My wife and I are having a baby just 1.5 months from now (hooray!). And our insurance provider, Anthem Blue Cross, is cutting coverage to our local hospital network and maternity services in 10 days (boooo!). The entire process of finding out about this (via the news, not our insurance or the hospital) and getting continued coverage has been an absolute nightmare. We jumped the hoops, sent in all the required paperwork, and even got the billing department at the hospital involved. We're still only covered if we happen to be lucky enough that the doctor who is named on the continued coverage agreement happens to be on call at the time of delivery, otherwise it'll be out of pocket to the tune of $10,000 of dollars. At this point it feels like we're betting it all on red.

The response to the United Healthcare shooting illustrated just how frustrated people of the US are in their healthcare system and I'd like to do my part to continue to keep that topic front of mind in the American psyche. I've written up a little op-ed on our experience and I was wonder if any Tilderinos have managed to get one published before. Any insight would be very welcome.

After deciding to get back into the gym after a long hiatus, I was shopping around my area and trying to decide between Crunch or LA Fitness, each for about $40/mo, plus steep initiation fees and annual fees. Searching for a way to get a discounted rate, I stumbled across One Pass Select, offered by my health insurer, United Healthcare. While I was fully prepared to dunk on United, because of how often Dr. Glaucomflecken does, this particular member benefit turned out to be pretty great.

One Pass Select essentially functions as a gym aggregator, offering multiple memberships for one flat rate. So rather than paying Crunch or LA Fitness $40/mo and being subjected to their terms/conditions, I pay One Pass Select $36/mo and get access to:

• Crunch
• LA Fitness
• Anytime Fitness
• Workout Anytime

And a handful of other gyms I haven't signed up for, because they're not convenient to me. Four gym memberships for $36/mo is pretty cool. Plus if I ever want to cancel, I just cancel my One Pass Select membership from their website, instead of having to sacrifice a squirrel on the 8th day of the sabbath under a blood moon while chanting gregorian monk (the level of difficulty it felt like the last time I wanted to cancel a gym membership).

A quick Google indicates that other insurers offer similar programs:

• UHC has One Pass Select
• Cigna/BCBS/Kaiser have Active&Fit Direct
• BCBS also has Fitness Your Way
• Aetna has GlobalFit

This was a great find for me, that I'd never even heard of before. Sharing it to hopefully benefit someone else, as well!

Do you ever get that FOMO feeling that all your friends and family use insert-social-media-app name? That you are the outcast fighting the uphill battle of avoiding those horrible apps and the forced advertising they shove into your eyeballs every minute? Well, I did, and decided to give Instagram a shot to see how things are.

Well, you will not be surprised to hear that it is as awful as you probably imagine. It did not get better since I left maybe 5 years ago. It got worse. The only way it's better is, funny enough, the technical creative element. You can do a lot more. The video editor for the reels is surprisingly good and easy to use. Far better than iMovie (on iOS). Aaaand that's about it! Everything else is worse. More ads, more content that I just don't care about, etc.

An important realization about the content itself, reels and stories. We all know it's one-sided, that you often see only one side of a person. That's not new. What I did feel this time around is that, coming from zero FB/Insta/X/TikTok for over 5 years, being exposed to this kind of content suddenly starts inserting a vast amount of self-doubt in one's daily life. I'll use a mild example: fitness! I am an active person, I exercise more or less regularly, I walk my dogs, I do some outdoor activities, light sports, etc. Well, I start seeing content on this topic, and initially think "Oh, this guy has some good tips!" But then I see 10 other content creators with 10 different ideas of what is "right" and I end up so confused, doubting whether I am doing things right. Now take this example and think about other topics: mental health is a big one! All of a sudden I see these ads and accounts targeting me and making me feel like I'm not happy enough, or not investing enough time in whatever thing they are selling. I have a pretty strong radar for this stuff, I am conscious of how this works and on alert. It didn't get to me because I spotted the trend early. But I am wondering how many people are aware of this? Here on Tildes, probably most. Outside, in the wild? People glued to FB/Insta/X all the time? Probably very few.

A family member is constantly on Instagram, consuming this "mental health" content. When you get 10 different types of advice, how are you to know what to prioritize, what actually works. I think it does more harm than good. Zero advice may be preferable, in a way that lets your own psyche figure it out versus being bombarded by these "helpful" content creators.

I did go back to Instagram primarily to get back in touch with friends and family who I lost track of, or who use Instagram as a way of creative expression. Sadly, I realized few people actually do that, and most are just lurking, or watching reels and sharing reels. This gets old fast. Yes, some reels are funny and it's fun to laugh with the person next to you. But they are also addictive and I found myself defaulting to scrolling over other activities that are far healthier for the brain and for the heart.

