
My husband and I have been scraping by on his small post-doc salary and my freelance writing income for 18 months now. We’re deep in the trenches and figure we have another 18 months to go before my husband can finally get the university research job that we’ve both been dreaming of–so he can finally start in his career after more than 10 long years of school and post-doc work, and me, so we can finally have a salary that covers expenses for our family of 5 and offers a little bit extra.
Then, this winter we learned that my husband’s mentor might be moving 16 hours away for a better job, and he asked my husband if he would like to move with him. The next few weeks were a flurry of discussions and calculations. Was moving so far away worthwhile?
If you find yourself, like we did, contemplating a long distance move, there are many variables to consider.
Will the new job give you more money or less? Don’t automatically assume that a job where you will make less is a deal breaker. If the cost of living in the area is less, you may do just fine with a reduction in salary.
Also be aware that some national companies pay the same rate for a certain position, no matter what area of the country you live in. Your company might pay $50,000 for your position whether you live in Nebraska, where the cost of living is relatively low, or in San Francisco, where earning $50,000 may cause you to live close to the poverty level because the cost of living is so high.
Sometimes, taking a lower salary is worthwhile if you have a good chance at job advancement and salary increases in the future. Likewise, taking a job that pays more initially but offers only slight chances of advancement and income increases over the years should be considered carefully. Upward mobility is something most employees are looking for.
Will the new job give you skills and knowledge that will make you more attractive to other companies? In the academic world, landing your first, tenure-track position job is often the most difficult. Once you land one and prove yourself there, you make your chances of finding another job in a different area and institution better. That is one reason why my husband was considering the move.
Look at your own career field and the potential job in particular. Will relocating and taking the job help you be able to move to a different company and earn more?
Another important consideration besides income is the cost of living. CNN Money has a handy cost of living comparison calculator that lets you input your current city and the city you are considering moving to. You enter what your current salary is, and the program will tell you how much you will need to earn equivalent in your new city as well as the percentage price difference in groceries, housing, utilities, transportation and health care.
For example, if you are considering moving from Omaha, Nebraska to San Francisco, CA and you are currently making $50,000, you would need to make $93,118 in San Francisco to experience a similar financial lifestyle because the cost of living is so much higher. (The big shocker–housing is 274% more expensive in San Francisco than Omaha.)
We live in the suburbs of Chicago, currently, which enables us to remain a one car family. I have the car all day for running errands and driving the kids to extracurricular activities. My husband takes public transportation. That saves us a great deal of money because we don’t have to have a second car and the loan payments, repairs, maintenance, insurance, gas, and plate registration. We also don’t have to pay for parking downtown, which is expensive.
The town we were considering also has a good public transportation system, so we won’t have to spend more money there. If we were instead considering a town without a good public transportation system, we would have to calculate how much more per month we would have to pay for the luxury of owning two vehicles.
As a family, we like to have fun on the weekends. If we live somewhere with plenty of free and low cost activities, we save a significant amount of money. The town my husband was considering moving to is close to a university, so there are many free and low cost activities.
While this might not initially seem like an important consideration, if you’re looking at living in the new location for several years, you’ll want to be active and engaged in the community. If you have to fork over large amounts of money to do so, your budget will take a hit.
If you’re close to your immediate and extended family, will the move you’re contemplating take you closer or farther from home? Right now we’re only 3 hours away from extended family and friends, which is a fairly easy car drive, considering traffic. If we move, we’ll be a 17 hour drive away. Since we’re a family of 5, hopping a plane once or twice a year is likely not an option since it will cost too much. How often do we want to make the 17 hour car drive, and how often will friends and family come down to visit us?
If you’re not close to family and friends at home, this isn’t an issue, but if you are, don’t discount the real power of homesickness. Many people take jobs far away and incur expenses such as paying for a long-distance move and selling their homes only to want to return to the area they left in a year or two.
Some employers will pay for your move or at least a portion of your move. Others don’t.
While it might seem silly to include the cost of moving in your calculations, it is important. If you’re considering a long distance move as we were, your expenses for moving an entire household can really add up. Using online tools, I estimated our 1,000 mile move would cost us at least $6,000, and that’s after some serious decluttering and selling of worn out furniture that we wouldn’t take along.
