ATHLLC7370648210
00:00:00.000 | (upbeat music)
00:00:02.400 | - Hello, and welcome to another episode of All The Hacks,
00:00:05.520 | a show about upgrading your life, money, and travel.
00:00:08.320 | Now, with open enrollment coming around the corner
00:00:10.840 | for so many people, and for some of you,
00:00:12.560 | maybe it's already started,
00:00:13.960 | I really wanted to do an episode
00:00:15.520 | to help you go through that decision-making process
00:00:18.200 | because I've tried to optimize it
00:00:20.280 | many, many times in my life,
00:00:22.000 | and I felt like that's something worth sharing.
00:00:24.000 | And then on top of that, I did a ton of research,
00:00:26.320 | as I always do, to try to help you guys out.
00:00:28.520 | So the majority of this episode
00:00:30.080 | is gonna focus on health insurance,
00:00:31.840 | and we'll go really deep there,
00:00:33.160 | and we'll share some hacks to save money and optimize,
00:00:35.560 | but I'll also make sure to touch on dental and vision
00:00:38.120 | and some other open enrollment options
00:00:39.800 | like HSAs, FSAs, and employer life insurance.
00:00:43.000 | And then at the end,
00:00:44.040 | just because I'm recording this from Hawaii,
00:00:45.920 | I'll share a few tips from our experience on the Big Island,
00:00:49.080 | not too much, but just a few things that we've done
00:00:51.080 | that we thought were really fun.
00:00:52.240 | So lots to cover, let's jump in right after this.
00:00:57.240 | We recently took a trip to Hawaii,
00:00:59.080 | and for the first time ever,
00:01:00.520 | I felt like I crushed the sandcastle game,
00:01:03.200 | and that's thanks to a class I took on Masterclass
00:01:05.680 | all about sand sculptures.
00:01:07.640 | And that's just one of so many amazing things
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00:01:14.360 | to negotiating tactics,
00:01:16.080 | which is why I love that I'm able to partner with them
00:01:18.440 | for this episode.
00:01:19.720 | And each time I'm watching Masterclass,
00:01:21.840 | whether it's on TV, on the site, in the app,
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00:01:25.800 | the quality speaks for itself,
00:01:27.320 | and it really feels like the instructors
00:01:29.280 | are your own personal mentors
00:01:30.760 | that are helping you reach the next level.
00:01:32.800 | And just thinking about how much it would cost
00:01:34.760 | to take one-on-one classes from the world's best is crazy,
00:01:38.280 | but with a Masterclass,
00:01:39.400 | annual membership is only $10 a month,
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00:01:45.800 | with new ones added every month,
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00:01:50.600 | that's really helped me recharge better every single night.
00:01:54.200 | So boost your confidence and find practical takeaways
00:01:57.400 | you can apply to your life and at work.
00:01:59.960 | And right now, our listeners will get an additional 15% off
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00:02:19.400 | (upbeat music)
00:02:21.800 | Okay, so I wanna start this episode
00:02:23.680 | giving an overview of some of the really common terms
00:02:26.320 | you need to understand to make sense of all this.
00:02:28.760 | So first, I'm gonna just talk about the plan types.
00:02:31.360 | There's HMOs, PPOs, and EPOs.
00:02:34.000 | And for total context, there might be other types.
00:02:36.720 | This isn't meant to be a fully comprehensive guide
00:02:39.120 | to everything you might ever cover,
00:02:40.840 | but I went pretty deep, so hopefully this covers a lot.
00:02:43.360 | The main distinction here is with a PPO,
00:02:46.160 | you can see a specialist without needing help.
00:02:48.720 | With an HMO, you need to have a primary doctor on file
00:02:52.480 | to refer you to be able to go see a specialist.
00:02:54.760 | So if you wanted to see a dermatologist,
00:02:56.560 | you need to talk to your primary care physician
00:02:58.600 | and get them to refer you.
00:03:00.000 | In my personal stance, that's frustrating for me,
00:03:02.660 | so I've always gone with a PPO.
00:03:04.720 | Although recently we switched to what's called an EPO,
00:03:07.480 | which is kind of like a hybrid of the two.
00:03:09.960 | It's really more like a PPO in that you can see anyone,
00:03:12.800 | but you can only go in network.
00:03:14.960 | So if your doctor's out of network with an PPO,
00:03:17.960 | usually you can do that with a higher deductible
00:03:20.360 | or a higher out-of-pocket maximum or less coverage,
00:03:23.440 | higher copay, or maybe there's no copay.
00:03:25.100 | But with an EPO, you cannot go out of network.
00:03:27.960 | So a lot of HMOs are similar, at least with Kaiser.
00:03:30.720 | One kind of big caveat if you live in a state with Kaiser
00:03:33.200 | is that when you're on a Kaiser plan,
00:03:34.820 | it's usually an HMO plan or a PPO plan,
00:03:37.040 | but you can only go with Kaiser.
00:03:38.820 | You can't see a doctor outside of the Kaiser network.
00:03:41.300 | In general, the most flexibility you can get
00:03:43.720 | comes with a PPO plan, and the HMOs and EPOs
00:03:46.520 | are usually a little bit less expensive.
00:03:48.240 | Next is the deductible, which is usually the amount
00:03:51.000 | you have to spend before your health insurance kicks in.
00:03:54.480 | That said, there are a handful of expenses
00:03:56.260 | that usually are covered before the deductible,
00:03:59.000 | stuff like preventative care, telehealth,
00:04:01.260 | pregnancy, and some basic labs.
00:04:03.160 | One interesting thing that I actually learned
00:04:04.840 | in this process, a lot of plans list
00:04:06.860 | individual and family deductibles.
00:04:08.880 | I'd always assumed that if you had a plan
00:04:10.740 | that covered multiple people,
00:04:12.000 | your deductible was the family deductible,
00:04:13.820 | and it was just you, yours was the individual.
00:04:15.780 | But in reading the plan details, I actually read,
00:04:17.760 | if you have other family members on the plan,
00:04:19.760 | each family member must meet their own
00:04:21.720 | individual deductible until the total amount
00:04:24.240 | of deductible expenses paid by all family members
00:04:27.120 | meets the overall family deductible.
00:04:28.960 | So there are cases where for a family
00:04:30.840 | that might work to your benefit,
00:04:32.280 | if one person needs a lot of medical care,
00:04:34.280 | they're not actually gonna need to hit
00:04:35.660 | that entire family deductible first.
00:04:37.880 | They're actually gonna only need
00:04:38.800 | to hit that individual deductible.
00:04:40.280 | I actually think that could have changed the calculus
00:04:41.960 | on some of the things that we've decided in the past,
00:04:43.980 | but the past is the past.
00:04:45.320 | Next is co-insurance.
00:04:46.560 | And so sometimes you'll see a co-insurance
00:04:48.580 | listed as 20% or 10%,
00:04:50.320 | and that's the percentage you are required to cover,
00:04:53.040 | and your insurance will cover the rest.
00:04:54.360 | So in fact, if you look at the plans, a lot of the tiers,
00:04:57.720 | usually you'll see bronze, silver, gold, and platinum,
00:05:00.320 | and those tiers usually correlate
00:05:02.540 | to the co-insurance amounts.
00:05:03.720 | So at bronze, you're responsible for 40%,
00:05:06.200 | silver, 30%, gold, 20%, and platinum, 10%.
00:05:09.920 | Now, usually those kick in after your deductible is met.
00:05:13.180 | Then you have your co-pay,
00:05:14.440 | where for some types of services, there's co-insurance,
00:05:16.880 | and then for others, usually like a primary care visit
00:05:19.560 | or a specialist visit, there is a co-pay,
00:05:21.440 | usually somewhere between 10 and as high as $95.
00:05:25.340 | Usually you have to meet your deductible before,
00:05:27.480 | but depending on the plan,
00:05:28.860 | sometimes those co-pays actually work
00:05:31.160 | even for a specialist visit before your deductible is met.
00:05:34.240 | So that's definitely one thing
00:05:35.640 | that when I looked through all these plans,
00:05:37.540 | I couldn't actually get perfect clarity on,
00:05:39.560 | so I would definitely read into that.
00:05:40.960 | Next, there's out-of-pocket maximum,
00:05:42.700 | and that's the total amount you'll be liable for
00:05:44.560 | before insurance will cover everything.
00:05:46.400 | So once you hit your out-of-pocket maximum,
00:05:48.140 | that's the max you're gonna have to spend on health coverage.
00:05:50.460 | And similar to the deductible,
00:05:51.940 | if you have other family members on your plan,
00:05:54.360 | they each have to meet their own out-of-pocket limits
00:05:57.220 | until the overall family out-of-pocket limit has been met.
00:06:00.520 | So again, this is not what I expected,
00:06:02.520 | which is actually quite beneficial.
