Episode Transcript
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Speaker 1 (00:06):
Hi, It's Brian Thomas with John Rollman from Cover. Since
y I normally am the host of the fifty five
Cadsey Warning Show, but on Sunday Mornings I got to
sit down with John and talk medical insurance. It's another
edition of Rethink Healthcare Together. And you may think that
sounds kind of strange and it might be tedious, but no,
we learn every week that this is actually really amazing,
amazing what John and the team at Cover since he
(00:27):
can do by way of finding a better way to
get you insured with medical insurance dollar one coverage, less money,
group insurance included. As we fast approach open enrollment period,
I'm sure there's a bunch of businesses out there going, well,
I'm just gonna call the same company I've been working
with every year and just resign up for the same thing.
That's because they haven't listened to you, John and what
(00:47):
you're able to do. Good to talk with you again,
my friend. Always great seeing you.
Speaker 2 (00:50):
Oh YouTube, Brian, always glad to be here.
Speaker 1 (00:52):
So what should we be thinking of as we approach
open enrollment? Oh and by the way, real quick here
five one three eight hundred two two five five five
one three eight hundred call that's cover. Since he's number,
you're going to want to have that number in mind
because after you hear what John has to say, you're
gonna want to get in touch with them for a
multitude of reasons. You can check out on the web
and get the process of him looking at your current
(01:13):
insurance coverage versus what he could do for you at
coversinc dot com. The form there you can fill out.
There is no obligation to you reach out talk to
John or any one of the team and let them
look into it. You'd be amazed what they can do
by finding a better way. Anyway, With that in mind, John,
where are we here this time of year? Open rollments
(01:34):
coming fast?
Speaker 2 (01:35):
Yeah, we have two major open enrollments right now. Of
course the medicare here. One is fastly approaching here October fifteenth,
So we're actually really booking up right now. A lot
of the listeners have called in to at least get
themselves scheduled because they know of the annual notice of change,
which you keep talking about. Yeah, every week on the
show is so important this year. So again, if you're
over sixty five, you're going to have to be more
(01:58):
than likely re looking at your prescription drug plan this year.
If you're on a Medicare advantage plan, it's definitely beneficial
for you to, you know, get an appointment here for
us starting October fifteenth then later just basically to be
able to go over your options because we're expecting some
big changes here. We're actually starting to see some of
the plans right now. And yeah, so some of the
carriers have actually started showing us some stuff and it's
(02:20):
definitely a little concerning, so you know, definitely want to
make sure that your plan is in line for exactly
what you need. We are seeing some changes on the
provider side, so you know, again if you're on a
certain plan, we need to make sure your doctor is
even going to be a network for you next year.
Speaker 3 (02:37):
That's gonna be very important for you.
Speaker 2 (02:38):
So again, if you're on Medicare, like I said, an
unadvantage plan, or you know, everybody over sixty five probably
has a prescription drug plan, get it scheduled. Let's make
sure you guys are in line for the twenty twenty
five season. But you know, again there's multiple open rollments,
right so we have the Medicare, we have open enrollments
coming up for a lot of the group plans. So
you know, guys, you'll be choosing, hey, what's my new
(03:00):
plan for next year for myself or my family all
my group benefits. So it's one of the things that
you know, we can help look at some more affordable options,
not even changing your major medical plan, Brian, but maybe
looking at maybe it's a cheaper option to take a
higher deductible, and you know, looking at some of the
other products that we can add on to that to
make it even more affordable for you. And the cost scheme.
(03:21):
You know, you'd be surprised how many people I see
take you know, the gold package plan. I want the
copace for doctor visits and all this and the lower deductible.
But you have to realize there there's a huge cost
to those type of plans.
Speaker 4 (03:33):
Yeah, we've talked about that a lot.
Speaker 1 (03:34):
The cost is massive, and this great illustration of you know,
you always look at multiple different ways to achieve a goal.
You know, what's the goal Where the person is in
their life. Do they have children, for example, are they
past childbearing age, they have other issues and there are
different little types of insurance that can fill in the
holes with maybe what you've got so with that in mind,
(03:57):
let's talk what about you know, I like children in sports,
they get injured all the time. I mean, it's one
of the reasons some of my my two children were
prohibited from playing certain sports by my wife who did
not want to deal with certain childhood injuries. I'm not
naming names on sports, but you know, I mean it's
gonna happen.
Speaker 2 (04:16):
I mean, you see it all the time, right it's
I mean, almost two thirds of claims to go through
emergency rooms right now are accent related, right And you
look at a lot of even the group plans right now,
I mean, and everything's subjucated to deductibles and co insurance,
and most people aren't aware of that. They walk in,
they hand their insurance card at the emergency room and
(04:37):
lo and behold, here's a three, four or five thousand
dollars bill because you know, little Jimmy ended up breaking
his arm playing football, you know, And it's a huge
windfall to see that kind of expense come down the
road when we can plan for those type of things.
And I don't care what deductible you have now, because
(04:57):
as we know, with even on the group side, and
I group all the time, you know the out of
pocket expenses are are are mimicking the Affordable Care Act.
I see seven eight nine thousand dollars out of pocket
for an individual and you get in the emergency room,
run up a four or five thousand dollars claim you're
paying the entire bill.
Speaker 3 (05:15):
That's scary.
Speaker 2 (05:16):
Not to mention that group policy is probably costing you know,
the employer and you somewhere in the neighborhood of eighteen hundred
dollars a month.
Speaker 1 (05:22):
Rogare mind boggling when you know that there's that much
out of pocket and you still have the the premium
premiums just mind boggling.
Speaker 2 (05:30):
So you know, looking at you know, kind of coming
into your open enrollment, you know, one of the things
that really engage yourself with is, Hey, what does what
is maybe the HSA qualified plan look for? What is
the high reductible plan? Is that going to save me
to three hundred bucks a month? Because if that is
the case, you know, one of the things you should
do is reach out to us and we can show
you ancillary products that we can add on to that
(05:52):
plan that will make it even better than that gold
plan that you were looking at with all the cope's
and all the bells and whistles.
Speaker 1 (05:59):
So in other words, you it would be paying a
premium for another insurance policy, but the premium will be
far less than these expenses we're talking about if you
just stick with the so called gold plan, which really
is a misnomer.
Speaker 2 (06:12):
Oh absolutely, it's you know, so you just have to
kind of think about it. Is the more you get
the primary It's kind of like if I was living
in Miami, you know, am I going to go buy.
Speaker 3 (06:23):
Heated leather seats on my car? Right?
Speaker 2 (06:25):
I mean, it doesn't really make sense. So people end
up buying these plans of all these bells and whistles,
and they a lot of times don't need them, and
there's a huge cost to those and the insurance companies
know that. I mean, they're going to know that. At
the end of the day, it's you give me a dollar,
I might pay eighty cents back, you know, And that's
kind of how they're looking at it. So the more
(06:46):
first dollar benefits that you get, the lower copage is
the lower reductible. I mean, sometimes it's smoking mirrors because
even going from a five thousand to a twenty five
hundred dollars aductable you're out of pocket might be the
same if you have a bad year, and we know
the way the expenses are even in the emergency rooms
right now, chances are you're you're blowing way past that deductible.
You're getting into your co insurance, you're still paying the
(07:07):
same out of pocket expense when you go in. So,
you know, going back to the kids' sports pieces, you know,
one of the first things when I first started selling
insurance that made the most sense to me was buying
an accident policy. I'm not talking about those guys that
come knocking on the doors of the businesses, you know,
all the you know, the the animal sounding companies, you know.
Speaker 1 (07:31):
I mean they have the commercial tell you literally nothing
about what they're It.
Speaker 2 (07:35):
Tells you literally nothing. But a lot of those plans
aren't really designed to pay the actual out of pocket
expenses that you're going to incur over top of your
major medical plan.
