Episode Transcript
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Speaker 1 (00:07):
Hi, It's Brian Thomas, the host of the fifty five
KRC Mornings except on Sundays when I get to facilitate,
as I always like to call it a discussion with
John Roman from Cover sincey here, you're gonna want to
call him after you hear what we talk about. As
I always point out that number and I'll repeat it
later on in the show, it's a five one three
eight hundred call five one three eight hundred two two
five five. You can also reach out to John and
(00:28):
the team at coversincy dot com as a forum there
you can fill out to get the process started. In
that process is a better way to get medical insurance,
better coverage for less money, is the way I always
like to boil it down. Plus the benefits of John
and the team throughout the process. As long as you're
insured through them, as you're broker, they will help you
negotiate and navigate any problems you face down the road,
(00:48):
like claims, denials, mysterious eobs and things you don't quite get.
They've got a whole well oiled machine over there, and
again this comes at no cost to you. Just unbelievable
process they have going on with the John, Good to
see again, my friend you two, Brian, good morning, good morning.
And you know I always like to point out, you know,
(01:09):
the bottom line is the bottom line, and you've explained
that to me and the listeners so many times over
the time we've been talking. But let's talk and focus
today on cost say saving strategies, you know, tips for
reducing healthcare costs while maintaining comprehensive coverage. That can be done.
Speaker 2 (01:26):
Huh, it absolutely can be done. And I'm gonna segue
in before we get into this deep dive here. The
best thing we can do when it comes to healthcare
is treat it like we do anything else in our lives.
If we're gonna shop for something I always mentioned like
a if I'm gonna walk into best Buy tomorrow and
buy a TV, I'm just not gonna walk in there
(01:46):
and see a TV hanging on the on the wall
and be like, all right, here's my credit card. You
go online in the back in my car. Exactly. I'm
gonna go online. I'm gonna look into it. I'm gonna
compare it with four other companies. I'm gonna be on
Amazon seeing what it costs there. I mean, I want
to know the cost, And the first thing I'm always
gonna ask Brian is what's the cost? How much does
that TV costs?
Speaker 1 (02:04):
Right?
Speaker 2 (02:05):
So the best thing we can always do is don't
treat insurance and healthcare any differently then we treat everything
else we do in our lives. Because you can shop
healthcare and this is something that we actually do for
our clients. We actually have the tools, like we actually
have a program. It's like the Kelly Bluebook for car lookup,
(02:26):
we have that for healthcare. So we have that for
our clients. We can share with you. You know, where you
can get imaging done, where you can get different testing done, surgeries,
whatever it is. You can shop for these things. And
sometimes Brian sad to say cash can be key. I've
seen so many times where walking through a facility and
going I need an MRI and I go, oh, what's
(02:47):
a cash price? And it's like, wow, why is this?
You know eighty percent off?
Speaker 1 (02:53):
That can work with contractors in your home sometimes too.
You know, I don't ever ask them about their relationship
with the irs, so what they and don't report. But
I know you're talking about a different type of cash
is king here. But yeah, you can get a discount.
Speaker 2 (03:07):
I the guy that gotta ask the guy I got
three quotes to do my roof. I was shopping around
and one guy came in and he was like, eight
grand and everybody else he goes, you pay me cash.
I was like, I'm going to the bank today, get
right right.
Speaker 1 (03:18):
Yes, I have successfully done that myself several times over
the years.
Speaker 2 (03:22):
And that's why I said, we're doing with everything else,
we do. Do that with healthcare. Do that with what
you're doing. You'll be shocked, just because you know, we're
kind of getting to the first category here, choosing the
right health plan, right. I mean, I don't care where
you're at on health insurance nowadays, I mean the deductibles,
you out of pocket expenses, the copays, they've escalated astronomically,
(03:43):
a lot of the things that you hear all the time,
and like when I you know, we call into insurance
companies or I hear people talk like, oh, I talk
to the insurance company and they told me that it
was covered. I'm like, yes, it's covered, but it's subjicated
to your deductible and co insurance. And man, your deductible's
nine grand. Yeah, so yes, the three eight thousand dollars
is covered if you met your nine thousand dollars. So
(04:03):
that's why you paid three grand. Like, oh, well this sucks,
I'm like, well, yes, because you got and you got
six grand more out of it. You still got six
more a hand to go, So you can do it.
You can do it two more times and it's still
gonna get you know, so again, choosing the right plan,
comparing things, Understanding how to pocket expenses work, Understanding how
deductibles and copays. They're just so imperative to have that
(04:27):
real understanding and really understand like we always talk about,
like the ACA plans and a lot of major medical
insurance policies, especially I have a family. I got three
kids and a wife. I mean, you know, our out
of pocket on our major medical plan is twice my
deductible right for the family. So if you're walking around
with you know, a you know, an Obamacare or a
(04:47):
marketplace plan, it's ninety two hundred dollars is the maximu
out of pocket. But if you're on a family plans
times two that it's eighteen four hundred dollars that you
guys are.
Speaker 1 (04:56):
To say that, it just blows my mind it's it's
a tough pill of swallows.
Speaker 2 (05:00):
I've been doing this for twenty years and I remember
selling the five thousand dollars acts, you know, out of
pocket for family plans, and the fact that it's gone
up almost four hundred percent. Yeah since then is mind blowing.
When you know, healthcare has even gotten more expensive. So
it's just, you know, everything's just so much more expensive
(05:21):
on this realm. So it's you know, understand those things
and understand, you know, the type of plans that you have.
You know, a lot of us get subducated into insurance
plans where you know, like, oh, I'm at work and
I chose the high deductible health plan HSA plan, and
now I'm on a prescription that costs five hundred bucks
a month, while I was like, well, you're out of
pockets seven grand. So the sixth grand you're paying for
(05:44):
the drug, you're paying all year because it's never paying
a dime on the plan that you choose. So again,
it's it's so imperative to really understand the plan that
you have, choosing the right plan. And even if you
have a plan through work and you're starting to see
a lot of these expenses there are a lot of
good options out there. Like we talked last week about Medicare,
(06:04):
the supplements to gap plans, there's a lot of little
gap plans that you can add to a major medical plan.
It's what we do for a living to eradicate those
out of pocket expenses. So again, making sure you choose
the right plan, but look and say, hey, sometimes it's
worth paying a little bit more to alleviate that eighteenth
pous side.
Speaker 1 (06:23):
And then this is the concept that you regularly talk
about that's worthy for me to just sort of point
out for someone who's just tuning in and listening. You
work with several hundred or a couple of hundred insurance
companies and literally thousands of different policies. So this allows
you to layer coverage. So you've got maybe your Obamacare plan,
but if you throw another policy along with that, you
(06:47):
get that a policy that covers those out of pocket expenses.
So it might be a separate insurance policy, but together
they alleviate a sizeable burden from you from a financial standpoint.
Speaker 2 (06:56):
Absolutely. I mean I approach health care coverage for my
clients the same way when I was originally working with
my financial planner, he goes, John, that's such a bad
idea that you put all your money into one stock.
I'm like, yeah, I think that's probably not good to
have all my exit one bass.
Speaker 1 (07:13):
Right, I think.
Speaker 2 (07:13):
But he spits it doing really well, he goes yeah,
until it doesn't.
Speaker 1 (07:17):
Yeah, it's the bucket with the holes. In analogy last
time or a couple of weeks ago, when we were
talking and you got a bucket which is your affordable
care plan, but it's got a lot of holes in
it because it doesn't cover everything. And what you do
is take these other policies and you patch the holes
to give people, you know, at least a sizeable amount
of comfort that they're not going to get whacked with
eighteen thousand dollars out of pocket.
