Episode Transcript
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Speaker 1 (00:02):
Hi, It's Brian Thomas system to Pike about Hersey Morning
Show Monday through Friday, but facilitator of Rethink Healthcare Together,
which is what we do every Sunday at this time
with John Rohman from Cover Sincy Cover sincy dot com
and say he reached down on the team and I
strongly encourage you to reach out to them talk about
your medical insurance. That's what this program is all about,
enlightening you and explaining all the problems, the pitfalls, the holes,
(00:24):
and how to cover them for less money. Less money
for better coverage is really the bottom line with cover sincy,
so at no obligation to you, at no cost to you,
reach out to them again, cover sincy dot com as
a form there you can fill out to have them
take a look at where you are from a medical
insurance perspective, and we're working with hundreds of insurance companies
and thousands of policies come up with a different package
(00:45):
of insurance again to provide you better coverage like dollar
one coverage for less money. You can call them up
at five one three eight hundred call five one three
eight hundred two two five five and of course Medicare
issue We talked about that last week on it Welcome
to John, and it's always a pleasure talking with you on.
Speaker 2 (01:01):
A sung Oh YouTube.
Speaker 1 (01:02):
Brian, Well, the point is don't delay, don't wait until
the period comes, like, what is it, October fifteenth.
Speaker 3 (01:08):
Yeah, So anyone that's on Medicare, if you're looking at
the annual open enrollment, or maybe you're just saying, hey, listen,
I'm over sixty five, I haven't looked my plan in
a while. I think it's it behooves you. It makes
very good sense that you'll give us a call. We
are trying to schedule out all of your listeners right now.
You have October fifteenth through December seventh. But don't delay,
(01:30):
don't wait till last minute. We always get those stragglers
that they try.
Speaker 2 (01:33):
To call in like the night of yeah, and try to.
Speaker 3 (01:36):
Get taken care of. Get taken care of now because
you again you're getting your annual notice of change. You
probably don't even know understand a lot of what's in there.
It's a really good time to sit down with one
of our agents and talk. You know, this is everything
we do is secure on our website. I'm not a
marketing company. I don't sit there and resell your data
or anything like that. Everything you do is is completely
(01:56):
confidential hip a compliant any information that you fill in
on our websites, you will sit down one on one
with one of either myself or one of my agents
that will do a complete free analysis of your current situation.
Speaker 2 (02:08):
They'll show you some of the holes.
Speaker 3 (02:09):
In your plan and they'll give you some options if
you if you choose to want to make a financial
decision to you know, cover those holes.
Speaker 1 (02:17):
And you know, the great thing is you do you
explain it all and how it all works, but you
also do the math. Yeah, and that it's an important
element We've talked about so many many times, Like even
if you're not talking about medicare, you're talking about regular
medical insurance without a pucket, liabilities and premiums, and you
add it all up and you find out, No, this
is why going this direction with these options cost you
(02:38):
less money, even though like you think you're saving money
by doing what you're doing. No, you walk through a
very detailed explanation and enlightened listeners about their options out there.
So right now, medicare folks you're approaching. Is the great
thing about this is you have the conversation, You're going
to have peace of mind, the questions will be answered,
You'll know exactly what you're going to do when the
day comes when you're supposed to sign up, hit the
(03:00):
ground running and you'll be happy because you'll have better coverage.
And John will explain that all to you.
Speaker 3 (03:04):
I get a little funny anecdote here for you, Brian,
because you know, I don't realize, we don't realize how
we operate mentally. So my assistant ends up is my
mother in law. She always makes a joke because she'll
she'll work with numbers for me. She goes, hey, this
this client has this and this out of pocket. I'm like, okay,
this is her true cost healthcare. I just do it
like quickly in my head, and she goes, I sit
there my calculator and I do it. I go, you're
(03:26):
off by fifty cents. Well, the funny thing is, I
don't know if I told you this story. So you know,
my entire business is family, right, my my my father
in law, my mother in law, my wife, my brother,
my mother worked for me. Well, now my youngest brother
up in Wisconsin, and just there was a drain on
(03:48):
him after for a while, and he was like, man,
I like what you do. I want to help people
a little differently. So he needs insurance license. So came
in for the last three with me. I've been training
him about the business, right, so now he's in the
business as well. And my mother in law mentioned that
story to him, like your brother goes He's been that
way his entire life because you usually have seen how
he used to do it with my parents when we
tried to convince them we needed a computer and how
(04:08):
much time it would save him from ready reports. So yeah,
I've had that my entire life. Yeah, And I realized
from day one, like, listen, it's insurance jargon. It just
can be way over people's head. Right if I start,
If I sat here today and all I did was
just give you the jargon and talk to you from
the insurance standpoint, you probably turn this radio station off.
Speaker 2 (04:31):
Yeah, clearly.
Speaker 3 (04:32):
Yeah, And I said, how does people really operate? I
operate on numbers, right. I wanted to know, like, this
is what it costs me, and if I buy this
doesn't make financial sense. I literally walk into like all
these stories and they when when you buy that the warranties,
and I do a quick calculation in my hand, and
I go, if I break this TV or something happens
to it within this timeframe, and when this is what
I'm paying, does it make sense to buy it? And
(04:54):
I'm like, well, if I can rebuy this TV in
two years, it doesn't make sense by it, so exactly,
don't do it. That's why I ever buy the warranties.
And of course then my TV goes and yeah, then
I'm like darn, but I saved more money over time.
But when I started looking at it for clients, it's
exactly the same premise. I always go, hey, if you
buy this, you have to go this long without doing
anything to make it make sense. Yeah, and if it's
(05:16):
over five years, always buy it. Five years is for me,
from what I've seen, is that number. And if you
have kids in a family, you can even shorten that
because we're just extrapulating higher numbers, right. But that's you know,
when I talk to clients all the time, that's a
lily why Tom's like, hey, you can add this on now.
It only makes sense if you have a claim in
the next twenty years.
Speaker 1 (05:37):
Well, I mean a real quick illustration last week you
walked through that with the cost of the home healthcare
plan getting people in your home to care for you,
like if you, you know, have an accent, an injury,
or otherwise physically disabled in your old age, that for
basically four hundred bucks a year that's covered. But if
you had to pay out a pocket for that to
have someone come in to your home regularly on an
(05:57):
hourly basis, it's easy to do the math and know
why four hundred bucks annually.
Speaker 2 (06:02):
So I'm telling I'm very good at math.
Speaker 3 (06:03):
I couldn't even do that number because you're talking about
somewhere in the neighborhood of sixty seven thousand dollars a month,
a month a month, so for four hundred bucks a year,
I mean, that's crazy fifty years.
Speaker 1 (06:12):
I mean, like see, okay, that's why I brought that
one up, because that math was really easy.
Speaker 3 (06:18):
That it's easy, I mean that it doesn't make sense
at all at that point. It's I mean, I look
at going out. I mean, my wife and I just
went out to dinner the other day and it was
over one hundred bucks. I'm like forty bucks.
Speaker 1 (06:27):
I mean, it's like, come on, guys, forty bucks a
month to get someone in your home to care.
Speaker 3 (06:31):
For you or your love one yes quarter or tank
for my truck.
Speaker 1 (06:34):
Well, and you know you started off in the context
of Medicare, because that period is fast approaching. So schedule
your appointment with John on the Team five point three
eight hundred call. But this also applies to regular insurance
as well. This point in time is when people should
be making their appointment.
Speaker 2 (06:50):
Yeah.
Speaker 3 (06:50):
So again, if you're in a situation, if you're on
a marketplace plan, so Obamacare, healthcare, dot gov, ACA, all
the different acronyms for it, right the opening home, it's
vastly approaching, right, So November first, here's the big thing.
