Latest / Bill of Health / Her Son Broke His Femur — Did Their Health Share Actually Work? With Niki Chamberlain (Bill of Health Ep.10)
Transcript
- 0:05I wanna make a change, but I'm afraid to make a change because if I make
- 0:12a change, there will be change.
- 0:16As I continue to sit across the table from people discussing health
- 0:19insurance and the seemingly unending cycle of cost increases, bigger
- 0:23deductibles, higher out-of-pocket maximums, rising prescription drug
- 0:27costs, a myriad of policy changes, I hear a pretty common refrain, "Hey,
- 0:31Bill, I need to make a change," or, "Hey, Bill, something has to change."
- 0:36And this comes from blue-collar workers, white-collar workers, self-employed,
- 0:40all the way up to the middle management and C-suite offices alike.
- 0:44I think we can all see that the current model of healthcare and health insurance
- 0:48in this country is not sustainable.
- 0:51Yet we're so indoctrinated into the typical group health insurance model,
- 0:57the typical fee-for-service physician practices, that moving away from that
- 1:01becomes trying to become a smarter healthcare consumer in the process.
- 1:04It just seems like it's just a bridge too far.
- 1:07People are scared of making changes.
- 1:18Well, welcome back to The Bill of Health, folks.
- 1:19I'm your host, Bill Feig, the health insurance guy, and today
- 1:21I wanna spend just a little time talking to someone who was actually
- 1:24brave enough to break the cycle.
- 1:27She said, "That's it. I'm done with the hamster wheel. I'm all in on
- 1:31being a smarter healthcare consumer."
- 1:33She not only made the change, but has extremely valuable insights on
- 1:36how alternatives operate, and most importantly, she is willing to share
- 1:43I've said this before, ladies and gentlemen, I will keep saying it, I
- 1:46have been client-facing in all the work that I've done, meaning I'm across the
- 1:49table from the employer or the employee helping them make tough decisions, and
- 1:52one non-negotiable for me is that in the background, the people helping me
- 1:56bring the proposal to life, the people doing the hard work are always the
- 2:00most ethical and the most trustworthy that I can find, and I really, really
- 2:04love talking to smart people, and we absolutely have one of those today.
- 2:08Ladies and gentlemen, all the way from Amarillo, Texas, give a warm Build a
- 2:12Health welcome to Nikki Chamberlain.
- 2:15Good morning, Nikki.
- 2:16So glad to have you.
- 2:17Nikki, what I'm gonna do is give you maybe 60 seconds or so just to give
- 2:21a little introduction as to who you are, what you do, where you came from.
- 2:27Just basically give us a little bit about you and I'm sure obviously
- 2:30mention your family and anything we need to know about you.
- 2:32All right?
- 2:33Sure.
- 2:33Okay.
- 2:34Well, thanks for having me.
- 2:35I am a mom to three, and I'm a wife of 20 years, and also been employed,
- 2:42self-employed with my husband in a construction industry for 15 years.
- 2:47And that's sort of what led us down the path of looking for some
- 2:51alternative to what traditional medical coverage was out there.
- 2:56Yeah.
- 2:57Mm-hmm.
- 2:57Mm-hmm.
- 2:58All right.
- 2:58Very good.
- 2:59How old are the kiddos?
- 3:00We've got 16, 14, 12.
- 3:04We're busy.
- 3:05We're busy.
- 3:05Teens or pre-teens.
- 3:07Yes.
- 3:07I love it.
- 3:08I love it.
- 3:09I love it.
- 3:09Okay.
- 3:10So you mentioned that you're self-employed, you
- 3:13were looking for a change.
- 3:15Obviously, health insurance for the self-employed is just sometimes not
- 3:19tenable situations, very expensive.
- 3:21You were looking for a, a choice or an alternative.
- 3:23What did you settle on?
- 3:24What did you guys decide to use?
- 3:26Well, we use Sedera Medical Cost Sharing, which is a health
- 3:30share- Mm-hmm … community.
- 3:31Prior to that, I mean, we were all over the place.
- 3:34We had tried traditional coverage.
- 3:36Our premiums were so high with a high deductible, and anytime
- 3:41we were using them- Yeah.