If you’re moving a large household, you could easily pay four figures (or more, sometimes) to move your items. Is this something you can pay for? Can you sell everything and furnish your new place with new or used items?
Deciding to make a long distance move is never easy. There are many variables to consider, and some may be in conflict with others. As for my husband and me, we’re still up in the air with our decision, though we’re leaning toward staying put for now.
How about you all? Have you made a long distance move for work? What other variables did you consider? Was your move better for you financially or career-wise?
Share your experiences by commenting below!
***Photo courtesy of https://www.flickr.com/photos/86435488@N00/33495908/in/
The following is a guest post. Enjoy!
When searching for auto insurance, the actual insurance agent you will be dealing with may be more important than the name of the company holding the policy. This agent will be the person you deal with on a regular basis. If you have a question about your policy or are trying to make a claim, the agent assigned to your account is the one with whom you will be in contact with. That is why it is important to find a good agent that has expert knowledge and years of experience in the insurance industry.
Finding an Agent
One of the best ways to find an agent is to ask the people you know. Your friends and family can give you the referrals that they have had good experiences with. They can also give you a heads up on which insurance companies and agents to avoid. Another option is to do a quick search online for local agents and read the reviews posted by pervious and current clients. A good agent will need to be trustworthy and someone with who you feel comfortable talking and interacting with. To know if you feel comfortable with a particular agent simply talk to them for a few minutes. He or she will be learning some very private information about yourself so being comfortable and trusting them should be a huge factor in your decision.
The vice president of Navion Insurance Associates, Chad Bitterlich, says that consumers looking for an agent should seek out those who have experience outside of the sales portion of the auto insurance industry, such as claims or underwriting. Mr. Bitterlich also warns consumers to beware of agents who merely want to give you a cheap price quote since the agent should be more concerned about the amount of coverage needed over the actual price of the coverage.
Remember to always check with your state’s insurance department to make sure the agent has a valid license with good standing. And always keep copies of all proposals, applications, quotes and other documents you receive from the agent.
Captive Vs Independent Agents
Captive agents are those who only work with one carrier while independent agents can represent multiple carriers and offer a wide selection of quotes and coverage that a captive agent cannot offer. If you are interesting in shopping around at different insurance carriers, an independent agent is the way to go. They can provide you with multiple quotes from various insurance carriers to help ensure you are getting the best coverage available for a great price.

We were all children once.
At times, our parents would be brave enough to take us with them to the store and it totally backfired. They tried to keep us away from the toy isles, but when we got a glimpse of one of those “must-have” toys, we began to ask for it repeatedly. We thought of all the reasons why we deserve to have that toy. Perhaps we have been extra good lately, or maybe we would promise to be extremely good in the future. Maybe we could convince mom or dad that this toy was educational and would propel us into a new category of learning. Finally, we tell them that we will forfeit our birthday or Christmas presents for this toy (always a good idea at the time, but doesn’t feel too brilliant when our birthday rolls around…). The bottom line was, we wanted it and simply couldn’t do without it.
Yes, we were all children once, but now we are living in adulthood. We have homes to maintain, bills to pay, and some of us even have children of our own to take care of. Our hairlines are receding and might be getting a little “salty,” but we can all still revert to our childhood selves when the time is right.
Here are a just a few things that bring out the child in us when we see them:
Oh boy, when we see these items we know that they are not really needs, but we start devising a reason why it would make sense for us to have them. Perhaps we just got a promotion at work and feel deserving of that executive-looking car. Or, maybe you have stuck to the family budget for an entire month and feel the need for a little bit of a spending spree. After all, your husband did just get that new driver. You deserve it!
That child-like mentality might never leave us, but if we want to be wealthy in the future, we are going to have to learn to suppress those immature feelings. You can’t deny this to be true. Money is finite, which means that life has trade-offs. Every purchase has it’s opportunity costs.
I recently heard a story that illustrates this concept perfectly:
A salesman decided he was going to work his butt off for a year to hit his income goal of $200k. If he accomplished this, he was going to drive to the Mercedes dealership, hand over his piece of junk car, and buy a brand new $80,000 Mercedes with cash that he saved up from his impressive earnings.
