Author Topic: Chronically ill mustachians - share your money saving tips  (Read 6151 times)

lauren214

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Chronically ill mustachians - share your money saving tips
« on: August 18, 2015, 01:19:38 PM »
Long time lurker, first time poster here.  I've enjoyed reading much of the advice offered here on the forum. However, I haven't found many tips related to saving on medical/ chronic illness related expenses (my largest budgetary item) other than not getting sick in the first place - which isn't really an option with genetics :) I'm sure there are lots of mustachians out there coping with expensive medical conditions and I was hoping that we could all share some ideas for reducing the associated costs.

Some of the things I'm already doing (as an example of the kinds of tips I'm looking for and hopefully as a reference for any other chronically ill mustachians who might be able to use them).
1. Maximizing tax deductions for medical expenses - pretty much deduct anything recommended by my doctor, which covers a ton.
2. "Disability" discounts - I found out you don't actually need to be "disabled" in a wheelchair or social security sense, but just need the blue hanging parking tag, which are actually available for all sorts of different conditions.  This hanging tag can save you money all over the place, particularly on public transit, so it's worth acquiring even if you don't have a car).
3. Utility discounts - At least where I am (San Diego), you can apply for reduced electricity if you have a medical issue that requires extra electricity use - like climate control, powering medical devices etc.

Any other suggestions or tips that anyone has would be awesome and greatly appreciated!



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AlwaysLearningToSave

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Re: Chronically ill mustachians - share your money saving tips
« Reply #1 on: August 18, 2015, 04:21:15 PM »
I'm not chronically ill, but I have sometimes been successful negotiating a lower price for services by paying cash at the time of service rather than billing it through my insurance provider.  I'm not sure how well this would work for the chronically-ill, though, if a significant portion of your bills are paid by the insurance company.  I've only ever done it when it was very unlikely that I would satisfy my deductible for the year so I didn't care if I got credit toward satisfaction of my deductible.  If it is possible to pay cash at the time of service and then submit the bill to the insurer so that you get credit toward satisfaction of the deductible, then you could get the best of both worlds. 

Of course, this probably depends very much on the specific service provider and health insurers involved.  And it only works when there are easily-predictable fees.  I highly doubt you are going to successfully negotiate cash at time of service with a hospital!

lauren214

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Re: Chronically ill mustachians - share your money saving tips
« Reply #2 on: August 19, 2015, 08:37:50 AM »
Alwayslearningtosave - thanks for the tip. Not super relevant to me since most of my stuff goes through insurance, but will certainly keep it in mind if I decide to try a treatment that my insurance won't cover.

Jschange - I'm definitely with you on the keeping food around thing. I tend to just cook a whole bunch when I'm feeling up to it and then eating down my stuff when I'm not doing so well.

I'm incredibly fortunate that I work from home so I don't commute every day. My bus system is actually free for people who are eligible for paratransit (for people who can't use the regular transit system all or some of the time) essentially to incentivize using the regular transit system - it might be worth seeing if there are any similar programs where you are.

I'm in the same boat as you on the insurance front, even the best plan is so much less expensive than paying out of pocket for all my stuff.  I'm pretty sure they hate me :)

Lyssa

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Re: Chronically ill mustachians - share your money saving tips
« Reply #3 on: August 19, 2015, 03:44:51 PM »
I tried sourcing through internet or foreign pharmacies with reasonable success. Otherwise I do not try to save money re my chronic condition. I'm convinced it will be both healthier and cheaper in the long run to handle my health as best as I can so the damage will be minimized over the years and decades.

However, I think this depends a lot on the specific illness in question. If its close enough to a "real disability" you should absolutely use dedicated spaces, services and discounts.

What comes for free moneywise but takes some time and work is a stoic attitude towards your condition. The psychological damage in most cases depends largely if you choose to dwell on your misery or can see the bigger picture of you having a lot of other privileges and having at least born into the best possible time (so far) to have a certain illness/disability. 

maryofdoom

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Re: Chronically ill mustachians - share your money saving tips
« Reply #4 on: August 20, 2015, 09:34:15 AM »
What comes for free moneywise but takes some time and work is a stoic attitude towards your condition. The psychological damage in most cases depends largely if you choose to dwell on your misery or can see the bigger picture of you having a lot of other privileges and having at least born into the best possible time (so far) to have a certain illness/disability.

Lyssa, I understand your point here, but this part of your post really bothers me.

