By Nandi Ashley, as told to Hallie Levine
My number one piece of advice when it comes to others who need to navigate the health insurance system: Make sure you have health insurance. I didn't, and it cost me $20,000. I've spent much, much more on health care bills than I would have if I had just signed up for COBRA and paid premiums. Here's my story, in the hope that it won't happen to you.
Going Without Health Insurance
I resigned from my job in corporate America in April 2025. I intended to sign up for COBRA, which would have allowed me to stay on my company's current health insurance plan, as long as I paid my own premiums, for up to 18 months.
When I researched it, though, I learned that my COBRA costs would be sky-high. I decided instead to enroll in my state's health insurance marketplace. Unfortunately, I missed the deadline by a few days.
I'll be fine, I thought. After all, I'm still relatively young and healthy, with no underlying health conditions. What could go wrong?
A few days later, on April 17, I walked back from my neighbor's house and fell. I heard a loud crack and knew immediately that my foot was broken. Two people who were outside ran over and helped me back home. My daughter came to pick me up and rushed me to the emergency room for an X-ray.
When the doctor came out, he said, "The good news is we have answers. The bad news is both of your feet are broken." I'd apparently broken my right foot a month ago, when I'd bumped into something. I hadn't realized it because the pain hadn't been that bad. I had decided not to go to urgent care, because I hadn't wanted to pay the cost of a copay.
The doctor explained that since both feet were injured, I needed to be hospitalized for a few days as I was a fall risk. Now, with both feet injured, I'd need to be hospitalized. My heart sank. All I could think about was how much this would cost me, without insurance.
Hospitalized Without Health Insurance
When I was hospitalized, they pumped me up with pain medication and brought in occupational and physical therapists to help me figure out how to move around. All I could think of was, "How much is this going to cost?"
The physical therapist showed me how to use crutches, but I couldn't navigate them. They switched me to a walker, and that was still difficult. I had to use my hands to propel it, to take pressure off of my feet. As a result, my hands ended up bruised and swollen. That required more medication and more therapy visits. It seemed like a never-ending cycle.
The hospital did provide a financial expert to discuss health care costs with my family. My husband and daughters spoke to them, because I was in so much pain. While there were grants available to help with the hospital bill, we didn't qualify because our family income was too high. In hindsight, I wish we had asked more questions and pressed them to help us find other options. But there were a lot of moving parts at that moment, and none of us could truly focus on it.
Surprise Medical Costs
We had to spend more money even when I was discharged. The hospital provided a walker, but we had to purchase a portable toilet, as well as a bench where I could sit in the shower. Both were about $200. I also still found it hard to move around with the walker. My family purchased a wheelchair for me, which was another $500. It seemed like the hemorrhage of money would never stop.
Hospital doctors had recommended physical therapy, but I couldn't afford it without insurance. I also didn't want to spend the money on the pain medications they prescribed. Healing was very painful. My recovery was much slower because I wasn't able to go to physical therapy. It took months for me to be able to walk without a walker or crutches.
It was a painful time, physically and emotionally. I not only had to cope with pain and its impact on my life, I was worried sick about how I was going to pay for my $20,000 hospital bill.
The Struggle to Find Affordable Health Insurance
If my family just had this one $20,000 bill, we may have been OK financially. But most of our savings had been wiped out three years earlier, in November 2022, when I had spinal surgery. While I did have health insurance, we ended up spending thousands of dollars out of pocket between deductibles and copayments. I needed months of physical therapy then, too. Over time, all those costs add up.
After my hospitalization, I vowed never to go again without health insurance. I reached out to an insurance broker, and as soon as I could, I signed up for a policy that began in February 2026. (I couldn't do it earlier because open enrollment for the health insurance marketplace doesn't begin until November.)
Unfortunately, it's not a great plan. I pay $574 a month for insurance that has a deductible of $12,000. Even once I reach that, there's a $50 copay just for in-network visits. But we won't have to pay more than $17,000 out of pocket if another emergency hits.
How to Get Help With Medical Bills
Ask for help. Sometimes, when you are in the middle of a crisis, it's hard to navigate the process. It's so much easier to give up and retreat into a corner. Yes, it's a lot and can be overwhelming. But there are people out there who can help you.
I recently was part of a roundtable for WebMD to discuss health care costs. There was an insurance broker on the panel who mentioned that there were grants available to help people like me who are faced with overwhelming medical costs. I told him I wish I'd been able to speak to him when I was hospitalized, as he may have been able to point me in the right direction.
There are organizations out there that may be able to help. Groups like Dollar For can help you figure out if you qualify for a hospital program that discounts or completely forgives bills. The Patient Advocate Foundation also has a National Finance Resource Directory where you can search for financial support options in your area.
Don't leave any stone unturned. If your hospital caseworker says you don't qualify for any options, ask them to look again. Reach out to extended family and friends and ask if they know of any resources that could help. Your local place of worship may have suggestions, too.
It should not be so hard to navigate health insurance. I went through this years earlier, when my teenage daughter was diagnosed with Hodgkin lymphoma. Back then, we had good health insurance. But the system was still overwhelming. Decisions had to be made quickly. When your daughter has terrible reactions to chemotherapy and medications, it's awful to have to call health insurance to make sure that her treatment is fully covered.
Today, my family and I have moved forward. We are still researching ways to pay our hospital bill. But you can avoid this entire situation if you just make sure that you are up to date on your health insurance. You may not think you need it now, but in a split second, life can change. Consider it insurance for if – and when – the unthinkable happens.
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SOURCE:
Nandi Ashley, life coach, Norcross, Georgia.