On December 10th, this man hit his earnings goal of $200,000! He was now ready to buy his brand new Mercedes to reward himself for his tireless work. Just like he said he would do, he went to the dealership, pointed at the Mercedes he wanted and simply said, “I want to test-drive that one.”
He took it for a drive and it was everything he thought it would be. The leather seats hugged him close, and the heated steering wheel kept his hands nice and warm during the drive. This car cornered like no car he had ever driven and was falling in love with it. The child inside of him was saying, “This is your car dude. You deserve it. Everyone is going to envy you and you will be the talk of the neighborhood. This is your car.”
He almost handed over the cash, but then the adult in him finally came into the conversation: “$80,000 is a lot of money. You could buy a very dependable used car for much less money, and it will last you for a long time. Think about the opportunity costs. What if you invested this money instead?”
As it turns out, this man did not buy the car. Now, 20 years later. The Mercedes is worth $4,000 and his $80,000 mutual fund has ballooned into $500,000 dollars.
Be sure to listen to the adult in you. What if, instead of buying that item, you invested the money instead? Is this purchase still worth it?
***Photo courtesy of http://www.flickr.com/photos/erin_costa/5941282494/sizes/l/

In case you missed the first 30 editions of the 10% Blog Income Give Back, after doing some thinking at the beginning of October 2011 about what direction I want this blog to grow and evolve towards in the future, I decided that any income made from this blog would have more significance to me at a personal life values level if I knew that a portion were being given back to the following places:
Because of these considerations, I’ve decided that each month going forward, I’m going to give away 10% of my net (after-tax) blogging income/profit to My Personal Finance Journey readers (5%) and to charity (5%). Listed below is a summary of the results we’ve achieved together thus far through this give back effort:
So, that’s the overall flow of things and a brief recap of what’s happened so far with the give back initiative. Now, let’s get in to the specific details for this month’s (April 2014) giveaway.
Like previous months, I’ve decided to use the RaffleCopter giveaway management tool to handle sign-up facilitation for this giveaway, so simply go through the steps listed in the widget below to enter the running for the prize and accumulate entry points.
There is no limit to the amount of points you can earn. If you refer 10 subscribers – your name will have accumulated 170 entry points! Or, if you link to the giveaway more than once, you can accumulate those 10 entry points multiple times. You can also share other My Personal Finance Journey articles via social media sites once per day. In the event of a tie, I will be using a random number generator to select the grand prize and runner-up (2nd place) prize winners.
Important instructions: After you complete an entry method, make sure to click and fill out the “I Did This” or “Enter” button in the widget so that I have a record of your points.
Remember, the deadline for entries will end at 11:59 PM, April 30th, 2014 (~2.5 weeks from today – the start of the give back). Good luck to you all! Please contact me if you have any questions. After the deadline for entries passes, the grand prize and runner-up prize winners (one with the most points and second most points accumulated, respectively) will be contacted via email to receive their prizes.
***Photo courtesy of https://www.flickr.com/photos/tejvan/4420933678/in/

Also, if you’re interested in sharing your own financial story/journey with us in a reader profile of your own, just shoot me a quick email, and we can get the ball rolling!
We are 30’s-something newlyweds living in Los Angeles. We met while through friends as undergrads at UCLA (Go Bruins!)
Like most college students, we both had to take out student loans. While we should have saved more during our college years and early 20’s, we went chugging along, enjoying our lives, and saved minimally. All that changed when we started discussing marriage. We buckled down and put our savings in high-gear. We paid off our engagement and wedding all in cash – not putting a penny on our credit cards! We were inspired by this and now, we are bent on eliminating our student loans and living a debt-free life! We are also very much driven by adventures – we are absolute foodies and restless travelers! Since food and travel were two of our biggest expenses, we have created ways to reduce our expenses: we cook amazing food at home and we’re travel hackers! We take advantage of cash-back offers and miles & points in order to stretch our budget even more. Through our blog, we share all the ways we are still enjoying our life, while making sure we are focused on financial independence! We’re moving towards being debt-free in the next 12-24 months and retired by the time we’re in our 40’s 🙂
We both hold down our 9-5’s – Anneli in Recruiting/Talent Consulting and Carlos in Commercial Insurance in the Entertainment Industry. Together, we make over 6-figures and are able to save more than 20-25% of our income for retirement. We toyed with the idea of home-ownership, but most of the housing in the LA area is overpriced. Since we want to travel the world once we’re retired, we are holding off on owning our house for now. Perhaps once we’re retired, we can pay for a house all in cash!! (Fingers-crossed!) We are fanatical budgeters and keep track of all our expenses, investments with an eagle eye!
