We try to anticipate large expenses and save accordingly. (Not always accurately.) Before we had a slush savings account to cover unexpected expenses, we would just skim off the accounts we had and cut back on cash purchases, like food and clothing until it was covered. Medical expenses are a whole different thing. When we had our first child, he was a preemie with a cataract. We spoke to the hospital and eye practice frankly about our financial situation. They were willing to accept payments over the long term until they were paid off, and the eye doctor called it square. When our finances became worse, we spoke to them again and the hospital covered our remaining debt from a fund they had, and the eye anesthesiologist required we continue with the payment plan.