Episode Transcript
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Speaker 1 (00:06):
Hi, It's Brian Thomas, host to the fifty five Parssey
Morning Show at least Monday through Friday and every Sunday.
At this time, I get the facilitate a conversation and
it's always an extraordinarily interesting conversation in spite of the
subject matter. John Roman from Cover since he always providing
uh solutions and options for a better way to get
your medical coverage.
Speaker 2 (00:24):
He's as a.
Speaker 1 (00:25):
Broker working exclusively for you or if you're a small
business person, for your business, looking at each person individually
and coming up with a package of medical insurance that
is in just so many ways a lot more affordable
but also providing better coverage, which seems like an impossible chore,
but he does it every single day, and he's kind
of a multitude of illustrations of how that's accomplished on
(00:47):
this program every week. And I know he's helped out
a lot of my listening audience who've taken my advice
and made the phone call no obligation call, no cost
to you five three eight hundred call five one three
eight hundred two two five five tall. He reads the
team at Cover sincey or Go online Coversinsey Dot com
and there's a form you can fill out to initiate
(01:07):
this process. Just try to be as comprehensive as you
can and answering the questions on the form so they
can hit the ground running with you and they'll get
right back with you. John Rolman, it's always great talking
with you. Happy Sunday to.
Speaker 2 (01:17):
You, you too, Brian, Good morning.
Speaker 1 (01:19):
Good morning. All right, let's just talk in generalizations. Are
there any dramatic changes going on right now? I know
open enrollment is closed, it's no longer available, But on
a ten thousand foot basis, what are we looking at
right now as we sit here on this Sunday.
Speaker 2 (01:35):
Well again, you know, you get to kind of look
at where the marketing's at. And I always think it's
funny like during open enrollment, we see a lot of
them marketing paid by our federal government to push the
healthcare marketplace healthcare dot gov, and you know a lot
of listeners and a lot of you know, people that
even call into our office kind of get into this
mindset that you know, I can only change my insurance.
(01:58):
I can only you know, get insurance during this small
finite amount of time, and you know that's only for
THEACA or Healthcare dot Gov website, you know plans. That's
that's the only time you can technically get into those
plans unless you have a you know, a life changing situation.
But what a lot of people don't realize, and this
(02:19):
is people that call into our office all the time, Brian,
is that there are so many options outside of the
marketplace that can absolutely help your listeners because a lot
of people don't need to be on Obamacare coverage. They
there's a lot better options out there. You know, we've
talked on this show so many times about some of
the downfalls of the marketplace. You know, HMO's high out
(02:42):
of pocket expenses. I mean, like you know, you said,
if I buy a plan here in Cincinnati, you know
I can't. I can't go to Dayton and get coverage.
You know, it's it covers like a fifty mile radius
of your house.
Speaker 1 (02:54):
So what you're saying, you know, I just want to
make sure this point is absolutely crystal clear up front.
If somebody's listening and they're on an Obamacare policy, marketplaces,
to call it what you want, they could get something
else at any given time during the.
Speaker 2 (03:06):
Year, any given time of the year. Yes, absolutely, especially
when it becomes the private plans and there's so many options.
That's where we really excel in what we do by
having a lot of outside the marketplace options.
Speaker 1 (03:18):
Yeah. You worked with a couple of hundred plus different
insurance companies.
Speaker 2 (03:21):
Yeah, with with like thousands of different plans. Yeah. So
I mean that's where we really maximize, you know, savings
for our clients because comparable on the on the outside
of the marketplace plans, the private plans we call them,
you know a lot of times they're forty to sixty
percent cheaper than doing a full place, full price marketplace plan,
(03:44):
which mind blowing. It is, well, and you have to
kind of understand how the marketplace really works, right, I
mean there's there's no pre existing conditions, you know. I
mean I literally here at the end of last year
wrote someone that had never had health insurance diagnosed with
cancer and was able to write them with a plan
starting January first, And you know, I've been doing this
(04:07):
for twenty years. I mean, that wasn't an option twenty
years ago. It's like, oh, I'm sorry, man, you didn't
have insurance. Like it's not it's not the house on
fire situation.
Speaker 1 (04:16):
I know that was the incentive to get insurance like
fire insurance for your home. You know, your home could
catch on fire, and the threat of that was what
drove you to pay the damn premium annually because let's
hope I never have to use it, but at least
it's in place. And that's when they took pre existing
condition obligations out of that. They deincentivize people to go
out and get their own medical insurance.
Speaker 2 (04:36):
Oh, you're absolutely right. And but what it's made and
this is what we see on the pricing, right. So
pricing when it comes to health insurance is all about
the people in the pool, right, we call it, you know,
if you think about it, like insurance is like an
in ground swimming pool, right, So who are you swimming with?
Speaker 1 (04:54):
Right?
Speaker 2 (04:55):
You know? And most of the people that are on
these plans are either you know. Again, hopefully if you're listening,
you're getting a good tax credit and it is affordable
for you, right, because you're getting a subsidized planned by
the government. But there's so many people that call into
that I find out that are paying full price for
these plans because they do not realize Brian, that there's
(05:17):
other options out there. They think like, hey, this is
what the government's telling me to do. This is my
only option, and you know that just really puts them,
I think in a lot of situations in a world
that are hurt not only financial on the premium side, but
you know, it's not the greatest coverage. You know, it's
not something where I'm going to go, you know, this
is definitely worth a Mercedes like premium payment. I'm not
(05:40):
going to pay for Mercedes if I'm driving a Pinto.
That doesn't really make sense. You know, I want to
make sure that I'm getting quality dollars for what I'm
paying for and coverage. But you know, the real big thing,
kind of going back to it, really is the fact
that again understanding that pool that you're in, you know
a lot of the people in this pool have medical issues.
There's a reason that they're on these plans because they
(06:03):
needed those pre existing conditions covered. They have issues they
can't potentially maybe qualify for private plans. So that's where
they're at. So again, for a relatively healthy person, I'm
not saying someone that has blood pressure or cholesterol issues
or even you know, non insolent diabetes, they can still
get private plans. But you probably if you're listening, and
(06:24):
that's that's you in that situation. You're not on a
lot of medication, not going through cancer. You didn't have
a heart attack last year. You know, you can absolutely
qualify for private plans and the skies open up. At
that point, Brian, I mean, it's go back to the
PPO plans. You know where. Hey, I'm I'm in Cincinnati.
I want to go get cancer treatment five years from
now when I get diagnosed at MDA Anderson. You know,
(06:44):
in Houston, one of the best cancer hospitals in the world.
You can go on a PPO plan. But if you're
on an HMO plan stuck here in Cincinnati. I mean,
I know, we got good doctors here, but that's your
only option. That's your only option. At that point, it's
it's I can't open it up. You can't call me,
go John, I'm on a marketplace plan and you know
that they can't really treat my condition here. I need
to go somewhere else. I'm like, are they a network?
(07:07):
Because if they're not, you're not getting get paid for well.
Speaker 1 (07:10):
So that ultimately boils down to your getting better coverage
for less money, better coverage for less money because Remember
the pool when you go to the private side, right
is you have to be relatively healthy to get in. Well,
they have actuaries, and yes, they pay attention, and they
worry about what their bottom line is and.