We are all about paying off our student loans! We’re 1/2 debt-free – we paid off Carlos’ student loans last year. Now it’s all about attacking Anneli’s loans. Once that’s done, we are debt-free!! We are also thinking about starting a family relatively soon – so saving for a baby is front and center in our budget. It’s awesome that we’re pretty much on the same page with most things financially. It’s easy to outline our goals and figure out how we can make things happen!
We are excited to continue our savings and investment strategies in order to retire early and travel the world!
Always be future-oriented!
What you do today – how you spend of save your money will dictate what kind of retirement you will have in the future! Be creative – instead of finding ways NOT to do something – ask HOW can you make it happen instead. Additionally, find a partner in the truest sense of the world – if we’re on the same page with our goals, that’s the most important thing!! As a couple, we are a team and it’s a beautiful thing 🙂

One of the sneakiest financial developments of the past decade has been the proliferation of grey charges added to consumer’s accounts, often without the consumer realizing it.
There are so many companies taking advantage of grey charges that nearly everyone is affected in some way. In many cases, the consumer has been charged these charges for months before they realize it.
Fortunately, you can fight back against grey charges and eliminate them from your life if you identify them and take steps to protect yourself against them.
Grey charges are repeated charges made to your bank account or credit card without you authorizing each purchase.
Companies that request the right to deduct money directly from a consumer’s bank account for goods or services fall into this category. Other companies enroll you in a service plan that allows them to charge your debit or credit card on a regular basis without you authorizing each charge. In most of these cases, you cannot access the service or product without first giving the company authorization for automatic charges to your accounts. Some companies use every trick that they can to get onto your credit card statement because they’re banking on the fact that you’re not paying attention during the sign-up process.
Grey charges can be found in magazine subscriptions, online game subscriptions, book or movie club memberships, automatic renewals, and free services that switched to premium paid services without your knowledge. The most notorious source of grey charges is the free trials that require your credit card for the trial. Securing your credit card information in the beginning ensures that the companies can charge a consistent stream of subscription fees at your expense. The trial is what gets you in the door and allows them to charge your credit card bill every month.
It is important to try and reverse or cancel the charges as soon as possible to prevent more money from being siphoned out of your account. Having the charges eliminated can be time consuming and it is very easy to get frustrated with the situation. In fact, getting rid of these charges can be extremely difficult if you are dealing with an unscrupulous company. After all, the company that placed these charges on your account want to keep the charges going for as long as possible so that they can make as much money as they can.
In some cases, the company will throw up unnecessary roadblocks to prevent you from canceling the charges quickly. These roadblocks may include having to travel to a physical location to cancel the service in person, having to send in paperwork or documentation to the company, having to provide a reason for the cancellation or discuss the cancellation with multiple representatives of the company.
The easiest way to avoid these charges is to simply not do business with companies that engage in this practice. Grey charges often happen because consumers aren’t paying attention when making a purchase, so you can combat these charges by being mindful and monitoring your purchases on your credit card and bank account statements on a monthly basis. You should also read the fine print before going through with the transaction and ask questions about anything that you do not understand. If the rep cannot answer the questions or there is no one available to ask, you may want to reconsider your purchase.
A few years ago, I decided that I was going to join a local gym to get into better shape. This gym would only grant you a membership if you signed up for the membership plan that deducted the membership amount from your bank account automatically. I had no problem with this while I was going to the gym regularly, but the problems began when I decided to cancel my membership while planning to move across town to a new neighborhood.
There seemed to be no way to cancel my membership. When calling the company to cancel, I was told that I had to speak with a customer service representative in person. Traveling to the location to cancel in person brought a long interview where I was encouraged to make use of their other facilities (too far away to be convenient where I was moving) or put the membership into hiatus (allowing them to continue charging my account a lesser fee for no service at all).
