The Tigress is prowling. Let her out to play.

Midlife Inside-Out Self-Care Checklist for Grown-A** Women

Strategies for saving money and staying healthy.

Hold up! Did you know that under the ACA, insurance providers must cover certain screening procedures at no cost to you?

In my experience, insurance companies, hospitals, and labs are hoping you don’t know your rights. Raising awareness about preventive screenings is the main reason I’m writing this post.

Insurance companies sometimes deny claims. Hospitals and labs may bill you for services that are still under claims review. The bill they send says nothing about pending insurance. If you pay the hospital, then insurance won't cover it and you won’t get your money back. You’ll see what I mean below.

All those corporate bs shenanigans are enough to make you just blow the whole preventive screening thing off, right?

Please don’t. While I love a spa treatment, too, consider your self-care from the perspective of staying healthy for the next 2 or 3 decades.

My strategy is to leverage healthcare on both sides of the border.

Midlife Selfcare Inside Out Checklist

  • Mammogram — due 2023— covered under ACA. Insurance alert: 2021, Memorial-Hermann Hospital System in Houston billed me repeatedly, like, for months, for $600 in scans covered by insurance. Props to the Molina Healthcare rep who told me not to pay them because the claim was in review. If I had paid them, then Molina would not and I couldn’t get that money back.
  • Colon screening — I just did this at the urging of my PCP here in Montana. I know, I know. Ick factor. I put it off, too. But, as my older brother said, “Get out of your own way, it’s free.” Insurance alert: BCBS Montana denied the $700 claim, hoping I would not know any better, I guess. They also don’t make it convenient to get them to do the legal thing. I was on the phone for an hour with their claims rep 3 weeks ago and the claim is still under review.
  • Bone Density Screening— I just asked my doctor to order this because I want a baseline before I turn 60 in a couple years. Doctors don’t usually order this screening until age 65 but I’ve been on thyroid meds for years, so I qualified. This screening procedure is covered under ACA, check your policy for exemptions for age limits.
  • Food is preventive medicine. I buy the highest quality I can find, avoiding processed foods and mass-produced meat. I’d rather pay more for food than pay for medication later.
  • Daily movement for strength, flexibility, and sanity. Mat pilates has been a revelation to me. It works better for me than yoga, but everyone is different. You do you.
  • Meditation and subconscious reprogramming techniques have changed my brain, I’m sure of it. I’m much less reactive than I used to be.


Alcohol deserves its own section. Getting lit is hard on our bodies, ladies. Mama doesn’t need wine. But I know she likes it because I do too. I should give it up completely but I just really love wine on a gorgeous day on the patio or on special occasions like a yacht cruise in Cabo or a beautiful nice restaurant.

I drink a lot less than I used to, yet I still spend energy futzing around managing it. Here are two resources that helped me a few years back and still do:

  • An article about how addiction is not about you or the drug, it's about your cage. Change the cage, change your life. I’m not saying the theory is the answer for everyone, but it helped me.
  • The Naked Mind book and website by Annie Grace.
  • Getting truly serious about prioritizing daily movement. Working out with a hangover if you are over 55 is the worst.

Medical Tourism

If you live out of the US most of the time, you can save money on health insurance by purchasing an ex-pat policy. A year policy costs about as much as one or two months of unsubsidized premiums for US-based insurance.

Expat policies won’t cover you in the US, so if you are under 65, purchase a temporary policy for the times you visit the states. I saved thousands over the years with this strategy.

In 2016 I had 5-hour hernia surgery in a modern hospital in Mexico City. It cost me a grand total of about $7K. My doctor had US training in laparoscopy, spoke English, and had a great sense of humor. I recovered beautifully and saved at least 30K vs. the same procedure in the US.

I’m sold on Mexico for medical. I go down south for the following, saving hundreds of $ a year, depending on what is needed:

  • Lab Work: Complete blood work for cholesterol, thyroid function, etc at less than half the cost of US labs. You can just roll up to the lab without a doctor’s order.
  • Medications: Pharma prices in the US are a mystery to me. My branded thyroid medication is half the price in Mexico. And I can get it OTC — no RX needed. I buy extra boxes to stock up for when I come back here.
  • Skincare products: You can buy European skin products that aren’t sold here, like really good sunscreens that the FDA hasn’t gotten around to approving.
  • Pap screening test: Mexico has many excellent female doctors and nurses. It’s all good, ladies.
  • Dental: Teeth cleaning and any dental, 40–50% cheaper than in the US. Check out my comparison shopping for dental services in Playa del Carmen.

Cosmetic Procedures and Pirates

Cosmetic procedures and beauty treatments aren’t in the realm of inside-out preventive screenings. But I know you want to know.

Botox, laser anything, custom facials — all about half price. Do your homework and read reviews. If a service is super cheap and has no reviews, I don’t go there.

I got estimates for an eyelift and facelift in 2021 (oh yes I did). The total estimate was about 40% less than US procedures, including a hospital stay, which was not included in the US. A glance at my Instagram will show you that I did not, in fact, get a facelift.

That’s because the pirates of the Yucatan kidnapped me. I told my ego to walk the plank. Wrinkles ahoy! I decided to spend the money exploring the Maya culture, pirate towns, and jungle of the Yucatan instead, researching for my Way of the Tigress book. You can read about how that all went down in the book.

hunting cocos in the Yucatan

Next up — for my yet-to-be-named, best-mind-body ever project starting with my September birthday, I’m getting some baseline testing for vitamin and hormone levels done in Mexico in early 2023.

So, am I missing anything from my Midlife Self-Care Checklist?

More importantly, how about you?

Amiga, I know it’s no fun to think about some of the stuff we screen for, but it’s much easier for you and your loved ones if diseases are caught early.

How is your inside-out self-care checklist going?

PS Feel free to share this with a woman who needs to see it. 💞



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Kala Philo

Kala Philo

Hi! I’m a Web3 and tech marketing writer and co-founder. I also write about personal growth via immersive travel. More info at