We have a lot of clients, and we have a
lot of listeners that call in. We want to make
sure you guys are priority. So the biggest thing right
(07:12):
now would be to call in and get yourself scheduled
and already lined up. And I mean, let's do it
in the beginning of November, right like that way. If
anything changes, if if we have to pivot somewhere, we
have plenty enough time to readjust your plan for January first,
which happens, right, But I want to make sure you're
resolved and get that taken care of, because I'm telling
you right now, I already have clients that the marketplace
(07:33):
is starting to contact, and they're starting to scare people
because they're reaching out. That's what my clients are calling.
I had a client literally call in this week and goes, hey,
the healthcare marketplaces reach out to me. Now I'm going
from what they said because it's usually usually late and
they usually start contacting people in like October, right, so
i'd be doing this in August.
Speaker 2 (07:52):
Is a little scary.
Speaker 3 (07:53):
It could be some call center which those do to
do that, but what we're talking about, they weren't the
only person. We have a couple other people call it.
And so now that's why I'm bringing it to light. Hey,
you might be getting contact, you might start getting letters.
I don't want you to fret. The biggest thing you
can do is give us a call. Get scheduled, regardless
if you're a client or not. Because I really want
to sit down with anybody that's on a marketplace plan
(08:15):
for twenty twenty six, because guys, there are such big, huge, humongous,
I don't care what term you want to use, changes
coming for twenty twenty six for the marketplace plans and
they're not good, and it's not good. Out of pocket
expenses they are going up. I know right now there's
insurance companies, big ones that are canceling coverages. So you
(08:35):
can have insurance right now and you I'm upon an
insurance company and it'll be gone. And I will say
this because they're gone and is gone January first, big
insurance company no longer doing business in our area. They're
no longer doing business in all fifty states, so they
just completely cease doing business for January of twenty twenty six.
If you're on a plan, you have to change. It's
not an option. You don't have insurance at twenty twenty
(08:56):
on January first.
Speaker 2 (08:58):
Right.
Speaker 3 (08:58):
Secondly, the tax credits, guys, they're they're they got gutted, right.
We lost the open ended where you can have a
higher income and still get help with your health.
Speaker 1 (09:09):
Insurance kicked in in COVID during COVID.
Speaker 3 (09:12):
Yeah, they ticked in the COVID. That was part of
the American Rescue Act that they put that in there
to help everybody, which we thought would day around.
Speaker 2 (09:19):
I mean I was pretty shocked then, you know.
Speaker 1 (09:22):
For your premium, Yeah, so the tax really is all
that made it affordable for a lot of.
Speaker 3 (09:26):
People, which again it did, and for a lot of
people we'd have I mean, especially if you're only like
your sixties and I had a little bit higher income,
it was because your premium is so much higher.
Speaker 2 (09:35):
Your premiums can be a four or.
Speaker 3 (09:36):
Five times more expensive than your twenties. So you start
seeing people in their sixties with their their their base
price of their health insurance is eight nine hundred thousand
bucks a month. You know, so they were getting yes, yes, Brian,
but I mean.
Speaker 1 (09:49):
Ten thousand plus dollars out of pocket liability.
Speaker 3 (09:52):
Before the person before you even get insurance, and twenty
grand out of pocket before you can even use your
insurance right for a family. But listen, they were getting help, right,
So I have so many listeners that were like making
husband and wife making ninety grand a year. Maybe they're
only paying five hundred bucks a month for this plan. Well,
guess what happens January first, it's gonna jump to sixteen
eighteen hundred dollars a month.
Speaker 1 (10:12):
And what's seventy thousand dollars in family income? That means
you can't take advantage.
Speaker 3 (10:16):
No Texte at no text credit, no tax credit for
this people that goes away. So that's why it's so important,
because if I don't adjust your plan before then you
might be sol and I can't do anything until next year.
So it is why it's just skuys. It's so important
that we talk everybody that's on these plans.
Speaker 2 (10:33):
Don't.
Speaker 3 (10:34):
Don't go to healthcare dot gov. They can't. They can't
even advise you on what to do. They can go
here's the plans, which ab or say, right. They can't
sit down and make sure that you're at the right plan.
You know it Just it's so imperative because of the
tax credits and and the worst part, Brian, and this
is where I see the biggest hole for a lot
of listeners is maybe those ones that have lower income.
(10:56):
So they were getting what they call the cost share
and reduction, where we your income was low enough that
they were not only helping you with your premiums, they
were helping you through out of pocket expenses. Because listen,
you're making twenty eight grand a year, how can you
pay ten grand? You can't, you can't, right, So a
lot of these people were getting plans that out of
pockets maybe two or three grand, right, because that's a
(11:17):
little bit more affordable for those people. It's still be
a stretch, but now it's gone. So that cost sharing
reduction that a lot of people were getting on those
silver plans is gone twenty twenty six for everybody. So everybody,
regardless of your income, if you're just a smidge over
medicaid and can't you know, can't get medicaid, you are
now going to a ten thousand, two hundred dollars out
of pocket come January first. And these people need massive help.
(11:42):
And here's what we're seeing, and this is what we're Listen.
If there's one takeaway you get for me today, if
you're on a marketplace plan, get out of the silver plans.
It don't make sense anymore. Everybody should move to a
bronze plan. The bronze plans are probably be twenty percent cheaper,
has the same out of pocket. They'll just scare you
with a little bit higher aductible.
Speaker 2 (12:00):
Doesn't make a difference.
Speaker 3 (12:01):
Guys, with how expensive even an emergency room is now,
you're hitting your entire out of pocket if you go
into the hospital or have a surgery. It's just numbers, right,
So they'll scary. You're like, oh, well, you're going from
a five thousand to a seven thousand dollars a douctible.
Don't worry about it. You look at the out of pocket.
That's always a number I advise people to actually care about.
But if I can save you twenty percent more there
(12:23):
moving from a silver to a bronze plan, I can
then use a little bit at savings to get you
gap coverage so that you never pay ten grand. Ever,
I mean that I can't stress that enough. I mean,
there's just so many people on these plans, Brian, that
I know going into twenty twenty six that are gonna
be paying more money because they didn't hear this message.
(12:43):
And how many people are gonna probably file bankruptcy because
now they're going because I mean, the average debt for
medical that the people fire bankruptcy is ten grand, and
now you're out of pocket's ten grand per person. So
you're gonna see people that get on these plans and
can barely afford them and then go use them and
can't even.
Speaker 1 (13:02):
Afford the bill, and with the same pile of money
they're getting for really no, I'll call it no insurance
under that scenario. You just reallocate the dollars spent monthly
to different a different plan like that gap plan double
with the bronze plan. Yeah, same money, not a pocket
liability under that scenario. That's the package for this very low.
Speaker 3 (13:26):
I mean, our goal is to bullet proof you as
much as possible. We're gonna layer your coverages so that
you'll never be in a situation that you're ever gonna
have to think about, oh my god, I gotta go
pay ten grand because I'm in a situation or more.
I mean, god forbid, you're at a network and pay
the entire bill, right, And that's why it's so important
to sit down with one of our independent advisors that
(13:47):
will go over this with you.
Speaker 2 (13:48):
Guys.
Speaker 3 (13:49):
Again, everything's free. It's a free evaluation of your current situation.
And I always will tell you this. If you are
in the best possible situation, I will leave you alone
and tell you don't change your plan. Yeah, I mean,
that's not my.
Speaker 1 (14:00):
Point that I want to doing commercials Like you know,
this analysis is free and almost because you don't have
to change insurers or deal with a different form of
you know, different types of medical plans. If you say no,
you're in the best possible place you can be. I
John Roman and the team of Cover since searching through
and scouring thousands of medical policies that we have access to,
(14:21):
can't find you a better solution. That's actually kind of
good news in a way. At least it makes you
feel bad, like, well, if I haven't spent in my
wheels for the last several years.
Speaker 3 (14:29):
It's like, you know, go into a lawyer and says
you don't have case, right, like okay, thanks, yeah, yeah, okay,
appreciate it. Appreciate it. Then you know, I thought I did,
but you don't know what okay or don't do that right.