Even after reiterating multiple times to multiple people that I wanted to cancel my membership, I still found that I was being charged the full membership fee months later. I ended up closing the bank account to prevent any more charges from being deducted from the account without my authorization. In response, the company began sending me letters letting me know that they were continuing to charge me and that I now owed them money that I needed to remit immediately, instead of just cancelling my membership. I had to threaten legal action to get the harassment to stop.
While not all companies are bad in this way, I have to admit that this one bad experience has ruined it for everyone else. I have never again signed up for an account with any company that required them to make automatic transactions from my bank account for goods or services. I would love to join another gym, but instead I walk around my neighborhood and exercise at home. There are some products that I would love to try, but having clearer skin isn’t worth the headache I might face trying to cancel the service plan.
This is the decision that I have made, but it may not be the right decision for you. Before signing an agreement with any company that wants you to allow them to make automatic charges to your accounts, review your options carefully. You can also go online and perform a search to see if there have been many complaints by people trying to cancel the service or stop the automatic charges from occurring. You may find that the product or service is not worth the trouble after all.
How about you all? Have you had difficulty with grey charges in your life? How did you get the charges to stop?
Share your experiences by commenting below!
***Photo courtesy of http://www.flickr.com/photos/restlessglobetrotter/3378489363/

This year I got a surprise when I finished up my taxes.
I owe quite a bit to the federal government. Why do I owe money? The answer for my situation is simple. I earned income on the side.
Anytime you earn income on the side of your regular job, you are required to pay taxes on it. The government wants their cut of everything that you make, so even if you get paid in cash, you are still supposed to report it. While I knew that I was going to make extra money last year, I didn’t realize how much. I could have avoided having to pay this year (plus any potential penalties) if I would have just properly estimated my taxes.
Estimated taxes are payments that you make to the government to cover your tax liability on income not subject to withholding. A common form of this income would be earned through self-employment. Even though I am employed full-time, any extra income that I make on the side from freelancing and running a small business is considered self-employment income. Other applicable income includes interest, dividends, alimony, proceeds for the sale of assets, rent, and prizes/awards.
Anyone who believes they will owe more than $1,000 when taxes are due should be prepared to pay estimated taxes. If you had a tax liability for the previous year, then you might have to pay estimated taxes.
It can be difficult to calculate how much you will need to pay for estimated taxes, but the IRS does have a calculation worksheet. They include it on their 1040-ES form. This form provides great detail into when you will have to pay and also helps you calculate how much you will owe. There are a few ways to calculate your estimated tax liability.
100% of previous year – If you owed more than $1,000 when you filed your return, then the safest way to deal with estimated taxes is to go with 100% of your previous years taxes. This would be to simply take what you owe to the federal government on your previous return and that would be what you need to pay. If your previous year’s adjusted gross income was more than $150,000, then you will need to go with 110%.
100% of current year – This number can be hard to know. You can use the IRS worksheet or software like TurboTax to help you calculate this number. If you are going to make the same salary, but can estimate how much you will make on the side this year, then this method can work. You use this calculation to ensure you don’t owe again on the next return. You do have the ability to change your calculation during the year, especially if your income fluctuates.
If you don’t estimate your taxes properly, then you could owe a penalty. I had to pay one this year because I didn’t meet the criteria to have the penalty waived. This is an underpayment penalty. The penalty is currently an annual 4% of the amount you underpaid each period. This penalty can be avoided if your tax payments for the year exceed the lower of these two withholding scenarios:
You could also owe a penalty if you don’t pay your estimated taxes on time. If you are past their specified due dates, then you could be eligible for a penalty.
If you have your estimated taxes calculated, then it is important to understand how to pay them. The 1040-ES form comes with four payment vouchers. This allows you to split up your estimated tax liability into four payments. These can be equal or you can change the amounts depending on your calculated income. The IRS has strict payment deadlines. Here are the due dates for this current year.
1st Payment – Due on April 15th
2nd Payment – Due on June 16th
3rd Payment – Due on September 15th
4th Payment – Due on January 15th of the next year
If you want more in depth information about due dates and how you deal with them, then read more from the IRS estimated taxes section.
