Doxcost - The Ultimate Guide To Health Insurance

#021 - Reprise: Don't Fear The High Deductible is an encore presentation of our most popular show.  Health Savings Accounts (HSAs) work with High Deductible Health Plans (HDHPs) save you the most money, period.

In order to open a Health Savings Account, you must be enrolled in an eligible High Deductible Health Plan.  Most people see High Deductible and get scared away.  High Deductible Health Plans go as low as $1,400 for an  individual in 2021 and $2,800 for households with two or more.

Learn more about HSA and HDHP limits for 2021

Don't Pay Tax And Keep Money In Your Pocket

Money deposited in a HSA account is not taxed. 

Money deposited in a regular savings account (or checking or investment account) is taxed - often referred to as after tax because Uncle Sam takes his tax out of your paycheck and what is left is after tax.

Learn more about Health Savings Accounts here

Our family has utilized Health Savings Accounts since they started in 2004.  I prefer Lively.

Visit Lively here - I receive a nominal fee for recommending Lively

As I always, I appreciate you very much!  Tell your family, friends, coworkers and your boss about Doxcost!

Next episode we'll take another look at why you get your health insurance through your employer....

Support the show

Book a One on One with Scott now!  Click the link below!

Not sure which health plan fits you best?

[Pick My Best Plan - Book 1:1]

New to or want to better start saving tax-free?

[Start My HSA The Smart Way - Book Now]

#020 - Your money is being taken from you and you don't even know it.  Your health insurance premiums are higher, in part, because you sign away your health insurance benefits to third parties who act in their best interest, not necessarily yours.

Assignment of Benefits (AOBs) is essentially demanded by hospitals, doctors and pharmacies before they will serve you.  You probably don't even know it, either.  You are presented a bunch of documents, don't read them, sign bottom of the page and then they proceed.  What you signed basically gives the provider direct access to the money that the insurance company is contractually obligated to pay to you.  Your money is being taken from you.

Once you sign your benefits away, you lose control.  Providers enlist their attorneys to author AOBs with the intent to seize control over your benefits so that they make sure that they get paid at whatever amount they deem appropriate.  The AOB is specifically written so that you cannot reverse the decision you make - it is irrevocable, irreversible.   Name any other thing that you purchase where you actually allow someone to push you aside while they decide what happens with your money?

State lawmakers and regulators will probably start to scrutinize these arrangements.  The State of Florida passed a law to regulate Assignment of Benefits related to property insurance.  As the Center For Medicare and Medicaid Services (CMS) starts to scrutinize transparency, AOBs will likely be considered, as well.

Check out my pal Whitney Johnson here:

Disrupt Yourself Podcast

You have question and we have answers!  Let us know your questions here:

Your Questions For Doxcost

Thanks, as always, for listening.  Tell your family, friends, co-workers!  We're here for you!

Next episode....we'll look at networks, break them down so you can understand how/why they  were put together and why they cost you more in your insurance premiums and how they may become obsolete.

When football was football and not a passing league!  Nobody finds daylight like #20!

Barry Sanders

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Book a One on One with Scott now!  Click the link below!

Not sure which health plan fits you best?

[Pick My Best Plan - Book 1:1]

New to or want to better start saving tax-free?

[Start My HSA The Smart Way - Book Now]

#019 - I Hate Insurance and other comments about health insurance and healthcare are highlighted in a snapshot look at how people view their current situation within the health insurance and healthcare systems as exclaimed on Twitter.

Follow @doxcost on Twitter

Lots of angst and anguish can be found on Twitter.  We decided to take a look and see what is really bothering people about  health insurance and healthcare. 

Scott puts "I Hate Insurance" in the search box.  Some comments are amusing, some is unfortunate and some is disturbing.   I respond in an honest and helpful way or at least put things in context.

Lots of people misunderstand health insurance. The tangling of health insurance and healthcare is on full display.

Why You Save By Getting Your Health Insurance Through Your Employer - Episode 3

A  couple of doctors, obviously well-educated, display their ignorance regarding their profession's direct contribution to the "thousands and thousands of dollars insurance companies have convinced people to spend on their health insurance".  Payments to providers (i.e. Doctors, Hospitals, Pharma) are the single largest component of the cost of your health insurance premiums.

