Speaker 1: Episode to fifty four, how to save money on health
Speaker 1: insurance and open enrollment explained with Eileen Doherty. Welcome to
Speaker 1: the Frugal Friends podcast, where you'll learn to save money,
Speaker 1: embrace simplicity, rights, and liberal with your life. Here your
Speaker 1: host Jen and Jill. Welcome to the Frugal Friends podcast.
Speaker 1: My name is Jen, my name is Jill, and today
Speaker 1: we are bringing you one of the most exciting episodes
Speaker 1: we've ever done. That's right, health insurance, specifically open enrollment
Speaker 1: because for many of our listeners in the US, open
Speaker 1: enrollment starts today. Oh, we're on the edge of our seats,
Speaker 1: but make sure you're sitting down because, like Jen said,
Speaker 1: super topic, especially if you're driving, Please sit down. Yes,
Speaker 1: but seriously, so glad to be talking with Eileen, because
Speaker 1: this is an area that is so confusing and we
Speaker 1: could do well to be wise with how we're spending
Speaker 1: in this category. I mean, for most of us, I
Speaker 1: think we mentioned it in this episode. It's it's a
Speaker 1: high ticket line item in our expenses, housing, transportation, food,
Speaker 1: and health insurance, Like those are our top expenses at
Speaker 1: any given month and certainly annually, not just the health insurance,
Speaker 1: but then the costs of healthcare, above and beyond health insurance.
Speaker 1: So there's just so much to be considering, and Eileen
Speaker 1: really helps break it down into some really bite sized
Speaker 1: pieces of what we can be thinking about when it
Speaker 1: comes to the type of health insurance that we choose. Yeah,
Speaker 1: and we hear so much on the internet, you know,
Speaker 1: pay attention to your groceries, pay attention to your coupons
Speaker 1: and your rebate apps, and YadA YadA. When we talk
Speaker 1: about cutting expenses here on the Frugal Friends podcast, we
Speaker 1: look at it as an eighty twenty view. So let's
Speaker 1: focus on the twenty of our expenses that get us
Speaker 1: eighty percent of our results. Instead of the small latte purchases.
Speaker 1: We're looking at our big, multi thousand dollar purchases, and
Speaker 1: health insurance is one of those. So we hope that
Speaker 1: you really are excited for this episode because it will
Speaker 1: save you tens of It could save you tens of
Speaker 1: thousands of dollars over your lifetime, way more than cutting latte's.
Speaker 1: That's no joke. But first, our sponsors. Today's sponsor is
Speaker 1: brought to us by best case Scenarios. They're doing a
Speaker 1: hard push to remind the general public that they still exist.
Speaker 1: When Jenn and I had our intro call with them,
Speaker 1: we did sense a tinge of bitterness regarding how much
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Speaker 1: promising that it will always pan out that way, but
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Speaker 1: avoiding catastrophes, de escalating that situation, and championing that dream job. Also,
Speaker 1: best case scenarios are strong supporters of high yield savings accounts.
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Speaker 1: If you're here for best case scenarios, check out C
Speaker 1: I T Banks high yield Savings account at Frugal Friends
Speaker 1: podcast dot com slash c I T. They're currently offering
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Speaker 1: savings accounts. Best case scenarios here for all the best
Speaker 1: case things. I love that. Thank you. Best case scenarios
Speaker 1: what an underrated scenario. So if you are super interested
Speaker 1: in health care, we actually have some other episodes to
Speaker 1: queue up that are just as exciting as this one.
Speaker 1: So the first one is when we recently did, which
Speaker 1: is think is super important that everyone should listen to
Speaker 1: sometime in their life sooner rather than later. Episode two thirty.
Speaker 1: So that is how to negotiate medical bills we did
Speaker 1: with Dr Virgie Ellington. She is a doctor and patient
Speaker 1: care advocate and so she I mean, we'd go step
Speaker 1: by step how to negotiate medical bills. And then we
Speaker 1: also touch on medical debt as well. But really really
Speaker 1: good episode because if you have to use health insurance,
Speaker 1: you're gonna have bills too, and maybe you think you
Speaker 1: can't negotiate them because you have health insurance, but that
Speaker 1: is untrue. Uh So, and then also uh episode twelve,
Speaker 1: how to save money on healthcare, we talk a little
Speaker 1: bit about everything, so not just insurance but also health
Speaker 1: care sharing, preventative care, that counts, stuff like that. So
Speaker 1: that's way back in the archives to listen to. Yes,
Speaker 1: but we still stand by what we said in that one.
Speaker 1: So oldie but a goody. But let's get into today's episode.
Speaker 1: Very impactful, Definitely one to share with your family and
Speaker 1: friends because nobody is going to tell you I have
Speaker 1: no clue what I'm doing with health insurance. Definitely, if
Speaker 1: you've got a company slack, drop this one in the
Speaker 1: company slack and they you know whatever HR channel in
Speaker 1: the Pizza Channel, whatever, uh, somewhere people will see it
Speaker 1: because everyone should know the things that we're talking about
Speaker 1: in today's episode, and we're talking about it with a
Speaker 1: friend of my Eileen Doherty. You know you can. You
Speaker 1: can do a podcast for four and a half years
Speaker 1: and still not be able to find the right guests.
Speaker 1: We have guests email us every day trying to be
Speaker 1: on the show. But when you're just trying to find
Speaker 1: a female health insurance expert, those are much harder to
Speaker 1: find than I built eleven businesses and made seven million
Speaker 1: dollars and sold on my companies. Interview me. Not a
Speaker 1: lot of those, not a lot of female health insurance experts.
Speaker 1: And then you just turn around at the gym and
Speaker 1: you're like hearing I I lean, I've worked in the
Speaker 1: US healthcare industry for twenty five years. I'm an executive
Speaker 1: vice president at a health insurance payments company, so I
Speaker 1: am unbiased to networks and you're like, what around? But
Speaker 1: then I've found the guess that a need and she
Speaker 1: loves right there waiting for me right around. Um. I
Speaker 1: did say I had a podcast, and Eileen was like, oh,
Speaker 1: I've been on podcast, and I'm like oh, oh, what
Speaker 1: do you talk about? And she's like, health insurance, and
Speaker 1: I'm like, ah, and so Eileen not just an expert
Speaker 1: on health insurance, but also a really cool lady. So
Speaker 1: let's get into it. Turn around, I'm gonna be able
Speaker 1: to get that one out of my head. Ah, Eileen,
Speaker 1: Welcome to the Frugal Friends podcast. We are very excited
Speaker 1: to have you here to talk about this really dry subject.
Speaker 1: But hopefully we can we can amp it up a
Speaker 1: little bit. I find it exciting, the pleasure. It's exciting
Speaker 1: for me just because I know very little about this topic.
Speaker 1: Just the prospect of learning and giving tangible tips that's exciting.
Speaker 1: But but you know, we're going to sprinkle it with
Speaker 1: fun some way, somehow. Yeah. One of the reason, I
Speaker 1: mean one of the reasons we like to interview experts
Speaker 1: and we like to critique Google articles because when I
Speaker 1: was a writer, the two topics that I was like,
Speaker 1: I do not write about these, I'm not an expert
Speaker 1: are insurance and taxes, like any type of insurance. Please
Speaker 1: don't make me write about this. They don't know it.
Speaker 1: And then they would always assign me insurance in tax articles.
