With the introduction of autism or other medical or mental health issues in your life, you may find that (through no fault of your own) you have more expenses than your budget can manage.

Even though you most people couldn’t handle it financially, you may find yourself feeling lost, guilty, or overwhelmed. You find that you suddenly feel like your competence is challenged, right? Because we have this thing in our society that “competent” people don’t end up in difficult financial straights….

Yeah, right.

Maybe the worst part is that people either start to slowly scoot away from you or they offer to help. Depending on your particular support system, this could go either way. But either way, it’s scary. It’s scary to be all alone, and it’s scary to depend on others.

So what now?

You’ve Made All the Possible Cuts

You’ve visited the websites of the financial gurus, and they all say: Budget every penny and don’t overspend.

It sounds like great advice. Unless it isn’t. You’ve already trimmed the fat, cut out all unnecessary expenses, and clipped coupons. You sold one of your cars and maybe even downsized from your home to an apartment (or even moved back home). Those necessary bills are still piling up.

The bottom line is that once you’ve used up your resources, they’re gone, and you’re left looking for the next source of funding.

And it hurts. No matter how willing you are to spend as necessary to meet everyone’s needs, it hurts.

You REALLY Can’t Cut More

As much as it would be awesome to cut some more, as much as you are willing to cut additional expenses, there aren’t any more to cut.

You can’t stop paying for food, doctor visits, medication, or insurance. You NEED those things or you wouldn’t be in this situation.

When you reach this point and you’re down to the expenses that are non-negotiable and the bills are still piling up what can you do?

How Can You Stay Afloat When You Are Drowning In Medical Expenses?

I’m going to get real with you. Few people or organizations give advice on how to do this because it’s so very hard. Just because something’s hard doesn’t mean it should be avoided.

You need help so here are my VERY BEST tips for you to help keep you moving forward, keep the financial anxiety in check and to make sure you know that you remain a competent person of integrity anyone would be fortunate to know.


1. Set up a time every month to continue checking the budget to see whether you have made all necessary cuts.

I do this to this day, and there are sometimes things I see that I hadn’t seen before. In addition, “creep” happens. Sometimes we add an expense or two and start moving down the slippery slope, so continued diligence is key.

I used to pay my rent with my credit card because it was due before my child support and alimony arrived. The credit card fee was $46 per month. How silly to pay that when there was enough in my bank account to pay without that card.

Also, when I rented this condo, the price of the condo plus the rent on a storage shed for our extra stuff cost less than the price of renting a house. The shed rents for $150 per month. After a little decluttering, we will be able to move the rest of our belongings into the condo.

Two small changes that had been hiding from me totaling $196/month. Best part? Paying my rent five days earlier and eliminating the shed won’t change my life AT ALL.

When we first rented the condo, I wasn’t ready to give up all of the extra stuff, or I at least wasn’t ready to decide which stuff to give up. Fast forward a few months, and I’ve decided and it will be a lot easier than it would have before.

Keep checking that budget!

2. Check the bank balance everyday if you need to.

This point seems counterintuitive to some, but for me, when I got most stressed about money, I looked at the balance every day.

It was sometimes hard for me to open my accounts, but after I got past that, there was some comfort in knowing just where I stood, and it helped me make better day to day decisions.

3. Work with medical providers, insurance companies, etc., on medical expenses BEFORE you incur them. You have little leverage regarding payment AFTER the service has been provided.

If you have any doubt about your ability to afford the expense or about whether it is covered ask questions FIRST. (Unless you are truly in an emergency situation, and even then there is sometimes time to ask questions.)

Often when I approached doctors about tests they ordered and discussed my ability to pay agains the benefit of the treatment, they helped me find a treatment plan that better fit my budget. It surprised me how many doctors had NO IDEA how much those tests cost and how quickly those costs add up.

They just follow protocol.

If you aren’t sure about insurance coverage, ask more questions. Doctor’s offices code their services with a number for purposes of letting the insurance company know what services they are requesting reimbursement for. Ask the doctor what code the will use for sending the bill to the insurance provider and call and ask whether that code is covered.

In addition, providers can have discounts available for folks who will struggle to pay, discounts for cash pay patients, and payment plans that are sometimes easier to negotiate before than after the procedure/service. Don’t be afraid to ask.

