In this eye-opening episode, David Contorno and Emma Fox dive into the harsh realities many face in accessing life-saving medications for chronic conditions. They share a heartfelt story of an 11-year-old boy desperate to help his mother, who lost access to her crucial MS medication due to an unexpected change in her health insurance plan. The discussion sheds light on the complexities of health insurance, the hidden options available, and how unaffordability can strike without warning. Emma and David provide practical advice on navigating these challenges, from leveraging manufacturer assistance programs to sourcing medications internationally. Join them as they unravel the tangled web of healthcare, offering hope and actionable strategies for those struggling with similar issues.

TIMESTAMPS:

[01:06] Story of an 11-year-old boy asking for help for his mother

[04:33] High-deductible HSA plans vs. copay PPO plans

[07:28] Manufacturer assistance programs, coverage issues, qualification requirements

[10:33]How drug coupons work and their impact on self-insured plans

[17:31] GLP-1 drugs (e.g., Trulicity, Ozempic) pricing and sourcing strategies

[24:49] Importance of consulting doctors when considering medication alternatives

[29:14] Emphasis on the responsibility of benefits consultants to impact company and employee finances

QUOTES

• "It has these horrific downstream effects, like eleven year old boys who are asking practical strangers to help his mom. You know, it really hurt my heart."- Emma Fox
• "But I wanted to explain that because coupons are, if you're in a fully insured plan, I, when I say I don't care, I do care a little, but I don't care nearly as much as when you're in a self-funded plan." - Emma Fox
• "Imagine if you were compensated for figuring out the things that we're talking about here. [...] You're impacting the money coming into their house and the money coming out of their house to a very large degree." -David Contorno

SOCIAL MEDIA LINKS

David Contorno

LinkedIn: https://www.linkedin.com/in/dcontorno/

Emma Fox

LinkedIn: https://www.linkedin.com/in/emmamariefox/

WEBSITE

E-Powered Benefits: https://www.epoweredbenefits.com/

Emma Fox: https://emmamariefox.com/

Mixed & Edited by Next Day Podcast

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