Speaker 1: And I'm like, if they're doing it to me, they're
Speaker 1: doing it to other people, So be skeptical about what
Speaker 1: you read on the internet. I'm like, let's let's talk
Speaker 1: to you. Let's talk to you. You got a background
Speaker 1: in this. Let's demystify health signing up for health insurance
Speaker 1: and using it. So let's talk about what is annual
Speaker 1: open enrollment UM and why do we have it? Why
Speaker 1: can you only do this one month a year. Okay,
Speaker 1: that's a great question. So open enrollments strictly speaking, right,
Speaker 1: is the yearly period, usually in the fall, when people
Speaker 1: can enroll in health insurance plans for the next calendar year.
Speaker 1: And the reason why it only happens once a year
Speaker 1: is because most most health insurance plans have annual based limits,
Speaker 1: deductibles and maximums that they've calculated in order to manage
Speaker 1: the risk for the group of people that they are ensuring,
Speaker 1: and because they're based on an entire year, they can't
Speaker 1: have people switching plans throughout the year and still manage
Speaker 1: that risk. It's a unique aspect about the way that
Speaker 1: health insurance plans are put together that leads to us
Speaker 1: being only able to enroll once a year UM. They
Speaker 1: do allow for other time periods for enrollment UM and
Speaker 1: we'll talk about that a little bit later, but they
Speaker 1: try to keep them to a minimum. The open enrollment
Speaker 1: period will vary b based on your if you have
Speaker 1: an employer based health insurance plan UM and those are
Speaker 1: normally like around three weeks in November, and most of
Speaker 1: us of the US population is covered by their employer's
Speaker 1: health plan. But if you have health insurance, say through
Speaker 1: the A C A, then the open enrollment runs from
Speaker 1: November one to January and during that time period you
Speaker 1: can go in and elect a new plan that matches
Speaker 1: your situation, your current situation as well as possible, and
Speaker 1: then it will become effective on January one. In most cases,
Speaker 1: that's the best explanation I have heard from anyone. Usually
Speaker 1: these conversations about open enrollment are being had with other
Speaker 1: people who don't know why, so maybe that's part of it.
Speaker 1: But we're always just like, and why only one here?
Speaker 1: And then it ends there and we move on frustrated
Speaker 1: and ignorant. So thank you Eileen for demystifying that, like
Speaker 1: the US health insurance was is weird, right? It was not.
Speaker 1: Health insurance in the United States was not originally created
Speaker 1: by health insurers. The very first plan that was ever created,
Speaker 1: back in the nineteen forties was put together by Baylor
Speaker 1: University Hospital for the Dallas Teachers Union. So hospital administrators
Speaker 1: created a health plan that covered a set of teachers
Speaker 1: in a local city, and the patients had absolutely no responsibility,
Speaker 1: so they said, we'll cover everything, no matter what. For
Speaker 1: it was like fifty cents a month or something, and
Speaker 1: so no matter how much health care you needed. Not surprisingly,
Speaker 1: the very first thing to happen after that happened is
Speaker 1: that all of the physicians that were in the network
Speaker 1: immediately raised all of their rates. And that is the
Speaker 1: beginning of a long pathway that has led us to
Speaker 1: the crazy place we are today with US health insurance.
Speaker 1: Thanks Baylor, Thanks Baylor. A munch hospital and illustrators didn't
Speaker 1: really know how to handle the risk on a health
Speaker 1: insurance plan, so not not totally thinking macro level, like
Speaker 1: what what are the consequences and the pros and cons
Speaker 1: of this? Well, but here we are. So you did
Speaker 1: talk about there could be some exceptions to open enrollment.
Speaker 1: Can you share a little bit about what what that
Speaker 1: would be, how we might find ourselves in that type
Speaker 1: of situation sure UM. So for most health insurance plans,
Speaker 1: whether they be employer based or their government sponsored UM,
Speaker 1: you will have an option to to change your enrollment
Speaker 1: outside of an open enrollment. Those are generally referred to
Speaker 1: as special enrollment, and they're based on life events. So
Speaker 1: if you get married, if you have a baby, if
Speaker 1: you adopt, if you get divorced, if you start a
Speaker 1: new job, you have the opportunity to enroll in a
Speaker 1: new plan. The rules around how much time you have
Speaker 1: after those events and when that additional person either becomes
Speaker 1: effective or terminates our planned dependent So you have to
Speaker 1: read your plan doctor meants to truly understand when it's
Speaker 1: actually going to become effective and when the window is
Speaker 1: for you to make changes. The A c A actually
Speaker 1: has another exception, which is UM, if your income changes dramatically,
Speaker 1: they give me the option to modify your plan during
Speaker 1: that time period as well m HM, which it's it's
Speaker 1: good to know that. It kind of stinks because when
Speaker 1: you have those opportunities for special enrolment, those are the
Speaker 1: times were the last thing on your mind is health
Speaker 1: insurance and you do only have a certain amount of
Speaker 1: time to to like change that if you need to,
Speaker 1: so kind of maybe checking with your health insurance plan
Speaker 1: to see when that is um is always just a
Speaker 1: good idea. Just kind of be familiar. I mean, I
Speaker 1: know it's boring, but reading your plan document is important
Speaker 1: part of being of owning a health insurance plan. And
Speaker 1: I mean, health insurance is becoming i think the fifth
Speaker 1: largest out going costs for an American household today so
Speaker 1: since and that's not always been the case, but patient
Speaker 1: responsibility has been continuously rising for decades. That is the
Speaker 1: portion that is paid by the patient on their health plan.
Speaker 1: And because of that, it's becoming more and more important
Speaker 1: for health for health insured people to become educated about
Speaker 1: their health plan. But the reality is that the health
Speaker 1: insurance literacy in the United States is very low, and
Speaker 1: that's not surprising because it's super complicated. It is a
Speaker 1: complicated insurance plan. A lot of people don't understand how
Speaker 1: to use it and most of the time, unless you
Speaker 1: have a chronic illness, you're not using it more than
Speaker 1: three or four times a year. So it is something
Speaker 1: that people don't have a lot of motivation to become
Speaker 1: experts at until they really need to, and unfortunately that's
Speaker 1: often past the time they've already made the choice about
Speaker 1: their health plan. So so so true. I mean, I
Speaker 1: just know it to be true. Anecdote. You know, sometimes
Speaker 1: it's in the back of my head, like I really
Speaker 1: should make sure that I've got the right type of
Speaker 1: plan and coverage, but it's like, yeah, I rarely go
Speaker 1: to the doctor, so it's not front of mine. But
Speaker 1: I do sometimes feel like I'm playing with fire a
Speaker 1: bit with the current plan that I have. Oh, this
Speaker 1: reminds me of right before the hurricane last week. I
Speaker 1: asked my homeowners insurance broker to send me a copy
Speaker 1: of all my policies, and I was shocked that I
Speaker 1: chose because me back when I was buying my house,
Speaker 1: I chose the highest her named her gain deductible. Right,
Speaker 1: it was too late at that point. By the top
Speaker 1: point they have a named storm in your area, you
Speaker 1: can't remind your contract. That's sort of what this is like.
Speaker 1: You know, you're you're invincible until you're not, and then
Speaker 1: you are reliant on your health plan that you chose
Speaker 1: a year ago when you thought you were never going
Speaker 1: to get sick. Yeah, So that leads us into are
Speaker 1: our first of the two questions that are gonna be
Speaker 1: the meat of this episode. So first is when I, okay,
Speaker 1: say I have insurance through my employer, it's it's what
Speaker 1: I got, it's what I chose when I got employed.
Speaker 1: When should I like change What would prompt me to
Speaker 1: change that? Because it's much easier for me to just
Speaker 1: not to just ignore it. So why should I change it?
Speaker 1: And when that is? That's a key question for sure.