Speaker 2 (07:39):
Yeah, there's no clients that we have that work with us,
that take our advice that'll ever be in that financial hardship, see,
because we always do that. There's just so many scenarios
like accident policies and critical illness and little indemnity plans
that will actually pay your surgeries first dollar coverage. I mean,
there's so many things that you can add on and
(07:59):
make get less expensive. And you know that's our strategy,
you know, make the major medical plan cheaper, add on
the secondary coverages which are actually a lot cheaper, and
together that that multi layer of coverage is usually cheaper
than taking the lower deductible.
Speaker 1 (08:15):
Yeah. I think people's initial perception is, well, if I
got all these insurance policies, it's going to cost me
just so much money in premium. And no, these extra
layers can really just be a very small amount of money,
but alleviate such a sizable financial burden. I mean, and
you know that out of pocket responsibility that's every year.
Speaker 2 (08:33):
Yeah, the average client that calls in are on a
major medical plan, Brian, Once we do our what we do,
I mean, the average savings is over thirty percent.
Speaker 1 (08:43):
There, you have it right there. So so conceptually that's
how it works. Yeah.
Speaker 2 (08:48):
Another thing too, kind of a good cross saving strategy,
and this is just that should be a no brainer.
Utilize preventive care please. Like you know, we have so
many I call the good old boys that are clients
of ours. And you know these are the mechanics, the plumbers,
(09:08):
the farmers, and you know, I get it. I'm I'm
self employed. You know, it's it's hard to break away
from what we do every single day. But you know
when I get these gentlemen that are in their fifties
and they they call in and we're helping them with
their health insurance, and I go, hey, when's the last
time are you going to any medications? Like who's your
(09:29):
primary care doctor? I don't go to a doctor. I
don't do this. And sure enough, I've been doing this
so long. These are the gentlemen that I'm hearing either
from them or their wives within the next three to
five years. And they had I had a guy on
July fourth, literally in a kayak have a stroke. Oh
and he was the healthiest guy, he told me in
(09:50):
the world. And I'm like, okay, And now like you know,
he's laid up in a hospital. I'm like, you know
a lot of these things can be prevented with preventive care,
you know, getting in, getting your check, I'll get your
blood work. I mean, that's the one thing we should
be doing. Monitoring what we're doing. There's again I'm not
a here, there's a big guy go like, hey, medication, medication, medication.
(10:10):
But you know, if your blood pressure is you know,
one eighty over one hundred, like you probably should be
on something to keep that down so you don't have
a stroke. Yeah, you know, finding cancer early or these
other issues that can kind of pop up that that
wreck your lives is paramount the ones that end up
having heart attacks that we've seen. I mean, and this
(10:32):
is just my personal experience from helping clients, is not
the ones that are getting physicals every year like those
those guys typically are fine. The ones that aren't is
the ones that don't go so utilize those preventative cares.
I don't care if you're getting in vaccines or not.
Are you You're fulfillment on your mental belief on that,
But just get the physical, get the blood work done.
(10:54):
I mean, there's there's so much that can be prevented
on this side. So if there's one big thing that
I saw a good push when the obamacares came plans
came out, is making sure preventative care was on the forefront.
And I've seen such a reduction in that realm of
when people actually utilize it.
Speaker 1 (11:11):
Yeah, but well you know, it reduces the overall claims exposure.
I mean that's like for private insurance companies, they want
you to do that because if you get ahead of
a problem, Like, look, your blood sugar levels are getting higher.
You need to do something about your diet or you
gonna end up with diabetes. So you can stop that.
And it's tracks you're not gonna be on diabetes medications
the rest of your life.
Speaker 2 (11:30):
Absolutely, And then God forbid what these physicians want to
put patients on now. Oh, I mean I know, I
mean every single climb we're getting, we're getting phone calls
from going, hey, I just became a diabetic doc. I'm
on I'm on trigger with grippl Zide or whatever the
name of it is right now journal and they're like, like,
how do I get this cover's like, you usualize it's
(11:50):
a thirteen oh dollar I'm on drug, right, Yeah, So
you know what we what we were helping you with
at three to four undred bucks a month, we got
to increase that to cover this more expensive drug because
I wasn't not selling you the Mercedes plan to cover
that drug. You want to pay this drug. So it's
it's a very strange situation to see that because there's
so many other first line neds and it's just amazing.
(12:10):
We'll get into prescriptions here in a second, but it's
it's amazing the massive push on this. You know, maybe
because it's a once a week dosing, maybe because it's
also helping weight, but guys, it's in a very expensive medication.
Speaker 1 (12:22):
Yeah, and you got to acknowledge that maybe if you
didn't have the weight problem to start with, you might
not be diabetic, you know, nedos epic too.
Speaker 2 (12:31):
We can get in the whole We can get to
a whole thing here about everything. I've started reading now
that the new that the people that we have in
government right now have brought to light on the food
and everything else that we're doing, the sugars and the
oiling of America.
Speaker 1 (12:43):
And yeah, trust me, I've been closely following that now
for quite some time and my eyes have been opened very,
very wide on that.
Speaker 2 (12:52):
But here's the funniest thing. Like I took a trip
to Europe a couple of years ago. I'm in Italy,
and I mean I enjoyed Petea. I'm you know, originally
from the East Coast, the East Coast pizza, right, But
it's like I can't eat a pizza anymore, and I
feel like I want to go take a nap for
a day. Yeah, you know, like I feel terrible after
that I was in Italy and that's probably the first
(13:13):
time I ate an entire pizza in forever and I
felt perfect. And I'm like, there's something off with what
we're doing in question. And I ate my way through
Europe absolutely because I wanted to try everything and lost weight.
Speaker 1 (13:31):
Isn't that amazing?
Speaker 2 (13:32):
And I came back to the United States and didn't
any of that stuff and gained weight. So how does that?
Speaker 1 (13:38):
How does that just it's just being in the United
States alone that makes you fat. That's all there is
to it. So pivoting over, so we were talking, Okay,
choose the right plan, utilize preventative care, get ahead of
your problems, and take care of yourself. In network providers, Obviously,
if you've got a network of providers, you want to
(13:58):
stay there or you're gonna pay a lot more money network.
Speaker 2 (14:00):
The biggest thing that most people don't understand about insurance
is what actually we've seen as far as reductions and
claims and cost is actually the in network providers, right,
the PPO or the insurance company discount a lot of
times is far superior than what they actually paying claims.
I've watched three hundred thousand dollars in claims come from
(14:22):
a client and those bills get knocked down to sixty
seventy grand. I mean, you're talking about two hundred and
thirty thousand reduction in costs on a claim. That's the
power of insurance. It's the buying power, it's the negotiated
rate that they have. That's why it's so imperative. I
don't understand how a hospital can even build that amount
and take seventy thoust. I don't understand like how that
(14:44):
actually works. They write that off. I don't get that.
But it's like I've seen that.
Speaker 1 (14:48):
I think the inflated rate has just pulled out of
their sphincters. Man, I just throw three hundred thousand dollars
on there. Whatever you know, it's in it's in network,
provide a role and going to get fifty eight or something.
Speaker 2 (14:58):
I know, and and kind of going back we talked
about like cash is key and stuff like that. I mean,
those things happen, but it's like those negotiated rates on
heart attacks and strokes and what I've seen on cancer
are just astronomical. That is the power of insurance. And
if you don't have insurance, I mean, you're not get
to get two hundred and thirty thousand dollars just count
on a heart attack, right, you know you're getting step
(15:20):
at that.
