May 27, 2025

Decode Your Insurance Coverage

Decode Your Insurance Coverage
iHeartRadio podcast player iconSpotify podcast player iconYoutube Music podcast player iconAmazon Music podcast player iconApple Podcasts podcast player iconPandora podcast player iconAudible podcast player iconPodchaser podcast player iconAudacy podcast player iconSpreaker podcast player iconDeezer podcast player iconPodcast Addict podcast player iconJioSaavn podcast player iconTuneIn podcast player iconCastbox podcast player iconCastamatic podcast player iconCastro podcast player iconFountain podcast player iconGoodpods podcast player iconOvercast podcast player iconPlayerFM podcast player iconPocketCasts podcast player iconPodimo podcast player iconPodurama podcast player iconPodverse podcast player iconPodyssey podcast player iconRSS Feed podcast player iconYouTube podcast player icon
iHeartRadio podcast player iconSpotify podcast player iconYoutube Music podcast player iconAmazon Music podcast player iconApple Podcasts podcast player iconPandora podcast player iconAudible podcast player iconPodchaser podcast player iconAudacy podcast player iconSpreaker podcast player iconDeezer podcast player iconPodcast Addict podcast player iconJioSaavn podcast player iconTuneIn podcast player iconCastbox podcast player iconCastamatic podcast player iconCastro podcast player iconFountain podcast player iconGoodpods podcast player iconOvercast podcast player iconPlayerFM podcast player iconPocketCasts podcast player iconPodimo podcast player iconPodurama podcast player iconPodverse podcast player iconPodyssey podcast player iconRSS Feed podcast player iconYouTube podcast player icon

Think you’ve got your health insurance figured out? Think again. Join Divya Parekh and legal experts Joanna Fawzy Doran and Monica Fawzy Bryant as they reveal hidden gaps, bust myths, and share must-know tips to help you take control of your coverage—before it’s too late.

Beyond Confidence is broadcast live Tuesdays at 10AM ET on W4WN Radio - Women 4 Women Network (www.w4wn.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com). Beyond Confidence TV Show is viewed on Talk 4 TV (www.talk4tv.com).

Beyond Confidence Podcast is also available on Talk 4 Media (www.talk4media.com), Talk 4 Podcasting (www.talk4podcasting.com), iHeartRadio, Amazon Music, Pandora, Spotify, Audible, and over 100 other podcast outlets.

Become a supporter of this podcast:https://www.spreaker.com/podcast/beyond-confidence--1885197/support.

WEBVTT

1
00:00:00.120 --> 00:00:02.319
The topics and opinions expressed on the following show are

2
00:00:02.359 --> 00:00:04.240
solely those of the hosts and their guests, and not

3
00:00:04.280 --> 00:00:07.200
those of W four WN Radio It's employees or affiliates.

4
00:00:07.320 --> 00:00:10.880
We make no recommendations or endorsement for radio show programs, services,

5
00:00:10.960 --> 00:00:14.000
or products mentioned on air or on our web. No liability,

6
00:00:14.119 --> 00:00:17.000
explicit or implied shall be extended to W four WN

7
00:00:17.079 --> 00:00:20.160
Radio It's employees or affiliates. Any questions or common should

8
00:00:20.160 --> 00:00:22.359
be directed to those show hosts. Thank you for choosing

9
00:00:22.480 --> 00:00:23.719
W four WN Radio.

10
00:00:25.719 --> 00:00:29.160
This is Beyond Confidence with your host DV park. Do

11
00:00:29.199 --> 00:00:31.320
you want to live a more fulfilling life? Do you

12
00:00:31.359 --> 00:00:34.240
want to live your legacy and achieve your personal, professional,

13
00:00:34.359 --> 00:00:38.560
and financial goals? Well? Coming up on ZVA Parks Beyond Confidence,

14
00:00:38.640 --> 00:00:42.200
you will hear real stories of leaders, entrepreneurs, and achievers

15
00:00:42.240 --> 00:00:45.640
who have steps into discomfort, shattered their status quo, and

16
00:00:45.719 --> 00:00:48.200
are living the life they want. You will learn how

17
00:00:48.240 --> 00:00:52.079
relationships are the key to achieving your aspirations and financial goals.

