What is a reasonable amount of debt load for someone with a chronic illness?

December 22, 2007 7:23 PM

What is a reasonable amount of debt load for someone with a chronic illness? I come from a family that doesn't accrue debt, which I realize is a luxury many people don't have, so I haven't had a model for managing debt. Specifics about my particular situation follow.

I have vasovagal/neurocardiogenic syncope with pacemaker implanted, and those suckers need to be replaced about once every 8 to 10 years. Also I'm planning to go into a field that, while rewarding and flexible, doesn't make rockstar amounts of money (library science, and I'm planning on a more wired area of the field). I haven't gone back to school for my MLIS yet, but I want to within a year to 18 months. I have a tiny bit of credit card debt that I should be able to knock out in a couple of months.

My goal when I was younger was to actually have saved money lying around to pay for random medical things as they cropped up, but that is looking less and less possible. :) I get to pay mass quantities of money to health insurance providers because I have a pre-existing condition, and I can't stop health insurance when I'm doing well because of the way the HIPAA continuity laws work.

Currently I am in reasonably good health, paying to COBRA, and working 30 hours a week for a not-terribly-large hourly rate as a temp. I probably will be taken on by the company permanently, but we haven't discussed any raise or health insurance yet. If what I could get there wouldn't work out long-term for me, I think I'd do all right at getting something else better, but I hope it does work out because I really like it there.

I have an English degree and call center experience; maybe is there something from home I could be doing on the side?

I'm living at home, rent-free but giving a lot of service as a caregiver. I also hoped to move out soon. Maybe it's too much to do all at once?

Given all of the above, what should my financial goals for 2008 include, and what should my broader long-term expectations for my economic stability be?

posted by RobotHeart to work & money (13 comments total)

Get a job with health insurance. Any job, or... better yet, the best job you can get. I understand that you're being very practical and responsible and looking at your best options in the short term, but....

You will never be able (sorry, probably never) to pay for medical costs yourself. Our convoluted medical insurance system has placed you in a situation where your best option is to not have to qualify for insurance, i.e., get a job.

Reasonable options include: any federal job, universities, large companies of any sort.

This does not, of course, preclude you from pursuing your career. You just got dealt a crappy hand. Something you have to deal with.
posted by nedpwolf at 7:39 PM on December 22, 2007

Why not move to Canada? I don't get why anyone with serious medical expenses would want to stay in the U.S. under the current circumstances. Plus, you won't be paid in US dollars, which are worth a lot less then they were a few years ago.
posted by delmoi at 8:02 PM on December 22, 2007

I say go for library science in the context of a university or government job (ie, most of them). Both institutions have decent health insurance and benefits. You're choice of careers probably won't hold you back.

As for the debt load, I'm pretty sure many companies who evaluate your credit report (ie, for mortgages and such) can ignore health related amounts, I wouldn't worry too much about it, especially if you are responsible with your bills.

Also if you end up paying for things yourself after COBRA runs out, you can probably negotiate your amount down with the hospital. They get paid a fraction of the amount anyway with health insurance, just convince them to take that amount from you directly.
posted by cschneid at 8:08 PM on December 22, 2007

I have to agree that if you have any interest in emigrating, this might be the time to do it, though it sounds like you may have family concerns keeping you close to home. I'm in good health but have a condition that requires screening and scares insurance companies, so I'm considering leaving the US. I see no hope for the near future because all leading presidential candidates want to keep the private insurance system alive.

A less radical approach would be to stay at home if you can handle it and make sure that your temp job goes permanent AND it includes good health coverage. School would likely put you in some debt, and any hiccup with your health insurance could expose you to massive debt. So my first priority would be to lock in the health insurance through a job or other group plan, get a steady income, and then start taking on student loans if necessary.

You might consider getting a university or similar job that gives you benefits for a minimal # of hours. For example, I once worked for a university that if I remember right provided full health benefits if you worked 20 hours. That was awhile ago, however.
posted by PatoPata at 8:35 PM on December 22, 2007

I don't think that credit companies ignore health-related debts. Why would they? Debt is debt in their eyes. A bank could easily hesitate to give you a mortgage if you're currently struggling to pay $30k in hospital bills. Medical debt doesn't magically go away. It's a major cause of bankruptcy, even for people who originally had health insurance.

I would also disagree with any advice that suggests you could let your COBRA run out. Letting any type of insurance lapse makes it far harder to get new insurance, as you probably know, since you referred to HIPAA in your original post.
posted by PatoPata at 8:40 PM on December 22, 2007

delmoi: I'm in a similar situation to RobotHeart, albeit a bit younger (and with a background in a potentially more lucrative/marketable field). My understanding is that you really can't move to Canada if you're in our boat; part of what they look at is your health. I believe they can and will reject a residency/citizenship application based on that, just like they will if they think you're not likely to be employable.

