Episode Transcript
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Speaker 1 (00:05):
Hi's Brian Thomas, host to the few five Care See
morning show Lease Monday through Friday. I enjoy my time
every Sunday with John Roman as well as all the
team members. From time to time we get the team
in here. But remember you can rely on any of
the team members that cover sincey to help you with
your just generally health insurance needs. Last week we talked
about long term care coverage, which you know freaked me out.
(00:26):
En if I reached out to John myself and have
him working on helping my wife and I get a
policy for long term care. But to get in touch
with them, and you're gonna want to it's five one
three eight hundred call five one three eight hundred two
two five five online Coversinsey dot com And as a reminder,
you can always regardless of which state you're in, John's
team is nationwide, so if you happen to be tuning
(00:49):
in from I don't know, I got listeners from Mississippi
and New Hampshire as well as other areas in the country.
He can help you out. And it's really important that
you get John to work on it. To take a
look at your medical insurance where you stand. They do vision.
They do dental long term care coverage, which again we
talked about last week. I can't stress enough after talking
(01:09):
to John about that one, the importance of looking into that.
But you don't have any obligation working with cover sincing
the team. You're not beholden to them. They're not going
to sell you information, but they are working for you
and at no cost to you. They'll take a look
at where you are in your life, what you've got
by way of medical insurance coverage, and probably come up
with a package, a better package of plans. And they
(01:30):
work with hundreds of insurance companies with access to thousands
of policies. But they're not working for those guys. They're
working for you, so they find the best possible solution
for you, giving your current circumstances. John always good to
talk with you, man. And in the past you've referred
to it as holes in the bucket. You know you
(01:51):
got your medical insurance, and you know you get it
through your employee. You're like, I'm covered, I'm covered. I'm covered,
and you always kind of joke about that. Now you're
not covered because you know, given any given circumstance, in
any particular claim that may not be covered by the policy.
Or you've got nine thousand dollars out of pocket liability
before the coverage even kicks in, which is just a
(02:11):
remarkable concept for me that that I struggle with that
one all the time. Or there are areas of coverage
or areas of your medical insurance policies that there is
no coverage, and that'd be a hole in the bucket.
Oh yeah, And so what you do is you fill
the holes.
Speaker 2 (02:27):
Oh yeah, I'm the guy that walks around on with
these leaky buckets, and I just take these big pieces
of tape as a form of policy, and I cover
the holes, right. And you know, I told you up front,
you know, I got into this business just shere as
of needing money to pay for law school, you know.
And that's that's how I got into this industry to
(02:49):
begin with. Because I made a career out of it. Yes,
But I mean I was the weird person that liked
to read contracts and I'd like to understand how things
were written, and it intrigued me. And when I got
into this business, it was like the first thing I
started doing was reading all the contracts that people would
buy for health insurance and it's and I would just
go around with a highlighter like that's not good.
Speaker 1 (03:10):
That's not good.
Speaker 2 (03:10):
That's not good. So when someone would come to me
and go, oh, I'm with XYZ insurance company, like, well,
I have a copy or policy here, let's kind of
go over line by line, they like, I don't want
to do that. I'm like, okay, here's the highlights, right,
and this is kind of where you're exposed, you know,
and you know, I'll kind of give you a brief
little story here, because again, we deal with so many
different dynamics. This was a few years back. We had
(03:32):
a we had we had a client. It wasn't even
a client, it was actually a family friend. Now they're
a client, But basically the situation was, you know, she
was getting benefits through her employer, uh teacher. The husband
was actually construction really just a self employed guy, sole
proprietor and did a bunch of remodels and different stuff
(03:54):
like that. And the situation was he ended up somehow,
I guess, closing off of a room and then doing
some work inside of it with the gas machine, and
I guess he didn't realize he was literally, you know,
giving himself carbon monoxide poisoning while he was in there, right,
and you know, he was on his wife's group health
(04:14):
insurance plan. Ended up going into the hospital. You know,
they ended up putting him into one of those hyperbaloch
eric chambers and stuff like that. They pump oxygen and
stuff back into him. But long story short, very expensive bill. Well,
the problem was he was on his wife's group health plan.
And what most people don't understand is like, oh, that
(04:35):
was great. You know, I'm self employed, my wife carries benefits.
It's really cheap for me to be on it. But
what way they didn't realize is that group health plans
do not cover work related injuries. That's why you have
workmen's comp that's exactly right, that's right. So it doesn't
cover your spouse when they get hurt on the job.
(04:57):
So I think the bills were upwards of over sixty
thousand that we're not paid because it was a work
related problem. And of course here in Ohio, it's not
mandated that if you're a self employed person that you
carry workmen's colm.
Speaker 1 (05:12):
That's the whole of the problem. They're hugely self employed.
Speaker 2 (05:15):
Huge hole, huge hole.
Speaker 1 (05:17):
So even though you are self employed, it's still not
a covered risk. Correctly, that's an eye opener that's worth repeating.
Speaker 2 (05:27):
I'm just I'm pointing out there right now because I
know a lot of your listeners are exactly in that boat.
I talk to them all the time. They're like, well,
you know, I don't really need it. My wife my plan,
My wife's really cheap. I'm like, okay, well what do
you do for a living now? I'm a I'm a roofer,
you know, I'm a construct I'm a plumber. God forbid,
I'm a electrician. I'll let you keep myself or something
a job, you know. In my situation, I mean, I
(05:47):
guess I could fall out of my chair by work,
but I mean there are there are risks that things
could happen. But especially if you're in one of those professions,
you know, really look at other alternatives that we can do,
and we can. We'll talk about some of those things
here today. Where again, it's just a hole in your bucket, right.
I'm not saying I have to get you out of
(06:08):
your wife's group plan and buy some more expensive plan,
you know, but there's things that we can do in
that context.
Speaker 1 (06:13):
That's that's more than a hole. Yeah, that's not even
having a bucket.
Speaker 2 (06:17):
It's a gusher. Yeah, yeah, it's definitely.
Speaker 1 (06:20):
It's an eye opening fact. Yeah.
Speaker 2 (06:22):
And I really wanted to bring up there because that's, again,
that's a huge gap since.
Speaker 1 (06:27):
I've never been self employed, obviously, that's never come across
my radar, which is why I'm reacting this way. Maybe
a lot of people know this, but clearly he didn't.
Speaker 2 (06:35):
No, I mean most people don't. I mean, and it
takes someone like me, you know, really being able to
have that conversation and get in front of that type
of person because there are usually people aren't calling in
because again he's like, well, I'm one hundred bucks a
month of my wife's group plan. I don't need to
go call John, you know, but he probably should have. Yah,
and he's a friend of mine, so you know, And then.
Speaker 1 (06:59):
He knew, he knew what you did for a living.
Speaker 2 (07:02):
I know, I know. And again, like I said, I mean,
I don't know everybody's dynamic. I didn't know he didn't
carry workman's comp you know. And it just those are
situations in life that you know, they're unforeseen and unless
you have a conversation with someone that's an expert in
that field, how would you know, you know, at the
end of the day.
Speaker 1 (07:20):
Well, and that's one of the ways you end up bankrupt.
Speaker 2 (07:22):
Absolutely, So again you know, like you know, just you know,
other gaps that you really want to look at, you know.
I mean it's again, we always say deductibles. That's the
easiest thing to look at, because that's the number that
most people are privy to, you know, knowing like, okay, yes,
deductible's five grand, nine grand, whatever it is. But you
have to remember too, it's that co insurance. I always
call it that second deductible. Then most people think like, oh,
(07:45):
I got a twenty plan. That's good, that's good? Is it?