00:06:03.980 | If you happen to be in a family
00:06:05.180 | where one person might have really high medical expenses
00:06:07.780 | and the rest of the family doesn't,
00:06:09.160 | you wouldn't actually be subject
00:06:10.420 | to that higher out-of-pocket maximum either.
00:06:12.600 | Many times that out-of-pocket maximum and that deductible,
00:06:14.880 | your copayments don't apply towards that,
00:06:17.060 | but usually those are pretty small,
00:06:19.060 | so I don't think that is gonna be a big factor.
00:06:21.020 | In addition to a lot of those criteria of HMO and PPO,
00:06:23.600 | there's also what's called a high-deductible health plan.
00:06:25.700 | And usually that is a plan
00:06:27.700 | that you would get for more catastrophic situations.
00:06:31.060 | Many, but not all, high-deductible health plans
00:06:33.400 | are eligible for an HSA, and I'll get to that in a minute.
00:06:35.720 | And the idea is you wouldn't get a lot of coverage
00:06:38.000 | for your basic visits,
00:06:39.240 | though again, preventative visits are usually always covered,
00:06:42.320 | but going to see a specialist,
00:06:43.640 | you're gonna pay completely out-of-pocket for that
00:06:45.680 | until you hit this very high-deductible,
00:06:47.800 | which, depending on your plan, could be as low as $1,600,
00:06:52.120 | could be as high as $7,000 or more.
00:06:55.000 | And so if you have a high-deductible health plan
00:06:57.820 | that meets certain requirements,
00:06:59.520 | you are also eligible for an HSA.
00:07:01.680 | And an HSA is a special savings account
00:07:03.860 | called a health savings account
00:07:05.080 | that you can put money into pre-tax.
00:07:07.360 | You can actually, while that money's there,
00:07:08.680 | invest that money.
00:07:09.880 | Many providers will let you open up,
00:07:11.600 | effectively, like a brokerage account for the HSA
00:07:13.640 | and invest it.
00:07:14.460 | All the gains on that account are tax-free.
00:07:16.640 | And then when you take the money out,
00:07:18.200 | which you must do to pay for eligible health expenses,
00:07:21.520 | you do not pay taxes there either.
00:07:23.160 | So it's got this triple-tax advantage.
00:07:24.920 | It's one of the most amazing investment accounts out there,
00:07:27.680 | but you are only eligible for it
00:07:29.480 | if you have a HSA-eligible high-deductible health plan.
00:07:32.720 | I'll get to a couple tricks with the HSA later,
00:07:35.040 | but that's just another little overview.
00:07:36.720 | Next, on plans, you'll usually see two lists of coverages,
00:07:39.880 | one for in-network and one for out-of-network.
00:07:41.960 | And so the way that works is every carrier has a network,
00:07:44.840 | but it's not just for the carrier.
00:07:46.320 | In fact, it's for the plan specifically.
00:07:48.360 | So you might have had Anthem or Blue Cross Blue Shield
00:07:51.440 | at one employer on one plan
00:07:53.120 | and go to another employer on another plan,
00:07:55.240 | and you might find that that network
00:07:56.880 | is not actually the same.
00:07:58.200 | So definitely need to make sure that your doctors
00:08:01.040 | that you want covered are in the network,
00:08:02.840 | even if you think they might be.
00:08:04.280 | And that's a really important thing
00:08:05.560 | because some plans have no out-of-network coverage,
00:08:07.960 | some plans have out-of-network coverage,
00:08:09.760 | but it's at a much, much higher deductible,
00:08:12.160 | out-of-pocket maximum, coinsurance, et cetera.
00:08:14.240 | So definitely, whenever I'm looking at any plans,
00:08:17.360 | if there are doctors that you're really tied to,
00:08:19.480 | you can go in there and search for whether those doctors
00:08:21.880 | are part of the network or not.
00:08:23.360 | And then last, where you even get these plans.
00:08:25.320 | So if you work at a company that provides health insurance,
00:08:27.840 | then it's pretty straightforward.
00:08:29.320 | You usually get the insurance from your employer.
00:08:31.800 | It's usually a much better deal to do that
00:08:34.000 | than any other place, and so that is an easy option.
00:08:37.160 | However, if your employer doesn't offer health insurance
00:08:39.120 | or you don't have employment, there are a few options.
00:08:41.400 | So one is from the exchange.
00:08:43.640 | So as part of the Affordable Care Act,
00:08:45.160 | there are healthcare exchanges in every state,
00:08:46.960 | and you can go and enroll in insurance.
00:08:49.100 | You can go on COBRA.
00:08:50.320 | If you've left your previous employer,
00:08:52.000 | you can stay on their health coverage
00:08:53.840 | as long as you cover it fully at the full cost
00:08:56.560 | for up to 18 months.
00:08:58.080 | Or if you own a business,
00:08:59.240 | you can actually shop for plans for your business.
00:09:02.240 | Or if you're over 65, you're eligible for Medicare.
00:09:04.760 | This episode is not gonna go deep on Medicare
00:09:06.600 | since I'm not very familiar with it,
00:09:08.200 | but I will say that in addition to Medicare,
00:09:10.320 | you can get supplemental policies
00:09:11.940 | to go above and beyond what Medicare offers.
00:09:13.920 | And we're gonna go back to things
00:09:15.440 | that are kind of broadly applicable to everyone,
00:09:17.240 | but just for the people looking on exchanges
00:09:19.120 | or trying to figure out what to do,
00:09:20.360 | there are also brokers who are there
00:09:22.420 | to help you find those plans,
00:09:24.200 | either as an employer looking for plans
00:09:26.280 | or just someone looking for a plan on the exchange.
00:09:28.840 | Typically, you're not paying them
00:09:30.400 | and your health insurance costs aren't gonna be higher,
00:09:32.720 | so there's not necessarily a downside
00:09:34.760 | to working with a broker,
00:09:35.760 | but having talked to three or four brokers
00:09:37.900 | going through this process for us this year,
00:09:40.040 | because we both left our employment
00:09:41.800 | and we were both looking for health insurance
00:09:43.640 | for the whole family,
00:09:44.600 | I couldn't find a broker that had access to any plans
00:09:48.080 | that I couldn't easily get access to myself.
00:09:50.280 | As an employer,
00:09:51.480 | you can usually go on a lot of these websites.
00:09:53.720 | So for all the hacks,
00:09:54.600 | we went on to these small business plans and looked at them.
00:09:57.040 | Some of the HR platforms we use,
00:09:58.920 | Gusto is a broker and can give you access to plans.
00:10:01.480 | So maybe as an employer,
00:10:03.000 | the brokers might be able to give you plans,
00:10:05.160 | but I don't think it's really worth shopping around
00:10:07.440 | to lots of brokers because at the end of the day,
00:10:09.540 | I didn't find anything unique from any of them.
00:10:11.820 | And on the individual side,
00:10:13.580 | I didn't find anything I couldn't have found on my own
00:10:15.940 | on the carrier websites or the exchanges.
00:10:18.140 | A couple notes,
00:10:19.020 | if you are looking at starting a business
00:10:21.020 | or getting insurance for your business,
00:10:23.020 | a lot of the carriers have a requirement.
00:10:25.380 | You need to have at least one non-spouse, non-owner employee.
00:10:29.980 | Now, in some plans, Kaiser and Blue Shield in California,
00:10:34.140 | you need a non-owner, but they can be a spouse employee.
00:10:37.560 | So you need a minimum of two employees.
00:10:39.280 | So it could be you and your spouse
00:10:41.240 | if they're not an owner in the business.
00:10:43.400 | And by owner, I don't mean, you know,
00:10:45.000 | through California joint property kind of law,
00:10:47.040 | I mean, owner on the LLC.
00:10:49.080 | If you're both owners,
00:10:50.360 | usually you need a third employee to be eligible
00:10:53.200 | for a lot of these plans who is not an owner.
00:10:55.000 | So definitely something to look into there.
00:10:57.080 | And one important thing to consider,
00:10:59.360 | when we were looking at all these plans,
00:11:00.960 | we were actually really surprised
00:11:02.680 | that certain doctors were just not in network anywhere.
00:11:05.840 | And so I have a few doctors at Stanford Medical,
00:11:09.360 | and I was trying to figure out
00:11:10.840 | which plans they would be under.
00:11:12.800 | And I went through over a dozen plans
00:11:15.400 | on the Covered California Healthcare Exchange site,
00:11:17.800 | and I couldn't find anyone that had our doctors in coverage.
00:11:20.680 | And so I called and I asked them,
00:11:22.360 | what insurance do you guys take?
00:11:23.840 | Because I'm so confused.