I love that when I went to a lawyer one
day and I'm like, we're buying buying our business and stuff,
and he goes It's like, well can you do this?
He goes, no, you can't do that, though, thank you.
I get it in my head. I'm not a lawyer,
(14:49):
you know what I mean. That's what you want in
an expert is to be able that an advice and puts
you in the right possible situation. And like I said,
when you deal with places like these call centers, and
we talked about this last week with medicare huge call centers.
That's Leeca coverages and Obamacare plans. That's the majority of
the marketing that goes out there, all over social media,
all over the internet, all over TV. Good luck reaching
(15:13):
back to the same person that sold it to you,
you know what I mean?
Speaker 2 (15:15):
And Steve input job, yeah, I mean.
Speaker 3 (15:18):
And you know which is funny because all those employees
that work for those call centers, guests who they call
come march me.
Speaker 2 (15:26):
They're calling me for job.
Speaker 1 (15:29):
Right, Yeah, you have mentioned that before, and they don't
get what you do. I mean, they're in the insurance business.
We there are people out there that work for an
insurance company that want to sell you that insurance company's
medical policy. And we've talked about that before as well.
They don't understand what you're doing. Now, I have a
we do. We do quarterly training. So again I always
say that I have hundreds of agents that actually are
(15:49):
under me throughout the company, throughout the country. And you
know what we do is every quarter we bring a
bunch of agents and train them and usually there are
newer agents that join our team and they're blown away
with the concepts.
Speaker 2 (16:02):
That we do.
Speaker 3 (16:02):
I've had I had an agent here recently who's been
in the business fifteen years selling health insurance, individual health insurance,
doing exactly what I do. I sat him down and
showed him what we do. He goes, I had no
idea you could do this. See, and I've been doing
this for fifteen I go, what have you been selling?
He goes, I just sell what the insurance companies tell
me to sell. And I thought there were really good plans.
I go, and what do you think now? He goes,
(16:23):
They're crap. They're crap the package as I put clients,
and he goes, I have to call people back because
I've left them expose from what I'm seeing, and he goes,
I didn't realize that, and he goes, I was putting
people with the silver and gold plans on the ACA.
I was writing these lower deductible plans for higher premiums.
And go, well, that didn't makes sense, right. You write
a higher deductible plan to cover the catastrophic and you
(16:45):
write a very affordable plan to cover all those out
of pocket expenses, and you layer the coverage.
Speaker 2 (16:50):
He goes.
Speaker 3 (16:50):
He goes, yeah, He goes, now I can call them
back and save them thirty to forty percent off what
they had, and I can get my clients better coverage.
And you know he's been doing great because he's just
to call on his current you.
Speaker 1 (17:02):
Know, hey, my eyes got open in the last year.
I've got a better option for you. Yeah, that's great. Well,
what are the top five mistakes people make? Generally speaking?
Speaker 3 (17:11):
I think the number one biggest mistake people have is
habit of having a plan and thinking, I have health insurance.
Speaker 1 (17:17):
I'm just done.
Speaker 3 (17:18):
I'm good, and never going back and will never going back.
It's literally like you own a car and you never
open the hood and check the oil. Ever, Like, come on, man,
like you have to. You have to pop that open.
You need to know how your coverage works. And if
you don't, I'll tell you right now. The easiest thing
for you to do just give us a call and
we'll tell you how your coverage works. Right, I mean,
(17:40):
that's the easiest thing for you. But if you really want,
call your insurance company, have them send a copy of
your sixty page document and read through it and come
through it and find your holes. And I'm telling you
right now, most people don't do that, and most people
don't even understand what they're looking at and that's really
what our goal is. I mean, my goal of selling
health insurance to clients is the holes.
Speaker 2 (18:01):
Where are the holes? Where is your exposure?
Speaker 3 (18:03):
And is that something that could potentially hurt you in
the future. And nine out of ten times, Brian, those
holes are absolutely going to hurt people in the future.
So that's really the biggest thing is just thinking that
you're paying for health insurance and you're good because no
one you literally the common I tell people when they go, hey,
I have health insurance.
Speaker 2 (18:23):
I'm good.
Speaker 3 (18:24):
It's like, oh, do you like your plan? They go,
oh yeah, it's okay plan. I was like, okay, it
sounds like something you use a lot. Well, I never
use it, do you know how good it is?
Speaker 1 (18:33):
That's why no one looks at it because they're not
experiencing a lot of claims. Now, their eyes would be
wide open about claims, denials and the holes in their
policy if they were not.
Speaker 2 (18:42):
Well oh yeah, And here's the.
Speaker 3 (18:43):
Worst part is when they start realizing that it's really
too late for me to do a lot of the
good things for me.
Speaker 1 (18:50):
So waiting too long to have this analysis, not doing
this analysis, I think, I tell my clients, you know,
even if I set you up right now, every two
or three years, I'm probably going to change you again.
I just want you to be kind of aware of that,
because new plans come out, different things happen. Things get cheaper,
other plans get better. So I want to be able
to readjust your plans. Like, as long as you stay
in relatively good health, you're in great hands here because
(19:10):
we'll just keep making sure to get better and better
coverage all the time. And our clients really, really really
appreciate that because we're so up to date on what's
going on. And if you're on a plan for a while,
it's at a date. It's like a computer. Man, eighteen
months goes by, like that thing's slow. It's like my
cell phone for whatever reason, like my iPhone, Like, yeah,
eighteen months later, it's really slow. I'm like, why is
my phone suck? I go get a new one, right,
(19:31):
And the network's change. You've talked about that, the rug
gets pulled out from under the you're insured, you go
to a regular doctor and next thing you know, that
doctor is no longer in the UH.
Speaker 3 (19:39):
And you don't know, and the provider WI you don't know,
or you're on one of those plans that it only
go once a year, and you know, you didn't change
your plan and they dropped you, and now you're stuck
on that plan for another year. I can't do anything
until till the following year. Now you just now you're
without your doctor. So networks are huge because it happens
all the time, and knowing what type of coverage you
have is is so paramount because at the end of
(20:00):
the day, if if your network changes, so a lot
of our private plans we do Brian, right, I have
great cares. I literally have a company right now that
has a network and they don't care if you say
in it, it's the same out of pocket if you
go out a network or a network, they don't care. Well,
so tomorrow if you wanted to go to I always
say MD Anderson is one of the best cancer hospitals,
(20:22):
and this is it is a network, by the way,
But if it was at a network, you can still go.
Speaker 1 (20:26):
Well, isn't it like operate like a PPO?
Speaker 3 (20:28):
Well, it's a PPO, but go look at your group
health plan PPO. What is the out of pocket on
your group health pay? Exactly double? It's double. So let's
say you have a ten thousand dollars out of pocket
on your network, it's twenty thousand.
Speaker 2 (20:41):
If you go out of network.
Speaker 3 (20:42):
This company has the same Internet A network and it's
like five grand. Yeah, so I mentioning like on the
private side, it's it's phenomenal and it just it gives
so much better piece of mind. But hey, guess what
if your doctor or hospital leaves a network, who cares
because you can still go. That's that's a great piece
in mind.
Speaker 2 (21:00):
So that's huge. Right.
Speaker 3 (21:01):
Assuming your employer coverage is always best is one of
the things I think is hilarious because I get employers
that call me all the time and I'm looking at
their plan like, chunk, can you help me?
Speaker 2 (21:11):
I'm like, I need to help you.
Speaker 3 (21:12):
Like how many of your employees actually tell you they
have good health insurance? Go do a poll, Go pull
your employees like, hey, on a one of the five scale,
ate your health insurance and like we'll do it, we'll
do it, we'll do it. So we don't know who
you are, right, don't don't do a raise of hand. No, no,
And most people probably say they don't think they have
very good insurance, and it's not because you're not paying
a lot of money as an employer. It's because the
(21:34):
out of pocket's so high. Every time they use, they're
paying so much money out of pocket, and the premiums
keep going up. Right, So even if you're on your
employer plan, you're like, this isn't this isn't okay. I'm okay,
I don't use my plan again, pop the hood. But
even if you're on an employer plan, God, those out
of pockets are so high you can look at adding
small pieces. God, you should get an accent in policy.
