0:00

Most hospitals in the U.S. are

0:02

actually non-profits, which means they have

0:04

to have financial assistance or charity

0:06

care policies. This is because a

0:08

lot of these non-profit hospitals get

0:10

government grants or funding, and because

0:12

they are taking that federal money,

0:14

or even sometimes statewide money, they

0:17

do need to have these charity

0:19

care policies. If you make below

0:21

a certain amount, the hospital legally

0:23

has to waive your medical bill

0:25

up to a certain percent. Sometimes

0:27

that's 100 percent. 50, 75, 25,

0:29

it's certainly worth checking. What's up,

0:31

rich friends? Welcome back to another

0:34

episode of Networth and Chill. I'm

0:36

your host, Vivian, too, aka, you're

0:38

rich, BFF, and your favorite Wall

0:40

Street girlie. And it seems like

0:42

everyone these days is talking about

0:44

health care. What does your insurance

0:47

even do? Why is everything so

0:49

damn expensive and why are there

0:51

so many acronyms? This conversation was

0:53

largely spurred by Luigi Mangioni killing

0:55

the United Healthcare CEO. And while

0:57

certainly I'm not advocating for murder,

1:00

a lot of the more muted and

1:02

peaceful efforts for a health care reform

1:04

seem to have fallen on deaf ears.

1:06

So this seems like a real wake-up

1:09

call for citizens and legislators alike because

1:11

it feels like regardless of political affiliation,

1:13

everyone can agree that health care is

1:16

too expensive. Americans are struggling through no

1:18

fault of their own with the cost

1:20

of living in the system and 20

1:22

million people nearly one in 12 adults

1:25

owe medical debt. The SIPP survey suggests

1:27

people in the United States owe at

1:29

least 220 billion. in medical day.

1:31

Today we're going to be diving into

1:34

the world of health care to help

1:36

you understand how plans and deductibles actually

1:38

work as well as some of my

1:40

personal favorite tips and tricks to save

1:43

on drug costs and procedures. Let's get

1:45

into it. Support for net worth and

1:47

chill comes from Amazon Pharmacy. The last

1:49

thing you want to do when you're

1:51

sick is go pick up your prescription

1:54

at the pharmacy because then you're standing

1:56

in a long line with a whole

1:58

bunch of other sick people and a

2:00

whole bunch of other sick people who

2:02

are sick. Amazon Pharmacy will deliver right

2:05

to you fast so you can get

2:07

meds without congregating amongst the contagious. Healthcare

2:09

just got less painful. Amazon Pharmacy. Learn

2:11

more at health. amazon.com So

2:21

first and foremost, let's cover what

2:23

types of health care plans there

2:25

are and what probably makes the

2:27

most sense for you. My biggest

2:29

nightmare, when I first started my

2:31

job, I was trying to figure

2:33

out what health insurance plan was

2:35

gonna work best for me, P-P-O-H-M-O,

2:37

HD-H-P, H-S-A, like what is with

2:39

the health care industry and loving

2:41

acronyms? I like to give this

2:44

as an analogy because I grew

2:46

up in. a household where my

2:48

parents were Chinese immigrants. Remember when

2:50

your mom told you that you

2:52

could either do chores today and

2:54

have fun tomorrow, or you could

2:56

have fun today and you could

2:58

do your chores tomorrow, but there

3:00

was under no circumstances any chance

3:02

for you to have two days

3:04

of fun in a row. That's

3:06

essentially how health insurance works, and

3:08

it's a really easy way to

3:10

remember. So think of it as

3:12

most to least involved. So most

3:14

involved would probably be a PPO,

3:16

middle an HMO, and an HDHB

3:18

would probably be like a quote-unquote

3:20

least involved. And there are other

3:22

plans aside from these three major

3:24

types, but these are the most

3:26

common, so we're going to cover

3:28

these. Simply put, think about it

3:30

like a sliding scale. And for

3:32

those of you watching on YouTube,

3:35

I'm going to put up a

3:37

graphic somewhere around my head that

3:39

you can reference on screen, but

3:41

for those of you just listening

3:43

in, just remember. PPO, HMO, HDHB,

3:45

most to least involved. The closer

3:47

you get to a PPO, the

3:49

higher your monthly upfront costs are

3:51

going to be, aka the premiums

3:53

are going to be high. But

3:55

your patient responsibility later on will

3:57

likely be less. On the flip

3:59

side, on the right-hand side, closer

4:01

to an HDHB, a high deductible

4:03

health plan, you're going to spend

4:05

much less up front on monthly

4:07

premiums. but you're going to pay

4:09

more out of pocket later if

4:11

you actually end up needing more

4:13

care. And typically, PPOs make sense

4:15

for folks with a lot of

4:17

upcoming medical expenses, things like pre-existing

4:19

conditions, ongoing therapy, family planning, etc.

