In my initial ‘nice to meet you’ post I mentioned two surgeries I need to have. Later, a friend told me that made me sound like I have some majorly weird medical problems. Alright fine. It’s not as weird as it sounds though, so just so you don’t think it’s something worse, I’ll tell you. I have very poor circulation in my legs and I need to have a major vein shut down in each leg to encourage circulation in the healthy veins. That’s not so weird is it? Well, I guess I’ll never know. Anyway, these two procedures are medically necessary, but also somewhat optional at this stage – meaning, my insurance will pay for them, but I won’t die if I don’t get them done tomorrow. Herein lies my dilemma. Do I have the surgeries and incur $7,000 of medical debt or do I put it off until I can afford to pay for them with cash?
Let me go backwards a bit and explain where the $7,000 figure came from. Like many Americans I pay several hundred dollars a month ($237 to be exact) to get mediocre healthcare coverage (I purchase my own coverage outside of work). I’m not complaining though. I spent a total of 20 years uninsured, so I’m grateful for any coverage. Reality is though, being covered only shelters me from catastrophic expenses. I still have to shell out several thousand dollars if I need care. For example, when I fell and had to get the nerve in my hand reattached (I’ll give you a moment to recover from the chills) I paid just under $10,000 out of pocket over a period of 13 months. My deductible was $5,000 and then I had to pay 30% of the remaining cost. Of course, when I was going in for surgery I didn’t know any of this. The surgery was very necessary and happened fast. I figured out the money situation afterwards.
This time is different though. My insurance is the same, but the medical situation is different. This time I called my doctor, got all the codes of the procedures, and then called the hospital to figure out how much each of those codes would cost. It took a while, but when I got off the phone I knew exactly how much having both surgeries would cost. The grand total before insurance? $16,000. Womp womp. I’ve already paid $1,000 of my deductible this year though, plus I have a $1,000 credit for some reason, meaning I would only owe $3,000 of $5,000 my deductible. But I would still have to pay 30% of the remaining total, which would be about $3,300. My total cost to have both surgeries this year would be $6,300 (if everything went as planned of course).
I’ll be real with you though, I don’t have $6,300 in cash. I have $3,000 in an emergency fund and every other cent I have is going to pay off my little car payment which is now at $6,281.56. The nice thing about medical debt is you can set up a payment plan, which if I spread the amount out over 12 months would be about $523.46 a month. I could pay that plus my little car payment of $153.85 for a year. No problem. Yet, the year would end and I would still have a car payment. I’m not really interested in setting my financial life back so far.
So I’ve decided not to have the surgeries this year. The only bad part is the $1,000 I already put into the pre-op procedures. When I do choose to move forward with the surgeries, I’ll have to pay this $1,000 again. In the long run though this is a minor consequence. For now, I’ll continue to focus on paying off my car payment cent by cent. My weirdo medical problem can wait another year.

Jasmin is Vice President of Marketing & Operations for Pete the Planner®. Jasmin runs special projects, manages programming for clients, and stews over new and creative ways to engage people with their finances. In her downtime you can find Jasmin hanging a light fixture or painting a room at her fixer upper.
I’m detecting a theme in your posts- a pattern of deferred maintenance (that bites you later). This is very inconvenient for things like cars and appliances. You end up heaping a bunch of time, effort, and emotional energy on the crisis and are forced to make distressed decisions. In social work, this cycle is described as “the poverty of the moment,” and it’s no place to be.
This seems like a place where a person could look into depreciation schedules, residual values, costs of ownership tables, and all of that stuff. But… the post was about your health… so that adds a really personal and potentially painful layer to the mix. My instinct? Get the surgery this year, using all the savvy money-saving strategies you can. [Find some appropriate Ben Franklin quotation you cite as a mantra so you feel better about the debt.] While you’re recovering, build a solid care and maintenance plan into your long range budget, and make sure it includes care and maintenance of your precious physical and emotional health. Best of luck to you!