Latest / Bill of Health / Stop Feeding Your Deductible – How to Save Thousands on Healthcare (Bill of Health Ep.2)

Transcript

Stop Feeding Your Deductible – How to Save Thousands on Healthcare (Bill of Health Ep.2) · Bill of Health

• 0:00
  All right, my friends, I want you to think about the last time you bought
• 0:03
  a vehicle, a car, a truck, whatever.
• 0:05
  Did you walk onto the showroom floor or the lot, look at the sticker
• 0:10
  price on the window, and just hand over your wallet and say, "Yes,
• 0:13
  I'll pay that, no questions asked"?
• 0:17
  Of course you didn't.
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  If your car needs an oil change or some tire work done, do you
• 0:23
  automatically take it to the dealer to have their mechanics do it, or do
• 0:27
  you go to a trusted local shop nearby that can do it for half the price?
• 0:32
  Of course, that's where you go.
• 0:33
  You protect your hard-earned money.
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  Yet when it comes to the dollars we spend on healthcare, we completely throw
• 0:41
  that consumer logic out the window.
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  We blindly hand over our insurance card.
• 0:45
  We cross our fingers.
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  We wait for the mystery bill to show up in the mail some six weeks later
• 0:59
  Welcome back to The Bill of Health.
• 1:00
  I'm your host, Bill Feigh, the health insurance guy, and today we're diving
• 1:04
  straight into the core of becoming a smarter healthcare consumer.
• 1:09
  This is something I'm absolutely passionate about and is so important,
• 1:12
  and we're uncovering how two simple concepts, cash pay and site of care,
• 1:18
  can keep hundreds, if not thousands of dollars in your wallet There's a couple
• 1:24
  concepts that I wanna start out with, some things that we need to think about.
• 1:28
  Mind shift, actually.
• 1:30
  You are a consumer every day.
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  You choose what cable company you use.
• 1:36
  You choose what car you drive.
• 1:38
  You choose what TV you buy.
• 1:40
  You choose everything in your life.
• 1:42
  You are a consumer, and in many of those instances, you act like a consumer.
• 1:47
  You shop.
• 1:49
  You try to save whenever possible.
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  As I mentioned earlier, we don't think about that when it comes to healthcare.
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  So the mind shift, the change, is that I want us all to think about
• 1:59
  that we are healthcare consumers and we need to behave like that.
• 2:04
  We need to start shopping.
• 2:07
  Also, we never really think about where we buy our healthcare.
• 2:12
  It seems odd.
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  We go to the doctor's office and the doctor says, "You need an X-ray,"
• 2:17
  the doctor writes a prescription for the X-ray, and the scheduler
• 2:20
  sends us probably to the hospital chain or to the affiliated medical
• 2:23
  center, the regional medical center, wherever that doctor is practicing.
• 2:27
  We don't really think about where we get our healthcare provided.
• 2:31
  As a consumer, though, we're gonna start thinking about things differently.
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  We are absolutely going to start thinking about being a smarter healthcare consumer
• 2:40
  and where we receive that healthcare.
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  All right, just a real quick story.
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  I was trying to be a smart healthcare consumer.
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  I needed to go to the urgent care for a bad back, so I called my local urgent
• 2:52
  care and I said, "I would like to know what the cash price for a visit would
• 2:56
  be." In my mind I'm thinking, most of the health plans that I see here, they
• 3:02
  charge $75 or $100 for a visit for the copay, so I should be able to get it
• 3:08
  less than that as a smart consumer.
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  I was super, super surprised when the receptionist came back and said,
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  "Yeah, the cash pay for a visit's going to be $180." Considerably different.
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  Well, here's the lesson I learned.
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  That's the sticker price.
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  They're gonna protect their commercial insurance contracts, those copays
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  that you're paying, and they're gonna give you the sticker or the
• 3:33
  chargemaster price, just like when you're walking into the car dealer.
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  The sticker price, and very rarely, my friends, as you know,
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  is the sticker price what you pay.
