 2013

Interesting. We have the same concept of "paying a visit back" here in Iran. We actually have a saying for that "each visit has a visit back!" (it sounds much better in Farsi LOL) So you all suggest forgetting about "back" and saying "pay a visit"?  

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Understanding Copays, Coinsurance and Deductibles

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Coinsurance, copays and deductibles are different out-of-pocket costs for health care, and being familiar with these terms can help you better understand your health coverage and costs. Even after you pay monthly premiums for health insurance , out-of-pocket costs can lead to high medical bills if you get sick or injured.

Here's how health insurance costs work.

Defining some health insurance terms

Before understanding how it all works together, let's brush up on some common health insurance terms.

Coinsurance

Coinsurance is a percentage of a medical charge you pay, with the rest paid by your health insurance plan, which typically applies after your deductible has been met. For example, if you have 20% coinsurance, you pay 20% of each medical bill, and your health insurance will cover 80%.

A copay, or copayment , is a predetermined rate you pay for health care services at the time of care. For example, you may have a $25 copay every time you see your primary care physician, a $10 copay for each monthly medication and a $250 copay for an emergency room visit.

The deductible is how much you pay before your health insurance starts to cover a larger portion of your bills. In general, if you have a $1,000 deductible, you must pay $1,000 for your care out of pocket before your insurer starts covering a higher portion of costs. The deductible resets yearly.

The premium is the monthly payment you make to have health insurance.

You pay the premium each month like a gym membership, even if you don't use the coverage. If you don't pay the premium, you may lose your insurance. If you're fortunate enough to have employer-provided insurance, the company typically picks up part of the premium.

Out-of-pocket maximum

The out-of-pocket maximum is the limit of what you'll pay in one year, out of pocket, for your covered health care before your insurance covers 100% of the bill. The maximum out-of-pocket limit for marketplace health plans (those on the Affordable Care Act health insurance marketplace) is $9,450 for an individual and $18,900 for a family in 2024 . (This amount doesn't include what you spend for services your insurance doesn't cover.)

Coinsurance vs. copay

Copays and coinsurance are different ways your health insurance may require you to pay for covered services. Here are the differences:

Copay vs. deductible

Your health plan may have both copays and deductibles, and whether you pay one or the other may depend on the services you receive. For some services, such as a visit to your primary care doctor, you may owe a fixed copay, such as $10 or $20. For other services, such as an MRI, you may have to pay the approved cost of the service up to your deductible.

Your copay may count toward your deductible, but it doesn't always. And you may owe copays for some services after you meet your deductible.

Coinsurance vs. deductible

Deductibles and coinsurance work together, but usually consecutively. As mentioned, the deductible is the amount you pay before your insurance starts covering the cost of your health care. Once you meet your deductible, you'll typically owe coinsurance (such as 20% of approved charges) on all additional services for the rest of the year.

You'll pay coinsurance on approved medical care until you hit the out-of-pocket maximum on your plan, after which your insurance will cover 100% of the rest of your care for the year.

How it all works together

Health insurance policies can have a variety of cost-sharing options. For example, some policies have low premiums, high deductibles and high maximum out-of-pocket limits, while others have high premiums, lower deductibles and lower max out-of-pocket limits.

In general, it works like this: You pay a monthly premium to have health insurance. Then, when you go to the doctor or the hospital, you pay either full cost for the services or copays as outlined in your policy. Once the total amount you pay for services, not including copays, adds up to your deductible amount in a year, your insurer starts paying a more significant chunk of your medical bills, commonly 80%. The remaining percentage that you pay is called coinsurance.

You'll continue to pay copays or coinsurance until you've reached the out-of-pocket maximum for your policy. At that time, your insurer will start paying 100% of your medical bills until the policy year ends or you switch insurance plans.

The catch: Your health plan's network

Here's the snag: The co-sharing scenario highlighted above works only if you choose doctors, clinics and hospitals within your health plan's provider network. If you use an out-of-network doctor, you could be on the hook for the whole bill, depending on which type of policy you have. This brings us to two related terms:

This is the group of doctors and providers who agree to accept your health insurance. Health insurers negotiate lower rates for care with the doctors, hospitals and clinics in their networks. So when you go in-network, your bills will typically be cheaper, and the costs will count toward your deductible and out-of-pocket maximum.

Out of network

A provider your insurance plan hasn't negotiated a discounted rate with is considered out of network. If you get care from an out-of-network provider, you may have to pay the entire bill yourself, or just a portion, as indicated in your insurance policy summary.

» MORE: What the No Surprises Act means for your medical bills

Doing the math on copays, coinsurance and deductibles

To illustrate with an example, consider a person — let's call her Prudence — who needs some health services. (Your costs would be different based on your policy, so you'll want to do your own calculations.)

Prudence's policy:

Insurance coverage: Single.

Annual deductible: $1,200.

Copays: $20 per office visit, $50 per specialist, $100 per ER visit; these don't count toward her deductible.

Coinsurance: 20% after she meets her deductible.