How Health Insurance Is Priced - What Makes Up A Dollar of Premium - Episode 11 

I appreciate you very much!  Tell your family, friends and colleagues - especially small business owners - to listen to Doxcost wherever they get their podcasts.  Follow us on Twitter @doxcost

Next up, we'll explain the cancer that is Assignment of Benefits and how that single-handedly takes you out of the loop with your doctor and your insurance.  You won't want to miss it next Thursday!

Support the show

Book a One on One with Scott now!  Click the link below!

Not sure which health plan fits you best?

[Pick My Best Plan - Book 1:1]

New to or want to better start saving tax-free?

[Start My HSA The Smart Way - Book Now]

#018 - Learn how an HSA will earn you a quick and easy return by making an eligible deposit before you file your taxes.

An HSA is  like getting free money!

Don't Pay FICA or Federal Income Tax
(some states still tax your HSA deposits)

FICA = Social Security Withholding AND Medicare Withholding = 7.65% of your paycheck

Federal  Income Tax Withholding = 10% to 37%

Maximum HSA Deposit in 2021
Individual - $3,600
Head of Household/Married/Family -  $7,200 per year

You keep the money instead of paying Uncle Sam

$3600 x .0765 = $275

$3600x .22 = $792

$1,067 stays in your pocket!  Why give it away when you do not have to?  If you're a family, you'll keep even more of your hard-earned paycheck!

I've utilized the benefits of Health Savings Accounts since their inception. I prefer Lively HSA

Learn about Lively HSA here

Thanks, as always, for your support!  Please share Doxcost with your family, friends and colleagues.  Visit doxcost.com to learn more.

Open Enrollment Workshop coming late summer 2021!

Support the show

Book a One on One with Scott now!  Click the link below!

Not sure which health plan fits you best?

[Pick My Best Plan - Book 1:1]

New to or want to better start saving tax-free?

[Start My HSA The Smart Way - Book Now]

#017 - Healthcare.gov review is a cursory look at the current exchange portal.   The site provides access to insurance plan options for the 50 states and District of Columbia.  Links can be found for both the federal website and individual state exchanges.

Go to Healthcare.gov here

This Healthcare.gov review still keeps in mind that the goal is to get 100% covered and spend the least amount possible on your health insurance.  This is best done utilizing a High Deductible Health Plan (HDHP) along with a Health Savings Account (HSA).  It makes sense to review our episode on HDHPs and HSAs!

Don't Fear The High Deductible

Healthcare.gov review highlights the fact the exchanges are not for everyone.  Nearly half of the US population gets their health insurance through employer sponsored plans.  Another 35% of people get their health insurance through the military, Medicaid or Medicare.  About 5% of people have individual plans.  About 10% choose to be self-insured or do not believe they can afford health insurance.  Healthcare.gov does a great job of informing people how to get help and how much financial assistance they can get.

Why get your health insurance through your employer?

Tax Day is now May 17, 2021!  Get an immediate return on your savings by contributing to your HSA before May 17.

Learn how to get an immediate return on your savings

Thanks, as always, for your continued support.  Please tell your colleagues, friends and family about Doxcost.  Follow us on Twitter @doxcost and at doxcost.com

Support the show

Book a One on One with Scott now!  Click the link below!

Not sure which health plan fits you best?

[Pick My Best Plan - Book 1:1]

New to or want to better start saving tax-free?

[Start My HSA The Smart Way - Book Now]

#016 Insurance company transparency is required by both the Affordable Care Act and the new Hospital Price Transparency rule that took effect on January 1, 2021.  Learn how insurance companies are complying and how (if) that helps you.

The Patient Protection Affordable Care Act, aka Obamacare, requires insurance companies to publish the prices they negotiate and amounts they pay to doctors, hospitals, pharma and other providers.

Learn about the PPACA here

Insurance company transparency required by Obamacare includes publishing Medical Loss Ratios (MLR).  An MLR is the percentage of paid claims plus reserves (IBNR)  relative to the total  premium an insurance company receives.  Obamacare requires that the percentage representing claims be at least 80% of total premium. 

While apparently meeting the federal government requirements, insurance companies do not present any of the information in a consumer friendly way, which is truly unfortunate.  Accessing the data is cumbersome.  The insurance jargon used is worthless to the average consumer. 