Speaker 1: So the most important thing to think about every year
Speaker 1: when open enrollment comes up is how has your life changed? Right?
Speaker 1: There is a whole group of people that when we
Speaker 1: were debating about the Affordable Care act Um in the
Speaker 1: early two thousand's, we called them the young invincibles, the
Speaker 1: twentiesomething year old. So are you single and under thirty.
Speaker 1: The chances are that you're The amount of health care
Speaker 1: usage you have is very low, except in some stream situations.
Speaker 1: So you would want a certain type of plan. But
Speaker 1: at some point you're gonna possibly get married, want to
Speaker 1: start a family, and start working towards developing a foundation
Speaker 1: for that. And not every plan has great fertility coverage
Speaker 1: or um coverage for having a baby. Uh, and you
Speaker 1: need to make sure that those things are well covered
Speaker 1: in a plan as your family begins to grow and mature. Also,
Speaker 1: if you have started to encounter healthcare issues UM that
Speaker 1: have increased your overall healthcare coverage, you may want to
Speaker 1: increase UM the healthcare coverage that you receive. Once you've
Speaker 1: reached the point where you're a family of six with
Speaker 1: a bunch of young kids and you have a ton
Speaker 1: of preventative care that needs to be done UM, it's
Speaker 1: important to make that as easy as possible. And then
Speaker 1: as you continue to mature and grow, you're going to
Speaker 1: find that you'll encounter UM you know, higher risk areas
Speaker 1: based on your genetic background. As your children begin to
Speaker 1: move off to college, will be wanting to look for plans.
Speaker 1: It may cover them until they're twenty six and UH,
Speaker 1: you'll start to look at what type of networks are
Speaker 1: available as you grow older into your sun sunshine years
Speaker 1: and are needing a set of doctors that can handle
Speaker 1: UM managing your care as you grow older, so age,
Speaker 1: family composition, UM that general demographics or things that you
Speaker 1: have to consider. M Yeah, it almost sounds like every
Speaker 1: year we would need to reevaluate if what we're using
Speaker 1: still works. Interesting that this comes up every year, Well,
Speaker 1: not surprisingly um. Something like seventy of Americans don't choose
Speaker 1: the right healthcare coverage for their current situation UM according
Speaker 1: to recent studies. But you know, one of the things
Speaker 1: like deciding what that coverage is is then then becomes
Speaker 1: like a math equation, and who wants to go back
Speaker 1: to doing math? Like, I mean, I have a spreadsheet
Speaker 1: that I use, UM, but it's you can get really complicated.
Speaker 1: And the reason is this right, So, the majority of
Speaker 1: Americans still make their decision for their health plan based
Speaker 1: on premium um what am I paying monthly just to
Speaker 1: get in the door on my health insurance? They look
Speaker 1: at premiums, they say that one's two hundred and this
Speaker 1: one is three hundred. Three hundred is obviously worse. I'll
Speaker 1: pick the two hundred plan. That's probably like Americans health
Speaker 1: care literacy, health insurance literacy is growing, though, so more
Speaker 1: people are starting to make their decisions based on deductible. Right.
Speaker 1: Deductible is this other concept. It is the amount of
Speaker 1: money you have to pay out of pocket before your
Speaker 1: health insurance kicks in in the year. And those health
Speaker 1: insurance deductibles have been getting higher and higher every year,
Speaker 1: and now most Americans that are employer based insurance. Are
Speaker 1: on a high deductible healthcare plan today, so you've got
Speaker 1: this premium and deductible. So a lot of Americans have
Speaker 1: started to choose the lower deductible right, so they'll say, oh, man,
Speaker 1: it's five thousand dollars from my family has a lot
Speaker 1: of money. I'd never be able to pay that should
Speaker 1: I have an emergency, so I'm going to choose the deductible.
Speaker 1: The problem with making that choice is that sometimes you're
Speaker 1: choosing a lower deductible but ending up with a higher premium,
Speaker 1: and the total amount you're paying in premiums throughout the
Speaker 1: year is more than what you bought down in deductible,
Speaker 1: and many people don't make that. They don't add that
Speaker 1: up in their heads, so they feel like they're covering
Speaker 1: themselves better, but actually they're paying more out of pocket
Speaker 1: monthly in order to de risk the plan. So that's
Speaker 1: something to consider. Another thing to consider is that most
Speaker 1: most plans today don't end in deductible um. Once you
Speaker 1: hit your deductible, either for your family or for individuals,
Speaker 1: you have to pay something called coinsurance UM. Many plans
Speaker 1: that coinsurance is eight twenty or nine ten up to
Speaker 1: a certain maximum. What that means is that you still
Speaker 1: pay twenty percent or ten percent until you reach a
Speaker 1: maximum dollar amount. Many people don't realize that there's that
Speaker 1: additional money on the entail in there, so they'll pick
Speaker 1: a lower deductible and end up with a plan which actually,
Speaker 1: over the entire cost of the year, if you max
Speaker 1: it out, is more expensive than if they had chosen
Speaker 1: a ninety ten plan. So, as you can see, this
Speaker 1: kind of stuff gets really complicated. There's also additional things
Speaker 1: out there um that you need to consider when looking
Speaker 1: for a plan. My personal favorite is the one that
Speaker 1: everyone overlooks, which is the quality of the network. So
Speaker 1: one thing that most people don't realize is that there's
Speaker 1: these big health insurance plans out there that we call
Speaker 1: them the Bucah's Blue Cross, United, Signa, Etna, and they
Speaker 1: have the best networks and they sell their networks to
Speaker 1: other health insurance plans to use. Since they have the
Speaker 1: biggest networks, they have the biggest ability to negotiate down
Speaker 1: rates as well on the allowed amounts. So if you
Speaker 1: have a United plan, you're starting at a lower dollar
Speaker 1: amount for that service than somebody else's who might be
Speaker 1: on what they thought was a cheaper plan with the
Speaker 1: worst network, something a lot of people don't consider. How
Speaker 1: can you tell the difference between a good network and
Speaker 1: a not so good network, or maybe even like where
Speaker 1: is my doctor? Where do I want my doctor to be? Like,
Speaker 1: So always start with exactly what you just said, right,
Speaker 1: start with my doctor. Right, who are all the doctors
Speaker 1: that my family uses? And if you're looking at a
Speaker 1: new plan, check to make sure all those doctors are
Speaker 1: in network. A lot of times people don't even take
Speaker 1: that step, and once they've moved into the new plan,
Speaker 1: they now have to get all new doctors, which is
Speaker 1: a big hassle and can affect your continuity of care.
Speaker 1: And then you wouldn't get the same amount of the
Speaker 1: same quality of care in that year that you would expect. Yeah,
Speaker 1: then the next step is there are provider network directories
Speaker 1: all over the internet. They're required to publish them. You
Speaker 1: can go and type in your city and see how
Speaker 1: big the network is and how comprehensive do I recognize
Speaker 1: all the doctors? Is there only one psychiatrist in my
Speaker 1: entire hundred mile area? Um? And you can get an
Speaker 1: idea for the depth of the network. Of course, if
Speaker 1: you hear the names Blue Cross, United, signat not like
Speaker 1: it's going to be a big, comprehensive, well negotiated network.