Speaker 1 (15:20):
Bill my cancer drug when I was on it and
I haven't been on for a while. He's thirteen thousand
dollars a bag billed, but the provider only received I
think three or four thousand dollars. That was the reimbursement
rate and that was agreed upon. It wasn't like I
had to pay the difference. No balance billing allowed, So nope,
there's not.
Speaker 2 (15:37):
And then that that's something that's really nice with the
new laws that are in play, the new balance building
and stuff like that, but they still exist and that's
something that you guys have to be truly aware of
when you're looking at your eobs and different things like that.
But again, network is very important, you know, especially if
you're on a marketplace plan, knowing that things are like
an HMO, so like you don't have at a network cover.
(16:00):
So if you walk into a hospital, we talk about
this all the time, and you know, God forbid, you're
you think you're in an emergency situation and you just
go to the local hospital and going, hey I'm here,
I'm thinking I'm having up some problems. And remember who
deems it an emergency is the insurance company? Yeah, you know,
they don't consider that life threatening. And you're at a network.
Guess who pays that bill? You They ain't paying a dime.
(16:21):
And I've seen it, and I've seen it too often.
So again, making sure you had the right plan, but
trying to stay in network is you know, is very
key in that situation.
Speaker 1 (16:30):
Well, how can folks save money on prescription? Oh?
Speaker 2 (16:33):
This, I love this. I love this because we literally
do this every single day. Number one ask questions to
your position, right, but we just talked about the the
the glip aside drugs, right, the manjourno and those type
of drugs. I mean, if if you just became diabetic,
like the doctor's like, hey, yeah, your blood sugars little
(16:54):
of it. I wanted to put you on a majourno
like thirteen hundred bucks a month, have a conversation like, hey,
is there other options that are not thirteen hundred dollars
a month? Like, have that conversation up front. But there's
so many medications that are out there that we've seen
brands and very expensive options. Always ask for a generic option. First,
(17:15):
try that. If it doesn't the general doesn't work, then
move on to the more expensive medication. Utilizing things like
mail orders. A lot of people don't realize. I mean,
you're on a maintenance drug. You shouldn't be going every
month and filling it out of pharmacy. A lot of
times the mail orders is significantly less expensive.
Speaker 1 (17:31):
Man.
Speaker 2 (17:32):
I love when people call into our office because we
have so many unique strategies here. There's many, including Canada,
including Canada. Yeah, we'll get to Canada last because I
love that one. But manufacture cope cards. You know, I've
I've helped clients right now on those like Manjernozempic manufacture
(17:52):
cope cards and literally cut the cost in half. I
mean yeah, so.
Speaker 1 (17:59):
The manufacturer itself is offering the discount discount.
Speaker 2 (18:02):
Yes, they have these manufacturing cope cards. A lot of
our clients utilize these. We utilize these with a lot
of different plans. We actually just had a client at
we actually did last yesterday this earlier this week, calls
in goes doc. They just put me on this drug.
It was Manjourno, you know, he was on the we
call him the Dude Plan. It was a cheap plan.
(18:23):
It was very good coverage, but wasn't paying thirteen nine
dollars month for his drug, so it said we had
to adjust your plan and put you on a plan
that covers it.
Speaker 1 (18:30):
Well.
Speaker 2 (18:31):
The cheapest Copey I could give him was like two
hundred and fifty dollars from re injournal on a plan
that wasn't astronomical on price. I go say, we're going
to go with this plan. He goes, I don't want
to pay two fifty. It's like, you're never going to
pay two to fifty. I was like, I'm going to
sell you the cheaper plan with the two hundred and
fifty dollars COPE, and then here's the manufacturer Copey card
that brings your drug down the twenty. So instead of
paying five hundred dollars more a month for the health
(18:52):
insurance plan that brings it down to twenty, I want
to give you the two hundred and fifty dollars cope
with the manufacturer Cope card.
Speaker 1 (19:00):
And then you present that to the pharmacy at the
time you're paying for the drug.
Speaker 2 (19:04):
You give him all that information in the pharmacy. Now
he's only paying twenty dollars for that drug because of
the plan that he was originally thinking about going on
was almost five hundred dollars more a month. Oh wow,
And that was a strategy We're able to help our clients.
So again why it's so important working with us. We
have those unique strategies to be able to do that.
And then getting back to the other thing. Canada prescriptions,
(19:25):
you can get them outside the United States. I've personally
used them. I've my wife was on a medication that
was almost three hundred and fifty bucks a month back
in the day, and we were able to get it
through Canada and I think it was like sixty bucks
a month. You know, the same exact drug from the
same manufacturer. The manufacturers literally located in Ireland. The drug
(19:48):
is made in Ireland, they ship it to the United States.
It was the same box, the same box in the
United States and the same box that went to Canada.
I just bought it from Canada for one dollars cheaper.
That was really what are they.
Speaker 1 (20:04):
Doing in Canada that makes it so inexpensive?
Speaker 2 (20:06):
They don't have to deal with all the bureaucracy that
we have here. That's all and everything else. I mean,
I mean, did you did you where's Majerna done. I
think it's like the Netherlands or something like that.
Speaker 1 (20:17):
Yeah, maybe, I guess neither.
Speaker 2 (20:19):
The cost of that drug is less than two hudred
bucks there from Manjourno.
Speaker 1 (20:23):
It's thirteen hundred dollars a month.
Speaker 2 (20:24):
It's thirteen hours not here and the pharma and they
don't even recommend it as a first line therapy there.
Speaker 1 (20:31):
Oh I'm sure of that. Is that PBMs in the
middle there that are driving them? Oh?
Speaker 2 (20:36):
Absolutely, yeah, absolutely, I've heard. I actually have friends that
are in that business, and they say, we add on
two to three percent on the cost of drugs.
Speaker 1 (20:44):
Yes, and you know they're going after payday lenders all
the time for charging you know, userus rates. I mean,
you think that they eradicate the pharmacy benefit managers. I
know there's talk about doing.
Speaker 2 (20:55):
That, but I mean, I just I think there's way
too many midtal men in that point. But again, it's
it's even the manufacturers. I mean, they know we're we
are one of the number one countries for paying for
development of these drugs, and they know, hey, if I
can get my drug in America, I can make money.
And they do. But again it's like, why can I
(21:17):
get my drug through India or through the UK or
Canada at a fraction of the costs. You know, I'll
tell every listener Canada Drugs online dot Com is where
were you issue? You send a lot of our clients
go look at your drug there. I have clients at
literally on medicare doing getting their drugs from there because
it's cheaper than even get they get on their prescription
(21:38):
party plan.
Speaker 1 (21:39):
You know.
Speaker 2 (21:40):
So it's you have to utilize the tools there and
you know this are the things that we help clients
with all the time.
Speaker 1 (21:45):
All right, Well, I know there are health savings accounts
and flexible spending accounts and these are pre tax dollars
that are placed in them. Correct.
Speaker 2 (21:53):
Yeah, so hsas are really good plans.
Speaker 1 (21:56):
That's the one where you get to keep the money.
Speaker 2 (21:58):
You get to keep the money. Y, Yes, health savings
account it works just like an IRA, but you can
use it for medical expenses. The beauty behind hsas is,
you know, I'm a firm believer and when I was younger,
I started funding my HSA before I was married with kids,
you know, I mean, I just started started shocking moneyway
I wasn't really having a lot of medical expenses. So
I was like, I'm just gonna keep putting money into
(22:18):
this extra account and I can use it the rest
of my life. And you know, when you have a family,
we depleted it pretty quickly. A couple of kids later,
you know, and then all my money's gone.
