All right, everybody. Today we’re gonna talk about health savings accounts, right? Many of you government employees are offered these HSAs at work, but you’re confused. Are they good for you and your family, or are they not? I believe they are. This episode, we’re gonna discuss that a little deeper than what you typically hear about. We’re gonna have some really genuine questions coming from Officer Ty, how he might be able to utilize this, how he can pay for services. It’s a big deal. I love HSAs. Stick around and I’ll hear it up.

Welcome to the Seed or Harvest Show, law Enforcement Edition, where we focus on financial education for a variety of things that not only affect your life, but also your spouse, your children, your charities, and your legacy. This particular episode, we’re focusing on the law enforcement officers and health insurance benefits. Okay? We discuss everything from health insurance and pensions, wills, and trusts, to the best way for everyday tax planning. Our intention is to bring the financial and legal professionals together with the everyday people who need their help, right? We have real conversations with real people who have real life questions and scenarios. And again, today we’re going to discuss another version of health insurance, and we’re gonna specifically dive into health savings accounts, commonly known, known as HSAs. Yep. All right. Wanna introduce, start our, uh, co-star here, officer Ty, 18 year, uh, veteran in Arizona, law enforcement, getting ready to retire here in a couple years and has lots of questions pertaining to what am I gonna do in retirement? Yep. Right. How am I gonna be affected when I leave? Um, this great job that I have now and these great benefits I have now, what happens to me when I jump over to the dark side, you know? Yep. You know, it can become self-employed or do whatever you’re gonna choose to do. So these are great questions, and again, we’re gonna focus on, uh, this is part three of health insurance, and today we’re gonna focus on HSAs. Yep. Right? And I look forward to seeing, testing your knowledge, my friend. Oh,

It’s gonna be bad.

Yeah. I don’t know. Yeah. I don’t know. You’ve been digging around a little bit, so I think you’re already prepped a little bit. You cheated on me. I know. I’d love to just catch you off the cuff. I,

I don’t really, yeah, we’ll see. I guess I don’t. We’ll see.

All right. All right. We’ll see. So, you know, there’s a, a lot of my clients, I personally love HSAs. Okay? I love HSAs. And for my clients, who are any of my healthy clients, a hundred percent who don’t qualify for subsidies, I always recommend HSAs. Always, always, always. I love HSAs. Why? I, they make a lot of sense. Um, because reality is statistically speaking, um, a, you’re probably needing a tax deduction, okay? So I love the, you know, the fact that you’re nestling money into a health savings account, which is a true savings account. So,

Just to stop you, so with that, with, with you saying that, does that mean that I should be putting money into it then? Because I have an HSA mm-hmm . But the, right now, the only money that’s getting put into it is, is what the, the city gives me,

Which is great. Right? That’s another beautiful thing of why you should have SS

A, but I always hear about tax reasons.

So if you are an employee and then you have a generous employer where they are willing to contribute a little bit to your hsa Yeah, absolutely. Reality is you have an annual limit of what can be contributed into that HSA by

Me or by the city or whoever. Okay.

The collective. Okay. Alright. So in 2025, that annual limit is $4,300 Okay. For you as an individual. Okay. And 85 50 for the family. Okay? Okay. So if you have a family in this HSA, then you can contribute up to $8,550. That’s gonna lower your taxable income for all the money that you’ve put in. Okay? Okay. So, and, and, and that increases by 1000 per individual. Well, husband, spouse, husband, wife, um, if you’re over 55,

Okay?

Okay. So

It behooves me to put money into it.

Absolutely. Okay. That money accrues, it’s gonna lower your taxable income. Today. That money is into a true savings account. A lot of people get health savings account confused with flexible spending account, which is an FSA. Yeah. Very confusing. All these acronyms. Yeah. And, um, so HSAs are great. They accrue, you know, I know a lot of people, it’s part of their retirement strategy to get a bunch of money nestled away in their health savings account for when the time comes down the road that they, uh, they need medical attention. Okay? Right. Even if they’re healthy as heck. Now, you know, the time, hopefully, here’s what I tell people, you want to need your health insurance because the only way you’re not gonna need your health insurance in the future means you instantly die.

Okay? Right? Okay?

That’s what that means. If you never, if you went through life and never used your health insurance, that means you just went, had a car accident, something, you just, you’re dead.

