Survival Techniques for the Barely Insured
If you’re anything like me, you’re barely insured. I don’t work for a company that offers benefits and so I’ve had to shop for individual insurance. Setting aside what a headache that was, I’ve ended up with catastrophic insurance. This means that if I step off a curb wrong and break every bone in my leg, I won’t be in totally ruined. That said, I don’t get any help with regular checkups or routine care.
There are lots of things I do every day to help keep the Doctor away that go far beyond a simple apple. Every day, I work toward more optimal health and have learned that prevention is far cheaper than treatment. Not only do I consider my health to be my greatest asset, but staying away from MDs is a financial reality I’ve had to learn to navigate. None of this is groundbreaking, but let it serve as a reminder that just like your financial health, your mental and physical health requires daily attention.
Get Insurance
Yes, it’s expensive and you’ll probably never use it. I haven’t had to go to the Doctor since college. The what-ifs however, are too disheartening to ignore. Any sort of grave accident or surprise diagnoses, without insurance, would have me sunk. I have an extremely high deductible and not surprisingly, it matches my emergency fund. If you feel like you don’t need insurance at all, you don’t necessarily need get much, but get yourself something.
Stay Active
We’ve heard it before but that still it doesn’t seem to budge some of us. According to a study by the American Journal of Health Promotion, extremely overweight Americans have medical costs nearly 70 percent higher than those who fall into the normal weight range. It isn’t all about keeping weight off; regular exercise keeps joints healthy and prepares you for life’s tumbles. I mean that literally. I have a friend who hasn’t a good sweat in years break his arm because he fell trying to avoid a skateboarder on the sidewalk. It’s an unfortunate event that probably could have been avoided with a little increased strength and flexibility.
That said, for some, gym memberships, even to the YMCA, can be budget busting. You don’t need to throw money at the problem. You’ll have less cool machines and built in inspiration, but there are things you can on a daily basis to keep yourself agile without spending a dime.
- Walk as much as you can, even if it means parking in the back of the parking lot.
- Take the stairs almost always even if you’re like me and live on the fifth floor.
- YouTube your fitness. You have to look a little harder for quality, but YouTube is full of videos to help you meet your fitness goals. Whether it be a short yoga workout, some ab exercises, modified pushups, tai chi, parkours, you name it; type it into your search bar and give it a try.
- Attack the kitchen. Turn your canned goods into weights and know that a 10-pound bag of flour weighs the exact same amount as a 10-pound dumbbell.
- The local playground is my favorite gymnasium. After dinner, when kids are home, the monkey bars provide more challenge than anything I’ve found in doors.
Think outside the gym. Staying fit doesn’t need to be a full time job, but it should be part of your daily life. At least for me, I can’t afford not to. Good health pays dividends in the long run.
“Eat Food. Not Too Much. Mostly Plants.”
Michael Pollan’s simple beginning to his book “In Defense of Food” echo in my head every trip to the market. Yes, an apple a day helps, but reducing the amount of processed foods we eat will help keep the doctor away. You can learn to cook. Healthy food choices can be affordable, and more than that, in the long run, healthcare cost included, they’re cheaper. I’m comfortable taking my cues on this one from a few big bad corporations. Many larger corporations, such as REI and General Mills, have started programs to educate employees about nutrient dense foods such as kale, quinoa, and broccoli as well as change the options in the cafeteria. The reason given? It helps reduce cost with their company-provided health insurance.
Dental Hygiene
Of course, dental isn’t covered under my insurance. That doesn’t mean I’ll get some floss and remember to brush twice a day and consider it done. From everything I’ve read, such as the difference between hard and soft plaque, with dental hygiene, there are some things we can’t do ourselves. Here as well, the name of the game here is preventative over treatment based. It’s a lot cheaper to keep good dental hygiene than to deal with a severe toothache or infection. In short, get your teeth cleaned.
I get my time with a DDS on the cheap by going to dental schools. Students in the clinic are nearing graduation and are closely supervised every step of the way. It takes all morning, but here in Seattle, the dental school is, on average, 40% cheaper per treatment than nearby dentists. For schools near you, check out the American Dental Association website.
Eyes Peeled for Savings
Most who need glasses know it by now. If you’re not sure, it’ll save you a lot of discomfort to get your eyes checked. Frames however, can be expensive. I’ve heard a lot of success stories from people going to the brick-and-mortar eyeglass shops, trying on various frames, and then going home and finding them on ebay for substantially cheaper. Also, keep your eyes peeled for two for one deals at your local eyeglass shop so you can have a pair waiting in the wings.
For your reading glass needs, I’ve heard great things about this website which doesn’t sell any reading glasses for more than $10, often offering 3 pairs for that price.
Get Bodywork
Massage, chiropractic care, and other forms of bodywork can substantially reduce your healthcare bill. Yes, massage is relaxing, but more importantly it strengthens the immune system, keeps your lymphatic system running strong, and can make minor aches and pains irrelevant before they become major problems.
There are great deals for massage on Groupon and other similar sites, but it can be a total crapshoot in terms of quality. The cheaper, more cooperate massage places are a dice-roll as well. Local massage schools have clinics and are less expensive and often just as good, plus you’re legally not allowed to tip.
Full disclosure here: I have private massage practice. I can attest that I have bartered for everything. From oil changes to website design to fresh produce, I’m often up to trade a massage for whatever, and I’m not alone. Most of my massage therapist friends agree. If you have any friends or co-workers who receive regular massage, ask for a recommendation, send an e-mail offering whatever service you can offer, and you may be surprised by the response. I’m not saying all massage therapists will do this as we are supposed to report any bartering to the IRS, but from my experience, most of us are up for a good ol’ fashioned barter.