Speaker 2 (07:31):
They're worried about adverse risk selection, right, so they're not
going to go out there and you know, murky the
water and go okay, we're gonna start taking insulin diabetics now,
which again makes that pool unhealthier, right right, company that
for the insurance company, they got to pay more claims,
so again it makes it drives up the costs. So
when you go to something where there's an entry level
(07:54):
to get through those doors, and again that really makes
a lot of sense that that's where the premiums because
of the cost of that health insurance plan are drastic
less expensive. And again that's the worst part about it
is that that's not information that's out there. We're not
seeing that be really pushed by insurance companies. Again, really,
the only ones promoting what's going on in this market
(08:17):
is is someone like me up prying. Yeah, yeah, because
they work for the listener, right, Yes, they work for
the listener, not the insurance company.
Speaker 1 (08:24):
Yeah.
Speaker 2 (08:25):
No, if I wanted to tell everybody across the board, like, hey, sorry,
your your family plans two grand a month, because that's
going great for a healthcare dot gov plan. You know,
that doesn't really make sense for a lot of people.
And you know, I mean, we've helped so many people,
even including our groups, look at this option, but it's
those pricings are just so astronomical in that marketplace. I
(08:46):
started doing this twenty years ago, a family of five
in their early thirties could get a five thousand dollars
reductible for five hundred bucks a month. That same plan
today is well over two grand. Oh my. So you know,
and what most people don't realize is that that market
does still exist in today's and today's and today at
(09:07):
twenty twenty five, we can still write those types of
coverages today so that you're not overpaying for health insurance.
So again, if you're relatively healthy and you're like, oh,
I think this is me, give us a call. I mean,
it's at least worth your time to see if you
can get better coverage for less than three years.
Speaker 1 (09:25):
All the time, it's like, I know, this sounds impossible.
That's because of exactly the point that you just made
that the insurance companies aren't out there is talking about it.
You need an advocate for you, not for an insurance company,
and going to the one guy who works for that
one insurance company is not going to be an advocate
for all the multitude of options that exist out in
(09:47):
the world that he might not be able to offer you.
Speaker 2 (09:49):
Yeah. I mean, I mean, if you call healthcare dot
gov and you're going, hey, I just need to know
what my options are, most of them aren't even licensed.
They're navigators, so they can just put your zip code
in who's your doctor? This is a plan your doctor takes.
They can't that's it. They can't tell you there's other options.
They're never they can't even because they're not licensed to
do it, so they can't go Well, you might want
to look outside of the marketplace and go see if
(10:11):
there's there's something cheaper, because this doesn't seem like a
good deal for you. They don't even do that. There's
here's your three call. Just follow up with this guy. Yeah.
And the other thing too, is you're not stuck. So
many people tell me they're stuck. I have to wait
till next year. When it comes to coverage, for especially
someone under sixty five. That's the mark we're talking about
right now. If you're under sixty five, you're not a
(10:33):
Medicare right. Insurance is month to month. You know, you
stop paying your insurance premium. Even in the marketplace, you're
not covered next month. So that's how it works. So
we can change your plan anytime. So just because you
sign up on a plan during open enrollment back in
November for January one, you can change that plan today
and I can start new coverage for you next month
(10:54):
on a private plan, and you can get rid of
that old marketplace plan you haven't even been using.
Speaker 1 (10:58):
Well now, ignoring the marketplace plan, what about people who
are insured through their employers, Like let's say I was
insured through iHeart and I have time.
Speaker 2 (11:05):
Now, that's a little that's a little different situation. Yeah,
so that's the different situations. So what we're talking about
here is people purchasing health insurance on their own, not
getting it through employer. There are again this is it
is worth a phone call, especially if you feel like
you're paying a lot or maybe the coverage isn't adequate
for you. There are some scenarios and options that I
have that can kind of walk clients through to see
(11:26):
how that works. Typically, the rule of thumb with group
insurance is you can only come on and come off
during your open enrollment period. Okay, all right, but that
does not mean that, you know, give you an example.
Let's say you're the person working for the family. You're
carrying the insurance coverage for your spouse and children. They're like, oh,
we're all stuck here. Well not, actually you're not, because
(11:49):
the way even the marketplace opened up an opportunity here
is I can still pull your your spouse and children
off that plan and put them on private plans because
they did an affordability piece here not too long ago,
because I guess like three or four years ago, because
what was happening was a lot of employers weren't paying
anything towards the spouse and children's coverage, right, so they
(12:11):
might employer might say, yeah, I'm going to really subsidize
your plan. I'm going to pay fifty percent of your
premiums on your health insurance. But when you add your
wife and kids on, you know, I'm not paying anything
for that. So we see so many people in these
group plans, I mean, poor individuals pay it, making fifty
sixty seventy thousand dollars a year and they're they're paying
fifteen hundred dollars a month for their family for their
health insurance. I mean, that's that's insane. And you know
(12:33):
when that fifteen hundred dollars could be three or four
er bucks a month on private coverage or some other
options out there. So there's there's so many scenarios to
kind of walk through, and that's why it's so important
to you know, schedule a time with a broker, sit down,
look at your options, you know, I mean, just like anything,
make a good financial plan, see what makes the most sense.
(12:54):
And you know, I always really strongly push this is
that you're not losing coverage. I mean, if anything, when
you even when you deal with people in my office,
it's it's always better coverage better. It's always layering your coverage.
And we've talked about this. If you want to go
back and listen to some of our previous shows, I
can totally talk about it. I mean, we layer your
coverage so well. I was dealing with a I was
(13:15):
walking through a client here actually yesterday on Friday, and
this is a guy we've done group coverage for and
it's funny. He's a lawyer, and uh like every year
he wants to have a meeting to go back over
the coverage again because he just forgets. He's like, why
am I paying for this? Why do I have these
extra plans? And then I literally broke it down for him,
(13:37):
and I'm like sharing. I'm like, listen, I think as
an employer, you know, not only are you your your
employees fully covered, but we layered them so well that
they're not having to worry about their out of pocket expenses.
Like and that's what we do. I mean, the goal
is when I pay a dollar to an insurance company,
I don't want to go, oh, here's my dollar and
(13:58):
then turn around and go, oh, I still got to
pay fifty cents every time I use this thing. That
doesn't make sense. And when you have such high out
of pocket expenses, which are way worse today than they
were twenty years ago. I mean, the exposure you have
financially if you use your plan or have to go
into the hospital is insane. You know, look at the
marketplace plans for a family. It's eighteen thousand, four hundred
(14:21):
dollars this year. It's just like I don't.
Speaker 1 (14:24):
Yeah, it's tough for me to get my head around
that because you know, there's a lot of people in
the world who don't have that kind of money to
shell out. I mean, you know, like I see the statistics,
very few people have, you know, even some stored away
income where they can afford a hit of five grand
or whatever, like you for an auto repair of something.
(14:45):
How are you gonna do? How are you gonna deal
with eighteen thousand dollars out of your pocket for medical
before the insurance coverage kicks in. It's I don't even
call that insurance coverage. It's like a scam.
Speaker 2 (14:54):
Well, and it's the rest of your life too, Brian.