- 3:42Yeah … we still were battling to get things paid for that should have been
- 3:45covered, or after all the premiums plus the deductible plus our out-of-pocket,
- 3:50I mean, it just wasn't attainable.
- 3:52It wasn't reasonable.
- 3:53And I just remember telling my husband, I'm like, "There has
- 3:55to be something else out there.
- 3:57There has to be an alternative.
- 3:59I'm just not convinced this is the way." But for a long time
- 4:02we just couldn't find anything.
- 4:03So each year you're kind of pricing out, okay, well, let's see if there's
- 4:06anything new out there this year, you know, and you're getting the
- 4:09same thing, high deductible, high premium, not really doing a lot for us.
- 4:14So that's where we came to land on medical cost sharing.
- 4:17On the cost sharing.
- 4:18Okay.
- 4:18So we've had previous episodes of this pod on health sharing- And I
- 4:23would encourage anyone who wants to know the basics on health sharing to
- 4:26go back and listen to those episodes.
- 4:27We had Richard Walton from Sedera come and talk to us a
- 4:30little bit about health shares.
- 4:31They certainly are becoming a more viable option.
- 4:34They've always been a viable option, but more and more people are coming
- 4:37to know them, I guess, is what I should say, simply because the current
- 4:41healthcare model is really untenable.
- 4:43All right, so let's talk about that because, and here's why I want the
- 4:46listeners to know, I've always said this and I've said it a thousand times, I
- 4:49wanna create a community where we have resources available for people who want
- 4:52to make that change, who want to jump to something alternative like a health share.
- 4:56And one of the things I find that is the most concerning for those folks that are
- 5:01wanting to make a change is that they just don't have any familiarity with it.
- 5:04They are just unfamiliar with how the mechanics work, how the cost-sharing
- 5:08works, and so that's what I really wanted to break down with you today.
- 5:11Give us just a little bit about the health share.
- 5:14You are working on a health share.
- 5:16Do you have a direct primary care provider for the day-to-day care,
- 5:20or do you go see somebody else?
- 5:21How do you do your direct primary care?
- 5:23We do have direct primary care, and I think that is absolutely
- 5:26the best option out there.
- 5:28You're paying cash for your care.
- 5:31Mm-hmm.
- 5:31The cost is actually less, it's manageable than when we had insurance
- 5:35and you're paying, again, a copay, and now I'm still getting a bill
- 5:38for the rest of the visit later.
- 5:41But the direct primary care is easy, it's affordable.
- 5:43For my kids, too, I mean, that's what we've used, Sedera, for those unexpected
- 5:48big things, and then the direct primary care for just our day-to-day stuff.
- 5:51I mean-
- 5:52Yes
- 5:52… I have a sick kid with an ear infection, take him to urgent care, take him to
- 5:55direct primary care, pay the bill, get the script, move on, and then
- 5:58you've got medical cost-sharing for if you have something big come up.
- 6:02I love that.
- 6:02We've had previous episodes, Niki, on direct primary care as well, so
- 6:06my listeners should be pretty well familiar with that, but I also am
- 6:09a direct primary care consumer.
- 6:10I find it great.
- 6:11I've got a better relationship with my care provider than I ever had
- 6:14with my primary care going through traditional health insurance.
- 6:17There's nothing wrong with those providers.
- 6:19They're not necessarily the problem.
- 6:21It's just that relationship I have with the direct primary care has
- 6:24really been kind of eye-opening, and I've really, really enjoyed it
- 6:28Well, nobody wants to be sick.
- 6:30I don't wanna go to the doctor.
- 6:31I want a direct primary care physician who's on my side helping me, like,
- 6:36"Let's keep you healthy. Let's get you healthy. Let's take care of all
- 6:39the things beforehand, during, after." It's more relational- Yeah … and
- 6:43I appreciate that so much, so much.
- 6:45Yeah.
- 6:46And we've said it before, let's say it again, it's direct primary
- 6:49care for your everyday needs.
- 6:51It's the healthshare for that catastrophic illness or the unexpected accident,
- 6:57maternity, those kind of things, right?
- 6:59For the bigger things, it's what the healthshare does.
- 7:01Now, so you've got a direct primary care relationship, and then mechanically you
- 7:05added, just so for the steps are clear, you added a healthshare in the background.
- 7:09Okay, you're a member of a direct primary care organization.