Scenario: Doctor visits and an MRI

Prudence goes in for an annual checkup. Because she goes to an in-network provider, this is a free preventive care visit. (If it had been an office visit for a medical issue, there would have been a $20 copay.) However, her primary care physician thinks Prudence should see an orthopedist based on her physical exam. The orthopedist later recommends an MRI.

Copays for an in-network specialist on her plan are $50. The MRI provider is in her insurer's network, and the approved insurance charge is $1,000 for the MRI, including the radiologist fees for interpreting the scan.

Imaging scans like this are "subject to deductible" under Prudence's policy, so she must pay for it herself, or out of pocket, because she hasn't met her deductible yet.

Total out-of-pocket costs: $50 for the specialist copay + $1,000 for the scan = $1,050.

Scenario: Trip to the ER

Later that year, Prudence falls while hiking and hurts her wrist. She heads to an in-network emergency room, for which she has a $100 copay. After the copay, ER charges are $3,400. Her deductible will be applied next.

Prudence has already paid $1,000 of her $1,200 deductible for her MRI, so she's responsible for $200 of the ER bill before her insurer pays a larger share. Of the remaining $3,200, her health plan will pay 80%, leaving Prudence with a 20% coinsurance of $640.

Total out-of-pocket costs: $100 for the ER copay + $200 for remaining deductible + 20% coinsurance ($640) = $940.

Prudence has now paid $1,990 toward her medical costs this year, not including premiums. She has also met her annual deductible, so if she needs care again, she'll pay only copays and 20% of her medical bills (coinsurance) until she reaches the out-of-pocket maximum on her plan.

Understanding how your health insurance works can save you money and grief now and down the road.

On a similar note...

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How do copays, coinsurance and deductibles work?

Medically reviewed by Leigh Ann Anderson, PharmD . Last updated on April 23, 2024.

Official answer

Copays, coinsurance and deductibles are terms that apply to the cost-sharing that many Americans pay as part of their medical insurance plans. These dollar amounts have a wide range but may go up to thousands of dollars per year based on your specific health plan.

Jump to the Health Care Insurance Glossary below for a quick explanation of relevant terms.

What is a copay?

A copay (copayment) is a set amount that you pay for a service or product, such as a doctor visit or a medication. You will usually pay this at the time of your visit, or you might be billed for it. You may need to meet your annual deductible before you start paying copays.

Copays are usually determined by your health insurance. You may have a different copay for various services, such as medications, lab tests, and visits to primary care doctors, specialists, urgent care centers or the emergency room.

• For example, you might pay a $20 copay each time you see the doctor for a sick visit. However, for preventive healthcare check-ups and preventive medicines like vaccines you should not have to make a copayment.
• For a prescription, your copay for “preferred”, “Tier 1”, or generic medications may be low, for example $10 or $20, and increase for non-preferred drugs that may be brand name drugs or medicines not on the health plan drug formulary. You pay this amount each time you get a prescription refill. Generics typically have lower copays than brand name drugs.
• In some cases, you may be responsible for the full cost of your medicine until you meet your deductible.
• You will typically pay copays for each visit or refill, or until you reach your annual out-of-pocket maximum set by your health plan (which could be in the thousands of dollars).

Your insurance plan will have a list of copays for you to review for various medicines, doctor visits and medical services. Contact them to determine your insurance deductible, copay, coinsurance or out-of-pocket maximum.

Related : Generic Drug FAQs

What is a deductible? Copay vs. deductible

A deductible is the dollar amount you pay for health care services before your insurance plan starts to pay.

• For example, you may have a $2,000 deductible per year before your insurance plan will pay for certain medical services or medications.
• After you have met the amount of your deductible by paying out of your own pocket, and your insurance plan has a record of this amount, you will then pay either a set copay or a coinsurance (for example: 20%) for services or products.
• In most cases your copay will not go toward your deductible amount.

How do I know if I have met my deductible?

If possible, set up an online portal with your health insurance plan to be sure these expenses are accounted for.

• When items are billed through your insurance card (even if you are still paying your deductible), your health plan will document these items so you can see how close you are to meeting your deductible.
• It is important you make sure that your insurance company is aware of any covered out-of-pocket expenses you have paid for yourself so that this amount can be applied to your deductible.
• Keep all of your receipts for anything you pay for out of your pocket, especially if you paid for something without your insurance card.
• Bottom line: even if you are paying out of pocket for something, you should still have the medical facility submit the charges through your insurance card so they can be applied to your deductible.

Some plans have separate deductibles for certain services, like prescription drugs. Family plans may have both an individual deductible and a family deductible which applies to all family members.

Your deductible amount is typically reset back to the maximum dollar amount once per year on your plan renewal date (which is often Jan 1). You will have to pay your deductible each year before payments are made by your health plan.

Can you have both a copay and deductible? Yes, your plan may include both, for example - having a copay for medical outpatient services like a doctor visit and a deductible for other services like x-ray imaging or CT scans.