Speaker 1 (22:28):
But we utilize them money. Forget that I have it.
Don't even use a whole bunch of money.
Speaker 2 (22:32):
Don't even use it. I mean, it's the best part,
but it's an IRA. You can use it to pay
your part B premiums, Brian, so you know, I'm sure
you're gonna be paying some ERMA, so you know you're welcome.
So you can use to pay those part B premiums.
You can use it to cover out of pocket expenses.
You can use it to pay off you need cataract surgery.
My parents just had cataract surgery, both of them, and
(22:55):
they you know, medicare only covers like the fifteen hundred
dollars lens, but these, like the better lenses for your
eyes are like six grand. So who pays the forty
five hundred dollars difference, Well, your HSA does. That's why
you have it. So you can utilize that money. So
it's good flexible spending counts. You'll see them a lot
through employers if you can really figure out and control
(23:16):
what you're paying out of pocket, and like I have
these expenses, I know I'm gonna do FSA. Flexible spending
accounts can work the problems that might does disappear at
the end of.
Speaker 1 (23:24):
The year's see, that's why I would never go down.
Oh my god.
Speaker 2 (23:26):
I talked to my brother like six months ago, and
he had just gotten married and his wife, you know,
she's like, I've been funding my FSA for like four years.
I'm like, what do you use the money for? She goes,
I don't. I've never used any of the money.
Speaker 1 (23:39):
I'm like, disappeared.
Speaker 2 (23:41):
You're telling me you're you're funding this every year for
thousands of dollars and because you're like, oh, it's all
pre taxing, you ever use it? She goes No, I'm like,
oh my god, that might just gone. It's bad for it.
I'm shocked to hear that. I'm not shocked because i mean,
I'm sure people it happens to them all the time,
you know, so that road I.
Speaker 1 (24:00):
Forget that even have an HSA. That's why it's money
still in there, no expense because I'm like, you know,
I'm oblivious to that.
Speaker 2 (24:06):
Hope isn't listening to show because I did not tell
him that. I just told them, like, stop doing it. Yeah,
I didn't want to throw under the bus. That's not
a fight I want to do.
Speaker 1 (24:15):
When he's going to pull up the account at some
point realize there's nothing in it.
Speaker 2 (24:20):
It's her count, it wasn't on his. But it was
just like.
Speaker 1 (24:25):
The show. All right, So hs ages unless you have
a firm grasp on what your annual expenses are for
medical claims, that case, you might want to go at FSA,
but you better use it on the fly while you're
incurring these expenses. Otherwise, sounds like health savings accounts a
way to go. And here's one I think we've talked
about before, avoiding unnecessary er visits. The last thing you
(24:47):
want to do, if you can avoid it, is go
to a hospital. Yeah.
Speaker 2 (24:51):
I mean, I'm telling you right now, I don't go
to emergency unless you think you're dying, Like did just
this shar out of pocket expenses now are just huge.
I mean, the best thing I can recommend to every
listener is today, you know, today's Sunday. Like literally just
go online, look up local urgent cares to you and
(25:11):
find but find out what they do, like do they
have an X ray machine? Can they stitch me? Can
they what can they do with these facilities and that
way you just know. But god, urgent care, I mean,
I've they're five to ten percent of the cost of
what it costs to the emergency room. And you know,
(25:33):
and a lot of the plans that we build for
clients literally if they go to urgent care, they're actually
making money, which is just phenomenal. If you don't understand
the process of how they make my go back and
listen to a couple of my shows, like I talk
to you about how you can make money on health insurance.
But urgent care, God, I mean, you just know. And
some of these have phenomenal facilities. I've seen big imaging
(25:54):
machines at some of these urgent cares. I had actually
something in my eye and they had a whole eye center,
Like they only set me down and wash it out,
And I'm like I would have gone through the emergency
room for this. You know, It's like those aren't emergencies anymore.
Even broken bones, you know. I mean you can know
where your urgent cares are and find out, like I
know three urgent cares with me and the watch days
(26:16):
they have X ray technicians there, and they're all three
different days. And don't go, Okay, my kid gets hurt
on a Monday, I'm going here. My kid gets hurt
on a Wednesday. I'm going here, like I'm not going
to go spend five hours in an emergency, you know,
and then it's five grand you know there, Just this
doesn't make sense. It doesn't make sense. Yes, yes, and
used tele purgatory. Yes, yeah, urgent and he used telehealth.
(26:37):
You'd be surprised. I mean, I've literally I've sliced my
hand open. I called through my telehealth app, which is
right on my phone. It was a FaceTime message. I
showed him my open wound. He goes, yeah, you can
get that futured good urgent gear. I'm hurt oka good
urgent gear. But I did it with my telehealth and
that was free. Otherwise, why would I go anny waste
my time?
Speaker 1 (26:57):
Yeah, Well, there's some homework for the listeners out there.
Find out where your local urgent care facilities are. There's
literally one across the street from each other on Montgomery.
I could throw a rock basically from one urgent care
to another one. Now, I don't know which services they offer,
but I know where they are in the event something
might happen. And actually we've utilized them in the past before.
Speaker 2 (27:18):
I got a good friend of mine has like he's
got a cold plunge at his urgent care. He's actually
on our show a few months ago.
Speaker 1 (27:24):
Oh that yeah, yeah.
Speaker 2 (27:26):
Yeah, And they do all kinds of testing right there
in their office, testosterone and all that type of stuff.
The whole holistic you know, you know approach. But I mean,
like they're out there, fine one, you know, know where
your local one is. Don't don't wait till it is
an emergency situation like oh I got to go to
the hospitals that I'm the where to go.
Speaker 1 (27:46):
All right, Well, wrapping up in the last minute and
a half or so, we've got here. Anything you want
to run down by way of cost saving options for folks.
Speaker 2 (27:54):
Yeah, the biggest thing I would tell you as far
as cost saving and outside of everything that we talked about,
is just understand and your policy, really understand it, look
at it, open it up. Know what your copays are
for certain situations, you know, and if you don't know
how to read that, give us a call, you know
that have that initial conversation, and we do that with
(28:18):
everyone that calls in. We give you. We look at
your plan, we go over, we see if there's any
holes or anything that we make recommendations. I will always
tell you this, if you're in the best plan for
your family, I'll absolutely tell you to stay there. Oh
with that question, you've just surprised how many clients I've lived, Well,
they're not even clients, and may because we nevern't able
to help them. I we go don't let anybody take
(28:38):
this from you. Someone's gonna call you six months from
now and they're gonna tell you they are the best
things since slice spread. And it's not because the plan
that you have is the best plan out there right now.
Stay where you're at.
Speaker 1 (28:51):
Yeah, And that's actually the best thing can happen to
somebody that comes to your door, although that would deny
them the opportunity to be able to have you solve
the problems, because as if they are insured through you,
then you are the problem solvers for everybody you get
at no additional costs. You can get in touch with
John and the team. Make sure you can. You can
work with a team member. You don't have to work
exclusively with John. That's five one three eight hundred call
(29:12):
five one three eight hundred two two five five get
the process started. Fill the form out online at coversinc
dot com. This has been another edition of Rethink Healthcare
together with John Roman from Cover. Since he John, it's
always great talking with you.