I was diagnosed with a seizure disorder after having brain surgery in November 2014. Even though I had only two "unprovoked" seizures, and even though I'm on a medication that is working really well to control them, I could have another seizure tomorrow...or I could never have one again in my life. No one can tell me, for sure, if I'm ever going to get better, if I'm going to get worse, or if it's going to stay the same.

I resent the implication that I should focus on what's going well for me and not "dwell on my misery." No amount of positive thinking is going to keep me from having this condition. Optimism doesn't cure seizures. Am I somehow not allowed to be mad about something that has happened to me, over which I have no control, and no ability whatsoever to fix? Must I put on a happy face to the world -- and to myself -- because the problem I have isn't as bad as those that some people have? I'm all for stoicism as a philosophy, but I don't want it to be used as a way to dismiss the real, genuine problems that disabled people face (both financially and otherwise).

I also don't think it's useful to classify disabilities into those that are "real" and "not real," but that's a separate issue.

I don't mean to jump all over you and your points, which are perfectly valid; but my life has been significantly altered by my experience and I find it to be a sensitive subject.

maryofdoom

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Re: Chronically ill mustachians - share your money saving tips
« Reply #5 on: August 20, 2015, 10:06:40 AM »
Seconded. I'm not really chronically ill any more*, but the suggestion that I could positively think my way into dealing with a shitty situation was obnoxious. Nope, being sick sucked, was stressful, and it's kind of hard to ignore intrusive medical problems. And the fact that, say, I have the privilege of having a functional family doesn't really fix that. Mitt Romney is rich, but he's still going to watch his wife slowly die, in pain, while young. Somehow I don't think counting his money is going to fix that.

*It turns out all my medical issues were caused by a raging, untreated infection and they cleared up after the infection was treated which nobody anticipated. Everyone though I'd be living in my parents' basement on SSI right now. It's a miracle.

Yikes! I'm glad to hear you're doing better now.

I struggle with this mostly because my condition has seriously impacted my life (your driver's license gets revoked for six months every time you have a seizure, and I live in the suburbs where biking is hazardous, at best; plus I don't think you can operate a bike either when you're on a six-month seizure ban) and I'm mad about it. I mean, I lost my job back in February. That's life-altering, in and of itself. When combined with these health issues, I've had a rough year. I feel like being angry about this entire situation is a perfectly valid reaction.

And at the same time, I have, literally, the bare minimum criterion of what it takes to have this condition. I can't imagine what people who have more serious and more disabling conditions must feel like.

lauren214

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Re: Chronically ill mustachians - share your money saving tips
« Reply #6 on: August 20, 2015, 12:00:21 PM »
Lyssa - I definitely agree with you that cutting corners to save money when it negatively impacts ones health is not a good idea if it can be avoided. However, there are a lot of ways that one can save money on the same treatment/ benefit. For example, extreme heat intolerance is one of my worst symptoms and i am able to function dramatically better in a 68 degree environment. So I can either pay the normal utility rate, or I can take advantage of the utility company program designed for people who, due to a medical condition, have above average energy needs, which gives a discount. Same benefit, but at a lower cost - which I am all for!

As far as the "real-ness" of a given disability goes, i think that if a medical condition interferes with your ability to function/ live life normally/ live as you otherwise would if you didn't have that condition, it's pretty darn real

I agree with you that attitude is important when coping with chronic illness, but I don't think that it's necessarily a black and white divide where you either dwell on your misery all the time or are 100% positive. For me, I am generally pretty positive and can do about my situation, but i can definitely admit to having the occasional pity party. I actually find that I'm doing better now from a psychological perspective allowing myself to experience and express negative emotions from time to time rather than trying to be positive 100% of the time. Again, I think that everyone is different in how they cope - focusing on gratitude doesn't work for me, but it's huge for others. But I think your general point that coping skills are valuable is very valid.

Maryofdoom and Serpentstooth - As you can see from my reply to Lyssa above, I think that the overarching idea of coping skills as a valuable tool for people with chronic illness is valid - but not so much that the 100% positivity/gratitude path is the only appropriate/ healthy way to cope. As I mentioned above, I think the occasionally pity party is actually a healthy thing, and the whole "think about the good things in your life" or "it could be worse" routes are pretty ineffective for me. My main coping skills are - 1. Finding creative ways to adapt tasks or situations that I'm not able to do. Like organizing my kitchen so that I can cook while sitting down.  2. Accepting imperfection/ limitations (always a work in progress as I naturally tend to lean towards perfectionism). Like not beating myself up over not accomplishing as much in a day as I'd planned or allowing myself a good cry every once in awhile.
Anyways, long story short, I agree that having coping skills is a great asset, but think that which coping skills (optimism, gratitude, creativity, humor, accepting imperfection, and certainly others I haven't thought of) are helpful/ beneficial is highly variable from person to person. Saying that coping skills are beneficial, at least to me, doesn't dismiss or minimize the challenge that people with disabilities face - it recognizes that coping skills are needed precisely because these challenges are so great.