You know?
Speaker 1 (07:49):
Is it?
Speaker 2 (07:49):
You know? What's how much of that twenty percent do
you owe?
Speaker 1 (07:53):
You know?
Speaker 2 (07:53):
I used to see plans back in the day, Brian,
this is before Obamacare, and it actually still exists because
people decided to keep them. But they had twenty percent of.
Speaker 1 (08:01):
Everything, including a hospitalization.
Speaker 2 (08:03):
Well there was no stop loss. So used to have
policies that. I mean, they're still out there. I run
into them, not very frequently anymore, but I mean, can
you imagine running up a five hundred thousand dollars bill
and twenty percent.
Speaker 1 (08:16):
I mean, that's I had to say.
Speaker 2 (08:18):
I'm not trying to laugh at that point, but it's like, oh,
mind boggling that there still exists. But I mean they're
out there. I mean Medicare Medicare the part be coverage, right,
you know, you owe twenty percent, So if you don't
do a supplement or at even an advantage plan, you're
on the hook for twenty percent of whatever your bill is.
And you know, I mean people thinking, well, I mean
(08:39):
a couple hundred bucks twenty percent is not bad. Okay,
what about a couple hundred thousand you know later in
life if you don't do something or have a plan
or take out a Medicare supplement to cover that. So
again there the co insurance could can absolutely destroy you.
And even in today's market, you look at the bronze
(08:59):
and silver, you know, marketplace plans, O, bomacare, whatever you
want to call them. I mean somebody's are seventy thirty,
sixty forty, you know, so they're not even as good.
So you know, forty percent of a bill is a
lot worse than twenty percent.
Speaker 1 (09:11):
And again, as you point out, that's on top of
the out of pocket responsibility.
Speaker 2 (09:14):
That's on top of the deductible. Yeah. So it's like
you know, and that's why I always call it smoke
and mirrors. I get people all the time going, oh,
I chose a fifteen hundred dollars plan. Okay, it's good,
but you're out of pockets still ninety two hundred. Yeah
you know, so yes, I mean, let's be honest, if
you go to the emergency room, you're probably hitting the
entire ninety two hundred.
Speaker 1 (09:34):
You can't walk into a hospital without getting a multiple
thousand dollars bill.
Speaker 2 (09:37):
Absolutely. And then the other big gap that most people
aren't always privy to is the ad of network. Right, So,
I mean, hopefully you have a PPO type plan, but
what most people don't realize is that the ad of
network even on a PPO I'm not meaning to get
into the HMOs where you have zero coverage out in right, right,
But if you're at a network on a PPO plan,
(09:59):
the out of pocket usually it's double. Right. So if
if you have an a out of pocket for your
family that's eighteen grand in network, well it could be
thirty six thousand at a network.
Speaker 1 (10:11):
You know, and these numbers are eye opening.
Speaker 2 (10:14):
You know, and like I said, I mean you tie
it back to you know, even what we talked about,
you know, some of the things last week. You know,
it's you know, bankruptcy comes to mind at these points, right,
I mean clearly. You know, if you have a thirty
six thousand dollars bill, I mean, it's bankruptcy, right, and
you know it just it's just unreal, you know, and
you think about all the other things that some of
(10:35):
these insurance companies don't coover. I mean, specialty drugs, mental health,
and some in some situations, right, alternative care.
Speaker 1 (10:43):
You know.
Speaker 2 (10:44):
You know, I just just talking to a client the
other day that was talking about meeting braces for kids
and stuff like that, and now their dental plan wasn't
covering it and they were a lot more money out
of pocket, or oh I need an implant, you know.
I mean, there's there's so many gaps out there, and
in all facets of insurance, not just the health side
or the medicare. I mean, it's it could be the
(11:04):
dental sidean god. I mean I've had people even coming
to me and talk about, oh I'm great, I got
life insurance, and you find out they bought it through
a credit union that they got it for really cheap,
and you find out it's an accident only plan. You know,
I got one hundred thousand dollars through my credit union
and I'm paying like a couple of bucks a month.
I'm like, well, it only covers if you die from
an accident, right, right, I mean, anything else happens your life,
(11:27):
it pays nothing. Well, I didn't even know that, right.
Speaker 1 (11:30):
That's the film noir movie Double Indemnity.
Speaker 2 (11:33):
I haven't seen that one.
Speaker 1 (11:34):
Oh, you kidding me, Well, that's your I know that's
your forte oh film noir. I love film noir. Yeah,
the Double Indemnity.
Speaker 2 (11:40):
I have to watch that one. I'm a fan too,
but I haven't seen that one.
Speaker 1 (11:43):
Fred McMurray and Barbara Stanwick. The pattern in the movie
is just classic film noir.
Speaker 2 (11:52):
Well that's the best part. That's why I love Quentin
Tarantina movies.
Speaker 1 (11:56):
Yeah, yeah, Tarantine. I'm sorry, we're going down already. We're
supposed to talk about insurance here and the and the
holes in the bucket anyway.
Speaker 2 (12:04):
No, that's great, but I mean again, like I said,
it's just it's looking at those examples. Is looking at
those scenarios. I mean, this actually was a public report
where were kind of hitting on bankruptcy. But according to
American Journal of Public Health, almost two thirds of bankruptcies
are tied to medical issues. You know, and listen, at
(12:25):
the end of the day, most those people had health insurance.
That's the worst thing to think about it. I'm paying
for something I never looked at it because either I'm
getting it through an employer. I'm fine, I have health insurance.
It's like you have a car, but doesn't mean it's
going to go down the road all the way before
it dies, right, you know, It's you have to pop
the hood and see what kind of engine you have,
(12:46):
you know, if you don't have a V six or
a V eight. I mean, you'd be surprised how many
times I pop the engine of an insurance contract and
I look inside at it and it's a freaking hamster wheel. Yeah,
you know, And I mean, like, this does not even
gets you to inn the your driveway Sarah.
Speaker 1 (13:01):
The nineteen sixties British Laylan product. There's some car people
out there that get that, I'm sure, but I'm I
like the whole thing. I've opened that up and I
just see a little rat running around on a weel. Yeah,
I mean, and the and that's the reality of it,
and that's why it's so good to look at it.
And again, it doesn't make a difference of what stage
(13:22):
you come to us. You know, if you if you
are on a group health plan, you know, we can
look at some of those gaps, you know, if you're
a husband's self employed or vice versa. I mean, let's
have a conversation. You know, we talked about long term care.
I mean, there's so many things that just people don't
have all the insurance that they need for And I'm
not a big proponent saying you have to be over
insured in all aspects, but a little insurance and all
(13:45):
those little buckets makes a lot more sense at the
end of the day. And you can demonstrate on paper
the value of investing a little bit more in these policies,
because I think people get the perception like, oh, he's
just layer me up with a whole bunch of different
surantce cover all these holes in the bucket, and it's
just gonna cost me a blue billion dollars s for
on a monthly basis. But that's not it.
Speaker 2 (14:06):
That's no you know the funniest part about it is
I always tell clients, and I do this a lot
with the groups. I'm like, listen, you're gonna the strategy
that I'm gonna share with you is gonna be definitely
different than anything you've ever seen before, because I I
to be honest with you, I hate selling someone in
insurance policy that's through one insurance care even all their products, right,
(14:29):
because not every insurance company does has the best price
or has the best coverage in each of those areas.
Speaker 1 (14:35):
Right.