4:21

Whereas high deductible health plans, HDHBs,

4:23

make sense for folks who are

4:26

largely healthy and they don't do

4:28

too much beyond preventative care, like

4:30

their annual physical and seeing their...

4:32

gynecologists for an annual pap smear

4:34

and maybe they have a one-off

4:36

visit to their dermatologist. The reason

4:38

why it's so hard for people

4:40

to talk about health care in

4:42

general or as a giant swath

4:44

is because for most people it's

4:46

not uniform. Our health care in

4:48

the United States has largely been

4:50

commercialized so it's only as good

4:52

as your employer is able to

4:54

provide benefits. A PPO from one

4:56

company. can differ vastly from another

4:58

company and the same goes for

5:00

HMOs and HDHBs. The coverage you're

5:02

going to get at a hedge

5:04

fund or a Google or a

5:06

major tech player might be really

5:08

different than the one that you

5:10

get at a medium-sized business that

5:12

has a hundred or less employees.

5:14

So just think about this. Know

5:16

that everything I say today is

5:19

in general, but you may need

5:21

to think a little bit more

5:23

specifically for your own care. So

5:25

let's get into all of the

5:27

associated costs and we're going to

5:29

cover the one that you're going

5:31

to see first. So monthly premiums.

5:33

When you sign up for your

5:35

company's health care plan or you

5:37

get health care through the Affordable

5:39

Care Act or whatever, your monthly

5:41

premium is basically what you pay.

5:43

for the privilege of having insurance.

5:45

I'm going to be honest, for

5:47

me, this often really just feels

5:49

like I'm throwing money into a

5:51

black hole, which is kind of

5:53

the case. You have to pay

5:55

for this even just to have

5:57

insurance and be insured. But in

5:59

addition to that, you are going

6:01

to spend money on something called

6:03

a deductible. An annual deductible is

6:05

essentially what your... for paying before

6:07

your health insurance starts to pay

6:10

for most covered services? And you're

6:12

probably wondering, hmm, why am I

6:14

paying for health insurance to then

6:16

again pay before it all kicks

6:18

in? You're asking a great question,

6:20

I don't have a great answer,

6:22

but you do have to pay

6:24

this amount of money before your

6:26

health insurance really starts to, and

6:28

I quote, kick in. So deductibles

6:30

are owed in addition to these

6:32

monthly premiums, and it is... and

6:34

not an or. Essentially how this

6:36

works is your premium along with

6:38

a bunch of other people's goes

6:40

into a pot and then the

6:42

health insurance company invests it so

6:44

that when you eventually do need

6:46

to call them for help and

6:48

need help paying for larger medical

6:50

bills they'll actually have the money

6:52

to be able to afford your

6:54

conditions and your treatments. As an

6:56

example, say you have a health

6:58

insurance plan with a $1,000 deductible.

7:00

20% co-insurance, a $2,000 out-of-pocket limit,

7:03

and a $2 million annual limit.

7:05

Essentially what this would look like

7:07

is for a payment process, for

7:09

the first $1,000, you would owe

7:11

100% up to that $1,000 deductible,

7:13

with some exceptions obviously for covered

7:15

services. But then between the $1,000

7:17

and the $2,000 out-of-pocket limit for

7:19

treatments and procedures and things that

7:21

you're getting, you would essentially pay

7:23

20% of that and then essentially

7:25

your health insurance would then be

7:27

able to cover all other expenses

7:29

once you'd hit your out-of-pocket limit

7:31

and they would pay up to

7:33

that $2 million limit. Again, there

7:35

are... caveat's left right and center

7:37

for what procedures, what treatments, what

7:39

services are covered, and what aren't,

7:41

and there's a lot more to

7:43

be discussed here, but that's simply

7:45

how it works. I like to

7:47

always say this is great in

7:49

theory, but how does this actually

7:51

work in practice? Well, not very

7:54

well. Our health care system is,

7:56

for lack of a better word,

7:58

super- up and it's really confusing

8:00

so there's always exceptions to certain

8:02

rules and one thing I always

8:04

like to remind people of is

8:06

that 80% of medical bills have

8:08

errors in them so even though

8:10

I'm in theory explaining how a

8:12

lot of these things work you're

8:14

going to have to be reviewing

8:16

every single bill or document that

8:18

gets mailed to you that gets

8:20

emailed to you just because you're

8:22

going to want to make sure

8:24

that you are actually being billed

8:26

appropriately and that is not a

8:28

given in this industry. Let's actually

8:30

get into something very, very sexy.