Also, this strategy will eliminate those days and weeks when you wait for the bills to start rolling in with no idea what your financial hit is going to be. You’ll already know, and you’ll already have a plan in place.

The first discussions may feel a little awkward, but that’s okay have them anyway. It gets easier! It’s nothing more than doing business.

4. If for some reason you didn’t get the cost squared away before using a service, or there is a problem with payment, etc., tackle it directly.

If the problem is with the insurance company, get that Explanation of Benefits (EOB – the sheet the insurance company sends you detailing their payments) out, call the insurance company and ask them to explain it.

They can be very helpful.

If you disagree with the decision of the insurance company, ask them to explain the appeals process and then read about the appeals process on the EOB, insurance company website, or with the company providing the insurance (your employer). Do both to make sure you understand the process, when in doubt, whatever they have in writing rules.

Keep asking questions and appealing until you are satisfied with the answer or you run out of appeals. If it is a lot of money, many lawyers do free consultations and checking in with one may be helpful.

More recent appeals I’ve filed were filed by the doctor’s office rather than by me. Make sure you check with the doctor’s office to see if they will assist you here. Many will, and they should.

I’ve had to appeal a number of claims over the years and the effort has saved me tens of thousands of dollars. Don’t be afraid. Be direct. Be patient. Be persistent!

5. If you’ve set up a payment plan or made arrangements to make a payment and you’re not going to be able to, call proactively and explain the situation.

Ask the person on the other end of the call to note on your account that you are trying to make arrangements to make payments.

Many providers are more generous in working with you if you are out in front of your issues.

They may be able to set up a different payment plan for you, give you an extra month to pay, etc., you won’t know what they can do for you until you communicate with them.

I’ve had many a provider continue to wait for payment while I slogged through the appeals process for MONTHS without asking me to pay a single penny while the issues was resolved. Each time the extended my due date, they thanked me for my call.


When you are in a position where life has given you some big financial challenges, and you are cutting back and trying to keep up, it’s easy to slip into a scarcity mindset.

You may begin to feel like there isn’t enough, there will never be enough, and your life has been ruined. You can only cut back so much after all. As I mentioned above, once the resources you had on hand are gone, you may feel like there’s nothing left.

Why do others have enough and not you?????

So while all of the tips above are important, this one may be the MOST important:  Cling to a mindset of abundance.

Know that there is enough in this world for everyone. When you feel yourself looking desperately for more to cut, ask yourself if there isn’t a way to GET MORE instead.

Back when my kids were married and I was still married, my hubby and I found that flipping houses helped us keep up with our financial obligations to our daughters’ medical issues. We would buy a house below market, live in it a few years and sell it for a profit after just a bit of repair and updating.

In addition, at one point when we were in debt, he took advantage of his company’s tuition reimbursement plan to acquire an MBA.

We paid only for parking and his calculators.

Within two years after graduation, he was making WAY more money. He hadn’t quite doubled his income, but it was close and SO VERY HELPFUL.

Had we been thinking only of cutting, we would have missed this opportunity to have MORE.

Was it HARD?

You betcha. But as hard as it was, I think it was easier that continuing to find cuts to make where there were no more cuts to make.

Outsourcing may enable you to put yourself in a position where you can earn more as well.

If you can pay someone else to deliver your groceries, clean your home, mow your yard, change your oil, etc., this can free you up from the time and stress of having to do it yourself. If your income potential is greater than the cost of having these things done for you it’s a WIN!

In families where expenses are tight, outsourcing is often the first expense to go, but sometimes it’s the benefit of these expense that keeps everything moving.

Think carefully about whether getting rid of help would save or cost you money. (I’m going to write a separate post on this topic and I’ll link back to it here.)

Keep in mind that while cutting back is a viable strategy, so is looking for MORE.

It’s out there, you just have to keep looking.

Also, encouraging yourself to have a mindset of abundance feels WAY better than thinking about having a mindset of scarcity and when you start thinking about it in those terms, it just feels better.


I’ve just taken on the financial end of things so far, but while big medical stuff is happening in your life, it’s important to take care of yourself.

I know that sounds funny, because the reason you’re in this boat is because you are incurring expenses to take care of yourself (or a significant other), but from a financial perspective, it is easy to think that when times like this happen, you should cut out ALL and EVERYTHING that isn’t absolutely necessary.