Everyone should own an accent in policy. I carry an accent
(21:57):
policy for twenty years before I even had kids. I'm
telling you the best part about my accident policy. I know,
no matter whatever happens any scenario, kid gets hurt, I
get bit by a brown recluse, spider dog bites me,
I get into a car accident, which, again, car insurance
doesn't cover all your medical expenses. The most I ever
pay on an accident is one hundred bucks. Regardless of
the bills five hundred or fifty thousand. I will only
(22:20):
pay one hundred bucks on any accent ever do. And
you can add that to any plan right under the sun.
Speaker 1 (22:25):
See, and I think that's something that people overlook, that
very element you just pointed out. Just because you're on
your employer's group plan doesn't mean you can't act in
your own best interest. Get that accident policy, for example,
which won't be very much money out of pocket. Additionally,
but considering the massive savings you're going to have, I
have it in place.
Speaker 3 (22:45):
I'll get with you right now. You can do an
accident policy that I would recommend. It's less than fifty
bucks a month for your entire family, and it'll give
you a hundred dollars reductible on an accent. It works
with your current health insurance, so they coordinate. They'll pay
your out of pocket expenses. It's for less than fifty
bucks a US, so six hundred bucks a year. You'll
never have to worry about meeting your deductible, your co insurance,
(23:07):
or all those kope's. It's worldwide coverage, so you can
go get hurt in Mexico and it'll still help you
cover your bills. It costs the out of pocket on
its one hundred bucks one accident. So I did, yeah,
one accident. I mean, if you're out of pockets like
let's say five grand, I'm paying six. It's it's almost
nine years. So one accident in nine years, because I
guarantee if you have an accent, go to the emergency room,
(23:28):
you're paying five red right, right, it always is starting figure,
starting figure, right, and you're only paying a hundred bucks.
So if you have one accident in your family in
nine years, you should have bought the plan. And I'm
telling you, with my three kids, I'm in the emergency
room probably like every eighteen months. Well, it's whatever it is.
My son broke his arm last year and broke his
(23:49):
finger the other year. I mean, you just you're taking
him in. My son fell off his hoverboard Christmas morning
because he decided to right around this hoverboard and take
a trash out. I mean those things happened, right. I
had a client get by bit by a brown recluse
spider seventy thousand dollars later in here. No, no, I
mean I don't have a lot of these personal stories
(24:10):
that their clients. Sorry, seventy thousand dollars in skin.
Speaker 1 (24:12):
Grafts from one spider bye, one.
Speaker 3 (24:16):
Spider by bitter calf and like literally started just de
tearing and they do skin grafts on. It is over
seventy thousand dollars and she paid a hundred bucks for
the entire event. So yeah, I'm just telling you, like,
that's a small policy. I don't know their story because
I just I think is just so important. One of
(24:36):
my one of my best agents, one of my best
independent agents. She actually came over to us because her
daughter was the flyer on our gymnasts on our my
daughter's gymnastics team. So the one they they throw up
in the air. Oh yeah, And one day she was
throwing up in the air and she goes, oh my god,
I hope she doesn't ever they don't ever drop her
and she gets hurt. She goes, I have an HSA plan.
(24:57):
So it's a highductible health plan. She goes, my deductible six.
So my wife turned her and goes, I got a
plan for you. So she sold her an accident policy
right there. So she literally came back to me three
months later she goes, that was like the best little thing.
Speaker 2 (25:10):
I haven't used it. I that's the best little thing.
How do I do that? And now?
Speaker 3 (25:13):
And she's been an agent for me for the last
five years. She and did that because she saw the
value of that.
Speaker 1 (25:18):
That's amazing.
Speaker 3 (25:19):
Yeah, so I'm telling you, like, and she had a
group health plan, great benefits. Her husband works for a
fortune five hundred company, but they had a six thousand
dollars a doubtable and she's like, I don't want to
pay that if my kid falls.
Speaker 2 (25:29):
You know.
Speaker 1 (25:30):
I seem to recall a story when my sister was
in high school that one of the high school cheerleaders
actually got paralyzed in doing that. Yeah, imagined the medical
bills on that.
Speaker 2 (25:39):
Oh, I'm huge.
Speaker 1 (25:41):
The tragedy in and of itself was bad. But when
you got a tragedy like that coupled with infinite medical
bills to deal with it, Oh yeah, accident policy in place.
Speaker 3 (25:51):
And here's the worst part, Brian accent plans are phenomenal.
You gotta buy the right one, right, No, because this
is this is a big point that I want to
make out to you. But they're not all equal because
there's accident and policies out there that I don't sell
that literally won't cover you if you're in an intercollegiate
or collegiate sporting event. There are accident plans that won't
(26:11):
cover your driving ATVs. There's accident policies that won't cover
you and a lot of different situations. I don't sell
those plans.
Speaker 1 (26:18):
Right, Okay, that's where your expertise comes in, because someone's
listening to this. I'm gonna call whoever. I'm just I'm
gonna go out and buy myself one of those accident
policies and they'd see you.
Speaker 2 (26:28):
Are they go online?
Speaker 3 (26:30):
Or I don't sell those accident plans and only cover
after for the first thirty to sixty days after the
event I tore my shoulder working out my rotator. Cover
my labor and surgery was six months after, right, so
it would only cover the first claims to the first
ninety sixty days. If I would have had the different policy,
it wouldn't have paid for the big part of my bill,
which is my surgery. Mine did because that's the one
(26:53):
I have, and that's the one I use and have
for twenty years, and that's the one I recommend for
my clients.
Speaker 1 (26:57):
And that's when you recommend for your clients. Of course.
So I guess the conclusion we need to come to
here is do not wait, wait, schedule the appointment, get
on the list. You know, even if it's you're working
with your group through your employer. You still talk to
John on the team because there's obviously a better way
saving you all that out of pocket liability. And of course,
(27:19):
folks out there dealing with medicare you're getting close to it,
get an appointment with John. He has opened my eyes
and enlightened me. I'm not yeah, I'm going to be
sixty next month, so I'm not pushing this whole idea
of medicare and I'm not thinking about it yet. But man,
you have really opened my eyes to some of the
serious holes pitfalls people can fall into dealing with medicare.
Speaker 2 (27:38):
Oh my god, it is.
Speaker 3 (27:38):
But I'm telling you right now, if you do the
right if you set it up the right way, yeah,
it'll be the best coverage you've ever had in your life.
Speaker 2 (27:44):
I firmly stand behind that.
Speaker 1 (27:47):
Big qualification though on that if you said, if you.
Speaker 2 (27:50):
Set it up the right way.
Speaker 3 (27:51):
So when I was training my sales staff how we're
doing medicare this year because of this year out of
pocket expenses and the gaps and all that we're doing,
I literally sat down with them. I go, now that
I went over this package with you, what is your
feelings to go? This is the best health coverage we sell. Yeah,
I mean that's my agents that have been doing this
for years, knowing that the Medicare way that we can
set up with Medicare advantage and the gap coverage they
(28:13):
flat out set. The best coverage we've ever sold is
the package that we're putting, regardless of any other packages
that we have.