Speaker 1: Mm hmmm. This might be adjacent to what you've already said,
Speaker 1: and maybe you've covered it already. But if if I'm
Speaker 1: in a position where I've decided I do want to
Speaker 1: relook at this and maybe I do need to make
Speaker 1: a change, are there any things that you would say,
Speaker 1: kind of in general, these are the most important things
Speaker 1: to be looking at when choosing health coverage. Yes, so,
Speaker 1: I think a lot of times people focus on the dollars,
Speaker 1: and that is important, Like I think it is a
Speaker 1: key feature, UM, But here are a couple of other
Speaker 1: things you might want to consider. So again, the network
Speaker 1: for me is a really big one because United negotiated
Speaker 1: discounts are significantly bigger than a lot than than say
Speaker 1: a smaller UM self funded plans negotiated discounts would be.
Speaker 1: But you should also be taking a look at the
Speaker 1: planned documents, which are always available as part of the
Speaker 1: open enrollment walkthroughs, to look at plan exclusions and any
Speaker 1: plan maximums that are on the plan. Right, So it's
Speaker 1: very common for UM certain things that you may be
Speaker 1: wanting in the period in life that you're in to
Speaker 1: be excluded like fertility treatments. UM, that's a big exclusion, UM,
Speaker 1: and sometimes that is a really important part of what unique.
Speaker 1: Also certain types of diabetes treatments, certain types of drugs
Speaker 1: that you may be wanting. For mental health, there was
Speaker 1: a big legislation that just passed in the last couple
Speaker 1: of years UM for mental health parity, requiring that mental
Speaker 1: health coverage be equivalent to medical coverage on all plans
Speaker 1: that are covered by the a c A, but not
Speaker 1: necessarily on employer based plans. So it's important to pay
Speaker 1: attention to mental health coverage. Another thing I think it's
Speaker 1: really interesting UM to consider is the maximums. Most state
Speaker 1: laws and federal law prevent UM full healthcare coverage plans
Speaker 1: from putting like an nual or a lifetime maximum on
Speaker 1: their benefit. But if you happen to be UM trying
Speaker 1: to purchase a plan yourself beyond the lookout for something
Speaker 1: that they call junk plans or short short term plans
Speaker 1: in the marketplace. They look too good to be true,
Speaker 1: and oftentimes they really are. They will put maximums on
Speaker 1: things like surgical benefits. I've seen one as low as
Speaker 1: like four thousand dollars a year for your total surgical maximum.
Speaker 1: And I can promise you you can't have surgery anywhere
Speaker 1: in the United States on anything for four thousand dollars.
Speaker 1: I mean my appendectomy was thirty six thousand dollars ten
Speaker 1: years ago, so that's you know, not going to cover
Speaker 1: you for anything. So those are the things that I
Speaker 1: think I would be on the lookout for. I also
Speaker 1: am a huge proponent of Health Savings account and h
Speaker 1: r A UM add ons to high deductible health plans.
Speaker 1: It's a great way for you to save money and
Speaker 1: have a higher deductible without having health plan, try and
Speaker 1: save for you in premiums. Yeah, that's UM. I love
Speaker 1: h A S two for people who are familiar in
Speaker 1: h S A is only you can only get it
Speaker 1: with a high deductible health care plan. But after usually
Speaker 1: around two thousand dollars that you put in, you can
Speaker 1: invest the rest and you can use it just like
Speaker 1: a retirement account, which is great. And it's tax free
Speaker 1: on all medical like all qualified medical expense, so it's great.
Speaker 1: We did we I wanted to ask you about this
Speaker 1: because we had somebody in our group asking about so
Speaker 1: she was diagnosed with a some kind of healthcare thing
Speaker 1: and anticipated some medical costs rising, but she loves her
Speaker 1: hs A, and so she was she was contemplating do
Speaker 1: I go to the lower deductible plan because I do
Speaker 1: expect rising medical costs, or do I hold to my
Speaker 1: h s A and keep investing there, maybe use the
Speaker 1: funds there, because she didn't know like how much this
Speaker 1: new thing would cost as brand new, So like any
Speaker 1: advice for maybe somebody kind of dealing with with that
Speaker 1: in general, being like I might have to go to
Speaker 1: the like I might have some medical stuff this year,
Speaker 1: but I really love my h s A any deciding factors.
Speaker 1: I'm a strong proponent of self ensuring whenever possible, I mean,
Speaker 1: and the ability to I strongly believe most people should
Speaker 1: push the deductible as high as they can manage um
Speaker 1: and lower their premium and then just self save the
Speaker 1: remaining money and hs A if they have that available
Speaker 1: to them. I'm not as big of a proponent of
Speaker 1: h r A S but because that money is then
Speaker 1: owned by the employer and not by you. But like
Speaker 1: you said, the h s A is money that you
Speaker 1: can roll over. You can invest it if the market
Speaker 1: is doing well, that money UM could really be worth
Speaker 1: even more. It's also tax free and a great wave
Speaker 1: for you to continue to build your own way to
Speaker 1: de risk your healthcare. However, if you really feel like
Speaker 1: you're going to have increasing needs in health services, I
Speaker 1: think it makes a lot of sense to look for
Speaker 1: a more comprehensive plan and pay the extra money to
Speaker 1: get more benefits. Yeah. I mean, and you're only restricted
Speaker 1: really for a year for whatever plan you have, so
Speaker 1: if you choose wrong, you can always change it the
Speaker 1: next year too. Yes, absolutely, and there's a good reason
Speaker 1: for adding more to that. Emergency savings. Is the hr
Speaker 1: A the same as f s A or those different
Speaker 1: so UM flexible spending accounts are a little bit different. UM.
Speaker 1: They normally covered like dependent daycare UM, and they do
Speaker 1: sometimes have like health insurance coverage, but usually those are
Speaker 1: ruled into an h RA and HRA differs from an
Speaker 1: hs A and the fact that an HRA is an
Speaker 1: employer owned account that the employer UM puts money in
Speaker 1: and the employee can also submit money, but that money
Speaker 1: is owned by the employer and when the employee leaves,
Speaker 1: that money is retained by the employer. And if it's
Speaker 1: not used in the year. It also is still retained
Speaker 1: by the employer UM, so it's a benefit and it's
Speaker 1: something that employers do to offset employer risk UM. So
Speaker 1: it is a good option. But it's not employees, it's
Speaker 1: not the employee's money, and it doesn't have cash value. Yeah, okay,
Speaker 1: but both of them can be used to pay for
Speaker 1: qualified health expenses, and there's a lot of qualified medical
Speaker 1: expense a lot almost anything you can get at CBS
Speaker 1: almost anything. Yes, absolutely. And I actually used my hs
Speaker 1: A to pay for my child's travel back from college
Speaker 1: to go to a health employment Wow. So and that
Speaker 1: was validly covered. Yes. So your HC has a lot
Speaker 1: of flexibility around what it can cover to support UM
Speaker 1: your health insurance needs, health care needs. And you don't
Speaker 1: have to pull those funds out immediately. You can wait
Speaker 1: and let it grow if you don't need it, Like
Speaker 1: I've saved with KAI all of my UM everything I
Speaker 1: paid for that pregnancy that I you know, got a
Speaker 1: bill and paid for and have an itemized receipt for
Speaker 1: whenever I want, I can take that money out of
Speaker 1: my h s A and submit that receipt whenever. So
Speaker 1: it's great. You can let the stock market pay for
Speaker 1: your medical treatment, like, just let it grow, let it
Speaker 1: pay for it, and then take the money out. I'm
Speaker 1: just clarifying that Kai is three years old and you're
Speaker 1: saying you could submit for reimbursement from your hs A
Speaker 1: like three years after giving birth. Yeah, because I had
Speaker 1: the hs A while I was on that the plan. Yeah,
Speaker 1: let's just say, you just got to be careful with
Speaker 1: an agent, say when the when the stock markets not
Speaker 1: doing that great, that you're not paying more ease than
Speaker 1: you are earning from the stock market, so you have
Speaker 1: to watch it. Like when you invest it. If you