- 7:12You are a member of a healthshare.
- 7:15You pay cash for your services there at the direct primary care.
- 7:20That direct primary care person is kind of your quarterback.
- 7:22They'll send you to get the X-ray if you need it.
- 7:24They'll send you to get the imaging if you need it or the labs, and
- 7:27almost always it's at a reduced rate than what you would pay for a
- 7:30traditional health insurance program.
- 7:33Niki, here's the big question.
- 7:35You are cash pay.
- 7:37That word cash pay, we're gonna talk about it a little bit later, but cash
- 7:40pay scares the heck out of people, because what they fear is that when
- 7:44they go into the emergency room or they go to the doctor because of
- 7:49something big, that they're gonna be held hostage come discharged to pay for
- 7:54the entire bill all the way up front.
- 7:57They're gonna get hit with all of these things that are gonna be terrible for
- 8:00them, and they have to come up with cash up front, cash up front, cash up front.
- 8:03The mechanics of this really bothers people or challenges people, and here's
- 8:06why I want to talk to you so bad.
- 8:09You're not only a member of a healthshare, you've used their services.
- 8:14You had one of those terrible days.
- 8:16And would you be willing to share with us what happened to you within
- 8:19the details you're willing to share, and what it was like navigating the
- 8:22healthcare system with that healthshare?
- 8:26I absolutely would.
- 8:27So I have a pretty active family.
- 8:28We've got these three teens and preteens, and we are out and about.
- 8:32We are a mountain family.
- 8:34We are a beach family.
- 8:35We are a hiking family.
- 8:37We are a skiing and snowboarding family.
- 8:38We are out there.
- 8:39Ah, okay.
- 8:40So, and we we have one kid who if something is gonna happen,
- 8:43it is gonna happen to him.
- 8:45He's the 12-year-old.
- 8:46So several years ago, we were on a ski trip, and he got into a really bad
- 8:51accident and ended up breaking his femur.
- 8:55It was in an area of the mountains that turns out there were no doctors.
- 9:00So I'll kind of tell you what that looked like.
- 9:01We sat in ski patrol for about three hours.
- 9:05We took a three-and-a-half-hour ambulance ride to the closest hospital.
- 9:09That was a level two trauma.
- 9:11I'd never been in any kind of accident or situation like this, and
- 9:14so it was terrifying, first of all.
- 9:17You know, they bust those doors open, and about 20 people swarm him, and we
- 9:22walk through the emergency room, and this sweet little nurse comes up to me and
- 9:27she pats me on the back and she says, "Hey, mama." She's like, "Okay." She's
- 9:30kind of pointing out all the doctors.
- 9:31Here's what they're doing.
- 9:32You know, they're cutting his shirt off.
- 9:33I mean, it's scary.
- 9:34And she says, "Can I have your driver's license and your insurance card?" And
- 9:38I said, "Well, I don't have insurance.
- 9:39I'm cash pay." And I just remember the look on her face, shock, first of all,
- 9:44and she just patted me on the back and she said, "It's gonna be okay."
- 9:48You know, my mind was racing with, like, I'm watching my kid being put on
- 9:51this table and not knowing everything that was gonna transpire with that,
- 9:55and then also in the back of my mind, like all of us do, the money, right?
- 9:59Like you- Sure … can't help but think- Sure … about how this is gonna
- 10:02play out, and we had been members of the medical cost-sharing community
- 10:06for several years, but never needed to access those funds, never needed that.
- 10:11So I thought, "Oh, my gosh. How is this gonna work?" Is it gonna
- 10:14work was really my question.
- 10:16Backing up just a little bit, in ski patrol, you know, they
- 10:19make you pay before you leave.
- 10:21So I'm like, okay, reaching in my ski pants, and I'm like, I've got my
- 10:25credit card and my driver's license.
- 10:27Swipe that card, you know, for whatever it was, 900 and something dollars,
- 10:30and off we go in the ambulance.
- 10:31So I'm like, okay, are we in-network or out-of-network?
- 10:34Those were my questions, because-
- 10:36Ka-ching, ka-ching, ka-ching, ka-ching
- 10:38… we were in the middle of nowhere.
- 10:39Yeah.
- 10:40And now the hospital that we were going to is in a large city.