Most health plans pay the full cost of certain preventive benefits, like vaccines, mammograms or yearly annuals with $0 copays even before you meet your deductible. Check your health plan details for benefit descriptions.

What is a high deductible plan?

Certain plans, known as “high deductible plans” are less expensive than other plans but have a higher deductible (for example, $4,000 per year).

One advantage to these plans, besides having a lower premium, is you may be able to set up a pre-tax Health Savings Account (HSA) through your employer. You can use the HSA to help pay for your expenses now or in the future. Some employers may contribute extra dollars to your HSA, too, as a benefit.

What happens if you don't meet your deductible?

At the end of your plan year, if you still have a deductible to pay you will not owe it. However, when your new yearly plan starts, you will start over with your full deductible amount.

• For example, if your deductible is $4,000 and you have only paid $2,500 out of pocket towards your annual amount, your $4,000 deductible will begin again on the day your annual plan restarts.
• This can be especially difficult if you have a large amount of medical expenses towards the end of your plan year. You may get close to paying off your deductible, but then when the annual plan restarts, you will be responsible for paying yet another full annual deductible before the insurance will pick up any costs.

What happens if I pay more than my deductible?

If for some reason you pay more than your annual deductible, your insurance company will reimburse you for the overpayment. Contact your insurance plan and explain your situation so that they can document it, and investigate for a refund.

To avoid this scenario, be sure to review your Explanation of Benefits (EOB) sent to you by the insurance company and match it up with any medical bills you may have.

Is it better to have a low or high deductible?

In general, health plans that cost less (with lower premiums) have higher deductibles, and plans that are more costly have lower deductibles. Which plan is best for you will depend upon your circumstances, such as age, health and ability to pay for your premiums.

To determine your specific costs, call your the customer service phone number listed on the back of your insurance card, or look at your plan online.

What is coinsurance? Is coinsurance the same as a copay?

No, coinsurance is not the same as a copay. Coinsurance is the percentage of costs that you pay after you have met your deductible (such as a 20% coinsurance). For example, if a doctor’s visit cost $100, you will pay 20% (or $20) once you have met your full deductible. If you still have not met your deductible, you pay the full amount of the doctor’s visit, or $100.

As another example, say these are your yearly plan benefit fees:

• $3,000 deductible
• 20% coinsurance
• $8,000 out-of-pocket maximum

Let’s say you have surgery and a hospital stay and the allowable fee charged to you is $10,000. If your deductible is $3,000 (and you have not met it), you will pay the first $3,000 out of pocket. If your coinsurance is 20%, you will also pay 20% of the remaining amount ($7,000) which equals $1,400 (your coinsurance). You are responsible for $4,400 and your insurance will pay $5,600.

In math terms: $10,000 (charge) - $3,000 (deductible) = $7,000 (x20%) = $1,400 (coinsurance).

You have an out-of-pocket maximum of $8,000. This means you’ll only pay up to that amount per year, and after that your insurance pays 100% of all covered services for the rest of the plan’s calendar year.

What are preventive benefits?

Most health plans must cover certain preventive services at no cost to you. These may include annual well exams, vaccines and cancer screening tests such as a mammogram or colonoscopy. These services will be paid for even if you have not met your deductible, and you typically would not have a copay or coinsurance, either.

There are many other preventive services offered. Your health plan can give you a full outline of these services and how often you can receive them. Preventive services are offered to both adults and children.

Examples of preventive services included in health plans include:

• Blood pressure screening
• Cholesterol screening
• Cancer screenings, for example, mammograms, colonoscopies or cervical cancer
• Immunizations
• Depression or other mental health screenings
• HIV screening; PrEP medication
• Tobacco use screening
• Type 2 diabetes screening
• Obesity screening
• Well-baby and well-child visits
• Birth control (in most cases)

This is not a complete list, so be sure to contact your health plan for a full description of preventive services. These services are also subject to changes as determined by the health plan or government.

What is an Explanation of Benefit?

You may have received an Explanation of Benefit (or "EOB") in the mail or online from your insurance company. What is an EOB? An EOB will tell you how much your insurance paid for a particular covered medical service or product, and what your shared costs are, if any. You should receive one of these forms (in your insurance portal or in the mail) each time a healthcare provider submits a bill to be paid through your insurance.

Be sure that the amount of money you owe on your EOB matches the bill your doctor or medical facility sends to you. If not, call the insurance company or medical billing office to investigate the difference. Mistakes can be made, so take the time to review these EOB documents carefully.

Health Care Insurance Glossary

Copay - A copay is a set dollar amount that you pay for a medical service or product, such as a doctor visit or a medication. You will usually pay this at the time of your visit. For example, your copay each time you see the doctor for a sick visit may be $20. Prescription copays may be $10 for generics or $60 for non-preferred brands.

Coinsurance - Coinsurance is a percentage (%) of a medical charge that you are responsible for paying. For example, if you have a 20% coinsurance and have met your deductible, you will pay 20% of that charge. If a doctor’s visit costs $150, you will pay $30 (20% of $150) as your coinsurance.