Speaker 1: invest just a few thousand dollars, sometimes the bees end
Speaker 1: up being more than your earning, so you want to
Speaker 1: put it out cash. Um Yeah, yeah, yeah, you always wanna. Obviously,
Speaker 1: if you're in a high fee investment account, it sometimes
Speaker 1: makes more sense to just pull it out sooner. Mine
Speaker 1: is in very low fee index funds that I have
Speaker 1: easy access to, so I feel good about it that
Speaker 1: they're the same funds in my retirement accounts are in
Speaker 1: so I feel good about that. But okay, so back
Speaker 1: to open enrollment. Give us like, like, is there a
Speaker 1: checklist that we can do to get ready for open enrollment,
Speaker 1: any like pre homework that we can do well. I mean,
Speaker 1: just making sure that you understand how much to spend
Speaker 1: in health care for the previous year is important. A
Speaker 1: lot of times we lose track of how much that
Speaker 1: is because the equation is so complicated. But if you
Speaker 1: have an idea of how much the total charge amounts
Speaker 1: were for all the services that you UM took on
Speaker 1: throughout the year, at least a rough amount UM, that
Speaker 1: will help you to be able to evaluate plans as
Speaker 1: you're looking at them. The next thing is to ensure
Speaker 1: that when your employer, if you have your health insurance
Speaker 1: to your employer when they published their open enrollment availability
Speaker 1: of plans, take the time to read through the options UM,
Speaker 1: maybe in a little bit more depth than you have
Speaker 1: the best UM and given what you might you know
Speaker 1: have picked up from us talking today, start thinking about
Speaker 1: what type of plan would make the most sense for
Speaker 1: your family UM and what you know financial ability you
Speaker 1: have to support it UM. And then lastly, like think
Speaker 1: about what your family is going to be like in
Speaker 1: the next year or how you want it to be
Speaker 1: UM so that you're prepared for it. If you have
Speaker 1: healthcare coverage that doesn't have great obstetrics, UM, and you're
Speaker 1: planning to try and have a baby, then you might
Speaker 1: want to have some thought about that when you're going
Speaker 1: into looking at planned documents. I mean, any final tips
Speaker 1: on just ways we can maximize this opportunity when it
Speaker 1: only comes around once a year? How do we get
Speaker 1: the best possible? And my mind is gonna go to
Speaker 1: like the least expensive for the best thing. And you've
Speaker 1: given us a lot of tips already, but any any
Speaker 1: final thoughts on how do we maximize this annual opportunity? Well,
Speaker 1: so make sure you so. Health care Health insurance literacy
Speaker 1: is like a particular like has a particular place in
Speaker 1: my heart and mind. Right now. I feel like we
Speaker 1: are very smart consumers as Americans, but we haven't taken
Speaker 1: the time to educate ourselves on some basic terms and
Speaker 1: knowledge about health insurance. And I know why. It's not
Speaker 1: like the forefront of our minds all the time. UM,
Speaker 1: But as you begin to become a greater consumer of
Speaker 1: health care services, it's important to educate yourself on all
Speaker 1: of those terms. What's it inductible? What's coordination of benefits? Um?
Speaker 1: What's a co pay and why does it matter? And
Speaker 1: you know how our surgical benefits covered and what are
Speaker 1: possible exclusions? What is an exclusion? Um? That type of
Speaker 1: information will really arm you as you're heading into the
Speaker 1: open enrollment season and having to choose what is really
Speaker 1: a pretty big financial choice for your family in the
Speaker 1: next year. Do you have any recommendations on like good
Speaker 1: websites or resources where people could become more health insurance literate? Well, so,
Speaker 1: believe it or not, UM, the Affordable Care Act websites
Speaker 1: are great about explaining a lot of these terms because
Speaker 1: their job was to take a population that didn't have
Speaker 1: benefits or HR department and help them become more literate
Speaker 1: for accepting and UM and identifying an insurance plan for themselves. UM.
Speaker 1: So I find that the marketplace is a great place
Speaker 1: to find information. There are also a ton of websites
Speaker 1: out there which our patient advocacy sites that are all
Speaker 1: about raising literacy UM And there is a website called
Speaker 1: quizzify dot com that I really love that has a
Speaker 1: lot of videos that helps to raise your your knowledge
Speaker 1: level not just about health insurance, but also about health
Speaker 1: care itself and the different types of choices that you
Speaker 1: may have to make. That's amazing. Yeah, because there's so
Speaker 1: many like add ons to it. You've got the dependent
Speaker 1: care f s A or the h R A or
Speaker 1: or do we go ages A or multiple high deductible plans,
Speaker 1: and there's so much And for the longest time, I think,
Speaker 1: maybe even sometimes still I still confuse deductible and premium.
Speaker 1: Like I have still confused the two words, and you're
Speaker 1: not Americans are still don't know the like aren't able
Speaker 1: because why you only really think about it once a year.
Speaker 1: So yeah, definitely, well you know what I think about
Speaker 1: every week. I never have to be reminded of this terminology,
Speaker 1: sometimes multiple times a week, multiple yes, multiple times a week.
Speaker 1: The bill of the week. That's right, it's time for
Speaker 1: the best minute of your entire week. Maybe a baby
Speaker 1: was born and his name is William. Maybe you've paid
Speaker 1: off your mortgage, maybe your car died and you're happy
Speaker 1: to not have to pay that bill anymore. That's bill
Speaker 1: Buffalo Bills, Bill Clinton. This is the bill of the week.
Speaker 1: I mean, every week we invite our listeners or our
Speaker 1: guests to share with us their bill of the week,
Speaker 1: and we know you have one for us, So let
Speaker 1: us let us know it alright. So I didn't realize
Speaker 1: this until the very beginning when we started here, but
Speaker 1: I picked something a little bit boring. Um, So I'm
Speaker 1: not sure if because you should want to switch me out,
Speaker 1: people are just going to get more bang for their
Speaker 1: buck on the info on this episode. That's exactly something
Speaker 1: they didn't expect. Yeah, and I'm that weird person to
Speaker 1: gets super excited about all of this, So I don't
Speaker 1: even notice that you're bored, um why you're here. But um,
Speaker 1: I when you said bring in something that's like a
Speaker 1: bill or or bring in a bill, I I thought about, Um,
Speaker 1: these explanations of benefits that we always get in the
Speaker 1: mail after we have a medical service, and they always say,
Speaker 1: this is not a bill, and I think it's really interesting, Um,
Speaker 1: some of the things that can be written on these bills. Um.
Speaker 1: So I a friend who also works in the healthcare
Speaker 1: industry and recently had a baby, and she received an
Speaker 1: explanation of benefits, which is from your health insurer, from
Speaker 1: your pair, not from your provider, telling you how they
Speaker 1: adjudicated the claim that you're providers sent to them to
Speaker 1: your doctor sent them acclaim, they adjudicated it, They put
Speaker 1: together this beautiful display that's super complicated about how they
Speaker 1: paid the provider so that you can see what you
Speaker 1: might ohe and she was looking over her explanation of
Speaker 1: benefits and noticed that her normal, healthy delivery, natural childbirth
Speaker 1: delivery was coded as a level for emergency and she
Speaker 1: didn't understand why, so she called health enture and she
Speaker 1: found out that the doctor's office that you know, the
Speaker 1: provider that she had gone to for her delivery, that's
Speaker 1: how they upcode it to get the higher rate associated
Speaker 1: with level for emergency childbirth. And they do it for everybody,
Speaker 1: and oh my goodness, so welcome to the US health
Speaker 1: care system. And of course the insurer had um missed
Speaker 1: it um and they went back and readjudicated the claim,
Speaker 1: which caused, you know, a lot of headache for her
Speaker 1: because then the provider tried to balance bill the remainder
Speaker 1: to the patient, and then she had to involve insure again.
