Clearing up Open Enrollment Confusion. Here's what you need to know

Wednesday, November 22nd

00:28:08

HSA vs Copay? Which is a better choice for you and your family?
Don' make the same mistake that most people make during Open Enrollment

Tom Julian Marketing Director at Fidelis Care helps clear up the Open Enrollment Confusion

More information: https://www.fideliscare.org

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Transcript - Not for consumer use. Robot overlords only. Will not be accurate.

Welcome to seven figures and teeny writers and seven figures is presented by Stanley first credit union from personal waiting to business services at home loans. They're number one priority is finding a solution that works for you locally. This week we had planned to talk about reinventing yourself inspiring you to press on after a financially crippling divorce or a company lay out. But a lot of youth who lives in reached out to me asking for some clarity around health insurance. So we're gonna focus on that today even though he gets the last thing that we went ideal weight especially during the busy holiday season for many people that deadline is fast approaching and I think it's eight Tuesday. That a majority of people feel very overwhelmed didn't baffled by it all so. Let's clear some of that fog in breakdown exactly what you need to know we cash in a time Julian marketing director at the Dallas Karen thank you for shedding some light on this trip. We are all so confused top when it comes open enrollment time this is the email from HI that we hate to see that could affect a because we scratch our heads were like oh god I don't understand. Any of it and it feels like it's. It's set up to confuse us even more or so we invited you into the podcast on to the podcast. To clear things up for us if you don't mind. Not a are okay. So let's start from the beginning first of what are the biggest mistakes that most people make when they are going through this enrollment process. Not taking their time in looking to make sure that before p.s are there and back to fort peas I mean they have you look at the price and Lisa price really talked about premium we're also talking about what's covered what you're caught sharing would be. If you're admitted to a hospital where your doctor Lloyd B console and then you prescription drugs are they covered by the planet and what level they cover and then the final piece would be. Well the pro writers don't entry your writers known network as well and in the final few would be if you do all clear then you went up with peace of mind for you and your family. Okay earth so our goal is to get to that final. Exhausting sitting at a computer and trying to understand. In a lot of us you're right we probably don't take enough time with fed. My husband and I sat down the other day and we said abort mission in the middle of that we're like I add I don't know what to do it and axed so. Oh. If only uncle Leo outlines the and there's just a small little window that we have to work breath when we got to get this done right. Whether it's truly New York State Powell on the exchange or whether it's Medicare. Or in your case through your employer. Ty was always an issue. Yeah okay. So now do people tend to get too much coverage sometimes you find are not enough. I was. It's a good question and I don't think you can ever had if you can afford to pay for the coverage I don't particularly have too much coverage. Are right but what it comes down to is basically either you pay up front first services that you may need or you pay at the time the services because you end up a higher deductible or higher co pay or higher cautionary. That's a nice transition in two. The HSA vs co pay because I feel like more and more and you trade each had a validate this statement or not. More and more companies are going DH SA route to try and why is that is that beneficial for our crew the company or us as B. They actually solves okay actually votes on what you're seeing and a lot of this you know as a result would be up. Affordable Care Act and more people getting ensured in and demanded that he put in the smoke isn't places and things they nature but what it really does is it allows people to safe premium dollars. By paying a higher. I'm a pocket. All right so in other words if you didn't hit your deductible you were co pay maybe fifty dollars and so out of 25 docs. So which is a question of you know when you what are you paying the money. OK so you're gonna pay them money no matter watt. Right you're saying you immediate and it didn't. If you utilizing this service yes because don't forget. On what happens is if you they put into deductible IN or HSA and I. I'm on the company's gonna give you some money towards yes let's say normally. And also there. Premiums than they hate insurance is what was your. Cost sharing of the premium is lowered. So now let's back up just one quick second for those who are not familiar with HSA's health savings accounts. And you describe it in and out shallow what it is. Are basically what it is is it's really up and fund well. If you are familiar at all with your pretext deductions. Art where you put money aside to pay for day care or in some cases per game or four. Medical items or services that are normally covered by your health plan or should share the cost sharing stuff fry net front and a net. Basically EP's first. And before your coverage kicks sent. So you're