8:32

We're going to talk a little

8:34

bit now about HSA's. And I

8:36

know when you think of a

8:38

tax-admanaged account, you're probably thinking of

8:40

a 401k or a Roth IRA,

8:42

which By the way, you should

8:44

be maxing out every year if

8:47

you can, but there is a

8:49

lesser known way that you can

8:51

get tax benefits with a health

8:53

savings account, aka an HSA. You

8:55

might have seen it talked about

8:57

on social media, but essentially it

8:59

is a tax advantage savings account

9:01

that you can use to pay

9:03

for qualified medical expenses. And there

9:05

is a reason why the financial

9:07

services industry calls this the triple

9:09

threat tax advantage. So how does

9:11

it work? You can contribute to

9:13

an HSA if you have a

9:15

qualifying high deductible health plan, HDHB.

9:17

And what you are able to

9:19

do is you are able to

9:21

contribute money that is pre-tax reducing

9:23

your taxable income. So that's tax

9:25

savings number one. These funds roll

9:27

over year after year, unlike FSA's.

9:29

There is no use it or

9:31

lose it rule. So this is

9:33

your money to keep. This account

9:35

belongs to you, even if you

9:38

change jobs or insurance plans. you

9:40

are able to withdraw this money

9:42

to spend tax-free on any qualified

9:44

medical expenses, that's tax benefit number

9:46

two, and number three, once you

9:48

do turn 65, if you have

9:50

had a very healthy life, which

9:52

I truly hope for every single

9:54

person listening to this, you can

9:56

then actually withdraw. all those funds

9:58

for non-medical expenses without penalty, you're

10:00

just going to have to pay

10:02

traditional ordinary income tax on it.

10:04

So it will work essentially like

10:06

a 401k or an IRA would.

10:08

Aside from those three amazing tax

10:10

benefits, if you are still wondering

10:12

why you should even use an

10:14

HSA, well it really just allows

10:16

you to make sure that you

10:18

are paying as little as possible

10:20

for your medical expenses. Reason being

10:22

when you are paying for those

10:24

medical expenses pre-tax, the government is

10:26

essentially subsidizing those medical things that

10:28

you are having done or are

10:31

paying for. It is also one

10:33

of the only ways that your

10:35

medical funds can actually be invested.

10:37

So obviously an HSA is a

10:39

great idea to pay for current

10:41

medical expenses using your HSA funds,

10:43

but you can actually. save and

10:45

invest that money once you have

10:47

over a thousand dollars in most

10:49

cases and that essentially allows your

10:51

money to keep up with inflation

10:53

it allows your money to grow

10:55

and it gives you an opportunity

10:57

to essentially put in X but

10:59

take out Y. So today you

11:01

can actually invest for those future

11:03

health care costs and it doesn't

11:05

hurt that it is an additional

11:07

retirement account. We all know that

11:09

one in five Americans actually has...

11:11

Big Fat Goose Egg, $0 saved

11:13

for retirement. So it is more

11:15

important than ever, especially right now,

11:17

to make sure that you are

11:19

planning for the future. And this

11:22

is a great way to let

11:24

it grow tax free, let that

11:26

money grow tax free, and also,

11:28

all the while, being able to

11:30

cover expected major medical expenses. Some

11:32

people use one strategy of putting

11:34

their expenses. right now today on

11:36

a credit card and then being

11:38

able to reimburse those costs immediately

11:40

with their HSA. So say I

11:42

go and go to the doctor

11:44

and they say, hey, you have

11:46

a $40 copay on this, great.

11:48

I can then pay for that

11:50

with my credit card, get the

11:52

credit card points, and then reimburse

11:54

that $40 bill with my age

11:56

essay and get that money back.

11:58

But there's actually another school of

12:00

thought, which is if you don't

12:02

use this age essay while you're

12:04

young, it can actually help with

12:06

bigger and potentially more expensive procedures

12:08

as you age. So instead of

12:10

getting that $40 back, you leave

12:12

it in there, you let it

12:15

continue to grow, you continue to

12:17

invest it. But say when you're

12:19

60, 65, you need a hip

12:21

replacement. That is going to be

12:23

very expensive and this HSA can

12:25

really offset some of those costs.

12:27

And honestly, just remember, the health

12:29

care system is going to try

12:31

and screw you left right and

12:33

center. So you just need to

12:35

make sure that you are fighting

12:37

back and using all of these

12:39

resources to your advantage to optimize

12:41

so you can make your money

12:43

go a little bit further. Support

12:45

for net worth and chill comes

12:47

from Amazon. Have you ever gotten

12:49

sick on a very expensive, very

12:51

non-refundable family trip? Amazon One Medical

12:53

has 24-7 virtual care so you

12:55

can get help no matter where

12:57

you are. And with Amazon Pharmacy,

12:59

your meds can get delivered right

13:01

to your hotel fast. It's kind

13:03

of like the room service of

13:06

medical care. Thanks to Amazon, healthcare

13:08

just got less painful. Learn more

13:10

at health. amazon.com. Now let's move

13:12

on to how you can manage

13:14

some of these health care costs.

