August 2018 Money Diary: Preparing To Travel Around The World & Dealing With U.S. Medical Bills

Jennie here.

Hi all, sorry this post came so late! It’s been a bit of a hectic transition period. Since August (until now - early September) we’ve traveled or moved at least four times. How time flies! And now we're currently in Hawaii taking a "break" and relaxing before we begin our crazy adventure.

So what happened in August?
 


Our “New” Origami Life Begins


Last month, we shared our experience with moving out of Los Angeles. And this past month (August) marked the first time that I’ve been “unemployed” (or funemployed) in the last six years. It actually felt really strange to have 100% control of my days. For example, some days, I’d work from 6am to 8am, take a break, go running at 9am, and back to work again. There were a lot of days that were spent leisurely floating from activity to activity.

 
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Financially, I’d say it was a pretty solid month. For starters, because we left Los Angeles on August 1st - we saved $1,600 on rent and other bills. However, we spent about $1,900 on business expenses (including a new laptop and phone). So our spending rate was relatively high compared to the previous month. But these were also one-time, necessary expenses.

In terms of earnings, I got paid out by my company for essentially a month’s salary (yay) and Ivan and I both billed hours for our business.
 


Dealing With The U.S. Healthcare System & Financial Assistance


I went back to Albuquerque in August for two reasons:

  1. Spend some time with my family

  2. Take care of my parents’ medical bills

It’s no secret to my close friends that I grew up in a low-income household so the biggest concern for me while I travel is that my family make rational financial choices (or if not, I set things up to minimize any potential damage).

Last year was rough on my family - both my mom and dad got sick, had surgery, or went through some extended medical treatment; it was awful and more than anything - they racked up more than $15,000 in medical bills (after health insurance - land of the free!).

Spoiler alert: they couldn’t afford to pay those kind of bills.

So what does this have to do with me? Well, I stepped up and took care of the medical bills and was able to bring some of the larger institutional hospital bills down. In some instances, it was simply helping my family apply for financial assistance programs.

In the end, I was able to help my parents save anywhere between 60% to 75% on several of their medical bills. That meant thousands of dollars in savings!


What did I learn in the process of dealing with the U.S. healthcare system?


U.S. Medical and Hospital System


Lesson 1: The U.S. private healthcare system is a fucked up and completely random system.

When dealing with one hospital, I had to call between 4 to 6 different departments within their system just to verify my parents’ outstanding medical bills. Oftentimes, there are different billing departments or systems for physicians, facilities, and emergency services - AND most hospitals include “contractor” services (e.g. outsourcing anesthesiology or lab teams). It’s almost as if they just “make up a number” when they bill the patient. And if the patient can’t afford that number, they just “make up” another, much lower number. It’s completely random.

Lesson 2: You need to be informed to navigate through the system.

If you don’t validate every line item and/or talk to the right people, it’s hard to know what’s negotiable and what isn’t. So I’d suggest calling and talking (pestering) as many people as possible within your specific hospital. The system is so complex that even seasoned hospital reps can’t help guide you through it.
 


5 Tips On How To Get Your Hospital Or Medical Bill Reduced


If you’re having a hard time paying for your bills, here’s a few things to know:

  1. Always ask - even if you get laughed off the phone. Typically, larger institutions will have some sort of financial support or payments plan. Just call and ask about it. It doesn’t hurt to ask. I asked about financial assistance programs at smaller private practices but they kind of shrugged me off the phone - they only accepted payments or setting up monthly payments; they’re incentivized to get money from you before they send your bill to collections, but that usually takes a while.

  2. Most hospitals should have a “financial assistance” page on their website. In my opinion, they bury the lead when you get your hospital bill but you can definitely find financial assistance information. Just search on Google: financial assistance + [hospital name].

  3. Even if you’re not sure whether or not you should apply for financial assistance - you should try anyway. Sure, most of the applications are based on income tiers but if you’re having a difficult time (e.g. multiple medical bills, you’ve got a ton of student loan or auto loan debt, you’re recently unemployed, etc.) then it’s worth a try. You’ll never know until you ask for it. Also, once a hospital receives your application, they should put your account “on hold” during the evaluation to avoid sending it to collections.

  4. You can speak with a financial assistance support agent at the hospital. It seems like a lot of the larger hospitals will have some sort of support arm for questions and to help you manage through a financial assistance application. Call them even if you think you know what you’re doing. Ask a ton of clarifying questions.

  5. Look into your benefits, you might have support service like “Health Advocate”. There are services out there that can help you negotiate your healthcare services or look into healthcare specific questions for you.


Dealing With Pre-Departure & Administrative Tasks Before Our Round The World Trip


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Other financial highlights of our time in August:

 
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  • We were cat-sitting for my sister for two weeks while she was away in Europe. This was a nice change of pace for us since we’ll be on the move for the next couple years. Plus, the cat eventually learned to tolerate us and gave us a routine (e.g. cat-feeding and play schedule).

Savings: Half a month’s rent in Los Angeles (~$712)

  • We lost about 5 pounds each, working out and swimming in my sister’s community pool and gym. Honestly, we’re bringing our weight down for the long-term health benefits. It’s amazing how much easier it is to lose weight when you “have time” to work and focus on your physical and mental health.

Savings: Month gym cost (between $30 to $60 per person)

  • Validating our marriage certificate to begin my permanent residency papers in Taiwan. Although Ivan and I have been legally married for the last four years, we’ve yet to register our marriage in Taiwan. We decided earlier this year that we’d actually start my permanent residency process in Taiwan. Unfortunately, we had to have the Taiwanese embassy in Boston validate our certificate before moving forward.

Expenditures: $15 fee for our application; $7 for postage via snail mail

The bureaucracy is expanding, to meet the needs of the expanding bureaucracy.
— Oscar Wilde
  • We had to send additional evidence for our U.S. immigration application. Let’s put this into perspective, we sent in our application to the United States Citizenship and Immigration Services in 2016 and they just got back to us and requested for MORE information. Basically U.S. Citizenship and Immigration was telling us: “because of our delay, you need to provide us with more evidence of your marriage for the period of our delay...so we can spend even more time reviewing that evidence”.

    Two years and counting. We begrudgingly sent in more information to cover the last two years to showcase that our marriage is still legitimate. Le sigh.

Expenditures: $7 for postage via snail mail.
We had to bite the bullet and send it in but really, it cost more than $7 - more like it cost $7 and two years of dignity and patience lost.

  • We got global health insurance and life insurance. While I dealt with my parent’s bills, Ivan took care of our health and life insurance for our RTW trip. For our global health insurance, we went with Cigna which cost about $142 per month for the both of us (excluding U.S. coverage except for short visits). For context: the cost of getting coverage in the U.S. was equal to coverage for the rest of the world combined.

Expenditures:
$1,700 per year (for both of us) with a $1,500 deductible and 20% copay (excluding the U.S.)
$18 per month for life insurance (I consider my family to be dependents in the event that something happens to me)  

  • A relative died in August and I had to get my dad and uncle last minute flights to Florida with points. Fortunately, we had points to spare. We were also reimbursed by my uncle for less than the carrying value of the points. But family is family. And some things are more important than money.

Earnings: We received cash for $650 - minus last minute booking fees of $160 equals $490.

 

That’s it for this month's Money Diary! Tune in next month for our first month of a traveling money diary.