basically in a new uptake exploding and as well. OK so this is pretax money going into this. Account if it works as like a checking account almost right. OK as a pretext money goes into this account now this is the count that you're gonna used to pay these high here. Co pays when you have a doctor's appointment or whatnot right. And so first let me use yes. How do we get this let's say I aid choose to do the HS save route if I have a choice and not every employer offers a choice son just dictate which way to go out. Howell quickly can you build up the money in this account what if I have a doctor's visit on January 2 and hit it as if I mean I haven't muddy Matta town MI. You know you're not accept that but the young beauty of the most of men in percent of correct the beauty of bad is that you actually can still get covered. And it just catches up with the. Oh see you pay initially aiming keep your receipts and may you get reimbursed. On Iraq. Okay this money is forever always yours freight. And that is that what makes it enticing over the co pay plan. Because some people yes to some people yes I'm and it normally. Two people who used be agency's way of going are the ones that don't don't plan on having a lot of services. Are they not made a lot of papers services it correctly use. So that would be it would really call them being principles. Eric which would make it for peacekeepers came out it was a target marketing me once they were 21 to 36 years old were healthy and or services. All right and then if you can give him a lifestyle which side helped the annual exercise and things like their chances are you're not gonna use a lot of a lot of services. So you're not spending now premium dollars in anticipation of Jews and services. And come back as. When if you have kids would you recommend this for feel because it darling that the doctors. Well that's good transition for families and I would recommend mr. Ella people and most people are eligible for would be to put their children child health plus. To meet with somebody and navigator or whenever. I don't care representatives and discussing an opportunity because it. Chapel pluses either free or low cost health insurance for any child up to the age of the basically until it covered in Italy during ninety spurt that electorate no co pays or no. Coinsurance or ignored deductible it straight up first dollar coverage. And it's very good coverage covers everything. Can you take advantage of the Childs health plus when you do have. An option through your employer or you make a certain income level. Well if you can't discount talk today and just people out there are certain regulations they can spend X amount of dollars on health insurance and use you are covered for you can apply for. Child plus or if the coverage is not. Teary good. All right our limited coverage and the children would qualify for that but you can get all the information through our website at www. Care dot org. There's Delis cared dot org okay I wonder file if we can go back to agency persist Tropez because that's the big question a lot of people are tackling right now pros and cons of each. The benefit the typical stuff that it could eventually and it becomes felt were actually being in the individual choice. Ha ha okay. Again you see a lot of younger couples taking yet the Asia say and you find at the children and people children would rather hear a bit higher co pay al-Qaeda there's a right. And it's all about putting dollars in the pocket. And how you could use those dollars to what I. Tell it like gambling yeah and I have two children or crushing new word there. Lawyer Greinke and so they knew what to do I get a look at what he just only assure. And then look at what you're going to be putting away when Ursula. HSA or what you're doing media pretext. Or shelter and things like I haven't come up with here if your formula how how much out of pocket you respond and when you respond. If you hit frequent doctor visits you know it was a young children do but you you probably you like people are up paying the extra premium and getting to lower coping. The verses have been able to through an Asia say paying to point 500 dollars up front first before the plane to accept. That's good advice yet tell us what you would tell your family we're all family here right infidelity scared that you think we are without your OK so go through last year. In T Elliott everything that you spend doctors' visits. Dental write any dental work. Capital position. Prescriptions of prescription insurance you know children's and ample popular protections and think yeah psychotic OK they give you how much it would horseshoe from this planet which is concussion from this plant what is playing covers what they're playing covers so you'll have your historic viewpoint and you can just compare what you do in the future. OK so the main thing to get to ask yourself is there. How frequent do you in due utilized a doctor and go to the doctor Nene have prescriptions of tally up that. And that's the main question right to determine co pay or HSA. And I we can figure out which way you're you're gonna say emotionally. Now let's get into. And I know this is a big thing for many companies is the flex spending accounts is what is it in what's your advice signing your take on it. Well fortunately council pretext dollar is going into a dedicated fund went to repeat for child care. Whether before medical expenses theater are