00:11:25.120 | And Stanford actually said
00:11:26.480 | they don't accept non-group policies,
00:11:29.320 | meaning they don't accept health insurance
00:11:31.400 | that is not through an employer.
00:11:33.280 | So none of the Covered California Exchange plans
00:11:36.000 | would work at Stanford.
00:11:37.120 | So if you're getting a little confused,
00:11:38.960 | it might be that maybe the doctor or the hospital
00:11:41.960 | or the medical provider you work with,
00:11:43.840 | maybe they don't take non-group plans,
00:11:45.760 | and that's definitely something to consider.
00:11:47.480 | In fact, for us, it put a strong, strong advantage
00:11:51.160 | to the COBRA plans and the small business plans
00:11:53.760 | because we wanted to be able to continue seeing the doctors
00:11:56.300 | that we were already looking at.
00:11:57.320 | And then last, all of that, there are a few other options,
00:12:00.060 | things like medical sharing plans.
00:12:01.680 | I'll come back to that later
00:12:02.960 | because I guess the idea here was to give an overview
00:12:05.560 | of just the terms and the things you're gonna run into.
00:12:07.820 | But medical sharing plans
00:12:09.160 | are an alternative to health insurance
00:12:11.240 | that is eligible for the requirements
00:12:13.360 | that you have coverage from the Affordable Care Act,
00:12:15.960 | but they are very different and I'll get to them.
00:12:18.360 | Now that I have kids, I wanna be more focused at work
00:12:22.000 | so I can spend more time with them.
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00:14:57.200 | So when I go through this process,
00:14:58.380 | there's kind of two axes.
00:14:59.640 | There's the carrier and the plan.
00:15:01.640 | And so you might be looking at,
00:15:02.920 | especially if you're on the exchange,
00:15:04.520 | there's two or three carriers that all offer a bronze PPO.
00:15:08.540 | So you need to decide which carrier do I want
00:15:10.580 | and then which type of plan do I want.
00:15:12.200 | If you're employed by a company,
00:15:13.640 | you might not have a lot of choices.
00:15:15.200 | You know, in California, I've typically had companies
00:15:17.720 | where there is a Kaiser option and then an other option,
00:15:20.720 | whether that's Cigna or UnitedHealthcare
00:15:22.600 | or Blue Cross or Blue Shield,
00:15:23.960 | but there's usually not a carrier choice
00:15:26.000 | other than Kaiser and non-Kaiser.
00:15:27.960 | So you don't really have to think about the carriers,
00:15:29.760 | but if you're on the exchange
00:15:31.120 | or you're picking as an employer,
00:15:32.800 | it can be tricky to decide which carrier makes sense.
00:15:35.880 | In fact, if you look at the ratings in California,
00:15:38.580 | only Kaiser has more than three stars.
00:15:41.040 | Every other carrier on the exchanges in California
00:15:43.760 | is a two or three star carrier
00:15:45.560 | by whatever system Covered California uses for stars.
00:15:49.000 | There's not an obvious way
00:15:50.400 | to decide which carrier makes sense.
00:15:52.560 | It kind of feels a little bit like airlines.
00:15:54.400 | Some people have their favorites
00:15:55.600 | and then other people have had terrible experiences
00:15:57.780 | with what could be someone else's favorites.
00:15:59.600 | And so for every person that's probably said,
00:16:02.080 | "Oh, UnitedHealthcare was great.
00:16:03.520 | "They covered everything."
00:16:04.480 | There's certainly gonna be a person who said,
00:16:05.980 | "Well, they wouldn't cover anything
00:16:07.060 | "and it was so frustrating to deal with them."
00:16:09.040 | So at the end of the day,
00:16:09.960 | I'm really focusing on just the plans that are there
00:16:12.640 | and picking a carrier that seems reputable,
00:16:15.080 | but it's a little bit for me a crapshoot
00:16:16.920 | as to which carrier is the best.
00:16:18.400 | And I kind of wish that it was a situation
00:16:20.880 | where I worked at a company and I didn't get to pick
00:16:22.840 | because honestly, I don't think there's an easy way
00:16:25.560 | to know which one is going to be the best
00:16:27.360 | for your circumstance in advance.
00:16:28.940 | So ultimately, what it really comes down to
00:16:30.760 | is picking a plan.
00:16:31.640 | So first, you've got that question of EPO, PPO, or HMO.
00:16:35.300 | And I think that if you have a primary care doctor
00:16:38.420 | and you're okay having them be the point person,
00:16:40.520 | you can save some money going to an HMO,
00:16:42.600 | but if you really prefer to be able to have the flexibility
00:16:45.160 | to go see a specialist and not need anything,
00:16:47.560 | then a PPO could be great.
00:16:48.880 | And then when it comes to EPOs,
00:16:50.440 | I think the really important thing
00:16:52.140 | is that you do an exhaustive search
00:16:54.000 | to see if every doctor or provider
00:16:55.920 | you might want to go to is covered.
00:16:57.400 | And so what we did was we went in
00:16:59.280 | and searched for all the doctors we've seen,
00:17:01.120 | but then we also went to like the 20 best medical facilities
00:17:04.720 | all around the country
00:17:05.880 | in case some crazy extreme thing happened.
00:17:08.520 | What if we got a rare form of cancer
00:17:10.280 | and we wanted to go to Johns Hopkins or Mayo Clinic
00:17:13.240 | or some other very specialized center,
00:17:15.400 | but we looked and all those doctors were covered.
00:17:18.160 | And so we felt really good about the EPO we were going to.
00:17:20.800 | And in a lot of cases, the EPO plans are really great.
00:17:23.640 | Ours has no deductible, no co-insurance,
00:17:26.000 | basically co-pays only for everything.
00:17:28.440 | So ER visit is $150, hospital, surgery, that kind of stuff,
00:17:32.800 | zero dollar co-pay, zero co-insurance.
00:17:35.200 | You have no expenses.
00:17:36.720 | Most doctors visits are $20, $30,
00:17:38.880 | but you can only go in network.
00:17:40.520 | So it's a huge issue if the network wasn't good.
00:17:42.720 | And then the question is,
00:17:43.560 | do you want the high deductible health plan or not?
00:17:45.200 | I used to think a high deductible health plan
00:17:46.720 | only made sense
00:17:47.600 | if you weren't going to be spending that much on coverage.
00:17:49.800 | But actually now that I did the math,
00:17:51.600 | having to pay for these plans on our own,
00:17:54.080 | the increased premiums,
00:17:55.520 | and I guess I never defined premium,
00:17:56.920 | but premium is the amount you pay each month for your plan.
00:17:59.540 | The increased premiums on plans with much lower deductibles
00:18:02.440 | often are so high that it makes up entirely
00:18:06.360 | for the cost savings on the deductibles,
00:18:09.400 | meaning you're almost cost shifting.
00:18:11.520 | So if you had a lot of healthcare expenses in January,
00:18:14.160 | with a really expensive plan,
00:18:15.840 | you're paying a high premium every month
00:18:17.720 | throughout the year,
00:18:18.680 | but you're not having to pay a ton of money
00:18:20.440 | upfront in January.
00:18:21.560 | Whereas if you paid a much lower premium,
00:18:23.200 | but needed a lot of care in the beginning of the year,
00:18:25.160 | you'd have really high bills.
00:18:26.520 | So I thought maybe I would just try to give you an example
00:18:29.280 | of two plans that are on Covered California for us,
00:18:32.680 | that we considered,
00:18:33.560 | it's the Bronze and the Platinum PPO from Blue Shield.
00:18:36.680 | A lot of these plans aren't gonna make sense
00:18:38.180 | if you don't live in the state in the same exchange,
00:18:40.440 | but I think the overall comparison is helpful,
00:18:42.700 | no matter where you are.
00:18:43.760 | So the premiums for us as a family of four
00:18:46.880 | were $2,000 a month and $4,000 a month.
00:18:50.200 | So significant extra cost.
00:18:52.480 | The deductibles were $0 on the expensive plan,
00:18:55.840 | but they were about $6,000 for an individual
00:18:58.260 | and almost 13,000 for a family on the Bronze PPO.
00:19:01.880 | So really high deductible that you're gonna have to hit.
00:19:04.920 | However, if we have to spend an extra $2,000 a month
00:19:08.180 | for that Platinum PPO plan,
00:19:09.760 | that's gonna cost us $24,000 a year.
00:19:12.940 | By the way, yes, health insurance in California
00:19:15.620 | for two people that are 39 years old and two kids
00:19:18.280 | is really, really, really expensive.
00:19:20.220 | So that $24,000 of extra premium
00:19:22.400 | could more than cover the deductible.
00:19:24.240 | In fact, the out-of-pocket maximum
00:19:26.160 | was $8,000 and $16,000 for individual and family,
00:19:29.520 | which we could absolutely completely cover
00:19:31.560 | with the total cost of the premiums
00:19:33.140 | for the Platinum plan also.