What do you think? Am I way off the mark here? Did you have a similar experience with these platforms?

@RoyalHenOil's comment in another thread got me thinking, and I feel like it might be helpful for me to hear what other Tilderinos have to share about this. I've wondered for years if I might have ADHD. Any time I've looked into it, it never seems like I check enough boxes for that to be an accurate label. But I've also gotten the impression that many psychological things like ADHD might be better understood as a spectrum (or even a region?), so lately I keep coming back to the possibility that I just have some other/related flavor of executive dysfunction. Or maybe I just haven't figured out how to "adult" properly yet for other reasons. I don't know, but it feels like being able to name the way my brain works would help things somehow.

I tried for hours to write up an explanation of my experiences, but I couldn't come up with anything that felt accurate and was a reasonable length, so the five-second version is this: The thing I keep coming across and identifying with is the "hyperfocus mode" that some people report. I enjoy this but also feel like it must have something to do with my struggles in some areas. I can prioritize tasks effectively plenty of the time, but I also can't at other times. If I used an Eisenhower matrix, things in the "important but not urgent" category would mostly be gathering dust (except for ones I happened to focus on). I don't really have any control over the "hyperfocus mode" and its target changes unpredictably.

There's an exhausting amount of nuance I could add to the above. I'd really love to hear from anyone who's had experience with any sort of divergent executive function that doesn't seem to fit into any of the currently available boxes we use to understand these things.

Addendum: I reread RoyalHenOil's comment just now and I think responding to it directly might be easier than writing out my own explanation from scratch, so I'll include that response here for anyone who feels like reading it.

Hello Tildes,

My partner and I are at the point where we need to get more care for my dad and I could use some advice from people who have been down this road. He's in his early nineties and still living in his home, and the family has been lucky in many respects. Dad still has good cognitive function, he has excellent health care through his military retirement (USA: Tricare for Life). My brother is living in the family home, so there's someone in the house overnight in case there's a fall or other serious issue.

Last year we got Dad set up with a medical alert service, so he's only one button press away from talking to a helper if he's in crisis. My partner and I are down visiting him about once a week to help with chores and hang out. Same with my other brother. We've been holding things together.

But Dad's having difficulty with normal life stuff (walking, bathing, eating) and he's transitioning into a bedbound state, losing weight and eating very little. He seems fairly comfortable, just extremely tired and increasingly frail.

To be clear, I'm not asking for medical advice. Where I'm stuck is: How do we initiate and navigate the process of getting him a home health aide? His medical team was entirely unhelpful when we asked about case management. They say "if he's struggling, bring him to the ER" but he absolutely does not want to go to the ER, and we're loathe to force him at his age unless he's in crisis. Also, the ER is full of people with the flu right now.

We've reached the "we can't put this off any longer" moment, I think. Any advice on getting the ball rolling would be appreciated. Do we just randomly call up home health agencies? How do we figure out what his insurance will and won't cover?

Thanks so much.

GP

Hello all! My lease is up mid-March of this year. For personal mental health reasons I would like to secure a move-in date of around mid-February and perhaps even earlier than that, because I'd like to have things finalized before my ex starts her own moving out process. This is the first time I'll be apartment hunting on my own, and while I have definitely talked to many friends and mentors regarding my options, I figured I wouldn't mind getting thoughts from folks here.

I have a few hard requirements for personal reasons: I would ideally not be too far from groceries (I have a car), be able to go for walks/runs without having to drive to a specific place, not too far away from the main airport here as I have to fly for work very very occasionally or when visiting family, and central HVAC. I have, generally, two options to choose from:

1. The expensive option, 1500 base rent and estimated 300-400 for utilities/parking/etc. At this time I do not believe it possible or even worth looking for anything slightly cheaper than this - whether it's a studio or a 1bed, the cost is more or less the same in this area. And even if the location were less of a factor and I looked farther away from the main city / big hubs, at best we're looking at $100 cheaper and I don't think that is big enough savings given how inconvenient location is.

2. The budget option, estimated 700-800 with utilities included, 3 housemates. A friend is currently sharing a house that his family owns with two other housemates. I've never met said housemates but they are personal friends of his. All housemates are male, I am female. I would be getting a single master bedroom, attached bathroom. At this time I do not consider the... eyebrow-raising-ness? of being the sole woman to be a problematic factor.

