How to Prepare for an ACA Repeal – 6 Important Steps

Affordable Care Act Faces Uncertain Future

On Wednesday, May 1st 2019 the Trump administration signaled it’s legally challenging the constitutionality of the entire Affordable Care Act (ACA). This marks a shift from their earlier position that parts of the act were good and parts should be struck down. If the entire ACA repeal goes through, then up to 20 million people in the US are in a position to lose coverage.

The Thrifty Patient is an a-political, pro-patient organization. Our mission is to help all patients, no matter how they vote. So, instead, we’re looking at who has benefited from the ACA and how you can prepare for an ACA repeal if you are going to lose coverage.

Who Benefits the Most from the ACA?

There are 4 groups of people in particular that benefit from the ACA. If you’re one of the over 20 million in one of these groups, you would be rightly concerned about what an ACA repeal means for you.

1. People with Pre-Existing Conditions. The ACA ensured that insurance companies couldn’t deny coverage to people with costly pre-existing conditions. Here are some proposed examples of pre-existing conditions. Before the ACA, there were over 400 pre-existing conditions defined by insurance companies, the most common being Cancer, Diabetes, Pregnancy, Mental Illness, and Hepatitis.

2. Young Adults. Under the ACA coverage was extended to the age of 26. You may have noticed young people think they’re invincible. You combine this with the fact that many young people don’t have very well paying jobs until their late 20’s and you’ll find many not affording or thinking they can skip coverage.

3. Low-Income & Lower-Middle Class Families. The ACA allowed states to expand medicaid coverage to so that your household qualifies if the household’s income is below 138% the income level. Check this tool to see if your state expanded coverage and your household qualifies!

4. People who Need / Use a lot of Care (Via Elimination of Lifetime Caps). One group of people who benefited tremendously was people who have required very costly cares. Before the ACA you had limits to the amount insurance would pay out to cover your bills. For people like newborn Timmy Morrison’s parents, who got a $2 million dollar medical bill – this could quickly bankrupt you. Medical bills are still the #1 cause of bankruptcy in the US, and the ACA was a step towards addressing this.

Is the ACA Repeal giving you a headache?

How to Prepare for an ACA Repeal

If the thought of and ACA repeal gets your heart pounding and your blood pressure skyrocketing…

First, take a deep breath. There are many steps and barriers until that’s a reality. Even if it does happen, we all hope that the politicians have learned how popular at least parts of it are, and won’t want the fallout of kicking everyone off.

Second, start doing research. As the demand grows, options like transparent, out-of-pocket care are becoming more widely available. Also look into what options will allow you to obtain care for free. We have an excellent write up on how to get free dental care. ACA repeal or no repeal, these options are worth knowing about!

Third, take stock of your finances. If you receive care for free now, what can you start saving towards medical expenses? Look into options like High Deductible Plans and Health Savings Accounts. These options are especially important to young adults, who may be aging off their parent’s plans earlier. Don’t let an ACA repeal catch your bank account flat-footed.

Fourth, begin asking about ways to save money now. There are many options out there for drug cards, generic medications, free wellness programs, and so on. Even if the repeal doesn’t go forward, you can only benefit from knowing more about your options.

Fifth, use your coverage now! Take care of those health problems NOW while your coverage is solid. If you’ve been putting off going to the dentist, do it now. If you’ve had shortness of breath, or a sore back or knees that you’ve been ignoring, now might be the best time to get them taken care of. Best case scenario, a year from now you feel better then ever and you still have your coverage.

Finally, if you feel strongly one way or the other about a repeal, take action and contact your representatives to tell them how you feel. At the Thrifty Patient we want to help empower every person to be the best advocate they can be for themselves.

Get Your Free National Park Pass

5 Ways to Get a Free National Park Pass

Can I Get a Free National Park Pass?

Spring is here and the weather is finally warming up. As part of our launch into April, we’ll be exploring five ways to get a free national park pass. Read below to find out who qualifies for a free national park pass. Want to just skip to the park page? Click Here!

1. You have a Qualifying Permanent Disability

Free National Park Pass

Who is Eligible?: This free LIFETIME pass is available to people who have been medically determined to have a permanent disability.

To get the pass you can either fill out the online form, mail in a paper application, or apply in person. If you fill out the application online or mail it in, there’s a $10 processing fee. If you are planning to apply in person, then you do not need to fill out any forms in advance, just make sure to contact the site to ensure they have passes available. As with all of these passes, in addition to yourself, this pass also covers everyone in the same vehicle as you.

