My concern was the swim; I couldn’t chance having a coughing fit or asthma attack in the water without access to my inhaler, and I also worried that with my ears being so congested (so odd and annoying), any water that lingers could easily turn into an ear infection. I do not want to be sick again, and I do not want to be on antibiotics again, so I stayed home while my friends completed the course.  

Missing the starting line at a race like this is doubly frustrating because in addition to missing out on race day festivities, you forfeit the fee to be on the course. In this case, I think it was $75. Quite the cost not to participate. There’s no sense in asking for a refund, these events are non-refundable because whether I’m there or not, the race must go on. The supplies, the permits, the race crew, the photographers; they’re all there whether I show up or not. So I don’t mind losing out on the money; the production crew has a job to do and the organizers are clear about the no-refund policy. But seeing all my friends’ smiling, confident faces in their race pictures? The camaraderie displayed in the pre-race group shots? The enthusiasm on display in their race reports? I’m more sad I missed out on the experience than the money.

All that said, I can’t be too sad; I have a long race season  ahead and now it’s time to transition from triathlon and focus on running. Marathon training officially kicks off tomorrow and I need to be mentally ready for all the ups and downs the next 18 weeks hold. In retrospect, I guess I’d rather have been sick before marathon training and be healthy for the rest of the summer and early fall. Time to focus on wellness and getting back to fighting form.

The post Missing the Starting Line appeared first on The Budgeting Babe.

I am definitely sensitive to gluten.

The treatment for both of these conditions is a gluten-free diet. The diagnosis for celiac requires a specialist visit and an endoscopy, an invasive procedure that requires anesthesia. My physician says that based on my family history, she doesn’t need a celiac disease diagnosis to tell me to go gluten free, I just should do it. However, she said if I need to know whether I am celiac or not, I could see a specialist. But the end result would not be different; I would need to avoid gluten either way.

What a pickle.

After years of digestive testing that started in high school, it’s come to this.  How much do I want to know? How much do I need to know? What will a diagnosis do for me that a probable cause will not?   

I go back and forth. The reason for my current dilemma is this: in November a blood test for celiac came back negative. In February I went gluten-free for nearly 30 days, with positive results. In March, I added gluten back in, with very negative results. I took another blood test yesterday, but since the first came back negative and the tests are notoriously fickle, I don’t expect to learn much from it. Celiacs will tell you a diagnosis with endoscopy is necessary, pursue it. Non-celiacs say to leave it at gluten-sensitive and move on. The question is, can I?

After years of visits to different GI docs and primary care visits for various pains in the abdomen, and a supremely unsatisfying “irritable bowel syndrome” diagnosis several years ago (which is basically the equivalent of a shoulder shrug and a pat on the back), plus many other seemingly unrelated irritations like migraines and ovarian cysts, I would like to know.

I would like to know for sure whether this is “all in my head” or if something truly is happening. I would like to know if I can have a beer and a pizza every once in a while and risk only a headache and some discomfort, vs. risking intestinal damage. I would like to know.

Still.

If one physician tells you that he or she need doesn’t a confirmed diagnosis to start the treatment, why pursue the diagnosis? Why go under anesthesia, at a cost of (I believe) about $1,000 plus the specialist visit?

Objectively, I tell myself that it makes more sense to just consider gluten off-limits for the most part and proceed with life. The end result will be the same. Plus, working in academic medicine, I believe that in five or 10 years there will likely be another, better, less invasive test that is cheaper and more accurate.

Still.

My mind has questions. It wants confirmation, validation, something.

Anything.

I know that as a patient, I am my own best advocate. But then I go back to the doctor’s question: “How will the endoscopy make anything different for you? If it comes back negative, won’t you still go gluten free?”  Yes, I will. The end result will be the same. It’s a good question to ask, and is probably along the advice that many doctors would give, especially as physicians are criticized in the media for ordering unnecessary tests, spending too much money, and driving up the costs of health care.

To her credit, she left the discussion somewhat open ended, “It just depends on whether or not you need to know. I would need to know. But everyone is different. It’s up to you. The results will be the same.”

I have the number for a specialist. I’m not sure whether I will use it.

What a pickle.