- 10:42I mean, this can't be a network.
- 10:44My mind really didn't fully grasp- Yeah … there is no network.
- 10:48No network.
- 10:48There's no network.
- 10:49I couldn't get it So we get to the hospital, we go through all the stuff.
- 10:54He ends up having a lot happen.
- 10:56He ends up having a surgery there, metal plate put in.
- 10:59He broke his femur in two places.
- 11:01This kid was… He was going hard.
- 11:03So there for a couple nights, and the last day that we were there, the hospital
- 11:09social worker calls, and get on the phone with her, and I mean, you just
- 11:13hear concern in her voice 'cause she's about to deliver this number of, like,
- 11:17astronomical amounts And she says, "Okay."
- 11:20She says, "Now I understand you're a cash pay customer or patient." I said, "Yes,
- 11:24ma'am." And she said, "Okay, well, your bill is…" She tells me this number,
- 11:28and I'm like, "That's not a number.
- 11:30That is- Right … insane." And she said, "But what we do for cash patients,
- 11:34we take off 40% automatically." I thought, "Well, that was easy."
- 11:39You know, like, why or how?
- 11:41And you know, I didn't really fully understand, so okay, okay.
- 11:44So we load our kid up and take him back.
- 11:47You know, we have to drive four hours to get us back to where we're at,
- 11:50get back home, and then it starts with just, I mean, physical therapy.
- 11:55He's in a wheelchair.
- 11:57We're doing all kinds of follow-up doctor's visits.
- 11:59We are racking it up everywhere we go.
- 12:02"Hey, we're cash pay, we're cash pay, we're cash pay." Okay, you know, and
- 12:05they're knocking that off, right?
- 12:07I mean, you're getting this cash pay price.
- 12:10So when I sat down and reached out to Sedera and was like, "Here's
- 12:15what happened, you know, we've had this accident." "Okay, my
- 12:18needs coordinator, talk me through what this is gonna look like."
- 12:21"Start uploading your… Open a needs case.
- 12:23Start uploading your receipts." "Got it." And I'm like, so I pull out of my
- 12:26pocket from my ski pants my $900 receipt from ski patrol, and I'm like, "Look
- 12:30what I got, you know, I've got it." Yeah.
- 12:32Upload that, and then all the other little things that we kind of
- 12:34accumulated along the way, right?
- 12:36We'd paid a few things out of pocket.
- 12:38We rented his wheelchair.
- 12:39We'd paid for a few physical therapy appointments.
- 12:41We'd already paid for kind of a follow-up doctor's appointment.
- 12:44All of those things, you just start submitting in until you've kind of reached
- 12:48that initial insurable amount that you hit before the community kicks in and pays.
- 12:53So it was… I couldn't believe it.
- 12:56I could not believe how easy it was.
- 12:58Now, I will also say, like, I like having the control.
- 13:02I never liked getting a bill from insurance that
- 13:04was confusing to me to read.
- 13:06I was like, "Hey, well you- Right … you said it was this amount,
- 13:08but you discounted this amount, but insurance paid this amount.
- 13:11Now I have to pay…" I mean, I didn't understand any of it.
- 13:13I mean, it was confusing.
- 13:15When I got the bill from that hospital, it was like, "Hey, here's the services,
- 13:19here's the discount, here's the number that you owe." I was like, "Well,
- 13:21that makes sense." It's so clear when you start getting those bills.
- 13:25Yep.
- 13:26There was nothing, you know, really hidden in there.
- 13:28It's so black and white.
- 13:30Submitting everything to Sedera was, I mean, easy.
- 13:34So we had a $2,500 initial insurable amount, so essentially that is our
- 13:39amount that we were responsible to pay- Pay first … out of pocket before
- 13:43the community would start sharing.
- 13:45To the penny bill, I paid $2,500.
- 13:49Now, ultimately, I'll tell you, that son had a second surgery, 'cause he
- 13:52had to have that metal plate taken out, which led to more physical therapy,
- 13:56more follow-up doctor's appointments.
- 13:58Every single one of those was shared because it was a true
- 14:01need, like this is what it's for
- 14:03It was a continuation of that first incident
- 14:06Yes.
- 14:07So I mean, I can't imagine ever going back to anything other than using this.