not covered or to pick up theatrical pace. And then also some places went to church parking you can put. Money's tight for parking. Okay on the pretext basis to cover that as well. So basically what you're doing is you're taking your. Dollars unit you're earning put him into account its pretext. And then using it also. And we knew use that money is there ever any tax. On Eddie there each year end or are Asian pulled money out to use it are now. I should get out. OK of course of procedure prank that would be silly so that you encourage people to take advantage of that. I'm lighting by employer Kyrgyz us do it yes OK it's. And you encourage your family. Might we don't OK that's it that's how we need to hear her determined. How much did you know you can you can actually allocated as much money is you want to it I guess Ohio but so. Most tea. What stunning accounts meter use solution so you wanna be careful on this aspect of it like for Turkey for example or dependent care he told our fixed cost you know took our shoot forty dollars and look at Kirk or its caution you 500 dollars a month are I don't know this week or month for take care. Are you know published when he deployed in the air. Medical medical expenses again what nick is what you did or prior year and it is pretty ample. This year you know you have overnight and you know you are indeed nucleus is. Actually meet Whitaker places Akashi in peace and audio. If you need medical attention as star is you know an ambulance or hospital stay. What do we need to know I've I've had people reach out to me as they go through there enrollment saying what is the hospital. At coverage. Okay I'm hostile coverage is you you basically have. Well I'm used to lecture as an example a cure her any insurance coverage from us. Okay. And what you get admitted to hospital you have a deductible with Medicare. It is the first X amount of hours we counseling and stay air quality or responsibility. And then after they get it poverty 80% so it is built into it deductible appoint 500 and bill is worth a thousand. So different we 15100 in and help pay 80% of the 15110. You have to pay the other. Point percent which in this case would be 300. And copy your deductible. Choppy OK so when you get a question like that in open enrollment you have to check yes can you want coverage. With. The hospital right yeah oh yes you never want to opt out of that one OK I don't now if UN HSA brow which you have to pay me. More for a hospital stay here and it ended in the. It again it depends on the plan critical what the future site. Because again you have looked to me just say is being this in the amount of money I have to spend before the plane covers anything. Cash. It really is a big question that you're gonna have to sit down as a family and figure out can you come up with this money initially. That's correct and in the long run though it could be more cost effective now you're saying. Yeah. If you look at ths say is that kind of like here. Collision deductible in your car. And we hopefully you have never gonna need it but with knuckles with a different. Eminem be nice to have money left over an attic council can keep rolling over seven when he 65 yet all this money to take every medical bells but. Yeah but who knows. The deal it's let's try to have Medicare Advantage programs in native. Other things of that nature. The majority of people that you work with and they you've talked to. Are they taking advantage of the agents say you're the co packed. It's different for for don't care because we don't offer those programs can't protect. We're more in the line of the first dollar coverage except when model plants which don't qualify for eight ths face. Right I can tell you that my son has an HSA. With two children in he finds its you know a little posse sometimes when I'm Oakmont. At the bit states. To be expected yeah so and put it again agencies have been around a long time there are getting just two and they are pops papers. But it really is ten new digest those big dollar amounts. Take it comes down to. It comes down to the options that your company did issue as an employer and it comes down to your own personal financial situation. We're compelled to. Now I know a lot of a lot of people and you CNN white man's I mean it's just sitting there and the pharmacy counter and T did Tallet darker however they referred to address this is no real. Is there something that we should be aware of is it too good to Beecher or is it really didn't. You know I Agilent do we majoring but it it's kind of like when. My parents were growing up in me and they are headed GT. Our eight general practice person you picked up the phone on this very morning it was a Doctor Who answer. Wow yeah I. All right he knew his patience and there'll he knew what was going on and he would describe took over the phone call it into the pharmacy Torre walked around the block. And have to get to retirees can pick up and go home they're taking less. I think it's just evolved into the pit now they were using technology. OK so it's kinda Golan back. To what it once once. I've in my opinion yes big because now you're you're you're still gonna hit that when he for a reservist available to me yeah yeah. Our eight it's keeping you out of the ER. Yeah right so. And if you dig at the end of his great. Arie and then no would they say it's minimal charge you for that is that is that true that it is. I haven't seen the charges that