13:16

for yourself so you can make

13:18

the most of your money. First

13:20

up, let's talk a little bit

13:22

about hospital bills. Horror story on

13:24

the eve of my 25th birthday

13:26

party, I was getting ready, I

13:28

had, you know, just taking a

13:30

little bit of a nap, I

13:32

had a crusty little baget sandwich

13:34

that I was going to cut

13:36

into, and I actually took a

13:38

bread knife to my finger accidentally.

13:40

I didn't mean to, I just,

13:42

it slipped off the baget. slash

13:44

my finger, and I saw a

13:46

little chunk of my nail and

13:48

my skin and my flesh fall

13:50

into my kitchen counter. I was

13:52

rushed to Mount Sinai Hospital. I

13:54

had to go through a metal

13:56

detector. I sat bleeding in the

13:59

waiting room. it was horrific. And

14:01

to add insult to injury, by

14:03

the way, because I ruined my birthday,

14:05

I was in the hospital for eight

14:07

hours, I didn't stay overnight, but I

14:09

was seen by some specialists, I got

14:12

an x-ray, what have you. To add

14:14

insult to injury, I was then given

14:16

a $16,000 bill for my joy ride

14:18

to Mount Sinai. I didn't even take

14:20

an ambulance. I took a yellow cap.

14:22

Like just the cost of being in

14:25

the hospital was so, so... prohibitively expensive

14:27

and I had really good insurance at

14:29

the time but even after insurance I

14:32

still owed $1,300 and for me at

14:34

25 that felt like an insurmountable amount

14:36

of money. So one thing I really

14:38

want to talk about is how hospital

14:41

bills and unexpected medical costs can be

14:43

really crippling and they can wipe out

14:45

your savings but just like everything

14:47

else in your life you can negotiate

14:49

these bills and you should. and you

14:51

can end up saving thousands. Hi friends,

14:54

quick pause in our show to take

14:56

a question from my besties in our

14:58

new segment called Phone a Friend presented

15:00

by Amazon where we answer your burning

15:02

questions. What do I do if I

15:05

have a medical bill I can't afford

15:07

to pay? Sincerely, broke my arm and

15:09

now I'm just broke. Okay, let's tackle

15:11

this together. Medical bills can be super

15:13

overwhelming, but there are steps you can

15:16

take to manage them. First, we are

15:18

requesting an itemized bill. Believe it or

15:20

not, about 80% of medical bills have

15:22

errors. So you want to ensure that

15:24

you're not being charged for something you

15:26

did not receive. Two, once you have

15:28

that itemized bill, you can head to

15:30

a platform like fair health consumer to

15:32

see what your procedure should have cost.

15:34

Next, we're going to reach out to

15:36

your health care provider. If you were

15:38

way over-over Ask to make sure that

15:40

they utilize the correct billing code. If

15:42

not, ask about waivers, discounts, or relief

15:44

plans that might be available to you.

15:46

You might be surprised at what they

15:48

can offer if you just ask. If

15:51

your medical provider can't offer any discounts

15:53

right away, many medical practices do offer

15:55

payment plans. Let them know that you

15:57

want to pay, but are going to

15:59

need a little bit of... flexibility, they

16:01

prefer to work with you rather

16:03

than not get paid at all.

16:05

Next, seek financial assistance. Many hospitals

16:08

have charity care programs or financial

16:10

assistance options. It's totally worth asking

16:12

if you qualify, especially if your

16:14

income is below a certain threshold.

16:17

Typically a couple multiples above the

16:19

poverty line in your neighborhood. This

16:21

matters because dealing with medical debt

16:23

can feel super overwhelming and it

16:26

can impact your credit score and

16:28

financial future. Knowing your rights and

16:30

options can help you navigate

16:32

this very tricky situation. Now, back

16:35

to our show. First things first,

16:37

let's talk about this. You are

16:39

going to call the hospital and

16:41

say, hi, I'd like to receive an

16:43

itemized bill. And according... to 80% of

16:45

studies, which I mentioned earlier. Medical bills

16:47

do have errors in them, so you

16:50

really do want to check this. And

16:52

even if there isn't an error, you

16:54

want to make sure that each item,

16:56

line item, has a billing code next

16:58

to it. So then you know exactly

17:00

what they are billing you for and

17:03

how they're coding it. 80% wrong is

17:05

crazy. Imagine getting a 20% in class.