- 14:12Yeah.
- 14:12For our family, for a lot of people, this is the answer.
- 14:16It's just scary because I think that we think the word insurance equals security.
- 14:22Oh, I've got insurance.
- 14:23I've got insurance.
- 14:24I'm covered.
- 14:25I've got insurance.
- 14:25No, that is not always the case.
- 14:28There are two things I wanna circle back to.
- 14:31One, when you're there at the hospital, you tell them that you're cash pay.
- 14:35The social worker gives you a call Were there two big security
- 14:40guards at the door posted up-
- 14:41not letting you leave before you paid that cash bill in full?
- 14:45No, there was not.
- 14:47I mean, it wasn't a thing at all, right?
- 14:49They just are
- 14:50like- They didn't have the bill ready, right?
- 14:51No.
- 14:51They just told you what it was gonna be, but they didn't have
- 14:53an itemized bill ready for you probably for 15, 20, 30 days maybe?
- 14:57Oh, yeah.
- 14:58It was at least that before stuff started coming in, and that was the other thing.
- 15:02Yeah.
- 15:02I got a bill.
- 15:03You know, with insurance, that was the other thing.
- 15:05I remember I would get a bill, and then another bill, and then another bill.
- 15:09I'm like, "Why are more bills still coming? Aren't we settled up on this?"
- 15:12With this, one bill.
- 15:14Here it is.
- 15:15This is your final amount, and no, you did not have to pay before leaving.
- 15:19Now, there again, the ski patrol scenario, that was a little different.
- 15:22Yeah.
- 15:22And I think there are some other- Right … urgent care places that maybe operate
- 15:25in that way, but they're not gonna be those large amounts where they're…
- 15:29There's nothing they could do really, right?
- 15:31Yes.
- 15:32Yes.
- 15:32That's right.
- 15:33I honestly feel like, and I had somebody tell me this, that the one thing I'm
- 15:36not gonna be able to do if my family's involved in an emergency is to worry about
- 15:42settling up with a bill right there in the emergency room, and I'm trying to explain
- 15:44to people that that's not how it works.
- 15:46Even if you didn't have health share, that's just not how it works.
- 15:49So that was great.
- 15:50I appreciate you answering that.
- 15:50The second thing is the nurse puts her arm around you and says,
- 15:54"It's gonna be okay, mama" right?
- 15:55I
- 15:56mean, she looked more scared than I did.
- 15:57Yes.
- 15:57I'm sure she thought, "How are you gonna do this?"
- 16:00But everything happened after that.
- 16:02You didn't have to separately negotiate or try to talk down or negotiate down
- 16:07the price of the orthopedic surgeon, or you didn't say, "Hey, how about just
- 16:11one bottle of IV fluid instead of two?" You just let them take care of your son.
- 16:16That's right.
- 16:17Yeah, I mean you want them to get the best care, and it wasn't
- 16:19like he wasn't gonna get the best of the best of the best, right?
- 16:22Like- Yeah … those doctors don't know, know what they're doing in terms of,
- 16:26like, who has insurance, who doesn't.
- 16:28They don't care.
- 16:29They don't care.
- 16:29They're gonna treat every patient the same.
- 16:31It was not an issue at all, at all.
- 16:35I love that.
- 16:35Okay.
- 16:36You've mentioned $2,500 unshareable amount.
- 16:39We're gonna talk about unshareable amounts here in, in just a little
- 16:41bit, but $2,500 unshareable amount.
- 16:43Ski patrol, you know, you had to maybe pay up front, got reimbursed maybe
- 16:47for the therapy sessions or something.
- 16:48So there was a little bit out of pocket.
- 16:51You had control of that 'cause you chose the $2,500 amount.
- 16:54You could have chosen differently.
- 16:55You could have chosen more or you could have chosen less.
- 16:58Yes, that's correct, and we just think we had a conversation that was like,
- 17:01okay, what would be an amount, you know, the cost-sharing that we use
- 17:06has anywhere between 500 and 5,000.
- 17:07So what is the amount that we're comfortable writing a check for-
- 17:11Yes
- 17:12… easily knowing that the rest will be shared- Yeah … for a need?
- 17:16So 2,500 felt like a reasonable amount while keeping our monthly contribution
- 17:21at an amount which we could also
- 17:22Which we could afford.