While the politicians can claim they did something for their constituents and the insurance companies can claim that they are dutiful and compliant in meeting the needs of consumers, the information is worthless.  Further, the time and money spent producing the data is part of the administrative expense added to the premium you pay....so your insurance costs more with nothing to show for it.

See how insurance companies meet Obamacare requirements here

CMS, the Center for Medicare and Medicaid Services, requires insurance company transparency, at least from what the former Secretary of Health and Human Services says. 

From the HHS site: The rule requires that most health plans and health insurers not only provide easy-to-understand personalized information on enrollee cost-sharing for healthcare services, but must also publicly disclose the rates they actually pay healthcare providers for specific services. 

Still, what insurance companies really need to disclose and publish is what their rates are, what their loss ratios are, what their expenses are and what their profit is.....and don't be fooled....not-for-profits make lots of money......

See the  statement including Insurance Company Transparency here

Bottom line is that you need to take control.  Stick with me and we'll get it done!

Next episode, we'll look at the healthcare exchanges and see what might be usable and useful to you, a friend or a family member.

Thanks, as always, for listening.  I appreciate you and the time and support you afford me.  Tell your family, friends and colleagues.....we're all in this together!

Support the show

Book a One on One with Scott now!  Click the link below!

Not sure which health plan fits you best?

[Pick My Best Plan - Book 1:1]

New to or want to better start saving tax-free?

[Start My HSA The Smart Way - Book Now]

#015 Learn how Hospital Price Transparency rule, as directed by Obamacare,  Trump administration rule and Biden administration execution,  will  help you take control and save on your health insurance  premiums and out of pocket costs.

As of January 1, 2021, hospitals must publish and provide consumers the price of the services before providing their services.

You, the consumer and patient, need to ask (demand...nicely) that the doctor inform you of the cost of the procedure before you agree to undergo the procedure or otherwise be treated by the doctor.  The CMS asks you to report complaints if you do not get what you expect.

Visit CMS Hospital Price Transparency page

Visit healthcare.gov Patient Protection Affordable Care Act pages

No different than anything else you buy, you should want to comparison shop.  And the information to comparison shop should now be readily available from the doctor.

Why shouldn't you see a menu of prices for services provided by hospitals?  The answer is you should!  And you should demand it if you don't!  Or at least find another hospital that does, like Surgery Center of Oklahoma.....they publish their prices!  You may just find that a short plane ride to Oklahoma City for surgery is cheaper than staying home where they won't tell you what it will cost.....wonder why they won't tell you.......!  #makethemcompete

Unfortunately, the way that some hospitals are attempting to comply with the transparency law leaves much to be desired.  I am confident that market competition from yet-to-be-discovered sources will find great opportunity in the incumbent's complacency in much the same way that a guy selling books forever changed the way we purchase all kinds of items from lots of now defunct retail stores.

In the next episode, we'll cover how insurance companies address transparency and what you need from them.

As always, thanks for listening!  Tell your colleagues, friends and family about Doxcost!  Follow on Twitter @doxcost and at doxcost.com

Support the show

Book a One on One with Scott now!  Click the link below!

Not sure which health plan fits you best?

[Pick My Best Plan - Book 1:1]

New to or want to better start saving tax-free?

[Start My HSA The Smart Way - Book Now]

#014 - Providers of health care - hospital, doctors, pharma - operate to make a profit, whether they say so or not.  Are you paying too much?  Yes.

While insurance companies are often the recipient of consumer ire for the rising cost of health insurance, the cost inputs to those insurance premiums - most notably paid claims (aka the cost of doctors, hospitals, pharma and other providers) have the most significant effect on the price of your health insurance premiums.  These input costs need to be equally, if not more, scrutinized!

This episode illustrates how hospitals and other providers are equally driven by profits.  And there is nothing wrong with profits.  Value is created when the product or service meets the lowest price possible when the buyer and seller have a meeting of the minds.

Your call to action is to purchase health insurance as you would any other consumable product.  Identify the cost ahead of your purchase.  Don't just take whatever they give you.  And if you just say to yourself, "oh, insurance will pay for it....no big deal....."  STOP!  You are paying for it....you just don't realize it and the system likes it that way.