I mean it's like everything my water software when it's
five grand to fix it. So, I mean, like I
got to do a fix a water softener, We had
to do some insulation in our office. I mean, it's
like these expenses come out of nowhere. I mean, the
same thing happened with your health. That's just another line
item that's going to be drastically reduce your savings. I
(15:16):
mean it's and that's a tough pill to swallow, especially
as we get older, right, I mean, now things start
creeping up. Now we start having issues, you know, now,
God forbid, Yeah, maybe I'm hitting my deductible this year,
but what have I have an ongoing condition? And now
it carries over into the next calendar here, well, guess
what your deductible? Yes, everything starts back over. Now I
got another nine ten thousand dollars out of pocket. It's like, well,
(15:38):
this this whole thing right, maybe sucks some money away
to pay this deductile. Well well now this is happening
to me for two or three years in a row.
Now that money is liquidated, Now you start looking at,
well do I touch my retirement fund? How do I
pay for these things? I mean, you just work thirty
or forty years of your life to now start tapping
into your savings that you're using for retirement to cover
(15:59):
medical expenses and other things that you're going on. You know,
that's just that's a crazy scenario. You know. Now you're
pushing retirement age because while I gotta I gotta work
till seventy because I gotta replenish my nest egg. You
know that that shouldn't be those situations. So, you know,
and that's something that we look at every time Brian
that we work with a client that's you know, yes,
(16:19):
I'm looking at your short term today, what's your current situation?
Can I save you money? But the goal here is
long term. It's not a question of if. It's when
you're going to use this and are you in a
better situation when you use this and when I found you?
And that's really always my goal because I always ask
clients at the end, like one of the questions. And
if you if you're if you got insurance from me,
(16:40):
you'll probably think this is funny because you're like, you
did ask me that I go, I go, God forbid,
you got diagnosed with cancer? Which plan would you rather
be on? The one that I showed you today or
one you currently have? And I've never had anyone tell
me the one they currently have ever.
Speaker 1 (16:57):
Trust me, brother, because I've been down that road. And
cancer is say what you want about it. We all
mutually agree. It's the one thing that is we are
all in uniform agreement, regardless of our race, creed, ethnicity,
or political struke. Cancer sucks. It sucks, but it sucks
for a lot of reasons. And one of the big
reasons is it's expensive to deal.
Speaker 2 (17:18):
With yeah, and then lost work, right, and everything else
comes from on you know. And Brian, most of my
clients are self employed. You know, they don't get that.
Oh I've worked for thirty years. I got, you know,
two months of vacation time. I remember my dad retired,
was retiring as a as a police officer. You know,
(17:39):
they had this whole thing where you can save up
your sick time and it never went away, right, and
he had like two and eighty days and they and
they actually like whatever the union contracts is just crazy.
I mean, I don't know if it still exists. When
he toy, but they would pay you out. Yeah, they'd
pay you out at the end. So we got like
fifty percent of his days paid out at the end.
(18:00):
And I was like, wow, that's kind of crazy. I
was like, I was like, Dad, how do I get that?
He goes goes John, you're self and played. You'll never
have that. I was like, I know that.
Speaker 1 (18:08):
Or you work at iHeart, you'll never have that.
Speaker 2 (18:11):
I don't have that here, but I mean, man, yeah,
you usually lose it. I mean, and you know we've
had you know, I've talked about this last year. One
of our shows, you know, one of the things we
always look at in the beginning of the year is
we keep statistic numbers on like how many people that
we know in that first quarter of the year get
diagnosed with cancer, and that's a growing number. I mean,
(18:32):
we're we're in February right now, and we're already seeing
this trend upward for us. So I think last year
we had someone in the neighborhood of like twenty six
people diagnosed with cancer clients between like you know, January
one and March thirty first, and we're over twenty right
now and it's middle of February.
Speaker 1 (18:52):
So there's something nefarious going on out there in the world.
It's one of the reasons why I'm happy this is
rfkjunior guy in charge, Ah says, because I think he's
going to shed some light on our collective deteriorating health
at least I hope, So at least I have a
hope in that regard.
Speaker 2 (19:10):
I mean, I mean, he's definitely looking at it on
that and Brian and I think there's a lot of
really good data that I'm seeing from that. I mean,
I'm big, like I refuse to let my kids eat
any of that stuff. I mean I'm literally the guy
at the grocery store looking at the box and I
see something I can't pronounce. I'm not buying it.
Speaker 1 (19:27):
I've been doing that for a long time now, as
in an effort to hope maybe navigate my cancer. I've
been telling my listeners, you know, I cut all the
sugar out of my diet, or most of it. We
make our own bread at home. Now, you know I've
been and that sugar, God Almighty, is it everywhere. So
if you're looking to improve your health, I'm telling you
here right now, if you're hearing my voice, cut the
(19:50):
sugar out of your diet and you will feel better.
Speaker 2 (19:53):
Period.
Speaker 1 (19:53):
I don't care anymore whether it impacts my cancer. Just
cutting it out has I just has improved my state
of being generally.
Speaker 2 (20:01):
Oh yeah. I mean my wife and I did it
like a few years ago where we stopped doing those
those those oils. I mean, there's nothing in our house
with high fructose corn syrup at all, Like we won't
even purchase it. Got to rid a lot of the dies.
And I'll tell you why. You know, yeah, it's kind
of you kind of feel bad for the first like
three weeks. It's like like you're you're going through Yeah,
(20:23):
you're going you're literally going through withdrawal from like these
toxins that are in your body. Then you're actually and
then you start losing weight, you start feeling better, you
start sleeping better. Yeah, I mean it's it's it's it's unreal.
And it's like I didn't even do anything other than
just cut these things out. Then you can feel better,
Then you can start working out. Then you really lose weight.
So I mean it's a it's definitely a cycle. But
you're right. I mean, at my level, I look at
(20:46):
you know, what is this trend? I mean I've been
doing this twenty years. Why is this number creeping up
higher and higher and higher. Yes, we have more and
more clients, but the numbers are matching. It's like the
percentage of people is getting worse. And you start looking
at other countries, Like I've visited Europe a few years ago,
and I mean, like, you don't see fat people in Europe,
you know, you really don't. I Mean, everybody's relatively healthy,
(21:07):
they're all they eat well, and it's like, what is
the trend going on? So yeah, I mean that's something
to really think about because all of us have succumbed
to this state of how our food has been processed.
And you know, why is my bread last for two
months before it gets moldy. That doesn't make any sense.
I buy stuff from a fresh baker, it's like moldy
(21:30):
in like four days. Oh yeah, you know, those things
just still make sense. And you know, you have to
understand that we're all in that boat. So you know,
I'm in that boat. I've eaten that crap for years.
So at the end of the day, what's it likely
that I'm going to get cancer? I know there's a
more reality for that, So I have to have a
plan if that comes up to me. I mean, I
(21:50):
want to make sure I have access to the best hospitals.
I'm going to make sure I have a critical illness policy.
Something is gonna give me a big lump sum check
so I don't have to worry about, you know, paying
my mortgage, I don't have to work about work, and
I can just worry about getting better. I mean, there's
so many things that we can do to plan for
that hopefully non existent scenario, but it does happen. But
you should have a plan for that because more often
(22:11):
than not, I mean, we're seeing numbers. What it's like
one to five before sixty five will have it. I mean,
it's it's ridiculous.