Documentation Needed for the Free National Park Pass

Here’s the requirements for documentation, directly from the form:

A statement signed by a licensed physician attesting that you have a permanent physical, mental, or sensory impairment that substantially limits one or more major life activities, and stating the nature of the impairment;


A document issued by a Federal agency, such as the U.S. Department of Veterans Administration, which attests that you have been medically determined to be eligible to receive Federal benefits as a result of blindness or permanent disability. Other acceptable Federal agency documents include proof of receipt of Social Security Disability Income (SSDI) or Supplemental Security Income (SSI);


A document issued by a State agency such as a vocational rehabilitation agency, which attests that you have been medically determined to be eligible to receive vocational rehabilitation agency benefits or services as a result of medically determined blindness or permanent disability. Showing a State motor vehicle department disability sticker, license plate or hang tag is not acceptable documentation.

Have You Heard About the Trend of Taking Uber Instead of an Ambulance to the ER!
Read More on the Thrifty Patient!

Honorable Mention

6. Discounted Senior Passes

Discounter National Park Tickets for Seniors

Who is Eligible?: US Citizens and permanent residents 62 or older.

The Senior Pass is one of the very best bargains out there. For $80 you can get a lifetime pass or for $20 the annual pass.

$80 won’t even get you a day at theme park, but it will buy you lifetime access to every national park in the US sounds like a pretty great deal to me! Read more here.  

2. You’re a US 4th Grader

Who Qualifies?: This is a really fun program available to all 4th Graders in the US.

Educators can even get the annual free national park passes for each of their 4th Grade Students. Here are the details! More rules and conditions can be found here!

3. You’re a Member of the US Military

Who Qualifies?: All current US military members and their dependents. Also most members of the US Reserves and National Guard and all of their dependents.

You’ll need your military ID when applying (CAC Card of DOD Form 1173). This’ll get you (and your dependents) a free $80 annual pass to the parks. Here’s the full FAQ for the annual military park pass.

$20 off at Mission Farms CBD

4. You’ve Volunteered more then 250 hours at a

Who is Eligible?: Anyone who has volunteered 250+ hours at a national park.

This free national park pass is a really nice perk to reward your generosity and dedication. You do not need to complete all 250 hours in a single year. Read more about the volunteer passes here and here.

5. You Head to the Park on a Free Entrance Day

Fee Free Days

2019 Has a number of free entrance days to the National Parks

Straight from the website ala the very journalistic copy-and-paste.

$20 off at Mission Farms CBD

Hello Uber, The ER Please!

Uber to the ER?

A disturbing trend or a viable option for emergencies? We look at who is using Uber for emergency transport and some of the reasons why they’re doing it.

Remember this blog provides general information and discussion about medicine, health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice.

Why Not Take an Ambulance to the ER?

Uber is definitely not the safest way to get here

Let’s cut to the chase. The main reason people are taking UBER is because it’s really expensive to take an ambulance. Which begs the question… Why is it so expensive to take an ambulance? That’s where the issue gets muddy. Here’s some of the reasons why ambulance bills are so high.

  • Did you know many ambulances are privately owned entities?
  • People without insurance often don’t pay their ambulance bills, so they need to increase rates on the people who do pay in order to make up for it.
  • Health insurance only pays after you meet your deductible.
  • Ambulances use a ton of complicated equipment and are staffed by highly trained EMT’s

So is Uber the Answer?

Photo by from Pexels

Taking an Uber to the ER is like playing Russian Roulette. I don’t recommend it – I can’t recommend it.  But I can see why it’s tempting. A two mile trip in an ambulance might cost $2700. The median income is only $32,000, so that’s more than a month’s salary for the average person. A little fender bender, a ride to the hospital, and suddenly you’ve lost a month’s salary. So, who picks Uber over the ER?

Who Picks Uber?

  • People who aren’t having an emergency. According to this New York Times article, Dr. Anupam Jena recommends that people who aren’t having an emergency don’t call an ambulance. “Ambulances are for emergencies. If you’re not having one, it’s reasonable to consider another form of transportation.”
  • People who simply can’t afford the bill. They say the average household can’t afford a $400 emergency bill. Forget paying a $2,700 one for a 2 mile trip. You might as well rent a nice limo.
  • People who need non-emergency routine trips. Elderly patients and the chronically ill may need routine trips to the hospital. Unless it’s an emergency they often don’t elect to take an ambulance.
  • People who want to make sure they get to THEIR hospital. An ambulance will take you to the closest hospital, not necessarily the hospital you want to go to. If you take an Uber you’ll go exactly to where you want to go.

How do Uber / LYFT / and other ride-share companies feel about this?

Photo by Oleksandr Pidvalnyi from Pexels

Officially they don’t like it. has official statements from Uber and Lyft.

“When it comes to medical emergencies, Lyft should not be used as a substitute for emergency transportation. People should be calling 911,” wrote a Lyft spokesperson. Similarly, Uber commented, “Uber is not a substitute for law enforcement of medical professionals. In the event of any medical emergency, we always encourage people to call 911.”

Think about it, it puts the driver and the company both in positions of real liability. If something happened on the way to the hospital and the driver knew it was an emergency, how would it play out for them if things went bad?