00:19:34.480 | And so while the Platinum plan had no deductible
00:19:37.240 | and a 4 1/2 or $9,000 out-of-pocket maximum,
00:19:40.880 | it just didn't seem to make any sense.
00:19:42.840 | And that was after really digging.
00:19:45.040 | At the beginning, I thought, well, yeah,
00:19:46.420 | let's pay upfront a lot
00:19:47.960 | so that we don't have all these ongoing expenses.
00:19:49.920 | But when I actually dug in to do the math,
00:19:51.800 | I was totally surprised that the increased premium cost
00:19:55.280 | just negated all the benefits.
00:19:57.160 | Now, if you work at a company
00:19:58.600 | where your employer is giving you both options
00:20:00.700 | and you don't have to pay any extra,
00:20:02.380 | then sure, I would much rather have the Platinum plan
00:20:04.800 | because all my ongoing expenses are gonna be much lower.
00:20:07.500 | For these two plans, they had the same network.
00:20:09.320 | And while the PPO had 10% co-insurance
00:20:12.200 | and the Bronze had 40,
00:20:13.400 | it was a bit strange because the Bronze 40
00:20:15.760 | doesn't actually kick in till you hit the deductible,
00:20:17.820 | so it didn't really matter that much.
00:20:19.240 | But on the PPO, it definitely kicked in.
00:20:21.280 | As an example, the Bronze plan to go to the ER
00:20:24.120 | was a 40% co-insurance after you hit your deductible,
00:20:27.200 | and the Platinum PPO was $150.
00:20:29.120 | So again, if you don't factor in the cost of the premiums,
00:20:32.480 | then the Platinum PPO feels like a much better deal.
00:20:35.160 | Co-pays were $15 and $30 instead of $65 and $95.
00:20:39.400 | So very, very different.
00:20:41.120 | The one cool thing that I learned
00:20:42.960 | that I'd never seen before until I dug in
00:20:45.200 | was that the Bronze PPO actually had a feature
00:20:47.840 | called first dollar coverage.
00:20:49.520 | And I'd never seen this before,
00:20:50.860 | but basically they cover the first three visits,
00:20:54.400 | whether they're primary care, specialist, urgent care,
00:20:58.000 | before you need to meet your deductible.
00:21:00.020 | So that's definitely something to look into
00:21:01.800 | if you're considering one of these higher deductible plans,
00:21:04.220 | because you might not realize
00:21:05.560 | that something else is covered.
00:21:06.720 | That Bronze PPO was actually,
00:21:08.280 | despite the high deductible,
00:21:09.600 | not actually eligible for an HSA.
00:21:12.120 | There was a Bronze high deductible health plan
00:21:13.640 | that was eligible for an HSA, slightly higher deductibles,
00:21:17.120 | but surprisingly lower out-of-pocket maximum.
00:21:19.520 | That said, there was no co-insurance, no co-pays,
00:21:22.200 | no first dollar coverage for visits.
00:21:24.560 | Other than preventative care,
00:21:26.000 | you are on your own for absolutely everything.
00:21:28.560 | That said, you're also eligible for an HSA.
00:21:30.880 | The HSA contribution limits for a family this year
00:21:33.000 | are $8,300, for an individual it's $4,150,
00:21:36.080 | and by this year, I mean for 2024.
00:21:38.260 | So depending on your tax bracket,
00:21:40.400 | let's say you're at the 35% tax bracket,
00:21:42.560 | putting that money in that HSA
00:21:43.840 | is actually probably gonna save you about $3,000.
00:21:46.640 | And on top of that, it's gonna grow over time,
00:21:48.960 | you're not gonna pay tax on that, and when you withdraw it.
00:21:51.200 | And honestly, one of the hacks
00:21:53.140 | that I've heard so many people use for an HSA,
00:21:55.800 | instead of just using it to meet the deductibles
00:21:57.800 | and the costs in the year that you're contributing to it,
00:22:00.360 | if you have the cash flow, use your savings,
00:22:02.800 | use your salary to pay your medical expenses,
00:22:04.960 | and just let that account grow as long as it can, tax-free,
00:22:08.960 | until maybe you're in retirement
00:22:11.040 | and need that money for other medical expenses,
00:22:13.400 | and you've built up a massive, massive amount,
00:22:15.980 | because it could compound for 30 plus years.
00:22:18.560 | And by the way, if you wanna create a Dropbox
00:22:20.880 | or Google Drive folder and put all your medical receipts
00:22:23.480 | and expenses there, just in case
00:22:25.040 | you don't have medical expenses like you think in the future
00:22:27.900 | or maybe healthcare changes,
00:22:29.160 | you can actually reimburse yourself.
00:22:30.960 | There's not actually a limit
00:22:32.040 | to how long expenses are eligible to be reimbursed.
00:22:34.800 | You could save those receipts from 2024,
00:22:36.840 | but reimburse yourself for them 30 years from now,
00:22:39.320 | assuming nothing else changes, of course.
00:22:41.400 | And so the HSA is great, I wish I could contribute to it.
00:22:44.240 | Ultimately for us, we actually ended up going
00:22:46.400 | with the Cobra plan.
00:22:47.480 | I'd always in my mind assumed Cobra
00:22:49.400 | was the most expensive thing.
00:22:50.640 | For whatever reason, people kind of had just made me feel
00:22:53.040 | like Cobra is so expensive, but for us,
00:22:55.040 | we could get a plan that was as good or better
00:22:58.020 | than the top $4,000 a month plan on the exchange,
00:23:01.800 | and the Cobra pricing was about $2,200.
00:23:04.040 | So way, way, way more cost-effective for us.
00:23:06.980 | It was an EPO, which we love
00:23:08.980 | because we don't have to think about the expense.
00:23:11.320 | I think that's the other challenge
00:23:12.920 | when you pick a high deductible health plan
00:23:14.880 | that you have to really process is,
00:23:16.760 | is there a psychological effect
00:23:18.300 | that's going to change how you get care?
00:23:20.560 | So for example, if you know that going to the pediatrician
00:23:24.040 | when your child is sick is gonna cost $400,
00:23:26.840 | do you go or do you kind of hold it out for five days
00:23:30.280 | because you don't wanna spend that cost?
00:23:32.840 | At the beginning of the year, of course you said,
00:23:34.880 | well, it's way cheaper even if we go to the doctor
00:23:37.280 | every single time than to pay these higher premiums,
00:23:39.960 | but in the moment, are you gonna do it?
00:23:41.800 | So for example, I had this crazy pain
00:23:44.640 | in my upper abdomen area, and I had no idea what it was,
00:23:48.240 | and it was so incredibly painful.
00:23:50.740 | I ended up on a Saturday just going to the emergency room,
00:23:53.200 | and because my health insurance plan
00:23:54.900 | covered everything other than $100 deductible,
00:23:57.560 | I thought, I just need to get this solved.
00:23:59.240 | It's Saturday, I don't wanna wait until the morning,
00:24:01.440 | and so I just went, and the bill for that ER visit,
00:24:04.080 | when I actually looked at the bill,
00:24:05.840 | obviously I didn't have to pay it,
00:24:07.360 | but when I looked at what the insurance company paid,
00:24:08.880 | it was over $10,000, which could be a whole 'nother
00:24:11.800 | conversation about how ridiculously expensive that was.
00:24:14.580 | I saw a doctor, did one test.
00:24:16.600 | I have no idea how that's justified,
00:24:18.600 | but I didn't have to pay it,
00:24:19.840 | and so I didn't really need to fight back,
00:24:21.680 | but knowing that cost, if I had a high deductible
00:24:24.680 | health plan, I definitely wouldn't have gone,
00:24:26.600 | and maybe you could argue that's better.
00:24:28.100 | Maybe I didn't need to go, maybe I could have held out,
00:24:30.040 | but I think there are a lot of circumstances
00:24:31.620 | where because we don't have to pay so much for each visit,
00:24:34.880 | we're a little bit more liberal with how much care we get,
00:24:38.240 | and I know that even sometimes Amy and I
00:24:40.640 | have caught ourselves saying,
00:24:41.520 | do we wanna run to this doctor's visit,
00:24:43.000 | and all we had was a $35 co-pay,
00:24:45.280 | and we were like, is it even worth it?
00:24:46.600 | Which, yes, $35 should never get in the way of health.
00:24:49.240 | For frugal people, sometimes I know it will,
00:24:51.080 | but if it was four or $500,
00:24:52.440 | I feel like it would get in the way every time,
00:24:54.520 | and so in a way, getting on a plan
00:24:57.020 | that doesn't have that high deductible
00:24:58.620 | kind of forces us to do that.