Speaker 1: So I thought that might be a little interesting tippit
Speaker 1: about not a bill, So I actually hurt you rather
Speaker 1: than that's not boring. I mean, I'm fired up over here.
Speaker 1: Balanced it something that we don't talk about. That is yeah,
Speaker 1: it's also it's not a bill, but it is a
Speaker 1: headache I have. So I have a bill from my
Speaker 1: uh first birth that it's like hundreds something dollars. And
Speaker 1: I was switching insurance because I was part of a
Speaker 1: layoff eight weeks before I gave birth. So I was
Speaker 1: switching from my insurance which was my coverage, to my
Speaker 1: husband's insurance and had something very close of a point
Speaker 1: meant some blood work or something very close to the switch.
Speaker 1: And so they submitted it to both or or the
Speaker 1: wrong one and they rejected it. And they are they
Speaker 1: have me in like collections for this thing that should
Speaker 1: be covered by insurance, that is covered by insurance, but
Speaker 1: they just can't figure out who it's covered by. And
Speaker 1: I was like, I can tell you who it's covered
Speaker 1: by if you tell me the date, and so they
Speaker 1: just haven't. It's not their priority and they don't care
Speaker 1: about me. So every time I call, they're like, you know,
Speaker 1: you have something in collections with us, and I'm like, no,
Speaker 1: I don't. It's so interesting that you that it's that
Speaker 1: you talk about it like that, because um, this this
Speaker 1: is something that we in the industry are really interested
Speaker 1: in right now, Like the experience of health care payments
Speaker 1: from the patient or members point of view is so
Speaker 1: negative that we don't even know where to begin to
Speaker 1: improve the process, either providers or health insurers. I would
Speaker 1: have to call every single day to that office to
Speaker 1: make them care enough to to do something about this,
Speaker 1: and I don't have the time. I mean, think, think
Speaker 1: about when you have to call an airline twice and
Speaker 1: how negative your reaction is to that, and how much
Speaker 1: airlines work to try and stop you from having to
Speaker 1: make those two phone calls. But in health care industry,
Speaker 1: it's so disparate, and there's so many different connection points
Speaker 1: that we've not been able to create that level of service.
Speaker 1: And we haven't needed to because until the last two decades,
Speaker 1: patients weren't really a significant part of the equation, so
Speaker 1: none of the systems were built to do that. I mean,
Speaker 1: I love your this is not a bill. This is amazing,
Speaker 1: This is this took quite a turn in this Bill
Speaker 1: of the Week segment, and and I am I'm feeling
Speaker 1: the fire in my value right now. So I'm going
Speaker 1: to turn it back to our listeners and tell you
Speaker 1: if you've out of this is not a bill, or
Speaker 1: this is totally a bill, or a bill. You don't
Speaker 1: have to pay a bill. You do have to pay
Speaker 1: whatever it is. Visit Frugal Friends podcast dot com, slash bill,
Speaker 1: leave us your bill. Even if it gets me fired up,
Speaker 1: it's a good thing. It makes me feel alive. Now
Speaker 1: it's time for the line. So today, in our vulnerable
Speaker 1: part of the show, we are all going to share
Speaker 1: what's an interesting health insurance experience you had and what
Speaker 1: did you learn from it. This is just an extenuation
Speaker 1: of the Bill of the Week segment. I think, I know,
Speaker 1: I know, I give Okay, I'll expound on it though,
Speaker 1: But so, Eileen, why don't you go first an interesting
Speaker 1: health insurance experience you've had and what you've learned to
Speaker 1: give me yours or somebody you've witnessed. I'll tell a
Speaker 1: positive one in which a weird instance of my health
Speaker 1: plan lead to a very positive outcome for me. So,
Speaker 1: right after I got married ten years ago, like like
Speaker 1: literally the week after, I woke up with like pains
Speaker 1: in my lower abdom I am the child of a doctor,
Speaker 1: so I knew immediately I had a pennicitis, but I
Speaker 1: wasn't on my husband's insurance plan, and before that I
Speaker 1: was I was running my own business, so I didn't
Speaker 1: really have insurance. UM, so I was uncovered and I
Speaker 1: hadn't rolled on to his plan yet. And I went
Speaker 1: to my doctor and he was like, yep, pennocidas, we
Speaker 1: need to go to the e R. And I was like, well,
Speaker 1: I'm not at my husband's plan yet. Is there something
Speaker 1: else you can do? And he was like, no to
Speaker 1: the R. But I was like, uh, well, like I'm
Speaker 1: weren't suying, I work it out today, And so he
Speaker 1: gave me these really strong antibiotics and sent me home.
Speaker 1: Well like by midday, my husband had mostly sorted everything out,
Speaker 1: and I went ahead and went to the e R
Speaker 1: and that I had a pennicidas And the next morning
Speaker 1: I had an appendeck to me through the e R.
Speaker 1: And when it all got sorted out in the end,
Speaker 1: the way I had been admitted to the e R
Speaker 1: and the way that they coded it, um, my surgery
Speaker 1: ended up being an emergency surgery and on the United
Speaker 1: Healthcare plan at that time, they covered it a hundred percent.
Speaker 1: So even though my appendectomy, which slightly ruptured and became
Speaker 1: like a really big deal, was like a seventy thousand
Speaker 1: dollar event, I paid zero dollars and after that happened,
Speaker 1: that plan realized the flaw of their set up and
Speaker 1: changed the plan for everyone next year. But a bit,
Speaker 1: a bit of knowing, like if you know the details
Speaker 1: and you know how to work the plant, then you
Speaker 1: can really do well. That's the lesson. Well, I mean
Speaker 1: you didn't. You didn't do that well because you had
Speaker 1: a partially raptured apend. But there was a silver line
Speaker 1: and doing great, great, it was good, like health was
Speaker 1: that was question? Oh my god? Wow, Um, I no
Speaker 1: longer have an appendix either. I lean bodies. I have
Speaker 1: no idea. That was when I was younger, And I
Speaker 1: should ask my parents how how that whole insurance they
Speaker 1: worked out? But yeah, finding ruptured appendices. I don't know
Speaker 1: how you say that. It's such a traumatic experience for
Speaker 1: like parents, Like you think your kids just oh, I
Speaker 1: have an upset stomach. You always have an upset stomach
Speaker 1: when you don't want to eat broccoli or when you
Speaker 1: don't want to go to bed, and then that could
Speaker 1: be ruptured appendix. Yeah, like how do you know the different? Though?
Speaker 1: So this is not meant to be medical advice. I'm
Speaker 1: not a doctor, sure, not a door. But a lot
Speaker 1: of the time an appendix can it can be more
Speaker 1: indicative of an X if you have them jump up
Speaker 1: and down and it hurts worse, or if when when
Speaker 1: you push in on it and it hurts worse when
Speaker 1: you let go and not when you push in, that
Speaker 1: can be an indication of AIS. But again, that clinical
Speaker 1: not a doctor. This is not a bill, this is
Speaker 1: not a podcast. This is not a podcast. I'm like
Speaker 1: an executive at a health care payments company, like, yeah,
Speaker 1: don't go with what I said. But well, and this
Speaker 1: is anecdotal. But for me, I was vomiting a lot,
Speaker 1: and you take me to the doctor. Yeah, yeah, yeah,
Speaker 1: lots of vomit. Okay, So I'll expound on mine a smidge.
