Cartoon of broken piggy bank with signs of joint pain

Bear markets. Inflation. Pain at the pump. As the experts debate whether a full-blown recession is in our future, most of us are already feeling the pinch. But when you’re living with a chronic illness (something like rheumatoid arthritis, Crohn’s, osteoporosis, or ankylosing spondylitis), you know doctor visits, medications, and so on just can’t wait for the market to bounce back. So how can you make sure your health isn’t compromised during an economic downturn? Here, a few tips you can take to the bank. 

Have a Health Emergency Fund

Sure, you know you need to set aside enough cash for three months’ rent and to pay for unforeseen expenses like a new boiler or a can’t-wait car repair. But Andy Pendergrass, a financial planner based in Minden, LA, who happens to have rheumatoid arthritis, also recommends building up cash reserves to cover the cost of “health emergencies that could carry a high financial bill.” Advises Pendergrass, “You want to have at least enough to carry your deductible.” 

Review Your Health Insurance Policy

If you get your health insurance through your employer, the choices are generally limited. But during the open enrollment period, take a close look at higher-premium, lower-deductible options. Such plans are often a good choice for people with chronic illness because of the frequent HCP visits, higher-than-average prescriptions, and other medical needs.  

To figure out if it makes sense for you, do a careful comparison. “If you know, for example, that your meds cost a certain amount each month, find out how long it would take before you meet the deductible and the insurance starts kicking in,” says Pendergrass. “You might discover it’s worth paying the additional premium for lower out-of-pocket expenses.”  

Get Free Help

Shopping for health insurance on (the site associated with the Affordable Care Act, also known as Obamacare)? You may feel overwhelmed by all the choices. If so, take advantage of free, unbiased help: Go to and enter your zip code to find an “assister” or “health care navigator” who can walk you through your options.  

Consider an HDHP/HSA One-Two Punch

That’s a high-deductible health insurance plan (HDHP) plus a Health Savings Account (HSA). If you enroll in an HDHP (in 2022, the IRS defines it as a plan with a deductible of at least $1,400 for an individual or $2,800 for a family with maximum out-of-pocket expenses of no more than $7,050 for an individual or $14,100 for a family), you qualify for an HSA. Basically, it’s like a 401K dedicated to health expenses, and if your employer doesn’t offer one, you can open one on your own. (Check with your insurance company to see if they partner with an HSA institution, or ask your bank.) Just like with a 401K, you contribute pretax dollars from your paycheck to the account, which builds up tax free, and you can use the funds—also tax free—to pay for medical expenses, such as deductibles, co-pays, OTC drugs and other eligible expenses.  

Your HSA balance rolls over from year to year, so there’s no pressure to use it or lose it like there is with a Flexible Spending Account (see below). You also have the option of reimbursing yourself for medical expenses later on using money from your HSA — and there’s no statute of limitations. “If I pay $500 for my RA medications today out of my checking account, I can reimburse myself for that expense when I’m retired 30 years from now,” says Pendergrass. “In the meantime, the money in my HSA will have been growing for 30 years. It goes in pre-tax, grows tax free and comes out tax free if used for medical expenses.” 

Think About a Flexible Spending Account

OTC drugs, dental care, eyeglasses, feminine hygiene products, medical equipment, SPF lip balm, aloe vera gel, First-Aid supplies — if paying for these items eats into your budget, an FSA might be for you. Offered by your employer, an FSA lets you set aside pre-tax dollars from your paycheck to pay for such medical expenses. Every plan is different — some even include a gym membership or massage therapy with a prescription — so check to see exactly what’s covered.  

But before you sign up, know there’s a catch: You have to correctly estimate how much you’ll spend during the year because whatever money you don’t use won’t get rolled over, so you’ll lose it. And one more thing to investigate: the logistics. Some FSAs give you a debit card or checks that are pretty easy to use, while others have a complicated reimbursement system. If yours relies on the latter, ask yourself if you will realistically be up for the hassle. 

Say Yes to an HRA

Some employers offer a Health Reimbursement Arrangement (HRA), money they provide to help employees pay for health expenses, like doctor visits, dental care, medications, and more. It doesn’t cost you a thing — it’s entirely funded by your employer — and the money is provided to you tax free. If your company offers an HRA, you’ll have to sign up during the open enrollment period, so do your research and be prepared to say yes when the time comes as you have everything to gain. 

Be Budget Savvy

“For people with chronic illness, visits to health care providers, medication, and so on need to be a category in our budget,” says Pendergrass. To get started, look at a year’s worth of health-insurance premiums, co-pays, supplies, and OTC drug costs. And don’t forget to add affiliated expenses. “For example, if you use the sauna at your gym to help with arthritis pain, you have to figure that in, too,” notes Pendergrass. If necessary, cut out other discretionary spending — “Wait till the new Top Gun movie is streaming, rather than see it in the movies,” says Pendergrass — to make sure you keep your health budget intact! 

Ask for Savings

When you get a medical bill, it’s perfectly okay to negotiate. Ask your provider if they’ll shave off 10 percent if you pay in full or in cash. Or ask if they offer a sliding scale. 

Take Advantage of Telehealth

For checkups when lab work isn’t necessary or there’s no other reason why your doctor has to see you in person, ask if a telehealth visit will do the trick. “Especially if you have to travel a good distance for your doctor — for example, I go three hours away to Dallas for my rheumatologist — it’s a good way to save on gas,” says Pendergrass.

Compare Pharmacy Costs

Just as the price of peanut butter can vary from supermarket to supermarket, the price of meds can vary from pharmacy to pharmacy, so shop around. Apps like,, and make comparison shopping easy. Or try an online mail-order pharmacy like and Not only will you get your meds delivered right to your door (no driving to the drugstore), these pharmacies also offer loyalty programs and discount cards that can add up to further cost savings. 

Ask for a 90-Day Prescription

You’ll get a three-month supply for the price of one co-pay! And while you’re at it, call your insurance company and ask how to maximize medication coverage. For example, they may cover more of the cost of a different medication that could still work for you. Talk through any alternative medications with your prescribing health care provider. 

Go Generic

Ask your doctor or pharmacist if a generic drug will work as well as a pricier brand name drug. And when buying OTC products, opt for generic store brands. They have the same exact active ingredients as brand name products and must meet the same rigorous FDA approval process. The only difference: packaging and inactive ingredients, such as preservative and flavorings, which don’t affect the medicine’s mechanism of action. 

Get Free Coronavirus Support for Chronic Illness Patients

Join the Global Healthy Living Foundation’s free COVID-19 Support Program for chronic illness patients and their families. We will be providing updated information, community support, and other resources tailored specifically to your health and safety. Join now.

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