The post A Diagnosis, at What Cost? appeared first on The Budgeting Babe.

So, I meal planned, shopped, and baked this weekend,  and ate a fair amount of gluten-filled meals (because they will be my last for a while). While shopping, I was pleasantly surprised to find that a lot of my sauces and dips from Trader Joe’s were already gluten free. (The folks at Trader Joe’s were just awesome on my first GF shopping trip!) And I baked a loaf of banana bread last night that smelled AMAZING while I was cooking it. I’m realizing that my diet really won’t be that drastically different than what I normally eat; I’ll just have to make some substitutions for breads and pastas, and I won’t be eating out as much. 

The budget implication.
I kept hearing about how expensive GF foods are, and I can see that they are certainly pricier than items generally found on sale at, say Aldi or Jewel. But I was already shopping at Whole Foods and Trader Joe’s, so the price difference per item isn’t really that great — just a few cents here and there per item. I will have to look at receipts for the month, but I’m pretty sure that any price increase on the GF foods will be offset by less dollars spent eating out and visiting local bars.

Finding support
There’s good news here, I already have a great built-in support network since so many of my family members are starting to go gluten-free. I’ve already put some of their shopping tips to good use and plan to use more of their lifestyle, cooking, and budgeting tips during this experiment. I’ve been thrilled to see how many resources are available online, too. There are tons of recipes out there!

I hope I come out of this experiment feeling better. At the very least, the next few weeks will be interesting. I’ll keep you all posted on how it goes.

The post Gluten Free, Day 1 appeared first on The Budgeting Babe.

Here’s the rundown before the insurance kicked in:

• Bill 1: When my knee was injured, I saw a specialist. That cost $294 for a 20-minute session with the orthopaedic doctor. He ordered a few X-rays, which addded a cost of $167 to my bill. Based on this appointment, he recommended an MRI.
• Bills 2 and 3: The hospital charged me $2,950 for the radiology bill. Additionally, I received a charge from the Faculty Foundation, separate from the hospital, for $347 for “MRI outpatient.” Presumably this was the charge for the doctor to review my MRI results, though it’s difficult to tell unless I call and inquire about it.
• Bill 4: Then, for the follow-up appointment, I was charged an additional $131 for the specialist’s time to give me a diagnosis. (I’m now in physical therapy for five weeks – I’m considering those charges separately.)

So prior to insurance, provided that all the bills have come in, I owed the hospital $3,889. (About the amount in my designated “rainy day fund” that is separate from all my savings).

Thankfully I have insurance, unlike a lot of people I know. Here’s the breakdown of what I owe after insurance:

• Bill 1 (initial consultation and x-rays): I owe $36.40 (there was a nice reduction because I stayed in-network)
• Bill 2 (MRI from hospital): I owe $221.25
• Bill 3 (random “MRI outpatient” bill): I owe $26.20
• Bill 4 (second consultation): I owe $25 (again, in-network reduction worked here)

In total, I owe $308.85 - not insignificant, but a small portion of the original cost. I wish I had money left in my flex spending to cover the costs, but I wasn’t anticipating any major procedures this year and so only put in enough to cover routine care.

Looking at these bills, though thoroughly confusing, makes me consider how lucky I am that I can work with physicians and physical therapists to get myself back into running form. I hear so many sob stories on TV about people who “used to run” or “used to work out” and have since become overweight or obese. I really didn’t get how that was possible, but when I look at these numbers, it’s easy to see how it could happen to someone out of a job with no insurance – she may try to stay healthy and work out, but a fall, a slip, a tear, or just overuse can stop an athlete in her tracks. And without the right network of care, she might never get back to her passion.

I pray there’s never a day when I’m uninsured. My boyfriend has been off and on insurance for years – even a white collar professional can become one of America’s uninsured while between jobs. (And as a former financial services sector employee, he’s been there a few times.) Currently a full-time law student, he is on some kind of minimal catastrophic coverage plan through his University. I hope he has a rainy day fund

The post Ouch! The Cost of an MRI appeared first on The Budgeting Babe.

Yep, I’ve been there.