Keep Your Mental Health In Order
Your mental health is just as important as your physical health. If you feel like you might have any minor mental health issues, there are a number of things you can do to address them on your own. I was raised by a Licensed Clinical Social Worker and I’ve often heard my mother give the following advice:
- Make sure you’re getting enough sleep
- Consult self-help books
- Discuss issues with close friends
- Look at your ratio of work to play and work to reduce stressors
- Cultivate your simple joys and do things bring you pleasure
If you ever feel like you can’t manage your feelings, take advantage of free mental health screenings, primarily offered during the month of October (national Mental Illness Awareness Month). Check out the Screening for Mental Health website for a location near you.
Many therapists also offer a sliding scale session based on income. Check out Psychology Today therapist finder for one in your area.
Be Mindful
Yes, accidents happen, but most of my accidents happen when I’m doing one thing with my mind in a totally different place. When I first started massage, one of my first days of appointments, I was making breakfast tacos, going over techniques and routines in my head while slicing an avocado and slid the knife right into my hand. I had to cancel appointments for an entire week.
Staying mindful of what I’m doing is one of the best preventative lifestyle choices I make. It takes time, attention, intention, and constant training, but not only am I living more in the present, but I’m far less likely to slip on a banana peel.
Minimal insurance isn’t for everyone, but for those of us who are barely covered, we need to take extreme care of our bodies every day.
How can you emphasis prevention over treatment? What are some of your ways of circumventing healthcare costs?
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There are 106 comments to "Survival Techniques for the Barely Insured".
These are some great tips. Luckily I’m fully insured because of my job but if I wasn’t I think it’d be pretty stressful. Staying active, eating healthy and getting enough sleep are definitely good tips and are something I need to work on more.
Allow me to add an extra one for the end:
Be prepared, financially and emotionally, for when things don’t go quite as planned.
Easily the most difficult part, for me, of being diagnosed with Rheumatoid Arthritis was the emotional part. Silencing the voice in my head that kept screaming “but I did everything RIGHT!”
I emphasized prevention, I ate right, I exercised regularly, and yet, my body was hijacked (yes, that’s what it felt like) by something I just couldn’t control.
Now, several years on, I’ve necessarily come to develop a different relationship wih my body, but those first long months of feeling outrage and even betrayal were really really hard.
Build yourself a toolkit as part of your preventative strategy: an emergency fund for urgent care, possibly a longer-term fund for possible long-term drug costs (biologics are *expensive*), build your mental resilience, train your patience muscles, practice forgiveness (especially of yourself) and have some plan B and C dreams that you can turn to for hope and motivation when plan A gets sidelined.
I am another one who did everything right and ended up sick. I have a disease that in prior years was almost always automatically fatal, but, thanks to modern science, can now be managed for several years with some very expensive medications. I am thankful that dh and I lived a low debt load/high savings lifestyle while I was healthy so that we have a cushion to pay for my very expensive medications. Those medications will allow me to see my kids grow to adulthood (hopefully). But I’m also happy that I have a plan B and a plan C for my life.
i would hit the “like” button a dozen times more if I could 🙂 Lifestyle choices can have a big impact on our health, but they aren’t the only factor.
I second the idea to control what we can control, and be ready for what we can’t.
This is a really great reminder! I know I have a tendency to be a little too self-congratulatory sometimes because I take my vitamins and I maintain a healthy weight. But, I do realize that most of my good health is a combo of dumb luck in the genetic lottery and age – I haven’t hit any major age-related issues yet.
I am also reminded every time I run for the bus that I really should do more aerobic exercise……
I could not have said it better. All the prevention in the world (and I did it all) could not prevent me from being diagnosed with a non-preventable, non-curable chronic illness at 30.
Besides having a very large savings and retirement account, there is nothing that could prepare you for the financial hit. Unfortunately I didn’t have those things so it hit me in the worst way.
Between the loss of wages from having to go on short-term state disability and eventually long-term/SSDI and the insane amount of money I had to pay out-out-of pocket for health care expenses every month before Medicare kicked in, I thought I would never get out of the hole I was in – emotionally and financially.
Thankfully I’m back at working part-time and I have Medicare, but my life financially will never be the same. Life will never be the same.
In terms of prevention, it helps. If I didn’t eat a very healthy, strict diet and exercise as much as I do, I’m sure I would be worse off.
Unfortunately prevention isn’t everything.
I have RA too, and may I just say that that is excellent advice, beginning to end. Hugs to you, my dear.
I was diagnosed with RA 14 months ago…and I’m still angry. And no, I didn’t take care of myself, but that is altogether another extremely long story. Regardless, I’ve taken on the added expense of trips to doctors, copays, etc. Plus I’m working diligently to lose weight and exercise cautiously.
Thankfully, I can still work full time. But who knows for how much longer? My husband and I have had to reconsider our retirement plans. Long road trips nearly kill me, so don’t think I’ll be full time RVn.
I am very thankful for the “good” days and try to spend more time with my husband, children and extended family.
Best wishes Kate!
I am another one who was hit by a rare chronic illness that, while not fatal, leaves me unable to work and is expensive to treat. I urge people to get disability insurance if it’s affordable because, well, you just never know. Like Kate mentioned, the emotional part of illness can be devastating. For me, it’s the issue of not working and being unable to contribute financially other than disability income. Being on disability is in itself rather damaging to self-worth. Frankly, many people see disability as just another entitlement program for lazy people who don’t want to work. I’d love to be able to work again.
Massage is my best friend, BTW. Wish it were covered by insurance (it was in Washington state, but nowhere else I’ve lived).
My last employer in California (a year before I was diagnosed) offered disability insurance as part of their benefit package and thank goodness they did. Though its not enough to live on completely, its a great monthly supplement to my income.