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  We have to start thinking about that, right?
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  We have to start thinking about sticker price.
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  Is there a way to get this price down?
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  And absolutely, almost always there is.
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  So beyond the sticker price, I want us to also think about The two things we talked
• 4:01
  about earlier, being a smart shopper, looking for the best possible price, and
• 4:05
  also where I'm receiving those services.
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  And I wanna start with something called the deductible realization.
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  We all kinda know what a deductible is.
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  It's the amount of money you typically pay before insurance kicks in, and we
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  think that we are responsible for paying that deductible wherever the doctor
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  or the nurse practitioner sends us.
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  That's what we have to pay.
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  We don't ever think about being a smart healthcare consumer.
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  Maybe you've got a network you have to deal with.
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  Maybe that's why the doctor sends you to a particular place.
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  Think about it.
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  As a cash pay patient, as somebody who's having to pay a deductible,
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  maybe you have a great healthcare plan.
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  That healthcare plan has a deductible that's 2,000, 3,000, $4,000, or
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  maybe you're like a lot of other individuals I deal with who have a
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  $7,500 deductible, a $10,000 deductible.
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  And you think to yourself, "Boy, I gotta go where the doctor sends me so that I
• 4:56
  can start getting this deductible chipped away at Let me ask you a question.
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  How long have you had an insurance plan, and how many times have
• 5:05
  you actually hit your deductible?
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  Unless you've had a catastrophic illness, a terrible accident, or
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  something of that nature, you've probably never hit your deductible.
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  I'm not gonna tell you how old I am, but I am in my fifties.
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  In my most recent memory, I can only think of hitting my deductible one time.
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  So you may never hit your deductible.
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  If you go to the doctor when you're sick a couple times, if your kids
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  go for runny noses and things like that, or a rash or something, you
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  may never, ever hit your deductible, and so you're always paying cash.
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  You're always trying to satisfy your deductible.
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  If you never hit that deductible, you just keep feeding the monster
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  that you will never satisfy.
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  You are one hundred percent paying money out of your pocket for the
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  inflated sticker prices of those services, and then at the next calendar
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  year, it resets, and you do it again.
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  So as a smart consumer, as a smart healthcare shopper, why don't
• 6:03
  we ask a couple of questions?
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  The doctor's gonna prescribe lab work.
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  The doctor's gonna prescribe a CAT scan or an X-ray.
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  The doctor's gonna prescribe this procedure.
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  Let's stop and ask a couple of questions.
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  "Where would you normally send me for that procedure, Doctor?" "I'm gonna
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  send you to the regional medical center that I'm affiliated with." "Okay.
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  Can you tell me or provide a good faith estimate, or can they provide
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  a good faith estimate as to how much that procedure is going to cost?
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  And what if I choose to pay cash somewhere else?" Absolutely
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  within your power to do so.
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  Let me give you an example.
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  I have a stomach acid problem.
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  I take a pill to control stomach acid every day.
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  And because of that, I oftentimes get an upper endoscopy done to
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  make sure that my stomach and my esophagus are in good shape.
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  I go, the doctor prescribes it to me.
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  I go start looking for places to have it done.
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  I can go to the regional medical center that my doctor's affiliated
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  with, which I've done a dozen times, and I know what it's gonna cost me.
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  It's probably gonna cost me somewhere near forty-five hundred dollars.
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  Well, I've started asking questions.
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  Can I go someplace else and save money?
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  Since that forty-five hundred dollars is not gonna touch my
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  deductible, I'm a cash pay patient, I'm gonna be a smart consumer.
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  Can I get that same service done someplace else for a cheaper price?
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  Not sacrifice the quality.
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  I'm not going to some back alley doctor.
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  I'm going to a healthcare professional who is board certified
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  and licensed to practice medicine.
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  I'm going to a facility that is certified and licensed and full of professionals.
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  There's no sacrifice in quality, but can I save money?
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  And the answer is yes.
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  I can go to a different place and pay 27, 28, 2900 instead of paying
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  45, $4700 for that same procedure.