Speaker 2 (29:24):
You too, Brian, Thank you
Hi, It's Brian Thomas, the host of the fifty five
KRC Mornings except on Sundays when I get to facilitate,
as I always like to call it a discussion with
John Roman from Cover sincey here, you're gonna want to
call him after you hear what we talk about. As
I always point out that number and I'll repeat it
later on in the show, it's a five one three
eight hundred call five one three eight hundred two two
five five. You can also reach out to John and
(00:28):
the team at coversincy dot com as a forum there
you can fill out to get the process started. In
that process is a better way to get medical insurance,
better coverage for less money, is the way I always
like to boil it down. Plus the benefits of John
and the team throughout the process. As long as you're
insured through them, as you're broker, they will help you
negotiate and navigate any problems you face down the road,
(00:48):
like claims, denials, mysterious eobs and things you don't quite get.
They've got a whole well oiled machine over there, and
again this comes at no cost to you. Just unbelievable
process they have going on with the John, Good to
see again, my friend you two, Brian, good morning, good morning.
And you know I always like to point out, you know,
(01:09):
the bottom line is the bottom line, and you've explained
that to me and the listeners so many times over
the time we've been talking. But let's talk and focus
today on cost say saving strategies, you know, tips for
reducing healthcare costs while maintaining comprehensive coverage. That can be done.
Speaker 2 (01:26):
Huh, it absolutely can be done. And I'm gonna segue
in before we get into this deep dive here. The
best thing we can do when it comes to healthcare
is treat it like we do anything else in our lives.
If we're gonna shop for something I always mentioned like
a if I'm gonna walk into best Buy tomorrow and
buy a TV, I'm just not gonna walk in there
(01:46):
and see a TV hanging on the on the wall
and be like, all right, here's my credit card. You
go online in the back in my car. Exactly. I'm
gonna go online. I'm gonna look into it. I'm gonna
compare it with four other companies. I'm gonna be on
Amazon seeing what it costs there. I mean, I want
to know the cost, And the first thing I'm always
gonna ask Brian is what's the cost? How much does
that TV costs?
Speaker 1 (02:04):
Right?
Speaker 2 (02:05):
So the best thing we can always do is don't
treat insurance and healthcare any differently then we treat everything
else we do in our lives. Because you can shop
healthcare and this is something that we actually do for
our clients. We actually have the tools, like we actually
have a program. It's like the Kelly Bluebook for car lookup,
(02:26):
we have that for healthcare. So we have that for
our clients. We can share with you. You know, where you
can get imaging done, where you can get different testing done, surgeries,
whatever it is. You can shop for these things. And
sometimes Brian sad to say cash can be key. I've
seen so many times where walking through a facility and
going I need an MRI and I go, oh, what's
(02:47):
a cash price? And it's like, wow, why is this?
You know eighty percent off?
Speaker 1 (02:53):
That can work with contractors in your home sometimes too.
You know, I don't ever ask them about their relationship
with the irs, so what they and don't report. But
I know you're talking about a different type of cash
is king here. But yeah, you can get a discount.
Speaker 2 (03:07):
I the guy that gotta ask the guy I got
three quotes to do my roof. I was shopping around
and one guy came in and he was like, eight
grand and everybody else he goes, you pay me cash.
I was like, I'm going to the bank today, get
right right.
Speaker 1 (03:18):
Yes, I have successfully done that myself several times over
the years.
Speaker 2 (03:22):
And that's why I said, we're doing with everything else,
we do. Do that with healthcare. Do that with what
you're doing. You'll be shocked, just because you know, we're
kind of getting to the first category here, choosing the
right health plan, right. I mean, I don't care where
you're at on health insurance nowadays, I mean the deductibles,
you out of pocket expenses, the copays, they've escalated astronomically,
(03:43):
a lot of the things that you hear all the time,
and like when I you know, we call into insurance
companies or I hear people talk like, oh, I talk
to the insurance company and they told me that it
was covered. I'm like, yes, it's covered, but it's subjicated
to your deductible and co insurance. And man, your deductible's
nine grand. Yeah, so yes, the three eight thousand dollars
is covered if you met your nine thousand dollars. So
(04:03):
that's why you paid three grand. Like, oh, well this sucks,
I'm like, well, yes, because you got and you got
six grand more out of it. You still got six
more a hand to go, So you can do it.
You can do it two more times and it's still
gonna get you know, so again, choosing the right plan,
comparing things, Understanding how to pocket expenses work, Understanding how
deductibles and copays. They're just so imperative to have that
(04:27):
real understanding and really understand like we always talk about,
like the ACA plans and a lot of major medical
insurance policies, especially I have a family. I got three
kids and a wife. I mean, you know, our out
of pocket on our major medical plan is twice my
deductible right for the family. So if you're walking around
with you know, a you know, an Obamacare or a
(04:47):
marketplace plan, it's ninety two hundred dollars is the maximu
out of pocket. But if you're on a family plans
times two that it's eighteen four hundred dollars that you
guys are.
Speaker 1 (04:56):
To say that, it just blows my mind it's it's
a tough pill of swallows.
Speaker 2 (05:00):
I've been doing this for twenty years and I remember
selling the five thousand dollars acts, you know, out of
pocket for family plans, and the fact that it's gone
up almost four hundred percent. Yeah since then is mind blowing.
When you know, healthcare has even gotten more expensive. So
it's just, you know, everything's just so much more expensive
(05:21):
on this realm. So it's you know, understand those things
and understand, you know, the type of plans that you have.
You know, a lot of us get subducated into insurance
plans where you know, like, oh, I'm at work and
I chose the high deductible health plan HSA plan, and
now I'm on a prescription that costs five hundred bucks
a month, while I was like, well, you're out of
pockets seven grand. So the sixth grand you're paying for
(05:44):
the drug, you're paying all year because it's never paying
a dime on the plan that you choose. So again,
it's it's so imperative to really understand the plan that
you have, choosing the right plan. And even if you
have a plan through work and you're starting to see
a lot of these expenses there are a lot of
good options out there. Like we talked last week about Medicare,
(06:04):
the supplements to gap plans, there's a lot of little
gap plans that you can add to a major medical plan.
It's what we do for a living to eradicate those
out of pocket expenses. So again, making sure you choose
the right plan, but look and say, hey, sometimes it's
worth paying a little bit more to alleviate that eighteenth
pous side.
Speaker 1 (06:23):
And then this is the concept that you regularly talk
about that's worthy for me to just sort of point
out for someone who's just tuning in and listening. You
work with several hundred or a couple of hundred insurance
companies and literally thousands of different policies. So this allows
you to layer coverage. So you've got maybe your Obamacare plan,
but if you throw another policy along with that, you
(06:47):
get that a policy that covers those out of pocket expenses.
So it might be a separate insurance policy, but together
they alleviate a sizeable burden from you from a financial standpoint.
Speaker 2 (06:56):
Absolutely. I mean I approach health care coverage for my
clients the same way when I was originally working with
my financial planner, he goes, John, that's such a bad
idea that you put all your money into one stock.
I'm like, yeah, I think that's probably not good to
have all my exit one bass.
Speaker 1 (07:13):
Right, I think.
Speaker 2 (07:13):
But he spits it doing really well, he goes yeah,
until it doesn't.
Speaker 1 (07:17):
Yeah, it's the bucket with the holes. In analogy last
time or a couple of weeks ago, when we were
talking and you got a bucket which is your affordable
care plan, but it's got a lot of holes in
it because it doesn't cover everything. And what you do
is take these other policies and you patch the holes
to give people, you know, at least a sizeable amount
of comfort that they're not going to get whacked with
eighteen thousand dollars out of pocket.