- 17:23Mm-hmm.
- 17:23Love it.
- 17:24I love it.
- 17:24So remember now, folks, she's paying for a direct primary care relationship, she's
- 17:28paying for a health share membership.
- 17:30Those two numbers combined are probably considerably less than what
- 17:34she was paying for traditional group health insurance for the family.
- 17:38I bet that number was an order of magnitude less than what she was paying.
- 17:43It was half.
- 17:44Oh, I mean, come on.
- 17:46I've said it before, this is not a protracted sales pitch for health
- 17:50shares or alternative to insurance, it's just that more people need to
- 17:54understand how these things work.
- 17:56More people, I think, would be willing to try them, it would be right for their
- 18:00families if they had more security.
- 18:02Your story's gonna go a long way to helping give people a lot more confidence.
- 18:07Let me ask you this, how's your boy?
- 18:08Is he doing okay?
- 18:09He's great.
- 18:10He's great.
- 18:10He's fine?
- 18:11It was a long recovery.
- 18:12He is, he healed completely.
- 18:15It was, it was quite the journey, but I will say navigating it with Sedera,
- 18:20the way that they set it up on the back end with a needs coordinator, I had the
- 18:25same person every time I call, every time there was communication about me
- 18:30submitting another bill, another invoice or whatever it was, it was so easy.
- 18:35I would email, I would call.
- 18:37Yeah.
- 18:37She would reach out to me, "Hey, I'm still waiting for some more information
- 18:39from you," in opposed to times when you're going through the menu of, like,
- 18:44three different, press 1, press 3- Yeah.
- 18:46… press all those things- Yeah, right … and then get a different person every
- 18:49time and have to re-explain everything.
- 18:51It just made it so simple to turn that stuff in and get reimbursed.
- 18:55And the next question I have is a delicate one, because it all depends on
- 18:59how the information is submitted, when it is submitted, all of these things,
- 19:02plus you've got multiple things going for reimbursement all of the time.
- 19:06But on average, the other question I get a lot is, well, how long does
- 19:09it take them to finalize the claim?
- 19:12I call it a claim 'cause I'm still stuck in insurance language.
- 19:14How long does it take them to take care of that sharing need?
- 19:17Can you give us any insight as to what that looked like for your family?
- 19:20Sure.
- 19:21It was different throughout the process 'cause there were- Yeah … we were
- 19:24being reimbursed, you know, at different times for different things 'cause it,
- 19:28you know, it accumulates as you're doing different procedures or whatever.
- 19:32I do remember the first time that a reimbursement hit my account, I thought,
- 19:35"Oh my goodness." I checked my balance and thought, "Oh gosh, a deposit
- 19:38got made to my account on accident.
- 19:40The bank made an error." It was three weeks after I'd submitted my bill.
- 19:43Three weeks.
- 19:45And that was the large one- Okay … that I thought, "Oh
- 19:46my gosh," like, "Here we go."
- 19:48I wrote the check to the hospital, and then I showed Sedera, "I have a zero
- 19:52dollar balance at this hospital." You wanna be a good community member, right?
- 19:57Ideally, we do it all the right way, and we wanna keep our costs down.
- 20:00It's better for the community, it's better for every member if
- 20:03we're doing the right thing on our end and taking care of our bills.
- 20:07You know, I would maybe submit some for several weeks, maybe a month
- 20:12would be the max amount of time that it took for reimbursement.
- 20:15I was surprised at really how quickly it came through.
- 20:17Again, you're kind of stuck in this mode of how long it takes with insurance,
- 20:21how long will these things take?
- 20:22It just doesn't operate like that in the medical cost-sharing world.
- 20:25Okay, thank you for that.
- 20:27Last question I have for you, Sedera and other health share organizations
- 20:31also have teams of people who are expert at bill negotiation.
- 20:36Did you have a scenario where they had to look at a bill and say, "I think
- 20:40this is an error," or, "I'm gonna go and go back and negotiate that down"?
- 20:44Were you aware of that going on in your particular sharing need?
- 20:47I do remember one of the bills that I received, they asked me
- 20:51to go back and get an itemized- Yes … bill, and so I did do that.
- 20:56It was so simple though.