And sometimes that’s the case, but if you can, maybe try to add a little joy back into life.

1. Give yourself some grace.

Adjusting to this new reality (even if it’s temporary) will take time. There will be times you spend money on something you don’t need only to regret it later. If the happens, you can take back the item or remind yourself that’s not where you are right now.

It’s okay. Few people can shift their financial circumstances on a dime. So give yourself some time to figure it all out and give yourself grace while you do it.

2. Have a few “luxuries” that make you feel pampered.

For me it looks like a $2.50 bottle of foaming hand soap. I can’t tolerate most grocery store soaps, and this little bottle of soap makes me feel like a million bucks. I get up in the morning and use it first thing.

One of my daughters has a “thing” for orange juice. For about $1.99 (or less if it’s on sale), she feels like she is living large when she enjoys her OJ.

No, it’s not a trip to Disneyland, but you’d be amazed how a few really affordable comfort items can keep you from feeling like you’ve hit bottom. In addition having a few “treats” around may help you avoid the urge to go out shopping.

Like a good bath bomb? So does one of my daughters. When life builds to a breaking point, she and her $5 bath bomb head for the tub.

I’ve also found that if we have good, yummy, healthy food in the house it makes everyone feel like life is good. Knowing your next meal is a pantry away is magic for getting your stress level under control.

We have a rule at our house that everyone eats three meals a day. We’ve found that it keeps everyone grounded and forward moving. If someone is struggling, the first question we ask is, “ When did you eat last?”

You can read more about this rule in my post, “Taking Care of Yourself When You Are Hanging by a Thread.”

3. Get out and discover the world of FREE/nearly FREE activities.

When life gets crazy hard, you may find yourself sticking close to home. You realize that when you leave home it puts miles on your car, there is the expense of gas, time, energy, etc., it becomes overwhelming to leave.

But if you like to get out, feeling stuck at home quickly becomes unhealthy. If you feel you can swing it, try going out to the park, go for a hike, visit a friend, have a friend visit you, find a free day at a local museum or a local community event or festival.

Getting out can restore you so you can get back to the business of business feeling a little lighter and more ready.


This is last, because it is my personal least favorite. Some people are much better at it than me, and hats off to them, because sometimes I need help and I don’t like asking for it, so guess what?

I don’t get it!

Help may come in the form of assistance from family and friends, church organizations, an online request, government assistance, discounts from providers, etc.

Most often, you have to ask. Even when it’s embarrassing, even when it hurts, ask.

When my kiddos were little ones, they were at the doctor or in therapy pretty much every day.

Finally, after depleting our resources, I called about a government program and asked for help.

The kind and generous social worker who came to my house and was helping me through the paperwork while I cried stopped and told me that we were exactly the type of family the program was intended to help.

That while our tax dollars go to pay for the roads we all use and no one feels a bit guilty about that, I shouldn’t feel guilty about using this tax-based program for folks whose medical stuff is beyond their means and insurance coverage.

She helped me survive having to take that step, and I’d love to do the same for you.

It stinks when you have to ask for help, but it’s okay.

If you’re not sure what programs are available in your area, local support groups may be a great source of information.

If you can get help that protects you from debt or more debt, take it. Avoiding debt is WAY easier than paying off debt. Stay out of debt if you can, do your best if you can’t, but don’t go into debt without asking for help.

The Real Test of Whether This All Works

As I was writing this article, my kiddos were talking to me about our financial past. I explained just how bad it got, all the things we did to keep afloat, and my daughters were STUNNED.


They were unable to think back and guess which times we were struggling and which times we were fine. Why?

Because we were proactive, we engaged in a little self-care, we lived with a mindset of abundance, and we (eventually – though not as soon as I should have) asked for help.

It made me feel so very good to know that while I couldn’t protect them from all of the medical stuff they’ve had to go through, I did protect them from the financial stress around it.

These tips won’t fix everything for sure if you are dealing with a ton of medical expenses, but hopefully they will help and, if nothing else, they will take off the edge, the worst of the anxiety and help you know there are lots of strategies out there you can implement to keep moving forward.

Most importantly, know that you are not alone, that few people have the resources to have prepared for what you are going through, and that you can do this.

Want to remember this? Pin it to your favorite Pinterest Board!

Costs of Autism

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