they I know. Some health until charger for all earned your health plan they have played four or nursing care. Which is basically saying can you call them up people what your record they tell you what to do. Treatable your health plan but. Yeah I mean it's. If you teach people. And again you know you wanna get to the level of care. Better for you at the time I mean if it's true emergencies and go to the emergency room but it yourself or with an earache or you had sore throat is susceptible what they disrupt. Great it's how can it be diagnosed and give you that it by acts right away with Al going to eat. Eat you mentioned struck her in in getting me antibiotics which we know about prescription drugs I've been told that in in some cases you can actually price chat. Prescription drugs to make sure the firm sedate you're working with gives you the lowest price if that's something that you guys encourage individuals to do work. You can't well you can price check New York State has a a place under PPO. Department of what's like it's as you know you can check your drug prices here honesty amount centers for Medicare Serbs is also has some drug. Tracker further Medicare site where you can see the ferraris is what they charge OK but again you're your plan. That you have. Already has deals with pharmacies and things of that nature so you're pretty much getting the lowest cost you get. But you can always call the pharmacy you can call. If you go to Pharmacia A now and you think if pharmacy. On an supremacy will tell you that. OK so who would you recommend. Price chuck who does this benefit most. Anybody who's gonna be putting out a pocket purse. Should be checking net or if it it's scary beast and it a cure program you should always check this. A combustible losses mostly means currently intersect co pay so it's a lesson to percentage. And you're still only to repay you cope. Is there I think Al's that you can think of being in this for as long as you have. Before we move onto the great things that you guys duet for Dallas care. Any being that we should be aware of our make sure we don't forget to do you were locator. Or taken action second with during open moment. Well what you wanted to make sure you do it again is Shaq what you did the test and sure that you can. Survive future shall we say yeah but but don't you just don't take any action make sure you will roll insulting. Chris having coverage and some covered it better and having no coverage whatsoever. Content if you have questions about what's best for use it don't care HR department. It should they should be able to help you decide which is the best alternative if they're the train professional. Now let's talk about the great things because you Wear the go to people that I thought of when I sat hey we have questions about and open enrollment here for Dallas can you do such wonderful things. In your such big supporters of our community I know. At the radio station at the buzz whenever we're out and about doing charity work you are right there alongside us you're always giving back so. Let's go through some things that you guys wanna promote ad for Dallas care. Well. Bolstered your. Which is probably already know that we started within every child current campaign earlier this year because it was identified due to restore hundreds. Thousand children who were still uninsured near state. How a 100000. Seat. Yes. So we went through debt in the spring me and now we're at a new. Program that we're trying to promote let's let's get everyone covered. What we're doing as a transition from just him naked covered now because of going into the open enrollment for the New York health exchange. That's another way to get everyone covered currently in upstate New York. Did its throughout upstate New York it's about five to 6% people still don't have health insurance. All right so if you look at the size of your state would. Couple million people. Are in New York State and then use table cheek. I percent of it it's a big number is more expert at six you know so different than what our goal is now we're wanna get everyone covered. Open your role which started November 1. Ought to get coverage by January 1. He nipped and rolled by December 15 for the metal levels all right if you go to rolled an annual coverage until February 1. Any actual opener Roma and on January 31 this year. You're hearing a lot and you know the public about CCA and repeal and I'll add other yeah and as of right now if you don't show credible coverage for the nine months you're still gonna hit that penalty and I believe it's under 35 dollar per adult. Championship event for child or the 2% of your income whichever is greater. So. These you wanna avoid it except I we're here to help we have over twenty community offices located throughout New York State. Because tiny office locations by calling us at 1888. The Dallas or by going to fit don't care dot org slash find an office. Right. Again you can call lesson will be glad to help move we have. Health benefit representatives which are basically people who are walking through to new York state of health on web site. Were available. Whenever people need us we have chip that works interview Sunday evenings early mornings. They'll come to wherever you are if you can come to us will come GO. You can look on our web page were all the information you needn't find a doctor Peter doctor organic hope. It's how much they'll crush you were rolling in