Deductible - A deductible is an amount you are required to pay before your insurance will pay towards your expenses. For example, some plans have a $2,000 per year deductible. Once you meet this amount, your insurance will then pay for covered services, minus any copays or coinsurance you may be responsible for.

Explanation of Benefit (EOB) - A mailed or online document that explains what was paid to the medical provider for a service or product, based on your plan coverages. If you owe the provider anything, it will be outlined in this document. Your bill from the doctor and your Explanation of Benefit should be the same dollar amount. EOBs can be inherently difficult to understand; if you need help call the insurance company.

High deductible health insurance plan - High deductible plans have a higher deductible, for example $4,000 or $5,000 per year, but may be less expensive to buy (they have a lower premium). With these types of plans, you may also be able to set up a pre-tax Health Savings Account (HSA) through your employer. You can use the HSA to help pay for your medical expenses now or in the future.

Out-of-pocket maximum - Out-of-pocket maximum is the maximum amount you would pay per year for medical expenses based on your insurance plan. Once you meet your out of pocket maximum, the health insurance company then pays for 100% of covered medical expenses. Yo uno longer have copays or coinsurance.

Health insurance premium - Your health insurance premium is the dollar amount you pay for medical plan benefits. This may be taken out of your paycheck if your employer provides health insurance, or the government may take it out of your social security if you have Medicare Part B. In 2024, the Part B premium is $174.70 a month. Part C premiums are billed through the private insurance company associated with your Medicare Advantage plan.

Preventive benefits - Preventive benefits are the doctor visits, health screenings, procedures and immunizations (vaccines), among other benefits, that are provided typically at no cost to you through your insurance. Check your plan benefits to determine your full benefits.

• Healthcare.gov. Accessed April 23, 2024 at  https://www.healthcare.gov/
• Understanding the Health Insurance Marketplaces. Kaiser Family Foundation (KFF). Accessed April 23, 2024 at  https://www.kff.org/understanding-health-insurance-marketplaces/

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Visiting Sleeping Beauties: Reawakening Fashion? You must join the virtual exhibition queue when you arrive. If capacity has been reached for the day, the queue will close early.

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What Part B covers

Medicare Part B (Medical Insurance) helps cover 2 types of services:

• Medically necessary services: Services or supplies that meet accepted standards of medical practice to diagnose or treat your medical condition.
• Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage when treatment is likely to work best.

You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment . 

If you're in a Medicare Advantage Plan or other Medicare plan, your plan may have different rules. But your plan must give you at least the same coverage as Original Medicare.  

Part B covers things like:

• Ambulance services  
• Clinical research
• Durable medical equipment (DME)  
• Limited outpatient prescription drugs
• Mental health & substance use disorders
• Oxygen equipment & accessories  

IMPORTANT INSULIN BENEFIT!  If you use an insulin pump that's covered under Part B's durable medical equipment benefit, or you get your covered insulin through a Medicare Advantage Plan, your cost for a month's supply of Part B-covered insulin for your pump can't be more than $35. The Part B deductible won't apply. 

If you get a 3-month supply of Part B-covered insulin, your costs can't be more than $35 for each month's supply. This means you'll generally pay no more than $105 for a 3-month supply of covered insulin.

If you have Part B and Medicare Supplement Insurance (Medigap) that pays your Part B coinsurance, your Medigap plan should cover the $35 (or less) cost for insulin.

Next step: Understand what Part A covers   Take action: Find out if Medicare covers a test, item, or service you need  Learn more: Learn what Original Medicare doesn’t cover  

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What does pay yourself first mean?

• Implementing the strategy
• Impact of paying yourself first

Pay Yourself First: Definition and How it Works

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• Paying yourself first means saving money before using it for bills and other spending.
• This approach to budgeting protects you in financial emergencies and provides for future opportunities.
• You can set it up using automatic transfers from your paycheck to dedicated savings accounts.

When it comes to your money, earning it is only half the battle. Once you've got the cash flow, putting a plan in place to manage, save , and invest it is crucial to your long-term financial well-being.

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Quicken Simplifi is a great budgeting tool if you want to create a detailed monthly spending and savings plan and don't mind paying for a subscription. If you would rather get a budgeting app that doesn't have a subscription fee, you'll have to consider other options.

• Up to 50% off on Simplifi for all new customers
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Often described as "reverse budgeting," paying yourself first ensures that saving is not only accounted for early and reliably, but that it becomes a priority. Your savings turn into a monthly expense — paid to you, by you.

Definition and explanation

Developing a budget doesn't have to be difficult. One of the most popular methods for doing so is built around a simple principle: pay yourself first.

"Most people spend their money, and then say 'Oh, I need to save.' Then at the end of the month, they just forget and they never really save," says Erik Sussman, a certified financial planner and CEO of The Institute of Financial Wellness . "So instead, we implement pay yourself first. That means before you pay the light bill, before you pay your mortgage, before you pay for your clothing, you pay yourself first."