Become an informed and rational consumer of health care.  It starts now!

Easily research data, from industry publications such as Becker's Hospital Review:

Ascension records $1B annual loss

Happy Saint Patrick's Day!  Be sure to check out surfing in Bundoran!

Bundoran Surf Company Ireland

We'll continue on with helping you to be a better consumer of healthcare.  Next we'll look further at the new rules handed down by CMS for transparent pricing.

Tell your family friends about Doxcost!  We're growing!  Catch us on Spotify or wherever you get your shows.

See ya next time!

Support the show

Book a One on One with Scott now!  Click the link below!

Not sure which health plan fits you best?

[Pick My Best Plan - Book 1:1]

New to or want to better start saving tax-free?

[Start My HSA The Smart Way - Book Now]

#013 - Learn why the amounts paid to doctors, hospitals, pharma and other providers are the single biggest factors in the cost of your health insurance.

Understand how underwriters and actuaries use historical paid claims to forecast future claims, establish reserves and keep pace with inflation.  These amounts are then utilized to create the health insurance rates that you pay.

Paid claims are the amounts paid, on behalf of members of the employer group or individual pool, to doctors, hospitals, pharma and other providers. 

IBNR (aka Incurred But Not Reported) is a reserve amount insurers must hold back to pay claims from the current year that are paid in the future - next year or years after.  IBNR is calculated as a percentage of paid claims.

Trend is an amount that provides the ability of insurance premiums to keep pace with inflation.  Medical trend (medical inflation).  Trend is different than general inflation and has risen at much higher levels than general inflation over the past few decades.  Trend is applied to paid claims and reserves.

See the following link from PWC that illustrates their methodology in considering 2020 and 2021 medical trend.

2021 Medical Cost Trend - PwC

We celebrate International Women's Day!  Follow some great women here:

NCAA Women's Basketball  Tournament - every game on ESPN

Next episode we continue to tackle how your insurance is priced and the factors that affect its price.

Thanks, as always, for your continued support!  Doxcost continues to grow by leaps and bounds.  Tell your family and friends to catch Doxcost on Apple Podcasts or where ever you get your shows.

See ya next time!

Support the show

Book a One on One with Scott now!  Click the link below!

Not sure which health plan fits you best?

[Pick My Best Plan - Book 1:1]

New to or want to better start saving tax-free?

[Start My HSA The Smart Way - Book Now]

#012 - Learn what everyday stuff underwriters use to price your health insurance.

Control what you can and forget the stuff that underwriters use, everyday stuff, like your age, sex and ZIP code, that is arbitrary and you cannot change.

If you live in New York or California, your rates are likely to be much higher than the person that lives in Nebraska or Mississippi.  It's not your fault, just an economic reality.  If you  live in a low cost state, expect lower claims cost....if most of the employees live in a low cost state.

If your company is full of accountants or actuaries, expect a lower rate, in general, than if your company is a high performance racing team that participates in speed games.  Truth is that I worked for a company whose Chief Actuary spent his leisure time as a driver racing at Watkins Glen....so it is not always a perfect assumption!

And, as for profit, which we discussed in Doxcost Episode 11, here is a link to a report on a publicly traded company, which owns hospitals, that announced its financial results for 2020.  The company announced over $500 Million in profit in 2020 on nearly $12 Billion in revenue (aka the claims you incur and that the insurance company pays and reserves for).

CHS sheds 18 hospitals, swings to $511M profit

Also, I did like this author's characterization of Not For Profit companies.....Not For Profit sounds nice, but don't be fooled.  Read the post here:

How Non-Profit Hospitals Are Driving Up The Cost of Health Care

Thanks, as always, for your support.  It's all about Knowledge Experience Education and Information.  Tell your family, friends and coworkers about Doxcost!

Next episode we will tie together all of the aspects of pricing so that you understand how what the actuaries and underwriters consider affects the price you pay for your health insurance.

I appreciate you very much!

Support the show

Book a One on One with Scott now!  Click the link below!

Not sure which health plan fits you best?

[Pick My Best Plan - Book 1:1]

New to or want to better start saving tax-free?

[Start My HSA The Smart Way - Book Now]