Okay?

Right? You want to have to have, you don’t, none of us want a problem, but inevitably we have some bumps along the way and you need to go in and have things dealt with. Okay? Right. So the only way you’re not finding a lump somewhere or anything going on, it means you’re not using your health insurance to find it. And then you’ve found it, and then you’ve treated it so you continue to live. Okay? So really there are, uh, you know, it’s, it’s, it’s, I never really thought about it that way, but I had a conversation with somebody who brought that up and I was like, and that was my response. Like, you want to use it? Because they’re like, I don’t ever wanna use it. Well, there’s a point where you do, ’cause that keeps you living. Yeah. Right? Yeah.

You should be getting your like year, like, what is it? 45? You need to be checking for

All sorts of things, right? It goes on and on. So, again, what HSAs, let’s talk about this a little bit. People are confused by ’em, when to get ’em, when to not get ’em. I recommend getting them all the time. HSA is one of the positive things about HSAs is they typically have the lowest out of pocket maximum. Okay? Okay. And we talked about in episode two on health insurance, we talked about out-of-pocket maximums, how those work. So with your HSA accounts, you typically those, that’s where you’re gonna find your lowest out of pocket maximums. Because the whole thing about an HSA, the whole premise is the health. You are basically taking responsibility for your up upfront healthcare costs. Okay? Most of the time, most HSA plans, they don’t have doctor’s copays for, uh, upfront benefits. They don’t have copays for prescriptions. They’re typically designed for healthy individuals.

Okay? And so you really don’t have much benefit within the plan until you reach your out-of-pocket maximum. So you’re basically telling the insurance company, Hey, I’m going to, I’m all in on my own healthcare costs until I reach that 5,000 out OFP pocket maximum. Okay? 5,800 out of pocket maximum compared to a typical copay plan, which is like a $2,500 deductible, 80 20 copay, remember that scenario? Yeah. Okay. 8,000 out of pocket maximum type deal. Okay? Those plans are always have, I shouldn’t say always. 98% of the time we’ll have a higher out-of-pocket maximum because the insurance company is getting involved sooner. Okay. $2,500. Anything after that they’re getting involved. You go to the doctor’s office and you have a copay to go see the primary care physician, 25 bucks, the insurance company’s paying a portion. Yeah. So because they’re paying in earlier, they require you to pay in longer.

Okay. Does that make sense? Yep. That’s the way they look at it. They’re in the game earlier. So you’re in the game longer. Okay. Right. So that’s one of the things I love about it for my healthy clients. ’cause the only way they’re gonna max out is if they do have a big deal need replacement, big, big accident, something major. Yeah. Right. Okay. And, and so along the way, while you’re healthy, you’re gonna be sitting there lowering your taxable income by funding that plan. So if the city is currently funding for you 2,500 bucks, whatever that is, a pay period, take a look at maxing that out, get it, get it to that extra amount. Okay. Why not? It’s gonna accrue. You’re gonna use it. And one of the fun things that we’re gonna about to do right now that I thought is let’s do a q and a on what’s covered through your HSA.

Right? Let’s take a look and let’s see, most people are very confused. Um, what is an HSA? And then beyond that, how do I use the HSA? So maybe before we get into the quick Q and A of what’s covered, let’s talk about how things are covered and how you pay for things. So I assume with your HSA, you said you’re currently in one. Yep. And my guess is they probably sent you a handy dandy a little HSA visa card. Yeah. Like a visa card, debit card card, yep. Mm-hmm . Right? And then they probably also sent you a checkbook. I don’t have a checkbook. Okay. I have the credit card, though. That makes sense. That they stopped doing the print. Yeah. Before they used to send you a checkbook and a debit card. Okay. You know, to that was attached to that HSA. So I have certain clients who fully fund their HSAs every year.

They just write a check and they transfer money into that HSA, so they get the tax deduction. Okay. I have other clients that don’t, that transfer money into their HSA account once they incur a cost, a healthcare cost. Okay. So you can, and then they still ultimately pay using that debit card, okay? Okay. But they’ll leave the account empty until they go to the doctor and they have a $300 bill. So what’s the benefit of that? Just no benefit. They’re, they’re still getting the $300 tax deduction. Okay? Reality is if you do not, and the, if you do not have an HSA account, the IRS states that you do not get to deduct medical expenses until they exceed 9.5%, I believe is the number to hold me, hold me to that number. But I’m pretty sure until it exceeds 9.5% of your gross income. So if you have a standard copay plan and you make a hundred thousand dollars a year until you have $9,500, 9.5% Okay.

