Tuesday, Sep 28, 2021 • 21min
The Real Cost of Staying Healthy
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Even if you have insurance, health care is expensive in the U.S. Today’s guest has been struggling with mental illness for more than a decade—and in April of this year, her physical health suddenly spiraled. Taking time off for a surgery, recovery, and specialist appointments meant lost wages and major medical bills. Now she's trying to safeguard both her health and her bottom line—but she's not sure how to budget for unexpected medical expenses.
Expert: Bola Sokunbi of Clever Girl Finance
For more on the topics covered in today's episode, visit glamour.com/money.
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Speakers
(2)
Samantha Barry
Bola Sokunbi
Transcript
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Break
00:14
With getting sick in the last six months, I really, the numbers keep piling up and my income keeps tumbling down. So it's really, really been a hard couple of months with my perspective on our financial situation, it feels really grim.
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Samantha Barry
00:37
I'm
Samantha Barry
, the editor in chief of Glamour
and this is She Makes Money Moves.Share
00:43
Even if you have insurance, healthcare is expensive in the
US
. According to a 2020 survey by the Kaiser Family Foundation
, an American worker with job-based insurance will have to spend, on average, about $6000 a year to ensure her family. And that's after her employer kicks in more than $15,000.Share
01:06
She'll also spend on average more than $1600 a year per person to cover deductibles. Lowering the cost of health care has been on
President Biden's
agenda since before he took office.Share
01:18
We're going to do everything in our power to ease the burden of healthcare on you and your family, tackling costs, increasing access, lowering the price of prescription drugs. Families are reeling really right now.
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Samantha Barry
01:31
For some women, of course, the costs are much, much higher.
Share
01:35
Unfortunately, my therapist does not accept my insurance. And so a therapy session with my therapist is about $120.
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Samantha Barry
01:43
Today's guest, who we're calling Lauren to protect her privacy, has been struggling with mental illness since she was in high school in the mid-2000s. In April of this year, her physical health suddenly spiraled. She started experiencing pain around her period that wouldn't go away.
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01:60
Doctors first diagnosed her with endometriosis, which can be treated but not cured. But since then she's been told by multiple specialists that that diagnosis was incorrect. So she's still looking for answers. This is her story.
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02:14
Hi, my name is Lauren and I live in
Virginia
. I struggled with depression in high school and through college. After college, I really was struggling with what seemed like depression but I'm pretty sure it was really bad PTSD from a sexual assault that happened in high school.Share
Samantha Barry
02:30
Lauren continued to struggle through grad school, while she was working towards her Master's degree in social work.
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02:35
So that came with me through graduate school, which was really difficult, because graduate school was tough to balance. Work and school and internships and mental health..
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Samantha Barry
02:45
Despite her struggles, Lauren finished grad school in 2014, immediately started working, and got married in 2015. When she got pregnant in 2017, she decided to be more aggressive with her mental health treatment.
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02:59
When I got pregnant I knew I needed to get my trauma train back on track, and kind of take care of my mental health, so that I could really focus on being a mother.
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Samantha Barry
03:10
One thing that helped? Equine assisted psychotherapy.
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03:14
That really touched in places that I wasn't able to do with just plain talk therapy before. After the birth of my daughter I felt really good, things were going great. And slowly but surely my mental health started to decline. And I actually started seeing a therapist for perinatal depression which is depression that happens after a baby.
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Samantha Barry
03:36
While working and raising her daughter, who's now three, Lauren has continued to prioritize her mental health.
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03:42
I always prioritize my mental health, but now I have this little kid that's like, depending on me, for me to kind of be healthy. And so the past couple of years I've been in treatment as needed and working on my mental health, and really promoting self-care for myself, for my kid, for my husband.
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Samantha Barry
04:01
But as Lauren was prioritizing her mental health, her physical health became a concern.
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04:07
And in April I was having a lot of pain that was not my normal cramping related to my period. And so I actually ended up in the emergency room, and after about three hours the doctor said "We don't know what's wrong. We're going to send you home with some pain medicine".
Share
04:24
And I looked at her and I said "I just met my deductible and my coinsurance, and I'm going to need to speak to the GYN hospital list, because I don't think I'm going to stay out of the emergency room if you just send me home with pain medication". And so that doctor came in and he sat down, he looked at me and he asked me to start my story from the beginning.
Share
04:46
And he listened to everything. And he said "After listening to you, it sounds like you have endometriosis. And I'm really sorry because I've had a lot of patients with endometriosis and it's really hard, and I really hope you find a team that can treat it for you because it doesn't have to be". And so that day I got on the computer and I started googling furiously.
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Samantha Barry
05:10
Lauren's emergency room visit had been on a Saturday, and the following Thursday she was in surgery. Her doctor removed a small piece of what they thought was endometriosis and then put her on birth control as part of her long-term treatment plan. But the birth control left her in such severe physical pain that Lauren, who's now working part-time as an outpatient therapist, had to cancel appointments with her patients.
Share
05:37
When I get sick, I don't have a cushion, I don't have time off. So when I get sick, if I can't put it back in my calendar for that week, I don't get paid for that session. So I just don't have the ability to cancel.