00:25:00.480 | I wish I just had the mental ability
00:25:02.540 | to not get caught up there,
00:25:03.780 | and that psychological pressure didn't affect me.
00:25:05.760 | It would be much easier,
00:25:06.700 | but for me, that was really tricky.
00:25:08.120 | So that's just something to consider.
00:25:09.800 | It's a big impact on all of this.
00:25:11.400 | That said, financially, the Platinum Plan
00:25:14.040 | seems to almost never make sense in almost any scenario,
00:25:17.080 | so I started doing some research.
00:25:18.360 | Does the Platinum Plan ever make sense?
00:25:20.440 | And there are tons of articles that point out the math
00:25:23.360 | that no, it doesn't really make sense.
00:25:25.160 | The only arguments would be if that is the only way
00:25:28.440 | to get in-network doctors that you want,
00:25:30.560 | or if your employer's covering the cost of it, that's great,
00:25:33.280 | or if you really need that spread out cash flow.
00:25:36.360 | If having a $10,000 expense in the beginning of the month
00:25:39.620 | would really be a problem,
00:25:41.280 | but paying an extra $1,000 or $2,000 a month
00:25:44.160 | over the course of the year wouldn't,
00:25:45.480 | then maybe that makes sense.
00:25:46.600 | And one thing I should point out,
00:25:47.720 | if you are paying for this as a business,
00:25:50.280 | the cost of health insurance is often deductible.
00:25:52.920 | So this is not an episode on tax advice.
00:25:55.000 | I am not a CPA,
00:25:56.080 | but that's definitely something to consider
00:25:57.920 | as you factor in how much you're gonna be spending
00:25:59.800 | on medical coverage, how much of it's tax deductible.
00:26:02.220 | Maybe the plans are, but the medical expenses aren't,
00:26:05.160 | and that might change the calculus there a little bit.
00:26:07.300 | And then the psychological thing is real.
00:26:09.160 | I was actually looking into this,
00:26:10.360 | and now I'm like, hmm, I started thinking
00:26:12.480 | platinum made sense, now I'm thinking gold.
00:26:14.800 | Fortunately, because we're on COBRA for 18 months,
00:26:17.520 | we have about 14 more months
00:26:19.200 | before we have to think about any of this.
00:26:20.840 | But in 14 months, I honestly can't tell you
00:26:23.760 | what I think we're gonna do.
00:26:24.660 | I would have told you something completely different
00:26:26.780 | two weeks ago, and instead of trying to figure it out,
00:26:29.400 | I thought, let's just wait until then
00:26:31.280 | and share everything I've learned.
00:26:32.560 | But if one thing is for sure, it's that going into it,
00:26:34.960 | I thought the platinum plan was for sure it,
00:26:36.880 | and now I'm not sure I agree.
00:26:40.000 | I got so fed up with ridiculously expensive razor blades
00:26:43.360 | that I had to search for a better option,
00:26:45.180 | and I not only ended up saving a ton of money,
00:26:47.820 | but I'm now getting an even better shave,
00:26:50.240 | which is why you've gotta check out Henson Shaving,
00:26:52.440 | who I'm excited to partner with for this episode.
00:26:54.840 | First off, Henson Shaving is an aerospace parts manufacturer
00:26:58.760 | that decided to bring their precision engineering
00:27:00.960 | to a razor.
00:27:02.140 | Why does that matter?
00:27:03.200 | Well, it turns out razor blades
00:27:04.580 | are kind of like diving boards.
00:27:06.460 | The longer the board, the more wobble,
00:27:08.760 | which leads to nicks and cuts.
00:27:10.760 | So a bad shave isn't actually a blade problem,
00:27:13.840 | it's an extension problem,
00:27:15.560 | and by using aerospace-grade machines,
00:27:17.800 | Henson makes metal razors that extend out
00:27:20.220 | just .0013 inches, less than the thickness of a human hair,
00:27:25.220 | which means a secure and stable blade
00:27:27.680 | with a vibration-free shave.
00:27:29.980 | I actually spent the first few weeks
00:27:31.560 | using my Henson razor on one half of my face
00:27:34.100 | and my old overpriced cartridge razor on the other,
00:27:36.900 | so I can very confidently say it's a much better shave,
00:27:40.240 | and the best thing, once you own a Henson razor,
00:27:42.880 | it's only about $3 to $5 a year
00:27:45.480 | to replace the standard dual-edged blades.
00:27:48.740 | It's time to say no to subscriptions
00:27:50.760 | and yes to a razor that will last you a lifetime.
00:27:53.840 | Visit allthehacks.com/henson to pick the razor for you
00:27:57.640 | and use code ALLTHEHACKS
00:27:59.440 | to get two years worth of blades free with your razor,
00:28:02.720 | just make sure to add them to your cart.
00:28:04.720 | That's 100 free blades when you head to allthehacks.com/henson
00:28:09.720 | and use code ALLTHEHACKS.
00:28:13.540 | Money can be stressful,
00:28:16.700 | but if you wanna find some inner peace
00:28:18.300 | from actually knowing how much you're spending and on what,
00:28:21.560 | so you can be more intentional
00:28:23.120 | about your financial decisions,
00:28:24.580 | you have to check out Copilot,
00:28:26.600 | which is one of my all-time favorite apps.
00:28:28.700 | I check it almost every day,
00:28:30.420 | and I'm so excited to finally be partnering with them
00:28:32.900 | on this episode after being such a huge fan.
00:28:35.460 | Copilot makes it seamless and easy to track your spending
00:28:38.760 | and in my case, boost your savings.
00:28:41.060 | I've tried dozens of apps for tracking spending
00:28:43.420 | and Copilot is the only one I've kept using.
00:28:46.260 | You can link it to accounts at over 10,000 institutions
00:28:49.420 | and their automatic expense categorization
00:28:51.660 | is the best I've ever used
00:28:53.560 | with custom Amazon and Venmo integrations
00:28:55.740 | to make it even better.
00:28:57.180 | You can completely design your spending categories
00:28:59.780 | and subcategories and easily set up rules
00:29:02.220 | to assign transactions to them in the future.
00:29:04.900 | Thanks to Copilot, I have never had a better grasp
00:29:07.460 | of our spending and cashflow,
00:29:09.340 | which honestly has probably resulted in hundreds
00:29:11.820 | or maybe even thousands of dollars of savings each year.
00:29:14.620 | So for the best app to track your spending,
00:29:16.860 | subscriptions, investments, and now real estate,
00:29:19.660 | go to allthehacks.com/copilot on an iPhone or Mac
00:29:23.760 | to download Copilot and enter code HACKS2
00:29:27.020 | during onboarding for a two-month free trial.
00:29:30.000 | Again, that's allthehacks.com/copilot
00:29:32.940 | and the code HACKS2 for a free two-month trial
00:29:36.420 | of my favorite personal finance app.
00:29:38.680 | I just wanna thank you quick for listening to
00:29:42.400 | and supporting the show.
00:29:43.880 | Your support is what keeps this show going.
00:29:46.720 | To get all of the URLs, codes, deals,
00:29:49.420 | and discounts from our partners,
00:29:51.180 | you can go to allthehacks.com/deals.
00:29:54.740 | So please consider supporting those who support us.
00:29:57.860 | I also wanna talk about some hacks.
00:29:59.020 | So that's a lot about how to think about this,
00:30:00.860 | how to make decisions,
00:30:01.700 | but there are a few things if you're looking at this
00:30:03.580 | and saying, wow, it's really expensive.
00:30:04.760 | How do I bring costs down?
00:30:06.040 | How do I do things a little differently?
00:30:07.540 | And there are a few really interesting tactics I've heard.
00:30:10.620 | So one is enrolling in college.
00:30:12.940 | And this might seem a little crazy,
00:30:14.540 | but there are a lot of universities
00:30:16.020 | that offer really, really, really compelling
00:30:18.500 | health insurance plans for students,
00:30:20.100 | even some community colleges.
00:30:21.540 | So definitely take a look in your area
00:30:23.760 | or maybe there's an online university
00:30:25.460 | where you can enroll and take a few credits,
00:30:28.340 | learn something, and in return,
00:30:30.140 | save way more on the health insurance that you might need.
00:30:33.420 | And some of those do include family plans.
00:30:35.580 | So I saw someone posting in a long thread on Reddit
00:30:39.060 | about how they ended up spending like $500 a semester
00:30:42.700 | or something for college,
00:30:43.900 | but in return save $10,000 a year on health insurance.
00:30:47.060 | So that's one.
00:30:47.900 | Another one, which may or may not be something
00:30:49.420 | you're interested in,
00:30:50.260 | but there are really great health plans
00:30:51.900 | at much, much less cost to you
00:30:53.940 | if you are part of the military reserves.