Monkey stache

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Re: Chronically ill mustachians - share your money saving tips
« Reply #7 on: August 20, 2015, 09:22:00 PM »
If you have to take a brand name drug that doesn't have a generic there's a few ways to save. Often the drug manufacturer will have a program that helps with costs if your income is under a certain amount.

The other option is to trick the system into cheaper meds. Ask your doctor for a higher monthly prescription and tell them you're doing it to save money. For example, if you need 60 pills a month ask your doctor to prescribe 120 monthly but only have it filled every other month. Please tell your doctor what you're trying to accomplish so it doesn't seem suspicious. They won't do this with pain meds but I believe those are all available as generics. Often the monthly cost of a medication is the same whether it's 60 or 120 pills so you cut that expense in half (proof that medication prices are completely made up).

Many health insurance companies have online pharmacies which will mail you meds (pain meds also don't apply). Which is awesome since it auto-refills and it's one less trip to the pharmacy.  They usually have a deal where you buy 2 months of a prescription and get the 3rd free by using their online pharmacy. Using the online pharmacy paired with asking my doctor to "double" my meds reduced my co-pay from $90 to $30 a month. I saved $720 a year doing this.

dantownehall

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Re: Chronically ill mustachians - share your money saving tips
« Reply #8 on: August 21, 2015, 07:42:52 AM »
Obviously everyone responds to a chronic illness differently - I'm not gonna tell anyone else how to deal with theirs, but this woman helped me a lot with the way I think about my serious chronic health problems:

http://www.alpineguild.com/COPING%20WITH%20CHRONIC%20ILLNESS.html

Lyssa

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Re: Chronically ill mustachians - share your money saving tips
« Reply #9 on: August 21, 2015, 10:32:21 AM »
@ MaryofDoom, Serpenstooth and Lauren

It was not at all my intention to tell anybody that they should pretend everything is fine or that there are "real disabilities" and chronic conditions are somewhat less real (hence the quotation marks, I just wanted to reflect that there are certain legal restrictions re the conditions with which you are allowed to use e.g. dedicated parking spots. At least around here this is measured in how close to are to the "classic" disabilities (please read the "") like being paralyzed or blind.

I do not at all pretend that my endometriosis is a great thing to have or fine or that it doesn't matter. But it sure beats having Huntingtons, ALS, dementia and a lot of other things.

Maybe the way I received the diagnosis shaped this way of thinking since the initial suspicion was that I had ovarian cancer (i.e. a death sentence). So when I heard "endometriosis" my answer pretty much was "ok, cool".

There have been other times and rougher times since. But it helps me to try to keep things in perspective and tell myself: Ok, you lost the genetic lottery once. But you've won it in so many other respects.

Neither my luck  nor my illness are or have been in my sphere of control. I do not deserve to have a chronic condition and it "does not make sense on a higher level" and it also does not make me a better person or is there to teach me something about life and the universe. It just is. Just like I just happen to be born in the 80ies and not in the Roman Empire and in the middle of Europe and not in Afghanistan. And without Huntingtons or ALS.

Hope this helps to explain what I meant a little more clearly. I really did not mean to offend.

pomegranatemom

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Re: Chronically ill mustachians - share your money saving tips
« Reply #10 on: August 21, 2015, 11:18:18 AM »
Thanks for starting this thread! I'm also a long time lurker, first time poster. I have two awesome kids and one of them has a (genetic) chronic illness. Healthcare is a huge part of our budget! I already practice a lot of the ideas mentioned, but I should look into the reduced utility rate program again.

Wanted to mention that when we deduct our health expenses for the year we also deduct the mileage.
http://www.irs.gov/uac/Newsroom/New-Standard-Mileage-Rates-Now-Available;-Business-Rate-to-Rise-in-2015
 I make a massive spreadsheet at tax time using all my office copay receipts. Some of those specialty clinics are quite a drive so this makes a difference for us.