Some of the factors I'm considering, that probably isn't comprehensive because I'm new to all this:

• Living with housemates. I haven't had to share a house with so many people since my first year of college, which was 14 years ago. My ex did keep me honest over the last year of living together, and from a brief call with the friend who would be renting out the room, his housemates do keep to themselves, don't really use the kitchen, plenty of fridge space, etc.

• Living alone. I actually haven't "lived alone" since the last semester before I dropped out of college. My roommate at the time was taking a leave of absence and I had the studio to myself for three months. I feel neutral about this.

• Laundry? House has in unit laundry. No apartment I've looked at has in-unit laundry unless I add at least $200 on top of the base price.

• WFH and personal space. I do work remotely and for my entire WFH life, I have always had my personal PC setup, bed, and work setup in the same room. This has been difficult for me in the last two months while recovering from the breakup, and moving into a 1bed apartment would allow me to have a dedicated work setup away from bed since I personally value that higher than a nice living room space (no television, no problem). Or I could even fit that work setup into a small but still cozy living room space, who knows. However...

• MONEY. I've broken down all my fixed monthly costs, including any recurring annual subscriptions. I am estimating very, very high for absolutely everything, such as monthly grocery costs (400/mo, which is the highest that my ex and I split over the last 10 months. We're both very light eaters and "groceries" would include the occasional toiletries restock and such). Right now I am looking at taking home around $1300/mo living in my own apartment, vs. $2300/mo sharing the house.

  • Furnishing a new apartment, vs... not. Ex and I split all costs 50/50 for everything BUT furniture, and she paid for most items such as the sofa, coffee table, TV console, dining room table, ie. she will be taking those items with her. I do not want a large sofa but cozy seating in a living room space is, well, not cheap. The only furniture I'd bring with me is a decent Ikea shelf cabinet thing, my two standing desks, a single bookshelf, a twin bed. I would not be acquiring additional furniture if I move into the single bedroom.
  • Schooling costs. I don't know if I've gotten into this online degree program yet, won't know until probably April, and even if I do get in I am not sure if I will jump into it (though at this time I am leaning towards it just to have a guided path which I'm lacking right now with my career). This is an estimated 30k over the course of 2 years, or $625/mo. Not counting any potential textbooks.
  • Lasik/PRK? I have pretty poor eyesight. I have always been afraid of pulling the trigger on this, but I would like to in the next few years.
  • Current savings. I have a little over $20k in savings. I don't know anything about stocks, I have a 401k I never look at. My financial literacy boils down to "I use my credit card like a debit card" and my only current debt is a financed car, costs are factored into the numbers posted above.

• Mental health? Monthly therapy costs are factored into my numbers. So is a $150/mo cost of classes at a local muay thai gym (picked up recently for sake of both physical and mental health, joining a community, a regular activity to take me out of the apartment).

What considerations am I missing from the above? What would you go for? I mentioned I have not lived on my own for a very long time, and to be honest I don't have concrete long-term financial goals. Obviously property ownership is like... the American Dream and whatever... but frankly I am so very far from being able to realize such a goal that it just is not a factor when it comes to me saving money. I just don't want to look back at myself in 2027 and regret my finances. My family is in another part of the state and I can't rely on them for money or housing... well, I actually can, for housing, and save even more money, but I vastly prefer the climate where I am at now and my mental health will suffer far more living with family than with 3 housemates.

I really appreciate any thoughts! I know I have time, there is no rush, but I am also aware that distracting myself with this has been pretty helpful with, you know, not being too depressed about circumstances.

I am hopefully starting a new job soon, and their health and vision insurance is UHC. We can also choose a regional plan (UPMC for anyone in the western PA area) through my wife's job.

All my previous employers have been local, so we've always had UPMC coverage. This is my first time dealing with a national insurance company.

Likely my new plan will be be less expensive and have lower deductibles than my wife's.

Pittsburgh is split between UPMC (a hospital system that grew an insurance arm) and AHN (an insurance provider who grew a hospital system). Ironically, UHC may offer me more options since they seem to have most of the UPMC and AHN providers in their network.

I've checked all my doctors and the major hospitals, and they are all listed as in-network. I'm already getting my maintenance medications through CostPlus, so I'm not that worried about prescriptions.

My wife and I are in our 40s and relatively healthy, but I know we are reaching the point where (statistically, and looking at friends the same age) we're likely to have some big health events in the next five years.

Outside the very obvious news story that comes to mind when thinking about UHC, what are your experiences with them? Things to watch out for? Things you wish you knew going in?

Edit: thanks everyone for your input. This largely confirms my expectations, but I appreciate people taking the time to share.