00:30:55.540 | So if you wanted to join the Army Reserves, Marine Corps,
00:30:58.240 | any of the military reserve programs,
00:30:59.660 | great healthcare there.
00:31:00.820 | If you have the kinds of expertise
00:31:02.300 | that you could be a part-time teacher
00:31:03.980 | or professor at a university,
00:31:05.420 | again, you could get some similar coverage there,
00:31:07.620 | or even a part-time employee.
00:31:09.260 | If there's a company that might employ you,
00:31:10.940 | give you health insurance as a part-time person,
00:31:13.020 | that's interesting.
00:31:13.940 | So those are some hacks on getting plans.
00:31:15.740 | Now we'll talk a little bit about medical sharing plans.
00:31:18.220 | So this is a really interesting one
00:31:20.260 | and it's quite controversial.
00:31:21.660 | There's a John Oliver, last week tonight,
00:31:23.780 | entire episode devoted to this.
00:31:25.740 | I'm not gonna try to re-summarize all of that,
00:31:28.220 | but I will make it clear
00:31:29.700 | that these are not health insurance.
00:31:31.740 | So the way these plans work
00:31:33.020 | are that members contribute money to a organization
00:31:36.500 | and that organization has rules
00:31:38.740 | about how they will contribute to members
00:31:41.180 | who need expenses paid for medical services.
00:31:43.700 | They don't guarantee the payment
00:31:45.460 | and they certainly aren't held to the same standards
00:31:47.900 | and consumer protections as health insurance plans.
00:31:50.260 | For example, the Affordable Care Act
00:31:52.140 | requires insurance companies
00:31:53.780 | to spend at least 80 to 85% of their premium dollars
00:31:57.100 | on medical care.
00:31:57.940 | No rules like that here.
00:31:59.460 | Most of these companies are private,
00:32:00.780 | so seeing how their operations work is almost impossible,
00:32:03.940 | but there have been a few court cases
00:32:05.620 | that resulted in some learnings
00:32:07.340 | and at least one of these medical sharing companies,
00:32:09.500 | it turns out they spent something less than 20%
00:32:12.420 | of the premiums they collected on medical care.
00:32:14.580 | So really a weird space.
00:32:16.340 | I have some friends that have been on these
00:32:18.220 | and have had great experiences,
00:32:20.000 | but again, very different sets of rules.
00:32:22.340 | They're not required to cover any pre-existing conditions.
00:32:25.140 | They can place lifetime or annual caps on things.
00:32:28.740 | A really catastrophic health event
00:32:30.440 | could easily exceed your sharing plan limits.
00:32:33.100 | And also many of them are very tied into a religion.
00:32:36.420 | And so if that's not something
00:32:38.300 | that is part of your lifestyle,
00:32:39.860 | it can be a bit strange.
00:32:41.700 | So if that's not something that's part of your lifestyle,
00:32:43.820 | it might not be a good fit for you.
00:32:45.380 | I know there are some medical sharing plans that,
00:32:47.140 | for example, if you have a child out of wedlock,
00:32:49.620 | not covered by insurance, things like that.
00:32:51.720 | And so definitely, definitely worth reading into them.
00:32:54.820 | I do think that if you're earlier in your life
00:32:57.180 | and there's really low costs,
00:32:58.700 | maybe it could be a way to save money.
00:33:00.300 | But for me, I don't want something
00:33:02.380 | that might have some limit,
00:33:03.820 | might require me to jump through hoops,
00:33:05.700 | or just might require me to spend a lot of money
00:33:08.780 | because I didn't get covered.
00:33:09.980 | Or even have to go through a lot of hassle.
00:33:12.060 | Many of these plans require you to pay on your own
00:33:15.180 | and request reimbursement.
00:33:16.840 | Not all of them.
00:33:17.680 | The general idea of these plans is interesting.
00:33:20.260 | The idea that we would basically group self-insure
00:33:23.340 | is definitely interesting,
00:33:24.620 | but the more that I read into them,
00:33:26.220 | the more I think that it's something
00:33:27.620 | that I'm not personally interested in.
00:33:29.400 | That said, if anyone listening has experiences,
00:33:31.840 | would love to hear about them
00:33:32.940 | because I don't feel like I have enough first-hand experience
00:33:36.060 | but from what I've read,
00:33:37.020 | it's not something that we're considering at all.
00:33:39.220 | When it comes to saving,
00:33:40.180 | two other big areas that I thought I'd focus on.
00:33:42.380 | One is if you're on a plan with high deductibles
00:33:45.980 | and you wanna cut the cost down of your medical care,
00:33:48.500 | there are two things.
00:33:49.340 | So one is direct primary care.
00:33:50.940 | There are a lot of doctor's offices
00:33:52.300 | and doctors around the country
00:33:53.900 | that have started creating a direct relationship
00:33:56.580 | with their patients.
00:33:57.420 | So someone wrote in that they use PartnerMD
00:34:00.540 | in the Northern Virginia, DC area,
00:34:03.020 | where you pay usually a monthly or annual fee
00:34:06.220 | and that covers your ability to get primary care visits
00:34:09.260 | or message your doctor if you're sick
00:34:11.260 | and get a prescription or any of the kind of basic things
00:34:13.460 | you'd see your primary care doctor for
00:34:14.900 | without having to pay out of pocket each time.
00:34:17.240 | It's not quite concierge medicine
00:34:19.200 | in that they're not focused on crazy testing and longevity
00:34:22.340 | and coming to your house,
00:34:23.420 | but they are creating kind of a fixed cost
00:34:26.260 | to cover all of your primary care needs.
00:34:28.180 | In the past, I've also talked on the pediatric side
00:34:30.740 | about two companies that we've tried out.
00:34:32.500 | One's called Summer Health
00:34:33.860 | and one's called Blueberry Pediatrics.
00:34:35.740 | And they're effectively direct primary care for pediatrics.
00:34:38.580 | So you pay a fixed cost of $20 a month
00:34:41.180 | and they will be on call through mostly text message,
00:34:44.460 | but also you can schedule calls with Blueberry
00:34:46.860 | to be able to talk to a doctor
00:34:48.380 | to help with situations related to your kids.
00:34:50.180 | Obviously, if you need to go into the office
00:34:51.780 | and do a test, they can't do that,
00:34:53.420 | but it really would cut down on that cost.
00:34:55.940 | So if you have a high deductible health plan,
00:34:57.660 | definitely something to look into
00:34:59.360 | to lower the cost of your health insurance
00:35:01.740 | so you don't have to hit those deductibles.
00:35:03.660 | On the more expensive side,
00:35:04.740 | there are concierge medical practices
00:35:06.660 | where you'd spend anywhere from thousands
00:35:09.100 | to tens of thousands of dollars a year
00:35:11.220 | and have access to doctors
00:35:13.140 | and that would cover all of your visits,
00:35:14.700 | usually cover all of your testing as well.
00:35:16.980 | But that I will save for another episode
00:35:19.300 | outside of the scope of open enrollment.
00:35:21.120 | And then finally, if you are paying
00:35:22.780 | for a lot of your own medical expenses
00:35:24.480 | because you have a high deductible health plan,
00:35:26.340 | definitely worth negotiating,
00:35:27.940 | definitely worth asking for cash rates.
00:35:30.060 | I know that some hospitals and facilities even publish
00:35:33.140 | if you're paying cash, we'll give you a discount.
00:35:34.940 | I did a whole episode with Marshall Allen,
00:35:37.340 | episode 34 of all the hacks.
00:35:39.100 | He wrote an amazing book called "Never Pay the First Bill"
00:35:41.860 | that's all about fighting back
00:35:43.380 | and pushing back against healthcare costs.
00:35:45.180 | And so if you are paying on your own,
00:35:47.140 | you should always be negotiating with your providers
00:35:49.440 | and with any facilities and asking for cash rates.
00:35:52.180 | If you're paying for your own prescriptions,
00:35:53.660 | there are sites like GoodRx or RxSaver
00:35:56.380 | that you can use to get discounts on prescriptions as well,
00:35:59.120 | or at least shop around and find the best prices.
00:36:01.820 | That is definitely something worth doing
00:36:03.660 | if you are paying on your own.
00:36:05.100 | So I think that mostly covered everything I've learned
00:36:07.140 | on the health insurance side.
00:36:08.420 | I'm sure more will come up.
00:36:09.780 | If you have other things to share, let me know.
00:36:11.740 | We're gonna probably do an episode like this
00:36:13.340 | every few years so we can cover whatever's changed.
00:36:15.700 | But I also wanna talk about some of the other things
00:36:17.880 | that you're gonna be doing for open enrollment.
00:36:19.380 | So when it comes to dental and vision insurance,
00:36:21.260 | there are a lot of mixed opinions
00:36:22.600 | because dental insurance, for example,
00:36:24.620 | often doesn't cover that much and has a cap.