Speaker 1 (28:20):
It's the right thing to do. Get in touch with
Don on the team it covers, since he don't care
what state you're in. They can help you out this
all across the whole country of ours. To start that
process and do it, or just go ahead and do it,
I mean, don't delay. It's cover sincey with Wireeye coversincy
dot com before we can fill out online to start
the process, or call them at five one three eight
hundred two two five five that's five one three eight
(28:42):
hundred call Enlightening as always John Roulman from Cover, since
you appreciate the opportunity to speak with you and enlighten
the listening audience on me well the better path and
steer them toward five one three eight hundred call. This
has been another edition of Rethink Healthcare together with John
Roman from Cover since
Hi, It's Brian Thomas system to Pike about Hersey Morning
Show Monday through Friday, but facilitator of Rethink Healthcare Together,
which is what we do every Sunday at this time
with John Rohman from Cover Sincy Cover sincy dot com
and say he reached down on the team and I
strongly encourage you to reach out to them talk about
your medical insurance. That's what this program is all about,
enlightening you and explaining all the problems, the pitfalls, the holes,
(00:24):
and how to cover them for less money. Less money
for better coverage is really the bottom line with cover sincy,
so at no obligation to you, at no cost to you,
reach out to them again, cover sincy dot com as
a form there you can fill out to have them
take a look at where you are from a medical
insurance perspective, and we're working with hundreds of insurance companies
and thousands of policies come up with a different package
(00:45):
of insurance again to provide you better coverage like dollar
one coverage for less money. You can call them up
at five one three eight hundred call five one three
eight hundred two two five five and of course Medicare
issue We talked about that last week on it Welcome
to John, and it's always a pleasure talking with you on.
Speaker 2 (01:01):
A sung Oh YouTube.
Speaker 1 (01:02):
Brian, Well, the point is don't delay, don't wait until
the period comes, like, what is it, October fifteenth.
Speaker 3 (01:08):
Yeah, So anyone that's on Medicare, if you're looking at
the annual open enrollment, or maybe you're just saying, hey, listen,
I'm over sixty five, I haven't looked my plan in
a while. I think it's it behooves you. It makes
very good sense that you'll give us a call. We
are trying to schedule out all of your listeners right now.
You have October fifteenth through December seventh. But don't delay,
(01:30):
don't wait till last minute. We always get those stragglers
that they try.
Speaker 2 (01:33):
To call in like the night of yeah, and try to.
Speaker 3 (01:36):
Get taken care of. Get taken care of now because
you again you're getting your annual notice of change. You
probably don't even know understand a lot of what's in there.
It's a really good time to sit down with one
of our agents and talk. You know, this is everything
we do is secure on our website. I'm not a
marketing company. I don't sit there and resell your data
or anything like that. Everything you do is is completely
(01:56):
confidential hip a compliant any information that you fill in
on our websites, you will sit down one on one
with one of either myself or one of my agents
that will do a complete free analysis of your current situation.
Speaker 2 (02:08):
They'll show you some of the holes.
Speaker 3 (02:09):
In your plan and they'll give you some options if
you if you choose to want to make a financial
decision to you know, cover those holes.
Speaker 1 (02:17):
And you know, the great thing is you do you
explain it all and how it all works, but you
also do the math. Yeah, and that it's an important
element We've talked about so many many times, Like even
if you're not talking about medicare, you're talking about regular
medical insurance without a pucket, liabilities and premiums, and you
add it all up and you find out, No, this
is why going this direction with these options cost you
(02:38):
less money, even though like you think you're saving money
by doing what you're doing. No, you walk through a
very detailed explanation and enlightened listeners about their options out there.
So right now, medicare folks you're approaching. Is the great
thing about this is you have the conversation, You're going
to have peace of mind, the questions will be answered,
You'll know exactly what you're going to do when the
day comes when you're supposed to sign up, hit the
(03:00):
ground running and you'll be happy because you'll have better coverage.
And John will explain that all to you.
Speaker 3 (03:04):
I get a little funny anecdote here for you, Brian,
because you know, I don't realize, we don't realize how
we operate mentally. So my assistant ends up is my
mother in law. She always makes a joke because she'll
she'll work with numbers for me. She goes, hey, this
this client has this and this out of pocket. I'm like, okay,
this is her true cost healthcare. I just do it
like quickly in my head, and she goes, I sit
there my calculator and I do it. I go, you're
(03:26):
off by fifty cents. Well, the funny thing is, I
don't know if I told you this story. So you know,
my entire business is family, right, my my my father
in law, my mother in law, my wife, my brother,
my mother worked for me. Well, now my youngest brother
up in Wisconsin, and just there was a drain on
(03:48):
him after for a while, and he was like, man,
I like what you do. I want to help people
a little differently. So he needs insurance license. So came
in for the last three with me. I've been training
him about the business, right, so now he's in the
business as well. And my mother in law mentioned that
story to him, like your brother goes He's been that
way his entire life because you usually have seen how
he used to do it with my parents when we
tried to convince them we needed a computer and how
(04:08):
much time it would save him from ready reports. So yeah,
I've had that my entire life. Yeah, And I realized
from day one, like, listen, it's insurance jargon. It just
can be way over people's head. Right if I start,
If I sat here today and all I did was
just give you the jargon and talk to you from
the insurance standpoint, you probably turn this radio station off.
Speaker 2 (04:31):
Yeah, clearly.
Speaker 3 (04:32):
Yeah, And I said, how does people really operate? I
operate on numbers, right. I wanted to know, like, this
is what it costs me, and if I buy this
doesn't make financial sense. I literally walk into like all
these stories and they when when you buy that the warranties,
and I do a quick calculation in my hand, and
I go, if I break this TV or something happens
to it within this timeframe, and when this is what
I'm paying, does it make sense to buy it? And
(04:54):
I'm like, well, if I can rebuy this TV in
two years, it doesn't make sense by it, so exactly,
don't do it. That's why I ever buy the warranties.
And of course then my TV goes and yeah, then
I'm like darn, but I saved more money over time.
But when I started looking at it for clients, it's
exactly the same premise. I always go, hey, if you
buy this, you have to go this long without doing
anything to make it make sense. Yeah, and if it's
(05:16):
over five years, always buy it. Five years is for me,
from what I've seen, is that number. And if you
have kids in a family, you can even shorten that
because we're just extrapulating higher numbers, right. But that's you know,
when I talk to clients all the time, that's a
lily why Tom's like, hey, you can add this on now.
It only makes sense if you have a claim in
the next twenty years.
Speaker 1 (05:37):
Well, I mean a real quick illustration last week you
walked through that with the cost of the home healthcare
plan getting people in your home to care for you,
like if you, you know, have an accent, an injury,
or otherwise physically disabled in your old age, that for
basically four hundred bucks a year that's covered. But if
you had to pay out a pocket for that to
have someone come in to your home regularly on an
(05:57):
hourly basis, it's easy to do the math and know
why four hundred bucks annually.
Speaker 2 (06:02):
So I'm telling I'm very good at math.
Speaker 3 (06:03):
I couldn't even do that number because you're talking about
somewhere in the neighborhood of sixty seven thousand dollars a month,
a month a month, so for four hundred bucks a year,
I mean, that's crazy fifty years.
Speaker 1 (06:12):
I mean, like see, okay, that's why I brought that
one up, because that math was really easy.
Speaker 3 (06:18):
That it's easy, I mean that it doesn't make sense
at all at that point. It's I mean, I look
at going out. I mean, my wife and I just
went out to dinner the other day and it was
over one hundred bucks. I'm like forty bucks.
Speaker 1 (06:27):
I mean, it's like, come on, guys, forty bucks a
month to get someone in your home to care.
Speaker 3 (06:31):
For you or your love one yes quarter or tank
for my truck.
Speaker 1 (06:34):
Well, and you know you started off in the context
of Medicare, because that period is fast approaching. So schedule
your appointment with John on the Team five point three
eight hundred call. But this also applies to regular insurance
as well. This point in time is when people should
be making their appointment.
Speaker 2 (06:50):
Yeah.
Speaker 3 (06:50):
So again, if you're in a situation, if you're on
a marketplace plan, so Obamacare, healthcare, dot gov, ACA, all
the different acronyms for it, right the opening home, it's
vastly approaching, right, So November first, here's the big thing.