Hello. I usually talk about trains, except today, I just want to vent on my finances and my wishes for a less expensive world.

I have found myself in financial straits,as I had amassed debt last year, lost work for months and amassed more debt. It’s in the low tens of thousands. of course I also lost my healthcare because I live in a rich country run by morally destitute anti-intellectuals.

On paper, I will pay off the debt in 18-24 months, if god allows. I have work now.

This city’s transit system has been hobbled in bad faith and will be destroyed come January….Fares have already risen, service cut. My train to work will be cut because the state refuses to provide services for its most productive citizens. It is twice as long by bus, suicide by bicycle on roads built for tanks, so I will have to sacrifice time or life.

It seems the price of electricity has increased. I would generate my own, but it is impractical.

Sadly my possessions are breaking too. This is the way of things, it’s just miserable timing, and each discovery of a failing mechanism or dilapidated object piles onto the defeat. The window frame has rotted and the glass fallen -- the house is frozen. Not a single plant survives. (The landlord will fix it, but not hurriedly…..) Bulbs burnt out, rooms dark. My bicycle needs new brakes, a new chain, my helmet has been destroyed and should be replaced, but for now I have been riding without. The computer has broken after 14 years, admittedly about time…. An expensive thing to replace, so now I only have my phone, whose battery has degraded quite a lot and will not be usable for too much longer, and a small laptop on death’s door too. I had worn my single pair of walking shoes for 5 years until, yesterday, the sole fell off. (Thankfully, I have one more, but it is formal and uncomfortable) A new pair is more costly than I remember… I know a cheap one will disintegrate in a season and do nothing for the snow, and a quality one is beyond financial prudence. My jacket is worn and torn by years and embers, beyond my ability to sew, and I must darn and darn and darn all the socks and gloves with holes, which I hate to do, and i am not good at. The denim jeans are ripped, in a place difficult to patch, and the pockets torn. I cannot bear the cold the same anymore, so I also need an overcoat, which I cannot afford. The fitted sheets are inexplicably torn by some punitive act of god, probably irreparably. The pillows are compressed, worthless, and causing me pain. Even the tent, which I might use to regain some sanity in the woods, has had its elastic poles dried solid and is basically unusable. At least I have a few books.

My lifestyle is structurally cheap. Affordable city, relatively low rent, multiple housemates, no car, only occasional commute, no dog, no wife, no children. Not too much to pay for. I eat simply. I am content with it.

Yet somehow I find myself with hundreds of dollars of credit card purchases this month, more than an entire paycheck, and last was also more. Qualifying for a healthcare plan has reduced my medical costs, but the difference is withheld, and I’m realizing that often it costs more than it would cost out of pocket, so at best it makes no difference. The dental and vision are exorbitant, so I just hope I don’t get a cavity.

I suspect I need glasses, or will soon. I can tell my eyesight is beginning to worsen. But it’ll have to wait a couple years.

The fear of a worse medical emergency persists. The deductible is rather high for a plan that offers no HSA and the co-pay is unremarkable, the coverage limited. Perhaps the least useful healthcare plan I’ve ever had.

I do not gamble. I like to drink beer but have abstained recently. My hobbies are inspecting train and street infrastructure, studying the Holy Bible, moralizing on the internet and persuading the government to institute a better society. I lapse sometimes and make impulsive purchases, but not frequently. I have not even gone to see a game in two years.

It’s a great pain to review your statements and recognize that almost none of the purchases were wasteful, only a few technically unnecessary. There were just too many overall.

What upsets me most is the social distance I have gained from my condition of functional poverty. the agony of refusing visits, trips, games, concerts, shows, dinners, coffees, drinks grinds on me daily. Yes it is still nice to say hello, it is just not the same. The pity, or disgust, the symbolic offers of charity received. Mostly the confusion—the awkwardness, the unsolicited advice (which I don’t normally mind, but it gets old). I prefer to socialize with bourgeois progressives, academics and professionals who care about engineering and mathematics and government policy and theory. It’s what I care about. I do not really resent them, but everything they do costs more money than I possess, so it is difficult to see friends and I cannot hope to keep up with colleagues after work.

I don’t object to work but I resent the fact that I must pay for my own healthcare. I also resent that my government neglects my transportation and my safety. I resent the pollution of the air, the NIMBYism driving up rents and leaving the addicted even more hopeless. I acknowledge the mistakes I’ve made that have led me here. I can’t undo the past, but Congress could socialize all medicine in the next budget if it wanted to…. repeatedly chooses not to.

That’s all. I just wanted to complain. You can give me advice if you want. I’m relatively financially literate, just poor and human.