At first glance, Sacramento’s SCI-FIT looks like any other gym. Until you realize the people working out are in wheelchairs. SCI-FIT is a therapy center for people with spinal cord injuries. Its clients rave about the highly specialized therapy sessions -- but struggle with the cost.

Kathy Fuetsch drives to SCI-FIT each week from Reno for a session with her daughter Caitlin. Seven years ago, Caitlin suffered two severe strokes at the age of 25.

“I was saying, I don’t know if we’re going to be coming back, because for 8 hours a month, it’s $750,” Kathy said.

Kathy, a single mother and former public school teacher, quit her job to take care of Caitlin full-time. Caitlin’s brain function is normal; Kathy says her physical improvement is consistent, but slow.

“To be honest, all we do is pay whatever we can,” Kathy said.

To stay afloat and keep Caitlin in therapy, Kathy turned to organization HelpHOPELive. The site makes it possible for patients and their families to raise money online to pay for bills. So far, they’ve raised $32,000, but Kathy said it wasn’t an easy choice.

“It’s humiliating, in a way. Because as a parent, I feel that regardless of the age of my children, I should be able to provide for them and help to take care of them. It gets to the point that you have to eat it and say, 'I can’t do this anymore',” Kathy said.

The Feutsches’ story may sound extreme, but their financial issues are not unique. Physician Davis Liu treated patients for many years before writing a book called “The Thrifty Patient.” He now works at the startup LemonAid Health, which helps patients get basic treatment and prescriptions at a lower cost. He said rising costs and high-deductible plans are taking a serious toll.

“Over time I’ve noticed them saying, ‘I’ve got a $500 deductible, are you sure I really need that?’ They’re asking more about prescription costs. It’s happening more than it did a decade ago,” Dr. Liu said.

Dr. Liu said some patients are over-paying on preventative care, visiting the doctor more times each year than they really need to. To break the habit, Dr. Liu recommends the site Users can plug in their age and sex, and the site explains what preventive services are actually necessary each year.

If there’s an accident or illness, Dr. Liu said patients should ask their doctors upfront what’s really necessary – and what can wait.

“A lot of surveys show that doctors know patients want these conversations, but patients don’t have them because they’re either embarrassed, or scared,” Dr. Liu said. “But it’s important to have these conversations, so patients aren’t choosing between paying their rent or paying for food and their prescriptions.”

But in order to be really prepared, it’s important for patients to do their own research as well. Dr. Liu recommends price-comparison sites and, which can help patients figure out what a procedure or treatment will cost through various providers.

As for prescriptions – which can add up fast – Dr. Liu recommends the site, which will ship prescriptions directly to patients at a more competitive price.