Speaker 2 (14:35):
So the insurance companies know, like, hey, if you buy
our medical and our dental and our vision and our
accident policy, you know it's we're gonna give you a
really good deal. But then you start looking at you
know what am I actually paying for that accent policy
that's fifty percent more in half the coverage than this
other company. So I tell people all the time, I'm
like the mad scientists. You usually come to me like
you were buying a vehicle and go I always use
(14:58):
the truck analogics of a big truck guy. So it's like,
I love how Dodge interiors are, like those new panels
and everything that happ inside the Dodges are great. I
love my forward engine, but I really wish I could
have a Chevy Tailgate that has like a five fold
down thing.
Speaker 1 (15:12):
Right.
Speaker 2 (15:12):
I can literally build that for you, right, And That's
what I'm doing when it comes to your health insurance.
I look at health insurance and all your insurance products
is being a portfolio. I want to be like a
financial planner for you and go, hey, I would like
to sell you this policy, but this carrier has better
product for this aspect. I'm going to sell you this
one and we're going to build you a portfolio and
get it. At the end of the day, you're like, oh,
(15:33):
what am I supposed to do? And you just give
us a call. I'm like, this is what happened to me.
We will tell you which one to.
Speaker 1 (15:37):
Use, right. And I can understand how that because it
isn't the traditional way of getting your insurance. That having
four different policies with four different companies issuing them, it
could be a little confusing, but it's a great opportunity
to emphasize that when you work through John and the
team that covers since you keep them and at no
(15:58):
additional costs to you, they will solve all of your
problems for you, Like I was mentioned denied claims. I
mean the headache and the indigestion. Just even thinking about
spending two hours on the phone with an insurance company
try to get something sorted out. I don't have to
do it. Just call you, Hey, we figure this out
for me, would you, John, Thanks, rather appreciate it. Get
back with me when you let me know what's going
to happen. That's the same way with how the insurance
(16:20):
policies work. You get in the scenario you're like, wait
a second, now, which one do I go with and
what do I need to do? Just a quick phone
call and you'll see you're like, oh, you've got the
following do this and turn to use this policy and
it'll cover you.
Speaker 2 (16:32):
We literally have a black book of numbers for insurance
companies that when we find a good customer service person,
we write their name down and get their direct number
because I want to bypass the prompts and the loops
because we have to do it too, you know. And
you know, one of the biggest things Brian just just
kind of like a caveat here is I've trained my
staff now, especially dealing with some of the Medicare insurance
(16:54):
companies like the Medicare advantage side. A lot of the
carriers are outsourcing a lot of their phone rooms. They're
like India and outside the country. I've literally told them,
I was like, if you, if someone picks up with
the customer service side and you can't understand them for
the first fifteen seconds, hang up.
Speaker 1 (17:09):
And call back Steve.
Speaker 2 (17:10):
Yeah, but it's just like if you it's hard to want,
it's even hard for us to understand, like, you're not
going to get anywhere with them, then you just hang
up and recall in Yeah, And it's just that's just
the nature of it. So again, if we can help
alleviate that stress on you and at least get you
the answers or point you in the right direction, I mean,
that's that's gonna save you a lot of time.
Speaker 1 (17:28):
All right. So secondary insurance, these are your whole easier,
your your whole fillers that we're talking about here. So
let's walk through it and talk about what we're talking about. Yeah,
so think about things. You know, again, we've highlighted some
really important pieces here, but I can't stress enough where
I think one of the most important policies that you
can ever have in your life, regardless of where you're
(17:50):
getting your primary insurance is getting good critical on this coverage. This.
Speaker 2 (17:55):
I mean I've literally watched this, Brian changed lives of
my clients that have it. If I have a client
that calls in we find out they have cancer, the
first question I asked my care department is do they
have a critical of this policy. We stress it with
every client. Not everybody buys it, right, and they go, yes, okay.
The first thing I want you to do is get
the paperwork out to them so they can fill it out.
I need a doctor's neck, you know, just to show
(18:16):
that they actually have cancer or somebody. I need a
doctor's record. And then let's get that money in their
hands as quickly as possible, because the insurance company is
just going to send you the information and they're going
to like whatever. When you fill it out and get
it back to us, we'll pay you if it could
be a month from now or six months, right, but
we want to try to step in and like I
need this because I know at that point in your
life you're thinking about eighteen million other things, right, and
(18:37):
these are the policies that if you get a cancer diagnosis.
For example, they send you a fat check, that check
fat check. I've had clients literally get within the last
couple of year, I had to client get over one
hundred grand. And this exact on one of these policies,
you know.
Speaker 1 (18:53):
I mean, it doesn't completely take this thing out of
getting a cancer diagnosis, but it does.
Speaker 2 (18:57):
So no, I mean, but think, I mean, there's just
so many aspects to that. I mean, I know there
are things that that person might run into in their
life that it could be a experimental drug, right, I
mean then not covered by health insurance. It could be
maybe some people want to try some of the alternative routes.
You hear all these alternative routes. Now, I've me I
got things to pop up my Instagram feeds and stuff
(19:18):
like that, alternative forms of treatment for cancer. I mean,
health insurance is not going to cover those things. Think
about all the things that you're you're not working anymore, right,
I mean, you're going getting chemo a couple times a week.
I mean, how often are you going to go back
and go do roofing after that?
Speaker 1 (19:34):
You know what I mean?
Speaker 2 (19:35):
Like you're not you know, and I always say you
like you're the horse that pulls a cart every day.
The horse is locked up in the barn getting medical treatment,
the cart stay still, you know, And so that's a
huge piece of life. So again that's a huge gap
because no one's covering loss of income and no one's
going to cover the fact that maybe you're up here
and decide that the best place for treatment for you
(19:55):
is M. D. Anderson in Houston, which is one of
the best cancer hospitals in the world. Well, who's putting
you up in a hotel room while you're staying down there?
How are you paying for that?
Speaker 1 (20:03):
The critical illness criticalness policy? And in terms of affordability.
Speaker 2 (20:09):
Again, like I always say, the younger quer the cheaper
it is. So I mean, listen, my kids have it.
My son, my eighteen year old son, I just upgraded
his policy becausehen he got eighteen. It's like I'm paying
for it, but it's a fraction of the cost. I mean,
I think I got him on a hundred thousand dollars policy.
I don't even think it's twenty bucks a month, you know.
And I mean it's locked in for the rest of
(20:29):
his life. I'm like, you know, once he goes out
of college, like you can pay for this. Now, I'll
pay for it. Why you have it because I just
wanted to planet. But again, I mean even ten grand.
You know we're writing policies for ten grand, even for
people in their fifties, and you're talking maybe thirty bucks
a month. I mean, ten grant can cover all you're
out of pocket expenses. How muche is not to know
that you get cancer and you're out of pocket's nine grand.
(20:50):
You don't even worry about paying any of the bills
you have to check there. I mean, so at any level,
it's smart. And then we've always talked about it. You
can even tie these into the life insurance policies. We
get back to that. Even with the long term care
from last week. You know, you can have life insurance
policies that have criticalness. I have a million dollar policy
with one insurance company that their criticalness Brian pains out
(21:10):
twenty percent. Really, that's two hundred grand if I ever
had a cancer or heart attack. So again, buying these
and doing the right thing up front, it makes it
makes so much more sense, and it gives you more
availability to have I mean, I don't just have to
die with that policy.
Speaker 1 (21:28):
I get an answer that is just that that's an
amazing perk of that type of policy, right, yes.
Speaker 2 (21:33):
Yes, and these are but again, these are the conversations
we have our clients and and your listeners. So again
it's it's it's filling in those huge holes. Big proponent.