So what should you know about open enrollment? For those new to benefits, it’s the one time every year you’re asked to plan ahead by selecting new benefits plans for the following year. If you didn’t like your plan during the past year, you can change it. If you need something different, you can modify it. Admittedly, when I first started working I was totally confused by the whole process. I didn’t know an HMO from a PPO to save my life. Nor could I tell you what an HSA was or what a PayFlex card could be used for.

That all changed when, at 24, I got my wisdom teeth removed and got braces. I learned that you could put money away for health care income-tax free as long as I planned far enough in advance. I learned that staying in-network could save you hundreds of dollars each year. I learned that health care planning is a strategy, and in order to take full advantage of the system, you couldn’t ignore open enrollment. It’s exactly the opposite  - the more you plan, the more you save. And gosh do I like to save.

There are a ton of good articles floating around that can help guide you through changes in this year’s list of options. Smart Money and Chicago Tribune are among the articles I read to get up to speed on this year’s changes…. and there are a lot. Inevitably, costs will go up (reform or not, they always do). There are some new changes in my plan, namely that now preventive medicine services are free (I have yet to figure out what that means; most likely it encompasses screenings), over-the-counter drugs now require a prescription for flex spending, insurance companies can’t drop people for pre-existing conditions, and children are now covered up to age 25.

I have to do a bit more research before I elect my 2011 benefits. I spend a lot each year on health care for a variety of reasons, so I want to analyze last year’s choices and make sure they were the best decisions for me. (That sounds like a task for a Sunday morning and a cup of coffee, doesn’t it? Tonight I’ve got a Halloween costume to finish.) I hope that you take time from your crazy busy schedule to review your benefits this year, too. Don’t just do what your parents or your significant other does, and don’t ignore your options; read up, learn how you can take advantage of savings opportunities, and most importantly, plan ahead. And don’t wait until the last minute to do it. You’ll be thankful you took time to focus on your health this year.

The post Rollin’ with Open Enrollment appeared first on The Budgeting Babe.

In the budgeting world, organics are a hot topic. I’m lucky enough to be able to afford them, despite being a one-income household. I shop almost exclusively at Whole Foods and Trader Joe’s, and it shows in my monthly budget. I spend more on groceries and restaurants each month than any other one expense (aside from rent). It’s a conscious decision that I feel good about. I like knowing that no added hormones or antibiotics are in my food. I appreciate that my meat isn’t washed with ammonias and bleaches, and that my vegetables aren’t sprayed with harmful chemicals. I’m skeptical that animals are treated better by organic farmers, but I hope it’s true. I also hope that the farmers are using sustainable methods that are better for the planet. Of course, it’s impossible to know without actually visiting or seeing the farm where the food comes from, which I would like to do someday.

Given that background, then, I wasn’t surprised to see the conditions of “big food” farms featured on the movie I watched last night, “Food, Inc.” (2008). I posted on Facebook that I was watching the movie, and one of my cousins – also in a single-income household, but with four kids and a wife in school – replied, saying in his area the difference between a dozen regular eggs and cage-free eggs is more than $2.00. Multiply this cost difference to an entire shopping trip for a family of six, and you can see why organics are such a hot topic.  One of my co-workers calls Whole Foods “Whole Paycheck.” Most average, working families would have to significantly increase their food budgets to afford organics.  For a lot of folks, that’s simply not an option due to income. For others, it would require a complete change in priorities. Would you be willing to give up car payment number two in order to afford organic groceries every month?

Admittedly I’ve not done the math to figure out the cost difference between buying organic vs. buying regular. But others have. One woman estimated buying organics resulted in a 37 percent increase in her grocery bill. Another study claims that people who consistently buy organics and other healthy foods spend 20 percent more than those who buy less nutritious foods. So as a concerned budgeter, how can I be such a big fan of foods that cost more? Even with all that I like about organics, isn’t a 20 to 37 percent decrease in my biggest monthly expense an easy way to grow my net worth and increase my savings for a home?  Shouldn’t I be solely focused on the bottom line?