Of medical expenses, you don’t get to deduct those expenses. Okay? Right. So if you have $8,000 worth of expenses, you’re using post-tax dollars to pay that $8,000. Okay? Right? Whereas if you had that, if you had an HSA account, you could have routed a lot of that using pre-tax dollars. Okay. And that’s a big, big deal. You know, that’s a 20 to 30% savings, okay. Just in taxes. Okay. So people overlook that. They don’t really do the math, they don’t think about it in a long-term budgetary sense. And if you do the math on it, they’re great plans. Okay. Alright. So again, you’re gonna, you’re gonna have this account. You’re gonna have money sitting in your savings account comes with the debit card. You’re gonna route everything through the insurance company. So there’s a track record of it. And then the insurance company, ultimately, we’ve all seen that, seen the statement.

Okay? Here was the service, the retail cost was a thousand dollars after insurance adjustment, it was actually $200 insurance paid. 50 bucks you owe 150. Yeah. Right? We’ve all seen that statement. Yeah. At some point. So now you’re gonna take your HSA card and you’re gonna pay that one 50. Right? Whether you transferred money in for the one 50 or you already had a balance in there, it depends on you. Yeah. Doesn’t matter. Reality is today for 2025, uh, you can, as an individual, you can do $4,300 per year. Okay? 85 50 for the family. Okay. Or does it start in January? Starting in January. Okay. And you can, you can write that check in there, clear up to December 31st. Okay. Right? So you can take that tax deduction and I wonder, I mean, talk with your tax guy, maybe, maybe you can fund it clear up to April 15th.

I don’t know the answer to that. Not a tax guy. Okay. But it’s possible. But I don’t believe so, but I don’t know. So, you know, the next question comes down to what do you get to spend that money on? Right? One of my clients are confused about, okay, what’s this thing? What am I setting up? HSA, what? Yeah. And then beyond that, like what, okay, so what can I use it for? So let’s just start with the easy stuff. All right? So let me, let’s just start at the top. Do you believe you can pay your copay bills with an HSA card? Yes. Correct. Okay. All right. One for one for one. Looking good. All right. Check. Check. Okay. So now let’s say you’re, you’ve, uh, hurt your thumb, you need an x-ray. You go in and you get an X-ray, and you get a bill. Uh, it goes through the insurance and you got, you owe a hundred dollars. Can you use that? Can you use your HSA account to pay for that? Yes. Yes. Two for two. Doing well. Okay. So let’s move on. Let’s talk about dental. Okay? All right. Got a broken tooth. You go into the dentist, you got your little, you got your insurance. It’s covering whatever it’s covering. At the end of the day, you owe $225 towards, that’s your portion. Can you use your HSA dollars for that?

I’m gonna say no.

Okay.

Okay.

Yes you can. Damn it. Okay. It’s good. It’s good. It’s good. That’s, but you’re not, most people don’t realize they can use their HSA money for dental insurance. Okay? So that’s a good, that’s a big deal, right? So again, you’re using pre-tax dollars to pay that $225

Bill. Okay? Okay.

Um, let’s talk about eyewear. Alright? Go to the, you. You’ve got $500 worth of lenses on your glasses. Can you pay for that with your HSA account?

Yes,

That’s correct. Alright. Doing good. Three for four. Okay. All. So that’s the beautiful thing here, right? It’s not limited. Okay. So now I’m gonna throw you a curve ball, okay? All right. Can you go to Walgreens and use it for band-aids?

No.

You’re wrong. Again, really? Yes, sir. Hmm.

So, anything medical related?

Pretty much not anything. We have to be careful how we say the words, anything. But there’s a long list of things that you can use, um, even in an over counter, the scenario scenario, okay. That you can pay for using your HSA account using pre-tax dollars. Okay? Most people don’t know that. And then beyond that, um, what can be kind of cool? A lot of things turn into a prescription scenario. Okay?