17:07

You would be failing. I can't believe

17:09

the health care industry. thinks this is

17:11

appropriate or that they can get away with

17:13

it, but I want to make sure that

17:16

you don't have any erroneous charges on your

17:18

bill. So once you get this itemized bill,

17:20

you have all the billing codes, you have

17:22

everything. You're going to go to Fair Health

17:25

Consumer. This is essentially a website that allows

17:27

patients to look up what procedures and

17:29

services, and I quote, should cost, regardless of

17:31

whether or not you can actually afford to

17:33

pay this bill. You want to make sure

17:35

that you know what it is worth. And

17:37

then this is the fun part. This is

17:39

where we start to negotiate. For

17:41

all my millennials listening, I need

17:44

you to call. Do not email.

17:46

I need to call and I

17:48

want you to politely ask the

17:50

medical biller or the insurance specialist

17:52

on the phone questions that are

17:54

going to force them to tell

17:56

you what waivers, discounts, or relief

17:58

plans are available. questions like, hey,

18:00

which of these fees can be waived?

18:03

I know a lot of hospitals have

18:05

medical bill relief plans. Can you tell

18:07

me about yours? What discounts do you

18:09

offer for financial hardship? This is

18:12

going to be a way to ask

18:14

open-ended questions so you don't get a

18:16

yes or no. You get a explanation.

18:18

You are also going to ask if

18:20

they have payment plans available because you're

18:22

going to mention that you'd love to

18:24

be able to pay the bill off

18:26

in full, but would only be able

18:28

to do so. if some of those fees

18:30

were waived. This really helps to

18:32

incentivize an administrator to cut you

18:34

a break if those earlier questions

18:36

didn't work, though I am hoping

18:38

that these hospitals that you are

18:40

getting treatment at are going to

18:42

be very transparent and share all

18:44

of their waivers and discount plans

18:46

with you because legally they should.

18:48

Additionally, you should remember that a

18:51

lot of medical practices will work

18:53

with patients to set up monthly

18:55

installment plans. So oftentimes, no interest

18:57

to you, you can pay your

18:59

bill off over the period of

19:01

12 months, 24 months, 36, 48 months.

19:03

You can do this until the bill

19:05

is paid off. And as long as

19:07

you were on that payment plan and

19:09

you've made that pre-negotiated contract with the

19:11

medical provider, That means that your bill

19:13

will not go to collections. It will

19:16

not impact you in any way. You

19:18

will not get people cold calling you

19:20

at all hours of the night trying

19:22

to get that money. And that can

19:24

be a big relief for a lot of

19:26

people. Additionally, like I mentioned in my earlier

19:28

story, when I went to Mount Sinai to

19:31

get my finger fixed, I was 25. And

19:33

I certainly was not yet a millionaire. I

19:35

was not making the kind of money that

19:37

I make now or even have in the

19:40

past five years. I was very young. I

19:42

was very young. I was not making a

19:44

lot of money, I certainly wasn't making

19:46

a lot of money in regards to

19:48

New York City rent, New York City

19:50

cost of living. So what is important

19:52

for me to mention here is that

19:54

most hospitals in the US are actually

19:56

non-profits, which means they have to have

19:59

financial assistance. or charity care policies.

20:01

This is because a lot of

20:03

these non-profit hospitals get government grants

20:05

or funding or anything like that

20:08

and because they are taking that

20:10

federal money or even sometimes statewide

20:12

money. they do need to have

20:15

these charity care policies. So essentially

20:17

if you make below a certain

20:19

amount, the hospital legally has to

20:22

waive your medical bill up to

20:24

a certain percent. Sometimes that's 100

20:26

percent, sometimes that's 50, 75, 25,

20:29

but it's certainly worth checking. What

20:31

you're going to do is you are

20:33

essentially going to just Google the name

20:35

of the hospital you went to and

20:38

charity care policies. Normally, it's going

20:40

to be one of the first

20:42

search results, and you are going

20:44

to be looking for either a

20:46

PDF or a landing page, typically

20:48

a PDF, and you are going

20:50

to find their charity care policies

20:52

and their sliding scale. This is

20:54

why it's important. The sliding scale

20:56

is essentially going to show how

20:58

much money you can make up

21:00

to while still qualifying for this

21:02

charity care. So, for example, at

21:04

NYU Langone Hospital in New York

21:06

City, I'm speaking in this backyard.

21:09

You can actually make up to

21:11

8x the poverty line before

21:13

you phase out of charity care.