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Samantha Barry
05:49
Lauren decided to quit the birth control and find a specialist to help her devise a new treatment plan, which of course meant spending more money while losing hours that she couldn't work with her own patients.
Share
06:01
I actually had to change my schedule and see a specialist three hours away. We incurred $3,000 in healthcare bills, and we've paid off almost 2000 of them, and they still haven't stopped coming in. So I already had the feeling like, I needed to work and work and work to make money. And now I have time that I have to take off and big, big big bills.
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Samantha Barry
06:28
More on She Makes Money Moves right after this quick break.
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Break
Samantha Barry
06:57
I'm
Samantha Barry
welcome back to She Makes Money Moves.Share
07:01
Lauren is dealing with some major medical bills. In addition, a lot of her money goes to her therapist.
Share
07:06
I think my therapy bills just for therapy alone are about $6,000 a year.
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Samantha Barry
07:12
There's also the cost of her horses, which she uses in her own therapy. Before 2020, she also used them with her patients as part of a nonprofit she had set up. But she was forced to close the non-profit during the pandemic, which meant those costs are now an additional personal expense.
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07:29
The cost of my horses to maintain is at minimum $1,000 a month. And I know that seems silly and I am very, very, very privileged. I never want to leave that out, that I recognize that I am very privileged to have that option.
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Samantha Barry
07:46
She and her husband also have a mortgage, car payments, about $6,000 in credit card debt, and her student loans. There are also the expenses that come with raising a child, plus saving for her education and paying for activities.
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08:00
But right now we've had to put a pause on most extra spending, because we have medical bills that are taking precedence.
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Samantha Barry
08:08
Lauren is unsure of how to manage her finances when she has no idea how much it would cost to treat her mental and physical health long term. The latter is extra hard to plan for, since she still doesn't have a clear diagnosis.
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08:22
How the heck do you balance having incoming medical bills and still trying to stick to a budget? Because I don't know how to plan for unexpected medical bills. This is even harder than I ever thought possible.
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Samantha Barry
08:40
She's also having doubts about how she and her husband have spent their money in the past.
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08:45
Did I make a mistake in growing my family and buying our dream house, and doing all the things to be happy?
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Samantha Barry
08:53
And she's unsure if she should continue to work part-time or look for a job and an agency, which would mean more steady work, but also more pressure.
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09:03
I just, I have a hard time figuring out which is more of a priority, especially when I know my choices are gonna directly impact my family and also my physical and mental health.
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Samantha Barry
09:28
For today's episode, we're welcoming expert Bola Sokunbi.
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Bola Sokunbi
09:32
My name is Bola Sokunbi and I'm the founder and CEO of Clever Girl Finance.
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Samantha Barry
09:36
There's so much to unpick with Lauren's story. That, there was a lot that honestly probably worried me about where she is financially, but listen, there's always a baseline and it's moving forward to where you want to be financially.
Share
09:49
One of the things that definitely came up in her story that I think we need to dig into is unexpected medical bills, what that does to somebody's budget. How do you set yourself up for these unexpected medical bills that come up in your life?
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Bola Sokunbi
10:04
So, when it comes to medical bills, especially in
America
, they can be incredibly expensive. And depending on what the health issue is, the associate bill can derail your finances in a major way.Share
Samantha Barry
10:17
Right. Lauren has health insurance through her husband's job. And even with that insurance, she suddenly owed the hospital $3,000.
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Bola Sokunbi
10:25
Key thing here, if you are employed or you have the budget, having health insurance should be a non negotiable if you can afford it. So, if your employer has open enrollment and they're offering health insurance plans, you want to take advantage of it. If you are self-employed and you have enough money to pay a monthly premium, for getting your own personal health insurance, you want to take advantage of it. A lot of people assume, well, I'm healthy, I don't need it, but you never know, right?
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Samantha Barry
10:50
Completely. So number one, health insurance.
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Bola Sokunbi
10:53
And number two, you want to start putting money aside in an emergency fund in the event that you have to pay out-of-pocket expenses, and I'll give you a personal example. When I was pregnant with my twins, I had a very high-risk pregnancy.
Share
11:07
And after all said and done, my hospital bill came out to about $50,000. And my insurance covered 90% of it at the time, which was really great insurance, and I was out of pocket $5,000. And that was money I was able to tap into my savings to pay for, so I definitely recommend having some sort of fallback saving so that you can cover out-of-pocket expenses.
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Samantha Barry
11:29
Let's talk about those out-of-pocket expenses. Lauren got a $3,000 medical bill. She should just, shouldn't take that as gospel, right? Like, we should be questioning every medical bill that comes in the door.
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Bola Sokunbi
11:40
I would say so, yes. So if you get a medical bill, you definitely want to ask for an itemized breakdown, and you definitely want to pick up your phone and call and say, hey, I want to pay this medical bill. Can I negotiate the cost? Is that an option for me?
Share
11:55
The worst response you can get is a no, right? And you don't have the $3,000, then you can say well, how about we set up a payment plan, and I can pay $500 a month for this bill? Can you also make sure that there are no late fees or setup fees charged to me? So you can try to negotiate everything possible, but definitely start by asking for that itemized bill, so you know exactly what you are being charged for.