Speaker 2 (07:39):
Yeah, there's no clients that we have that work with us,
that take our advice that'll ever be in that financial hardship, see,
because we always do that. There's just so many scenarios
like accident policies and critical illness and little indemnity plans
that will actually pay your surgeries first dollar coverage. I mean,
there's so many things that you can add on and
(07:59):
make get less expensive. And you know that's our strategy,
you know, make the major medical plan cheaper, add on
the secondary coverages which are actually a lot cheaper, and
together that that multi layer of coverage is usually cheaper
than taking the lower deductible.
Speaker 1 (08:15):
Yeah. I think people's initial perception is, well, if I
got all these insurance policies, it's going to cost me
just so much money in premium. And no, these extra
layers can really just be a very small amount of money,
but alleviate such a sizable financial burden. I mean, and
you know that out of pocket responsibility that's every year.
Speaker 2 (08:33):
Yeah, the average client that calls in are on a
major medical plan, Brian, Once we do our what we do,
I mean, the average savings is over thirty percent.
Speaker 1 (08:43):
There, you have it right there. So so conceptually that's
how it works. Yeah.
Speaker 2 (08:48):
Another thing too, kind of a good cross saving strategy,
and this is just that should be a no brainer.
Utilize preventive care please. Like you know, we have so
many I call the good old boys that are clients
of ours. And you know these are the mechanics, the plumbers,
(09:08):
the farmers, and you know, I get it. I'm I'm
self employed. You know, it's it's hard to break away
from what we do every single day. But you know
when I get these gentlemen that are in their fifties
and they they call in and we're helping them with
their health insurance, and I go, hey, when's the last
time are you going to any medications? Like who's your
(09:29):
primary care doctor? I don't go to a doctor. I
don't do this. And sure enough, I've been doing this
so long. These are the gentlemen that I'm hearing either
from them or their wives within the next three to
five years. And they had I had a guy on
July fourth, literally in a kayak have a stroke. Oh
and he was the healthiest guy, he told me in
(09:50):
the world. And I'm like, okay, And now like you know,
he's laid up in a hospital. I'm like, you know
a lot of these things can be prevented with preventive care,
you know, getting in, getting your check, I'll get your
blood work. I mean, that's the one thing we should
be doing. Monitoring what we're doing. There's again I'm not
a here, there's a big guy go like, hey, medication, medication, medication.
(10:10):
But you know, if your blood pressure is you know,
one eighty over one hundred, like you probably should be
on something to keep that down so you don't have
a stroke. Yeah, you know, finding cancer early or these
other issues that can kind of pop up that that
wreck your lives is paramount the ones that end up
having heart attacks that we've seen. I mean, and this
(10:32):
is just my personal experience from helping clients, is not
the ones that are getting physicals every year like those
those guys typically are fine. The ones that aren't is
the ones that don't go so utilize those preventative cares.
I don't care if you're getting in vaccines or not.
Are you You're fulfillment on your mental belief on that,
But just get the physical, get the blood work done.
(10:54):
I mean, there's there's so much that can be prevented
on this side. So if there's one big thing that
I saw a good push when the obamacares came plans
came out, is making sure preventative care was on the forefront.
And I've seen such a reduction in that realm of
when people actually utilize it.
Speaker 1 (11:11):
Yeah, but well you know, it reduces the overall claims exposure.
I mean that's like for private insurance companies, they want
you to do that because if you get ahead of
a problem, Like, look, your blood sugar levels are getting higher.
You need to do something about your diet or you
gonna end up with diabetes. So you can stop that.
And it's tracks you're not gonna be on diabetes medications
the rest of your life.
Speaker 2 (11:30):
Absolutely, And then God forbid what these physicians want to
put patients on now. Oh, I mean I know, I
mean every single climb we're getting, we're getting phone calls
from going, hey, I just became a diabetic doc. I'm
on I'm on trigger with grippl Zide or whatever the
name of it is right now journal and they're like, like,
how do I get this cover's like, you usualize it's
(11:50):
a thirteen oh dollar I'm on drug, right, Yeah, So
you know what we what we were helping you with
at three to four undred bucks a month, we got
to increase that to cover this more expensive drug because
I wasn't not selling you the Mercedes plan to cover
that drug. You want to pay this drug. So it's
it's a very strange situation to see that because there's
so many other first line neds and it's just amazing.
(12:10):
We'll get into prescriptions here in a second, but it's
it's amazing the massive push on this. You know, maybe
because it's a once a week dosing, maybe because it's
also helping weight, but guys, it's in a very expensive medication.
Speaker 1 (12:22):
Yeah, and you got to acknowledge that maybe if you
didn't have the weight problem to start with, you might
not be diabetic, you know, nedos epic too.
Speaker 2 (12:31):
We can get in the whole We can get to
a whole thing here about everything. I've started reading now
that the new that the people that we have in
government right now have brought to light on the food
and everything else that we're doing, the sugars and the
oiling of America.
Speaker 1 (12:43):
And yeah, trust me, I've been closely following that now
for quite some time and my eyes have been opened very,
very wide on that.
Speaker 2 (12:52):
But here's the funniest thing. Like I took a trip
to Europe a couple of years ago. I'm in Italy,
and I mean I enjoyed Petea. I'm you know, originally
from the East Coast, the East Coast pizza, right, But
it's like I can't eat a pizza anymore, and I
feel like I want to go take a nap for
a day. Yeah, you know, like I feel terrible after
that I was in Italy and that's probably the first
(13:13):
time I ate an entire pizza in forever and I
felt perfect. And I'm like, there's something off with what
we're doing in question. And I ate my way through
Europe absolutely because I wanted to try everything and lost weight.
Speaker 1 (13:31):
Isn't that amazing?
Speaker 2 (13:32):
And I came back to the United States and didn't
any of that stuff and gained weight. So how does that?
Speaker 1 (13:38):
How does that just it's just being in the United
States alone that makes you fat. That's all there is
to it. So pivoting over, so we were talking, Okay,
choose the right plan, utilize preventative care, get ahead of
your problems, and take care of yourself. In network providers, Obviously,
if you've got a network of providers, you want to
(13:58):
stay there or you're gonna pay a lot more money network.
Speaker 2 (14:00):
The biggest thing that most people don't understand about insurance
is what actually we've seen as far as reductions and
claims and cost is actually the in network providers, right,
the PPO or the insurance company discount a lot of
times is far superior than what they actually paying claims.
I've watched three hundred thousand dollars in claims come from
(14:22):
a client and those bills get knocked down to sixty
seventy grand. I mean, you're talking about two hundred and
thirty thousand reduction in costs on a claim. That's the
power of insurance. It's the buying power, it's the negotiated
rate that they have. That's why it's so imperative. I
don't understand how a hospital can even build that amount
and take seventy thoust. I don't understand like how that
(14:44):
actually works. They write that off. I don't get that.
But it's like I've seen that.
Speaker 1 (14:48):
I think the inflated rate has just pulled out of
their sphincters. Man, I just throw three hundred thousand dollars
on there. Whatever you know, it's in it's in network,
provide a role and going to get fifty eight or something.
Speaker 2 (14:58):
I know, and and kind of going back we talked
about like cash is key and stuff like that. I mean,
those things happen, but it's like those negotiated rates on
heart attacks and strokes and what I've seen on cancer
are just astronomical. That is the power of insurance. And
if you don't have insurance, I mean, you're not get
to get two hundred and thirty thousand dollars just count
on a heart attack, right, you know you're getting step
(15:20):
at that.