18
00:00:52.359 --> 00:00:55.000
Moving your career business forward does not have to happen

19
00:00:55.039 --> 00:00:57.640
at the expense of your personal or family life or

20
00:00:57.719 --> 00:01:02.039
vice versa. Learn more at www dot Divpork dot com

21
00:01:02.119 --> 00:01:06.280
and you can connect with vats contact eds dvpark dot com.

22
00:01:06.560 --> 00:01:09.760
This is beyond confidence and now here's your host.

23
00:01:09.799 --> 00:01:15.359
W Park A good morning listeners. That's Tuesday and I

24
00:01:15.480 --> 00:01:18.439
get to be with you, so thank you for being

25
00:01:18.480 --> 00:01:22.519
part of us. And it was Memori Levey Can. I

26
00:01:22.680 --> 00:01:28.599
wanna be a tribute to all our fallen heroes and

27
00:01:29.040 --> 00:01:34.959
heroes because of whom we have our freedom. So very

28
00:01:35.000 --> 00:01:39.719
thankful for their services and for their families as well.

29
00:01:40.840 --> 00:01:46.079
So we always talk about kindness Circle and the story

30
00:01:46.079 --> 00:01:49.079
that I want to share is the story of Johanna,

31
00:01:49.319 --> 00:01:53.799
one of our audiences. So what Johanna shared was that

32
00:01:55.480 --> 00:01:58.840
she lives in an apartment building and what she found

33
00:01:59.079 --> 00:02:06.599
was that a mom had, you know, she had her

34
00:02:06.680 --> 00:02:11.000
two year old like down there, and it's like, you know,

35
00:02:11.039 --> 00:02:14.080
the mom was apparently on the first floor. So what

36
00:02:14.159 --> 00:02:17.400
Johanna said was like, you know what, why don't you

37
00:02:17.680 --> 00:02:21.759
bring your baby down first, and I'll watch the baby

38
00:02:22.159 --> 00:02:25.199
while your son is playing inside the house, and then

39
00:02:25.240 --> 00:02:31.479
bring your son down. So just that little kindness went

40
00:02:31.599 --> 00:02:35.599
such a long way and mom was so profusely grateful.

41
00:02:36.159 --> 00:02:38.120
So just kind of think about it, and of course,

42
00:02:38.199 --> 00:02:39.919
you know, you just don't want to jump into help

43
00:02:39.960 --> 00:02:42.800
because people can take it another way. So just kind

44
00:02:42.840 --> 00:02:45.560
of ask them and said, okay, and I'm your neighbor,

45
00:02:45.639 --> 00:02:49.319
you know, identify yourself. And that's what Johanna did. So

46
00:02:49.439 --> 00:02:53.800
thank you Johanna for keeping it going. For those of

47
00:02:53.800 --> 00:02:58.120
you who have got our books, we thank you because

48
00:02:58.520 --> 00:03:01.080
partial profits go to keep it our organ For those

49
00:03:01.120 --> 00:03:04.360
who have not got our books, get the books, any

50
00:03:04.400 --> 00:03:06.680
of the books that we have written. Entrepreneurs got in

51
00:03:06.879 --> 00:03:12.520
expert to influencer, your masterpiece and actually my another book

52
00:03:12.560 --> 00:03:16.560
will be coming out this year, so very excited about it.

53
00:03:17.120 --> 00:03:20.520
Get it and help us spread the message. And let's

54
00:03:20.680 --> 00:03:29.400
welcome our guests. Welcome Monica, Welcome Joanna.

55
00:03:30.680 --> 00:03:32.400
Thank you. It's nice to bear with you.