Cassie

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Re: Chronically ill mustachians - share your money saving tips
« Reply #11 on: August 21, 2015, 11:29:11 AM »
I teach a college course about this type of issue & interestingly the people that do best psychologically after acquiring a disability are the ones that grieve initially & then continue to look on the bright side, etc.  The people that do an occasional pity party overall do not do as well.  I was actually surprised when I first saw the research.  A major component of happiness is taking responsibility for what has happened even if you have not caused it & then moving forward. This even includes young active people that end up paralyzed & in a wheelchair.   I don't think there is any one right way to handle these things but just wanted to share what the research says.

lauren214

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Re: Chronically ill mustachians - share your money saving tips
« Reply #12 on: August 21, 2015, 12:41:54 PM »


The other option is to trick the system into cheaper meds. Ask your doctor for a higher monthly prescription and tell them you're doing it to save money. For example, if you need 60 pills a month ask your doctor to prescribe 120 monthly but only have it filled every other month. Please tell your doctor what you're trying to accomplish so it doesn't seem suspicious. They won't do this with pain meds but I believe those are all available as generics. Often the monthly cost of a medication is the same whether it's 60 or 120 pills so you cut that expense in half (proof that medication prices are completely made up).

This is a great tip- I actually do a modified version of this with pain pills and other scheduled drugs to avoid the hassle of having to get a "new" prescription every month as is required for a lot of drugs, which saves the time and energy of a doctor visit, as well as the money for copay and prescription.  My doctors will prescribe me, say, 60 pain pills (2x/day for 30 days), but that amount will last me for a year (I only need them when I dislocate something) - obviously this strategy needs to be discussed in advance with a doctor and it definitely requires a relationship/ trust.

I also use a somewhat related strategy - A lot of meds come in various dosages (eg one medicine will come in 25, 50, and 100 mg) and if you are taking a middle dosage (eg 75 mg), it will come as two prescriptions - a 25mg pill and a 50mg pill - and you have to pay two copays! But often if you ask the doctor to write it as 25mgs 3x per day, it will just come as a larger bottle of 25mg pills and you only have to do one copay.

@ MaryofDoom, Serpenstooth and Lauren

It was not at all my intention to tell anybody that they should pretend everything is fine or that there are "real disabilities" and chronic conditions are somewhat less real (hence the quotation marks, I just wanted to reflect that there are certain legal restrictions re the conditions with which you are allowed to use e.g. dedicated parking spots. At least around here this is measured in how close to are to the "classic" disabilities (please read the "") like being paralyzed or blind.

I do not at all pretend that my endometriosis is a great thing to have or fine or that it doesn't matter. But it sure beats having Huntingtons, ALS, dementia and a lot of other things.

Maybe the way I received the diagnosis shaped this way of thinking since the initial suspicion was that I had ovarian cancer (i.e. a death sentence). So when I heard "endometriosis" my answer pretty much was "ok, cool".

There have been other times and rougher times since. But it helps me to try to keep things in perspective and tell myself: Ok, you lost the genetic lottery once. But you've won it in so many other respects.

Neither my luck  nor my illness are or have been in my sphere of control. I do not deserve to have a chronic condition and it "does not make sense on a higher level" and it also does not make me a better person or is there to teach me something about life and the universe. It just is. Just like I just happen to be born in the 80ies and not in the Roman Empire and in the middle of Europe and not in Afghanistan. And without Huntingtons or ALS.

Hope this helps to explain what I meant a little more clearly. I really did not mean to offend.

I wasn't particularly offended - I interpreted your original response as encouraging the development of coping skills in general and positivity/ gratitude as the coping skills that work for you specifically.

Thanks for starting this thread! I'm also a long time lurker, first time poster. I have two awesome kids and one of them has a (genetic) chronic illness. Healthcare is a huge part of our budget! I already practice a lot of the ideas mentioned, but I should look into the reduced utility rate program again.

Wanted to mention that when we deduct our health expenses for the year we also deduct the mileage.
http://www.irs.gov/uac/Newsroom/New-Standard-Mileage-Rates-Now-Available;-Business-Rate-to-Rise-in-2015
 I make a massive spreadsheet at tax time using all my office copay receipts. Some of those specialty clinics are quite a drive so this makes a difference for us.

Yes, I always deduct for mileage - it definitely adds up!