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  That to me is being a smarter healthcare consumer.
• 8:00
  Yeah, but Bill, if I'm a cash pay patient, I'll never build
• 8:04
  up my deductible That's true.
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  But again, let's go back and ask ourselves, how many times have you
• 8:09
  hit your deductible in the past?
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  And let me remind you that that insurance you have is for catastrophes.
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  If you were ever in a bad automobile accident, if you were ever in a
• 8:19
  bad farm accident, if you were ever critically ill, you're gonna blow
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  past your deductible in no time.
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  Be smart when it comes to your deductible.
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  How?
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  How do we be smart about that deductible?
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  I'm gonna give you one example, and I'm gonna make sure that this
• 8:35
  gets put in the show notes, but there's a tool that you can use.
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  It's available for anyone to use, and what you'll do is you'll punch in your
• 8:42
  zip code, you'll punch in the procedure that you're trying to have done, or
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  if you have the actual CPT codes, the medical billing codes, you punch those
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  codes in, which by the way, your doctor can give you any time you ask for them.
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  And it will tell you in your area, in your zip code and in the surrounding area, who
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  provides that service, that diagnostic test, that blood test, that endoscopy,
• 9:02
  that colonoscopy, that whatever you're having done, and what the price is.
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  This company has contracted with those doctors to make sure that
• 9:10
  there's no surprise billing, and that's exactly what you pay.
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  This company I'm about to give you that will be in the
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  show notes is called MDSave,
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  mdsave.com.
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  MD as in doctor save.com.
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  I'm not compensated, I'm not sponsored by this program.
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  Side note, if anybody knows anybody from MDSave, I would love to have them
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  as a sponsor . They're not a sponsor.
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  Just look 'em up, mdsave.com.
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  That can save you hundreds or thousands of dollars, and it's super easy to do.
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  You take your prescription from the doctor, you go get your service, they
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  communicate back with the doctor, Bob's your uncle, and you've saved hundreds,
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  if not thousands, and you know that your insurance is still there for those
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  catastrophic things that you have.
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  That's number one.
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  That's being a smart consumer.
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  Mdsave.com.
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  The other thing we talked about was site of care.
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  Where?
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  Where do I get my procedures done?
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  This flows right back into mdsave.com or other sites out there like that.
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  You do not have to get that service done at your regional
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  medical center or the hospital that your doctor's affiliated with.
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  By the way, your healthcare professional is not doing anything
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  unethical or immoral by referring you to whoever they're affiliated with.
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  There's nothing wrong with that.
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  It's just that their particular onus is just on efficiency and making
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  sure that the information they need to treat you properly is there.
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  You can get that done anywhere.
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  Site of care is critically important.
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  Where do you have it done?
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  Not too long ago, was having some back problems.
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  My doctor wanted to send me for an old-fashioned black and white
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  X-ray of the spine just to make sure there's no stenosis or narrowing or
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  there's no disc compression, whatever.
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  Just a regular old black and white X-ray.
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  I could go to my regional hospital network and pay 100 or so or whatever the co-pay
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  was, or I could go to a freestanding imaging center and pay $35 for that X-ray.
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  There's no choice.
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  There's absolutely no other option for me.
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  I'm going to be a smart healthcare consumer any time I can.
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  So when you go to your doctor and they say, "Here's a prescription to get blood
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  work done. Here's a prescription or written out instructions for an X-ray
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  or a CT scan or an MRI." They want you to take it up to the front desk
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  to the scheduler to get it scheduled.
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  That's not your only options.
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  Say, "Thank you for that. I'm gonna shop around just for a little bit to
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  make sure I'm doing what I can for myself as a smart healthcare consumer,
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  and I may give that scheduler a call." That's not even a conversation
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  you have to have, but you can.
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  Let's say you did shop around.
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  Your regional network is very, very affordable, and so you
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  do give the scheduler a call and you get it taken care of.
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  Never let the scheduler basically book you at the hospital by default.