the entry ever. We're upper level of the tech. What is Sims and the main name. Group of people is it those who fall through the cracks is at the low income is it that that kids that are just coming off there at their parents. An insurance. Is there one group that you are really targeting more than another. And you had all the elements and live and everybody else gets it didn't know truly it truly is a little bit of everybody we have people here. May have just been. What was working and I was not working you don't know what they don't know how to excess speed. Available pro programs that are available to them. And how much is talking health insurance I'm talking you know to food stamps and talking keep. For people who are with low income we need to itself. Are raps can help them. Point them in their direction. We can't do the application form what we can point a minute direction. It is two point six year old is coming off the the elite policy sort of speak on who is working or is working middle late in their. They don't offer health insurance at he organization they work four or they're transitioning. To a new job is to be 120 days before they get health insurance. All right so I mean those are the type of people and then you have mutually of the people who have honed through the cracks who had health insurance but didn't renew what I'm tired now don't hit it any longer. So we guess you'd hate duke duke hit all the groups that we're we're targeting. And in conjunction with yet this is also opened a role for the Medicare program on this started on October 15 and only runs to December 7. So people who are coming in to Medicare or are Crowley on Medicare this is this season that they can review what they hear of and make changes based on their needs at this time as well. Blanket in the Medicare is is. Is very confusing too is an end especially with a group of people they you're talking referring to him. Yeah manicurist Medicare itself can be confusing even shoot you know they. You can't stay even have to little roll regard it's all right and when you're turning 65 you have the treatment prior to your succeed but Burke type in the treatment after. You're 65 birthday to apply for Medicare. So it's very important that you do apply and include people are currently working. Even though you have health insurance through your employer I'll have you still have to wait and apply for Medicare. Earning a cosmetic your party's race. There's no pots for the parred eight and that you have to roll net and then if you do retire and you have to prove that from that they were 65 intimidate you reach tired you hit with a call credible insurance which means that you had health insurance plots. Prescription drug coverage otherwise they. Put a lot of penalties. But this is guy I mean this is Medicare is what we pay into our whole lives. So when it comes time to sixty you at this is or isn't. Yeah cures that plane are charging down. Yeah. I got right. It isn't what you go a little bit you can get fouled. I think about it but again and it's and it's changing of it like everything else is changing. How do you feel what would you think is the future. Well I'd I'd. Wish I if I had a crystal ball might be playing auto. Yeah Manson that's a joke at. But you went beyond the public may be you know why you're something of a shock. Yeah I was hit access. But I think. In New York State we've. Your case is always stick who care to people in need thank although he. I can't it's. So they would covered in the first we've always had programs for people most in need them I don't see that changing a cathartic. People need health insurance it you know it's it's it's. It's not a privilege is basically a right thing you know and I don't select upon political unmet being political yep. People get sick they need to get well I mean if you're not sixty need to. Give provided notice and so they don't get sick and it just helps society in general there are studies done particularly were elementary school kids it. In what they found is that children with health insurance. Performed better than children without health insurance. And people say well that makes sense because earns all the time. Well yes it's why they perform better because they aren't squalid it's also proven that people. Their children who have had health insurance right from the get go perform better in elementary school. High school and are more apt to go to college were burned and it means a great. And it's not just getting the immunizations is given their rice checked it paving near you know ears checked in for hearing issues or send things of that nature. Tom little ball around and just. Make an amateur game and. I'm Julian and director of marketing at the Dallas here I really appreciate you. How Vanessa through this open enrollment time making ends everything that you guys you have to Dallas care. Well thank you for having us and we are just as but. Hauled her away to help him. Time for our favorite part of the podcast now Father Knows Best my dad's eighteen cents. Have a great weekend and good luck can take advantage of those great Black Friday deals. Talk to next week. They save money doesn't grow on trees. But you can watch your money grow if you plant did you know late areas. Invest in your company's 401K. Or IRA. With stock index funds. You put up money there and do nothing but watching growth. Tax free yes I had.
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