I teach a college course about this type of issue & interestingly the people that do best psychologically after acquiring a disability are the ones that grieve initially & then continue to look on the bright side, etc.  The people that do an occasional pity party overall do not do as well.  I was actually surprised when I first saw the research.  A major component of happiness is taking responsibility for what has happened even if you have not caused it & then moving forward. This even includes young active people that end up paralyzed & in a wheelchair.   I don't think there is any one right way to handle these things but just wanted to share what the research says.

Health psychology? I loved that class! But I think studying health psychology actually made it harder for me to cope since I was trying so hard to "look on the bright side", but it made me really frustrated (because I would often be unsuccessful) and depressed (because I felt like a failure for not successfully dealing with my illness in the "right" way).  Now, I would say that I'm pretty positive most of the time, but if I feel sad or depressed sometimes, that's okay too. This attitude has actually significantly increased the amount of time that I feel positive because it cuts down on the guilt/ frustration that came from trying to be positive all the time :) Basically a long response to say that I think that the best way to cope varies greatly from person to person, and that people should find and use the coping styles that work for them.

Blonde Lawyer

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Re: Chronically ill mustachians - share your money saving tips
« Reply #13 on: August 21, 2015, 02:45:21 PM »
There is a danger to being an "always on the bright side" person too.  I'm one and I ended up in therapy at one point when I developed anxiety that was linked to not grieving how Crohn's had changed my life.  I couldn't fool myself that "everything is just fine" anymore and I didn't know how to cope.

NataliaDuma

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Re: Chronically ill mustachians - share your money saving tips
« Reply #14 on: September 14, 2015, 01:56:44 AM »
I always try my best to live within my means and not overspend on things that I don't need. I work around a budget that I have set for myself. I give myself allowances each week for example and list down my gains and expenses. In such a way I can monitor which ones do I spend a lot of money in and which ones am I spending too much on.

I don't usually buy new clothes but instead rely on hand-me-downs or buy my clothes either at thrift shops or consignment stores. I also have a list of meals I will have for the week so that whenever I do my grocery I already know which items I need and in that way I can avoid spoilage and wasting ingredients.

It is definitely a lifestyle change for most people but it is a change you must face if you want to save up more money.

Axecleaver

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Re: Chronically ill mustachians - share your money saving tips
« Reply #15 on: September 14, 2015, 10:18:38 AM »
For expensive meds, check out pparx.org - I just posted about this last week at http://forum.mrmoneymustache.com/reader-recommendations/pparx-org-partnership-for-prescription-assistance/

Comparison shop your state's insurance exchange for the lowest total cost insurance plan. Estimate the number of doctor visits you have to do, and the monthly Rx costs, then compare that to the copays and max OOP. In my case, the top tier plans always come out cheaper than paying lower premiums for a higher OOP.

Compare the family plans to individual plans - in our family, I get platinum for the low Max OOP while Mrs Axe gets silver. In a family of three, it's cheaper to get one individual and one individual+child than it is to get a family plan, even if you're on the same plan.

Also take a look at ebay and other sites for lower cost supplies. There is risk inherent in this, but you can save a lot on durable medical equipment like wheelchairs and crutches, or testing supplies. It's also helpful when you've hit your maximum amount for the year/month and need just a little bit more to help you stretch the monthly limits.

MacGyverIt

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Re: Chronically ill mustachians - share your money saving tips
« Reply #16 on: September 14, 2015, 11:23:18 AM »

2. "Disability" discounts - I found out you don't actually need to be "disabled" in a wheelchair or social security sense, but just need the blue hanging parking tag, which are actually available for all sorts of different conditions.  This hanging tag can save you money all over the place, particularly on public transit, so it's worth acquiring even if you don't have a car).

I beg of you all, please please do not get one of these blue tags unless you truly need it and if you do, for god's sake don't the parking space if you can walk without severe pain. I've spent too many days watching people hop out of their handicapped parking spot with ease I truly envy - no wheel chair, crutches, cane or limp - meanwhile I either circle the lot looking for a spot close enough to be manageable, park way out and keep taking breaks on the walk into the building and pop pain meds the rest of the day, or keep circling and waste gas, time and patience until a space avails itself. /rant

Here are some great web sites for the U.S.A. segment of the audience when considering websites to purchase their pharmaceuticals:
https://www.pharmacychecker.com/
https://www.legitscript.com/

If you have friends who live in countries with reasonable health care systems, it is worth asking if they'd be willing to pick up meds for you. Overseas I can buy several medications without a prescription, while also cheaper than with my "cadillac" PPO health insurance in the States.