Speaker 1 (15:20):
Bill my cancer drug when I was on it and
I haven't been on for a while. He's thirteen thousand
dollars a bag billed, but the provider only received I
think three or four thousand dollars. That was the reimbursement
rate and that was agreed upon. It wasn't like I
had to pay the difference. No balance billing allowed, So nope,
there's not.
Speaker 2 (15:37):
And then that that's something that's really nice with the
new laws that are in play, the new balance building
and stuff like that, but they still exist and that's
something that you guys have to be truly aware of
when you're looking at your eobs and different things like that.
But again, network is very important, you know, especially if
you're on a marketplace plan, knowing that things are like
an HMO, so like you don't have at a network cover.
(16:00):
So if you walk into a hospital, we talk about
this all the time, and you know, God forbid, you're
you think you're in an emergency situation and you just
go to the local hospital and going, hey I'm here,
I'm thinking I'm having up some problems. And remember who
deems it an emergency is the insurance company? Yeah, you know,
they don't consider that life threatening. And you're at a network.
Guess who pays that bill? You They ain't paying a dime.
(16:21):
And I've seen it, and I've seen it too often.
So again, making sure you had the right plan, but
trying to stay in network is you know, is very
key in that situation.
Speaker 1 (16:30):
Well, how can folks save money on prescription? Oh?
Speaker 2 (16:33):
This, I love this. I love this because we literally
do this every single day. Number one ask questions to
your position, right, but we just talked about the the
the glip aside drugs, right, the manjourno and those type
of drugs. I mean, if if you just became diabetic,
like the doctor's like, hey, yeah, your blood sugars little
(16:54):
of it. I wanted to put you on a majourno
like thirteen hundred bucks a month, have a conversation like, hey,
is there other options that are not thirteen hundred dollars
a month? Like, have that conversation up front. But there's
so many medications that are out there that we've seen
brands and very expensive options. Always ask for a generic option. First,
(17:15):
try that. If it doesn't the general doesn't work, then
move on to the more expensive medication. Utilizing things like
mail orders. A lot of people don't realize. I mean,
you're on a maintenance drug. You shouldn't be going every
month and filling it out of pharmacy. A lot of
times the mail orders is significantly less expensive.
Speaker 1 (17:31):
Man.
Speaker 2 (17:32):
I love when people call into our office because we
have so many unique strategies here. There's many, including Canada,
including Canada. Yeah, we'll get to Canada last because I
love that one. But manufacture cope cards. You know, I've
I've helped clients right now on those like Manjernozempic manufacture
(17:52):
cope cards and literally cut the cost in half. I
mean yeah, so.
Speaker 1 (17:59):
The manufacturer itself is offering the discount discount.
Speaker 2 (18:02):
Yes, they have these manufacturing cope cards. A lot of
our clients utilize these. We utilize these with a lot
of different plans. We actually just had a client at
we actually did last yesterday this earlier this week, calls
in goes doc. They just put me on this drug.
It was Manjourno, you know, he was on the we
call him the Dude Plan. It was a cheap plan.
(18:23):
It was very good coverage, but wasn't paying thirteen nine
dollars month for his drug, so it said we had
to adjust your plan and put you on a plan
that covers it.
Speaker 1 (18:30):
Well.
Speaker 2 (18:31):
The cheapest Copey I could give him was like two
hundred and fifty dollars from re injournal on a plan
that wasn't astronomical on price. I go say, we're going
to go with this plan. He goes, I don't want
to pay two fifty. It's like, you're never going to
pay two to fifty. I was like, I'm going to
sell you the cheaper plan with the two hundred and
fifty dollars COPE, and then here's the manufacturer Copey card
that brings your drug down the twenty. So instead of
paying five hundred dollars more a month for the health
(18:52):
insurance plan that brings it down to twenty, I want
to give you the two hundred and fifty dollars cope
with the manufacturer Cope card.
Speaker 1 (19:00):
And then you present that to the pharmacy at the
time you're paying for the drug.
Speaker 2 (19:04):
You give him all that information in the pharmacy. Now
he's only paying twenty dollars for that drug because of
the plan that he was originally thinking about going on
was almost five hundred dollars more a month. Oh wow,
And that was a strategy We're able to help our clients.
So again why it's so important working with us. We
have those unique strategies to be able to do that.
And then getting back to the other thing. Canada prescriptions,
(19:25):
you can get them outside the United States. I've personally
used them. I've my wife was on a medication that
was almost three hundred and fifty bucks a month back
in the day, and we were able to get it
through Canada and I think it was like sixty bucks
a month. You know, the same exact drug from the
same manufacturer. The manufacturers literally located in Ireland. The drug
(19:48):
is made in Ireland, they ship it to the United States.
It was the same box, the same box in the
United States and the same box that went to Canada.
I just bought it from Canada for one dollars cheaper.
That was really what are they.
Speaker 1 (20:04):
Doing in Canada that makes it so inexpensive?
Speaker 2 (20:06):
They don't have to deal with all the bureaucracy that
we have here. That's all and everything else. I mean,
I mean, did you did you where's Majerna done. I
think it's like the Netherlands or something like that.
Speaker 1 (20:17):
Yeah, maybe, I guess neither.
Speaker 2 (20:19):
The cost of that drug is less than two hudred
bucks there from Manjourno.
Speaker 1 (20:23):
It's thirteen hundred dollars a month.
Speaker 2 (20:24):
It's thirteen hours not here and the pharma and they
don't even recommend it as a first line therapy there.
Speaker 1 (20:31):
Oh I'm sure of that. Is that PBMs in the
middle there that are driving them? Oh?
Speaker 2 (20:36):
Absolutely, yeah, absolutely, I've heard. I actually have friends that
are in that business, and they say, we add on
two to three percent on the cost of drugs.
Speaker 1 (20:44):
Yes, and you know they're going after payday lenders all
the time for charging you know, userus rates. I mean,
you think that they eradicate the pharmacy benefit managers. I
know there's talk about doing.
Speaker 2 (20:55):
That, but I mean, I just I think there's way
too many midtal men in that point. But again, it's
it's even the manufacturers. I mean, they know we're we
are one of the number one countries for paying for
development of these drugs, and they know, hey, if I
can get my drug in America, I can make money.
And they do. But again it's like, why can I
(21:17):
get my drug through India or through the UK or
Canada at a fraction of the costs. You know, I'll
tell every listener Canada Drugs online dot Com is where
were you issue? You send a lot of our clients
go look at your drug there. I have clients at
literally on medicare doing getting their drugs from there because
it's cheaper than even get they get on their prescription
(21:38):
party plan.
Speaker 1 (21:39):
You know.
Speaker 2 (21:40):
So it's you have to utilize the tools there and
you know this are the things that we help clients
with all the time.
Speaker 1 (21:45):
All right, Well, I know there are health savings accounts
and flexible spending accounts and these are pre tax dollars
that are placed in them. Correct.
Speaker 2 (21:53):
Yeah, so hsas are really good plans.
Speaker 1 (21:56):
That's the one where you get to keep the money.
Speaker 2 (21:58):
You get to keep the money. Y, Yes, health savings
account it works just like an IRA, but you can
use it for medical expenses. The beauty behind hsas is,
you know, I'm a firm believer and when I was younger,
I started funding my HSA before I was married with kids,
you know, I mean, I just started started shocking moneyway
I wasn't really having a lot of medical expenses. So
I was like, I'm just gonna keep putting money into
(22:18):
this extra account and I can use it the rest
of my life. And you know, when you have a family,
we depleted it pretty quickly. A couple of kids later,
you know, and then all my money's gone.
