5 money mind-shifts that will save your bank account when you're chronically ill

No, this isn't a primer on kicking off a criminal career. (Drat. I wish I were that cool.)

When you're sick, all your long-held financial wisdom crumbles in the face of reality. Job? LOL. Disability tax—who knew. And skipping lattes won’t cut it when three months of Humira costs $26,000.

You don’t need a budget. You don’t need thrifty hacks. You don’t need a lottery ticket. Those things are great, but if you’re going to survive this dinero drain, you need a LOBOTOMY. The good kind! As in, out with your old mindset about money, and in with a new.

Welcome to the new sickie money rules, where we hang onto as much money as possible—legally, ethically, gracefully—by considering cash in a whole new way.

When your doctor understands billing codes. Whew.

1. Treat “fixed costs” as anything but.

A $3k bottle of rifaximin *poof* became $0 when my savvy doctor used the "right code." (R19.7 instead of of the go-to K63.821.)

Four-figure hospital bill? Evaporated with a forgiveness form that no one tells you about, that won’t hurt your credit, that you too can qualify for while making up to ~$100k depending on your other expenses.

On the other end? “Separate ER deductibles” and “actually, that doctor was out of network” surprise bills are always ready to bite you in the now-untoned ass.

Lesson in healthcare’s funhouse financials?

Money doesn’t have to make sense.

Medicine doesn’t think money needs to make sense. So why do we? Turns out, the “rules” we thought we had to live by…aren’t rules at all.

And frustrating as this realization can be, it also opens a door. Lots of doors, actually. When medical money stopped making sense, I stopped trying to make most money make sense.

I stopped agonizing over for hours over exacting custom estimates in my consulting microbusiness. Now, I have set prices, based on value vibes. My clients don’t blink. (It helps that my client ROI is off the charts.)

I started ignoring “realities” of what things should cost. In the town where I live (a poster child for affordable housing crises), there’s no such thing as a basement studio under $1k. Yet I live in a quiet, cozy top-floor one bedroom with french doors, hardwood floors, mountain views, a clawfoot tub, and a huge walk in closet for less than that. With free water and heat included.

This “shouldn’t” be my reality. AND, yet, it is. Because fixed costs aren’t—at least not always. (Also? If I can score that 1% chance of getting ME/CFS, I can be the rare bird to land el cheapo housing in a fou fou place where the median home price is $687k.)

We’ll pretend my digs are always this clean.

2. Invest in community. No, really.

Most of us (sick or not) do not think we have the kind of community that would support our nitty-gritty, unglamorous needs (like dentist visits). I didn’t. But I couldn’t have been more wrong.

Community is wealth. Real, tangible wealth.

When I first got sick, I felt my community slipping away. I didn’t know how to connect if it wasn’t over hikes, bikes, and skis. Early attempts to express my illness experience were met with tone-deaf advice, scared stares, and useless platitudes.

And yet, those same people eventually became the supportive community that paid for me to go to off-insurance doctors, bought me a mobility trike, put a little cash in my account at the second-hand store, randomly sent me gift cards for groceries, mailed me bath bombs, left flowers on my doorstep, and covered my laundry service.

What changed was me, and how I interacted with that existing community. (That’s a whole separate post.) The point here is: community isn’t only a source of security and affording what we thought we couldn’t, but it is something well worth investing in—and I mean that financially, too.

And no, it’s emphatically not about bilking your friends. But it’s also not about caving to the American urge to make everything transactional. We’ll discuss.

My entrepreneur galpals didn’t even all know one another, yet they banded together to surprise me with a new mobility scooter.

3. Use gross tools in a good way.

The system is designed to keep you broke and shareholders rich—but you can leverage this while still playing fair.

Corporations toy with us. Take the toy. Not the bait.

For example: credit cards incentivize spending so you’ll rack up a bill—with interest. Why not take the free flight miles, the 3% back on groceries and gas, the $300 sign up bonus and just skip the whole interest part?

(Note: a reasonable answer might be, “because I struggle to control my spending on credit,” in which case, you know you best.)

First, I treat credit cards as a pass-through to my bank account—just a portal to ONLY money I already have. (This is key.) I do not carry debt personally, but I certainly don’t condemn it, and would leverage it under the right circumstances.

Second: I use different cards for different spending categories (medical, groceries, etc.) so I can quickly scan my spending. I pay these cards every WEEK. (Rando tip: I use a miles card for medical bills. I can barely travel, but I make a trip out to my Mom’s annually, which my medical spending pays for. It makes me feel like at least some of the money is going towards something happy.)

Third: I reap beaucoup rewards off those cards. NEVER spend a dollar where you aren't getting something back. I’m gaining about 3% on most purchases.

Finally: Thanks to all this responsible credit card usage, I’ve gained a credit score of 825. I’ve started putting it to work. I've begun opening the occasional new account (checking, savings, whatever) with $200-300 bonuses. (Often, you need direct deposit to get these bonuses, which is where an ACH direct deposit paycheck from your own microbusiness matters. More on microbusinesses soon!)

My medical bills land me enough airline miles to get to one big happy place: hanging out with my Mom in Oregon.