Speaker 3 (07:46):
You know.
Speaker 2 (07:47):
It's great, Yeah, I broke my collarbone and XYZ company
is going to hand me a check for one thousand dollars,
But my out of pocket expense in that bill is
three or four grand right now, So I mean it's
it's not even a wash. At that point, I'm still
paying from insurance premium and I'm still not really getting
my entire bill covered. So you know, one of the
things that I mentioned, you know, we looked at doing
(08:08):
accident medical expense plans, and this I've been doing it
for twenty years. It's the one thing I truly believe
in anytime I sell an insurance policy, it's the number
one thing that I recommend the clients because accidents can
happen at any point in time. I mean, yes, we
always want insurance for the cancer, heard attack, stroke things,
but we know that's very small percentage of people are
(08:28):
going to run into those situations. But I have three kids.
I mean, I will say there's probably at least an
inkling of an accident every year. Something's gonna happen. My
son just broke his arm a few months ago, riding
his bike the first day of summer, you know, I mean,
and you know, we walk into the children's hospital. They
(08:49):
have an urgent care, they have an emergency room, and
we go, well, they go, well, we think he broke
his arm, Well you can go up to urgent care,
and they go It's about two and a half hour wait,
and I'm like crazy, right, And I go, well, we're
here at the emergency room to actually have a facility
that both together. And they go, well, why don't we
go through the emergency room? Is there any wait there?
They go no, but it's more expensive. I'm like, well,
(09:09):
I don't care because I have an accident in policy,
and the accident policies are designed to completely one hundred
percent cover all of the out of pocket expenses that
you will incur on your major medical health insurance plan.
So I knew with my accident policy, the most I
would pay was a fifty dollars reductible.
Speaker 3 (09:28):
That was it.
Speaker 2 (09:29):
Because even though my out of pocket expense my major
medical plan is over eight grand, my accent policy completely
covers it. So I didn't even care. It's like, let's
go to the emergency room. We're gonna go walk right
in there, get the treatment. We're walking out all said
and done, and I still see people that came right
behind us, still waiting in the urgent care, not even
being seen.
Speaker 1 (09:48):
And I think about the time spent waiting in the
emergency room. I translate, this is the way my brain works.
I translate that into the value of the hour in
terms of what I used to build when I was
practiced law. And I know that rate has gone up
a lot over the years because it's been sixteen years
or rather eighteen years since our practice law. But it's
still you know, a significant time value of money. And
(10:11):
for me, my time is precious and the more I
can limit that time, the happier I am.
Speaker 4 (10:16):
So there's a value to that alone.
Speaker 2 (10:18):
Oh yeah, I mean, and Brian, these plans are very inexpensive.
I mean, we're talking thirty forty fifty sixty bucks a
month for our family, and you're getting your entire deductible,
your co insurance one hundred percent covered. You never have
to worry about, Hey, did my son go in and
he hurt his arm?
Speaker 3 (10:38):
Is it a sprain? We're not having that question in
our mind.
Speaker 4 (10:41):
Yeah, we do it.
Speaker 2 (10:42):
We do it as parents. Right, You're like, all right,
can I touch it?
Speaker 3 (10:45):
Is it broken?
Speaker 2 (10:46):
Do I really need to go to the emergency room.
Speaker 4 (10:48):
Put a bandage on it?
Speaker 3 (10:49):
Because because we.
Speaker 2 (10:49):
Start making financial decisions on our health, we talk about
this all time, like we shouldn't be making a financial decision.
You should just be able to go and get the
treatment that you need, and when we build plans, Brian,
that is our goal that you never have to worry
about making that choice. Do I do it because it's
gonna cost me money out of pocket? Or can I
just go and hand my cards over and everything will
(11:11):
work out fine?
Speaker 1 (11:12):
Right, Well, anybody that's been to the hospital already knows
how expensive it is. So if you're gonna end you're
gonna end up in the emergency room, you're gonna be
talking about thousands of dollars period, end of story. At
you say fifty bucks roughly a month maybe for a
family coverage on this, Yeah, one hospital visit covers the
premium for the entire year, or makes up for the
entire years with the premiums it could.
Speaker 2 (11:33):
It's it's even more than that. It's like seven years.
If you have an action like every seven years.
Speaker 4 (11:37):
It.
Speaker 2 (11:39):
Like pays for itself. So, I mean, I've carried it.
I bought an accident policy before I even had a family,
and I have it. I'm on the same plan that's
usually one I recommend. And you know they've paid out
and claims more than I've ever paid in premium with
three kids, And you look at all the things that
our kids do I mean riding a bike. You know,
my kids play two three sports each, so I mean
(12:00):
there's always that potential. Yeah, you know, and I don't
care if if you don't have kids. I mean, you
clean your gutters. We live in Ohio, you know, it's
like you walk outside when it snows, like you slip
on ice. I mean, there's so many things that can happen.
And yeah, and like I said, they're so inexpensive to
pick up these plans. And that's why I tell people like,
take the higher reductibles, add on these secondary coverages because
(12:22):
usually the money you're saving by taking the higher reductible
is a lot more money we're saving than even what
the cost is to add these secondary policies on.
Speaker 1 (12:30):
All Right, so quality accident coverage. There's one. What about dental.
Speaker 2 (12:34):
So this is something we've talked about here in our
show in the past, and in dental insurance. You know,
when I first got into this industry, it was very
difficult because everybody wants dental insurance. So we I have
a lot of different companies, so we would sell the
dental plans. Well, the problem that we always get back
as an insurance agent is they would call us, you know,
six months eight months later and going hey, John, the
(12:55):
plane you sold me sucked. I'm like, what do you
mean it's a really good plan to go?
Speaker 3 (12:59):
I don't know.
Speaker 2 (13:00):
Every time I use, I pay all kinds of money
out of pocket, and I'm like, what is going on?
And then we really what I really found out again
this is nineteen years ago, is I wasn't asking all
the right questions in the beginning. People just want to
give me the best policy, give me the most affordable plan.
I would sign them up, but what they would never
do is take a look to make sure if they're
dentists were a network. And that's a big problem with
(13:21):
dental insurance.
Speaker 4 (13:21):
It is.
Speaker 2 (13:22):
You know, there are a lot of dentists out there,
very good dentists that don't even take insurance anymore. But
even the ones that do, you have to make sure
that the plan that you're choosing, that dentist is in network.
Because this is a notorious one for balance billing. You'll
see all kinds of balance billing. You'll go in and going, hey,
my plan says I have for free preventative care for cleanings,
(13:43):
my kids, fluoride treatments. Why am I getting a bill
on the backside, Well, it's because they're not contracted with
that insurance company, and if they're not contracted, they're basically overcharging.
They don't get that negotiated right from the insurance company,
and you're basically just paying on the back end for
what's left over. And the other thing to look at
too is you know a lot of these plans, even
on the group side, they're very limiting coverage. You know,
(14:06):
you'll start seeing plans out there to have five hundred,
one thousand dollars maximum coverage a year. I mean we're
looking at root canals are now fifteen hundred dollars plus,
so it's not even covering an entire root canal anymore.
So again, making sure that you have very good coverage
because it's not just dental insurance is not just for
preventative care. It's I broke my tooth, you know, I
(14:27):
have I need root canalw I'm having major dental problems
in the future. That's really where you want that dental
insurance to kick in. And we have such very good plans.
I have plans that have no maximum coverage. I have
plans that will pay five thousand dollars I got plans
that will cover implants. I got plans they'll cover you know,
you know, braces and.
Speaker 3 (14:47):
Stuff like that.
Speaker 2 (14:48):
So it's again, it's again having that conversation, you know,
where are we at today, what's my goals for the future.