- 20:57But I don't recall any true negotiations happening to get it down.
- 21:01Yeah.
- 21:01Again, they just knock off so much already when you're cash.
- 21:04But I do remember having to obtain an itemized bill from one of the people.
- 21:08Itemized.
- 21:09Yeah.
- 21:09The other service that Sedera and others offer is part of that bill negotiation.
- 21:14If they see an error, they're gonna try to negotiate that down or work on
- 21:17your behalf, but it sounds to me like yours was thankfully so straightforward
- 21:21they didn't have to do that.
- 21:22That is great.
- 21:23Oh, Nikki, I can't tell you how valuable this information is.
- 21:25There are so many people out there who could use some help.
- 21:29I'm evangelizing now, but I've sat across the table from people who are
- 21:32making real decisions on whether I have healthcare or I pay the mortgage
- 21:35or I get the kids in their school, and they're just unaware or maybe a little
- 21:39bit hesitant to explore these other alternatives and the things that exist
- 21:44for them, and I think your testimony and your story is gonna just be so valuable.
- 21:48So I'm really glad that you're here.
- 21:50I want you to hang tight.
- 21:51We're gonna do a little business here, okay?
- 21:53Okay.
- 21:53Thanks, Bill.
- 21:54All right.
- 21:55Now's the time that we're gonna open up the Jargon Jar.
- 21:59The Jargon Jar is a segment where we take a confusing topic, something intentionally
- 22:04muddy, and make it as plain as we can.
- 22:07And I wanted today, because of Nikki's story, to talk about cash pay.
- 22:12People feel like if I'm using a health share and I walk into the emergency
- 22:15room and tell them that I am a cash pay patient, that I joked about it
- 22:20earlier, that before you leave that ER, that there's gonna be two guards
- 22:23at the door that not let you leave until they've shaken you down for every
- 22:26single dollar, and that is not the case.
- 22:29Cash pay just means that you're gonna avail yourself of all of
- 22:32the discounts that are there.
- 22:33We've talked about this in other podcasts.
- 22:35That price you see on the bill is sticker price.
- 22:38You don't pay sticker at the dealer.
- 22:40You would never pay sticker at the hospital either, right?
- 22:42Cash pay just means that you're gonna be in line for discounts.
- 22:46You have a health share in the background making sure that there's an initial
- 22:49unshareable amount that is yours to pay.
- 22:52The bills then get submitted and then get reimbursed.
- 22:55Being a cash pay patient puts you in control.
- 22:58You are in control.
- 23:00You can go to your, your direct primary care provider and that person can say,
- 23:04"Hey, I need you to get an X-ray."
- 23:05You can say, "Do you know of anybody?" You can shop around for other places to
- 23:08do it if you needed a price comparison.
- 23:10If you needed a procedure like a colonoscopy, there are services out
- 23:14there available to you that will show you what it should cost in your area
- 23:17and maybe even help you contract with some places to do it for that rate.
- 23:22You are not alone, and you are not going to be rejected at the hospital,
- 23:27even if you had a terrible illness like cancer You have a single
- 23:31unshareable amount that you're going to be the cash pay person for.
- 23:34They're gonna start sending your bills.
- 23:35You're going to get those reimbursed, and as you heard Nikki say today,
- 23:39the longest she waited was a month.
- 23:42And so I think being a cash pay patient should not strike the fear into anyone.
- 23:46In fact, it should be something that encourages you, emboldens you.
- 23:50You are in control as a cash pay patient, and that makes you a smarter
- 23:55healthcare consumer, for sure.
- 23:58All right, Nikki, you didn't know this was coming.
- 23:59It's time for a surprise.
- 24:01Oh,
- 24:01no.
- 24:02Yes.
- 24:03It is time for Five for Fighting.
- 24:07We're gonna ask you five rapid-fire questions.
- 24:09Don't think, just answer.
- 24:11We'd love to get your take on them, and sometimes they can be controversial.
- 24:14Here we go.
- 24:15Detroit-style, Chicago deep-dish, New York thin, St. Louis Provel, Nikki
- 24:21Chamberlain, who has the best pizza?
- 24:23New York thin, all day.
- 24:25New York thin.
- 24:25Okay.
- 24:26Hey, that's a good answer, good answer.