At its core, the pay-yourself-first method means having a specific amount of your paycheck set aside and saved every month before it can be spent on anything else.

"In essence, it's automating a saving strategy, or putting a plan specifically around savings," explains Autumn Lax, a CFP professional at Drucker Wealth Management .

Benefits of paying yourself first

Picture this: you've put all of your extra money toward paying down your mortgage as fast as possible. On the day you make your last payment, a tree falls on your roof. Suddenly you're not only back in debt, but you're in high-interest debt because you had to pay for the repairs with a credit card . It's this kind of scenario that makes paying yourself first so important.

As Sussman explains, even if you're putting your money toward a "good" goal, it doesn't mean much if something unexpected occurs.

"In an emergency, you can't call the loan company and say 'Hey, can you send me back that $10,000 extra that I sent in?'" he says.

Still, it's not just emergencies that paying yourself first protects against. It's also there for opportunities.

"You're much better off having the money in your possession," Sussman says. If you're putting your savings in some kind of growth-oriented fund, "you're earning 8% or 9%," he explains.

"That difference over a long period of time is a lot of money." This can be particularly beneficial for long-term financial goals like retirement .

And simply put: One day you'll need the money you're saving today, so it has to be a priority. As Lax says: "Once you retire, there's no more money coming in. And the only way that you'll generate an income is based on the assets that you've saved."

How to implement the pay yourself first strategy

1. budgeting for pay yourself first.

"First thing you've got to do is write out a game plan," Sussman explains.

Paying yourself first doesn't mean you neglect all of your other financial responsibilities in pursuit of your savings goals , so you've still got to account for them. Lax suggests reviewing your spending over the past few months, itemizing it, and figuring out your average spending by category.

It can help to start with your recurring and required expenses — for example, rent or mortgage, food, minimum loan payments, medicine, and bills. Once you calculate that minimum amount you know you'll have to spend every month, you'll be better equipped to determine how much you can afford to save each month .

2. Prioritizing savings over discretionary expenses

In an ideal situation, you should aim to save 20% or more of your income, and 10% at a minimum, Sussman says.

Let's say you bring home $3,000 per month. A good monthly savings target would be $600, or 20%. If you've calculated your minimum monthly expenses to total $1,400, for example, saving $600 per month is more than doable. It even leaves an additional $1,000 to spend freely or put toward other goals like paying down a mortgage.

However, with these numbers, you could just as easily decide you'll save $1,000 per month and put the $600 toward your discretionary spending . Ultimately, finding that sweet spot is going to be unique to each person based on their lifestyle, income, expenses, and goals. As a general rule, aim for 20% and adjust from there. If 20% isn't achievable, it may be worth looking into ways you can minimize your spending or increase your income.

3. Clarifying your goals

Once you know how much you're going to pay yourself each month, it's time to figure out where that money should actually be going.

"If you have no emergency cash reserve, I see that as a priority," Lax says. "The next place I would look to save is in tax-efficient vehicles like retirement plans ."

Another way to look at your savings is by timeline. "Break up your goals into short-, mid-, and long-term," says Sussman. Short-term could be an emergency fund if you don't have one. Mid-term might be purchasing a house. Long-term could be retirement. "You need to portion out how much to put in each of those buckets," he explains.

After determining how much you're saving every month, then delineate how those savings are specifically divided.

4. Setting up automatic savings

With all the numbers figured out, put your plan into action. One of the easiest ways to "pay yourself" every month is to automate the transfer from your checking account to the appropriate savings vehicle, like a high-yield savings account .

"If you just automate it, it happens without having to think about it," Lax says.

Not only does it make saving self-regulating, it also removes the money from your checking account before you can consider spending it. Some employers make it easy to deposit percentages of your check into different accounts. If that isn't possible, you can usually set up these transfers through your bank.

The impact of paying yourself first

Though paying yourself first is generally cited as a good habit to implement, like anything, there are pros and cons to consider before making any changes to your financial strategies.

On the plus side, paying yourself first "makes sure your money is going to the right places," Lax explains. And when it's automated, it's a generally low-maintenance system that accounts for all of your financial responsibilities.

It's also helpful when you're setting and visualizing goals. "You can actually see and work toward them," Lax says.

However, paying yourself first doesn't always make sense and can end up working against you if you have high-interest debt . Outside of building an emergency fund, "if you've got all of these bad debts, you don't want to pay yourself first," Sussman says.

The reason for this comes back to simple mathematics. "If you're paying 20% interest on a credit card, there's no realistic investment you can put your money in to get more than 20%," says Lax. "So you're kind of working against yourself."

Pay yourself first strategy FAQs

Paying yourself first means automatically saving or investing a portion of your income before spending on discretionary expenses.

Paying yourself first is important because it ensures that you don't forget — or procrastinate — saving money. It builds a healthy habit of saving money for emergencies and big goals, like retirement or buying a home .

You can start paying yourself first by reviewing your budget and listing out your most essential expenses. What remains should be split between savings and discretionary expenses.