For me, the answer is easy. It’s a matter of priorities. Yes, I want to grow my net worth and save for a home. But not at the expense of my health. If that means I have to have less home, car, or “things” to support my food choices, I’m OK with that. I know that my genetics aren’t great; preventable food-related diseases run deep on both sides of my family – heart disease, high cholesterol, stroke, diabetes, cancer – so the choices I make today could potentially save me health care costs in the long run. It’s an intensely personal choice. But it’s one that is worthwhile to think about if you’re in your 20′s – and before you start having kids – because the farther along you go buying cheaper calories, the more difficult it will be to make the switch in the long run.

I don’t know if I’ll always be able to afford organic groceries. If I were to lose my job, this is unfortunately one of the first choices I’d have to reconsider after all the easy decisions like cable and DVR. I feel pretty strongly that when I have kids, they’ll be eating organic foods, but it’s impossible to know whether my budget will be able to afford feeding extra mouths organically on a budget.

The benefit of budgeting, and constantly re-budgeting and evaluating your expenses, is that it gives you the freedom to make such lifestyle choices. If you want to buy organics, you have the option to build it in and ask yourself: what’s more important – cable TV or nutrition? If you’re looking solely at the bottom line, though, with no other context or consideration for long-term costs, I’d encourage you to read up on the subject and make an informed decision.

The post My Biggest Monthly Expense appeared first on The Budgeting Babe.

The bearable lightness of being

I recently lost 13 lbs and dropped two pants sizes. I feel great and I think it’s pretty sustainable (for me). I’m still losing weight, too. I didn’t use any fad diets or buy any expensive equipment, but I did completely change all my eating habits to (what I consider) a healthier diet.

I decided to change my eating habits because I felt like crap all the time. I always had heartburn, my stomach was always knotted up and, I’ll say it, I was constipated, gassy and bloated, like ALL the time. I just felt out of whack, and I didn’t like it. Plus, I had put on extra weight over the past five years or so that I’ve been working, despite exercising somewhat regularly. It was time for a change, and, being budget-conscious, as I am, I didn’t have the money to afford a trainer or dietitian, so I educated myself. That meant lots of trips to Borders to buy cookbooks and healthy eating books, Internet research and speaking with people I know in the nutrition field.

Now, admittedly, most people think I’m crazy when I tell them how I’ve been doing it. But it was either change my eating habits or go on expensive medication to help me digest my food, and I just wasn’t down with that. Plus, as I said, I felt like total crap every single day. I needed a major change!

Here’s what my plan boiled down to:
1. No more coffee, no more soda.
I replaced coffee with decaf green tea, and I replaced soda with a product called “fruit water” (and actual water, of course!). I was drinking so much caffiene each day that I wasn’t sleeping right, which caused me to be tired and fatigued all day long, which in turn made me eat more and work out less. Now, I sleep through the night and have energy in the morning, minus the headaches.

2. Less meat, more veggies.
For me, this has actually meant no red meat. I try to limit consumption of any meat to twice or three times per week. I look for food that’s easy to digest, and for me, meat isn’t one of them. Plus, my family has a history of heart disease, so my doc was pleased to hear that I had cut back on red meat. I don’t think I’m active enough to require most meat, since I mostly sit on my ass all day. Now get most of my protein through soy products, nuts, and of course, I still eat chicken a few times a week, as mentioned.

3. Cut way back on cheese, dairy.
I seriously ate cheese, loads of it, for every meal. And then I snacked on cheese throughout the day. I always carried cheese sticks in my bag to work, and my deli drawer was always brimming with bricks and bags of mozerella, cheddar, cheese spreads and whatever aged or artisan cheese I picked up that week. Brian and I even took trips to Wisconsin just to come back with cheese and beer. And that, my friends, was cause for the constipation. So, now I hold the cheese on my sandwiches, and instead ask for extra tomatos, cucumbers and avocado. I have also started carrying around fruit, which is way easier to digest. My daily snack of choice now? Apple with peanut butter. Yum, yum and yum.

However, I still enjoy a good pizza every now and again – probably once per week. Only now, it’s loaded with veggies, too.

4. Stop buying things with ingredients I can’t pronounce, and with ingredients that aren’t food. For instance, my peanut butter now only contains peanuts and salt. No more. Although someone with connections to the food industry will probably post something here against this, I’m pretty convinced that all the chemicals, hormones, steroids and chemical additives in food are bad for the digestive system. Especially artificial sweetners. (Maybe it’s not bad for everyone, but for me, I can directly track my use of Splenda to an increase in me feeling like shit.) Whatever the case, I want my food only to have food in it.