56
00:03:33.280 --> 00:03:37.360
Oh it's wonderful to have y'all, so share it with us.

57
00:03:37.400 --> 00:03:42.439
If you'll recall any times from your childhood or youth

58
00:03:42.520 --> 00:03:45.560
when somebody left or it was just an incident like

59
00:03:46.080 --> 00:03:47.360
that left to positive.

60
00:03:46.960 --> 00:03:52.120
Mark on you, well, that is a very broad question.

61
00:03:53.560 --> 00:03:55.159
I would say that.

62
00:03:56.439 --> 00:04:00.159
Maybe not from just from childhood, but I think that

63
00:04:00.639 --> 00:04:06.199
in my career there have been many times in doing

64
00:04:06.439 --> 00:04:09.879
the work that I've been doing where people actually took

65
00:04:09.919 --> 00:04:15.319
the time to share the impact that it had on them,

66
00:04:15.360 --> 00:04:16.240
and I think that that.

67
00:04:17.920 --> 00:04:20.879
Is incredibly rewarding in the work.

68
00:04:20.680 --> 00:04:21.720
That we do.

69
00:04:22.639 --> 00:04:24.839
But it also helps drive you.

70
00:04:25.279 --> 00:04:30.959
And it also helped give me perspective on the challenges

71
00:04:31.000 --> 00:04:34.279
that people that other people are experiencing.

72
00:04:34.319 --> 00:04:36.720
So it gives me perspective on my own life and

73
00:04:37.360 --> 00:04:39.600
how fortunate I am in many ways.

74
00:04:40.439 --> 00:04:43.439
Absolutely, how about you, Monica, I.

75
00:04:43.439 --> 00:04:46.319
Would certainly go what Joanna just shared.

76
00:04:46.439 --> 00:04:51.959
I will also say that through my professional life, I

77
00:04:52.120 --> 00:04:56.720
have had the absolute honor to work with some incredibly

78
00:04:56.759 --> 00:05:01.480
brilliant and hard working women, and a couple of those

79
00:05:01.480 --> 00:05:06.800
women really took the time to mentor me and to

80
00:05:06.839 --> 00:05:10.040
support me as I began my career, and that really

81
00:05:10.079 --> 00:05:12.759
showed me that the power of community can mean so

82
00:05:12.759 --> 00:05:16.399
many different things. And in that specific instance, you know,

83
00:05:16.480 --> 00:05:22.240
the community of strong, intelligent, driven women can really lift

84
00:05:22.240 --> 00:05:24.639
each other up and they can just do incredible things

85
00:05:24.639 --> 00:05:26.920
in life.

86
00:05:27.199 --> 00:05:30.680
So, Joanna, what got you into becoming a lawyer?

87
00:05:32.639 --> 00:05:35.920
Well, I have to admit that when I went to

88
00:05:36.000 --> 00:05:42.199
law school, I knew that I didn't want to be a.

89
00:05:41.519 --> 00:05:44.160
Litigator or be in the courtroom.

90
00:05:44.680 --> 00:05:48.839
I really found that there was power in the law

91
00:05:50.000 --> 00:05:54.399
that it creates the systems that we have to navigate

92
00:05:54.439 --> 00:05:57.079
and has an impact on our daily lives. And so

93
00:05:57.720 --> 00:06:01.600
I really wanted to be able to engage in the

94
00:06:01.639 --> 00:06:07.000
policy aspects of being a lawyer and being able to

95
00:06:07.040 --> 00:06:10.279
shape laws in a way that have a positive impact

96
00:06:10.439 --> 00:06:11.480
on our society.

97
00:06:13.279 --> 00:06:14.680
And how did you get involved in that?

98
00:06:16.240 --> 00:06:20.959
Well, I went to law school thinking that I wanted

99
00:06:21.000 --> 00:06:23.839
to do that on an international level. I was an

100
00:06:23.879 --> 00:06:29.079
international relations major in undergrad but then when I got.