00:36:27.340 | And so really it's kind of 50/50
00:36:29.680 | whether it makes financial sense.
00:36:31.340 | If your employer covers it completely,
00:36:33.180 | then it seems like a no-brainer.
00:36:34.540 | If you are someone who's regularly
00:36:36.780 | going to get your checkups,
00:36:38.020 | sometimes it can just be a break even there.
00:36:40.040 | If you have a filling every now and then
00:36:41.500 | or something like that, it seems to make sense.
00:36:43.420 | And then vision insurance,
00:36:44.740 | I actually have not ever used my vision insurance,
00:36:47.780 | but it's usually only cost somewhere
00:36:49.940 | on the order of $1 to $2 per pay period
00:36:52.460 | at whatever company I've worked with.
00:36:53.620 | So I just kept it on there.
00:36:54.980 | I haven't looked a lot into private vision insurance,
00:36:57.500 | so I don't have a lot there.
00:36:58.900 | So I'm sorry to leave you guys hanging
00:37:01.340 | if that's something that's really important to you.
00:37:03.140 | That's one where I'm gonna lean on someone
00:37:05.100 | that maybe knows more about doing private vision insurance
00:37:08.220 | if you're on your own or from an exchange
00:37:09.760 | and whether that makes sense versus from your employer.
00:37:11.860 | But I did actually, on the dental side,
00:37:14.220 | so when I went to the dentist recently,
00:37:15.700 | I was talking to my dentist
00:37:16.660 | about a lot of the cost of medical care,
00:37:18.220 | and he pointed out that he has a membership
00:37:20.540 | that is effectively like dental direct primary care.
00:37:22.780 | So for $375 a year, you can be a member of their practice.
00:37:26.260 | There's no deductibles, no maximums, no waiting periods,
00:37:29.220 | no pre-authorization,
00:37:30.500 | and that covers two cleanings and x-rays a year.
00:37:33.540 | And then on top of that,
00:37:34.620 | you get 25% discount on all treatment.
00:37:37.120 | So if you are without dental insurance
00:37:39.660 | or you decide that doesn't make sense,
00:37:41.100 | but you do wanna get cleanings done,
00:37:42.940 | it looks like at least one practice in the Bay Area,
00:37:45.740 | if not more around the country,
00:37:47.340 | have programs that might make it
00:37:49.100 | a little bit more predictable and affordable
00:37:50.900 | to be able to go in and get the basic care you want
00:37:53.220 | without having to rely on spending out of pocket
00:37:55.960 | every single time you do it at a higher cost.
00:37:58.100 | So that's dental and vision.
00:37:59.180 | A few other things that you often go through
00:38:00.740 | in open enrollment.
00:38:01.580 | So one is FSAs.
00:38:03.340 | So similar to an HSA, there is an FSA for health,
00:38:06.540 | which is a flexible spending account.
00:38:08.220 | However, very different is that unlike an HSA
00:38:11.020 | where you own the HSA,
00:38:12.740 | the FSA is something your employer owns.
00:38:15.240 | And so there is a little bit of a hack around this
00:38:17.980 | in that when you contribute to an HSA,
00:38:20.100 | if you leave halfway through the year,
00:38:21.980 | you actually aren't eligible
00:38:23.200 | for the full contribution amount.
00:38:24.580 | With an FSA, if you contribute to an FSA,
00:38:27.380 | most employers fund that FSA account January 1st,
00:38:31.140 | and then you pay for that amount
00:38:33.140 | over the course of the year.
00:38:34.300 | So if you were gonna leave a company at the end of January,
00:38:37.580 | let's say you wanted to quit your job
00:38:38.980 | after you got your bonus,
00:38:40.020 | as long as your medical expenses happened
00:38:41.900 | in that time you were employed,
00:38:43.260 | so in January, you could conceivably use
00:38:45.760 | the entire limit in January,
00:38:47.640 | but have only contributed 1/12 of the amount.
00:38:50.920 | So a little bit of a hack there
00:38:52.240 | if you're planning on leaving your job
00:38:53.680 | in January or February, fully fund your FSA,
00:38:56.520 | use it up, go get LASIK, or go do a full body MRI,
00:39:00.360 | or do some diagnostic testing, whatever you want.
00:39:03.040 | And that's a little bit of a hack there.
00:39:04.480 | On the flip side though,
00:39:05.600 | because the company owns the plan,
00:39:07.080 | many people don't use up all their FSA dollars,
00:39:09.520 | and then their employer actually gets
00:39:10.840 | to keep all that money.
00:39:11.820 | Depending on how you engage with your FSA,
00:39:14.200 | it could be beneficial to you,
00:39:15.400 | it could be beneficial to the employer.
00:39:16.800 | I will say never let your FSA dollars go unused.
00:39:19.560 | While you can usually not roll all of them over,
00:39:21.660 | there are lots of things that they're eligible for.
00:39:24.000 | If you're having children, you can buy baby monitors.
00:39:26.760 | I know the Oura Ring, I think I just got an email
00:39:28.920 | that the Oura Ring is now an FSA eligible expense.
00:39:31.940 | I love my Oura Ring,
00:39:33.080 | so that would definitely be a good way to use it.
00:39:35.160 | A lot of the diagnostic testing that you can do,
00:39:37.400 | whether it's blood tests or different things,
00:39:39.600 | those are often covered.
00:39:40.960 | 23andMe, genetic testing is often covered.
00:39:43.040 | I'll put a whole list together in a future episode
00:39:45.360 | about end of the year stuff and in a newsletter.
00:39:47.740 | But there is definitely enough things.
00:39:49.720 | And if you have nothing that you wanna do,
00:39:51.460 | you could always buy things and donate them
00:39:53.480 | to a local shelter for people who need them.
00:39:55.500 | So definitely make sure you use those FSA dollars
00:39:57.580 | before the end of the year.
00:39:58.460 | There's also an FSA for dependent care,
00:40:00.540 | which if you pay a nanny, au pair, childcare, daycare,
00:40:04.620 | anything like that,
00:40:05.580 | then definitely worth contributing to the FSA
00:40:07.720 | for dependent care.
00:40:08.620 | Though I will make one caveat.
00:40:10.260 | I would email your HR team or ask someone
00:40:12.900 | how often the FSA for dependent care gets clawed back.
00:40:16.660 | There are some rules around eligibility.
00:40:19.100 | And if certain types of employees who make more money
00:40:22.100 | or are more senior put in more money,
00:40:24.120 | but other employees who aren't in that group put in less,
00:40:27.060 | then they have to claw back the contributions.
00:40:29.020 | I know when I was at Wealthfront,
00:40:30.340 | it seemed like every year we contributed the max
00:40:32.600 | to our FSA for dependent care,
00:40:34.100 | and it got clawed back at the end of the year.
00:40:35.620 | So we actually were like loaning money to our employer
00:40:38.140 | for the year and getting nothing for it.
00:40:39.900 | So I would ask your employer
00:40:41.380 | if that's something that happens regularly or not.
00:40:43.780 | And if it does, then maybe think twice
00:40:45.860 | about whether it makes sense,
00:40:47.220 | or maybe ask them what they expect might happen next year.
00:40:50.060 | And then HSA.
00:40:51.140 | We talked a lot about the HSA before.
00:40:52.780 | The only thing that I'll mention
00:40:54.020 | is you don't actually have to use the HSA provider
00:40:57.060 | your employer offers.
00:40:58.460 | If your employer is willing to contribute to your HSA
00:41:01.780 | for you, and a lot of employers will put money
00:41:03.940 | into your HSA as a perk,
00:41:05.740 | because usually to be eligible,
00:41:08.100 | you chose a high deductible health plan
00:41:10.140 | that has a lower monthly premium.
00:41:11.700 | And so you're saving your employer money.
00:41:13.540 | And so in return, they're willing to give you money
00:41:15.620 | in the form of an HSA contribution.
00:41:17.540 | Oftentimes, they'll only do that with the HSA provider
00:41:20.660 | that they've partnered with,
00:41:21.660 | but you can open an HSA anywhere.
00:41:23.660 | So in the past, I've had whatever the HSA,
00:41:26.460 | I think it was health equity that came with the company,
00:41:28.780 | and it was terrible.
00:41:29.620 | The investment options had high fees.
00:41:30.980 | And so we actually moved it over
00:41:32.100 | to a company called Lively.
00:41:33.500 | I've also tried a company called Starship.
00:41:35.420 | So you don't need to keep your HSA
00:41:37.780 | at whatever HSA provider your employer offers,
00:41:40.420 | but you might need to leave it there
00:41:41.820 | if your employer contributes.
00:41:43.020 | A few other things through open enrollment.