The IRS provides you with three ways to pay your estimated taxes. They are:
If you don’t want to deal with paying the tax on your own, then you can have your employer withhold more on your regular paychecks. This only works if you are receiving paychecks. You would need to resubmit an adjusted W-4 to your employer requesting that they withhold more than they normally do. You will still need to make sure they are withholding enough so you don’t owe when you complete your return.
The debate continues on whether you should deal with taxes yourself or hire an accountant.
I have used TurboTax for years and it makes my taxes easy. It even helped me calculate the estimated tax payments for this year. That being said, I believe next year will be time to hire an accountant. We are selling our home and buying another, along with me cashing in some stock options, and making more side income. This year’s taxes are going to be complicated and I want to make sure it is done right.
(A side note from Jacob: I was quite surprised how affordable an accountant can be. Some of the premium plans for online tax prep platforms can charge you around $90, whereas, some accountants cost less than $300 to prepare your taxes.)
If you don’t feel comfortable calculating your estimated taxes, then seek professional help. There is no need to get it wrong and have to pay a penalty just because you didn’t understand the calculations. If you are tax savvy and you can use the TurboTax or H&R Block software, then feel free. It will cost less than a tax accountant and give you a little more insight into how estimated taxes are done. Either way, feel comfortable with the option you choose and make sure you properly calculate and pay your estimated taxes.
How about you all? Do you have to pay estimated taxes for your income that is not taxed when it is paid? How do you pay your estimated taxes – online, via check, or on the phone?
Do you use an accountant to file your taxes?
Share your experiences by commenting below!
***Photo courtesy of http://www.flickr.com/photos/moneyblognewz/5610981299/sizes/l

Do you remember when you were a kid and you were so excited to ride a 2-wheeler?
You were going to hop on and show your dad how talented you were, immediately riding away without his help. This is not how the story actually went though did it? Instead of riding like a veteran, you ran your bike into bushes, stacks of tires, buckets, and perhaps even parked cars in the street.
Beyond this, you may have even fell down when there were absolutely no obstacles. Your visions of perfection were quickly tarnished, and you grew increasingly frustrated at what you thought would be easy.
Some of you may have thrown your bike down and quit (perhaps more than once), storming inside in frustration (and probably crying to your mom). You thought you would never learn to ride that stupid bike, but you eventually did, didn’t you?
Around tax time, many of us begin to wonder where all of our money has gone each year. Those tax documents claim that we have earned $50,000, $70,000, maybe even $100,000, but what do we have to show for it?
A piddly-nothing savings account with $550 in it. What happened? How could we earn so much and keep so little? This is the point where we decide that we are going to grow up and ride that 2-wheeler. In other words, we are going to start tracking our money and make a budget.
Before the new month begins, we write all of our necessary expenses down on a piece of paper and vow to spend no more than that amount during the next month. Let’s say this totals to $2,500.
The month begins and we are excited. If we can get through the month following our budget, then we will have an extra $800 that can go into savings. Finally, a beefy savings account!
Everything seems to be going well for the first couple of days, but then we notice that our car is making a strange sound so we take it to the mechanic. Luckily, it isn’t anything too serious, but the repair still costs $80, which was not in our initial budget.
The month continues on and is dragging because we did not budget for any fun. After 20 days, you just can’t take it anymore and you head out with your friends for a night on the town. It wasn’t anything too extravagant: just a dinner, a few clothing purchases, and some drinks at the local bar.
The end of the month finally shows up and you total up you expenses. You just can’t wait to see that $800 go into the savings account, but…you don’t have $800 left. In fact, you don’t even have $500 left. Your grocery expenses were larger than expected, you forgot to include your phone and utility bills in the budget, and you also had the above expenses which weren’t initially accounted for either. After all these expenses, you only have $200 left over. You thought you were going to ride that 2-wheeler without a problem (after all, you are an adult and should naturally be good at this budgeting stuff), but it turns out that not only did you fall on the pavement and skin your knee, but you broke your arm as well!
“This whole budgeting idea is stupid, who needs it? I busted my butt for an entire month and have only held onto $200. I’m done with this.”- you say to yourself.