Speaker 1 (22:18):
It really is. Well, since we got off on it's
rethink health Care Together, as they have the segment, but
since we got on health rethink health Together, I know
there's a big trend and more and more people are
gravitating to it. Since more people now are paying attention
to kind of thing we're talking about. What about alternative
providers and alternative therapies, I mean insurance quite often, you know,
(22:39):
if it's not the state of the are you know
the what is the phrase I'm looking for for what
gets approved and what does not do? The policies that
you have contemplate people maybe going out and seeking chiropractic
care or alternative medicine care, that kind of thing.
Speaker 2 (22:58):
Yeah, there are some really good products out there right
now for those individuals. The one that always kind of
comes to mind is a lot of I call them
like boutique doctors, you know, the ones that are like
these They've got smart, they broke away from the hospital groups,
they started their own private practice back up again, and
they're like, listen, it's a big cost for us to
do this. So if you want to be a patient
(23:18):
of mine, you have to pay excellent amount a year
and then which is which is good, right, Because they
give you more individualized attention, you probably have more time
when you go in. I mean I go see my
doctors like five minutes, like in and out like you're
going on, And I can.
Speaker 1 (23:31):
Get a script filled and approve on the cell phone.
That's awesome. Just this is going on? Can you get
me take care of boom? I get the prescription called
in as a matter.
Speaker 2 (23:42):
And they're and they're and they're they're definitely nice. You
know some of them. I mean, I don't know if
your actual run insurance for you. Some of them don't
at all, So they're nice. Okay, that's a good thing.
So some of them, like listen, I don't build insurance
at all. This is your page, your fee. But I
mean they could still give you an item bill with
a CPT code that showed what you were in there for.
(24:03):
So when we sell our secondary plans, they're indemnity insurance.
And the biggest thing that I really like about those
indemnity plans is it's the true form of insurance. We
originally started with so it's called traditional insurance. So they
basically the insurance policy does not have a network that
you have to utilize. So they basically say, as any doctor,
(24:24):
any hospital in the United States that you go to,
so we will pay them directly. Or in the situation
where the doctor is not going to bill, as long
as you get an itemized bill and send it to us,
we will pay you directly for the fact that you go.
So you can still get a plan like that, even
though your doctor doesn't take insurance. Just get an itemized
bill for while you were in there with a code
on it, and you can submit that, get reimbursed, and
get paid back by the insurance company. So we have
(24:47):
those options, Brian, and then I'll just even take it
a step further. I mean, you mentioned chiropractic. That's a
big thing, so a lot of our clients use chiropractic,
and but telehealth, I mean you just mentioned I can
just mention my guy, it gives me a prescription, right,
I mean one of the things that I mean, I've
been doing this probably for like fifteen years selling telehealth benefits.
(25:08):
I mean most people didn't realize it even exists until
COVID because everybody was like, I'm not going to see
you because we don't want any more COVID coming through
our door. Right, make sure you have a package with telehealth.
I mean, that is so simple to use, and when
almost every I'd probably say ninety nine point nine percent
of the clients that we have have a telehealth benefit
(25:28):
tied into it. And I always tell them about your
first line of defense, like don't waste your time. You
got to go to work, you're not feeling well. I
have a sinus infection right now, I literally wanted telehealth
wrote me a prescription, you know, got antibiotic sent to
my pharmacy. I never had to leave my house, I
didn't take time off from work, picked it up on
the way home from work, got my prescription, paid nothing
(25:50):
because it's free with my telehealth, and started taking a prescription,
you know. I mean that's the beauty of telehealth. And
another step up is a lot of them are covering
mental health now.
Speaker 1 (26:00):
Oh and what an important thing that is amazing, especially
for young people these days. Apparently the internet and social
media has just ruined lives.
Speaker 2 (26:09):
Oh yeah, I mean, you know, we spend more time
with our screen than we do with real people. So
I mean having that connection, having that availability to talk
to somebody, And again there's still a big stigma behind it,
you know. I know people that are like I just
I don't want to walk into one of these facilities,
you know. But it's like, okay, well you can do telehealth.
You can go hide in your garage in your car
(26:30):
and you can call and talk to a therapist. And
you know, we literally have plans for entire families that
are less than fifty bucks a month that they can
get free mental health telehealth and it's onlimited usage.
Speaker 1 (26:43):
You can literally call hourly provider rated if you went
and sat down on a couch at some office somewhere.
Speaker 2 (26:49):
And so imagine that you can get for your entire
family for like fifty bucks a month. It's a plan
that we sell is solely just for that. And you
can literally talk to a therapists every day.
Speaker 1 (26:58):
That's mind blowing.
Speaker 2 (26:59):
And most people can't even get in right now, like
you can't even get see a face to face person.
Speaker 1 (27:04):
But you're saying though, because that's a really important point,
because somebody out there listening, going, yeah, right, it's like
trying to get a dermatology appointment, right, away. You gotta
wait around and wait around forever to get see somebody
you Meanwhile, you're experiencing like suicidal ideation or something. These
plans that you sell, these fifty dollars plans for telehealth,
(27:24):
you can get on the phone with someone right away.
Speaker 2 (27:27):
Yeah, you can schedule right through the app, so you
can be like I need somebody, and then even have
an emergency thing where you can get it right on
and then. I mean, but that's out there, and you'll
see a lot more therapists are going that way because
they can work from home, they can see more patience,
they can help more people. So it's it's a big
trend and I think it's only going to get better
and better. So I would say to people, embrace it.
(27:47):
It's a good opportunity for you. Sure, And why wouldn't you,
I don't know. I mean we use it, and I
mean I think it's a great it's a great product.
Speaker 1 (27:55):
Yeah, it psyched benefit's on your regular insurance policy. You'd
be facing that out of pot could out a liability
part right there.
Speaker 2 (28:01):
Yeah, you got cope's. I mean it's usually a specialist.
It's more expensive. I mean, there's justerral to right, you
got to get a referral, so you go on an HMO. Yeah,
you can't just go. Can't go just because you want. So,
I gotta go tell my primary care what's going on. Right,
He's gonna try and treat me with whatever he wants
to treat me. Oh, yep, you need another the pressant.
I just want to talk to somebody. I should be
go on an anti depressant, you know, because there are
(28:22):
scriptwriters right sure before you get to that specialist, And
it's like, I just want to talk to somebody, you know,
and you know, I'll Actually we have a lot of
clients that use it just for you know, spousal spousal support,
you know, like working working out their problems, marriage therapy.
Speaker 1 (28:38):
Yeah, yeah, thankfully never even had to contemplate that. I
always say, I, you know, out kicked my coverage and
I did so I can count on one hand the
number of fights we you had over the years. You know.
It's like you gotta learn to roll with it anyway.
There's that option as well. Well. We could go on
(29:00):
for a long time, but this is the end of
rethink Healthcare together for this week's episode, John always informative
and you know. Actually, I think probably inspiring for some
folks out there listening, going wow, I still have options
and it sounds like good ones. You do, so get
get in touch with John and the team. Don't forget
the team. He works with a bunch of people who
are all able to help you out. Five one three
(29:21):
eight hundred two two five five that's five one three
eight hundred call. You can initiate the process of engaging
this conversation online. Fill out the form as much as
you can. Coversincy dot com. This has been another edition
of Rethink Healthcare together with John Roman from Cover since
he
Hi, It's Brian Thomas, host to the fifty five Parssey
Morning Show at least Monday through Friday and every Sunday.