On the next topic here, hospital and Dendie plans. You know,
and this is something we structure with almost every health
insurance package that we write because two things here, hospital
and demnity plans. They don't care where you go as
(21:55):
long as it's a doctor or hospital in the United States.
There's no add to network with these plans. You want
to go to some hospital in California from Ohio, I
mean you can, doesn't make a difference. Clinic Mayo, clinic
doesn't make a difference because just like you know, just
like the Duck plan, right, it's a cash benefit. Indemnity
basically means cash. So there's a cash benefit tied to
(22:16):
your plan. You know, we have plans go that can
literally pay anywhere from a couple hundred dollars a day
when you're in the hospital to over ten grand a
day when you're in the hospital. Wow, you know, and
you know, especially for our higher income earners. I mean
that could be huge, That could be a supplemental cost
savings for you for you know, lost income. But these
(22:39):
are zero dollar reductibles. I always talk about people are
prohibited from sometimes using health insurance because they're afraid of
what it's going to cost them to use it.
Speaker 1 (22:47):
Right.
Speaker 2 (22:47):
Oh, I have I know someone that's a good friend
of the family that has not gone and got surgery
because she doesn't want to do it, because she doesn't
want to pay for it. You know, doesn't sound prudent,
it's not. But people, but Brian, people make those decisions
all the time, all the time. You know. People make
the decisions on dental right. Oh, but ever just pull
the tooth, you know what I mean, instead of fixing
(23:08):
it because I don't have the money to pay for it. Right,
and indemnity plans help alleviate that stress of having to
make financial decisions based upon your health because not only
are these first dollar coverage, Brian, but they can overpay,
you know, And there's so many clients that if I
literally called us and goes John, I just got a
(23:28):
big check from the insurance company. Do I send this
to the hospital? I'm like, no, that's your money that
you you bought a plan that ended up overpaying on
your medical expenses, that's yours.
Speaker 1 (23:39):
You get to keep that. I've mentioned many yes've done this.
Speaker 2 (23:42):
But Brian, it's not just your son. It's almost every
person that listens to your show. It has them, and
we get them all the time, you know, and it's
just it's peace of mind, but again, helping alleviate those
out of pocket expenses. We do this on the group side.
Almost every group that's ever called in from your show
that the shows that we've done and Little Life helped,
all of them have indemnity policies tied into their packages.
(24:05):
And you know, it's it's just always funny because they
don't understand it up front, but then usually about six
months later like ooh, we just had somebody use this,
and like John, it worked exactly how.
Speaker 1 (24:14):
You said the imagine that.
Speaker 2 (24:17):
So from John, Yeah, so, I mean, but again, indemnity
plans you can add to any group plan. Even in
that situation with my friend that you know ended up
getting the carbon monoxide poisoning, if you would have had
that with his wife's group plan, that plan would have
still paid because it's twenty four to seven coverage. They
didn't care if he was working or not.
Speaker 1 (24:35):
All right, the guy they should have been a worker's comp.
Speaker 2 (24:38):
Yeah, absolutely, it would have paid. It would have paid
it his xt situation. You know, kind of getting in
some of the more the cheaper plans. Brian, just real
quickly that are really important. Think about things like accident policies. Right,
accident policies are dirt cheap. Two thirds of all hospital
claims are resulting from accidents. You can add an accident
policy to any health insurance plan, or if you don't
(25:00):
even have insurance, you can just buy an accident in
policy and you can get plans that pay anywhere from
like three grand to twenty five grand on an accident.
And what they do is they cover the out of
pocket expenses on your primary insurance, or if you don't
have primary insurance, they'll pay the entire bill. So you
look at the average cost of a broken leg at
the emergency rooms, like five grand. Well, most people's deductibles
(25:21):
are higher than that. Yeah, so why wouldn't you buy
a plan that's twenty to thirty bucks a month that
if you have one accident in the next fifteen years,
it pays for itself.
Speaker 1 (25:32):
I love when you put it in those just really
stark terms. It's like, see, I mean, that's the way
I look at everything. I always I mean, and this
is kind of a caveat. When I look at clients
that want lower reductibles or higher re deductibles, I'm going,
if you can replace that deductible in savings more than
three years, take the higher reductible, you know, And that's
usually what it is. They're like, Okay, well the high
(25:53):
reductible is so much cheaper. If I had a claim,
the difference in price would take me six or seven
years to pay it back.
Speaker 2 (26:00):
Then to take the higher reductible it makes more sense, Well,
makes more sense to do the accident and policies. So
a lot of times I'll ad buy his clients, take
a little higher reductible, take that savings, and then buy
the supplemental that literally covers it all. So we build
avalut to just so many unique today doing something for that.
He has something for that, got something for this too.
(26:20):
But let's touch on gap insurance real quick here in
the remaining Yeah, I mean, just think about other gaps
that that are out there. You know, We've even mentioned
things like medicare right, I think. I mean we just
say gaps is kind of in general, like getting a
good Medicare supplement. I mean, if you're out there and
you're like, I'm good, I'm just on Medicare, and be
shocking how many people don't buy the other coverages. You know,
(26:41):
buy something along that line, you know, you know, to
to help out in those situations. But but a gap
can be at any any point, you know, I kind
of say this is more of a broad term. Gap
is long term care coverage? You have a gap. Gap
could be just your life insurance policy that you think
you have a life insurance plan through work, and the
gap that you have is the fact that it's not
(27:02):
going to go with you when you retire, so when
you actually really need the coverage, you're not going to
have it later on. So again, just think about that
as a gap. And you know, our goal really here
is just to kind of understand where they're at and
then show you the options to alleviate them.
Speaker 1 (27:18):
Well, and one of the props I'll give you and
your team it covers sense is that people don't have
to remember all of this and write it down and
have to ask you're the one that presents the information
and the options to them and lets them know where
the holes are in the bucket and you have a
solution to deal with that.
Speaker 2 (27:37):
So yeah, I mean, at the end of the day, Brian,
the biggest thing is just we want to alleviate the
hardships when you have that worst time in your life.
And I mean, and I think that's where you know,
not only our team helps prevent in the future, but
that's where our team really excels because again, I don't
care where you're at in life or who your insurance is.
(27:58):
I mean if it's with us or somebody else. When
you go through a major life changing medical situation, the
financial burden there and the time constraints on just even
trying to figure out if everything's being paid out right
or what's going on is is unbelievable. I tell everybody,
if you if you got if you had a heart attack,
like the first thing you should do when you get
home is get a big old folder and just start
(28:18):
putting everything in there that you get from the hospitals,
the doctors, the insurance companies, because you get the line
them all up. We can help you through that. But again,
it's it's a hardship. You'd be surprised how many times
behind we've seen billing just completely erroneous. Yeah, Oh we
never got a check from the insurance, but we're just
gonna bill you. I'm like, well, the insurance company is
saying they did sell the check and it looks like
it was cash. I mean, there's just like so many
(28:39):
things that can happen. And again, that time of life
is very hard. But that's why I really love all
these gap plans, because when people get big old checks,
they're not worrying about making ends meet or paying the mortgage.
Speaker 1 (28:52):
That's why you get in touch with John on the
team that covers SINCY. There's no obligation to you. Let
him figure out where you are in life and figure
out a better path for you. You and fill the
holes in those buckets. John Roman or any of the
team members can help you out. Give them a call
five one three eight hundred call five one three eight
hundred two two five to five, form online at the
website cover sinci dot com and again all fifty states.