Right? Like, you can’t right now just go in there and buy Gatorade with it. Yeah. But if the doctor prescribed you Gatorade, guess what? You can use your HSA account. Yeah. So it’s what’s real important here is you’re gonna have to keep track of all your documentation, because either way you’re gonna pay for it through your HSA account. And so technically you’re supposed to keep track of that documentation. ’cause you need to prove that you use those dollars for, in this case, Gatorade that was prescribed by a doctor. Okay? You can’t go into Walgreens and buy a 12 pack of beer on the receipt with Gatorade using your HSA account. Yeah. See what I’m saying? Yeah. So even though it’s, they’re both sold to Walgreens, you can’t do that. Okay? So it’s, it’s upon you to keep records and receipts to make sure that you were using your HSA account for credible pieces. Okay? Does that make sense? Yep. So one of the things that we talked about before this is, which I thought was very intriguing, you asked me, um, can I pay for my sauna, my

And cold plunge

And cold plunge? And I’m like, no way. I, I, I answered that. Nope. And you showed me the website where they’re stating you can use your HSA dollars mm-hmm . And it kind of dawned on me after that, after kind of thought about it. I’m like, I, that really surprises me. But I guarantee you what it comes down to is, was it prescribed by your doctor? Right? Is this cold plunge going to affect this ailment you have in your life? Okay. Is it part of the prescription to a remedy? Right. Okay. Is my guess. I could be wrong on that, but that’s what I’m gonna go with. Reality is when it comes to healthcare, um, laws are changing, laws are state by state. There’s a lot of quirkiness. So I’ve learned to say, well, this is what I think, but let me go find out definitively. Yeah.

’cause uh, well the reason I brought it up is because I was looking at one, there’s multiple ones I was looking at. Not all of them have the same little tab that says H-S-A-F-S-A funds can be used for it. There’s a few of them that do. So that was what brought it up. When you asked the question, I was like, well, this one I was looking at says hsa FSA is available. So,

Well, I’m gonna give a plug out to this website that I’m looking at right now. This’s called hsa store.com. So according to their homepage, the complete HSA eligibility list, here it is the most comprehensive eligibility list available on the web from A to Z items and services deemed eligible for tax-free spending with your flexible spending account, health savings account, health reimbursement arrangement and more will be here. Complete details and requirements. Important reminder, hras, FSAs and other account types can vary by plan design. So they’ve got their caveat in there. Yeah. Right. So my guess on the HSA side and FSA side, it’s gonna be a more limited list. Um, but here it says right here, here’s their caveat. Always check with your HRA or FSA administrator, right? Yeah. And that’s what you need. Again, you need a good broker. So you can call me up. Hey Mario, can you find out for me? And I’m gonna tell you, good luck officer Ty. Yeah, I don’t think so, but I’ll ask.

Yeah.

And I have the resources. I can got the number in my, in my phone to call and find out. And that was pretty cool to find out that they even said that there.

Yeah, it says it on

There. Yeah. So if you can get it prescribed, but I’m gonna take a look. HSA and I’m gonna put on here cold plunge and I’m gonna see if it comes up. ’cause I don’t think it will search, search results. Oops. We can’t find cold plunge on the list.

Try sauna.

So, so far that’s saying no, but I’m willing to bet, because that’s not by default. Right. I, again, this is where I’m gonna say I’m willing to bet if you’re prescribed. So when I type in sauna, no, I’m not getting any, no, I’m not getting anything for sauna as well. But again, I’m willing to bet if it’s something prescribed that it’s gonna override the standardized list. But I’m sure you’re gonna have to provide some additional documentation in the event you get audited.

So that’s, I I’m almost curious because I, like I said, I’ve been in the market to get, I had one, but I want to get a little bit better. One

Cold plungers on it.

Both.

Okay.

Um, and the one that I found is a bundle deal, and I think it’s still on sale, but it has the little HSA tab on there. So I’m curious if I go in there and try to pay with my card to see if it’s gonna go through or not.