We have a lot of clients, and we have a
lot of listeners that call in. We want to make
sure you guys are priority. So the biggest thing right
(07:12):
now would be to call in and get yourself scheduled
and already lined up. And I mean, let's do it
in the beginning of November, right like that way. If
anything changes, if if we have to pivot somewhere, we
have plenty enough time to readjust your plan for January first,
which happens, right, But I want to make sure you're
resolved and get that taken care of, because I'm telling
you right now, I already have clients that the marketplace
(07:33):
is starting to contact, and they're starting to scare people
because they're reaching out. That's what my clients are calling.
I had a client literally call in this week and goes, hey,
the healthcare marketplaces reach out to me. Now I'm going
from what they said because it's usually usually late and
they usually start contacting people in like October, right, so
i'd be doing this in August.
Speaker 2 (07:52):
Is a little scary.
Speaker 3 (07:53):
It could be some call center which those do to
do that, but what we're talking about, they weren't the
only person. We have a couple other people call it.
And so now that's why I'm bringing it to light. Hey,
you might be getting contact, you might start getting letters.
I don't want you to fret. The biggest thing you
can do is give us a call. Get scheduled, regardless
if you're a client or not. Because I really want
to sit down with anybody that's on a marketplace plan
(08:15):
for twenty twenty six, because guys, there are such big, huge, humongous,
I don't care what term you want to use, changes
coming for twenty twenty six for the marketplace plans and
they're not good, and it's not good. Out of pocket
expenses they are going up. I know right now there's
insurance companies, big ones that are canceling coverages. So you
(08:35):
can have insurance right now and you I'm upon an
insurance company and it'll be gone. And I will say
this because they're gone and is gone January first, big
insurance company no longer doing business in our area. They're
no longer doing business in all fifty states, so they
just completely cease doing business for January of twenty twenty six.
If you're on a plan, you have to change. It's
not an option. You don't have insurance at twenty twenty
(08:56):
on January first.
Speaker 2 (08:58):
Right.
Speaker 3 (08:58):
Secondly, the tax credits, guys, they're they're they got gutted, right.
We lost the open ended where you can have a
higher income and still get help with your health.
Speaker 1 (09:09):
Insurance kicked in in COVID during COVID.
Speaker 3 (09:12):
Yeah, they ticked in the COVID. That was part of
the American Rescue Act that they put that in there
to help everybody, which we thought would day around.
Speaker 2 (09:19):
I mean I was pretty shocked then, you know.
Speaker 1 (09:22):
For your premium, Yeah, so the tax really is all
that made it affordable for a lot of.
Speaker 3 (09:26):
People, which again it did, and for a lot of
people we'd have I mean, especially if you're only like
your sixties and I had a little bit higher income,
it was because your premium is so much higher.
Speaker 2 (09:35):
Your premiums can be a four or.
Speaker 3 (09:36):
Five times more expensive than your twenties. So you start
seeing people in their sixties with their their their base
price of their health insurance is eight nine hundred thousand
bucks a month. You know, so they were getting yes, yes, Brian,
but I mean.
Speaker 1 (09:49):
Ten thousand plus dollars out of pocket liability.
Speaker 3 (09:52):
Before the person before you even get insurance, and twenty
grand out of pocket before you can even use your
insurance right for a family. But listen, they were getting help, right,
So I have so many listeners that were like making
husband and wife making ninety grand a year. Maybe they're
only paying five hundred bucks a month for this plan. Well,
guess what happens January first, it's gonna jump to sixteen
eighteen hundred dollars a month.
Speaker 1 (10:12):
And what's seventy thousand dollars in family income? That means
you can't take advantage.
Speaker 3 (10:16):
No Texte at no text credit, no tax credit for
this people that goes away. So that's why it's so important,
because if I don't adjust your plan before then you
might be sol and I can't do anything until next year.
So it is why it's just skuys. It's so important
that we talk everybody that's on these plans.
Speaker 2 (10:33):
Don't.
Speaker 3 (10:34):
Don't go to healthcare dot gov. They can't. They can't
even advise you on what to do. They can go
here's the plans, which ab or say, right. They can't
sit down and make sure that you're at the right plan.
You know it Just it's so imperative because of the
tax credits and and the worst part, Brian, and this
is where I see the biggest hole for a lot
of listeners is maybe those ones that have lower income.
(10:56):
So they were getting what they call the cost share
and reduction, where we your income was low enough that
they were not only helping you with your premiums, they
were helping you through out of pocket expenses. Because listen,
you're making twenty eight grand a year, how can you
pay ten grand? You can't, you can't, right, So a
lot of these people were getting plans that out of
pockets maybe two or three grand, right, because that's a
(11:17):
little bit more affordable for those people. It's still be
a stretch, but now it's gone. So that cost sharing
reduction that a lot of people were getting on those
silver plans is gone twenty twenty six for everybody. So everybody,
regardless of your income, if you're just a smidge over
medicaid and can't you know, can't get medicaid, you are
now going to a ten thousand, two hundred dollars out
of pocket come January first. And these people need massive help.
(11:42):
And here's what we're seeing, and this is what we're Listen.
If there's one takeaway you get for me today, if
you're on a marketplace plan, get out of the silver plans.
It don't make sense anymore. Everybody should move to a
bronze plan. The bronze plans are probably be twenty percent cheaper,
has the same out of pocket. They'll just scare you
with a little bit higher aductible.
Speaker 2 (12:00):
Doesn't make a difference.
Speaker 3 (12:01):
Guys, with how expensive even an emergency room is now,
you're hitting your entire out of pocket if you go
into the hospital or have a surgery. It's just numbers, right,
So they'll scary. You're like, oh, well, you're going from
a five thousand to a seven thousand dollars a douctible.
Don't worry about it. You look at the out of pocket.
That's always a number I advise people to actually care about.
But if I can save you twenty percent more there
(12:23):
moving from a silver to a bronze plan, I can
then use a little bit at savings to get you
gap coverage so that you never pay ten grand. Ever,
I mean that I can't stress that enough. I mean,
there's just so many people on these plans, Brian, that
I know going into twenty twenty six that are gonna
be paying more money because they didn't hear this message.
(12:43):
And how many people are gonna probably file bankruptcy because
now they're going because I mean, the average debt for
medical that the people fire bankruptcy is ten grand, and
now you're out of pocket's ten grand per person. So
you're gonna see people that get on these plans and
can barely afford them and then go use them and
can't even.
Speaker 1 (13:02):
Afford the bill, and with the same pile of money
they're getting for really no, I'll call it no insurance
under that scenario. You just reallocate the dollars spent monthly
to different a different plan like that gap plan double
with the bronze plan. Yeah, same money, not a pocket
liability under that scenario. That's the package for this very low.
Speaker 3 (13:26):
I mean, our goal is to bullet proof you as
much as possible. We're gonna layer your coverages so that
you'll never be in a situation that you're ever gonna
have to think about, oh my god, I gotta go
pay ten grand because I'm in a situation or more.
I mean, god forbid, you're at a network and pay
the entire bill, right, And that's why it's so important
to sit down with one of our independent advisors that
(13:47):
will go over this with you.
Speaker 2 (13:48):
Guys.
Speaker 3 (13:49):
Again, everything's free. It's a free evaluation of your current situation.
And I always will tell you this. If you are
in the best possible situation, I will leave you alone
and tell you don't change your plan. Yeah, I mean,
that's not my.
Speaker 1 (14:00):
Point that I want to doing commercials Like you know,
this analysis is free and almost because you don't have
to change insurers or deal with a different form of
you know, different types of medical plans. If you say no,
you're in the best possible place you can be. I
John Roman and the team of Cover since searching through
and scouring thousands of medical policies that we have access to,
(14:21):
can't find you a better solution. That's actually kind of
good news in a way. At least it makes you
feel bad, like, well, if I haven't spent in my
wheels for the last several years.
Speaker 3 (14:29):
It's like, you know, go into a lawyer and says
you don't have case, right, like okay, thanks, yeah, yeah, okay,
appreciate it. Appreciate it. Then you know, I thought I did,
but you don't know what okay or don't do that right.
I love that when I went to a lawyer one
day and I'm like, we're buying buying our business and stuff,
and he goes It's like, well can you do this?