(29:14):
If you're listening, he can help you out cover since
he dot com has been another edition of Rethink Healthcare
together with John Roulman, and don't forget the team. You
can work with any of them at cover since he
Hi's Brian Thomas, host to the few five Care See
morning show Lease Monday through Friday. I enjoy my time
every Sunday with John Roman as well as all the
team members. From time to time we get the team
in here. But remember you can rely on any of
the team members that cover sincey to help you with
your just generally health insurance needs. Last week we talked
about long term care coverage, which you know freaked me out.
(00:26):
En if I reached out to John myself and have
him working on helping my wife and I get a
policy for long term care. But to get in touch
with them, and you're gonna want to it's five one
three eight hundred call five one three eight hundred two
two five five online Coversinsey dot com And as a reminder,
you can always regardless of which state you're in, John's
team is nationwide, so if you happen to be tuning
(00:49):
in from I don't know, I got listeners from Mississippi
and New Hampshire as well as other areas in the country.
He can help you out. And it's really important that
you get John to work on it. To take a
look at your medical insurance where you stand. They do vision.
They do dental long term care coverage, which again we
talked about last week. I can't stress enough after talking
(01:09):
to John about that one, the importance of looking into that.
But you don't have any obligation working with cover sincing
the team. You're not beholden to them. They're not going
to sell you information, but they are working for you
and at no cost to you. They'll take a look
at where you are in your life, what you've got
by way of medical insurance coverage, and probably come up
with a package, a better package of plans. And they
(01:30):
work with hundreds of insurance companies with access to thousands
of policies. But they're not working for those guys. They're
working for you, so they find the best possible solution
for you, giving your current circumstances. John always good to
talk with you, man. And in the past you've referred
to it as holes in the bucket. You know you
(01:51):
got your medical insurance, and you know you get it
through your employee. You're like, I'm covered, I'm covered. I'm covered,
and you always kind of joke about that. Now you're
not covered because you know, given any given circumstance, in
any particular claim that may not be covered by the policy.
Or you've got nine thousand dollars out of pocket liability
before the coverage even kicks in, which is just a
(02:11):
remarkable concept for me that that I struggle with that
one all the time. Or there are areas of coverage
or areas of your medical insurance policies that there is
no coverage, and that'd be a hole in the bucket.
Oh yeah, And so what you do is you fill
the holes.
Speaker 2 (02:27):
Oh yeah, I'm the guy that walks around on with
these leaky buckets, and I just take these big pieces
of tape as a form of policy, and I cover
the holes, right. And you know, I told you up front,
you know, I got into this business just shere as
of needing money to pay for law school, you know.
And that's that's how I got into this industry to
(02:49):
begin with. Because I made a career out of it. Yes,
But I mean I was the weird person that liked
to read contracts and I'd like to understand how things
were written, and it intrigued me. And when I got
into this business, it was like the first thing I
started doing was reading all the contracts that people would
buy for health insurance and it's and I would just
go around with a highlighter like that's not good.
Speaker 1 (03:10):
That's not good.
Speaker 2 (03:10):
That's not good. So when someone would come to me
and go, oh, I'm with XYZ insurance company, like, well,
I have a copy or policy here, let's kind of
go over line by line, they like, I don't want
to do that. I'm like, okay, here's the highlights, right,
and this is kind of where you're exposed, you know,
and you know, I'll kind of give you a brief
little story here, because again, we deal with so many
different dynamics. This was a few years back. We had
(03:32):
a we had we had a client. It wasn't even
a client, it was actually a family friend. Now they're
a client, But basically the situation was, you know, she
was getting benefits through her employer, uh teacher. The husband
was actually construction really just a self employed guy, sole
proprietor and did a bunch of remodels and different stuff
(03:54):
like that. And the situation was he ended up somehow,
I guess, closing off of a room and then doing
some work inside of it with the gas machine, and
I guess he didn't realize he was literally, you know,
giving himself carbon monoxide poisoning while he was in there, right,
and you know, he was on his wife's group health
(04:14):
insurance plan. Ended up going into the hospital. You know,
they ended up putting him into one of those hyperbaloch
eric chambers and stuff like that. They pump oxygen and
stuff back into him. But long story short, very expensive bill. Well,
the problem was he was on his wife's group health plan.
And what most people don't understand is like, oh, that
(04:35):
was great. You know, I'm self employed, my wife carries benefits.
It's really cheap for me to be on it. But
what way they didn't realize is that group health plans
do not cover work related injuries. That's why you have
workmen's comp that's exactly right, that's right. So it doesn't
cover your spouse when they get hurt on the job.
(04:57):
So I think the bills were upwards of over sixty
thousand that we're not paid because it was a work
related problem. And of course here in Ohio, it's not
mandated that if you're a self employed person that you
carry workmen's colm.
Speaker 1 (05:12):
That's the whole of the problem. They're hugely self employed.
Speaker 2 (05:15):
Huge hole, huge hole.
Speaker 1 (05:17):
So even though you are self employed, it's still not
a covered risk. Correctly, that's an eye opener that's worth repeating.
Speaker 2 (05:27):
I'm just I'm pointing out there right now because I
know a lot of your listeners are exactly in that boat.
I talk to them all the time. They're like, well,
you know, I don't really need it. My wife my plan,
My wife's really cheap. I'm like, okay, well what do
you do for a living now? I'm a I'm a roofer,
you know, I'm a construct I'm a plumber. God forbid,
I'm a electrician. I'll let you keep myself or something
a job, you know. In my situation, I mean, I
(05:47):
guess I could fall out of my chair by work,
but I mean there are there are risks that things
could happen. But especially if you're in one of those professions,
you know, really look at other alternatives that we can do,
and we can. We'll talk about some of those things
here today. Where again, it's just a hole in your bucket, right.
I'm not saying I have to get you out of
(06:08):
your wife's group plan and buy some more expensive plan,
you know, but there's things that we can do in
that context.
Speaker 1 (06:13):
That's that's more than a hole. Yeah, that's not even
having a bucket.
Speaker 2 (06:17):
It's a gusher. Yeah, yeah, it's definitely.
Speaker 1 (06:20):
It's an eye opening fact. Yeah.
Speaker 2 (06:22):
And I really wanted to bring up there because that's, again,
that's a huge gap since.
Speaker 1 (06:27):
I've never been self employed, obviously, that's never come across
my radar, which is why I'm reacting this way. Maybe
a lot of people know this, but clearly he didn't.
Speaker 2 (06:35):
No, I mean most people don't. I mean, and it
takes someone like me, you know, really being able to
have that conversation and get in front of that type
of person because there are usually people aren't calling in
because again he's like, well, I'm one hundred bucks a
month of my wife's group plan. I don't need to
go call John, you know, but he probably should have. Yah,
and he's a friend of mine, so you know, And then.
Speaker 1 (06:59):
He knew, he knew what you did for a living.
Speaker 2 (07:02):
I know, I know. And again, like I said, I mean,
I don't know everybody's dynamic. I didn't know he didn't
carry workman's comp you know. And it just those are
situations in life that you know, they're unforeseen and unless
you have a conversation with someone that's an expert in
that field, how would you know, you know, at the
end of the day.
Speaker 1 (07:20):
Well, and that's one of the ways you end up bankrupt.
Speaker 2 (07:22):
Absolutely, So again you know, like you know, just you know,
other gaps that you really want to look at, you know.
I mean it's again, we always say deductibles. That's the
easiest thing to look at, because that's the number that
most people are privy to, you know, knowing like, okay, yes,
deductible's five grand, nine grand, whatever it is. But you
have to remember too, it's that co insurance. I always
call it that second deductible. Then most people think like, oh,
(07:45):
I got a twenty plan. That's good, that's good? Is it?