I'm planning on having a family. Well, we know I
have three kids. I mean my drawa is one of them.
Was going to get brace.
Speaker 4 (15:01):
Yeah, so no question about that.
Speaker 2 (15:03):
So again it's it's just making sure that they're all
set up the right way and making sure that even
if you're choosing a dental plan through your group, you know, hey,
if I'm stuck with my dentists, is he not in network?
Well then maybe I don't want to choose that option,
and give us a call and pick up a plan
that actually makes sense for your family.
Speaker 1 (15:17):
All right, Well that's a wonderful thing to contemplate. And
how many if you had a guest, I know, I
always mentioned that you're working for your clients. You have
access to hundreds of insurance companies and thousands of different plans,
and this is one category among those thousand plans, these
dental insurance plans. If you had a guess how many
different dental plans are out there available for you to contemplate,
(15:40):
depending on anybody's given circumstance. Hundreds hundreds just dental love.
Speaker 2 (15:44):
Yeah, I mean the first question if you were call
on you just like I need dental insurance, please just
tell us your dentists first. That's that's the easiest way
because basically what all we do at that point is
we actually call the dentists office and go who are
you contracted with? And the first thing is that what
we take all plans. If they're ppa, that basically just
means they want to balance bill. So he's like, no,
who are you contracted with? And go, well, we have
(16:05):
like two carriers and that's the two carriers that we'll
look at.
Speaker 4 (16:07):
For Okay, that makes sense.
Speaker 1 (16:09):
Great, cut through the chase on that one makes it
very simple for us to have no doubt about all right,
And this is subject we've talked about before, and you
just alluded to it or mentioned to it in the
scenario you painted under the emergency you know, you got
your kid, you're standing there. There's urgent care. There's emergency
emergency care. Remind folks of the difference of it and
(16:29):
why it matters in terms of how you're working with
your clients to find the right policy.
Speaker 4 (16:34):
Yeah.
Speaker 2 (16:34):
So one of the things we discussed with our clients
is the ability to shop your healthcare right. I Mean
we talk about this a lot on the show, but
basically when we do a one on one meeting, it's
one of the things I trained my guys on. So
it's helping people understand costs that are out there, the
pitfalls that you can run into. But you know, really
(16:55):
the biggest piffle, like I always say, is the emergency room.
I mean, it's just it's a trap that we run into,
you know, and it's a huge, huge expense. It's a
it's basically a cash cow for these hospitals that I see.
Oh yeah, yeah, I mean it's just a huge money grab.
I mean I've watched these expenses go up one thousand
percent in the twenty years I've been selling insurance.
Speaker 3 (17:15):
But it's well, they.
Speaker 1 (17:16):
Got your your most vulnerable time. I mean it's an emergency.
You know, you got blood scoring on an a order
or something. I mean, you know, time to dicker overprice.
Speaker 2 (17:25):
If that is, If that's what's going on. If you
have blood scoring after order, you absolutely should go to
the emergency room. But the problem is we could we
see so many people go to the emergency room because
they think it's just it's access to another doctor, you know.
And the one thing to understand too is insurance companies
have started really cutting back on this too, And if
they don't deem it's a life threatening and emergency, they're
not even covering the bills. I've literally watched major insurance
(17:48):
companies turn around and decline claims because someone decided to
go in and run up a fifteen thousand dollars bill
in an emergency room for something that wasn't life threatening.
Speaker 1 (17:56):
Well, I understand scenarios where people maybe this is designed
to encourage people to have preventative care. We can then
we're going to be talking about that in a few
minutes here. But to get a PCP and see your
primary care physician and you know, have regular checkups and visits.
Because sometimes people get an infection, you get sinus infection,
they'll go to the emergency room and try to get
(18:17):
treatment there.
Speaker 3 (18:18):
Yeah.
Speaker 2 (18:18):
I mean I had a client get bronchitis and go
there one time, and she thought it was severe enough.
I mean, from what she said, she could barely breathe,
which I would deem an emergency, but the insurance company said, no,
it's bronchitis. It's not an emergency like threatening situation. They
declined or claim. So again, you're right, I mean, making
sure that you are going to a PCP, making sure
you get these things addressed earlier. And understand, guys, there's
(18:39):
these urgent cares out there. On the A few shows ago,
we actually brought a client in that owns an urgent care,
right I mean, and talked about the level of care
that they can provide at these places that it's more nominal.
I mean, we're talking thousand percent cheaper and a lot
of cases and walking through the er doors. But kind
of understanding how the insurance companies are are wishing, you know,
(19:01):
us to kind of get treatment there. But it's also
you know, as a parent, understanding you know what's available
in my area at urgent cares, you know, so I
don't have to run to an emergency room. You know,
I know urgent cares that can flush your eye if
you get a you know, something in your eye. I know,
I know urgent cares that have X rays in there.
I know, you know, I mean ditches stitches. Yeah, I
mean these are places that you can go. And when
(19:22):
we build out plans, Brian, I mean a lot of
our plans that we build out for clients have have
co pays for urgent care. But remember we sell the
indemnity plans that go with it. So a lot of
these indemnity plans, like one of the plans we sell
has a fifty dollars cope for urgent care on the
major medical well, the indemnity the secondary coverage that we
add on form past two hundred and fifty dollars when
they go to urgent care. So basically they walk out
(19:46):
with two hundred dollars and it pays for like three
a year per frame. Me member, So it's like, you know,
I'm trying to incentivize you to stay out of the
emergency room, go to urgent care. In worst case you
go to urgent care, well, I'll make two hundred bucks
and then if my conditions worse on the full recon
me go to the emergency room at least.
Speaker 1 (20:01):
In which case you have covered that it is in
fact an emergency.
Speaker 2 (20:04):
Service and you have an emergency service, yes, but again
making sure that you guys are kind of doing the
same thing, but and just understanding. I mean, I think
as a good parent, we should know what kind of
is available to us in our area. So if you're
in an area like look around at some of the
urgent cares that are there and going okay, well when's
when's the X ray technician? And so I know, Okay,
this guy's on the Thursday, this one's on a Tuesday,
(20:24):
So I can avoid the emergency. Wait, I can just
go to urgent care. And I know, hey, John sent
me up with a really good plan. I'm not paying
anything to go here. I'm not going to question is
it a sprain? I don't care. I'm gonna go get
it checked because I know I'm not paying anything out
of pocket.
Speaker 1 (20:38):
And the urgent care facilities are they're popping up all.
Speaker 2 (20:42):
Over the place, and you can be very careful though.
Speaker 1 (20:45):
It's why I kind of answer that question, because you know,
picking and shoot just because you're in this urgent not emergency,
but urgent situation. Okay, you have a gash that's big
enough to justify stitches, all right, So which one do
I go to is a great question.
Speaker 2 (21:00):
Which one do you go to? And making sure that
it's not the one that's sitting there partnered up.
Speaker 4 (21:05):
With the hospital because we charge you the same thing, will.
Speaker 2 (21:07):
Charge the same thing, or at least charge you significantly
more than some of the you know, standardized you know,
urgent cares that are in private practice. So again, knowing
which where you're going to go, I mean I've fell
into that loop before. We're going into an urgent care
that I thought was an urgent care and it was
just a small er that looked you know, and ended
up running up thousands of dollars in bills.
Speaker 4 (21:28):
I'm like, wow.
Speaker 1 (21:30):
So that was like a hospital satellite office, a.
Speaker 2 (21:31):
Hospital satellite offices, right, And they did blood work and
I think the blood work alone was over eleven hundred
dollars or something that we could have went and got
done at.
Speaker 3 (21:40):
A lab for eighty bucks. Yeah, you know.