Speaker 1: So uh so, yeah, I'm still like quote unquote in collections.
Speaker 1: It's not like on my credit report. So that's why
Speaker 1: I'm not like calling every day. They are quote unquote
Speaker 1: working on it. But so in that switch, I learned
Speaker 1: something really interesting. So we were on my works plan
Speaker 1: because they covered health insurance a hundred percent, you didn't
Speaker 1: get to pick. Yeah, I mean, they're the choices were
Speaker 1: very limited for what you got to pick because they
Speaker 1: paid for it. I think you had single or family essentially,
Speaker 1: And I switched to my husband's plan when we lost
Speaker 1: that instead of going into Cobra, and I was eight
Speaker 1: weeks away from my delivery and my bill, my total
Speaker 1: out of pocket went down. So I had already paid
Speaker 1: for my entire pregnancy delivery everything I'd paid in installments,
Speaker 1: and they sent me a refund, which also makes this
Speaker 1: like hundred and fifty dollar bill like that much more infuriating.
Speaker 1: I was like, you sent me money back? What? So
Speaker 1: I think I didn't even realize that the plans could
Speaker 1: cost different, Like it could be a different cost depending
Speaker 1: on what you're insure is so that is something that
Speaker 1: I would ask my doctor me, like, Okay, if I'm
Speaker 1: on this plan, what is the total package of my
Speaker 1: pregnancy and delivery going to cost? If I am on
Speaker 1: this plan, what is it going to cost? I didn't
Speaker 1: realize it had to do with the network. I didn't
Speaker 1: realize until you said that at the beginning. I would
Speaker 1: have never asked my oh B the billing department that,
Speaker 1: but that would have been something to factor in along
Speaker 1: with monthly premium payments, So like, does it make more
Speaker 1: sense to pay a little bit higher in a premium
Speaker 1: to get this lower cost for the pregnancy versus paying
Speaker 1: a lower premium to paying more for the overall care.
Speaker 1: I didn't even know to think that. So if you
Speaker 1: are pregnant, there you go. Definitely, Like those negotiated rates
Speaker 1: that they have with met with between directory services and
Speaker 1: providers are very different from insurer to insure, and like
Speaker 1: United can walk into almost any doctor's office and say,
Speaker 1: for the benefit of being a part of our network,
Speaker 1: we will offer you a sixty sixty of what you
Speaker 1: charge to start, right, And a smaller directory would be like,
Speaker 1: what do we have to give you to be in
Speaker 1: our network? Like, it's a totally different negotiation, you know.
Speaker 1: So um, you know you want to be a part
Speaker 1: of the you want to be with the bigger you know,
Speaker 1: negotiator or get a significant discount on premium um for
Speaker 1: a less significant allowed like allowed amount of negotation negotiation.
Speaker 1: So mhm, so interesting. Jill, Wow, Well here you go.
Speaker 1: I have not interacted with health insurance very much, so
Speaker 1: I yeah, I've had a lot of different types of
Speaker 1: plans current Lee though I am on like a medical
Speaker 1: sharing plan, so it similar to our bill of the
Speaker 1: weak segment. This is not a bill. What I have
Speaker 1: technically isn't insurance. It's more of a fail safe. And
Speaker 1: and what I've what I've learned in what little interaction
Speaker 1: I have had in getting quotes for insurance is I
Speaker 1: got a fend for myself. I gotta be scrappy. And
Speaker 1: the last appointment that I went to, I mean, I
Speaker 1: I really don't go to the doctor. It's kind of
Speaker 1: a problem, but it's worked for me so far. And
Speaker 1: I did have to go to the dermatologists this year.
Speaker 1: We are not doctors giving medical I'm telling you, dotal,
Speaker 1: this is my anecdotal personal experience. Don't don't do what
Speaker 1: I do or what I say when it comes to this.
Speaker 1: I did have to go to the dermatologist this year.
Speaker 1: I did that felt like I'm caring for myself. I'm
Speaker 1: actually going to see someone for a concern that I have.
Speaker 1: But it wasn't in network. So I was just like,
Speaker 1: I'm self pay. I'm just gonna tell these people I
Speaker 1: don't have insured. I wonder I was wondering if they
Speaker 1: treated you as self pay that they did. They did,
Speaker 1: and I'm gonna and so here's my lightning round is
Speaker 1: what did we learn so this is kind of like
Speaker 1: medical insurance adjacent. They did tell me up front what
Speaker 1: the cost would be just to go in for the visit,
Speaker 1: but that any minor procedures or care that they provided
Speaker 1: to me in the exam room would be quoted to
Speaker 1: me in the exam rooms. I'm like, okay, this is
Speaker 1: all new, let's try it out. So I did need
Speaker 1: to have some procedures done in the exam room. They
Speaker 1: were like, like it split, they did it super fast,
Speaker 1: and they just verbally told me the prices. So I'm
Speaker 1: sitting here just like okay, yea and mentally calculating it,
Speaker 1: like yeah, we could do that, we could do that,
Speaker 1: we could do that. Get out to the front desk
Speaker 1: and it's a different price. So then I'm standing there
Speaker 1: band aids all over the place like, uh, that's not
Speaker 1: what she told me, and they're like, yeah, that's what
Speaker 1: we told you. So then she had to get the
Speaker 1: doctor to come back out, and I'm not too proud,
Speaker 1: like yeah, I'll sit here and like fight back with
Speaker 1: what you told me, but what I learned. So here's
Speaker 1: the Like, if there are any takeaways and anyone's like
Speaker 1: me going into the doctor's office, I wish I would
Speaker 1: have gotten it in writing or like taking a screenshot
Speaker 1: or something, because it felt so arbitrary, because she's like
Speaker 1: because even like the friend desk person was like, oh, well,
Speaker 1: we can ask, which tells me there might be different
Speaker 1: prices that they're quoting to different people. So rather than
Speaker 1: my word against their word, I wish that I would
Speaker 1: have had them, Okay, what's the procedure, what's the price,
Speaker 1: what's the procedure? What's the price? And I didn't get
Speaker 1: it in writing. And the good news is is that
Speaker 1: that is federally mandated required as of January of this
Speaker 1: year for all self pay patients. They have to provide
Speaker 1: you with what's called a good faith estimate before the
Speaker 1: service UM. That was covered by the No Surprises Act
Speaker 1: and was mandated into federal law in January. So from
Speaker 1: now on, if you're a self pay patient, UM, you
Speaker 1: should be receiving a good faith estimate from all providers
Speaker 1: for any scheduled apointment that scheduled um longer than three
Speaker 1: days away from today's day. Yeah, and again she told me,
Speaker 1: like before I said yes to each procedure, she told
Speaker 1: me a price. It's just my recollection of what she
Speaker 1: told me. Which I feel like I would be the
Speaker 1: more accurate one in that situation because I'm the one
Speaker 1: paying it out of pocket and calculating it in my
Speaker 1: head right there on the table. So that was a bummer.
Speaker 1: But I think being a self pay patient is an
Speaker 1: interesting space to being in healthcare right now. Um, you
Speaker 1: can't really see a doctor that takes care Caid because
Speaker 1: they have most Favored Nation clauses in their contracts with them.
Speaker 1: But there's a lot of really great spaces where you
Speaker 1: can self negotiate. I think that's incredible. That's good that
Speaker 1: you're doing that. Yeah, yeah, so, I mean it was
Speaker 1: reason in a ball at the end of the day,
Speaker 1: like it. But that's my like. Next time I go,
Speaker 1: I'm going to get them. We're not doing it verbal,
Speaker 1: You're putting it in writing for me. I ain't, no dummy.