Keep in mind that having disability insurance does not always mean you will receive payments. I have had a chronic illness since age 12, and I worked until last year at age 32. The insurance company denied my claim because they feel that if I was able to work before, then I should be able to work now. They do not recognize that my condition got worse, and of course there is a financial benefit for them if they deny my claim. So now, with no income coming in (and I am single, so there is no spousal income), I still need to pay my bills, plus pay a lawyer $8000 or $9000 to fight the disability company. I am applying for SSDI, but that won’t come through until 2013 at the earliest. My point is that having a lot of savings has made a huge difference. Always save up. In the best case you’ll have extra for retirement and in the worst case you’ll avoid eviction from your home and be able to pay for medication. Good luck to all of you who also have chronic illnesses!
my sympathies. I’m also from the school of doing alot right, at least, but life (and death) happens. My elderly mom needed care, then home hospice, then passed away leaving me executor. In the meantime I had to bailout of a career change (all but dissertation in an expensive phd program), my first career took a nosedive, I injured my back and needed spine surgery and so on. As for RA, I think when people hear “arthritis” – they have know idea just how bad this can be. Rheumatoid, your body and immune system turned against you. That’s a rough one and those meds are expensive (not to mention concern about side effects). I think the pointers mentioned here (all of which took me by surprise – I was truly expecting tips about insurance per se) are just excellent. Time for better body and mind care. Good luck and best wishes to you.
I think these tips are good for EVERYONE not just those “barely insured”. My husband and I fall under the “family” plan for our insurance despite not having children, so our deductible is $10,000/yr. We do get preventative treatment covered, but we’re looking at meeting our deductible this year, unfortunately. As Kate mentioned, you can’t account for everything (we’re facing that now) but having as many ducks in a row before hand goes a long way. All of these tips apply to us despite being “fully insured” because, as they say, an ounce of prevention is worth a pound of cure. Thanks for the great post!
Yessss! I think sometimes we fall into the trap of thinking that because we have financial resources, we can buy our way out of most problems. Some problems can’t be fixed, no matter how much we can afford for treatment. Lifestyle choices are just one piece of the puzzle, but it’s a piece I’d rather have in place than not.
I’m digging the message here, not always heard in the PF/frugality world.
“Eat whole foods!? But, there arent any coupons for those!”
Thats right, invest in yourself and your health. What a novel concept.
So you haven’t been to the doctor (even for checkups) since you were in college, but you consider massage and chiropractors to be a good money saving tip?
How about get checked out by an MD every few years to make sure everything is working ok and you don’t have any indolent medical problems. Doctors aren’t just for when you’re sick. Most high deductible plans (although maybe not yours) cover preventative care.
I work at a hospital and I see plenty of people that were “so healthy they hadn’t seen a doctor in 30 years”. They get cancers, strokes, and heart attacks, too.
I agree. I’m an advocate of yearly physicals because I know quite a few people who have had health issues caught early because of routine checks and screening. (I also know people who ignored their yearly check-ups and suffered the consequences, but that’s another story.) Some conditions like high blood pressure and diabetes are usually found through routine tests because they have no symptoms in their earliest (and most treatable) stages.
When it comes to routine tests, you also need to establish a baseline when you’re healthy. Some people don’t fall within the normal ranges, so routine tests can let a doctor know if things are “normal for you” or if there is an underlying problem.
I think you could push this to every two years, at least that is what my internist recommended for a healthy person in their thirties. We have our blood work run every two years as well. It is expensive but important.
And ladies, please please please stay current on your annual exam. One of my husband’s coworkers was diagnosed at 30 with Stage 3 cervical cancer. I don’t know for sure, but it is likely she contracted HPV in her twenties and let her annual lapse for a few years. You can get it done for less at a clinic like Planned Parenthood if insurance is an issue. I actually get a $50 gift card from insurance each year for doing my annual.
But I did hear from my OB that the rules are changing and if you’ve never had abnormal results, that it might in the future be every 2 years.
Caveat: not all cervical cancer is caused by or related to HPV. Yes, annual screenings can help treat any STIs that are contracted (provided your gyno does STI tests with the PAP, not all do) and can help with early detection. But cervical cancer can and does occur independently from HPV, so I wouldn’t jump to conclusions.
I agree wholeheartedly about establishing baselines. Growing up with a nurse for a mom (and a dad who was once an EMT) I was taught at an early age to know what my baselines are. I know that if my blood pressure is 120/80, it might be normal for someone else, but it’s high for me (normally 100/65). When I was 23 I got my cholesterol checked for a “baseline” value and surprise! it was borderline high – genetic predisposition on both sides of my family. By changing up my diet and increasing my exercise I was able to knock 15 points off the first year and keep it down. I still really miss pepperoni though 🙁
In Colorado, Channel 9 sponsors an annual health fair where you can get the usual blood and some other tests done for very little.
I would still try to see a general practitioner for an annual exam. When I didn’t have insurance, I worked with my doctors regarding the cost of xrays, paps, annuals, blood work, etc. Maybe I am lucky, but I was surprised how much less they charged me than they charged the insurance company. It is worth talking to a doctor to see what options you have. They are there to help you.
Sometimes I wonder if health care providers infalte their rates in order to get enough payment from the insurance companies to cover their costs and make a small profit. The difference between a doctor’s rate for a procedure and what the insurance company will pay out can be pretty large, and if someone who is blessed with really good coverage they don’t have to make up the difference.
I wonder this as well. Our system is so messed up.
Allow me to add my voice to the “I did everything right and I still got sick” chorus. My amazingly healthy 19-year-old daughter was struck down by Guillain-Barre syndrome. Within a couple of days she was paralyzed up to her eyeballs and on life support. Luckily she was attending a university with a great medical center, and luckily we had insurance.
She didn’t do anything wrong per se. But sick happens.
Sometimes it happens stealthily. Years ago I interviewed a guy who made a living leading treks up Mt. McKinley. During the off season he paid $20 for a blood panel at the local Health Fair because — like so many other self-employed folks — he had no insurance.
The test indicated a kidney issue. Turns out the organs were failing. But he felt fine.