Aim to save 20% of your income through automatic transfers to a savings account, retirement plan, or both. If you can't manage 20% yet, don't sweat it. Try auditing your spending to see if there are any areas you can cut back on or find ways to increase your income.

Paying yourself first is primarily a savings strategy. But you can use the same framework to pay off debt by setting aside a specific percentage of your income each month, automatically, and using it for repayments.

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Temporary workers usually don’t get the overtime pay they deserve, new Mass. study finds

More than half of temporary workers in Massachusetts didn’t receive overtime pay when they worked more than 40 hours in a week, according to a new report released by the Massachusetts Coalition for Occupational Safety and Health on Wednesday.

The yearlong study uncovered rampant violations of a state law that went into effect more than a decade ago, including instances of retaliation against workers who challenged working conditions.

Labor advocates with MassCOSH say not enough is being done to enforce worker protections for the hundreds of thousands of temporary workers in Massachusetts. Beyond holding employers accountable for those violations, they also argue that the law needs to be revised to create stricter protections for temporary workers so that, for instance, they’re guaranteed pay and benefits equal to permanent employees.

At Our Savior’s Lutheran Church in East Boston, Francisca Sepulveda, director of the Immigrant Worker Center at MassCOSH, picked up the microphone to introduce the subjects of MassCOSH’s study: 50 temporary workers fired over text on New Year’s Eve without notice, 17 housekeepers in the hotel industry defrauded out of overtime pay and another group of laborers who worked without personal protective equipment during the pandemic.

“Temporary workers do essential work in this state,” Sepulveda said. “For the past years, even though we had legislation enacted in 2013, we were still seeing at our worker center many workers having issues — discrimination issues, safety and health issues, wage issues.”

Staffing agencies act as a middleman between host companies and temporary workers. Heather Rowe, chief of investigations at the fair labor division of the state attorney general’s office, estimates there are more than a thousand temporary staffing agencies registered with the state — and an unquantifiable number of unregistered agencies that more commonly exploit workers.

“We need more temporary staffing agencies to know — and their client businesses to know — that if you cheat your workers out of their wages and out of their workplace rights to gain a competitive advantage for yourselves and for your own wallets, Fair Labor will hold you accountable for the laws that you break,” Rowe said.

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The report identified specific gaps in workplace protections and outlined a series of recommendations that aim at forging a future where temporary workers, many of them immigrants, are adequately compensated and don’t fear mistreatment at work.

Advocates hope that staffing agencies will begin creating pathways to permanent employment for “perma-temps,” temporary workers who end up working at one job site for many months or even years, among other reforms that are only achievable through an expansion of the 2013 “Temporary Workers Right to Know” law. The report recommends the state also give workers the right to refuse work at a job site where salaried workers are striking and increase licensing requirements for staffing agencies.

“Our report demonstrates that temporary workers in Massachusetts are not protected by our laws as much as they should and can be,” said Michael Tomase, a law school student who works at the Boston College Law Civil Rights Clinic, which partnered with MassCOSH to produce the study and report. “The time is now to act on these recommendations, to increase knowledge and enforcement of existing temp worker laws and to pass legislation that will require equal pay for equal work for temporary workers.”

Through an interpreter, Mayra Molina, a former temp worker who now works as a paralegal at an immigration relief firm, gave impassioned final remarks before the small audience disbanded: “Sigamos, sigamos presionando.” Let’s continue, continue pressing on.

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President Joe Biden will visit Austin on Monday to commemorate Civil Rights Act

WASHINGTON — President Joe Biden will travel to Austin on Monday for a rescheduled appearance at the LBJ Presidential Library to commemorate the 60th anniversary of the Civil Rights Act, the American-Statesman learned Tuesday morning.

Biden's visit, originally set for July 15, was postponed after the attempted assassination of former President Donald Trump during a campaign rally in Pennsylvania. White House sources familiar with the president's trip told the Statesman that Biden will be in Austin on Monday for the previously scheduled celebration. The White House later confirmed the visit in a news release.

Biden, who has been isolating at his Rehoboth, Delaware, vacation home as he recuperates from COVID-19, in a bombshell announcement Sunday said he would not seek reelection amid pressure from Democrats for him to step aside after a disastrous debate performance last month against former President Donald Trump gave rise to concerns about the incumbent's fitness for the office. Biden instead has endorsed Vice President Kamala Harris for the Democratic presidential nomination.

More: Austin Rep. Lloyd Doggett's first call for Biden to withdraw sparked a national movement

There is a certain poignancy in Biden’s appearance at the LBJ library — the presidential library and museum of Lyndon Baines Johnson, the 36th U.S. president — after his decision to step aside from seeking a second term. 

Johnson, a former vice president and Senate majority leader from Texas, was the last incumbent president to forgo reelection to the White House. Johnson decided to step aside in 1968 under pressure from protests against the Vietnam War. 

U.S. Rep. Lloyd Doggett, D-Austin, the first Democratic congressional lawmaker to call for Biden to step aside, made the connection to Johnson in early July ahead of Biden’s planned July 15 appearance in Austin.