Our Thoughts

The cost savings are tempting and sadly, for many, the bill for the ER visit alone might discourage many from seeking help. Ubering to the hospital might not be about being cheap, it might be just about having enough money to pay for the ER visit and this month’s rent. Still, in good conscious we can’t recommend it. It takes medical professionals years of training and experience, along with specialized testing to tell if something like a chest pain is an emergency or not. If something goes wrong in an Ambulance, they have special equipment and the ability to clear traffic to get to the hospital faster – something a ride-share can’t.

At the end of the day, this is your call, and here at Thrifty Patient we fully believe in giving you all the information you need to be an empowered patient.

What are your thoughts on using Uber, LYFT or another rideshare for trips to the Emergency Room? Would you do it yourself? We’d love to hear your thoughts in the comments below!

8 Simple Ways to Make the Most Of Your Next Doctor Visit!

(And maybe even make some money!)

Going to the doctor’s office can be a pain. You’re usually sick or hurt and don’t get me started on the waiting! But, it doesn’t have to be so bad. Your doctor is there to help, and there are things you can do to get even more out of your next doctor visit.

Doctor Visits don't have to be so painful and unproductive!
Image Courtesy Pixabay

Have you ever walked out and realized you forget to talk about something or are unclear of what was talked about? Ever feel like you’re being rushed through the appointment? Here are some tips to make every visit as successful as it can be. The Thrifty Patient is here to help you plan to make the most out of your next doctor visit!

1. Treat yourself like your time is worth at least $150.00 per hour!

 Photo by from Pexels
Photo by from Pexels

You are the CEO, President, and Sole Proprietor of your body. Your time is valuable! Go into the doctor visit with a mission, goals, and the attitude that you’re here to meet with a highly skilled contractor of the most valuable business on the planet, Me. Inc. 

2. Write down your agenda, but limit it to 2 or 3 major topics.

Photo by Aaron Burden on Unsplash

Would you believe patients talked about everything they went to the office for on only 21% of doctor visits!

Make sure you set the agenda. Be concise and upfront about why you’re there. The doctor will appreciate it and you’ll be able to leave the office feeling confident that every issue was taken care of.

3. Don’t let the 12-18 second rule get you during your brief Doctor Visit!

Photo by Sonja Langford on Unsplash

12 – 18 Seconds… “That’s the average time it takes a doctor to interrupt you as you’re describing your symptoms. By that point, he/she has in mind what the answer is, and that answer is probably right about 80% of the time.”
– Dr. Groopman

Doctors are highly skilled problem solvers. They quickly want to help you with your health. But when people are nervous they might need a little time to work up to what they want to say. Your doctor won’t take offense if you calmly say there’s more you want to tell them. In fact I’m sure they’ll be happy you gave them even more info to work with!


Trust me, your doctor has seen it all. By keeping details to yourself that you find embarrassing, you leave vital clues out of the picture. Personally, I’m proud when I do manage to shock my doctor, like the time I got Pink Eye so badly the doc exclaimed “Whoa!”.

5. Write It Down Before You Leave!

Photo by Ben White on Unsplash

Going to the doctor is stressful. Studies show 40% to 80% of what you’re told is forgotten before you leave! I mean come-on, it takes doctors years of training to learn all this stuff, how are you supposed to remember it when sick and worried?

Before you leave the office, write down what the doctor tells you and use the Teach-Back method to make sure you got it straight.

As the doctor is telling you what will happen next, write it down, then at the end say “Ok Doc, let me make sure I’ve understood all you said”. You’ll be surprised, you might even think of questions while you recite it back to them!

6. Check Those Meds!

Photo by rawpixel on Unsplash

St. Joseph’s recommends that, for your safety, you keep a list of all your medications and bring that list with you whenever you visit your doctor. The doctor will appreciate it and it might save you a costly visit in the future to correct a mistake.

Here’s a great link to a medication sheet that St. Joseph’s created which you can fill out before your next visit!

7. Save on Drugs

Photo by Kate Trysh on Unsplash

One in seven people don’t get their prescriptions because they cost too much. Part of the reason The Thrifty Patient was created is to help end this. If you’re having trouble paying for drugs, ask about a discount drug card during your next doctor visit. They’re free and offices usually have a stack lying around.

They also may have samples. Trust me, if they have samples they want to get them off their hands and into the hands of patients who can use them!

8. Want Free Money? Check Your HSA!

Photo by maitree rimthong from Pexels

Do you have a Health Savings Account (HSA)? Some employers have their HSAs setup so that if you complete a physical, dental, and eye appointment – or meet other conditions – they’ll contribute a ton of money to it. This could be hundreds of dollars of free money!

If you do have an HSA check with your employer to see if they offer this perk. Then on your next Doctor visit plan to get that physical done. It might also catch a problem that you can fix now rather then later!

Find Out About All the Money You’re Losing if you have a High Deductible Plan but No HSA in our upcoming April article!