If I'm wrong, please do post and correct me - that's a tempting option.
posted by spaceman_spiff at 8:42 PM on December 22, 2007

RobotHeart, if you want to move to Canada (and will be a fine upstanding citizen etc), I'll happily marry you to get you out of the perverted and felonious hellhole that is the USA health insurance racket,
posted by dirtynumbangelboy at 9:43 PM on December 22, 2007 [6 favorites]

I had a stay in a hospital when I was younger. Broken bones that required surgery and rehab. Orthopedic surgeries, which are usually less money than anything cardiac-related. The bills were, thankfully, covered by insurance. Good thing, since they were well over a million dollars.
No, I'm not kidding.
Two surgeries. About 2 weeks in intensive care, a month in a standard room, and a little over a month in a long-term care rehab wing.

Over a million fucking dollars.

One day in a normal hospital room is about $500 in "cheap" areas. Intensive care is more than twice that.

Even if your bills for one surgery are a quarter of that (or a hundredth of it!) could you afford it? I know a few librarians, none of them make the kind of money where they can stash away $10,000 into their savings.

You need insurance. Get a job at Starbucks if you need to!! No one can afford surgery and hospital stays without it. Do NOT let your coverage lapse, either. In the US they can deny you coverage for previously existing conditions... UNLESS you've been insured basically non-stop since the condition developed. Let COBRA lapse and you might as well never get insurance again, as they can reject to pay for anything related to your pacemaker or current health issues and be fully within their legal rights.
posted by Kellydamnit at 10:24 PM on December 22, 2007

Blue Cross offers individual health plans now, and even if you have a pre-existing condition, there is no waiting period if you're currently covered under COBRA. It's not cheap, but it is good insurance. I have Lupus and several related manifestations and stayed at a dreadful job under a sociopathic boss for five years just because I needed the insurance. But when BC started offering individual plans a few years ago, I took a job that I actually liked and just paid for my own insurance.
posted by Oriole Adams at 10:43 PM on December 22, 2007

As a Canadian working in a public libraries I have to echo moving here. Yes, they do look at your health but as part of the larger context of who you are and what you can contribute to the country. There are large numbers of 65+ years old immigrants to Canada and any statician can tell you their health care cost will outweigh their economic benefit. Being young and employable negates the relatively small cost of surgery every eight years. If you are young, with a wanted degree (I know quite a few American librarians up here) then I see no reason for you to at least apply (self-assement test here). FWIW, MLS jobs at my library pay around $60,000 to start with full benefits and full OHIP (the provincial name for medicare) is available after 3 months residentcy. You can also work in libraries without your MLIS and just a BA, for myself, I do not have an MLIS and probably won't bother getting it because I earn $40,000 while working only 20 hours a week in a job I am good at and I love. If you were able to move to Canada to take your degree I believe the tuition here is cheaper too than in the US (as a resident it is almost $3,000, the foreign tuition is $10,000 at McGill but less than $5,000 at UWO). If you had any questions about libraries or immigrating to Canada please feel free to Mefimail.

And if you marry DNAB I call dibs on being a flower girl. I woud LOOVE to see what he would wear to his own wedding, I think it would be something smashing!
posted by saucysault at 6:03 AM on December 23, 2007

Hmm. I wouldn't mind Canada... ten years from now. Right now it just doesn't seem right, given a lot of unrelated things I won't go into here. (Do marriage proposals happen ofter on MeFi? :)

My COBRA is actually through Blue Cross, Oriole Adams. I wonder how much it would cost me to flip to a personal plan? I do like the Blue Cross benefits I currently have. I should look into that.

I've used a personal Medical Mutual plan before, while in college and not working. It cost me about $200 more per month than I'm paying now, which is not affordable for me if I keep the current job I have and don't get a raise, and maybe not even otherwise. Plus the coverage simply sucked. I don't have a good example of my own that pops up in my head just now. I also have a friend who has spina bifida who was on Medical Mutual -- so nice of them to only pay for one leg brace, considering she has two legs. ::sigh::
posted by RobotHeart at 11:27 AM on December 23, 2007

I am in a similar situation, though I am older than you are. You absolutely must be in a group insurance situation. If you're out on your own the insurance companies keep raising your rates until you're effectively squeezed out. I've been dealing with this for years and my credit is shot. I was a successful freelance writer for many years until the insurance issue did me in. I now work a retail job just for the benefits. I don't know the best solution, but if you figure it out, let me know, because this just sucks. I had a stroke and open heart surgery and require some ongoing care.
posted by astruc at 1:17 PM on December 23, 2007

Also if there are any Canadians on the east coast who'd like to marry me, feel free to apply within. :)
posted by astruc at 1:48 PM on December 23, 2007