Who is replacing Joe Biden? Kamala Harris most likely Democratic presidential nominee

After Biden’s announcement Sunday, Doggett said, “When I respectfully called for President Biden to step aside almost three weeks ago, I recognized that this would be a painful and difficult decision, not unlike that faced long ago under different circumstances by President Lyndon B. Johnson. Today’s courageous action caps decades of selfless service and opens the door to a convention that can build on our progress and prevent a takeover of our country by Trump and his gang.”

In Austin, Biden will be the keynote speaker at the Civil Rights Act commemoration and will receive the Liberty and Justice Award from the LBJ Presidential Library and the LBJ Foundation. The event will take place in the library's auditorium, which can accommodate 1,000 people.

More: Looking forward and back as the Civil Rights Act turns 60

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Admera Health Agrees to Pay Over $5M to Settle False Claims Act Allegations of Kickbacks to Third Party Marketers

Admera Health LLC (Admera) has agreed to pay the United States $5,389,648 to resolve allegations that it violated the False Claims Act by paying commissions to third party independent contractor marketers in violation of the Anti-Kickback Statute (AKS). Admera will pay an additional $147,851 to individual states for claims paid to Admera by state Medicaid programs.

Admera is a New Jersey-based company that provides biopharmaceutical research services for healthcare institutions and provided clinical laboratory testing services to healthcare providers relating to pharmacogenetics until 2021. Pharmacogenetics analyzes how a patient’s genetic attributes affect their response to therapeutic drugs. The settlement announced today resolves allegations that, from Sept. 1, 2014, through May 21, 2021, Admera made commission-based payments to independent contractor marketers in return for recommending or arranging for the ordering of genetic testing services in violation of the AKS. The AKS prohibits offering or paying remuneration in return for arranging for or recommending items or services covered by Medicare and other federally funded programs.

“The law prohibits health care providers, including those that provide laboratory services, from paying kickbacks in the form of commissions to third parties as an inducement to generate business,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “The department is committed to holding accountable those who engage in kickback arrangements that undermine the integrity of federal healthcare programs.”

“By entering into kickback arrangements, health care companies can cause providers to make medical decisions that are motivated by financial gain rather than the patient’s best interest,” said U.S. Attorney Phillip A. Talbert for the Eastern District of California. “Our office is committed to ensuring the accountability of participants in the health care system who put their own financial needs ahead of patient welfare.”

“Kickbacks can negatively influence medical decision making and corrupt the legitimate doctor-patient relationship,” said Special Agent in Charge Steven J. Ryan of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “This settlement demonstrates HHS-OIG’s commitment to identifying and holding accountable those who allegedly engage in unlawful financial relationships at the expense of Medicare patients and the taxpayer.”

As part of the settlement, Admera has admitted that it made millions of dollars of commission payments to independent-contractor marketers (the Marketers) to induce them to arrange for or recommend that healthcare providers order and refer clinical laboratory services to Admera, including genetic tests, that were reimbursable by Medicare and/or Medicaid, that it paid Marketers through arrangements that took into account the volume and value of genetic testing referrals, and that Admera was informed that the payment of commissions to independent contractors did not comply with the AKS but continued to enter into such contracts.

The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by relators, Sunil Wadhwa and Ken Newton, co-founders of Financial Halo LLC/MedXPrime, a former third-party marketer for Admera. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam case is captioned U.S. ex rel. Wadhwa and Newton v. Admera Health, LLC et al (E.D. Cal.). Relators will receive $862,343 of the proceeds from the settlement.

The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the Eastern District of California, with substantial assistance from HHS-OIG.

Trial Attorney Elizabeth J. Kappakas of the Civil Division’s Fraud Section and Assistant U.S. Attorney Colleen Kennedy for the Eastern District of California handled the matter.  

The investigation and resolution of this matter illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to HHS at 800-HHS-TIPS (800-447-8477).

The claims resolved by the settlement are allegations only. There has been no determination of liability.

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When Tech Fails, It Is Usually With a Whimper Instead of a Bang

While in some corners of Silicon Valley people worry about the risks of A.I., a simple failed software update caused a worldwide outage.

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By David Streitfeld and Kate Conger

Reporting from San Francisco and New York

For a couple of years now, the artificial intelligence community has been warning that there is a chance their work will go south and humanity will end in a conflagration worthy of a superhero movie.

Friday brought a pointed reminder that disaster is at least as likely to creep in quietly, perhaps from a piece of technology so mundane that hardly anyone knows it exists.

Our lives are built on systems piled on systems. As we board airplanes, cross bridges, pay bills, download updates, track our children at camp and generally try to make it through the day, we take them for granted.

Until they fail.

This week’s global software outage, immediately proclaimed as the biggest in history, was not caused by terrorists or A.I. or rogue hackers demanding billions in ransom. It wasn’t even done as a lark by some off-the-charts smart teenager. Those are the Hollywood versions. Instead, it was a routine upgrade that somehow went off the rails.