When I spend less out of pocket than I do at Costco after insurance for a life saving medicine, I want to Facepunch every politician who's ever said, "The United States has the greatest health care system in the world!" Bullsh-t.

Gin1984

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Re: Chronically ill mustachians - share your money saving tips
« Reply #17 on: September 14, 2015, 11:34:28 AM »

2. "Disability" discounts - I found out you don't actually need to be "disabled" in a wheelchair or social security sense, but just need the blue hanging parking tag, which are actually available for all sorts of different conditions.  This hanging tag can save you money all over the place, particularly on public transit, so it's worth acquiring even if you don't have a car).

I beg of you all, please please do not get one of these blue tags unless you truly need it and if you do, for god's sake don't the parking space if you can walk without severe pain. I've spent too many days watching people hop out of their handicapped parking spot with ease I truly envy - no wheel chair, crutches, cane or limp - meanwhile I either circle the lot looking for a spot close enough to be manageable, park way out and keep taking breaks on the walk into the building and pop pain meds the rest of the day, or keep circling and waste gas, time and patience until a space avails itself. /rant

Here are some great web sites for the U.S.A. segment of the audience when considering websites to purchase their pharmaceuticals:
https://www.pharmacychecker.com/
https://www.legitscript.com/

If you have friends who live in countries with reasonable health care systems, it is worth asking if they'd be willing to pick up meds for you. Overseas I can buy several medications without a prescription, while also cheaper than with my "cadillac" PPO health insurance in the States.

When I spend less out of pocket than I do at Costco after insurance for a life saving medicine, I want to Facepunch every politician who's ever said, "The United States has the greatest health care system in the world!" Bullsh-t.
Just because they can jump out now does not mean that they won't need the nearby spot when they come out.  You can ONLY get the parking permit if your doctor thinks you need it and attests to it (at least in my state).  And it can take awhile.  I had sciatic nerve damage and had trouble walking when I was in grad school then I got pregnant.  There were days where I came to work fine and then going home could not safely get to the car.     
« Last Edit: September 14, 2015, 12:27:14 PM by Gin1984 »

lauren214

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Re: Chronically ill mustachians - share your money saving tips
« Reply #18 on: September 14, 2015, 12:24:23 PM »


2. "Disability" discounts - I found out you don't actually need to be "disabled" in a wheelchair or social security sense, but just need the blue hanging parking tag, which are actually available for all sorts of different conditions.  This hanging tag can save you money all over the place, particularly on public transit, so it's worth acquiring even if you don't have a car).

I beg of you all, please please do not get one of these blue tags unless you truly need it and if you do, for god's sake don't the parking space if you can walk without severe pain. I've spent too many days watching people hop out of their handicapped parking spot with ease I truly envy - no wheel chair, crutches, cane or limp - meanwhile I either circle the lot looking for a spot close enough to be manageable, park way out and keep taking breaks on the walk into the building and pop pain meds the rest of the day, or keep circling and waste gas, time and patience until a space avails itself. /rant

Here are some great web sites for the U.S.A. segment of the audience when considering websites to purchase their pharmaceuticals:
https://www.pharmacychecker.com/
https://www.legitscript.com/

If you have friends who live in countries with reasonable health care systems, it is worth asking if they'd be willing to pick up meds for you. Overseas I can buy several medications without a prescription, while also cheaper than with my "cadillac" PPO health insurance in the States.

When I spend less out of pocket than I do at Costco after insurance for a life saving medicine, I want to Facepunch every politician who's ever said, "The United States has the greatest health care system in the world!" Bullsh-t.
Just because they can jump out now does not mean that they won't need the nearby spot when they come out.  You can ONLY get the parking permit if your doctor thinks you need it and attests to it (at least in my state).  And it can take awhile.  I had sciatic nerve damage and had trouble walking when I was in grad school then I get pregnant.  There were days where I came to work fine and then going home could not safely get to the car.   

This.

I have been yelled at so many times by random strangers when I park in disabled parking spots because I "look fine".  Some of them are really aggressive.  I've also had people yell expletives out of their car windows at me for stealing "their" parking spot.

Those spots aren't only for people who can't walk without severe pain. For me, walking a long distance from my car into a building if it's warm out is inviting disaster.  The probability of me fainting and/or being dizzy enough to fall is high. Also, if I'm having a flare up of symptoms, the close parking space makes it easier to escape before things get so bad that I don't feel safe to drive.

Obviously I am against fraudulent use, but there are lots of people that have non-visible reasons for needing those spots.