Speaker 2 (21:43):
And the reason I want your listeners to hear this
is because those things are going to go against your
aductable like and people don't understand most plans don't have
copays for those things. You're not going to walk out
of there and going Okay, my plan I says fifty
dollars cope here, and why am I getting a bill
for two thousand dollars. I don't understand, and that's the
trap a lot of people end up falling into, is
(22:05):
kind of the unaware consumer.
Speaker 1 (22:07):
Let's rethink healthcare together with John Rolman Coversinc. Dot coms
where you find them again, there's a form you can
fill out to find out if there is a better
path for you and to answer and engage in this
conversation with anyone of John's team. Will to emphasize that
always do the discussions with John. I mentioned John specifically
when I'm doing commercials for him, but his team is
all highly trained and they're so any one of the
(22:29):
folks that are covered, since he can help you. All right,
Pivoting over to the thing we were just alluded to
a moment ago, preventative care.
Speaker 2 (22:34):
Yeah, so it's uh, I stress this more and more
basically because at the end of the day, it's it's
one of those things that's it's very highlighted in today's
health insurance realm. I was put there, if you guys know,
the term minimal essential coverage that's in the Affordable Care Act.
So basically any plan that's sponsored through like the ACA, Bombacare,
(22:58):
whatever you want to call it, healthcare market place, they're
going to have free preventative care in there. If you're
on a group health plan, they have to abide by
the same laws though you have free preventive care. It
was not something we saw a lot on the individual
side when I first started insurance. When I first started
doing insurance, you'd be shocked to find in company that
will be give you a hundred bucks for preventive care
for whatever reason in their great mind.
Speaker 1 (23:20):
Yeah, it does amazing because if you prevent, if you
get in early, it's kind of what I mentioned earlier.
You get in early, you solve what could be a
much greater, more expensive underscore for the insurance company, and
the individual problem down the road, well went ahead of it.
Speaker 2 (23:34):
Well, the problem they solved when I first started selling
insurance was listen, our premiums were five hundred percent cheaper
twenty years ago when I first started. I mean, a
family of family of five could have gotten one thousand
dollars aductable plan for under five hundred.
Speaker 3 (23:47):
Bucks a month.
Speaker 2 (23:48):
It's amazing, you know now that plan doesn't even exist
anymore at that level. But I mean I look at
the marketplace for my family, it's two grand for eighteen
thousand dollars. So when I was selling those plans back then,
you know, you would have those preventative care plans, but
they were more expensive.
Speaker 3 (24:05):
Because it's just it's just a dollar for dollar.
Speaker 2 (24:07):
Because the insurance cand be saying, you're gonna give me
a dollar, I'm gonna pay right back for the preventative care.
So of course they just tied it into the premium, right,
and people are like, well, I'm not going to pay
a thousand bucks a month just to get free preventive care.
I'll pay for it on my own, right. And we
saw that trend that people were going, I will opt
out of that benefit to save premium. Well, then what happens.
Speaker 4 (24:25):
They don't go to the doctor.
Speaker 2 (24:25):
They don't do it. You're absolutely under percent, right, I know.
And then it's kind of like I always say, like
I have these clients that are you know, and I
write so many self employed clients, and a lot of
them they are gentlemen in their fifties, right, And the
way they talk to me, John, I don't I don't
need all those bells and whistles. I don't go to
doctor less my leg's falling off or something, right, And
(24:47):
the worst part about it is like, you know, they're
the guys I find three or five years later, whether
one of my policies, I go, well I just had
a heart attack or I just had a stroke, I'm like,
I haven't seen a doctor in fifteen years. So I
was like, well, you're kind of a heart attack being
to happen. You know, you don't know what's going on.
So it is a huge benefit that I've seen now
that these plans do cover these benefits. And you know,
(25:07):
when we build out plans, Brian, not only do I
want you to have access to that preventative care benefits,
I actually even do it as a redundancy. So even
if your primary insurance is paying for it for you
for free, the secondary policies I have will actually pay
you to go get your preventive care benefits paid for.
You mentioned your son went in for a physical, you know,
(25:27):
ended up getting a check back on the what And
that's our goal. My goal is like, if I can
incentifize you, I don't want to have the conversation with
you five years from now.
Speaker 1 (25:35):
You'll never have to tell him to go get a
physical annually because he knows he's going to get it.
Was like a couple of hundred north of a couple
of hundred buck check back. We're going to the doctor
and that's after, of course the insurance company paid the
doctor off. So it's just wild how that works. Like
why not I'm gonna go get two hundred dollars off
to see the doctor and so you know he's still healthy.
But that's the can I ask this because personal experience
(25:59):
I have, because I saw in your notes that you
always provide me to schedule in advance these preventative care
because sometimes you know the doctor's offices are busy. You
want to plan ahead, get it on the calendar so
they know you're coming, you know when to go, and
just stick to the appointment dermatologist. Try to get into
a dermatologist on the fly. Are you're gonna tell you
six months a year down the road? Now I can
(26:20):
see in next February or whatever. So I have a
standing dermatology appointment. I go every six months because we
have a My father is an illustration of it. Northern
European been burned a whole bunch of times like I have,
and so he had a whole bunch of different things removed,
different types of cancers removed over the years. I don't
want that to happen, so I get ahead of it.
I had this standing appointment. Is that going to be
(26:42):
con I don't want to put you on this.
Speaker 3 (26:43):
That's not preventive.
Speaker 4 (26:44):
That's not preventive.
Speaker 3 (26:45):
No, I think it should be.
Speaker 2 (26:46):
You know, I do feel like, you know, especially when
you have clients that live down south. You know, I
got a lot of clients in Texas. I get clients
in California. I mean, I know that's like it's like
a thing, right, I know, like every six months I
go to a dermatologists. But you know, you are seeing
that that is not a preventive care things, So don't
think about it like, hey, my plan says preventive care.
I'm gonna go to dermritologists. It's gonna be free.
Speaker 3 (27:05):
It's not.
Speaker 4 (27:05):
Okay, I'm glad I asked you the questions.
Speaker 2 (27:07):
It's not because it's it's and then more than likely
it's gonna be your specialist cope. So it's gonna be
significantly higher than your primary care copey. And then you
know when they go to free something off or cut
something off. Yeah, I mean, be prepared because most health
plans you don't have a cope for that, so it's
gonna be subject to your deductible. You're gonna be paying
to get it removed, You're going to be paying for
to get biopsied or whatever they're going to up doing,
(27:29):
and it it could be you know, hundreds, if not
a thousand dollars out of pocket expenses on something like that.
But you know, again kind of going back to what
the secondary plans do, they actually pay for that. So
I mean that's why we build those policies in you know,
one of the companies we actually.
Speaker 3 (27:45):
Sell for.
Speaker 2 (27:47):
Literally has in office surgical benefits paid out and a
tune of hundreds of dollars. So for that exact situation
that dermatology visit, they go in and remove something. Usually
we're seeing those bills three to five hundred bucks, and
these plans completely cover it. So you're you have no
auDA pocket expense and no excuse to not go and
get it done.
Speaker 1 (28:05):
Exactly Well, I have thought prevented it merely because if
you have a family history of that kind of thing,
it seems to me removing that little thing early early
prevents a much much bigger problem likemetasticize cancer.
Speaker 4 (28:16):
It does happen.
Speaker 1 (28:17):
This has been another edition of Rethink Healthcare together with
John Roman from Cover since he work with any one
of his team, and you can start the process and
again you're not obligated to do anything. Just let them
look at what you got and come up with a
better plan, because I'm pretty darn certain he can. It's
five one three eight hundred call five one three eight
hundred two two five to five online again. Fill the
format right there to start the process Cover Sincy dot com.
Speaker 4 (28:38):
John, it's always pleasure talking here.