Well, I’m really curious myself. So you’re gonna have to do that. Walk the path. Yeah. You know, and, and may I, I, my understanding is HSAs don’t really vary. Yeah. Right. You know, the IRS has a standardized list of what’s acceptable. What’s unacceptable. Yeah. So I’m really curious if they’re gonna say okay without a prescription because

That, so another, I bought a red light, um, like back mm-hmm . For lower back pain. Mm-hmm . But it’s, uh, one of those red light therapy heat things. Yeah. Mm-hmm . And I used my HSA account for it. It let me, it let me go in there and

Well, I’m just, because they’re allowing you to buy it. I don’t know if I really believe that that’s necessarily makes it, uh, technically legal. Yeah. By HSA standards, you know, if the IRS came in and said, so

I’m gonna get audited now, is what you’re saying.

I’m not saying get audited. I’m just one. I’m just saying if you were to get audited, I wonder what, how that would come about. I wonder if they would, I wonder if they would ask for a receipt to prove that. Right. Um, and maybe red light therapy is something So I’m, that’s a good question. Red light.

Yeah. Lemme see if I can find that. I, I don’t remember what the,

See I, there are a handful of red

Light.

No, well, light therapy luxe collection, skin treatment panels. So there are a few things in here. Um, but I’m not, see, so it’s type in red light therapy and see what pops up. You know, so I do have a handful of items, a

Couple things.

So assuming, I mean,

Yeah, that red light ma, there’s

A ma mask mask. There’s a few different things, but it’s not, so I really, now, now you’ve got me intrigued here, right? Like where’s the line? Well,

So, because I, the reason I brought this up is because

We need to call these guys. We need demo on the podcast.

We should. Yeah. It would be interesting. Well, I would like to know like from the Sauna box people, ’cause so, sorry, I’m not plugging, I’m not saying that’s who I was looking at Sauna Box and maybe call them and be like, so it, because all it just has is, you know, it has your options when you pay, you know, credit card, you can do the PayPal, but then it has the HSA, but then it has that little tru me. So maybe that’d be somebody to talk to, like the true me people. ’cause it sends you to the True Med website when you do it. And I haven’t gone that far yet. I’ve just seen that it’s on there. You know, that it shows H-S-A-F-S-A available, but then it’s like through this true me. So I don’t know, maybe it just needs to do more research on the trum Me.

I, I, I, this is something that’s, um, I, I’d be really curious myself. So either way, it’s kind of interesting that you have a possibility of getting to buy that sauna Yeah. Using pre-tax dollars. Yeah. Right. And so now you’ve got me definitely intrigued. Um, you know, I don’t know. I I’m sure that, again, most websites you put in a credit card number, they don’t care if it’s an HSA or not. Yeah. Right. It’s gonna be, I’m sure the, you know, it’s, it’s upon you to know the law and make sure you do what’s going on. Right. Just, just like

See. But I don’t think, but

Isn’t isn’t that true in the law enforcement world that what is, what’s that? What’s that? Uh, what it’s called. Like a

Ignorance is not a Yeah. Ignorance defense. Yeah.

So I think my guess it’s kind of like that scenario. Yeah. Like, oh, you got, just got around it. Well, they sold me the Yeah. Alcohol

Officer. It said Officer HCC on there. Yeah. It said it. What

Do you want? Yeah. How am I supposed to know? Yeah.

So

I don’t, I I’m gonna go with that. It’s, it’s that play. And they’re just kind of

Thinking on the fact that you’re, I’m gonna to do some more research on it. ’cause I’m curious now. ’cause it,

See, maybe we shouldn’t have asked. Yeah. Because now you’re gonna find out. Now you, you know,

It’s gonna, it’s gonna ruin my, I wanna know more. I guess it’s basically finding more about this Tru me is who it’s through. ’cause I’ve seen other things with the HSA on there.

Okay. Tru me, we need, we need to know what’s going on here. Can somebody reach out to us and help us understand?

Yeah. Somebody sees this from Trum Med, please tell us,

You know, an hsa store.com looks pr like a great resource for people that I’ll start telling my clients about that I have HSAs. Um, but we need some clarification here. Yeah. Somebody who truly understands HSAs through and through, I know ’em at a surface level. I know what you can fund. I definitely love them. I highly recommend them to anybody out there. Even if you’re unhealthy, I still recommend them because of the lower out-of-pocket maximum. Right. There’s a lot of people on there who are on very expensive medication. So it’s a race to the out-of-pocket maximum. Remember that out-of-pocket maximum question. Yeah. So if you’re out-of-pocket, maximum is 5,800 bucks versus 8,000.