The heads-up meant serious medical scrutiny. Ultimately he needed a transplant.
That’s an extreme example, obviously. But I think about hypertension, aka “the silent killer,” cancer and other ailments that if detected early can be managed/cured.
Use this link to look for health care centers at which you pay based on your income (or lack thereof):
http://findahealthcenter.hrsa.gov/Search_HCC.aspx
Donna, thanks for the comments and that extremely useful link, and very best wishes to you and your kid.
I agree, but I also know that the check-up intervals can differ for men and women. So I should get an annual physical, but my boyfriend only needs a physical every 2-3 years so far. I imagine that as he gets older that recommendation will change.
If only it were that easy!
As a Canadian, my basic healthcare is covered, and my work provides insurance for the “extras”–massage, eyeglasses, dentist, etc. However, I do not have a GP/family doctor. I have been living in this city for 8 years, and still have not found one due to our huge shortage. So for me and my husband, an annual exam means taking a day off of work to sit in a walk-in clinic and HOPING that a doctor will see you, which is usually not confirmed until 2:00 PM. We are on a provincial waiting list for a GP, and I also call all the local clinics once a month to ask if they’re accepting new patients.
I am hoping to get pregnant soon, and am unable to schedule a pre-pregnancy check-up.
Ugh. I have nothing to contribute here, just needed to moan for a moment.
Great article!!
Ugh. The lack of GPs in our country, especially mid-sized cities, is appalling. My family doctor retired fifteen years ago … and we have not for the life of us been able to replace him.
Although to be fair, the only time we actually saw the GP was for physicals seeing as he was always booked months in advance. No taking your bronchitis there.
When Massachusetts passed its mandatory health insurance law a few years the demand for GPs spiked! I went to a healthcare panel at Boston University where one of the panelists said that even if the US went with universal healthcare there’d still be problems because the country doesn’t have enough primary care physicians to meet the demand from more insured.
So, in the US, it isn’t just the way health care providers are compensated and how patients are insured that’s a problem, but it’s also the number of physicians willing to go into primary care 🙁
Absolutely! – your massage therapist is not checking your cholesterol and triglyceride levels!
The YMCA actually can be cheap. My wife and I don’t really have the money for a fitness club, and so when we presented our financial case at the Y they cut our fee by a lot. We almost pay nothing. Big chain gyms with TVs and workout instructors in spandex shorts probably won’t give you a deal, but the YMCA is great for helping out families that are financially strapped.
Community center gyms and exercise programs are also often quite inexpensive!
I agree that it requires effort to live healthy on a budget. To Tim’s recommendation of YouTubing fitness, I have found http://www.sparkpeople.com to be very helpful. The website is free and is a good resource whether you are losing or maintaining a healthy weight. In addition to the hundreds of free fitness videos they have, they provide a way to track food and suggestions for improving your lifestyle.
I agree that an ounce of prevention is worth a pound of cure. It was nice to find a website that enabled me to do that while not requiring a significant amount of my budget.
I think your lifestyle tips are great, but I think your recommendation of not seeing a doctor unless there is a catastrophe is a bad idea. Just like dental care, checkups by a doctor are a part of preventative health can save you money in the longterm. It doesn’t have to be every year. Even every 5 years for basic blood work and a physical helps head off real problems. Men tend to ignore this for a good part of their lives but wouldn’t it be better to know your cholesterol numbers and blood sugar count? Women should go to the doctor more often than 5 years. PAP and general pelvic exam recommendations have changed recently and an annual exam may not be necessary. If I continue on I’ll get political, but you should see a doctor enough to know how your internal system is doing before noticeable warning signs.
The Affordable Care Act i.e. Obamacare REQUIRES that the coverage of routine prevention visits and tests are covered through any insurance you have. It’s part of the law that went into affect immediately after it was signed. I have a $15,000 deductible plan, but my check up, pap smears, mammograms and colonoscopy etc are all covered for free, and my rates didn’t go up to offset the cost of these tests. I expected that but it didn’t happen. Get your routine care! I love Obamacare!
YES! I was pleasantly surprised this year when I didn’t have to make a co-pay for my annual physical! I also don’t think I had a co-pay for my mammogram, either…
Actually this isn’t completely true – some older plans will be “grandfathered” in, so you might have to switch to a new plan to get that benefit.
By “catastrophic plan” do you mean a high deductible plan? I ask because for many high deductible plans wellness visits are covered 100% and you should be taking advantage of that. Also, when you pay out of pocket for services you pay a negotiated rate, not the sticker price, the difference can be significant. You may very well find that medical treatment is affordable out of pocket in these instances and that you don’t need to forgoe check ups and care for minor issues (which can turn into big issues if left alone).
Excellent post! There is a lot to think about here (said another barely self-insured person…..) My own approach to maintaining health is walking as much as possible and eating as little processed food as possible, and it works surprisingly well.
I don’t have a lot to throw into this conversation, except that dancing is an excellent activity for staying active. Dance lessons are often pretty expensive, though I’d guess at a lot of colleges you can find student groups who’d be happy to have extra members and teach you how to move.
Or just turn on the music and start moving.
LOL, its not the same.
These survial tips and prevention approaches should be considered by people regardless of insurance status. If one doesn’t have much insurance, really try to exhaust options looking for it. Medical bills can be incredibly high without the right insurance, and it’s not wise to think that other maintenance measure will be a foolproof way to avoid problems.
My husband and I also carry a high deductible plan with no office visit coverage. That’s fine because we rarely go to western medical doctors for anything.I see a naturopath once a year for my annual check up– for $100 she spends one full hour with me and we go over mind,body and spiritual health issues and I get my Pap done.
We recently moved and I fell into UTTER EXHAUStiON due to overwork,stress, etc.I had an acupuncturist who does incredible work.She charges $65 for an office visit/treatment and I see her once or twice a year for various tune ups. It works!!!!!!