101
00:06:28.839 --> 00:06:32.199
To law school, I found that there were a lot.

102
00:06:32.040 --> 00:06:38.079
Of places in our domestic policy that could be improved,

103
00:06:38.319 --> 00:06:42.480
and so I did an internship. Well, I was in

104
00:06:42.800 --> 00:06:49.560
law school that focused on providing services to people with

105
00:06:49.759 --> 00:06:55.319
disabilities and cancer and that is really what led me

106
00:06:55.480 --> 00:06:58.000
down the path to my current career.

107
00:06:58.399 --> 00:06:59.839
So it wasn't planned, but.

108
00:07:00.079 --> 00:07:05.680
It found Well, that's how life is. So many times

109
00:07:05.759 --> 00:07:08.959
we have plans and life takes a detour and sometimes

110
00:07:09.000 --> 00:07:12.279
we don't know. And that's the beauty of every day

111
00:07:12.360 --> 00:07:17.800
and it's a beautiful gift that we all have. Someone

112
00:07:17.879 --> 00:07:21.040
is go about you, how did you get into the career.

113
00:07:22.720 --> 00:07:27.920
Well, I'm sorry for the technical difficulties, but I too

114
00:07:28.160 --> 00:07:32.800
had a windy path towards becoming a cancer rights attorney.

115
00:07:33.639 --> 00:07:38.160
I went to law school knowing that I wanted to have.

116
00:07:38.079 --> 00:07:41.000
An understanding of how everyday.

117
00:07:40.600 --> 00:07:45.600
People could use the law to improve society, and so

118
00:07:45.720 --> 00:07:50.600
I started off working in Congress in trying to shape

119
00:07:51.480 --> 00:07:55.360
do my small part in shaping public policy and laws

120
00:07:55.480 --> 00:08:02.199
that would really uplift the lives of day Americans. Personal

121
00:08:02.240 --> 00:08:05.360
reasons had me leaving Washington, d C. And then I

122
00:08:05.399 --> 00:08:09.160
really struggled to find a career where I could use

123
00:08:09.240 --> 00:08:12.759
my knowledge of both policy and how laws were made

124
00:08:12.800 --> 00:08:17.519
and implemented, but in a really tangible way help a community.

125
00:08:17.720 --> 00:08:22.680
And thankfully, through Joanna's support, that led me to the

126
00:08:22.720 --> 00:08:25.079
cancer community and I've been here ever since.

127
00:08:26.240 --> 00:08:27.600
So how did you get together?

128
00:08:29.959 --> 00:08:35.600
So? Monica and I are actually sisters, so people know

129
00:08:35.799 --> 00:08:42.120
us in the cancer community as sisters, but we effectively

130
00:08:42.720 --> 00:08:47.879
grew up in a healthcare community. Our parents are both

131
00:08:47.919 --> 00:08:52.000
doctors and worked in the oncology space and gave us.

132
00:08:53.440 --> 00:08:55.960
Perspective and an introduction.

133
00:08:55.879 --> 00:09:01.639
To the challenges that patients and caregivers experience when diagnosed

134
00:09:01.679 --> 00:09:02.960
with sterious medical condition.

135
00:09:05.559 --> 00:09:08.039
So so many times what happens to Joanna is that

136
00:09:08.799 --> 00:09:14.240
you know you're working in the corporations, the daily conundrums

137
00:09:14.240 --> 00:09:17.720
and the daily humdown of life, and then all of

138
00:09:17.720 --> 00:09:19.879
a sudden, I mean, of course there are pressures. You

139
00:09:19.879 --> 00:09:21.840
know that you may have kids, you may not have kids,

140
00:09:21.879 --> 00:09:26.320
doesn't matter whether you're single or spouse or in partnership,

141
00:09:26.639 --> 00:09:30.320
wherever you are at, just that daily pressures are enough

142
00:09:30.360 --> 00:09:34.159
as it is, and then all of a sudden, any

143
00:09:34.840 --> 00:09:38.360
life threatening illness or cancer like immune and it's it

144
00:09:38.480 --> 00:09:42.320
is so traumatic in itself. So now you're in that

145
00:09:42.360 --> 00:09:45.600
situation or one of your loved ones is in that situation.