Admittedly, this is the most difficult part for those on a tight budget. My mom and I had a big discussion about this the other day because she can’t afford to buy what she wants because she has to feed my ginormous brothers. If you want to do this, just do what you can in little increments. For instance, the aforementioned peanut butter cost $1.99 at Trader Joe’s, which is cheaper than any Jif I ever bought. And the Whole Foods 360 brand is ususally comparable to what you get at a Jewel (Albertson’s) store, particularly if there’s something on sale. If you haven’t been to Trader Joe’s, I highly recommend it!

5. More home cooked meals, less eating out. Not only does it save an awful lot of calories, it also saves a ton of money. I have recently discovered how to broil fish, which is seriously a revolution to me. Fish in 6-8 minutes! Amazing and healthy!

6. Work out 3 times per week or more. In the begining of my food change, I really did this religiously. However, it stopped with the holidays and hasn’t picked up since due to the weather. But given that it’s on my list, I feel bad about it. Still struggling with this one, but when I do go, I feel great.

Well, I’m sure some people will write and tell me that this is too radical of a change, that it’s ridiculous and not budget-friendly, and that this leaves you with nothing to eat. But I used to eat pizza like three nights a week, eat McDonald’s at least once per week (mmm. cheeseburger.), I loved pasta with ground beef meat sauce and ground beef taco night and above all, I loved cheese with every meal. But I hated the way I felt, and now that I’ve made the change, I don’t miss any of those things.

Tell me your budget-friendly methods for staying healthy. I’d love to hear them!

The post The bearable lightness of being appeared first on The Budgeting Babe.

(Now I’m off to 1-800-contacts, where I can use my insurance plan (VSP) to file a claim before year’s end. Toodles.)

Given that I’ll spend a few thousand dollars on health care this year (more than usual due
to the braces and oral surgery), I could have saved a couple hundred dollars by utilizing my office’s
flexible spending account for health and dental care..
Prior to this year’s health fiasco, I didn’t understand how these accounts
work, so I did a little investigating.

Health spending accounts benefit employees because money spent on
health care is income-tax free. While government does not place a limit
on the amount of money you can set aside for health care, individual
employers sometimes do, often setting limits near the $2,000-$3,000 range (www.bls.gov/opub/cwc/cm20031022ar01p1.htm). Drawbacks do
exist to these accounts – if you overestimate your yearly health care
spending, you loose the extra money.

Though I haven’t put aside money for my health spending account yet,
I’m currently totaling up my costs for next year. Here are some tips
based on my strategy:

- Anticipate large costs: If you can put off an expensive
procedure until next year (when you can put in dollars against your account)
such as lasic eye surgery, wisdom teeth extraction or braces, plan to
do so. Then, discuss costs with your health care provider. Next year,
for instance, I’ll put $1,536 away to cover my monthly orthodontics payments.

- Check last year’s office visits: Count costs for annual visits to your
eye doctor, dentist, dermatologist, gynecologist, etc. I plan to also factor
in two doctor’s visits for colds. Add these to your running total.

- Include health care purchases: A quick look at your debit card or
checkbook will remind you of monthly prescription costs (heartburn medicine?
birth control?). Don’t forget about contacts and/or glasses (yes, you can use
1-800-Contacts under most plans).

This should give you a good idea of how much to store away in your
spending account. Of course, you can’t anticipate medical emergencies.
But based on your health history and purchase behavior, you can get a good
estimate for your account without going over.

And many Americans do go over. In fact, according to USA Today, $210 million
in unspent money is forfeited each year to health spending accounts (about
7 million Americans use these accounts). Upon closer look at the figures, given
that the average employee puts in $1,000 per year and leaves three percent
on the table, I estimate most people forfeit about $30 each year.

If, at year’s end, you’re stuck with money left in the account, fear not! Sandra
Block at USA Today offers helpful tips for draining your health spending account:

http://www.usatoday.com/money/perfi/columnist/block/2004-12-20-ym_x.htm

Some of my favorite ideas here are to restock your medicine cabinet
(check dates and toss out old medicines), buy new contacts (even if it’s only
one box!) and bump up payments on installment plans (like orthodontia).