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  Ask for independent imaging centers or freestanding labs
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  or wherever the case may be.
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  Use the tools that are at your discretion.
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  Absolutely 100% make sure that you're being the best healthcare consumer
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  you can, and that you're making sure you're getting your healthcare
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  where it's the most cost-effective.
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  Two big tips All right, my friend, we're at the part of the program where
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  we're gonna open up the jargon jar.
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  This is where we take the confusing, intentionally muddy
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  language of the insurance world, and we make it into plain English.
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  We've talked about it earlier today, but we're gonna talk about the deductible
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  and the maximum out-of-pocket.
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  Your deductible is what you typically have to pay first before insurance kicks in.
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  Yes, you may have to pay a flat $50 to go see your primary care physician, but
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  if that primary care physician orders labs or imaging or procedures, you
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  typically have to pay for that first.
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  If you have great company-sponsored healthcare, maybe your deductible is low.
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  Maybe your deductible is only 2,500, 3,000, 4,000, whatever the case may be.
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  For individuals using the marketplace in a bronze plan, their
• 13:03
  deductibles are typically 7,500.
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  They could be as high as $10,000.
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  Basically, the absolute worst-case scenario legal limit, basically, right,
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  your deductible is what you have to pay first until insurance kicks in.
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  The second concept, MOOP, maximum out-of-pocket.
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  Okay, friends, that's the finish line.
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  The insurance company says this is the most you'll spend in a given calendar
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  year before insurance pays for everything.
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  Some people have a deductible that's 7,500 and a maximum
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  out-of-pocket, a MOOP, of 10,000.
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  It could be all across the board.
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  Deductible, you pay first.
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  MOOP, everything after that, your maximum out-of-pocket,
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  the insurance company covers.
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  What confuses people is that if you go see your primary care for a $50 copay,
• 13:49
  you go see the urgent care for a $100 copay, you go see your specialist for
• 13:53
  a 75 or a $100 copay, that doesn't count towards your deductible.
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  You could go to that doctor 50 times paying $50 every time, and
• 14:01
  it doesn't touch your deductible That's why that deductible can
• 14:06
  sometimes be really hard to hit.
• 14:08
  That's why we wanna be smarter healthcare consumers.
• 14:13
  We wanna take better care of our wallet.
• 14:16
  Friends, if you have any questions about anything that we've talked about, the
• 14:19
  MOOP, or the, the maximum out-of-pocket, or the deductible, anything like
• 14:23
  that, I want you to hit us up, okay?
• 14:24
  And that kind of dovetails right into where we're at right now.
• 14:28
  Your health insurance is a financial safety net for catastrophes.
• 14:32
  It is not a discount shopping club for everyday care.
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  Start asking for prompt pay discounts or for prepaid discounts.
• 14:42
  Look at different retail centers and surgical centers.
• 14:45
  Shop.
• 14:46
  Be a better healthcare consumer.
• 14:48
  Save yourself some money.
• 14:51
  All right, my friends, if today's episode opened your eyes, make
• 14:53
  sure to follow our social feeds.
• 14:55
  Head on over to Instagram and TikTok and find me @billfythehealthinsuranceguy.
• 15:00
  We're gonna keep having conversations just like this to make us
• 15:02
  better and smarter consumers.
• 15:04
  We're not gonna pull any punches.
• 15:06
  We're gonna talk about what it takes to protect our wallets.
• 15:09
  My friends, thank you so much for listening to The Bill of Health.
• 15:12
  Be smart.
• 15:14
  Shop smart.
• 15:15
  Protect your wealth.
• 15:16
  And I'll see you next time
• 15:25
  This podcast is provided for educational purposes only and
• 15:27
  should not be considered legal, tax, investment, or insurance advice.
• 15:29
  Individual circumstances vary, and the listener should consult qualified
• 15:31
  professionals regarding their specific healthcare and financial situation.
• 15:32
  Opinions expressed are those of the host and guests and do not necessarily
• 15:35
  reflect the views of any insurance carrier or affiliated organization