Speaker 3 (28:40):
See Bryan. Thank you
Hi, It's Brian Thomas with John Rollman from Cover. Since
y I normally am the host of the fifty five
Cadsey Warning Show, but on Sunday Mornings I got to
sit down with John and talk medical insurance. It's another
edition of Rethink Healthcare Together. And you may think that
sounds kind of strange and it might be tedious, but no,
we learn every week that this is actually really amazing,
amazing what John and the team at Cover since he
(00:27):
can do by way of finding a better way to
get you insured with medical insurance dollar one coverage, less money,
group insurance included. As we fast approach open enrollment period,
I'm sure there's a bunch of businesses out there going, well,
I'm just gonna call the same company I've been working
with every year and just resign up for the same thing.
That's because they haven't listened to you, John and what
(00:47):
you're able to do. Good to talk with you again,
my friend. Always great seeing you.
Speaker 2 (00:50):
Oh YouTube, Brian, always glad to be here.
Speaker 1 (00:52):
So what should we be thinking of as we approach
open enrollment? Oh and by the way, real quick here
five one three eight hundred two two five five five
one three eight hundred call that's cover. Since he's number,
you're going to want to have that number in mind
because after you hear what John has to say, you're
gonna want to get in touch with them for a
multitude of reasons. You can check out on the web
and get the process of him looking at your current
(01:13):
insurance coverage versus what he could do for you at
coversinc dot com. The form there you can fill out.
There is no obligation to you reach out talk to
John or any one of the team and let them
look into it. You'd be amazed what they can do
by finding a better way. Anyway, With that in mind, John,
where are we here this time of year? Open rollments
(01:34):
coming fast?
Speaker 2 (01:35):
Yeah, we have two major open enrollments right now. Of
course the medicare here. One is fastly approaching here October fifteenth,
So we're actually really booking up right now. A lot
of the listeners have called in to at least get
themselves scheduled because they know of the annual notice of change,
which you keep talking about. Yeah, every week on the
show is so important this year. So again, if you're
over sixty five, you're going to have to be more
(01:58):
than likely re looking at your prescription drug plan this year.
If you're on a Medicare advantage plan, it's definitely beneficial
for you to, you know, get an appointment here for
us starting October fifteenth then later just basically to be
able to go over your options because we're expecting some
big changes here. We're actually starting to see some of
the plans right now. And yeah, so some of the
carriers have actually started showing us some stuff and it's
(02:20):
definitely a little concerning, so you know, definitely want to
make sure that your plan is in line for exactly
what you need. We are seeing some changes on the
provider side, so you know, again if you're on a
certain plan, we need to make sure your doctor is
even going to be a network for you next year.
Speaker 3 (02:37):
That's gonna be very important for you.
Speaker 2 (02:38):
So again, if you're on Medicare, like I said, an
unadvantage plan, or you know, everybody over sixty five probably
has a prescription drug plan, get it scheduled. Let's make
sure you guys are in line for the twenty twenty
five season. But you know, again there's multiple open rollments,
right so we have the Medicare, we have open enrollments
coming up for a lot of the group plans. So
you know, guys, you'll be choosing, hey, what's my new
(03:00):
plan for next year for myself or my family all
my group benefits. So it's one of the things that
you know, we can help look at some more affordable options,
not even changing your major medical plan, Brian, but maybe
looking at maybe it's a cheaper option to take a
higher deductible, and you know, looking at some of the
other products that we can add on to that to
make it even more affordable for you. And the cost scheme.
(03:21):
You know, you'd be surprised how many people I see
take you know, the gold package plan. I want the
copace for doctor visits and all this and the lower deductible.
But you have to realize there there's a huge cost
to those type of plans.
Speaker 4 (03:33):
Yeah, we've talked about that a lot.
Speaker 1 (03:34):
The cost is massive, and this great illustration of you know,
you always look at multiple different ways to achieve a goal.
You know, what's the goal Where the person is in
their life. Do they have children, for example, are they
past childbearing age, they have other issues and there are
different little types of insurance that can fill in the
holes with maybe what you've got so with that in mind,
(03:57):
let's talk what about you know, I like children in sports,
they get injured all the time. I mean, it's one
of the reasons some of my my two children were
prohibited from playing certain sports by my wife who did
not want to deal with certain childhood injuries. I'm not
naming names on sports, but you know, I mean it's
gonna happen.
Speaker 2 (04:16):
I mean, you see it all the time, right it's
I mean, almost two thirds of claims to go through
emergency rooms right now are accent related, right And you
look at a lot of even the group plans right now,
I mean, and everything's subjucated to deductibles and co insurance,
and most people aren't aware of that. They walk in,
they hand their insurance card at the emergency room and
(04:37):
lo and behold, here's a three, four or five thousand
dollars bill because you know, little Jimmy ended up breaking
his arm playing football, you know, And it's a huge
windfall to see that kind of expense come down the
road when we can plan for those type of things.
And I don't care what deductible you have now, because
(04:57):
as we know, with even on the group side, and
I group all the time, you know the out of
pocket expenses are are are mimicking the Affordable Care Act.
I see seven eight nine thousand dollars out of pocket
for an individual and you get in the emergency room,
run up a four or five thousand dollars claim you're
paying the entire bill.
Speaker 3 (05:15):
That's scary.
Speaker 2 (05:16):
Not to mention that group policy is probably costing you know,
the employer and you somewhere in the neighborhood of eighteen hundred
dollars a month.
Speaker 1 (05:22):
Rogare mind boggling when you know that there's that much
out of pocket and you still have the the premium
premiums just mind boggling.
Speaker 2 (05:30):
So you know, looking at you know, kind of coming
into your open enrollment, you know, one of the things
that really engage yourself with is, Hey, what does what
is maybe the HSA qualified plan look for? What is
the high reductible plan? Is that going to save me
to three hundred bucks a month? Because if that is
the case, you know, one of the things you should
do is reach out to us and we can show
you ancillary products that we can add on to that
(05:52):
plan that will make it even better than that gold
plan that you were looking at with all the cope's
and all the bells and whistles.
Speaker 1 (05:59):
So in other words, you it would be paying a
premium for another insurance policy, but the premium will be
far less than these expenses we're talking about if you
just stick with the so called gold plan, which really
is a misnomer.
Speaker 2 (06:12):
Oh absolutely, it's you know, so you just have to
kind of think about it. Is the more you get
the primary It's kind of like if I was living
in Miami, you know, am I going to go buy.
Speaker 3 (06:23):
Heated leather seats on my car? Right?
Speaker 2 (06:25):
I mean, it doesn't really make sense. So people end
up buying these plans of all these bells and whistles,
and they a lot of times don't need them, and
there's a huge cost to those and the insurance companies
know that. I mean, they're going to know that. At
the end of the day, it's you give me a dollar,
I might pay eighty cents back, you know, And that's
kind of how they're looking at it. So the more
(06:46):
first dollar benefits that you get, the lower copage is
the lower reductible. I mean, sometimes it's smoking mirrors because
even going from a five thousand to a twenty five
hundred dollars aductable you're out of pocket might be the
same if you have a bad year, and we know
the way the expenses are even in the emergency rooms
right now, chances are you're you're blowing way past that deductible.
You're getting into your co insurance, you're still paying the
(07:07):
same out of pocket expense when you go in. So,
you know, going back to the kids' sports pieces, you know,
one of the first things when I first started selling
insurance that made the most sense to me was buying
an accident policy. I'm not talking about those guys that
come knocking on the doors of the businesses, you know,
all the you know, the the animal sounding companies, you know.
Speaker 1 (07:31):
I mean they have the commercial tell you literally nothing
about what they're It.
Speaker 2 (07:35):
Tells you literally nothing. But a lot of those plans
aren't really designed to pay the actual out of pocket
expenses that you're going to incur over top of your
major medical plan.