Yeah.

Who cares? Pay the up upfront costs max out in the first three months and your healthcare’s a hundred percent free after that. Yeah. So, you know, I’m, I’m gonna stress to everybody out there always take an annualized look at your cost premium plus out-of-pocket maximum. See,

I need to, I need to do that. I need to see what with, with this new the, because like I said, I’ve only had it for a couple years.

It’s, it’s so critical. People don’t do that. They get so caught up. I want the $50 copay to go see the specialist. Well let’s talk about that. Okay. If we’re gonna buy a plan that’s gonna be $300 more a month, that’s $3,600 that you’re gonna spend. Just so you can access that specialist for 50 bucks. Yeah. Right. Well if that, if we can find you a plan that’s gonna lower your out-of-pocket maximum by $30,000, what are you doing? Yeah. Right. And so a lot of times I talk people off that ledge just by penciling out, take an annualized business approach. You know, and you will, you will see that more often than not, the HSA accounts are a better value, better bang for your buck. Even if you’re unhealthy. Where the HSAs aren’t as attractive for time. It’s for some, like I’m on, I was wanting an HSA for our account.

We have a copay plan. Uh, my partner has different things going on in her life. So she’s seen a lot of different specialists and whatnot and just, you know, proactively staying on top of her stuff. Yeah. So she really sees a lot. So she really was always wanted the copays. But as I penciled things out, what we found is that she was gonna save overall around $2,000 over the course of the year. ’cause she typically maxes out her plans. Unfortunately, having this surgery, surgery that surgery, dah, dah, dah, dah dah. Yeah. She’s gonna save $2,000 in cash flow if we were to jump over to the HSA. Hmm. Okay. Unfortunately, I caught it too late because I knew that she was uneasy with the HSA. Yeah. And so I didn’t really bring it up. I didn’t really push the episode. But I’m the one who would almost lose in that deal because if I were to have a minor ailment Right.

And I go in and need like a, whatever, a basic outpatient procedure, which anymore is gonna cost probably a thousand bucks. Yeah. Right. If I had a copay plan, maybe that outpatient procedure will only cost me $200 out of pocket. Whereas now I’m on the hook for the a thousand dollars. Yeah. Because you don’t have any coverage really outside of, and let me back up with that. When I say no coverage, ’cause that’s not accurate. You, your coverage. You have, we have what’s called network repricing. Okay. And this is really important. So if you show up at the doctor and you’re like, they’re asking for your insurance, you’re like, I don’t have insurance. Well, they have a cash pay price. Right. There’s no network versus if you show up and say, I have UnitedHealthcare, they don’t ask what your deductible is. They’re gonna ask, what’s your network?

And then they’re gonna ask for your card. Right. You go in there, they ask, they always ask you for your gimme your ID card. And the reason is because they wanna see the UnitedHealthcare. But then on top of that, they’re looking at which plan you’re associated with. Okay. Because by them accepting UnitedHealthcare and you having that plan, that plan has what’s called a fee for service schedule associated with it. So that’s basically saying that they’ve agreed to UnitedHealthcare’s price for that particular service. Okay. So when you’re in your deductible phase, you’re not paying the retail rate, you’re gonna pay the wholesale rate, which is that network repriced rate. Yeah. It’s usually on the card, right? No, no, no. Because it’s such a, such a big list, they could never fit it on the card. Okay. So, but the reality is, it’s, it’s another, it’s a benefit that people don’t recognize.

You go to Home Depot and you see the lumber cost, you know, you go in, as you go into a pro lumber yard, they pay a lower rate. Yeah. Right. Wholesale, wholesale rates. Yeah. It’s a substantial savings. Yeah. But people, they don’t, they think they get upset because like, oh, I’m paying $500 a month for my plan, I should get this for no cost. That’s not the way health insurance works, especially in the United States, especially with group plans and Obamacare. ’cause what people don’t have to understand about these insurance companies, they are on the hook for unlimited amount. Right. They don’t, they can’t say, oh, once you get to a hundred thousand dollars, we’re done. We’re not spending anymore. You, they’re on the hook. Is

That different? Is that different in other countries then? The way they do, like the socialized