At this time, I get the facilitate a conversation and
it's always an extraordinarily interesting conversation in spite of the
subject matter. John Roman from Cover since he always providing
uh solutions and options for a better way to get
your medical coverage.
Speaker 2 (00:24):
He's as a.
Speaker 1 (00:25):
Broker working exclusively for you or if you're a small
business person, for your business, looking at each person individually
and coming up with a package of medical insurance that
is in just so many ways a lot more affordable
but also providing better coverage, which seems like an impossible chore,
but he does it every single day, and he's kind
of a multitude of illustrations of how that's accomplished on
(00:47):
this program every week. And I know he's helped out
a lot of my listening audience who've taken my advice
and made the phone call no obligation call, no cost
to you five three eight hundred call five one three
eight hundred two two five five tall. He reads the
team at Cover sincey or Go online Coversinsey Dot com
and there's a form you can fill out to initiate
(01:07):
this process. Just try to be as comprehensive as you
can and answering the questions on the form so they
can hit the ground running with you and they'll get
right back with you. John Rolman, it's always great talking
with you. Happy Sunday to.
Speaker 2 (01:17):
You, you too, Brian, Good morning.
Speaker 1 (01:19):
Good morning. All right, let's just talk in generalizations. Are
there any dramatic changes going on right now? I know
open enrollment is closed, it's no longer available, But on
a ten thousand foot basis, what are we looking at
right now as we sit here on this Sunday.
Speaker 2 (01:35):
Well again, you know, you get to kind of look
at where the marketing's at. And I always think it's
funny like during open enrollment, we see a lot of
them marketing paid by our federal government to push the
healthcare marketplace healthcare dot gov, and you know a lot
of listeners and a lot of you know, people that
even call into our office kind of get into this
mindset that you know, I can only change my insurance.
(01:58):
I can only you know, get insurance during this small
finite amount of time, and you know that's only for
THEACA or Healthcare dot Gov website, you know plans. That's
that's the only time you can technically get into those
plans unless you have a you know, a life changing situation.
But what a lot of people don't realize, and this
(02:19):
is people that call into our office all the time, Brian,
is that there are so many options outside of the
marketplace that can absolutely help your listeners because a lot
of people don't need to be on Obamacare coverage. They
there's a lot better options out there. You know, we've
talked on this show so many times about some of
the downfalls of the marketplace. You know, HMO's high out
(02:42):
of pocket expenses. I mean, like you know, you said,
if I buy a plan here in Cincinnati, you know
I can't. I can't go to Dayton and get coverage.
You know, it's it covers like a fifty mile radius
of your house.
Speaker 1 (02:54):
So what you're saying, you know, I just want to
make sure this point is absolutely crystal clear up front.
If somebody's listening and they're on an Obamacare policy, marketplaces,
to call it what you want, they could get something
else at any given time during the.
Speaker 2 (03:06):
Year, any given time of the year. Yes, absolutely, especially
when it becomes the private plans and there's so many options.
That's where we really excel in what we do by
having a lot of outside the marketplace options.
Speaker 1 (03:18):
Yeah. You worked with a couple of hundred plus different
insurance companies.
Speaker 2 (03:21):
Yeah, with with like thousands of different plans. Yeah. So
I mean that's where we really maximize, you know, savings
for our clients because comparable on the on the outside
of the marketplace plans, the private plans we call them,
you know a lot of times they're forty to sixty
percent cheaper than doing a full place, full price marketplace plan,
(03:44):
which mind blowing. It is, well, and you have to
kind of understand how the marketplace really works, right, I
mean there's there's no pre existing conditions, you know. I
mean I literally here at the end of last year
wrote someone that had never had health insurance diagnosed with
cancer and was able to write them with a plan
starting January first, And you know, I've been doing this
(04:07):
for twenty years. I mean, that wasn't an option twenty
years ago. It's like, oh, I'm sorry, man, you didn't
have insurance. Like it's not it's not the house on
fire situation.
Speaker 1 (04:16):
I know that was the incentive to get insurance like
fire insurance for your home. You know, your home could
catch on fire, and the threat of that was what
drove you to pay the damn premium annually because let's
hope I never have to use it, but at least
it's in place. And that's when they took pre existing
condition obligations out of that. They deincentivize people to go
out and get their own medical insurance.
Speaker 2 (04:36):
Oh, you're absolutely right. And but what it's made and
this is what we see on the pricing, right. So
pricing when it comes to health insurance is all about
the people in the pool, right, we call it, you know,
if you think about it, like insurance is like an
in ground swimming pool, right, So who are you swimming with?
Speaker 1 (04:54):
Right?
Speaker 2 (04:55):
You know? And most of the people that are on
these plans are either you know. Again, hopefully if you're listening,
you're getting a good tax credit and it is affordable
for you, right, because you're getting a subsidized planned by
the government. But there's so many people that call into
that I find out that are paying full price for
these plans because they do not realize Brian, that there's
(05:17):
other options out there. They think like, hey, this is
what the government's telling me to do. This is my
only option, and you know that just really puts them,
I think in a lot of situations in a world
that are hurt not only financial on the premium side, but
you know, it's not the greatest coverage. You know, it's
not something where I'm going to go, you know, this
is definitely worth a Mercedes like premium payment. I'm not
(05:40):
going to pay for Mercedes if I'm driving a Pinto.
That doesn't really make sense. You know, I want to
make sure that I'm getting quality dollars for what I'm
paying for and coverage. But you know, the real big thing,
kind of going back to it, really is the fact
that again understanding that pool that you're in, you know
a lot of the people in this pool have medical issues.
There's a reason that they're on these plans because they
(06:03):
needed those pre existing conditions covered. They have issues they
can't potentially maybe qualify for private plans. So that's where
they're at. So again, for a relatively healthy person, I'm
not saying someone that has blood pressure or cholesterol issues
or even you know, non insolent diabetes, they can still
get private plans. But you probably if you're listening, and
(06:24):
that's that's you in that situation. You're not on a
lot of medication, not going through cancer. You didn't have
a heart attack last year. You know, you can absolutely
qualify for private plans and the skies open up. At
that point, Brian, I mean, it's go back to the
PPO plans. You know where. Hey, I'm I'm in Cincinnati.
I want to go get cancer treatment five years from
now when I get diagnosed at MDA Anderson. You know,
(06:44):
in Houston, one of the best cancer hospitals in the world.
You can go on a PPO plan. But if you're
on an HMO plan stuck here in Cincinnati. I mean,
I know, we got good doctors here, but that's your
only option. That's your only option. At that point, it's
it's I can't open it up. You can't call me,
go John, I'm on a marketplace plan and you know
that they can't really treat my condition here. I need
to go somewhere else. I'm like, are they a network?
(07:07):
Because if they're not, you're not getting get paid for well.
Speaker 1 (07:10):
So that ultimately boils down to your getting better coverage
for less money, better coverage for less money because Remember
the pool when you go to the private side, right
is you have to be relatively healthy to get in. Well,
they have actuaries, and yes, they pay attention, and they
worry about what their bottom line is and.