Speaker 3 (07:46):
You know.
Speaker 2 (07:47):
It's great, Yeah, I broke my collarbone and XYZ company
is going to hand me a check for one thousand dollars,
But my out of pocket expense in that bill is
three or four grand right now, So I mean it's
it's not even a wash. At that point, I'm still
paying from insurance premium and I'm still not really getting
my entire bill covered. So you know, one of the
things that I mentioned, you know, we looked at doing
(08:08):
accident medical expense plans, and this I've been doing it
for twenty years. It's the one thing I truly believe
in anytime I sell an insurance policy, it's the number
one thing that I recommend the clients because accidents can
happen at any point in time. I mean, yes, we
always want insurance for the cancer, heard attack, stroke things,
but we know that's very small percentage of people are
(08:28):
going to run into those situations. But I have three kids.
I mean, I will say there's probably at least an
inkling of an accident every year. Something's gonna happen. My
son just broke his arm a few months ago, riding
his bike the first day of summer, you know, I mean,
and you know, we walk into the children's hospital. They
(08:49):
have an urgent care, they have an emergency room, and
we go, well, they go, well, we think he broke
his arm, Well you can go up to urgent care,
and they go It's about two and a half hour wait,
and I'm like crazy, right, And I go, well, we're
here at the emergency room to actually have a facility
that both together. And they go, well, why don't we
go through the emergency room? Is there any wait there?
They go no, but it's more expensive. I'm like, well,
(09:09):
I don't care because I have an accident in policy,
and the accident policies are designed to completely one hundred
percent cover all of the out of pocket expenses that
you will incur on your major medical health insurance plan.
So I knew with my accident policy, the most I
would pay was a fifty dollars reductible.
Speaker 3 (09:28):
That was it.
Speaker 2 (09:29):
Because even though my out of pocket expense my major
medical plan is over eight grand, my accent policy completely
covers it. So I didn't even care. It's like, let's
go to the emergency room. We're gonna go walk right
in there, get the treatment. We're walking out all said
and done, and I still see people that came right
behind us, still waiting in the urgent care, not even
being seen.
Speaker 1 (09:48):
And I think about the time spent waiting in the
emergency room. I translate, this is the way my brain works.
I translate that into the value of the hour in
terms of what I used to build when I was
practiced law. And I know that rate has gone up
a lot over the years because it's been sixteen years
or rather eighteen years since our practice law. But it's
still you know, a significant time value of money. And
(10:11):
for me, my time is precious and the more I
can limit that time, the happier I am.
Speaker 4 (10:16):
So there's a value to that alone.
Speaker 2 (10:18):
Oh yeah, I mean, and Brian, these plans are very inexpensive.
I mean, we're talking thirty forty fifty sixty bucks a
month for our family, and you're getting your entire deductible,
your co insurance one hundred percent covered. You never have
to worry about, Hey, did my son go in and
he hurt his arm?
Speaker 3 (10:38):
Is it a sprain? We're not having that question in
our mind.
Speaker 4 (10:41):
Yeah, we do it.
Speaker 2 (10:42):
We do it as parents. Right, You're like, all right,
can I touch it?
Speaker 3 (10:45):
Is it broken?
Speaker 2 (10:46):
Do I really need to go to the emergency room.
Speaker 4 (10:48):
Put a bandage on it?
Speaker 3 (10:49):
Because because we.
Speaker 2 (10:49):
Start making financial decisions on our health, we talk about
this all time, like we shouldn't be making a financial decision.
You should just be able to go and get the
treatment that you need, and when we build plans, Brian,
that is our goal that you never have to worry
about making that choice. Do I do it because it's
gonna cost me money out of pocket? Or can I
just go and hand my cards over and everything will
(11:11):
work out fine?
Speaker 1 (11:12):
Right, Well, anybody that's been to the hospital already knows
how expensive it is. So if you're gonna end you're
gonna end up in the emergency room, you're gonna be
talking about thousands of dollars period, end of story. At
you say fifty bucks roughly a month maybe for a
family coverage on this, Yeah, one hospital visit covers the
premium for the entire year, or makes up for the
entire years with the premiums it could.
Speaker 2 (11:33):
It's it's even more than that. It's like seven years.
If you have an action like every seven years.
Speaker 4 (11:37):
It.
Speaker 2 (11:39):
Like pays for itself. So, I mean, I've carried it.
I bought an accident policy before I even had a family,
and I have it. I'm on the same plan that's
usually one I recommend. And you know they've paid out
and claims more than I've ever paid in premium with
three kids, And you look at all the things that
our kids do I mean riding a bike. You know,
my kids play two three sports each, so I mean
(12:00):
there's always that potential. Yeah, you know, and I don't
care if if you don't have kids. I mean, you
clean your gutters. We live in Ohio, you know, it's
like you walk outside when it snows, like you slip
on ice. I mean, there's so many things that can happen.
And yeah, and like I said, they're so inexpensive to
pick up these plans. And that's why I tell people like,
take the higher reductibles, add on these secondary coverages because
(12:22):
usually the money you're saving by taking the higher reductible
is a lot more money we're saving than even what
the cost is to add these secondary policies on.
Speaker 1 (12:30):
All Right, so quality accident coverage. There's one. What about dental.
Speaker 2 (12:34):
So this is something we've talked about here in our
show in the past, and in dental insurance. You know,
when I first got into this industry, it was very
difficult because everybody wants dental insurance. So we I have
a lot of different companies, so we would sell the
dental plans. Well, the problem that we always get back
as an insurance agent is they would call us, you know,
six months eight months later and going hey, John, the
(12:55):
plane you sold me sucked. I'm like, what do you
mean it's a really good plan to go?
Speaker 3 (12:59):
I don't know.
Speaker 2 (13:00):
Every time I use, I pay all kinds of money
out of pocket, and I'm like, what is going on?
And then we really what I really found out again
this is nineteen years ago, is I wasn't asking all
the right questions in the beginning. People just want to
give me the best policy, give me the most affordable plan.
I would sign them up, but what they would never
do is take a look to make sure if they're
dentists were a network. And that's a big problem with
(13:21):
dental insurance.
Speaker 4 (13:21):
It is.
Speaker 2 (13:22):
You know, there are a lot of dentists out there,
very good dentists that don't even take insurance anymore. But
even the ones that do, you have to make sure
that the plan that you're choosing, that dentist is in network.
Because this is a notorious one for balance billing. You'll
see all kinds of balance billing. You'll go in and going, hey,
my plan says I have for free preventative care for cleanings,
(13:43):
my kids, fluoride treatments. Why am I getting a bill
on the backside, Well, it's because they're not contracted with
that insurance company, and if they're not contracted, they're basically overcharging.
They don't get that negotiated right from the insurance company,
and you're basically just paying on the back end for
what's left over. And the other thing to look at
too is you know a lot of these plans, even
on the group side, they're very limiting coverage. You know,
(14:06):
you'll start seeing plans out there to have five hundred,
one thousand dollars maximum coverage a year. I mean we're
looking at root canals are now fifteen hundred dollars plus,
so it's not even covering an entire root canal anymore.
So again, making sure that you have very good coverage
because it's not just dental insurance is not just for
preventative care. It's I broke my tooth, you know, I
(14:27):
have I need root canalw I'm having major dental problems
in the future. That's really where you want that dental
insurance to kick in. And we have such very good plans.
I have plans that have no maximum coverage. I have
plans that will pay five thousand dollars I got plans
that will cover implants. I got plans they'll cover you know,
you know, braces and.
Speaker 3 (14:47):
Stuff like that.
Speaker 2 (14:48):
So it's again, it's again having that conversation, you know,
where are we at today, what's my goals for the future.