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Samantha Barry
12:19
Exactly. I think here's, you know, here's the reality. Sometimes those bills can be questioned and negotiated down. Sometimes there's something in the wrong line item. Sometimes by not having that first conversation, you're leaving thousands or tens of thousands on the table, right?
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Bola Sokunbi
12:36
Yes. And I have many members of my family that work in healthcare, and I've been told countless times that billing is done by humans and there are tons of errors. So you can be leaving thousands or tens of thousands on the table if you don't negotiate or at least ask for specific details and questions, anything that seems off to you.
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Samantha Barry
12:56
It sounds like Lauren has a handle on this $3,000 bill. She's paid off most of it. But what if she wants to set up a payment plan for a bill in the future? Is there a script she could follow?
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Bola Sokunbi
13:06
You know, I want you to state your intention, I want to pay my bill, but I can't afford to do it right now. And this is something that I just want to acknowledge for a second, because so many people have been severely impacted from the pandemic, who, you know, aren't able to pay large chunks of bills right now, because they lost their job, health issues, whatever it might be.
Share
13:26
So state your intention. I want to pay my bill, right? Can you help me? Is there a payment plan? Typically payment plans happen monthly, so you can come to an agreement of how much you can afford to pay, is it possible for me to do this over the next six months?
Share
13:41
So just be honest. And one thing to keep in mind, because sometimes when you're asking for help it can be intimidating if the person on the other end is just very nonchalant or they're aggressive, you don't have to talk to that person. You can hang up and call back, right? Ask to talk to somebody else.
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Samantha Barry
13:57
I think mental health is a consideration when people are looking at not only their finances, but the jobs that they take. So Lauren is weighing up a less flexible but more lucrative job. She's worried though that it means less control over her schedule and managing her mental and physical health. How could she ask those questions before she takes the job to figure out if it is the right place for her, and where should she be prioritizing?
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Bola Sokunbi
14:21
You know, in Lauren's case, I would challenge her to think about it differently. Because right now, she talked about traveling over two hours to see a specific provider and that is a huge chunk of time in a busy schedule.
Share
14:36
It could be that she can explore the options provided through this new job that will pay her more money, but might also have access to mental health services, either through the employer benefits or through insurance that are equally as good as where she's going two hours away, but locally, right? Before she makes that specific decision or writes off that job as not being helpful to her mental health needs. I would challenge her to explore that.
Share
15:04
But in terms of prioritizing, everyone should be prioritizing their mental health, because if you are not mentally well, if you do not feel okay, nothing else works. The finances they don't even matter, right?
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Samantha Barry
15:20
It's number one.
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Bola Sokunbi
15:20
Your health is number one, your health is number one. But you know, so, I do see where she's coming from. She's prioritizing her mental health, which is what she should be doing, but explore if there is options to take on that good job, earn more money but still get the care you need.
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Samantha Barry
15:36
I love that, I think that's very solid advice, Bola, because I think I couldn't agree with you more. Mental health should be your number one priority in all of the decisions you make, including financially.
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15:46
But you should also go into that with the, what are my options? Is there a way of asking those questions before you take a job, about what their health and medical benefits are? Can you deep dive into that before you take a job?
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Bola Sokunbi
16:03
Absolutely, you can ask these questions. If there's an offer on the table, you can ask questions about what type of benefits are going to be provided. Is there health insurance? Is there retirement savings plan? is there mental healthcare or are there benefits that offer mental and wellness programs and services?
Share
16:20
You should not feel ashamed to ask those questions, because at the end of the day, you're lending your expertise, your skills to this company to make them better, and their goal as a company should be able to make sure that their employees can do the work, right? And that's what your benefits are there for.
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Samantha Barry
16:39
Exactly. What else should she and her husband be thinking about as partners and parents?
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Bola Sokunbi
16:45
It's really important that she has similar financial goals as well as her husband, that they're talking about their finances and creating their plans together to save, to pay off debt, long term. Given that they have a child, making sure that they have the right type of insurance, life insurance, disability insurance, health insurance to cover their child's needs.
Share
17:06
And just really prioritizing her mental well being so that she can be there as a mom, present for her daughter, without feeling the burden of her medical concerns, or prioritizing herself. And making sure that she's getting the care that she needs and she's assessing her different options to make sure that she's selecting what works for her, so that she can be present as a mom for her daughter.
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Samantha Barry
17:29
Perfect. Bola, thank you so much.
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Bola Sokunbi
17:31
Thank you for having me.
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Samantha Barry
17:35
Keeping your mental and physical health in check can be like a full-time job. And for women living with a chronic health condition or mental illness or, like Lauren, both, that job can be overwhelming and expensive. But no matter where you are in your financial journey, remember this: your health is your most valuable asset.
Share
18:01
If your employer offers job-based insurance, make sure you're signed up and know the full scope of your healthcare. If you're self-employed, see if your local freelancers union offers insurance. Both options will mean less money in your pocket in the immediate future, but being reckless with your health or flat out ignoring your mental or physical needs, will cost you more in the long run.
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