You know?
Speaker 1 (07:49):
Is it?
Speaker 2 (07:49):
You know? What's how much of that twenty percent do
you owe?
Speaker 1 (07:53):
You know?
Speaker 2 (07:53):
I used to see plans back in the day, Brian,
this is before Obamacare, and it actually still exists because
people decided to keep them. But they had twenty percent of.
Speaker 1 (08:01):
Everything, including a hospitalization.
Speaker 2 (08:03):
Well there was no stop loss. So used to have
policies that. I mean, they're still out there. I run
into them, not very frequently anymore, but I mean, can
you imagine running up a five hundred thousand dollars bill
and twenty percent.
Speaker 1 (08:16):
I mean, that's I had to say.
Speaker 2 (08:18):
I'm not trying to laugh at that point, but it's like, oh,
mind boggling that there still exists. But I mean they're
out there. I mean Medicare Medicare the part be coverage, right,
you know, you owe twenty percent, So if you don't
do a supplement or at even an advantage plan, you're
on the hook for twenty percent of whatever your bill is.
And you know, I mean people thinking, well, I mean
(08:39):
a couple hundred bucks twenty percent is not bad. Okay,
what about a couple hundred thousand you know later in
life if you don't do something or have a plan
or take out a Medicare supplement to cover that. So
again there the co insurance could can absolutely destroy you.
And even in today's market, you look at the bronze
(08:59):
and silver, you know, marketplace plans, O, bomacare, whatever you
want to call them. I mean somebody's are seventy thirty,
sixty forty, you know, so they're not even as good.
So you know, forty percent of a bill is a
lot worse than twenty percent.
Speaker 1 (09:11):
And again, as you point out, that's on top of
the out of pocket responsibility.
Speaker 2 (09:14):
That's on top of the deductible. Yeah. So it's like
you know, and that's why I always call it smoke
and mirrors. I get people all the time going, oh,
I chose a fifteen hundred dollars plan. Okay, it's good,
but you're out of pockets still ninety two hundred. Yeah
you know, so yes, I mean, let's be honest, if
you go to the emergency room, you're probably hitting the
entire ninety two hundred.
Speaker 1 (09:34):
You can't walk into a hospital without getting a multiple
thousand dollars bill.
Speaker 2 (09:37):
Absolutely. And then the other big gap that most people
aren't always privy to is the ad of network. Right, So,
I mean, hopefully you have a PPO type plan, but
what most people don't realize is that the ad of
network even on a PPO I'm not meaning to get
into the HMOs where you have zero coverage out in right, right,
But if you're at a network on a PPO plan,
(09:59):
the out of pocket usually it's double. Right. So if
if you have an a out of pocket for your
family that's eighteen grand in network, well it could be
thirty six thousand at a network.
Speaker 1 (10:11):
You know, and these numbers are eye opening.
Speaker 2 (10:14):
You know, and like I said, I mean you tie
it back to you know, even what we talked about,
you know, some of the things last week. You know,
it's you know, bankruptcy comes to mind at these points, right,
I mean clearly. You know, if you have a thirty
six thousand dollars bill, I mean, it's bankruptcy, right, and
you know it just it's just unreal, you know, and
you think about all the other things that some of
(10:35):
these insurance companies don't coover. I mean, specialty drugs, mental health,
and some in some situations, right, alternative care.
Speaker 1 (10:43):
You know.
Speaker 2 (10:44):
You know, I just just talking to a client the
other day that was talking about meeting braces for kids
and stuff like that, and now their dental plan wasn't
covering it and they were a lot more money out
of pocket, or oh I need an implant, you know.
I mean, there's there's so many gaps out there, and
in all facets of insurance, not just the health side
or the medicare. I mean, it's it could be the
(11:04):
dental sidean god. I mean I've had people even coming
to me and talk about, oh I'm great, I got
life insurance, and you find out they bought it through
a credit union that they got it for really cheap,
and you find out it's an accident only plan. You know,
I got one hundred thousand dollars through my credit union
and I'm paying like a couple of bucks a month.
I'm like, well, it only covers if you die from
an accident, right, right, I mean, anything else happens your life,
(11:27):
it pays nothing. Well, I didn't even know that, right.
Speaker 1 (11:30):
That's the film noir movie Double Indemnity.
Speaker 2 (11:33):
I haven't seen that one.
Speaker 1 (11:34):
Oh, you kidding me, Well, that's your I know that's
your forte oh film noir. I love film noir. Yeah,
the Double Indemnity.
Speaker 2 (11:40):
I have to watch that one. I'm a fan too,
but I haven't seen that one.
Speaker 1 (11:43):
Fred McMurray and Barbara Stanwick. The pattern in the movie
is just classic film noir.
Speaker 2 (11:52):
Well that's the best part. That's why I love Quentin
Tarantina movies.
Speaker 1 (11:56):
Yeah, yeah, Tarantine. I'm sorry, we're going down already. We're
supposed to talk about insurance here and the and the
holes in the bucket anyway.
Speaker 2 (12:04):
No, that's great, but I mean again, like I said,
it's just it's looking at those examples. Is looking at
those scenarios. I mean, this actually was a public report
where were kind of hitting on bankruptcy. But according to
American Journal of Public Health, almost two thirds of bankruptcies
are tied to medical issues. You know, and listen, at
(12:25):
the end of the day, most those people had health insurance.
That's the worst thing to think about it. I'm paying
for something I never looked at it because either I'm
getting it through an employer. I'm fine, I have health insurance.
It's like you have a car, but doesn't mean it's
going to go down the road all the way before
it dies, right, you know, It's you have to pop
the hood and see what kind of engine you have,
(12:46):
you know, if you don't have a V six or
a V eight. I mean, you'd be surprised how many
times I pop the engine of an insurance contract and
I look inside at it and it's a freaking hamster wheel. Yeah,
you know, And I mean, like, this does not even
gets you to inn the your driveway Sarah.
Speaker 1 (13:01):
The nineteen sixties British Laylan product. There's some car people
out there that get that, I'm sure, but I'm I
like the whole thing. I've opened that up and I
just see a little rat running around on a weel. Yeah,
I mean, and the and that's the reality of it,
and that's why it's so good to look at it.
And again, it doesn't make a difference of what stage
(13:22):
you come to us. You know, if you if you
are on a group health plan, you know, we can
look at some of those gaps, you know, if you're
a husband's self employed or vice versa. I mean, let's
have a conversation. You know, we talked about long term care.
I mean, there's so many things that just people don't
have all the insurance that they need for And I'm
not a big proponent saying you have to be over
insured in all aspects, but a little insurance and all
(13:45):
those little buckets makes a lot more sense at the
end of the day. And you can demonstrate on paper
the value of investing a little bit more in these policies,
because I think people get the perception like, oh, he's
just layer me up with a whole bunch of different
surantce cover all these holes in the bucket, and it's
just gonna cost me a blue billion dollars s for
on a monthly basis. But that's not it.
Speaker 2 (14:06):
That's no you know the funniest part about it is
I always tell clients, and I do this a lot
with the groups. I'm like, listen, you're gonna the strategy
that I'm gonna share with you is gonna be definitely
different than anything you've ever seen before, because I I
to be honest with you, I hate selling someone in
insurance policy that's through one insurance care even all their products, right,
(14:29):
because not every insurance company does has the best price
or has the best coverage in each of those areas.
Speaker 1 (14:35):
Right.