21:15

If you make less than 6x the

21:17

poverty line, you can

21:19

actually get almost 100% of

21:21

your medical bill from that

21:24

hospital waived. And this is

21:26

so powerful because I think

21:28

people oftentimes get in their

21:30

head, oh, well, I need

21:32

to make $20,000 a year to

21:34

qualify for this. No. It oftentimes

21:37

does depend on the cost of

21:39

living in your area. So especially

21:41

in major cities, these charity care

21:43

policies are very flexible and honestly

21:45

very generous. So if you qualify,

21:47

you certainly should be taking advantage.

21:49

For the most part, these hospitals,

21:51

unless you catch like a really,

21:53

really kind administrator or a doctor

21:55

or nurse who makes an offhanded

21:57

post comment to you, they're not going

21:59

to... for this information up to you, so you

22:01

are going to have to go dig for it

22:04

yourself. I know it can be hard, I know

22:06

it can be tedious, but it's very much worth

22:08

your time. Additionally, if you don't

22:10

have the time or you're just overwhelmed,

22:13

you've tried to do a little bit

22:15

of this research, I do want to

22:17

plug a really amazing nonprofit. It's called

22:19

Dollar Four. If you are struggling with

22:22

this process of applying for charity care

22:24

and you don't know where to start

22:26

it, you don't know what to do.

22:28

Just go to Dollar four.org. They've already

22:30

helped relieve over $74 million dollars in

22:33

medical debt. It is awesome because every

22:35

dollar that is donated to Dollar4 actually

22:37

comes out the other end. as more money

22:39

saved for these folks that need this

22:41

help. Now let's take it out of

22:43

the hospital and head into more traditional

22:45

regular care that you might be receiving

22:48

from your family doctor or just a

22:50

specialist. Think less emergency but more ongoing

22:52

medical care that you're going to need.

22:54

Something that all of us have probably

22:56

struggled with is we go to the

22:58

doctor, the doctor tells us you need

23:00

to do X, Y, and Z. It

23:02

is imperative to your health, it's important,

23:04

it is medically necessary. And you say

23:06

great. get this blood work done, or

23:08

I'm going to get this treatment, I'm

23:10

going to get this service, I'm going

23:12

to get this procedure. And everything

23:14

is great, they run it through your assurance,

23:17

and then your insurance says,

23:19

you're denied on this claim. That is

23:21

so, so frustrating. And the

23:23

insurance companies oftentimes are using

23:26

AI or technology to send out

23:28

these denials. And there isn't even a human

23:30

looking at your claim, which is incredibly frustrating

23:32

because you're paying money into the system in

23:34

the hopes that it'll cover those bigger medical

23:37

costs for you. So why are you spending

23:39

all this money if they're not actually going

23:41

to hold up their end of the bargain?

23:43

One thing that I think has been such

23:46

an amazing new technological tool. So we are

23:48

going to fight AI with AI. If you are

23:50

getting claimed denials, coverage denials from your

23:52

insurance, you can check out a website

23:54

called fight health insurance.com. Your insurance is

23:56

denying you that medically necessary care. This

23:59

is the first. place I'd go. It

24:01

is an AI software tool created

24:03

by a woman named Holden Carrow.

24:05

She's a talented software engineer out

24:07

of Silicon Valley. She has obviously

24:09

a very unique skill set. And

24:11

this tech genius who kept getting

24:13

her own medical costs denied got

24:15

so mad, so frustrated, and so

24:18

pissed off that she built... a

24:20

service and a software that is

24:22

completely free to use, and she

24:24

made it completely open to everybody,

24:26

so that you can fight your

24:28

health insurance. And what this system

24:30

does is it can write an

24:32

appeal for a denied insurance claim

24:34

in 10 minutes or less, you

24:36

just input your information, again, it's 100%

24:38

free to use, and what a hero,

24:40

right? You have your own problem,

24:43

you find a solution, and then

24:45

you make it free for everybody

24:47

else knowing that this system absolutely

24:49

sucks and is not fair. I

24:51

mean, I can't speak highly of

24:53

her enough. We actually connected on

24:55

LinkedIn when I created the first

24:57

short-form piece of content mentioning this

24:59

resource, and she has just been

25:01

so wonderful and truly deserves everything

25:03

wonderful coming to her. And please,

25:05

please check out, fight health insurance.com.

25:07

It is... an incredible resource. What

25:09

I think is so powerful to

25:11

remind people of is that when these

25:13

AI software tools are denying your

25:16

health insurance claims, most

25:18

people don't appeal. And that's bad.

25:20

Because if you are not appealing,

25:22

then some completely relevant, completely

25:24

approved things are being denied and you

25:26

are just taking no for an answer.

25:29

So please try this AI software to

25:31

see if your insurance claim can be.

25:33

reassessed by often a human being, and

25:35

this go around, you are going to

25:38

be able to get it covered. If

25:40

you continue to get denied and denied

25:42

again, you can try something else. It

25:44

is called a fair hearing trial, and

25:46

you are going to tell your insurance that

25:49

you want this fair hearing trial.