Stuff? It’s, it’s different within plans within our country. Okay. That aren’t part of the aca. That which is Obamacare. So if anybody to be a qualified plan for, and as far as a a, an actual group plan, uh, or an individual plan that’s Obamacare, uh, qualified, affordable Care Act qualified. That’s one of the criteria. Yeah. It’s unlimited benefit. So if you’re in a coma for two years Right. They can’t cut you off. Yeah. Right. I, I personally know, uh, my, one of my best friends from college, his daughter was in ICU for like six months. Saddest thing you’ve ever seen in your life. She was three years old. She should not be here to this day. She racked up $3 million in bills. They were out of pocket 10,000 bucks. To my knowledge, she’s still alive to this day. She survived. Had they not had insurance, she

Be gone. Oh, no way. She

Well, yeah. She shouldn’t have a chance. I mean, there were so many tubes coming outta this poor little thing. Yeah. But they were using, you know, every modern medicine trick that they could to keep her alive and get her over, uh, whatever ailment she had. I don’t, I don’t recall. But it was so sad. So people have to realize that’s why we pay so much for insurance. Yeah. Because we have that kind of opportunity. And believe me, if your daughter was in that situation, you would wanna fight completely to, you

Know. Yeah. I mean, not to that extent, but when my daughter was born, she was in the hospital for 11 days because they thought she had some issues going on. But we only paid, um, total for everything was only like 400 bucks. And it was Wow. Yeah. And it was, we were, she was in the hospital for 11 days, uh, 11 or 12 days. I don’t remember exactly. But they had her on machines the whole time. ’cause they thought she had some kind of, some kind of breathing issue going on. So

Do you think the ins, do you think the hospital covered that cost? Or do you think the insurance company did? The insurance company? The answer, I say the

Insurance company. Yeah. And they build,

They build the hospital. Billed the insurance company. Yeah. And this is why we pay so much for insurance. And we all get very pissed off and get upset about the high cost of healthcare costs. But I assure you, once your loved one is in need of the care. Oh,

Yeah. Yeah. And, you know, and that was the thing too. So it was, I mean, whatever it was Cigna, I had Cigna at the time and they, like I said, it was like 400 bucks and they covered the whole thing. And I used to tell people like, yeah, you might, at the time people were shit talking Cigna a lot because it’s, you had to go to their doctors and Cigna had that big network of just Cigna hospitals that you had to go to mm-hmm . And if it was outta network, but

Yeah.

Problems. I know. I have nothing bad to say about them because that probably should have been a lot more expensive based on

Well, you know, and that brings up a whole nother topic in conversation that we should talk about on a future podcast, which is the HMO versus PPO conversation. Yeah. People

Are very, that’s something else. I wasn’t, when I signed up, when I, when I got my health insurance, when I started, I had the Cigna HMO, and that’s what I had for most of my career up until, you know, a couple years ago when I started this HSA plan. But that was the really, the reason I left the Cigna was because, uh, where I work, got rid of Cigna as an option for the health insurance. Like I still have it for dental insurance, but I, they got rid of it as far as the health insurance side of it. So,

Interesting. Yeah. You know, the HMO world has really lost a lot of popularity People. We, we really want convenience. Yeah. Right. And, and, and just in a nutshell, most traditional HMOs meaning means that you have to go see, uh, your primary care physician to be referred to a specialist. Yeah. Right. Um, and, and within the health insurance world, there are a lot of networks. And the, and a big part of what you pay a lot more money for is the more expansive network of providers. Yeah. The more narrow focused, uh, the more, the less providers, the less money you’re gonna pay. Yeah. Right? So when you’re in a place like Maricopa County, they’re even that narrow network is massive.

Yeah. Right. Well, I say a lot of people, a lot of people had the Blue Cross Pro program because it was, oops, sorry. ’cause it was wider. The, the, your network. Yeah. And the Cigna, Cigna one was smaller, but I never, I mean, the time I had, it never had issues with it. You know, I used, I used it quite a bit. Like I’d go get my yearly checkups and everything, and I never had issues with it. So it’s

Typically people that have challenges going on in their life, and the person, the specialists that they need that they’ve heard can fix them is over there. Which is outside of network. Yeah. Right. And that’s when people get really frustrated and they don’t understand and they want to see that person.

I think, I mean,

That’s the challenge.