Speaker 2 (14:35):
So the insurance companies know, like, hey, if you buy
our medical and our dental and our vision and our
accident policy, you know it's we're gonna give you a
really good deal. But then you start looking at you
know what am I actually paying for that accent policy
that's fifty percent more in half the coverage than this
other company. So I tell people all the time, I'm
like the mad scientists. You usually come to me like
you were buying a vehicle and go I always use
(14:58):
the truck analogics of a big truck guy. So it's like,
I love how Dodge interiors are, like those new panels
and everything that happ inside the Dodges are great. I
love my forward engine, but I really wish I could
have a Chevy Tailgate that has like a five fold
down thing.
Speaker 1 (15:12):
Right.
Speaker 2 (15:12):
I can literally build that for you, right, And That's
what I'm doing when it comes to your health insurance.
I look at health insurance and all your insurance products
is being a portfolio. I want to be like a
financial planner for you and go, hey, I would like
to sell you this policy, but this carrier has better
product for this aspect. I'm going to sell you this
one and we're going to build you a portfolio and
get it. At the end of the day, you're like, oh,
(15:33):
what am I supposed to do? And you just give
us a call. I'm like, this is what happened to me.
We will tell you which one to.
Speaker 1 (15:37):
Use, right. And I can understand how that because it
isn't the traditional way of getting your insurance. That having
four different policies with four different companies issuing them, it
could be a little confusing, but it's a great opportunity
to emphasize that when you work through John and the
team that covers since you keep them and at no
(15:58):
additional costs to you, they will solve all of your
problems for you, Like I was mentioned denied claims. I
mean the headache and the indigestion. Just even thinking about
spending two hours on the phone with an insurance company
try to get something sorted out. I don't have to
do it. Just call you, Hey, we figure this out
for me, would you, John, Thanks, rather appreciate it. Get
back with me when you let me know what's going
to happen. That's the same way with how the insurance
(16:20):
policies work. You get in the scenario you're like, wait
a second, now, which one do I go with and
what do I need to do? Just a quick phone
call and you'll see you're like, oh, you've got the
following do this and turn to use this policy and
it'll cover you.
Speaker 2 (16:32):
We literally have a black book of numbers for insurance
companies that when we find a good customer service person,
we write their name down and get their direct number
because I want to bypass the prompts and the loops
because we have to do it too, you know. And
you know, one of the biggest things Brian just just
kind of like a caveat here is I've trained my
staff now, especially dealing with some of the Medicare insurance
(16:54):
companies like the Medicare advantage side. A lot of the
carriers are outsourcing a lot of their phone rooms. They're
like India and outside the country. I've literally told them,
I was like, if you, if someone picks up with
the customer service side and you can't understand them for
the first fifteen seconds, hang up.
Speaker 1 (17:09):
And call back Steve.
Speaker 2 (17:10):
Yeah, but it's just like if you it's hard to want,
it's even hard for us to understand, like, you're not
going to get anywhere with them, then you just hang
up and recall in Yeah, And it's just that's just
the nature of it. So again, if we can help
alleviate that stress on you and at least get you
the answers or point you in the right direction, I mean,
that's that's gonna save you a lot of time.
Speaker 1 (17:28):
All right. So secondary insurance, these are your whole easier,
your your whole fillers that we're talking about here. So
let's walk through it and talk about what we're talking about. Yeah,
so think about things. You know, again, we've highlighted some
really important pieces here, but I can't stress enough where
I think one of the most important policies that you
can ever have in your life, regardless of where you're
(17:50):
getting your primary insurance is getting good critical on this coverage. This.
Speaker 2 (17:55):
I mean I've literally watched this, Brian changed lives of
my clients that have it. If I have a client
that calls in we find out they have cancer, the
first question I asked my care department is do they
have a critical of this policy. We stress it with
every client. Not everybody buys it, right, and they go, yes, okay.
The first thing I want you to do is get
the paperwork out to them so they can fill it out.
I need a doctor's neck, you know, just to show
(18:16):
that they actually have cancer or somebody. I need a
doctor's record. And then let's get that money in their
hands as quickly as possible, because the insurance company is
just going to send you the information and they're going
to like whatever. When you fill it out and get
it back to us, we'll pay you if it could
be a month from now or six months, right, but
we want to try to step in and like I
need this because I know at that point in your
life you're thinking about eighteen million other things, right, and
(18:37):
these are the policies that if you get a cancer diagnosis.
For example, they send you a fat check, that check
fat check. I've had clients literally get within the last
couple of year, I had to client get over one
hundred grand. And this exact on one of these policies,
you know.
Speaker 1 (18:53):
I mean, it doesn't completely take this thing out of
getting a cancer diagnosis, but it does.
Speaker 2 (18:57):
So no, I mean, but think, I mean, there's just
so many aspects to that. I mean, I know there
are things that that person might run into in their
life that it could be a experimental drug, right, I
mean then not covered by health insurance. It could be
maybe some people want to try some of the alternative routes.
You hear all these alternative routes. Now, I've me I
got things to pop up my Instagram feeds and stuff
(19:18):
like that, alternative forms of treatment for cancer. I mean,
health insurance is not going to cover those things. Think
about all the things that you're you're not working anymore, right,
I mean, you're going getting chemo a couple times a week.
I mean, how often are you going to go back
and go do roofing after that?
Speaker 1 (19:34):
You know what I mean?
Speaker 2 (19:35):
Like you're not you know, and I always say you
like you're the horse that pulls a cart every day.
The horse is locked up in the barn getting medical treatment,
the cart stay still, you know, And so that's a
huge piece of life. So again that's a huge gap
because no one's covering loss of income and no one's
going to cover the fact that maybe you're up here
and decide that the best place for treatment for you
(19:55):
is M. D. Anderson in Houston, which is one of
the best cancer hospitals in the world. Well, who's putting
you up in a hotel room while you're staying down there?
How are you paying for that?
Speaker 1 (20:03):
The critical illness criticalness policy? And in terms of affordability.
Speaker 2 (20:09):
Again, like I always say, the younger quer the cheaper
it is. So I mean, listen, my kids have it.
My son, my eighteen year old son, I just upgraded
his policy becausehen he got eighteen. It's like I'm paying
for it, but it's a fraction of the cost. I mean,
I think I got him on a hundred thousand dollars policy.
I don't even think it's twenty bucks a month, you know.
And I mean it's locked in for the rest of
(20:29):
his life. I'm like, you know, once he goes out
of college, like you can pay for this. Now, I'll
pay for it. Why you have it because I just
wanted to planet. But again, I mean even ten grand.
You know we're writing policies for ten grand, even for
people in their fifties, and you're talking maybe thirty bucks
a month. I mean, ten grant can cover all you're
out of pocket expenses. How muche is not to know
that you get cancer and you're out of pocket's nine grand.
(20:50):
You don't even worry about paying any of the bills
you have to check there. I mean, so at any level,
it's smart. And then we've always talked about it. You
can even tie these into the life insurance policies. We
get back to that. Even with the long term care
from last week. You know, you can have life insurance
policies that have criticalness. I have a million dollar policy
with one insurance company that their criticalness Brian pains out
(21:10):
twenty percent. Really, that's two hundred grand if I ever
had a cancer or heart attack. So again, buying these
and doing the right thing up front, it makes it
makes so much more sense, and it gives you more
availability to have I mean, I don't just have to
die with that policy.
Speaker 1 (21:28):
I get an answer that is just that that's an
amazing perk of that type of policy, right, yes.
Speaker 2 (21:33):
Yes, and these are but again, these are the conversations
we have our clients and and your listeners. So again
it's it's it's filling in those huge holes. Big proponent.