But, you have to remember that keeping track of your money is the only way to grow wealthy. If you want to live well in the long run, you have to be willing to scrape your knees with your budget once in a while. It will not be easy, but you will get better. Soon, you will be able to put $500 into your saving account, then another $750, and then you might be able to cut some expenses and earn a little more for a monthly net income of $1,000! If you hold yourself accountable, you will soon be riding in the Tour de France of budgeting and will be well on your way to budgeting your way to wealth!
How about you all? What strategies do you employ for dealing with discouraging set-backs in your personal finances?
Share your experiences by commenting below!
***Photo courtesy of http://www.flickr.com/photos/sahdblunders/8644936719/sizes/l/

Obamacare is causing a rise in cash-only doctors, a trend that has been at work for several years but seems to be accelerating. We’re not seeing a wholesale shift of medical practices going from primarily insurance-based payments to cash, but the number making the conversion is increasing steadily, at least from very low levels.
There are a number of reasons why both a doctor or patient would want to go the cash-only route. Though it isn’t for everyone, there are circumstances where it makes a lot of sense.
As much as anything, the healthcare industry is seeing massive shifts as a result of healthcare reform. What will be seen under Obamacare is more of a top-down system, which will invite a far higher level of rules and regulations. Many medical practices have already been struggling under the weight of increasing administrative responsibilities from healthcare insurance companies. But Obamacare is giving government a greater say in the process, which is increasing that burden substantially.
It’s not just that the increase in rules and regulations is merely irritating. Every healthcare practice experiences direct costs as a result of compliance. This will raise overhead in the form of increased staffing in order to meet compliance requirements. That will have the domino effect of also increasing indirect employee costs, higher insurance expenses, greater benefits, and even rental space for a larger staff.
A medical practice can sidestep these expenses by opting out of healthcare reform – and the insurance benefits it will provide – and going the cash-only route. It’s a form of cutting out the middleman – the insurance companies – in the healthcare industry.
Cash-only doctors are also able to treat patients the way they see fit. Participation in healthcare networks and their insurance company sponsors can create a series of enforced protocols, that a cash-only doctor does not have to adhere to. This gives the doctor much more flexibility in treating patients.
There’ll also be more flexibility in treating patients who are either struggling financially, or going without health insurance altogether. Doctors can charge lower fees with a cash-only basis, even adjusting those fees to the patient’s ability to pay.
Cash-only arrangements generally come in two forms: fee for service and subscription. Fee for service means that you can walk into a doctor’s office, receive treatment, pay in cash, and be on your way. With a subscription service, you pay a monthly fee to the practice, which can often get you unlimited visits.
There may be even more reasons why you as a patient would want to consider cash-only doctors. There are also downsides, and we’ll get to those in a minute. But first consider the following benefits:
People who don’t have health insurance.
Cash-only doctors will have an obvious advantage for people who don’t have any health insurance at all. Even though the healthcare reform law requires everyone to have health insurance, or face penalties, it’s still very likely that there will be millions of people without coverage anyway. Cash-only doctors will be a definite option for such people.
Cost. At some practices it may be possible to have doctor visits that will cost less than the co-payment you’ll need to pay under your health insurance plan. You may also get an increased level of service from a primary care physician, rather than getting shuttled off to a battery of specialists that are mostly matter of doctors practicing defensive medicine (that is, protecting themselves from lawsuits).
A return to the days of the family doctor. Under the current healthcare arrangement, doctors are typically limited to spending no more than a few minutes with each patient. The cost and burden of participating in a health insurance network require the doctor to see dozens of patients each day. Cash-only doctors won’t have that requirement, and will be in a position to spend as much time with you as is needed. Some cash-only doctors have even returned to making house calls.
Eliminating hassles with insurance companies. I don’t know about you, but any time I or anyone in my family receives any kind of medical treatment, it sets off a chain reaction of interactions with insurance companies to get the claim reimbursement for services rendered. Cash-only doctors will eliminate that interaction. It’s a cash and carry arrangement, and that’s the simplest form of business transaction.
“Concierge care”. This is essentially a subscription type service, and you pay a monthly fee for unlimited visits. It may also include a wider range of treatment options.
Competition to mainstream healthcare. We don’t usually think about the big picture when it comes to health care – we’re primarily interested in being treated. But cash-only doctors represent a potentially viable alternative to mainstream healthcare, and that may put downward pressure on fees and prices even with medical practices that work with insurance companies.