4. Take what is meant for you.

There’s no such thing as a welfare queen. (At least not on a meaningful scale.) I’ve spent time in poverty. I’ve worked with non-profit clients with disadvantaged constituents. I’ve lived years in online patient forums. One thing is glaringly obvious: People are EXTREMELY reluctant to accept assistance of any kind, far beyond the point they need it.

Often, their reason is, “someone else needs it more.” And yet, the resources simply aren’t that limited. My own home state couldn’t get enough people on its rental assistance program to avoid just…having to return grants back to the Federal government. Even more often: people underestimate how much they actually DO need the assistance. Tough but helpful truth: you might be that person who needs it most right now.

APPLY. If you qualify, it’s because the program was made for someone exactly like you.

As the sweet lady in the hospital financial office said to me, "honey, the point isn't to go bankrupt and grovel. These programs exist because we don't WANT people hitting rock bottom." I promise you, you have already paid somehow into the institutions that will later provide you assistance with your taxes, your past investments, etc. You have value beyond your investments. And? It doesn't need to be an exact transaction.

I qualified for and accepted *complete rent coverage* for a year and a half, reduced internet for over a year, three months pay from pandemic small business grants, complete hospital forgiveness for two years, a grant for trying novel medical treatments, and more.

The applications were easy. Actually making myself DO the applications was hard, though, because of the mental blocks. Individualism is pounded into our brains. Our culture tells us we must bootstrap, pull our own weight, go it alone…which no successful person has truly done, ever.

Receiving assistance freed me up financially to try to be as well as possible, which let me contribute back more to my community—personally, and through non-profit consulting that amplified philanthropy far beyond my own personal impact.

We’re so quick to give and so hesitant to take. I never blinked paying my taxes without cheating every year. I certainly spent enough years not knowing about forgiveness programs and paying through the nose to doctors and hospitals. I’ve paid. You probably have too. It’s okay to BE paid, sometimes.

(All that said…the journey of applying for disability is the mother of all assistance applications, and it deserves a separate discussion. For me, I can still make more (and write off more!) running a high-yield microbusiness.)

5. You don’t have to be rich to live richly.

My baked-in, standard American financial values kept me feeling scarce, scared, and isolated. Initially, this illness cost me HUNDREDS OF THOUSANDS of dollars on an extremely modest income. It decimated my ability to work.

I hemorrhaged money. I hemorrhaged hope.

As sickness destroyed my concept of how money was supposed to work alongside my bank accounts, this new paradigm took shape. Despite the big setbacks, it left me feeling more financially secure than ever before. I’m not rich. But I feel rich—I get to do nice things with nice people while wearing nice clothes. I get to give back. I have f-you funds and retirement accounts (however behind.)

And we need that as sickies. There’s an unspoken rule in capitalist culture that if you’re low-earning, you better be sufferfesting hard. Virtuously munching on undoctored ramen packets while side-hustling (on both sides) and DIYing your own hip replacement. And that money mentality just doesn’t fly when you’re unwell. (Ramen and hustling and home surgery will definitely make you sicker. Trust me.)

I still pull some Puritanical punches. I drive a $1 car, wear clothes from the free pile (the cute ones!), and rinse out my baggies. But I also lounge around in supremely comfy jammies (full price), spring for fun things like an outdoor campchair for two (with gift cards and discounts), and zoom around on my gifted Liberty Trike.

I want to be outside, I have to sit, and the benches are all deep under snow, so...we pooled gift cards, discounts, and cash to snag a snuggly camp chair for two (the Kelty Loveseat Low if you don’t want to research!)

Living well, even luxuriously in places, is an act of love and rebellion. Love for yourself—sorely needed when you live in a body that feels very difficult to love—and rebellion against a system that really doesn’t want you to have that bath bomb because…why?

It’s okay to luxuriate, even (especially!) if you’re poor. It won’t make you a better human to miss out on the good parts of being alive just because you’re broke.

ANYWAY. Despite severe financial realities, I’m doing alright. How?

Question costs.
Build community.
Leverage corporate greed.
Accept help.
And reap the rewards.

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More posts coming on ALL of the above—which one are you interested in most?

Speaking of questioning costs…here’s a few breaks.

I only recommend stuff I LOVE and use myself.

• Get $100 when you open a new Ally account using this link. (Gives me $50, too.) Minimum deposit is $1k. I’m so mad no one told me about high yield savings until I was nearly 40. (One reader said it worked on desktop, not on phone…heads up!)

• Get a $200 bonus (and then up to 3% cash back forever) on a no-fee card with American Express with this link. (I get $75.) Hot tip: go through their “special offers” to really load up on cash backs. I use Amex for both business and personal.

• Take $60 off a Liberty Trike like mine with this link (I think it gives me $60, too?) For the cheapest deal, get the “Classic” (aka, old, aka, mine) model or a refurb.

• If you feel a stirring to support this work, you can Venmo my “parent company” @flyingbicycle or fulfill my wildest n95 mask dreams on MyRegistry (my b-day was Wednesday!). Big time gratitude in advance.