On the next topic here, hospital and Dendie plans. You know,
and this is something we structure with almost every health
insurance package that we write because two things here, hospital
and demnity plans. They don't care where you go as
(21:55):
long as it's a doctor or hospital in the United States.
There's no add to network with these plans. You want
to go to some hospital in California from Ohio, I
mean you can, doesn't make a difference. Clinic Mayo, clinic
doesn't make a difference because just like you know, just
like the Duck plan, right, it's a cash benefit. Indemnity
basically means cash. So there's a cash benefit tied to
(22:16):
your plan. You know, we have plans go that can
literally pay anywhere from a couple hundred dollars a day
when you're in the hospital to over ten grand a
day when you're in the hospital. Wow, you know, and
you know, especially for our higher income earners. I mean
that could be huge, That could be a supplemental cost
savings for you for you know, lost income. But these
(22:39):
are zero dollar reductibles. I always talk about people are
prohibited from sometimes using health insurance because they're afraid of
what it's going to cost them to use it.
Speaker 1 (22:47):
Right.
Speaker 2 (22:47):
Oh, I have I know someone that's a good friend
of the family that has not gone and got surgery
because she doesn't want to do it, because she doesn't
want to pay for it. You know, doesn't sound prudent,
it's not. But people, but Brian, people make those decisions
all the time, all the time. You know. People make
the decisions on dental right. Oh, but ever just pull
the tooth, you know what I mean, instead of fixing
(23:08):
it because I don't have the money to pay for it. Right,
and indemnity plans help alleviate that stress of having to
make financial decisions based upon your health because not only
are these first dollar coverage, Brian, but they can overpay,
you know, And there's so many clients that if I
literally called us and goes John, I just got a
(23:28):
big check from the insurance company. Do I send this
to the hospital? I'm like, no, that's your money that
you you bought a plan that ended up overpaying on
your medical expenses, that's yours.
Speaker 1 (23:39):
You get to keep that. I've mentioned many yes've done this.
Speaker 2 (23:42):
But Brian, it's not just your son. It's almost every
person that listens to your show. It has them, and
we get them all the time, you know, and it's
just it's peace of mind, but again, helping alleviate those
out of pocket expenses. We do this on the group side.
Almost every group that's ever called in from your show
that the shows that we've done and Little Life helped,
all of them have indemnity policies tied into their packages.
(24:05):
And you know, it's it's just always funny because they
don't understand it up front, but then usually about six
months later like ooh, we just had somebody use this,
and like John, it worked exactly how.
Speaker 1 (24:14):
You said the imagine that.
Speaker 2 (24:17):
So from John, Yeah, so, I mean, but again, indemnity
plans you can add to any group plan. Even in
that situation with my friend that you know ended up
getting the carbon monoxide poisoning, if you would have had
that with his wife's group plan, that plan would have
still paid because it's twenty four to seven coverage. They
didn't care if he was working or not.
Speaker 1 (24:35):
All right, the guy they should have been a worker's comp.
Speaker 2 (24:38):
Yeah, absolutely, it would have paid. It would have paid
it his xt situation. You know, kind of getting in
some of the more the cheaper plans. Brian, just real
quickly that are really important. Think about things like accident policies. Right,
accident policies are dirt cheap. Two thirds of all hospital
claims are resulting from accidents. You can add an accident
policy to any health insurance plan, or if you don't
(25:00):
even have insurance, you can just buy an accident in
policy and you can get plans that pay anywhere from
like three grand to twenty five grand on an accident.
And what they do is they cover the out of
pocket expenses on your primary insurance, or if you don't
have primary insurance, they'll pay the entire bill. So you
look at the average cost of a broken leg at
the emergency rooms, like five grand. Well, most people's deductibles
(25:21):
are higher than that. Yeah, so why wouldn't you buy
a plan that's twenty to thirty bucks a month that
if you have one accident in the next fifteen years,
it pays for itself.
Speaker 1 (25:32):
I love when you put it in those just really
stark terms. It's like, see, I mean, that's the way
I look at everything. I always I mean, and this
is kind of a caveat. When I look at clients
that want lower reductibles or higher re deductibles, I'm going,
if you can replace that deductible in savings more than
three years, take the higher reductible, you know, And that's
usually what it is. They're like, Okay, well the high
(25:53):
reductible is so much cheaper. If I had a claim,
the difference in price would take me six or seven
years to pay it back.
Speaker 2 (26:00):
Then to take the higher reductible it makes more sense, Well,
makes more sense to do the accident and policies. So
a lot of times I'll ad buy his clients, take
a little higher reductible, take that savings, and then buy
the supplemental that literally covers it all. So we build
avalut to just so many unique today doing something for that.
He has something for that, got something for this too.
(26:20):
But let's touch on gap insurance real quick here in
the remaining Yeah, I mean, just think about other gaps
that that are out there. You know, We've even mentioned
things like medicare right, I think. I mean we just
say gaps is kind of in general, like getting a
good Medicare supplement. I mean, if you're out there and
you're like, I'm good, I'm just on Medicare, and be
shocking how many people don't buy the other coverages. You know,
(26:41):
buy something along that line, you know, you know, to
to help out in those situations. But but a gap
can be at any any point, you know, I kind
of say this is more of a broad term. Gap
is long term care coverage? You have a gap. Gap
could be just your life insurance policy that you think
you have a life insurance plan through work, and the
gap that you have is the fact that it's not
(27:02):
going to go with you when you retire, so when
you actually really need the coverage, you're not going to
have it later on. So again, just think about that
as a gap. And you know, our goal really here
is just to kind of understand where they're at and
then show you the options to alleviate them.
Speaker 1 (27:18):
Well, and one of the props I'll give you and
your team it covers sense is that people don't have
to remember all of this and write it down and
have to ask you're the one that presents the information
and the options to them and lets them know where
the holes are in the bucket and you have a
solution to deal with that.
Speaker 2 (27:37):
So yeah, I mean, at the end of the day, Brian,
the biggest thing is just we want to alleviate the
hardships when you have that worst time in your life.
And I mean, and I think that's where you know,
not only our team helps prevent in the future, but
that's where our team really excels because again, I don't
care where you're at in life or who your insurance is.
(27:58):
I mean if it's with us or somebody else. When
you go through a major life changing medical situation, the
financial burden there and the time constraints on just even
trying to figure out if everything's being paid out right
or what's going on is is unbelievable. I tell everybody,
if you if you got if you had a heart attack,
like the first thing you should do when you get
home is get a big old folder and just start
(28:18):
putting everything in there that you get from the hospitals,
the doctors, the insurance companies, because you get the line
them all up. We can help you through that. But again,
it's it's a hardship. You'd be surprised how many times
behind we've seen billing just completely erroneous. Yeah, Oh we
never got a check from the insurance, but we're just
gonna bill you. I'm like, well, the insurance company is
saying they did sell the check and it looks like
it was cash. I mean, there's just like so many
(28:39):
things that can happen. And again, that time of life
is very hard. But that's why I really love all
these gap plans, because when people get big old checks,
they're not worrying about making ends meet or paying the mortgage.
Speaker 1 (28:52):
That's why you get in touch with John on the
team that covers SINCY. There's no obligation to you. Let
him figure out where you are in life and figure
out a better path for you. You and fill the
holes in those buckets. John Roman or any of the
team members can help you out. Give them a call
five one three eight hundred call five one three eight
hundred two two five to five, form online at the
website cover sinci dot com and again all fifty states.
(29:14):
If you're listening, he can help you out cover since
he dot com has been another edition of Rethink Healthcare
together with John Roulman, and don't forget the team. You
can work with any of them at cover since he
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