My spouse is a chiropractor so I get adjusted regularly.We also trade massages with each other.I had someone give us a used table and we do half hour massages for each other maybe twice a month.
We often barter for other services,too.
All your suggestions are excellent!
I’d add: Find a couple of natural health practitioners you can see when you need to (before you need them) who have reasonable rates and give you REAL health care, not medicine!
And eat well, rest and relax more, and TRUST that your body does know how to be well! Read Dr. Andrew Weil’s books! And Dr.John McDougall.
GREAT POST!
Check again, I bet your office visits are covered now. The Affordable Care Act requires it.
Sorry, I meant your preventable care visits.
Actually – I believe we were asked:
“How can you emphasis prevention over treatment? What are some of your ways of circumventing healthcare costs?”
Seems like opinions and personal stories are right in line.
Regarding the dentist: When I didn’t have dental insurance, my dentist told me it would be fine to get a cleaning every 9 months instead of every six. (I have healthy teeth and apparently excellent hygiene. If you have dental issues, don’t listen to me!)
There is a myth that you cannot get any medical care without insurance, and I want to say very loudly that this is a very damaging myth.
Yes, there are some treatments that insurance will let you afford, but almost everyone can afford primary care.
If you have no insurance you have 3 options that I know about: 1) you can pay your doctor directly, 2) you can go to a clinic that will put you on a sliding scale fee, or 3) you can get subsidized care.
I am a patient at a local low-cost clinic and I can vouch for them. You can find one where you live on this website, and even if not every one of them on this website they list over 10,000 clinics in the USA:
http://www.needymeds.org/free_clinics.taf
These are often affiliated with hospitals and will refer you when necessary, you might even get a sliding scale plan in the hospital.
There may also be subsidized health care programs in your state or county. I get a type of insurance through my local university– one of the big reasons I live where I live.
If you have no insurance, please call your state, or better yet find a social worker who will know every resource available in your area.
Additionally, if you’re self-employed and in the right state, you can join the freelancers union for various kinds of insurance and other plans. Check here:
https://be.freelancersunion.org/benefits/
Body work can be great, but in my experience it’s expensive–an hour of massage where I live will cost me about the same as a self-pay checkup at the dentist ($70). And chiropractic treatment is probably good for your back pain, but it won’t cure hepatitis or rid you of parasites. So I stretch and do yoga for free (with DVD) and save my cash for prescriptions and that sort of thing.
Regarding self-pay, I have been doing that with dentists recently (more about that soon, ha ha). What I do is call the doctor’s office and say I want to make an appointment, and for what purpose, and then I say: “I am self-pay, how much will this cost me?” And they will look up and quote me a price in dollars and cents. If I don’t like it I can shop around.
Same thing when I’ve need a procedure– I ask for the exact price and they break it down for me: this much for this, this much for x-rays, etc. That way I can save up the money or pay from my savings or shop around. It often costs a lot less than we fear or imagine, certainly less than things like travel or a nice bicycle or regular spa treatments.
Anyway– insurance is one thing, but medical care isn’t all-or-nothing. Please explore your options.
Where is the “edit” button? Blagh!
I once saw a newspaper article where they called several hospitals in the area to see how much several kinds of common surgery procedure cost at their hospital. The difference in cost for the same procedure was quite stunning….so if you are paying for it, make sure you are shopping around first just like if you were buying a car.
Two minor additions:
For working out – check if your county has recreation centers with gyms, etc. They might not be the best equipped, but they can be a great cost effective way to access equipment you don’t want to own [mine runs me $15/mo].
For glasses – You can buy prescription glasses online for very cheap; like, $13-$55 cheap [lenses included]. It can be trickier/more expensive if you have an extreme correction, but even my straight-up terrible nearsightedness [-5.5 diopters in both eyes] is no problem.
I did a post at my MSN Money job about how to get glasses online for 5% to 12% cheaper (cash-back sites) and also how to get free eye exams if you meet certain income levels:
http://money.msn.com/frugal-living/post.aspx?post=1248178c-12da-4c97-b10d-bdc05ffd3a29
And another one about cheaper dental care:
http://money.msn.com/frugal-living/post.aspx?post=7cdb73bf-92e0-4fc5-a6d3-dfda31e257aa
And a third one about cheaper orthodontics:
http://money.msn.com/frugal-living/post.aspx?post=ee0dd5e0-df1f-40b9-9057-4ddfc49dae6c
Please don’t neglect your health on the basis that you feel just fine now. An ounce of prevention might not just be worth a pound of cure — it might also save your life.
There are some really great tips here! I rarely get sick and I correlate that to the fact I take care of my body.
I stay active; doing workouts in the park (for free!), walking, and riding my bicycle when possible. I take the stairs. I park far from the door. I carry my groceries home from the store.
I eat healthy; organic produce, whole grains, nothing processed. I have been vegetarian 10 years now.
I listen to my body and get rest when I need rest rather than push myself to get one more thing accomplished.
I do yoga; which for most people can be substituted for massages or chiropractic care. I know many people who have had chronic back issues and yoga has solved those issues.
And lastly, everything in moderation! Sometimes I have an issue with this when it comes to red wine though!
Mr. Everyday Dollar
I hope your luck holds. Don’t count on it.
I really like this article because it’s very hollistic. One of the main reasons I am looking to improve my financial situation is because of the stress created by not feeling secure financially. This article gives good tips and looks at the entire person, rather than simply looking for the most frugal options.
So, Tim, when you say you haven’t had to go to a doctor since college, do you mean that you simply don’t go to the doctor for anything, or that you go for regular check-ups but you just haven’t had any medical issue requiring you to seek care outside of the check-ups?
I’m also wondering how old you are – I’m guessing you’re young enough that you haven’t encountered any age-related problems, and you don’t need certain routine tests yet.