I'm planning on having a family. Well, we know I
have three kids. I mean my drawa is one of them.
Was going to get brace.
Speaker 4 (15:01):
Yeah, so no question about that.
Speaker 2 (15:03):
So again it's it's just making sure that they're all
set up the right way and making sure that even
if you're choosing a dental plan through your group, you know, hey,
if I'm stuck with my dentists, is he not in network?
Well then maybe I don't want to choose that option,
and give us a call and pick up a plan
that actually makes sense for your family.
Speaker 1 (15:17):
All right, Well that's a wonderful thing to contemplate. And
how many if you had a guest, I know, I
always mentioned that you're working for your clients. You have
access to hundreds of insurance companies and thousands of different plans,
and this is one category among those thousand plans, these
dental insurance plans. If you had a guess how many
different dental plans are out there available for you to contemplate,
(15:40):
depending on anybody's given circumstance. Hundreds hundreds just dental love.
Speaker 2 (15:44):
Yeah, I mean the first question if you were call
on you just like I need dental insurance, please just
tell us your dentists first. That's that's the easiest way
because basically what all we do at that point is
we actually call the dentists office and go who are
you contracted with? And the first thing is that what
we take all plans. If they're ppa, that basically just
means they want to balance bill. So he's like, no,
who are you contracted with? And go, well, we have
(16:05):
like two carriers and that's the two carriers that we'll
look at.
Speaker 4 (16:07):
For Okay, that makes sense.
Speaker 1 (16:09):
Great, cut through the chase on that one makes it
very simple for us to have no doubt about all right,
And this is subject we've talked about before, and you
just alluded to it or mentioned to it in the
scenario you painted under the emergency you know, you got
your kid, you're standing there. There's urgent care. There's emergency
emergency care. Remind folks of the difference of it and
(16:29):
why it matters in terms of how you're working with
your clients to find the right policy.
Speaker 4 (16:34):
Yeah.
Speaker 2 (16:34):
So one of the things we discussed with our clients
is the ability to shop your healthcare right. I Mean
we talk about this a lot on the show, but
basically when we do a one on one meeting, it's
one of the things I trained my guys on. So
it's helping people understand costs that are out there, the
pitfalls that you can run into. But you know, really
(16:55):
the biggest piffle, like I always say, is the emergency room.
I mean, it's just it's a trap that we run into,
you know, and it's a huge, huge expense. It's a
it's basically a cash cow for these hospitals that I see.
Oh yeah, yeah, I mean it's just a huge money grab.
I mean I've watched these expenses go up one thousand
percent in the twenty years I've been selling insurance.
Speaker 3 (17:15):
But it's well, they.
Speaker 1 (17:16):
Got your your most vulnerable time. I mean it's an emergency.
You know, you got blood scoring on an a order
or something. I mean, you know, time to dicker overprice.
Speaker 2 (17:25):
If that is, If that's what's going on. If you
have blood scoring after order, you absolutely should go to
the emergency room. But the problem is we could we
see so many people go to the emergency room because
they think it's just it's access to another doctor, you know.
And the one thing to understand too is insurance companies
have started really cutting back on this too, And if
they don't deem it's a life threatening and emergency, they're
not even covering the bills. I've literally watched major insurance
(17:48):
companies turn around and decline claims because someone decided to
go in and run up a fifteen thousand dollars bill
in an emergency room for something that wasn't life threatening.
Speaker 1 (17:56):
Well, I understand scenarios where people maybe this is designed
to encourage people to have preventative care. We can then
we're going to be talking about that in a few
minutes here. But to get a PCP and see your
primary care physician and you know, have regular checkups and visits.
Because sometimes people get an infection, you get sinus infection,
they'll go to the emergency room and try to get
(18:17):
treatment there.
Speaker 3 (18:18):
Yeah.
Speaker 2 (18:18):
I mean I had a client get bronchitis and go
there one time, and she thought it was severe enough.
I mean, from what she said, she could barely breathe,
which I would deem an emergency, but the insurance company said, no,
it's bronchitis. It's not an emergency like threatening situation. They
declined or claim. So again, you're right, I mean, making
sure that you are going to a PCP, making sure
you get these things addressed earlier. And understand, guys, there's
(18:39):
these urgent cares out there. On the A few shows ago,
we actually brought a client in that owns an urgent care,
right I mean, and talked about the level of care
that they can provide at these places that it's more nominal.
I mean, we're talking thousand percent cheaper and a lot
of cases and walking through the er doors. But kind
of understanding how the insurance companies are are wishing, you know,
(19:01):
us to kind of get treatment there. But it's also
you know, as a parent, understanding you know what's available
in my area at urgent cares, you know, so I
don't have to run to an emergency room. You know,
I know urgent cares that can flush your eye if
you get a you know, something in your eye. I know,
I know urgent cares that have X rays in there.
I know, you know, I mean ditches stitches. Yeah, I
mean these are places that you can go. And when
(19:22):
we build out plans, Brian, I mean a lot of
our plans that we build out for clients have have
co pays for urgent care. But remember we sell the
indemnity plans that go with it. So a lot of
these indemnity plans, like one of the plans we sell
has a fifty dollars cope for urgent care on the
major medical well, the indemnity the secondary coverage that we
add on form past two hundred and fifty dollars when
they go to urgent care. So basically they walk out
(19:46):
with two hundred dollars and it pays for like three
a year per frame. Me member, So it's like, you know,
I'm trying to incentivize you to stay out of the
emergency room, go to urgent care. In worst case you
go to urgent care, well, I'll make two hundred bucks
and then if my conditions worse on the full recon
me go to the emergency room at least.
Speaker 1 (20:01):
In which case you have covered that it is in
fact an emergency.
Speaker 2 (20:04):
Service and you have an emergency service, yes, but again
making sure that you guys are kind of doing the
same thing, but and just understanding. I mean, I think
as a good parent, we should know what kind of
is available to us in our area. So if you're
in an area like look around at some of the
urgent cares that are there and going okay, well when's
when's the X ray technician? And so I know, Okay,
this guy's on the Thursday, this one's on a Tuesday,
(20:24):
So I can avoid the emergency. Wait, I can just
go to urgent care. And I know, hey, John sent
me up with a really good plan. I'm not paying
anything to go here. I'm not going to question is
it a sprain? I don't care. I'm gonna go get
it checked because I know I'm not paying anything out
of pocket.
Speaker 1 (20:38):
And the urgent care facilities are they're popping up all.
Speaker 2 (20:42):
Over the place, and you can be very careful though.
Speaker 1 (20:45):
It's why I kind of answer that question, because you know,
picking and shoot just because you're in this urgent not emergency,
but urgent situation. Okay, you have a gash that's big
enough to justify stitches, all right, So which one do
I go to is a great question.
Speaker 2 (21:00):
Which one do you go to? And making sure that
it's not the one that's sitting there partnered up.
Speaker 4 (21:05):
With the hospital because we charge you the same thing, will.
Speaker 2 (21:07):
Charge the same thing, or at least charge you significantly
more than some of the you know, standardized you know,
urgent cares that are in private practice. So again, knowing
which where you're going to go, I mean I've fell
into that loop before. We're going into an urgent care
that I thought was an urgent care and it was
just a small er that looked you know, and ended
up running up thousands of dollars in bills.
Speaker 4 (21:28):
I'm like, wow.
Speaker 1 (21:30):
So that was like a hospital satellite office, a.
Speaker 2 (21:31):
Hospital satellite offices, right, And they did blood work and
I think the blood work alone was over eleven hundred
dollars or something that we could have went and got
done at.
Speaker 3 (21:40):
A lab for eighty bucks. Yeah, you know.