25:51

It essentially is a formal appeals

25:53

process where you can contest a

25:55

decision made by your insurance company.

25:57

Insurance companies do not want to

25:59

go through... the bad PR, they do

26:01

not want to go through the headache. So

26:03

as soon as your insurance company hears that

26:05

you want a fair hearing trial, they're probably

26:07

going to offer you an appeal, they're going

26:10

to say, oh, you know what, actually, we

26:12

can cover it. Maybe we can like cover

26:14

half of it. You want to make sure

26:16

that it is fully covered under the policy

26:18

of your insurance. So if you want, you

26:20

can take that small coverage or that discount

26:22

or that discount, but what you. could

26:24

potentially do is also actually take it

26:27

to your trial. An affair hearing trial

26:29

will essentially force your insurance company to

26:31

provide evidence as to why you don't

26:33

need this treatment or this procedure or

26:35

the service, while your doctor, a medical

26:37

practitioner with a license, will provide testimony

26:39

that you do. This is a really

26:41

great way to stick it to the

26:44

man if you have time, if you

26:46

have the resources to be able to

26:48

go through this and potentially if you

26:50

need that service immediately cover it out

26:52

of pocket. This is certainly a

26:54

great option. Now let's go from

26:56

hospitals to everyday medical care with

26:59

a doctor all the way down

27:01

to some of these smaller costs

27:03

which frankly aren't as small as

27:05

they should be. Let's talk about

27:07

your everyday expenses like your medications.

27:09

We do want to shout out

27:11

a billionaire who is doing something

27:13

correct. Thank you Mark Cuban. Mark

27:15

Cuban started a company called Cost

27:18

Plus Drugs and it is an

27:20

incredible way to help consumers avoid

27:22

high drug prices by charging manufacturers

27:24

prices plus a flat 15% markup

27:26

with a pharmacist fee. And I

27:29

know I just said 15% markup

27:31

plus pharmacists fee, but friendly reminder

27:33

healthcare pharmaceutical industry. This is an

27:36

industry where 500 to 1,000% markups

27:38

aren't uncommon. So 15% feels very

27:40

fair, helps them keep the lights

27:42

on, make sure that they can

27:45

continue to staff employees. But what's

27:47

really powerful about this is that

27:49

Cost Plus Drugs also established its

27:52

own pharmacy benefit manager. So it's

27:54

a company that works directly with

27:56

drug makers and pharmacies to negotiate

27:58

down the prices. of prescription medicines,

28:00

given that their significantly lower markup

28:02

is going to lead to a

28:04

lower cost, your medications are going

28:06

to be sold for a lot

28:09

less than what an insurance copay

28:11

might even total at your local

28:13

pharmacy. So I highly encourage you

28:15

to check it out, price compare,

28:17

and see if your medication is

28:19

cheaper online. Unfortunately, most of the

28:21

medications that they offer do have

28:23

to be shelf stable. So things

28:25

like, you know. my specialty medication

28:27

for my eczema that requires me

28:29

to jab in my leg or

28:31

insulin, things like that that need

28:33

to be refrigerated still aren't being

28:35

offered yet, but I do hope

28:37

to see this improve in the

28:39

future as well. Other things you

28:41

can consider are good Rx. This

28:43

is another site that does something

28:45

very similar and People absolutely love

28:47

the fact that they are able

28:49

to get their medication for less

28:51

without running it through their insurance.

28:53

And additionally, if you live in

28:55

a pharma desert, this is another

28:57

big concern. If the nearest pharmacy

28:59

to you is literally a two-hour

29:01

drive away, Amazon One Medical and

29:03

their pharmacy is actually providing door-to-door

29:06

medical service so you can actually

29:08

order things from your pharmacy online

29:10

and have it mailed to you

29:12

the same way that... your packages

29:14

are mailed to you. And this

29:16

is a really great way to

29:18

save time, because I do know,

29:20

you know, pharmacies often close roughly

29:22

around business hours, and if you

29:24

have a full-time job, this can

29:26

be very, very challenging. Last but

29:28

not least, I do want to

29:30

talk about one little tip trick

29:32

that I actually recently learned about,

29:34

and it's something called a copay

29:36

card. So I was recently at

29:38

my dermatologist, and this was incredibly

29:40

frustrating to me. more moderate severe

29:42

eczema, which I don't. I have

29:44

moderate eczema. It can actually be

29:46

really distracting to the point where

29:48

I'm on camera and I don't

29:50

feel confident. Or I can't sit

29:52

still at work because my back

29:54

itch is so bad. So treating

29:56

my eczema has been a lifelong

29:58

thing. I've been on topical steroids.