I think the only, the only issue that ever came up with it is I tore my bicep in 2015 and most of it was covered. But then, so this might be something we could talk about in another podcast. ’cause it still kind of irks me to this day. But everything was set Good. Get into the, get into the surgery, they put me out and then they had to switch anesthesiologist. Oh. And who was out. It just so hap it just so happens that he was out of network. And so then I get this big bill, you know, after, after the fact. And I was like, well, nobody ever said anything to me be that you guys were gonna switch this. So, like, how is that on, how is that my fault that you guys, you know? Yeah. It’s,

That’s a big challenge. And that happens, um, going into the ER situation especially. Yeah. Um, and it is a fight and you have to fight, um, with the providers. Um, your, I can tell you that your, your health insurance company, um, will likely reimburse you. Yeah. Right. Well, well

Eventually it just went away. Like, I fought it enough where it just was like, okay, we’re gonna deal with it. Well,

And that, and that’s what will happen. You know, the eventually they will. ’cause typically when you have an out-of-network provider, part of the reason they don’t take, in this case, whatever, we’ll just say Cigna, um, again, remember that fee for service schedule. Yeah. The network repricing. Yeah. So, uh, a provider has to agree to that fee for service schedule. So a lot of times they’ll say, Nope, I’m not gonna take that company because I don’t, I want more than what they’re offering me. Yeah. Right. And so that’s why they’re out of network. So many times it’ll get down to a point where they will say, screw it. I’ll take what they’re offering me and I’ll just, just deal with it. Write the rest off. Yeah. Right. It’s better than nothing. Yeah. Um, another time. There’s many other times where you could just go in there and just, uh, you know, reality is the medical per world is extremely negotiable.

Right. You go in there and be like, Hey, look, I, these guys are saying they’ll pay $150 of the $300 bill. I can give you 150 bucks and they’ll reimburse me and I’m, let’s call it a day. Yeah. Right. But, but a lot of times. But, but you have your billing departments that are that frontline defense for the provider. Yeah. Mm-hmm . So you gotta kind of get through that. And a lot of times that can be a challenge. Right. And so, you know, it’s, it’s, it’s tough, you know, and, and I don’t know what the right answer is. ’cause it’s really frustrating. And when the time comes, I’m fighting that battle, I’m sure I’ll be so upset. Like I see, hear so many of my clients that are so upset. Yeah. Um, but I honestly, being in being on the insurance side, I’m not, I’m an advocate for the consumer, not the insurance companies.

I understand the insurance companies, I understand the rules of the insurance companies. Yeah. But I’m an advocate for you. Yeah. Right. And so I’m just trying to help marry up your needs with what these guys can provide. Yeah. It’s a black, it’s pretty black and white. Right. You know, it’s, I, my my favorite line to tell people is buy insurance for what it is. Not what you want it to be. Right. This an emotional decision. Yeah. You know, if you’re making it emotional, you’re gonna lose and you’re gonna spend a lot more money. Yeah. Right. Buy it for what it is and what it isn’t. It isn’t, you know, and, and, and so you need to really understand what it isn’t. You need to make sure you have a good broker. They’re gonna help you find out the answers of what it isn’t. Yeah. And, uh, and that’s what brokers should be here for.

That’s what agents are here. So find yourself a good agent. That’s the moral of the story. Um, it sounds like we’ve teed up some other conversations. HMO versus PPO. Yeah. What happens when I have an out, out of network physician come in, an anesthesiologist come in, fight is what happens. Really? That’s, yeah. All right. I’m glad you’re on my side, man. I’m gonna call you. I was throwing stuff. No, I wasn’t really you said I was pretty funny. All right. So I think this is enough for today. And, uh, this, I mean, come on. We can only talk about health insurance for so long. Yeah. You know, I we’re, we’re boring each other more or less the audience. Yeah. So I, it’s so great being a health insurance agent. Lemme tell you how fun my life is. I bet you love it. I do. I actually do. Especially when, is it October when it really starts? Yeah. Yeah. But I do love it. I really do. I I like understanding the complexities and variables of what’s going on with you and your family with marionette to put the complexities of Yeah. It’s fun. So I do like that side, and I like the fact that I’m not rolling around fighting people out in the street and getting shot at. So that part’s kind of cool for me. Right. Yeah. But then it’s probably a good thing. All right, man. Another one down. Yep. All right.