Speaker 2 (07:31):
They're worried about adverse risk selection, right, so they're not
going to go out there and you know, murky the
water and go okay, we're gonna start taking insulin diabetics now,
which again makes that pool unhealthier, right right, company that
for the insurance company, they got to pay more claims,
so again it makes it drives up the costs. So
when you go to something where there's an entry level
(07:54):
to get through those doors, and again that really makes
a lot of sense that that's where the premiums because
of the cost of that health insurance plan are drastic
less expensive. And again that's the worst part about it
is that that's not information that's out there. We're not
seeing that be really pushed by insurance companies. Again, really,
the only ones promoting what's going on in this market
(08:17):
is is someone like me up prying. Yeah, yeah, because
they work for the listener, right, Yes, they work for
the listener, not the insurance company.
Speaker 1 (08:24):
Yeah.
Speaker 2 (08:25):
No, if I wanted to tell everybody across the board, like, hey, sorry,
your your family plans two grand a month, because that's
going great for a healthcare dot gov plan. You know,
that doesn't really make sense for a lot of people.
And you know, I mean, we've helped so many people,
even including our groups, look at this option, but it's
those pricings are just so astronomical in that marketplace. I
(08:46):
started doing this twenty years ago, a family of five
in their early thirties could get a five thousand dollars
reductible for five hundred bucks a month. That same plan
today is well over two grand. Oh my. So you know,
and what most people don't realize is that that market
does still exist in today's and today's and today at
(09:07):
twenty twenty five, we can still write those types of
coverages today so that you're not overpaying for health insurance.
So again, if you're relatively healthy and you're like, oh,
I think this is me, give us a call. I mean,
it's at least worth your time to see if you
can get better coverage for less than three years.
Speaker 1 (09:25):
All the time, it's like, I know, this sounds impossible.
That's because of exactly the point that you just made
that the insurance companies aren't out there is talking about it.
You need an advocate for you, not for an insurance company,
and going to the one guy who works for that
one insurance company is not going to be an advocate
for all the multitude of options that exist out in
(09:47):
the world that he might not be able to offer you.
Speaker 2 (09:49):
Yeah. I mean, I mean, if you call healthcare dot
gov and you're going, hey, I just need to know
what my options are, most of them aren't even licensed.
They're navigators, so they can just put your zip code
in who's your doctor? This is a plan your doctor takes.
They can't that's it. They can't tell you there's other options.
They're never they can't even because they're not licensed to
do it, so they can't go Well, you might want
to look outside of the marketplace and go see if
(10:11):
there's there's something cheaper, because this doesn't seem like a
good deal for you. They don't even do that. There's
here's your three call. Just follow up with this guy. Yeah.
And the other thing too, is you're not stuck. So
many people tell me they're stuck. I have to wait
till next year. When it comes to coverage, for especially
someone under sixty five. That's the mark we're talking about
right now. If you're under sixty five, you're not a
(10:33):
Medicare right. Insurance is month to month. You know, you
stop paying your insurance premium. Even in the marketplace, you're
not covered next month. So that's how it works. So
we can change your plan anytime. So just because you
sign up on a plan during open enrollment back in
November for January one, you can change that plan today
and I can start new coverage for you next month
(10:54):
on a private plan, and you can get rid of
that old marketplace plan you haven't even been using.
Speaker 1 (10:58):
Well now, ignoring the marketplace plan, what about people who
are insured through their employers, Like let's say I was
insured through iHeart and I have time.
Speaker 2 (11:05):
Now, that's a little that's a little different situation. Yeah,
so that's the different situations. So what we're talking about
here is people purchasing health insurance on their own, not
getting it through employer. There are again this is it
is worth a phone call, especially if you feel like
you're paying a lot or maybe the coverage isn't adequate
for you. There are some scenarios and options that I
have that can kind of walk clients through to see
(11:26):
how that works. Typically, the rule of thumb with group
insurance is you can only come on and come off
during your open enrollment period. Okay, all right, but that
does not mean that, you know, give you an example.
Let's say you're the person working for the family. You're
carrying the insurance coverage for your spouse and children. They're like, oh,
we're all stuck here. Well not, actually you're not, because
(11:49):
the way even the marketplace opened up an opportunity here
is I can still pull your your spouse and children
off that plan and put them on private plans because
they did an affordability piece here not too long ago,
because I guess like three or four years ago, because
what was happening was a lot of employers weren't paying
anything towards the spouse and children's coverage, right, so they
(12:11):
might employer might say, yeah, I'm going to really subsidize
your plan. I'm going to pay fifty percent of your
premiums on your health insurance. But when you add your
wife and kids on, you know, I'm not paying anything
for that. So we see so many people in these
group plans, I mean, poor individuals pay it, making fifty
sixty seventy thousand dollars a year and they're they're paying
fifteen hundred dollars a month for their family for their
health insurance. I mean, that's that's insane. And you know
(12:33):
when that fifteen hundred dollars could be three or four
er bucks a month on private coverage or some other
options out there. So there's there's so many scenarios to
kind of walk through, and that's why it's so important
to you know, schedule a time with a broker, sit down,
look at your options, you know, I mean, just like anything,
make a good financial plan, see what makes the most sense.
(12:54):
And you know, I always really strongly push this is
that you're not losing coverage. I mean, if anything, when
you even when you deal with people in my office,
it's it's always better coverage better. It's always layering your coverage.
And we've talked about this. If you want to go
back and listen to some of our previous shows, I
can totally talk about it. I mean, we layer your
coverage so well. I was dealing with a I was
(13:15):
walking through a client here actually yesterday on Friday, and
this is a guy we've done group coverage for and
it's funny. He's a lawyer, and uh like every year
he wants to have a meeting to go back over
the coverage again because he just forgets. He's like, why
am I paying for this? Why do I have these
extra plans? And then I literally broke it down for him,
(13:37):
and I'm like sharing. I'm like, listen, I think as
an employer, you know, not only are you your your
employees fully covered, but we layered them so well that
they're not having to worry about their out of pocket expenses.
Like and that's what we do. I mean, the goal
is when I pay a dollar to an insurance company,
I don't want to go, oh, here's my dollar and
(13:58):
then turn around and go, oh, I still got to
pay fifty cents every time I use this thing. That
doesn't make sense. And when you have such high out
of pocket expenses, which are way worse today than they
were twenty years ago. I mean, the exposure you have
financially if you use your plan or have to go
into the hospital is insane. You know, look at the
marketplace plans for a family. It's eighteen thousand, four hundred
(14:21):
dollars this year. It's just like I don't.
Speaker 1 (14:24):
Yeah, it's tough for me to get my head around
that because you know, there's a lot of people in
the world who don't have that kind of money to
shell out. I mean, you know, like I see the statistics,
very few people have, you know, even some stored away
income where they can afford a hit of five grand
or whatever, like you for an auto repair of something.
(14:45):
How are you gonna do? How are you gonna deal
with eighteen thousand dollars out of your pocket for medical
before the insurance coverage kicks in. It's I don't even
call that insurance coverage. It's like a scam.
Speaker 2 (14:54):
Well, and it's the rest of your life too, Brian.