Speaker 2 (21:43):
And the reason I want your listeners to hear this
is because those things are going to go against your
aductable like and people don't understand most plans don't have
copays for those things. You're not going to walk out
of there and going Okay, my plan I says fifty
dollars cope here, and why am I getting a bill
for two thousand dollars. I don't understand, and that's the
trap a lot of people end up falling into, is
(22:05):
kind of the unaware consumer.
Speaker 1 (22:07):
Let's rethink healthcare together with John Rolman Coversinc. Dot coms
where you find them again, there's a form you can
fill out to find out if there is a better
path for you and to answer and engage in this
conversation with anyone of John's team. Will to emphasize that
always do the discussions with John. I mentioned John specifically
when I'm doing commercials for him, but his team is
all highly trained and they're so any one of the
(22:29):
folks that are covered, since he can help you. All right,
Pivoting over to the thing we were just alluded to
a moment ago, preventative care.
Speaker 2 (22:34):
Yeah, so it's uh, I stress this more and more
basically because at the end of the day, it's it's
one of those things that's it's very highlighted in today's
health insurance realm. I was put there, if you guys know,
the term minimal essential coverage that's in the Affordable Care Act.
So basically any plan that's sponsored through like the ACA, Bombacare,
(22:58):
whatever you want to call it, healthcare market place, they're
going to have free preventative care in there. If you're
on a group health plan, they have to abide by
the same laws though you have free preventive care. It
was not something we saw a lot on the individual
side when I first started insurance. When I first started
doing insurance, you'd be shocked to find in company that
will be give you a hundred bucks for preventive care
for whatever reason in their great mind.
Speaker 1 (23:20):
Yeah, it does amazing because if you prevent, if you
get in early, it's kind of what I mentioned earlier.
You get in early, you solve what could be a
much greater, more expensive underscore for the insurance company, and
the individual problem down the road, well went ahead of it.
Speaker 2 (23:34):
Well, the problem they solved when I first started selling
insurance was listen, our premiums were five hundred percent cheaper
twenty years ago when I first started. I mean, a
family of family of five could have gotten one thousand
dollars aductable plan for under five hundred.
Speaker 3 (23:47):
Bucks a month.
Speaker 2 (23:48):
It's amazing, you know now that plan doesn't even exist
anymore at that level. But I mean I look at
the marketplace for my family, it's two grand for eighteen
thousand dollars. So when I was selling those plans back then,
you know, you would have those preventative care plans, but
they were more expensive.
Speaker 3 (24:05):
Because it's just it's just a dollar for dollar.
Speaker 2 (24:07):
Because the insurance cand be saying, you're gonna give me
a dollar, I'm gonna pay right back for the preventative care.
So of course they just tied it into the premium, right,
and people are like, well, I'm not going to pay
a thousand bucks a month just to get free preventive care.
I'll pay for it on my own, right. And we
saw that trend that people were going, I will opt
out of that benefit to save premium. Well, then what happens.
Speaker 4 (24:25):
They don't go to the doctor.
Speaker 2 (24:25):
They don't do it. You're absolutely under percent, right, I know.
And then it's kind of like I always say, like
I have these clients that are you know, and I
write so many self employed clients, and a lot of
them they are gentlemen in their fifties, right, And the
way they talk to me, John, I don't I don't
need all those bells and whistles. I don't go to
doctor less my leg's falling off or something, right, And
(24:47):
the worst part about it is like, you know, they're
the guys I find three or five years later, whether
one of my policies, I go, well I just had
a heart attack or I just had a stroke, I'm like,
I haven't seen a doctor in fifteen years. So I
was like, well, you're kind of a heart attack being
to happen. You know, you don't know what's going on.
So it is a huge benefit that I've seen now
that these plans do cover these benefits. And you know,
(25:07):
when we build out plans, Brian, not only do I
want you to have access to that preventative care benefits,
I actually even do it as a redundancy. So even
if your primary insurance is paying for it for you
for free, the secondary policies I have will actually pay
you to go get your preventive care benefits paid for.
You mentioned your son went in for a physical, you know,
(25:27):
ended up getting a check back on the what And
that's our goal. My goal is like, if I can
incentifize you, I don't want to have the conversation with
you five years from now.
Speaker 1 (25:35):
You'll never have to tell him to go get a
physical annually because he knows he's going to get it.
Was like a couple of hundred north of a couple
of hundred buck check back. We're going to the doctor
and that's after, of course the insurance company paid the
doctor off. So it's just wild how that works. Like
why not I'm gonna go get two hundred dollars off
to see the doctor and so you know he's still healthy.
But that's the can I ask this because personal experience
(25:59):
I have, because I saw in your notes that you
always provide me to schedule in advance these preventative care
because sometimes you know the doctor's offices are busy. You
want to plan ahead, get it on the calendar so
they know you're coming, you know when to go, and
just stick to the appointment dermatologist. Try to get into
a dermatologist on the fly. Are you're gonna tell you
six months a year down the road? Now I can
(26:20):
see in next February or whatever. So I have a
standing dermatology appointment. I go every six months because we
have a My father is an illustration of it. Northern
European been burned a whole bunch of times like I have,
and so he had a whole bunch of different things removed,
different types of cancers removed over the years. I don't
want that to happen, so I get ahead of it.
I had this standing appointment. Is that going to be
(26:42):
con I don't want to put you on this.
Speaker 3 (26:43):
That's not preventive.
Speaker 4 (26:44):
That's not preventive.
Speaker 3 (26:45):
No, I think it should be.
Speaker 2 (26:46):
You know, I do feel like, you know, especially when
you have clients that live down south. You know, I
got a lot of clients in Texas. I get clients
in California. I mean, I know that's like it's like
a thing, right, I know, like every six months I
go to a dermatologists. But you know, you are seeing
that that is not a preventive care things, So don't
think about it like, hey, my plan says preventive care.
I'm gonna go to dermritologists. It's gonna be free.
Speaker 3 (27:05):
It's not.
Speaker 4 (27:05):
Okay, I'm glad I asked you the questions.
Speaker 2 (27:07):
It's not because it's it's and then more than likely
it's gonna be your specialist cope. So it's gonna be
significantly higher than your primary care copey. And then you
know when they go to free something off or cut
something off. Yeah, I mean, be prepared because most health
plans you don't have a cope for that, so it's
gonna be subject to your deductible. You're gonna be paying
to get it removed, You're going to be paying for
to get biopsied or whatever they're going to up doing,
(27:29):
and it it could be you know, hundreds, if not
a thousand dollars out of pocket expenses on something like that.
But you know, again kind of going back to what
the secondary plans do, they actually pay for that. So
I mean that's why we build those policies in you know,
one of the companies we actually.
Speaker 3 (27:45):
Sell for.
Speaker 2 (27:47):
Literally has in office surgical benefits paid out and a
tune of hundreds of dollars. So for that exact situation
that dermatology visit, they go in and remove something. Usually
we're seeing those bills three to five hundred bucks, and
these plans completely cover it. So you're you have no
auDA pocket expense and no excuse to not go and
get it done.
Speaker 1 (28:05):
Exactly Well, I have thought prevented it merely because if
you have a family history of that kind of thing,
it seems to me removing that little thing early early
prevents a much much bigger problem likemetasticize cancer.
Speaker 4 (28:16):
It does happen.
Speaker 1 (28:17):
This has been another edition of Rethink Healthcare together with
John Roman from Cover since he work with any one
of his team, and you can start the process and
again you're not obligated to do anything. Just let them
look at what you got and come up with a
better plan, because I'm pretty darn certain he can. It's
five one three eight hundred call five one three eight
hundred two two five to five online again. Fill the
format right there to start the process Cover Sincy dot com.
Speaker 4 (28:38):
John, it's always pleasure talking here.
Speaker 3 (28:40):
See Bryan. Thank you
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