30:00

I've been on... Tack cream, I've

30:03

been on opsilora, which is a

30:05

brand name cream, and they've all

30:07

been helpful, but only to a

30:09

certain extent. And I really wanted

30:11

to try and address this cause

30:13

from the inside out. So recently,

30:15

my doctor prescribed me dupixent, which

30:17

is an injectable medication. You can

30:19

jab it into your leg or

30:21

into your stomach, but it really,

30:23

really has been, honestly, like, a

30:25

miracle drug. It has really, really

30:27

helped me a lot. But what

30:29

was really scary to me, The

30:31

first fill that I did through

30:33

my specialty pharmacy, again, because it

30:35

has to be refrigerated, it comes

30:37

with needles, the bill was $3,500.

30:39

And as someone who feels really

30:41

confident in their financial situation, I

30:43

still balked. I can't pay $3,500

30:45

every 28 days to live my

30:47

life to have this medication, and

30:49

that was incredibly frustrating. But this

30:51

is the smart part. The pharmaceutical

30:53

company that creates DuPixen actually provides

30:55

something called a copay card. And

30:58

how this works is you sign

31:00

up for this card as long

31:02

as you have commercial insurance through

31:04

an employer, you are able to

31:06

be eligible for this, and they

31:08

will cover those up to, I

31:10

believe it's $10,000 a year, in

31:12

those expenses. And while they are

31:14

covering those costs through this copay

31:16

card. Those dollars that are being

31:18

spent that are being paid for

31:20

not out of your pocket, but

31:22

towards your deductible, get you closer

31:24

and closer to your insurance covering

31:26

this medication. So for the first

31:28

$10,000 or so, the company pays

31:30

for it. And then since you've

31:32

already qualified for your insurance to

31:34

start kicking in, they will then

31:36

start paying for this very expensive

31:38

medication. I transparently didn't even know

31:40

how copay cards work. I'm very

31:42

fortunate to have been very healthy

31:44

almost all of my life, but

31:46

this was such an incredible tool

31:48

and it took my $3,500 do

31:50

picks and shot to $0 and

31:52

has made it really accessible for

31:55

me to feel confident in my

31:57

own skin. So certainly if you

31:59

have an expensive medication. Oftentimes there

32:01

are no generic alternatives. Oftentimes it's

32:03

relatively new. It's, you know, sometimes

32:05

a biologic, things like that. Consider

32:07

a copay card if available to

32:09

you. It can really, really help

32:11

you save. So that generally wraps

32:13

up this episode all around health

32:15

care. I do hope that this

32:17

helps give you a better understanding

32:19

of the health care system and

32:21

what you can do to help

32:23

decrease this burden on your wallet.

32:25

Remember, when in doubt, negotiate, negotiate,

32:27

negotiate. The health care system is

32:29

not set up to help you

32:31

get medical care, even though it

32:33

should be. It is set up

32:35

to make sure that these for-profit

32:37

companies make as much money as

32:39

humanly possible for their shareholders and

32:41

for their stakeholders. So their interests

32:43

and yours transparently are misaligned. This

32:45

is frustrating. I truly hope that

32:47

there is legislative reform that allows

32:49

us to get the medical care

32:52

we need in this country versus

32:54

all of our other developed nation

32:56

partners who have much more effective

32:58

systems. But until then, make sure

33:00

that you are doing right by

33:02

yourself, doing right by your finances,

33:04

and getting every single dollar that

33:06

you can from this industry to

33:08

help cover all of your medical

33:10

needs. Thank you so much, and

33:12

I'll see you guys next week.

33:14

Bye. Thanks for tuning into this

33:16

week's episode of networked and chill

33:18

part of the Vox Media Podcast

33:20

Network. If you like the episode,

33:22

make sure to leave a rating

33:24

and review and subscribe so you

33:26

never miss an episode. Got a

33:28

burning financial question that you want

33:30

covered in a future episode? Write

33:32

to us via podcast at your

33:34

richbff.com. Follow net worth and chill

33:36

pod on Instagram to stay up

33:38

to date on all podcast related

33:40

news and you can follow me

33:42

at your rich bFF for even

33:44

more financial know-how. See you next

33:46

week. Bye Thanks to Amazon for their support. Have you

33:49

ever been so sick that the thought of standing up

33:51

to go to the doctor made you even more sick?

33:53

Amazon One Medical has 24-7 virtual care so you can

33:55

get help. while horizontal. And with

33:57

Amazon Amazon you can get

33:59

medicine delivered fast, right to

34:01

your door. You just have

34:03

to make it to your

34:05

door. Thanks to Amazon, your door.

34:07

just got less painful. Learn

34:09

more at health Learn more at .com.