If you don’t like the idea of flexible spending accounts, other options exist,
like health savings accounts (HSAs) and reimbursable medical accounts.
You can find plenty of information about both on the Internet.

The post Open Enrollment Season – Check Your Spending appeared first on The Budgeting Babe.

$560 – Initial payment for my braces
(I can’t believe how much these ache! Beyond the pain, the braces feels like
Legos took over my mouth. The orthodontist also put little plates behind my
two front teeth called “Turbos” so I don’t bite off the bottom braces. Now my
molars don’t touch and all I can eat is soup. Sweet. Or should I say, “Schweet.”)

$25 – Co-payment (and parking) to my doctor’s office
(On Sunday, I got a horrible stomach ache. I’ve had it for two full days now.
Monday I got scared about it and went to the doctor’s office, where a trained
medical professional reaffirmed absolutely everything that Web MD told me
without the detailed explanations.)

$5 – Generic over-the-counter stomach medicine
(Hey, at least it’s cheap)

Had I anticipated these costs in advance, I could have utilized my office’s
flexible spending account for health and dental care. Given that I’ll
spend a few thousand dollars on health care this year (more than usual due
to the braces and oral surgery), I could have saved a couple hundred dollars.
Prior to this year’s health fiasco, I didn’t understand how these accounts
work, so I did a little investigating.

Health spending accounts benefit employees because money spent on
health care is income-tax free. While government does not place a limit
on the amount of money you can set aside for health care, individual
employers sometimes do, often setting limits near the $2,000-$3,000 range (www.bls.gov/opub/cwc/cm20031022ar01p1.htm). Drawbacks do
exist to these accounts – if you overestimate your yearly health care
spending, you loose the extra money.

Though I haven’t put aside money for my health spending account yet,
I’m currently totaling up my costs for next year. Here are some tips
based on my strategy:

- Anticipate large costs: If you can put off an expensive
procedure until next year (when you can put in dollars against your account)
such as lasic eye surgery, wisdom teeth extraction or braces, plan to
do so. Then, discuss costs with your health care provider. Next year,
for instance, I’ll put $1,536 away to cover my monthly orthodontics payments.

- Check last year’s office visits: Count costs for annual visits to your
eye doctor, dentist, dermatologist, gynecologist, etc. I plan to also factor
in two doctor’s visits for colds. Add these to your running total.

- Include health care purchases: A quick look at your debit card or
checkbook will remind you of monthly prescription costs (heartburn medicine?
birth control?). Don’t forget about contacts and/or glasses (yes, you can use
1-800-Contacts under most plans).

This should give you a good idea of how much to store away in your
spending account. Of course, you can’t anticipate medical emergencies.
But based on your health history and purchase behavior, you can get a good
estimate for your account without going over.

And many Americans do go over. In fact, according to USA Today, $210 million
in unspent money is forfeited each year to health spending accounts (about
7 million Americans use these accounts). Upon closer look at the figures, given
that the average employee puts in $1,000 per year and leaves three percent
on the table, I estimate most people forfeit about $30 each year.

If, at year’s end, you’re stuck with money left in the account, fear not! Sandra
Block at USA Today offers helpful tips for draining your health spending account:

http://www.usatoday.com/money/perfi/columnist/block/2004-12-20-ym_x.htm

Some of my favorite ideas here are to restock your medicine cabinet
(check dates and toss out old medicines), buy new contacts (even if it’s only
one box!) and bump up payments on installment plans (like orthodontia).

If you don’t like the idea of flexible spending accounts, other options exist,
like health savings accounts (HSAs) and reimbursable medical accounts.
You can find plenty of information about both on the Internet.

I know that it’s hard to focus on next year’s flexible accounts already.
But planning ahead will save you headaches in upcoming months, as account
deadlines loom and the holiday season kicks in. Determine your costs now, and
all you’ll need to do in the fall/winter is locate your tabulation sheet.

Don’t miss the cut-off date like I did!

The post Health Expenses – Ouch! appeared first on The Budgeting Babe.