He goes, no, you can't do that, though, thank you.
I get it in my head. I'm not a lawyer,
(14:49):
you know what I mean. That's what you want in
an expert is to be able that an advice and puts
you in the right possible situation. And like I said,
when you deal with places like these call centers, and
we talked about this last week with medicare huge call centers.
That's Leeca coverages and Obamacare plans. That's the majority of
the marketing that goes out there, all over social media,
all over the internet, all over TV. Good luck reaching
(15:13):
back to the same person that sold it to you,
you know what I mean?
Speaker 2 (15:15):
And Steve input job, yeah, I mean.
Speaker 3 (15:18):
And you know which is funny because all those employees
that work for those call centers, guests who they call
come march me.
Speaker 2 (15:26):
They're calling me for job.
Speaker 1 (15:29):
Right, Yeah, you have mentioned that before, and they don't
get what you do. I mean, they're in the insurance business.
We there are people out there that work for an
insurance company that want to sell you that insurance company's
medical policy. And we've talked about that before as well.
They don't understand what you're doing. Now, I have a
we do. We do quarterly training. So again I always
say that I have hundreds of agents that actually are
(15:49):
under me throughout the company, throughout the country. And you
know what we do is every quarter we bring a
bunch of agents and train them and usually there are
newer agents that join our team and they're blown away
with the concepts.
Speaker 2 (16:02):
That we do.
Speaker 3 (16:02):
I've had I had an agent here recently who's been
in the business fifteen years selling health insurance, individual health insurance,
doing exactly what I do. I sat him down and
showed him what we do. He goes, I had no
idea you could do this. See, and I've been doing
this for fifteen I go, what have you been selling?
He goes, I just sell what the insurance companies tell
me to sell. And I thought there were really good plans.
I go, and what do you think now? He goes,
(16:23):
They're crap. They're crap the package as I put clients,
and he goes, I have to call people back because
I've left them expose from what I'm seeing, and he goes,
I didn't realize that, and he goes, I was putting
people with the silver and gold plans on the ACA.
I was writing these lower deductible plans for higher premiums.
And go, well, that didn't makes sense, right. You write
a higher deductible plan to cover the catastrophic and you
(16:45):
write a very affordable plan to cover all those out
of pocket expenses, and you layer the coverage.
Speaker 2 (16:50):
He goes.
Speaker 3 (16:50):
He goes, yeah, He goes, now I can call them
back and save them thirty to forty percent off what
they had, and I can get my clients better coverage.
And you know he's been doing great because he's just
to call on his current you.
Speaker 1 (17:02):
Know, hey, my eyes got open in the last year.
I've got a better option for you. Yeah, that's great. Well,
what are the top five mistakes people make? Generally speaking?
Speaker 3 (17:11):
I think the number one biggest mistake people have is
habit of having a plan and thinking, I have health insurance.
Speaker 1 (17:17):
I'm just done.
Speaker 3 (17:18):
I'm good, and never going back and will never going back.
It's literally like you own a car and you never
open the hood and check the oil. Ever, Like, come on, man,
like you have to. You have to pop that open.
You need to know how your coverage works. And if
you don't, I'll tell you right now. The easiest thing
for you to do just give us a call and
we'll tell you how your coverage works. Right, I mean,
(17:40):
that's the easiest thing for you. But if you really want,
call your insurance company, have them send a copy of
your sixty page document and read through it and come
through it and find your holes. And I'm telling you
right now, most people don't do that, and most people
don't even understand what they're looking at and that's really
what our goal is. I mean, my goal of selling
health insurance to clients is the holes.
Speaker 2 (18:01):
Where are the holes? Where is your exposure?
Speaker 3 (18:03):
And is that something that could potentially hurt you in
the future. And nine out of ten times, Brian, those
holes are absolutely going to hurt people in the future.
So that's really the biggest thing is just thinking that
you're paying for health insurance and you're good because no
one you literally the common I tell people when they go, hey,
I have health insurance.
Speaker 2 (18:23):
I'm good.
Speaker 3 (18:24):
It's like, oh, do you like your plan? They go,
oh yeah, it's okay plan. I was like, okay, it
sounds like something you use a lot. Well, I never
use it, do you know how good it is?
Speaker 1 (18:33):
That's why no one looks at it because they're not
experiencing a lot of claims. Now, their eyes would be
wide open about claims, denials and the holes in their
policy if they were not.
Speaker 2 (18:42):
Well oh yeah, And here's the.
Speaker 3 (18:43):
Worst part is when they start realizing that it's really
too late for me to do a lot of the
good things for me.
Speaker 1 (18:50):
So waiting too long to have this analysis, not doing
this analysis, I think, I tell my clients, you know,
even if I set you up right now, every two
or three years, I'm probably going to change you again.
I just want you to be kind of aware of that,
because new plans come out, different things happen. Things get cheaper,
other plans get better. So I want to be able
to readjust your plans. Like, as long as you stay
in relatively good health, you're in great hands here because
(19:10):
we'll just keep making sure to get better and better
coverage all the time. And our clients really, really really
appreciate that because we're so up to date on what's
going on. And if you're on a plan for a while,
it's at a date. It's like a computer. Man, eighteen
months goes by, like that thing's slow. It's like my
cell phone for whatever reason, like my iPhone, Like, yeah,
eighteen months later, it's really slow. I'm like, why is
my phone suck? I go get a new one, right,
(19:31):
And the network's change. You've talked about that, the rug
gets pulled out from under the you're insured, you go
to a regular doctor and next thing you know, that
doctor is no longer in the UH.
Speaker 3 (19:39):
And you don't know, and the provider WI you don't know,
or you're on one of those plans that it only
go once a year, and you know, you didn't change
your plan and they dropped you, and now you're stuck
on that plan for another year. I can't do anything
until till the following year. Now you just now you're
without your doctor. So networks are huge because it happens
all the time, and knowing what type of coverage you
have is is so paramount because at the end of
(20:00):
the day, if if your network changes, so a lot
of our private plans we do Brian, right, I have
great cares. I literally have a company right now that
has a network and they don't care if you say
in it, it's the same out of pocket if you
go out a network or a network, they don't care. Well,
so tomorrow if you wanted to go to I always
say MD Anderson is one of the best cancer hospitals,
(20:22):
and this is it is a network, by the way,
But if it was at a network, you can still go.
Speaker 1 (20:26):
Well, isn't it like operate like a PPO?
Speaker 3 (20:28):
Well, it's a PPO, but go look at your group
health plan PPO. What is the out of pocket on
your group health pay? Exactly double? It's double. So let's
say you have a ten thousand dollars out of pocket
on your network, it's twenty thousand.
Speaker 2 (20:41):
If you go out of network.
Speaker 3 (20:42):
This company has the same Internet A network and it's
like five grand. Yeah, so I mentioning like on the
private side, it's it's phenomenal and it just it gives
so much better piece of mind. But hey, guess what
if your doctor or hospital leaves a network, who cares
because you can still go. That's that's a great piece
in mind.
Speaker 2 (21:00):
So that's huge. Right.
Speaker 3 (21:01):
Assuming your employer coverage is always best is one of
the things I think is hilarious because I get employers
that call me all the time and I'm looking at
their plan like, chunk, can you help me?
Speaker 2 (21:11):
I'm like, I need to help you.
Speaker 3 (21:12):
Like how many of your employees actually tell you they
have good health insurance? Go do a poll, Go pull
your employees like, hey, on a one of the five scale,
ate your health insurance and like we'll do it, we'll
do it, we'll do it. So we don't know who
you are, right, don't don't do a raise of hand. No, no,
And most people probably say they don't think they have
very good insurance, and it's not because you're not paying
a lot of money as an employer. It's because the
(21:34):
out of pocket's so high. Every time they use, they're
paying so much money out of pocket, and the premiums
keep going up. Right, So even if you're on your
employer plan, you're like, this isn't this isn't okay. I'm okay,
I don't use my plan again, pop the hood. But
even if you're on an employer plan, God, those out
of pockets are so high you can look at adding
small pieces. God, you should get an accent in policy.