I mean it's like everything my water software when it's
five grand to fix it. So, I mean, like I
got to do a fix a water softener, We had
to do some insulation in our office. I mean, it's
like these expenses come out of nowhere. I mean, the
same thing happened with your health. That's just another line
item that's going to be drastically reduce your savings. I
(15:16):
mean it's and that's a tough pill to swallow, especially
as we get older, right, I mean, now things start
creeping up. Now we start having issues, you know, now,
God forbid, Yeah, maybe I'm hitting my deductible this year,
but what have I have an ongoing condition? And now
it carries over into the next calendar here, well, guess
what your deductible? Yes, everything starts back over. Now I
got another nine ten thousand dollars out of pocket. It's like, well,
(15:38):
this this whole thing right, maybe sucks some money away
to pay this deductile. Well well now this is happening
to me for two or three years in a row.
Now that money is liquidated, Now you start looking at,
well do I touch my retirement fund? How do I
pay for these things? I mean, you just work thirty
or forty years of your life to now start tapping
into your savings that you're using for retirement to cover
(15:59):
medical expenses and other things that you're going on. You know,
that's just that's a crazy scenario. You know. Now you're
pushing retirement age because while I gotta I gotta work
till seventy because I gotta replenish my nest egg. You
know that that shouldn't be those situations. So, you know,
and that's something that we look at every time Brian
that we work with a client that's you know, yes,
(16:19):
I'm looking at your short term today, what's your current situation?
Can I save you money? But the goal here is
long term. It's not a question of if. It's when
you're going to use this and are you in a
better situation when you use this and when I found you?
And that's really always my goal because I always ask
clients at the end, like one of the questions. And
if you if you're if you got insurance from me,
(16:40):
you'll probably think this is funny because you're like, you
did ask me that I go, I go, God forbid,
you got diagnosed with cancer? Which plan would you rather
be on? The one that I showed you today or
one you currently have? And I've never had anyone tell
me the one they currently have ever.
Speaker 1 (16:57):
Trust me, brother, because I've been down that road. And
cancer is say what you want about it. We all
mutually agree. It's the one thing that is we are
all in uniform agreement, regardless of our race, creed, ethnicity,
or political struke. Cancer sucks. It sucks, but it sucks
for a lot of reasons. And one of the big
reasons is it's expensive to deal.
Speaker 2 (17:18):
With yeah, and then lost work, right, and everything else
comes from on you know. And Brian, most of my
clients are self employed. You know, they don't get that.
Oh I've worked for thirty years. I got, you know,
two months of vacation time. I remember my dad retired,
was retiring as a as a police officer. You know,
(17:39):
they had this whole thing where you can save up
your sick time and it never went away, right, and
he had like two and eighty days and they and
they actually like whatever the union contracts is just crazy.
I mean, I don't know if it still exists. When
he toy, but they would pay you out. Yeah, they'd
pay you out at the end. So we got like
fifty percent of his days paid out at the end.
(18:00):
And I was like, wow, that's kind of crazy. I
was like, I was like, Dad, how do I get that?
He goes goes John, you're self and played. You'll never
have that. I was like, I know that.
Speaker 1 (18:08):
Or you work at iHeart, you'll never have that.
Speaker 2 (18:11):
I don't have that here, but I mean, man, yeah,
you usually lose it. I mean, and you know we've
had you know, I've talked about this last year. One
of our shows, you know, one of the things we
always look at in the beginning of the year is
we keep statistic numbers on like how many people that
we know in that first quarter of the year get
diagnosed with cancer, and that's a growing number. I mean,
(18:32):
we're we're in February right now, and we're already seeing
this trend upward for us. So I think last year
we had someone in the neighborhood of like twenty six
people diagnosed with cancer clients between like you know, January
one and March thirty first, and we're over twenty right
now and it's middle of February.
Speaker 1 (18:52):
So there's something nefarious going on out there in the world.
It's one of the reasons why I'm happy this is
rfkjunior guy in charge, Ah says, because I think he's
going to shed some light on our collective deteriorating health
at least I hope, So at least I have a
hope in that regard.
Speaker 2 (19:10):
I mean, I mean, he's definitely looking at it on
that and Brian and I think there's a lot of
really good data that I'm seeing from that. I mean,
I'm big, like I refuse to let my kids eat
any of that stuff. I mean I'm literally the guy
at the grocery store looking at the box and I
see something I can't pronounce. I'm not buying it.
Speaker 1 (19:27):
I've been doing that for a long time now, as
in an effort to hope maybe navigate my cancer. I've
been telling my listeners, you know, I cut all the
sugar out of my diet, or most of it. We
make our own bread at home. Now, you know I've
been and that sugar, God Almighty, is it everywhere. So
if you're looking to improve your health, I'm telling you
here right now, if you're hearing my voice, cut the
(19:50):
sugar out of your diet and you will feel better.
Speaker 2 (19:53):
Period.
Speaker 1 (19:53):
I don't care anymore whether it impacts my cancer. Just
cutting it out has I just has improved my state
of being generally.
Speaker 2 (20:01):
Oh yeah. I mean my wife and I did it
like a few years ago where we stopped doing those
those those oils. I mean, there's nothing in our house
with high fructose corn syrup at all, Like we won't
even purchase it. Got to rid a lot of the dies.
And I'll tell you why. You know, yeah, it's kind
of you kind of feel bad for the first like
three weeks. It's like like you're you're going through Yeah,
(20:23):
you're going you're literally going through withdrawal from like these
toxins that are in your body. Then you're actually and
then you start losing weight, you start feeling better, you
start sleeping better. Yeah, I mean it's it's it's it's unreal.
And it's like I didn't even do anything other than
just cut these things out. Then you can feel better,
Then you can start working out. Then you really lose weight.
So I mean it's a it's definitely a cycle. But
you're right. I mean, at my level, I look at
(20:46):
you know, what is this trend? I mean I've been
doing this twenty years. Why is this number creeping up
higher and higher and higher. Yes, we have more and
more clients, but the numbers are matching. It's like the
percentage of people is getting worse. And you start looking
at other countries, Like I've visited Europe a few years ago,
and I mean, like, you don't see fat people in Europe,
you know, you really don't. I Mean, everybody's relatively healthy,
(21:07):
they're all they eat well, and it's like, what is
the trend going on? So yeah, I mean that's something
to really think about because all of us have succumbed
to this state of how our food has been processed.
And you know, why is my bread last for two
months before it gets moldy. That doesn't make any sense.
I buy stuff from a fresh baker, it's like moldy
(21:30):
in like four days. Oh yeah, you know, those things
just still make sense. And you know, you have to
understand that we're all in that boat. So you know,
I'm in that boat. I've eaten that crap for years.
So at the end of the day, what's it likely
that I'm going to get cancer? I know there's a
more reality for that, So I have to have a
plan if that comes up to me. I mean, I
(21:50):
want to make sure I have access to the best hospitals.
I'm going to make sure I have a critical illness policy.
Something is gonna give me a big lump sum check
so I don't have to worry about, you know, paying
my mortgage, I don't have to work about work, and
I can just worry about getting better. I mean, there's
so many things that we can do to plan for
that hopefully non existent scenario, but it does happen. But
you should have a plan for that because more often
(22:11):
than not, I mean, we're seeing numbers. What it's like
one to five before sixty five will have it. I mean,
it's it's ridiculous.