While I generally agree that these are good health tips in general (except for the “get bodywork” section but I don’t feel like talking more about it), what I really think is that the first item on the list should be, “get decent health insurance, even if it means getting a better job.”
Yeah, I know it’s hard, and not everyone is having much luck with it at the moment, but the site is “get rich” slowly, not “stay poor but hopefully at least not sick”. Sometimes the things that would really make a difference are hard, and that’s no reason to stop trying.
I also realize that it’s now completely out-of-fashion for young men to be prepared to support a family, but I can’t help thinking about my wife having our daughter with only catastrophic health insurance, or even routine care for young children with such insurance. But then maybe that’s why I went into engineering instead of massage therapy.
Advice doesn’t have to be gendered… I know many a gentleman on his wife’s insurance plan. I even know a couple of cohabiting couples who tied the knot because he lost his health insurance (would have gotten married eventually, but the lack of health insurance provided the catalyst). Women have an incentive to get and provide employer-based health insurance as well.
As Nicole says. My DH is self-employed and has been covered by insurance provided by *my* employers ever since we got married.
No mention of health savings accounts? If you have a high deductible plan you probably qualify to set one up. Your contributions are tax deductible, so it’s like getting a discount on your health expenses equal to your tax rate. At a minimum, if you know your physical/ whatever is going to cost roughly $400, just transfer that into your HSA before your visit and use that money to pay. The $400 contribution is now tax deductible, saving you roughly $80 – 100 if you’re in the 20/25% tax brackets. You’ll prob get the same rate of return as whatever your emergency fund is in.
THANK you!! Every time there is a health discussion here I mention HSAs, and none of the articles ever touch on them.
DH & I had high-deductible health plans for years through my employers. Being on an HDHP saved us *thousands* of dollars per year because the premiums were so much lower.
We saved the difference in a Health Savings Account, used the HSA to pay out-of-pocket costs when needed, and that money is ours forever, not like a “Flexible Spending Plan” where if you don’t use it, you lose it.
Right now we can’t use it because my employer doesn’t offer an HDHP. They are discussing it, but meanwhile I’ve asked DH to join AARP (he is just old enough) so we can quote *their* group HDHP. If we can’t get an HDHP through my employer, we’ll get it through AARP and go back to saving money specifically for healthcare.
Whatever money is still in the HSA at retirement age can be used for any purpose. Everyone should have one, tell your Congressperson that these should not be accessible only to people with an HDHP.
Yes, HSAs are great. In fact you don’t even have to estimate before you go to a visit. You could just wait until you get the bill, then transfer the money over (or even pay it in full with a normal account, then transfer some money into your HSA, then pay yourself back that amount). The only requirement is you had to had the HSA open (not necessarily the money in it) before you got the medical care.
Two caveats:
1) Be sure to keep the medical bills for tax records, usually 3 or 6 years for audits.
2) Many banks charge a kind of ‘low balance fee’ for HSA usually $2-$3/mo for balances under a few thousand ($2k-$5k), but shop around and find what works for you.
Not going to the doctor in years? VERY BAD MOVE. Preventive care is a heck of a lot less costly than the ramifications of a chronic condition that will affect your health for decades to come.
There are recommended guidelines on how often you need to go for a wellness visit that should include blood pressure, glucose, skin cancer exam, cholesterol check, thyroid check and more. Especially important for women is a pap smear and breast exam. Saving the $150 per year on an annual wellness visit isn’t worth risking having untreated diabetes destroying your vision, for example.
I think you’re overreacting a bit. Tim is what, 25? The chances of an otherwise healthy young man in his mid-20s having some sort of invisible problem that would change in any way if he didn’t miss an annual checkup or two are tiny. Even when I’ve gone to the doctor they haven’t done (nor recommended) most of the things you list. And you can check your blood pressure for free at most pharmacies.
Um, no, not overreacting at all. At age 21 I had two skin cancers removed that were discovered during a wellness visit. At age 25 I had severe foot pains. After conservative treatments failed, I was sent for an MRI. Turned out that the blood supply to a bone got cut off and the bone died (avascular necrosis). Had to have surgery to get the bone removed. Unexpectedly got pregnant while on birth control at age 26. Had the same bone in my other foot die at the age of 27 for the same reason. Unexpected miscarriage at age 30. Had a baby at age 31 then had severe PPD requiring hospitalization. Diagnosed with autoimmune thyroid disease at age 31.
All of these required regular physician visits.
I’m sorry about that, but you are hardly the typical case.
Also, you would have noticed all of those things (except maybe the skin cancer, but Tim lives in Seattle, so he’s pretty safe there) even if you didn’t go for regular doctor’s visits. I assume that if Tim had “severe foot pain”, he would visit a doctor, but he hasn’t done that because his feet feel fine. Presumably he’d also notice if he got pregnant, and see a doctor about that, too.
Just for a counterexample, I didn’t get skin cancer at 21 nor have the bones in my feet die for mysterious reasons.
I think you’re both right. Its not likely someone in their 20’s is going to get ill. But obviously it can and does happen to many young people and theres no sense in just avoiding the doctor because you’re young and feel immortal and the risks are low. Why gamble with your health?
I have great insurance (I work for a state institution) but I loved this article, too. My hubby and I are vegetarian, I cook most things from scratch, and I just started biking to work (should’ve started doing that years ago, saves money and is good for my health, plus I have found it is actually faster than when I drove!).
Great Article! I never knew that massages have all those health benefits. Does anyone know if myofascial release–foam rolling, lacrosee ball self massage–offers similar benefits?
My husband has chronic back problems, and he lives and dies by his foam roller and (I think) squash ball – especially the ball. He uses it every day, and swears it’s like getting a therapeutic massage for free.
Remember that it hurts like the dickens at the beginning, but that smooths out as your trigger points loosen. :0D
Self myofascial release has many benefits similar to those of massage. It is, after all, essentially self-massage. DH teaches SMR to all his physical therapy and personal-training clients.