Everyone should own an accent in policy. I carry an accent
(21:57):
policy for twenty years before I even had kids. I'm
telling you the best part about my accident policy. I know,
no matter whatever happens any scenario, kid gets hurt, I
get bit by a brown recluse, spider dog bites me,
I get into a car accident, which, again, car insurance
doesn't cover all your medical expenses. The most I ever
pay on an accident is one hundred bucks. Regardless of
the bills five hundred or fifty thousand. I will only
(22:20):
pay one hundred bucks on any accent ever do. And
you can add that to any plan right under the sun.
Speaker 1 (22:25):
See, and I think that's something that people overlook, that
very element you just pointed out. Just because you're on
your employer's group plan doesn't mean you can't act in
your own best interest. Get that accident policy, for example,
which won't be very much money out of pocket. Additionally,
but considering the massive savings you're going to have, I
have it in place.
Speaker 3 (22:45):
I'll get with you right now. You can do an
accident policy that I would recommend. It's less than fifty
bucks a month for your entire family, and it'll give
you a hundred dollars reductible on an accent. It works
with your current health insurance, so they coordinate. They'll pay
your out of pocket expenses. It's for less than fifty
bucks a US, so six hundred bucks a year. You'll
never have to worry about meeting your deductible, your co insurance,
(23:07):
or all those kope's. It's worldwide coverage, so you can
go get hurt in Mexico and it'll still help you
cover your bills. It costs the out of pocket on
its one hundred bucks one accident. So I did, yeah,
one accident. I mean, if you're out of pockets like
let's say five grand, I'm paying six. It's it's almost
nine years. So one accident in nine years, because I
guarantee if you have an accent, go to the emergency room,
(23:28):
you're paying five red right, right, it always is starting figure,
starting figure, right, and you're only paying a hundred bucks.
So if you have one accident in your family in
nine years, you should have bought the plan. And I'm
telling you, with my three kids, I'm in the emergency
room probably like every eighteen months. Well, it's whatever it is.
My son broke his arm last year and broke his
(23:49):
finger the other year. I mean, you just you're taking
him in. My son fell off his hoverboard Christmas morning
because he decided to right around this hoverboard and take
a trash out. I mean those things happened, right. I
had a client get by bit by a brown recluse
spider seventy thousand dollars later in here. No, no, I
mean I don't have a lot of these personal stories
(24:10):
that their clients. Sorry, seventy thousand dollars in skin.
Speaker 1 (24:12):
Grafts from one spider bye, one.
Speaker 3 (24:16):
Spider by bitter calf and like literally started just de
tearing and they do skin grafts on. It is over
seventy thousand dollars and she paid a hundred bucks for
the entire event. So yeah, I'm just telling you, like,
that's a small policy. I don't know their story because
I just I think is just so important. One of
(24:36):
my one of my best agents, one of my best
independent agents. She actually came over to us because her
daughter was the flyer on our gymnasts on our my
daughter's gymnastics team. So the one they they throw up
in the air. Oh yeah, And one day she was
throwing up in the air and she goes, oh my god,
I hope she doesn't ever they don't ever drop her
and she gets hurt. She goes, I have an HSA plan.
(24:57):
So it's a highductible health plan. She goes, my deductible six.
So my wife turned her and goes, I got a
plan for you. So she sold her an accident policy
right there. So she literally came back to me three
months later she goes, that was like the best little thing.
Speaker 2 (25:10):
I haven't used it. I that's the best little thing.
How do I do that? And now?
Speaker 3 (25:13):
And she's been an agent for me for the last
five years. She and did that because she saw the
value of that.
Speaker 1 (25:18):
That's amazing.
Speaker 3 (25:19):
Yeah, so I'm telling you, like, and she had a
group health plan, great benefits. Her husband works for a
fortune five hundred company, but they had a six thousand
dollars a doubtable and she's like, I don't want to
pay that if my kid falls.
Speaker 2 (25:29):
You know.
Speaker 1 (25:30):
I seem to recall a story when my sister was
in high school that one of the high school cheerleaders
actually got paralyzed in doing that. Yeah, imagined the medical
bills on that.
Speaker 2 (25:39):
Oh, I'm huge.
Speaker 1 (25:41):
The tragedy in and of itself was bad. But when
you got a tragedy like that coupled with infinite medical
bills to deal with it, Oh yeah, accident policy in place.
Speaker 3 (25:51):
And here's the worst part, Brian accent plans are phenomenal.
You gotta buy the right one, right, No, because this
is this is a big point that I want to
make out to you. But they're not all equal because
there's accident and policies out there that I don't sell
that literally won't cover you if you're in an intercollegiate
or collegiate sporting event. There are accident plans that won't
(26:11):
cover your driving ATVs. There's accident policies that won't cover
you and a lot of different situations. I don't sell
those plans.
Speaker 1 (26:18):
Right, Okay, that's where your expertise comes in, because someone's
listening to this. I'm gonna call whoever. I'm just I'm
gonna go out and buy myself one of those accident
policies and they'd see you.
Speaker 2 (26:28):
Are they go online?
Speaker 3 (26:30):
Or I don't sell those accident plans and only cover
after for the first thirty to sixty days after the
event I tore my shoulder working out my rotator. Cover
my labor and surgery was six months after, right, so
it would only cover the first claims to the first
ninety sixty days. If I would have had the different policy,
it wouldn't have paid for the big part of my bill,
which is my surgery. Mine did because that's the one
(26:53):
I have, and that's the one I use and have
for twenty years, and that's the one I recommend for
my clients.
Speaker 1 (26:57):
And that's when you recommend for your clients. Of course.
So I guess the conclusion we need to come to
here is do not wait, wait, schedule the appointment, get
on the list. You know, even if it's you're working
with your group through your employer. You still talk to
John on the team because there's obviously a better way
saving you all that out of pocket liability. And of course,
(27:19):
folks out there dealing with medicare you're getting close to it,
get an appointment with John. He has opened my eyes
and enlightened me. I'm not yeah, I'm going to be
sixty next month, so I'm not pushing this whole idea
of medicare and I'm not thinking about it yet. But man,
you have really opened my eyes to some of the
serious holes pitfalls people can fall into dealing with medicare.
Speaker 2 (27:38):
Oh my god, it is.
Speaker 3 (27:38):
But I'm telling you right now, if you do the
right if you set it up the right way, yeah,
it'll be the best coverage you've ever had in your life.
Speaker 2 (27:44):
I firmly stand behind that.
Speaker 1 (27:47):
Big qualification though on that if you said, if you.
Speaker 2 (27:50):
Set it up the right way.
Speaker 3 (27:51):
So when I was training my sales staff how we're
doing medicare this year because of this year out of
pocket expenses and the gaps and all that we're doing,
I literally sat down with them. I go, now that
I went over this package with you, what is your
feelings to go? This is the best health coverage we sell. Yeah,
I mean that's my agents that have been doing this
for years, knowing that the Medicare way that we can
set up with Medicare advantage and the gap coverage they
(28:13):
flat out set. The best coverage we've ever sold is
the package that we're putting, regardless of any other packages
that we have.
Speaker 1 (28:20):
It's the right thing to do. Get in touch with
Don on the team it covers, since he don't care
what state you're in. They can help you out this
all across the whole country of ours. To start that
process and do it, or just go ahead and do it,
I mean, don't delay. It's cover sincey with Wireeye coversincy
dot com before we can fill out online to start
the process, or call them at five one three eight
hundred two two five five that's five one three eight
(28:42):
hundred call Enlightening as always John Roulman from Cover, since
you appreciate the opportunity to speak with you and enlighten
the listening audience on me well the better path and
steer them toward five one three eight hundred call. This
has been another edition of Rethink Healthcare together with John
Roman from Cover since
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