Speaker 1: I learned to use the word good faith estimate and
Speaker 1: they are required to provide it for you. I love. Yeah. Well, Eileen,
Speaker 1: thank you so much. Uh. If anybody wants more health
Speaker 1: insurance literacy or more from you, where would you direct them? Um?
Speaker 1: So I have a LinkedIn page with my name Eileen Doherty. Um,
Speaker 1: you can tell that it's me because it's got my
Speaker 1: picture on it. But I also have a blog called
Speaker 1: Eileen dot Healthcare and an email address. You can contact
Speaker 1: me through that blog if you'd like to. Awesome, Thank
Speaker 1: you so much, Eileen. This has been very informative. I
Speaker 1: have written things down because I am going to need
Speaker 1: UH to do some reevaluating on our health insurance this year.
Speaker 1: So very very glad that we had this interview. It
Speaker 1: was entirely my pleasure. Thank you. Riveting right, Jill, I'm
Speaker 1: so glad you turned around at the gym and saw
Speaker 1: Eileen standing there with all the answers to your healthcare
Speaker 1: insurance needs and wants from a friendly face right here
Speaker 1: in St. Petersburg, Florida. Yeah, this is definitely this is
Speaker 1: a question I had and I wanted answered, and that's
Speaker 1: why we did this. This is the episode nobody asked
Speaker 1: for but everybody's getting because I had the question. We
Speaker 1: don't shy away from boring complicated topics. You'll learn this
Speaker 1: about us and we'll still laugh. We'll have a few
Speaker 1: laughs along the way. But yes, I needed this too,
Speaker 1: So you know, we give ourselves what we need now,
Speaker 1: what we want sometimes. Yeah, we don't show away from
Speaker 1: the topics that you didn't ask, so thanks for listening
Speaker 1: to them. Um. Many of you know that in addition
Speaker 1: to two episodes a week, we also have a private
Speaker 1: community for listeners specifically trying to pay off debt. If
Speaker 1: that's your one goal right now. We have a membership
Speaker 1: where we do monthly money challenges to keep you engaged
Speaker 1: and moving forward with your debt payoff. And we want
Speaker 1: to congratulate one of our members for a big win.
Speaker 1: This is from Susan and this is from when we
Speaker 1: did the values based spending challenge back in September. She says,
Speaker 1: just thinking about my values with every purchase was so helpful.
Speaker 1: I did the challenge during the last seven days of September,
Speaker 1: and I didn't actually make very many purchases, but I
Speaker 1: thought about this every time. It's a very different mindset
Speaker 1: for me in a real game changer. One of my
Speaker 1: values is work. I really love my job. I've been
Speaker 1: working a lot of hours of the last couple of
Speaker 1: weeks on a special project, so I decided to use
Speaker 1: a grocery delivery service for the week and spend a
Speaker 1: little extra so I could focus on working without needing
Speaker 1: to go to the store, which always takes longer than
Speaker 1: I think it should. Since I combined that with a
Speaker 1: strong meal plan, I may have even saved a little
Speaker 1: because I didn't make any impulse purchases because I wasn't
Speaker 1: at the store looking at all the things. So congrats, Susan.
Speaker 1: That is a very great benefit. And that is something
Speaker 1: even from my mom. She doesn't listen to the show,
Speaker 1: but I told I gave her this recommendation once and
Speaker 1: she's like, I must have saved twenty books by doing
Speaker 1: this because I avoided the twenty and impulse purchases I
Speaker 1: make every time I go to the store. And I
Speaker 1: was like, Mom, if you have a problem with impulse spending,
Speaker 1: I have a podcast for you. Turnaround, Mom, listen to
Speaker 1: the Frugal Friends. Yeah. So if you or your mom
Speaker 1: has a problem with impulse spending um and is trying
Speaker 1: to pay off debt. Then had to Frugal Friends podcast
Speaker 1: dot com slash club to see what else we offer
Speaker 1: in the Frugal Friends Club. See you all next time.
Speaker 1: Frugal Friends is produced by Eric Syrian. My mind is
Speaker 1: just on insurance and medical costs right now. Mm hmm yeah,
Speaker 1: and how angering it all can be. That's one of
Speaker 1: the reasons too, why I think I don't I'm not
Speaker 1: as literate in this topic as I could be is
Speaker 1: because even as literate as you can become, it can
Speaker 1: feel as though there's still so much work to be
Speaker 1: done just fighting these these issues. It's like it's not
Speaker 1: a well oiled machine that we're dealing with and just
Speaker 1: you know, understand how to add and subtract numbers. It's
Speaker 1: so complicated, and then there's so much fraud and in
Speaker 1: decency and headache and phone calls, and it just it
Speaker 1: feels a little bit like debilitating. It does. Yeah, it
Speaker 1: is unjust, and I think a lot of I mean,
Speaker 1: sometimes when we're dealing with an unjust system, we can
Speaker 1: just throw up our hands and say, well, I can't
Speaker 1: change it, so I don't know enough or I don't
Speaker 1: have enough skill to come out on top up, so
Speaker 1: we just don't try. And so that's like the goal
Speaker 1: with these episodes. It's just to give you a little
Speaker 1: more knowledge, a little more confidence, and a little more
Speaker 1: boldness to try. Yeah, and do I feel the same
Speaker 1: way even after years of you know, being in personal finance,
Speaker 1: writing about insurance, like hearing experts like this talk about
Speaker 1: it like it still feels debilitating because then it comes
Speaker 1: into time that I just don't have. It was super
Speaker 1: affirming for me to hear Eileen talk about we might
Speaker 1: be better off with the higher deductible and the lower
Speaker 1: monthly premium. I think because that's my circumstance right now,
Speaker 1: and I kind of always feel like, oh my making
Speaker 1: like the juvenile decision, thinking nothing bad is going to
Speaker 1: happen to me, although I do have that deductible saved
Speaker 1: as part of my emergency funds, so and so it's
Speaker 1: just affirming. I think that's one major takeaway from from
Speaker 1: me because I've had that thought like, well, I pay
Speaker 1: much higher each month to get a lower deductible, but
Speaker 1: at the end of the day, like I might be
Speaker 1: spending more not actually saving anything. And that's only if
Speaker 1: there's a massive catastrophe. So I I think that helps
Speaker 1: to to know, Okay, be as armed and ready as possible,
Speaker 1: but also smart about what's going to be best for
Speaker 1: you individually, knowing that it's not a perfect system. Yeah
Speaker 1: it's it's not perfect, but it's our system. It's what
Speaker 1: we've got, um so so take advantage of it as
Speaker 1: as well as you can. No, I think that's kind
Speaker 1: of the moral And you know what, all of those
Speaker 1: negotiating phone calls that we do and other aspects of
Speaker 1: our life will only serve us well for fighting these
Speaker 1: battles of medical costs and insurance coverages. And you know what,
Speaker 1: I think there's a part of me that needs to
Speaker 1: shift my perspective to this is such a hassle. I
Speaker 1: don't have time for this too. This is a part
Speaker 1: of life, like I will probably monthly find myself in
Speaker 1: some sort of back and forth phone call, whether it's
Speaker 1: negotiating something, writing something, giving accurate information for something that
Speaker 1: was inaccurate. I think it's just that is a part
Speaker 1: of being alive. Yeah, that is my version of a
Speaker 1: pep talk Welcome to life on the podcast. It's real life.