Neither SMR nor massage conveys the same benefits, specifically to the internal organs, as yoga. A self practice that combines yoga and SMR is ideal for most people who don’t have joint problems.
Always work with a trainer first to ensure you are “doing it right.” 🙂
Very informative! I have great health insurance but it does not include dental. Previously since I was a child I went to Mexico for dental treatment (not the case now, less visits since there is more violence in Mexico now) My husband has to have 4 cavities filled before he has an implant put in. Here this would cost $1000. We are waiting until December to have this done in Mexico (which puts his implant on hold)…but now I am going to check dental schools! Will also look for reviews, I have not been impressed with Dentists here in the USA, from my personal experience.
The OP is already a staff writer. Seems kind of pointless to provide feedback on whether we’d like to see him as a staff writer — he’s already got the job.
Like articles, comments aren’t always useful for other readers. Why be a troll about it?
I have to second using massage as preventative care! I considered them a luxury, just a want, whenever my husband went. He finally convinced me to join him, and we’ve been going every month together for almost a year. I used to take frequent “mental health days” (about once a month) where I would wake up so overwhelmed and depressed that the thought of getting up and going to work made me sick. (And I love my job, so I knew it was internal.) I didn’t think about it at first, I was just enjoying the massages, but I realized just how better I felt! That, plus actual vacations planned and executed, a change in my diet (less sugars and no caffeine), and regular walks around the neighborhood with my hubby, has made me feeling healthier than I have in years (and I’m only 27).
I was throwing my back out with some regularity once I started an office job, until I started getting a monthly massage. $69/month to avoid total immobility? Sign me up! Plus even if it is medically justifiable, it just FEELS indulgent.
Do not go to chiropractors. They are not doctors nor are they trained like doctors. Ditto with podiatrists. If you have a problem- chronic back pain, hip immobility- go to a physiatrist, a doctor of osteopathy, or a physical therapist.
I lost interest after I read “You’ll have less cool machines”. Should be “fewer”. Common grammatical error; please proofread.
Also the three typos and the not-cited statements about General Mills (I noticed because I’m interested in reading about that).
I know people on here don’t generally like spelling/grammar corrections, but it really does take (some) people out of the article.
Some blogs that I read use Editz in order to allow readers to point out spelling or grammar mistakes. Might be something for GRS to look into.
What if it the comparison was qualitative, not quantitative? I read it that way– that the machines at the Y won’t be as cool as the machines in the fancy place (in other words, “moar uncooler”, ha ha).
Regardless, I think there are bigger ideas in the article that warrant discussion, and it’s a bit unfair to discard it wholesale because of minor grammar disputes (or is it grammatical disputes?).
(Speaking of grammar, I never know where to put the period in relation to the parenthesis. English is a crazy language.)
Whoa, El Nerdo. Talk about being on the same wavelength at the same time. You said it better.
Yeah, I think ours is a perfectly valid reading, which is less cool than telepathy, but the timing was funny. 😀
The period goes outside of the parentheses (but only if you inserted a phrase in parentheses into a sentence).
(However, if your whole point is parenthetical, then keep it inside the parens.)
Thanks! And with a question mark? Normally we don’t put a period after a question mark but here I felt it necessary after the parenthesis (yes or no to this?).
There’s an American way and a British way – being Canadian, I tend to go back and forth between the two.
http://grammartips.homestead.com/inside.html
Did he mean less cool as in “not as cool” vs. less cool as in “not as many?”
Thanks. Great article.
About saving money when you get glasses – you do not have to buy new frames with every new prescription. You can have the new lenses made for your old frames. All the tech needs is to take a few measurements on the old frames. When the new lenses come in, it just takes a few minutes for them to swap the old lenses for the new, and off you go. That can save you a bundle!
I recently cancelled my catastrophic insurance because I didn’t realize that AFTER I paid $10,000, I would have to pay 60% of the remainder, which, at $100,000, would clearly bankrupt me. I have supplemental insurance and the sincere desire to stay healthy.
“I haven’t had to go to the Doctor since college.”
Sounds like you’re avoiding annual preventative care checkups. I think that regular checkups with your doctor are part of preventative medicine. Your doctor shouldn’t be avoided..
Maybe you feel 100% fine, but you should still get regular checkups. Hows your cholesterol level and blood sugar? I don’t expect you’re getting that checked without doctor visits and without knowing the levels you’ll have no idea if theres a problem. People who seem perfectly healthy otherwise can have issues they’re unaware of.
The cost of healthcare is so high now, if you have savings, you need to protect yourself and have some sort of health insurance.
When people tell me, “I’ll just be careful”, I tell them of a co-worker who chose no insurance. A healthy, trim, fit, health conscious 30 year old that happened to slip on ice one day. He walked around on his “sprained” ankle for 3 days, not wanting to pay for a doctor’s visit, thinking he could “tough it out”.
Finally he went to a doctor to find that he’d broken the ankle, needed an operation to pin the ankle bones after having walked on them for so long. $10,000 later, he asked area social services to help, but he still ended up owing $2000+. Last I heard, the ankle still isn’t “right”, but the person is too afraid to rack up more debt by going back to the doctor.
In my own case, hubby (provider of the family’s health insurance) was outsourced a few years ago and I was forced to find coverage not as good as I would have wished. Of course, this is when I messed up my back, lifting something WAY too heavy. After “toughing it out” for a half year, heat & ice therapy, lots of OTC pain/anti-inflammatory pills, a CAT scan and chiropractor visits and PT (after new insurance kicked in), I bought a barely used inversion table on eBay for $50. I use it each time my back starts to bother me and I swear I can hear the discs slipping back into line/place. I also go 4X’s a week for an hour to an exercise dance class that includes weight bearing exercises at the end. I am all for preventative lifestyle changes for general good health, but with healthcare costs going thru the roof, you really need at least the catastrophic plan.