- 24:28Be careful how you answer this one.
- 24:30Kansas City, North Carolina, Memphis, or Texas, Nikki Chamberlain, who has
- 24:36the best bar- Texas … Ah, come on.
- 24:38I don't even care what's gonna follow that word.
- 24:40Texas, Texas- … all the way.
- 24:42What was going to follow is why is the correct answer Kansas City?
- 24:45Oh.
- 24:45But you say it's Texas.
- 24:47Okay.
- 24:47All right, fine.
- 24:48Nikki Chamberlain, if you're sitting across the table from an employee who has
- 24:52a health plan through work, it's just too expensive to add a spouse or dependents,
- 24:57maybe a self-employed person or someone who just doesn't have health insurance
- 25:00at all, what's a couple of bullet points, what's a couple of things you'd
- 25:03want them to know about a healthshare?
- 25:05I would say a healthshare is not the scary thing that you think it is.
- 25:10It gives you freedom where you think it doesn't, and I think you worded
- 25:15it best when you say the control.
- 25:17It gives you the control to make decisions, your provider, your timeframe.
- 25:22You get to choose where you're going and when you're doing it.
- 25:25It really is a great option, and it'll save you money.
- 25:29It will save you money.
- 25:30Right.
- 25:31Thank you.
- 25:32Patriots, Cowboys, 49ers, Chiefs, or Texans, Nikki Chamberlain,
- 25:37who is your favorite NFL team?
- 25:39The Cowboys.
- 25:40Oh, my Lord.
- 25:42I mean, I can't help it.
- 25:43I've grown up here.
- 25:44Like, it is what it is.
- 25:45It's in our blood.
- 25:47All right.
- 25:47We're gonna go over that one.
- 25:48Nikki Chamberlain, what are a couple of quick bullet points you would say to
- 25:51someone who wants to break the cycle- of that traditional group health insurance
- 25:57but sits on the fence, what would you say about how you made that transition
- 26:02to a smarter healthcare consumer?
- 26:04I mean, I explored every option out there.
- 26:06Do it.
- 26:07Look to see what's out there.
- 26:08Go to every traditional insurance website you can find, get some quotes,
- 26:13compare everything, even compare your medical cost-sharing memberships.
- 26:17See which one is the best fit for you, because what's a good fit
- 26:20for one person may not necessarily be the best fit for someone else.
- 26:24Do your homework and look into it, because it is, at the end of the day, when you
- 26:28need it, you do need it to work for you, but it's worth the work to save the money,
- 26:35and then you don't have to think about it.
- 26:37Very good.
- 26:38I love that.
- 26:39Hang tight for us.
- 26:40We're gonna get out of here on that.
- 26:41Special thanks to our guest today, Nikki Chamberlain.
- 26:43I love, love, love talking to smart people, and Nikki has experience
- 26:47and a story worth sharing.
- 26:49Nikki's contact information is gonna be in the show notes.
- 26:51If you have another question about health shares, she's made
- 26:54it very clear that she's more than willing to answer those questions.
- 26:57I'm sure that she would be happy to do so for you.
- 26:59If you are a benefits coordinator at a small employer, if you are self-employed,
- 27:04if you are someone that does not have health insurance and you want to
- 27:09take the necessary steps to become a smarter healthcare consumer and save
- 27:12you some money, be sure to follow along, TikTok, YouTube, and Insta.
- 27:15It's Bill Fy, the health insurance guy.
- 27:17Subscribe to the pod on Apple or Spotify.
- 27:19Give us a review.
- 27:20We'd love to have your thoughts.
- 27:22And if I can personally help you explore your options, head on over to
- 27:24my website, core360benefitsgroup.com and schedule a 30-minute consultation.
- 27:30Thank you so much for listening to the Bill of Health.
- 27:33Ladies and gentlemen, be smart, shop smart, protect your wealth,
- 27:37and we will see you next time.
- 27:46This podcast is provided for educational purposes only and
- 27:48should not be considered legal, tax, investment, or insurance advice.
- 27:50Individual circumstances vary, and the listener should consult qualified
- 27:52professionals regarding their specific healthcare and financial situation.
- 27:54Opinions expressed are those of the host and guests and do not necessarily
- 27:56reflect the views of any insurance carrier or affiliated organization