CrowdStrike, a Texas company, specializes in protecting corporate clients from cyberthreats. It has been very successful at this. This time, though, the threat came from CrowdStrike itself, a problem for which it seemed unprepared.

The trouble began with a small Windows software update CrowdStrike sent to its customers on Thursday night. For some reason, this crashed every computer it touched. “Your PC ran into a problem,” users were cheerily informed. “It looks like Windows didn’t load correctly,” messages announced. The backdrop was the color of a perfect sky, also known as the Blue Screen of Death.

Any system can fail, and usually in unexpected ways. The Great Blackout of 1965, another contender for the greatest technology stumble of all time, shut off the electrical grid for 30 million people on the Eastern Seaboard. Silicon Valley couldn’t be blamed because Silicon Valley barely existed, but the culprit — a bad relay at a Canadian power station that caused a cascade of issues that broke the system — was equally mundane.

Living in the modern world is an act of faith. Most of the time we don’t think about it. Then the airplane we’re on shakes with turbulence. Or we read about how a door blew off. Or how planes crashed. Or — and this happened to people on thousands of flights on Friday — we can’t even get on the plane. It was worldwide pandemonium.

Planes are for obvious reasons a central theater of anxiety when technology is having a breakdown. But even those who weren’t trying to travel were upset on Friday. The computers couldn’t manage to get out of the passive voice to assign responsibility for their collapse, much less fix themselves, and the humans, at least initially, were not much better.

“It’s a mess,” Brody Nisbet, an executive at CrowdStrike, wrote on X as he suggested a possible workaround. “I’ve no further actionable help to provide at the minute.” He added a disappointed face emoji: 😞.

The message was later deleted.

CrowdStrike likely failed to do its due diligence, programmers said. Trying the patch out on a variety of Windows machines before sending it out to customers could have helped detect the issue.

“They should have had a test machine to emulate some of their clients’ old boxes and they would have seen the Blue Screen of Death,” said Matt Mitchell, a hacker and founder of CryptoHarlem, a cybersecurity education and advocacy organization.

CrowdStrike is not some tiny start-up. Founded in 2011, it has 8,000 employees and a stock market valuation that was heading to $100 billion, at least before the outage caused some investors to jump ship. CrowdStrike shares closed down 11 percent Friday.

If the company doesn’t have the name recognition of some bigger tech firms, it has its share of arrogance. A portion of its website is devoted to trash-talking its competitors. “ Microsoft’s security products can’t even protect Microsoft. How can they protect you?” CrowdStrike asks. Avoid Palo Alto Networks, it demands : “Don’t settle for a high-cost platform that’s hard to use, hard to deploy, and hard to manage.”

A message Friday from George Kurtz, the chief executive, seemed to minimize the outage, calling it “a defect found in a single content update for Windows hosts.” People complained that Mr. Kurtz was slow to offer an apology. (Hours later, he said, “I want to sincerely apologize directly to all of you for today’s outage.”) CrowdStrike did not respond to a request for further comment.

IT workers at affected companies were faced with a choice: walk around to each offline machine and remove the bit of flawed code, or wait and hope for a solution from CrowdStrike.

“The workaround works if you can walk to every laptop, type on the keyboard, and reboot it manually,” said Mikko Hypponen, a security expert and chief research officer at WithSecure, a cybersecurity company. “The problem that this poses is that normally large enterprises, which is what CrowdStrike customers are, maintain their fleet” with centralized controls.

In other words, the traditional way to fix a balky computer — turning it off and then turning it on again — was still the only solution, even as the computers themselves are now increasingly woven into worldwide networks. But the travelers trapped at the airport could not reboot those screens that were preventing them from flying.

What Mr. Kurtz called “a defect found in a single content update” is a modern-day threat. Only a few years ago, software updates were more complicated, more tedious. Every computer system was not linked to every other system, which meant failures were more contained.

“When it comes to cybersecurity, we talk about defense in depth — having a moat and then archers and a gate around the castle. We talk about having it set up where there is no single point of failure. But we are creating a situation where there is a single point of failure,” said Mr. Mitchell, the hacker.

People took the 1965 blackout in stride. The CrowdStrike outage disrupted but it has not yet been linked to any deaths. People have the weekend to complete their interrupted journeys. If CrowdStrike is lucky, the trouble will be forgotten within days if not hours.

Some day, though, the rest of us may not be so lucky, and some piece of boring technology — overloaded, neglected or poorly installed — will cause a genuine disaster. A software breakdown that causes a societal breakdown is probably better odds than A.I. bringing about world peace. The more networked the world gets, the greater the danger.

It would be a stupid way to go, as the poets anticipated long ago. “This is the way the world ends/ Not with a bang but a whimper,” wrote T.S. Eliot. These days, of course, he would add a thumbs-down emoji.

David Streitfeld writes about technology and the people who make it and how it affects the world around them. He is based in San Francisco. More about David Streitfeld

Kate Conger is a technology reporter based in San Francisco. She can be reached at [email protected]. More about Kate Conger