Speaker 1 (22:18):
It really is. Well, since we got off on it's
rethink health Care Together, as they have the segment, but
since we got on health rethink health Together, I know
there's a big trend and more and more people are
gravitating to it. Since more people now are paying attention
to kind of thing we're talking about. What about alternative
providers and alternative therapies, I mean insurance quite often, you know,
(22:39):
if it's not the state of the are you know
the what is the phrase I'm looking for for what
gets approved and what does not do? The policies that
you have contemplate people maybe going out and seeking chiropractic
care or alternative medicine care, that kind of thing.
Speaker 2 (22:58):
Yeah, there are some really good products out there right
now for those individuals. The one that always kind of
comes to mind is a lot of I call them
like boutique doctors, you know, the ones that are like
these They've got smart, they broke away from the hospital groups,
they started their own private practice back up again, and
they're like, listen, it's a big cost for us to
do this. So if you want to be a patient
(23:18):
of mine, you have to pay excellent amount a year
and then which is which is good, right, Because they
give you more individualized attention, you probably have more time
when you go in. I mean I go see my
doctors like five minutes, like in and out like you're
going on, And I can.
Speaker 1 (23:31):
Get a script filled and approve on the cell phone.
That's awesome. Just this is going on? Can you get
me take care of boom? I get the prescription called
in as a matter.
Speaker 2 (23:42):
And they're and they're and they're they're definitely nice. You
know some of them. I mean, I don't know if
your actual run insurance for you. Some of them don't
at all, So they're nice. Okay, that's a good thing.
So some of them, like listen, I don't build insurance
at all. This is your page, your fee. But I
mean they could still give you an item bill with
a CPT code that showed what you were in there for.
(24:03):
So when we sell our secondary plans, they're indemnity insurance.
And the biggest thing that I really like about those
indemnity plans is it's the true form of insurance. We
originally started with so it's called traditional insurance. So they
basically the insurance policy does not have a network that
you have to utilize. So they basically say, as any doctor,
(24:24):
any hospital in the United States that you go to,
so we will pay them directly. Or in the situation
where the doctor is not going to bill, as long
as you get an itemized bill and send it to us,
we will pay you directly for the fact that you go.
So you can still get a plan like that, even
though your doctor doesn't take insurance. Just get an itemized
bill for while you were in there with a code
on it, and you can submit that, get reimbursed, and
get paid back by the insurance company. So we have
(24:47):
those options, Brian, and then I'll just even take it
a step further. I mean, you mentioned chiropractic. That's a
big thing, so a lot of our clients use chiropractic,
and but telehealth, I mean you just mentioned I can
just mention my guy, it gives me a prescription, right,
I mean one of the things that I mean, I've
been doing this probably for like fifteen years selling telehealth benefits.
(25:08):
I mean most people didn't realize it even exists until
COVID because everybody was like, I'm not going to see
you because we don't want any more COVID coming through
our door. Right, make sure you have a package with telehealth.
I mean, that is so simple to use, and when
almost every I'd probably say ninety nine point nine percent
of the clients that we have have a telehealth benefit
(25:28):
tied into it. And I always tell them about your
first line of defense, like don't waste your time. You
got to go to work, you're not feeling well. I
have a sinus infection right now, I literally wanted telehealth
wrote me a prescription, you know, got antibiotic sent to
my pharmacy. I never had to leave my house, I
didn't take time off from work, picked it up on
the way home from work, got my prescription, paid nothing
(25:50):
because it's free with my telehealth, and started taking a prescription,
you know. I mean that's the beauty of telehealth. And
another step up is a lot of them are covering
mental health now.
Speaker 1 (26:00):
Oh and what an important thing that is amazing, especially
for young people these days. Apparently the internet and social
media has just ruined lives.
Speaker 2 (26:09):
Oh yeah, I mean, you know, we spend more time
with our screen than we do with real people. So
I mean having that connection, having that availability to talk
to somebody, And again there's still a big stigma behind it,
you know. I know people that are like I just
I don't want to walk into one of these facilities,
you know. But it's like, okay, well you can do telehealth.
You can go hide in your garage in your car
(26:30):
and you can call and talk to a therapist. And
you know, we literally have plans for entire families that
are less than fifty bucks a month that they can
get free mental health telehealth and it's onlimited usage.
Speaker 1 (26:43):
You can literally call hourly provider rated if you went
and sat down on a couch at some office somewhere.
Speaker 2 (26:49):
And so imagine that you can get for your entire
family for like fifty bucks a month. It's a plan
that we sell is solely just for that. And you
can literally talk to a therapists every day.
Speaker 1 (26:58):
That's mind blowing.
Speaker 2 (26:59):
And most people can't even get in right now, like
you can't even get see a face to face person.
Speaker 1 (27:04):
But you're saying though, because that's a really important point,
because somebody out there listening, going, yeah, right, it's like
trying to get a dermatology appointment, right, away. You gotta
wait around and wait around forever to get see somebody
you Meanwhile, you're experiencing like suicidal ideation or something. These
plans that you sell, these fifty dollars plans for telehealth,
(27:24):
you can get on the phone with someone right away.
Speaker 2 (27:27):
Yeah, you can schedule right through the app, so you
can be like I need somebody, and then even have
an emergency thing where you can get it right on
and then. I mean, but that's out there, and you'll
see a lot more therapists are going that way because
they can work from home, they can see more patience,
they can help more people. So it's it's a big
trend and I think it's only going to get better
and better. So I would say to people, embrace it.
(27:47):
It's a good opportunity for you. Sure, And why wouldn't you,
I don't know. I mean we use it, and I
mean I think it's a great it's a great product.
Speaker 1 (27:55):
Yeah, it psyched benefit's on your regular insurance policy. You'd
be facing that out of pot could out a liability
part right there.
Speaker 2 (28:01):
Yeah, you got cope's. I mean it's usually a specialist.
It's more expensive. I mean, there's justerral to right, you
got to get a referral, so you go on an HMO. Yeah,
you can't just go. Can't go just because you want. So,
I gotta go tell my primary care what's going on. Right,
He's gonna try and treat me with whatever he wants
to treat me. Oh, yep, you need another the pressant.
I just want to talk to somebody. I should be
go on an anti depressant, you know, because there are
(28:22):
scriptwriters right sure before you get to that specialist, And
it's like, I just want to talk to somebody, you know,
and you know, I'll Actually we have a lot of
clients that use it just for you know, spousal spousal support,
you know, like working working out their problems, marriage therapy.
Speaker 1 (28:38):
Yeah, yeah, thankfully never even had to contemplate that. I
always say, I, you know, out kicked my coverage and
I did so I can count on one hand the
number of fights we you had over the years. You know.
It's like you gotta learn to roll with it anyway.
There's that option as well. Well. We could go on
(29:00):
for a long time, but this is the end of
rethink Healthcare together for this week's episode, John always informative
and you know. Actually, I think probably inspiring for some
folks out there listening, going wow, I still have options
and it sounds like good ones. You do, so get
get in touch with John and the team. Don't forget
the team. He works with a bunch of people who
are all able to help you out. Five one three
(29:21):
eight hundred two two five five that's five one three
eight hundred call. You can initiate the process of engaging
this conversation online. Fill out the form as much as
you can. Coversincy dot com. This has been another edition
of Rethink Healthcare together with John Roman from Cover since
he
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