Cars, Cardio, and Coffee: Disability Expenses

Having a disability is expensive. Last year, I spent over $9,000 in out of pocket medical costs after insurance premiums. I'm relatively healthy and most of that cost is the maintenance required to keep me healthy. This year, I'm on target to spend a minimum of $6,000 on alternative transportation because I don't drive due to my lack of depth perception. That's $15,000 a year on health and transportation on the low end. That's before food, utilities, student loans for two degrees, or any other bills are considered. I've made career moves to stay on top of all of that because it's in the best interest of my family's stability (short-term and long-term). The last six years have been the most prosperous in my career and the most expensive (I know I'm not alone in feeling the impact of economic conditions). 

I started taking the bus a lot more over the past year to attempt to reduce the alternative transportation costs. Taking the bus to and from work is a 3 hour round trip. There's a lot of time and energy cost going on there. I've reduced my physical health maintenance to reduce the associated expense. Doing that costs me physically. 

Here's the thing, I have it pretty good on these aforementioned disability related expenses. I'm generally healthy so most of my medical costs are consistent for the maintenance they provide. I don't have medications or devices that have to be paid for in perpetuity (though that can always change). I'm able to mix up my transportation arrangements and modify my schedule if I need to in order to lower transportation costs. What if I had no options that made things more flexible? 

I've selected jobs based on walkable distance to necessities and amenities. I've selected jobs on the health plan over the salary (because a quality health plan will keep more of what I earn for general living expenses). There are trade-offs in any scenario. At one job, I lived so close I could walk to work and had zero commuting costs for work but I didn't have a good health plan and had to rely on state options for that. At another job, I had possibly the best health plan I've ever had, but there wasn't a direct bus route when I worked there or flexibility during bad weather, and I had to be creative about transportation, which made for long days and angry Uber drivers. 

I was at a conference recently for a couple of days and the four Uber rides I needed to get to and from the event cost more than the conference itself. Mileage is covered at IRS rates, so that helps reduce my out of pocket travel costs, but stuff like that is a relatively hidden cost of living with a disability. I utilize the flexibilities I have and the opportunities to carpool, which reduces the cost of being a disabled non-driver, but it doesn't eliminate it. 

On the medical side of the coin, if those expenses were high enough, I could sometimes count on an HSA or reaching the deductible to slow those costs down. In recent years, it seems like the insurance companies are leveraging the out of pocket max (usually higher than the deductible) to not cover the cost of care. In those instances, my options are medical debt or declining care. 

These are just realities and I'm usually pretty good at managing them. I also recognize that it postpones goals because it takes longer to build capital when the outputs can exceed the inputs at times. There's no perfect solution to this, if there was, I'd be using it. 

Some people might say, “but Tim, what about all the coffee you buy?” This is why context matters. I do sometimes spend too much money on coffee. I do that for a few reasons, thanks to some of my trauma related impulses, I can occasionally be impulsive about spending on stuff like coffee to feel better. Also, I burn 3-5 times the energy of the average person with my cerebral palsy, and coffee is a source of fuel. In the last year, I have cut my coffee expenses down from a near daily trip to the coffee house to maybe once or twice a week. I've tried different things like making coffee, which I don't usually have time for, and have to be careful with on the bus, skipping coffees (I'm sure I'm slower and grumpy when I do that), combining it with protein and smoothies to turn coffee into a meal, and buying a subscription to k-cups (sorry environment). 

The not so great solutions I've found to reducing my disability related expenses include getting less sleep so I can take the bus to work in the morning, requesting scheduling flexibility so I can take later buses and manage pain in the morning, going without preventative medical care to reduce out of pocket expenses, modifying my diet so that I consume less coffee and less in general (which reduces my energy levels). It's all an evolving process, but it's one that requires constant attention on my part to balance the relationship between expenses and needs.