The Chronic Tax
We talk a lot about how chronic illness can be both physically and mentally draining, but financially—not as much. There is no cost so overlooked as what I call the chronic tax. I think of the chronic tax as the money I put forward to live my life in the most “normal” way. Different chronic conditions require different chronic taxes. And while they may be seen as a luxury to those who are able-bodied, they are just another costly inconvenience to the chronically compromised. Chronic tax includes expenses paid to accommodate a condition, avoid a flare-up, and see a specialist. But it spreads to so many more areas that you wouldn’t even consider if you didn’t have a chronic condition.
It’s paying people to help you move and unpack your belongings because you can’t do it yourself anymore. It’s paying extra for a first-class ticket because you need the extra space. It’s paying for an Uber to a destination “within walking distance” while all your friends are walking. It’s paying more for a one-story flat home instead of the massive and affordable 3-story townhome because you can’t handle the stairs. It’s buying the nicer car with the squishier seats. It’s the most expensive health insurance plan. It’s the $2000 mattresses and robot vacuums. These aren’t usually expenses that health insurance companies approve for a health savings account. So, I want to share some ways I’ve learned to manage it.
Oh, and disclaimer: I’m extremely fortunate to have a job with good health insurance, a salary that I can afford to stretch, and a strong support system of people I can lean on. That being said, this is a list of some ways I’ve been able to make my money go even further.
Health savings accounts: MAX. THIS. OUT. If your job allows you to set aside some of your salary, pre-tax, for health purposes, put whatever you can into it. No, you won’t be able to pay for a $2000 mattress or first-class ticket with your HSA. But using the HSA wisely will allow you to save more money in the future so that you can. And you’d be surprised at the things you can use your HSA for.
High-yield savings accounts & rainy day funds: Despite the similarity in acronyms, HYSAs are very different than HSAs. This money can go to whatever chronic tax you need to cover. The more you put into it, the more you get out of it. HYSAs can give you 5-10% back on your money. Find a good one, and then do what you can to set aside a certain amount from every paycheck to a high-yield savings account for your chronic taxes.
Budget down to the day: This is such a scary and sucky thing to do. I know. There’s nothing I hate more than going through finances. But about six months ago, my partner and I sat down and went through every dollar in each of my accounts. First, we jotted down the take-home portion of my monthly salary (AFTER taxes, health insurance, etc.) and divided that between 30 days. Next, we documented every monthly cost I could think of down to the dollar. These costs included things like car payments, Wi-Fi, rent, groceries, subscriptions, manicures, and Starbucks. Then we divided those costs up over 30 days and calculated the difference. This gave me a realistic look at how much money I had left at the end of each day to spend on miscellaneous things. And guess where a lot of that goes? Chronic taxes. Seeing the numbers in front of me gave me a great baseline to understand what I could truly afford without breaking even or dipping into my savings.
Don’t feel guilty. Just do what you can: I know it’s easier said than done. I’m all for a strong savings account and have struggled with using the extra bit that would go into it if I didn’t have a chronic condition. But I do. And I deserve the comfort and ease of living just as much as the able-bodied person next to me. And you do too.
Be well,
Amanda