00:41:44.460 | Pre-tax transit.
00:41:45.460 | A lot of employers offer the ability
00:41:46.900 | for you to buy your local transit cards
00:41:49.420 | or even sometimes parking at pre-tax rates.
00:41:51.780 | So if those are things
00:41:52.620 | you're gonna spend money on already,
00:41:53.900 | definitely worth contributing
00:41:55.140 | and saving money on the taxes there.
00:41:56.660 | And then the last one is around life and disability.
00:41:59.060 | So many employers include some basic amount
00:42:01.620 | of life and disability.
00:42:02.760 | Usually don't get to even opt into it.
00:42:04.580 | It's just there.
00:42:05.460 | Definitely no harm in just accepting that,
00:42:07.340 | but there's also sometimes the option
00:42:08.900 | for supplemental life and disability insurance.
00:42:11.100 | And I think the one thing to consider
00:42:12.820 | when it comes to supplemental life and disability,
00:42:15.220 | it's a plan that's tied to your employer.
00:42:17.100 | So let's say you have life insurance at your job.
00:42:19.820 | You're 40 years old.
00:42:20.900 | You work there for 10 years and you have no health problems.
00:42:24.100 | So you just get it through your employer.
00:42:25.820 | And oftentimes it is a little cheaper,
00:42:27.860 | but let's say in that period of 10 years,
00:42:29.860 | you have an underlying health condition.
00:42:31.420 | You quit your job.
00:42:32.480 | Now you need to go somewhere else.
00:42:33.900 | They don't offer supplemental life or disability.
00:42:36.260 | And now you need to go get your own term life insurance.
00:42:38.620 | And now you're not eligible for the best rates
00:42:41.600 | because you have some health issue
00:42:42.960 | or because you're 10 years older
00:42:44.400 | and it's just more expensive.
00:42:45.620 | And so unless you have a job that's very, very stable,
00:42:48.980 | maybe you're a government employee
00:42:50.500 | and you have no plans to leave for the rest of your life,
00:42:53.140 | or maybe you have a preexisting condition.
00:42:55.740 | It makes it so expensive or even impossible
00:42:58.000 | for you to get your own life insurance coverage elsewhere.
00:43:00.800 | Maybe in those two scenarios, it could make sense.
00:43:03.060 | Otherwise, I would make a strong, strong recommendation
00:43:06.060 | to look for your life insurance separately
00:43:08.140 | and outside of your employer.
00:43:09.620 | So it's something that can stick with you
00:43:11.580 | for as long as you need it
00:43:12.900 | and isn't bound to being stuck in one particular job
00:43:16.320 | with one particular employer.
00:43:17.940 | So I think that covers everything open enrollment.
00:43:19.860 | I hope this was really helpful.
00:43:21.060 | Finally, I did say I was gonna give a few tips for Hawaii.
00:43:23.980 | We're here on the big island for a week.
00:43:26.120 | I'm here for a conference,
00:43:27.260 | but we decided to make a family trip out of it.
00:43:29.000 | I actually don't have a ton of tips
00:43:30.500 | 'cause it's only been two days,
00:43:31.860 | but I did wanna share a couple things.
00:43:33.860 | One, we had a family dinner at the Lava Lava Beach Club,
00:43:37.220 | and I would highly recommend it for anyone.
00:43:39.420 | I would go back without kids,
00:43:40.740 | but I would definitely go back with kids.
00:43:42.620 | It was just great.
00:43:43.700 | They had live music, good food, very kid-friendly,
00:43:46.980 | right on the beach.
00:43:48.040 | Definitely a recommendation that I would give anyone.
00:43:50.780 | And then last night,
00:43:51.620 | we left the kids at home with our au pair,
00:43:53.500 | and we went to the canoe house
00:43:54.820 | at the Auberg Monolani property, which is beautiful.
00:43:58.500 | We're staying at a rented house,
00:44:00.380 | so we're not staying at a resort right now,
00:44:02.340 | but it was wonderful.
00:44:03.460 | The corn ribs and the pork jowl were just incredible,
00:44:05.720 | so I would highly recommend those.
00:44:07.300 | Also the maitake mushrooms.
00:44:08.700 | So those were two tips.
00:44:10.180 | I was hoping to tell you
00:44:11.060 | about the amazing snorkel adventure
00:44:12.700 | we went on with Ocean Sports.
00:44:14.660 | However, they canceled this morning
00:44:16.420 | because there's a lot of swell in the water,
00:44:18.220 | so we didn't get to go on that.
00:44:19.340 | But I did learn something that works really well
00:44:21.700 | if you have young kids.
00:44:22.740 | So we went over to a place called Snorkel Bob's,
00:44:25.020 | and they rent these boogie boards with cutouts
00:44:28.500 | and a clear screen,
00:44:29.980 | and it actually has a cylinder that comes up
00:44:32.360 | almost like a paint can made of plastic
00:44:34.300 | so your kids can stick their face on it
00:44:36.060 | and look underwater.
00:44:37.100 | It's like a glass bottom boat
00:44:38.500 | built into a little boogie board.
00:44:40.180 | So we did rent one of those for Quinn
00:44:42.300 | so she could kind of go out
00:44:43.420 | and be able to look underwater.
00:44:44.700 | We're trying to teach her how to snorkel,
00:44:46.180 | but at three, it is a little trickier than you'd expect,
00:44:49.420 | or maybe it's equally as tricky as you'd expect,
00:44:51.780 | but that was a cool little hack that we found.
00:44:53.940 | And then also one thing we always do
00:44:56.100 | is we just go on Target whenever we're going to Hawaii,
00:44:58.740 | and we pre-order all the groceries that we might want,
00:45:01.200 | all the things, some diapers,
00:45:02.740 | whatever the stuff you need is,
00:45:04.020 | and then we just pick it up at the Target before we go.
00:45:06.400 | We did this in Maui, we've done it in Kona.
00:45:08.180 | It just makes it so, so much easier,
00:45:10.220 | and you just don't have to worry about a lot of hassle.
00:45:12.620 | Those are my quick three tips from our trip right now.
00:45:15.420 | And actually one more,
00:45:16.260 | we're staying right near the Fairmont Orchid,
00:45:18.420 | which I've been to a lot of times
00:45:19.700 | because the conference I'm going to is hosted there,
00:45:22.020 | and I think most people know this,
00:45:23.660 | but just in case you don't,
00:45:24.740 | all beaches in Hawaii are public.
00:45:26.900 | So you can access the beaches at resorts
00:45:29.420 | without having to stay at the resort.
00:45:30.980 | And so we've gone over to the Fairmont Beach,
00:45:32.860 | we've hung out on the beach, swam out on the water,
00:45:35.060 | but also most hotels,
00:45:36.860 | yes, they have overpriced drinks and food,
00:45:38.980 | but they also know that
00:45:40.540 | and don't care if you're staying there.
00:45:42.020 | So we were able to go to the beach,
00:45:43.760 | order drinks, order food, hang out,
00:45:46.180 | and not have to worry at all
00:45:47.700 | about staying at the properties.
00:45:49.620 | We could save money staying very nearby,
00:45:51.500 | use the beach,
00:45:52.380 | but also be able to get drinks at the beach
00:45:53.980 | just like you would if you were staying at a resort.
00:45:55.780 | So there's a little hack for Hawaii.
00:45:57.700 | Probably doesn't work in most other places
00:45:59.900 | where beaches are kind of owned and operated
00:46:01.780 | maybe by the resort,
00:46:02.860 | but in Hawaii, they are all public.
00:46:05.420 | That's all I've got this week.
00:46:06.500 | I hope this episode was really helpful
00:46:08.100 | for anyone going through open enrollment.
00:46:09.660 | I really hope that you guys can figure it out
00:46:12.060 | and get the best deal.
00:46:13.260 | I really wish that this entire health insurance process
00:46:15.860 | in the States wasn't as complicated and confusing as it is,
00:46:18.740 | but hopefully this has been helpful
00:46:20.460 | and makes it a little bit easier for you
00:46:22.780 | as you go through this period.
00:46:23.900 | So if you ever want to get in touch,
00:46:25.700 | you can send an email to podcast@allthehacks.com.
00:46:28.540 | I will read every single one of those emails.
00:46:30.620 | And if you have questions,
00:46:31.820 | they will all be considered for a future mailbag episode.
00:46:34.500 | I might not be able to respond to your email,
00:46:36.620 | but it doesn't mean I'm not reading it.
00:46:38.020 | And I don't love hearing from you.
00:46:39.140 | So thank you everyone for reaching out.
00:46:40.980 | That's all for this week.
00:46:42.140 | See you next week.
00:46:43.020 | (upbeat music)
00:46:45.600 | (birds chirping)
00:46:48.360 | [BLANK_AUDIO]