NOTE: The term “cash-only”, also extends to debit and credit cards, and presumably private installment payments. It’s use refers to the absence of funding from insurance companies.
For all of its virtues, the concept of cash-only doctors is not without its limits. Most obvious of course, is that cash-only is only viable at the primary care level. If you are operating without health insurance, and relying on cash-only doctors to treat you, it’s just a question of time before you will have a major medical expense that you will have to pay out-of-pocket. Because of cost, it’s unlikely that the providers of such services will accept a cash-only option.
If you are young and healthy, and rarely use health care of any sort, the cash-only concept will work well for the occasional doctor visit. But if it includes participating in a monthly subscription service, it may end up costing you more than you ever get out of it in benefits.
And since cash-only doctors are not part of insurance arrangements, it is unlikely that they are in any wide healthcare networks that would provide a large number of choices as to providers for expanded medical services. Again, this can be a complication when healthcare needs rise beyond the primary care level. Sooner or later, you’ll brush up against the need to use the services of insurance-only providers, and you’ll have to be prepared for that outcome – even while using a cash-only primary doctor.
You can find cash-only doctors in your area simply by doing a web search that includes cash-only doctors along with your ZIP Code. And of course, never overlook the value of word-of-mouth referrals from other people.
How about you all? Have you ever used – or considered using – the services of a cash-only doctor?
Share your experiences by commenting below!
***Photo courtesy of http://www.flickr.com/photos/eroc/7175277081/sizes/n/

Without really meaning to, I’ve spent my entire career working on different aspects of commercial and public infrastructure.
It’s ranged from the payments industry to transit/transportation and construction. I never connected the dots, but each of my jobs has been in industries that tackle big issues, albeit my role has been miniscule in the process.
Infrastructure is about putting the tools and systems in place to allow societies and individuals to meet certain needs. This can range from systems that allow you to use the same method of payment across the country, to creating public spaces that can be used for recreation, education and community events. It’s about having a network of roads, gas stations and more recently, electric charging stations to allow you to drive across country without it taking several weeks in a covered wagon. It made me think about what types of infrastructure do we develop as individuals? And is the infrastructure system we have in place a key to our success?
If you can view your own life through the lens of infrastructure, it may help you save time and heartache by simply viewing your daily activities through this filter. You can ask yourself if you have created a system to keep your body healthy in a routine, simplified way. Do you have healthy foods on hand at home? Do you keep some snacks with you in your backpack, in the car, or at the office so you can avoid sugary snacks? Is it easy to reload these foods? Is your grocery store nearby or on the way home? Do you have a standard list of items you need to replace weekly?
Exercise is another part of your health infrastructure. Do you play a sport that can be practiced daily? Yoga, surfing, Pilates, tennis and swimming are just a few sports that you can take up as daily play. But you’ll need to make sure they fit your lifestyle. If the nearest yoga studio is 50 minutes away, and you don’t like to practice alone, then yoga may not fit into your current infrastructure. On the other hand, if you find a sport or class that you can commit to playing daily, especially in the mornings, then that may quickly become embedded in your infrastructure. From there, you can further establish this part of your lifestyle by packing your workout clothes the night before, and placing the gym bag where you will see it when you wake up. If the infrastructure makes sense, it will be used more frequently, and it will lead to more positive elements being added to this infrastructure: such as having all of the ingredients for a green smoothie ready to go in the mornings, or keeping a mix of upbeat music for your workout on hand in your car or as a playlist on your phone.
All of these must work together properly when it comes to infrastructure. If something wasn’t properly planned, it will be discarded and abandoned. We learned this quickly in construction. If you built a ticket machine for a light rail station on the opposite end of where all passengers entered the station, it would be abandoned for the machine nearby, where people were nearby to ask questions, or learn from as they bought their tickets.
In the next part of this two-part post, I’ll examine infrastructure as it relates to managing your finances and fitting them into your overall life infrastructure.
How about you all? Do you view your life as a system that can be organized and ordered? Or are you living in total and utter chaos?
Share your experiences by commenting below!
***Photo courtesy of http://www.sxc.hu/photo/66986