“I have an extremely high deductible and not surprisingly, it matches my emergency fund.”
Then you’re Emergency fund is NOT ENOUGH. If you need expensive long term treatment starting in, say November, using up your whole deductibe and continue expenisve treatment into Jan the next year, you will need to come up with TWO YEARS deductible in those three or four months
Generally I think this was a good article and should be taken seriously by those who currently carry NO insurance.
Given that a high percentage of U.S. bankruptcies are due to medical expenses, health insurance is one of those things that – while you may never need it – if you DO need it, and don’t have it, you can be wiped out.
Someone young might get cheap insurance while in college or before age 24, stay on the insurance for about five years, and during that five years get regular checkups to establish your baselines and discover any of the conditions that typically don’t show up until you are fully, physically adult.
Also during that five years, of course, start establishing the healthy habits that will maintain you in the best possible health.
After age 30 if you have not manifested any chronic problems and if you are in good health according to your doctor, many people might safely drop insurance and simply “self-insure” by saving that money instead.
HOWEVER … as long as insurance companies are financing election campaigns, and if the ACA is voided or gutted, be aware that any condition that manifests while you are uninsured becomes a “pre-existing” condition that will functionally prevent you from achieving coverage, at anything close to an affordable price, later in life.
Over a lifetime it is probably cheaper to maintain high-deductible insurance than to move in and out of plans and run that risk of losing coverage exactly when you need it.
Do they have a written guarantee that they will never be injured in an unwanted event like a car crash? EVERYONE needs insurance.
“many people might safely drop insurance and simply “self-insure” by saving that money instead.”
No, you can not ‘safely’ drop health insurance. Thats a huge financial risk and liability.
1 in 10 people age 15-44 end up in a hospital annually. (maternity, broken bones, misc. illness)
Sorry, this site has become too mainstream. Haven’t found anything here over the last year or so (with the exception of Donna Freedman) that isn’t touted on every mainstream news site, financial blog, talk show, self help, blah blah blah.
This has become less about thinking and more about doing whatever every one else is doing and dissenting viewpoints are no longer credited or welcome either by the publisher or the group of active readers now congregating. It is all about how to jump through someone else’s hoops instead of how to create your own path.
There is a difference between stuffitis and storing in times of plenty, for lean times. There are innate problems with relying on just-in-time inventory, -money, -investing, blah blah blah–that are simply glossed over or not mentioned. There are big problems with our banks so “finding the right one” is an effort in futility. The same players are actively involved in the current and ongoing collapse of Europe but here you promote investing in these entities. There is no more thinking outside the box here.
I’m done. The emperor sold his clothes. It’s been nice GRS but I’m removing my notices and unsubscribing. Nice knowin’ you JD…good luck in the future; I’ll try to remember to check in with your personal blog.
Please, someone check his grammar.
Tim:
You’re hitting on several of the most important keys to healthy living. What I’d like to hear more about in a future post are the barriers that people face, and how to overcome them.
For example, why don’t most people who are uninsured get coverage? What stops us from staying active and are there creative solutions?
Also, the barriers to eating vegetables, dental hygiene, and preventative care?
Let’s keep this conversation going in future posts.
I find the moniker of “barely insured” completely incorrect. Catastrophic insurance is by no means “barely” insured. Having a limited benefit insured plan that only covers wellness visits and a few doctor’s office visits a year is barely insured. A catastrophic insurance plan that covers expenses above $5000 is what insurance was originally designed for. I understand that a wellness visit can cost up to a couple of hundred dollars a year, this can be budgeted for, and as a previous poster pointed out, with an HSA or a plain savings account the deductible can be planned for. My husband is 50 years old, in good shape, and pays $150 a month for a $5000 deductible plan. We decided it was better for him to keep his individual coverage than join my HSA group plan.
You make a good point. Tim may represent the generation that grew up thinking that the HMO was the “normal” insurance situation.
As you correctly note, insurance used to be about covering those disasters that can’t truly be budgeted for – the accidental injury or out-of-the-blue diagnosis.
Over the past 40 years, health insurance instead has become about covering the preventive care that we all should be taking care of for ourselves. Most middle-class people can afford to pay out of pocket for a wellness visit every year for everyone in the family. It’s simply a matter of making that a priority.
On a HDHP, DH and I paid $300 a month for comprehensive coverage. On a regular PPO, we pay $600/mo. That is $3600/yr that could be going into a new-car fund (or into an HSA!), a college fund, a house fund, an emergency fund, a vacation fund.
So I am highly motivated to get back into a HDHP. 🙂 I would much rather pay $125 out of pocket (or out of HSA!) for the clinic visit if I catch the flu, than $3600/yr for … nothing.
I liked the article…too few people pay attention to their insurance. If/when your body does not co-operate, your financial life will be saved from ruin by being insured. However, even if you have great insurance, it is important to police your medical statements! I think this is as or more important than reconciling your checkbook. My daughter has a recurring medical problem and by paying attention to the details, and contesting some of the benefit statements we have saved a minimum of $3000/year. Once we saved Almost $10,000. Definitely worth the time you put it in going over it…even if it is a pain!
Great article & relevant, to us, we are transitioning into self-employment and have been self-insured now for 9 months. We too are doing the high-deductible HSA. The great thing about the HSA is that up to $6k is tax-deductible. This is the only way I know to actually get any money back from your healthcare.
While some shopping around makes sense, personally I am not inclined to use the lowest bidder for my surgery.
Just want to chime in on the bartering system. For the past two years I have been trading twice-monthly English lessons for massages with a young Chinese lady (a qualified masseuse and reflexologist). I always feel that I am getting the better part of the deal, especially as she insists on feeding me lunch afterwards. I couldn’t do without my massages. I think that bartering works really well as long as both sides are perfectly clear about the deal. I hope my arrangement works for a long time, and I hope she does too.