Speaker 1 (22:28):
But we utilize them money. Forget that I have it.
Don't even use a whole bunch of money.
Speaker 2 (22:32):
Don't even use it. I mean, it's the best part,
but it's an IRA. You can use it to pay
your part B premiums, Brian, so you know, I'm sure
you're gonna be paying some ERMA, so you know you're welcome.
So you can use to pay those part B premiums.
You can use it to cover out of pocket expenses.
You can use it to pay off you need cataract surgery.
My parents just had cataract surgery, both of them, and
(22:55):
they you know, medicare only covers like the fifteen hundred
dollars lens, but these, like the better lenses for your
eyes are like six grand. So who pays the forty
five hundred dollars difference, Well, your HSA does. That's why
you have it. So you can utilize that money. So
it's good flexible spending counts. You'll see them a lot
through employers if you can really figure out and control
(23:16):
what you're paying out of pocket, and like I have
these expenses, I know I'm gonna do FSA. Flexible spending
accounts can work the problems that might does disappear at
the end of.
Speaker 1 (23:24):
The year's see, that's why I would never go down.
Oh my god.
Speaker 2 (23:26):
I talked to my brother like six months ago, and
he had just gotten married and his wife, you know,
she's like, I've been funding my FSA for like four years.
I'm like, what do you use the money for? She goes,
I don't. I've never used any of the money.
Speaker 1 (23:39):
I'm like, disappeared.
Speaker 2 (23:41):
You're telling me you're you're funding this every year for
thousands of dollars and because you're like, oh, it's all
pre taxing, you ever use it? She goes No, I'm like,
oh my god, that might just gone. It's bad for it.
I'm shocked to hear that. I'm not shocked because i mean,
I'm sure people it happens to them all the time,
you know, so that road I.
Speaker 1 (24:00):
Forget that even have an HSA. That's why it's money
still in there, no expense because I'm like, you know,
I'm oblivious to that.
Speaker 2 (24:06):
Hope isn't listening to show because I did not tell
him that. I just told them, like, stop doing it. Yeah,
I didn't want to throw under the bus. That's not
a fight I want to do.
Speaker 1 (24:15):
When he's going to pull up the account at some
point realize there's nothing in it.
Speaker 2 (24:20):
It's her count, it wasn't on his. But it was
just like.
Speaker 1 (24:25):
The show. All right, So hs ages unless you have
a firm grasp on what your annual expenses are for
medical claims, that case, you might want to go at FSA,
but you better use it on the fly while you're
incurring these expenses. Otherwise, sounds like health savings accounts a
way to go. And here's one I think we've talked
about before, avoiding unnecessary er visits. The last thing you
(24:47):
want to do, if you can avoid it, is go
to a hospital. Yeah.
Speaker 2 (24:51):
I mean, I'm telling you right now, I don't go
to emergency unless you think you're dying, Like did just
this shar out of pocket expenses now are just huge.
I mean, the best thing I can recommend to every
listener is today, you know, today's Sunday. Like literally just
go online, look up local urgent cares to you and
(25:11):
find but find out what they do, like do they
have an X ray machine? Can they stitch me? Can
they what can they do with these facilities and that
way you just know. But god, urgent care, I mean,
I've they're five to ten percent of the cost of
what it costs to the emergency room. And you know,
(25:33):
and a lot of the plans that we build for
clients literally if they go to urgent care, they're actually
making money, which is just phenomenal. If you don't understand
the process of how they make my go back and
listen to a couple of my shows, like I talk
to you about how you can make money on health insurance.
But urgent care, God, I mean, you just know. And
some of these have phenomenal facilities. I've seen big imaging
(25:54):
machines at some of these urgent cares. I had actually
something in my eye and they had a whole eye center,
Like they only set me down and wash it out,
And I'm like I would have gone through the emergency
room for this. You know, It's like those aren't emergencies anymore.
Even broken bones, you know. I mean you can know
where your urgent cares are and find out, like I
know three urgent cares with me and the watch days
(26:16):
they have X ray technicians there, and they're all three
different days. And don't go, Okay, my kid gets hurt
on a Monday, I'm going here. My kid gets hurt
on a Wednesday. I'm going here, like I'm not going
to go spend five hours in an emergency, you know,
and then it's five grand you know there, Just this
doesn't make sense. It doesn't make sense. Yes, yes, and
used tele purgatory. Yes, yeah, urgent and he used telehealth.
(26:37):
You'd be surprised. I mean, I've literally I've sliced my
hand open. I called through my telehealth app, which is
right on my phone. It was a FaceTime message. I
showed him my open wound. He goes, yeah, you can
get that futured good urgent gear. I'm hurt oka good
urgent gear. But I did it with my telehealth and
that was free. Otherwise, why would I go anny waste
my time?
Speaker 1 (26:57):
Yeah, Well, there's some homework for the listeners out there.
Find out where your local urgent care facilities are. There's
literally one across the street from each other on Montgomery.
I could throw a rock basically from one urgent care
to another one. Now, I don't know which services they offer,
but I know where they are in the event something
might happen. And actually we've utilized them in the past before.
Speaker 2 (27:18):
I got a good friend of mine has like he's
got a cold plunge at his urgent care. He's actually
on our show a few months ago.
Speaker 1 (27:24):
Oh that yeah, yeah.
Speaker 2 (27:26):
Yeah, And they do all kinds of testing right there
in their office, testosterone and all that type of stuff.
The whole holistic you know, you know approach. But I mean,
like they're out there, fine one, you know, know where
your local one is. Don't don't wait till it is
an emergency situation like oh I got to go to
the hospitals that I'm the where to go.
Speaker 1 (27:46):
All right, Well, wrapping up in the last minute and
a half or so, we've got here. Anything you want
to run down by way of cost saving options for folks.
Speaker 2 (27:54):
Yeah, the biggest thing I would tell you as far
as cost saving and outside of everything that we talked about,
is just understand and your policy, really understand it, look
at it, open it up. Know what your copays are
for certain situations, you know, and if you don't know
how to read that, give us a call, you know
that have that initial conversation, and we do that with
(28:18):
everyone that calls in. We give you. We look at
your plan, we go over, we see if there's any
holes or anything that we make recommendations. I will always
tell you this, if you're in the best plan for
your family, I'll absolutely tell you to stay there. Oh
with that question, you've just surprised how many clients I've lived, Well,
they're not even clients, and may because we nevern't able
to help them. I we go don't let anybody take
(28:38):
this from you. Someone's gonna call you six months from
now and they're gonna tell you they are the best
things since slice spread. And it's not because the plan
that you have is the best plan out there right now.
Stay where you're at.
Speaker 1 (28:51):
Yeah, And that's actually the best thing can happen to
somebody that comes to your door, although that would deny
them the opportunity to be able to have you solve
the problems, because as if they are insured through you,
then you are the problem solvers for everybody you get
at no additional costs. You can get in touch with
John and the team. Make sure you can. You can
work with a team member. You don't have to work
exclusively with John. That's five one three eight hundred call
(29:12):
five one three eight hundred two two five five get
the process started. Fill the form out online at coversinc
dot com. This has been another edition of Rethink Healthcare
together with John Roman from Cover. Since he John, it's
always great talking with you.
Speaker 2 (29:24):
You too, Brian, Thank you
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