146
00:09:47.159 --> 00:09:50.200
So initially, like you know, I've heard stories from my clients.

147
00:09:50.240 --> 00:09:53.360
They've said that, you know, the bosses, everybody's been very supportive,

148
00:09:54.399 --> 00:09:58.000
but that support kind of seems to keep on drying

149
00:09:58.120 --> 00:10:02.000
up if it lingers around long. And these are like,

150
00:10:02.120 --> 00:10:05.639
you know, long driven illnesses. So tell us, like, you know,

151
00:10:05.679 --> 00:10:07.240
how can people get through all of that?

152
00:10:08.799 --> 00:10:14.080
There are laws that do provide protections related to employment,

153
00:10:14.279 --> 00:10:18.360
both for employees who are diagnosed with serious medical conditions

154
00:10:18.399 --> 00:10:22.879
like cancer, but also for caregivers. But there are also

155
00:10:23.120 --> 00:10:28.120
employer policies that provide additional benefits and protections that can

156
00:10:28.159 --> 00:10:33.159
be supportive. And so when we're talking about employment, we're

157
00:10:33.200 --> 00:10:37.360
also trying to teach employers about the ways that they

158
00:10:37.399 --> 00:10:43.200
can support their employees dealing with chronic or serious medical conditions,

159
00:10:43.200 --> 00:10:46.080
because at the end of the day, employers want to

160
00:10:46.480 --> 00:10:50.360
keep valued employees, and so we have to remember that

161
00:10:50.639 --> 00:10:55.399
employers and employees they have a mutually beneficial relationship, and

162
00:10:55.519 --> 00:10:58.840
there's value in creating an environment that.

163
00:10:59.440 --> 00:11:02.000
Supports both the needs of both.

164
00:11:03.000 --> 00:11:08.240
And so while we are generally teaching employees about their rights,

165
00:11:08.320 --> 00:11:12.480
we also try to teach employers about what their legal

166
00:11:12.519 --> 00:11:17.000
responsibilities are under the law, but also ways to proactively

167
00:11:17.279 --> 00:11:21.240
try to support employees in those situations. But I fully

168
00:11:21.279 --> 00:11:24.159
realize that that is easier said than done, and we

169
00:11:24.240 --> 00:11:29.840
see the full spectrum of employee experience. So we see

170
00:11:30.039 --> 00:11:34.480
employees who have really supportive employers throughout their.

171
00:11:35.559 --> 00:11:37.240
Health condition experience.

172
00:11:37.320 --> 00:11:42.759
But then we also, unfortunately see the downsides of when employers.

173
00:11:42.240 --> 00:11:46.679
Don't understand their legal obligations or are less concerned with

174
00:11:46.759 --> 00:11:47.919
supporting their employees.

175
00:11:50.639 --> 00:11:55.159
So let's say, let's begin with an employer, what can

176
00:11:55.200 --> 00:11:57.840
they already put in place so if something like this

177
00:11:58.039 --> 00:12:01.559
happens to prepared for it well.

178
00:12:01.600 --> 00:12:04.840
From an employee perspective, I think the most important thing

179
00:12:04.919 --> 00:12:07.840
is to understand your rights and where the laws do

180
00:12:08.039 --> 00:12:09.519
and don't apply to.

181
00:12:10.960 --> 00:12:13.480
Excuse me, they're specific employer.

182
00:12:14.240 --> 00:12:17.639
So every law that we talk about actually applies to

183
00:12:17.720 --> 00:12:21.679
different types of employers. So if you're looking for protection

184
00:12:22.080 --> 00:12:26.120
under the Family and Medical Leave Act, for example, which

185
00:12:26.159 --> 00:12:29.799
is a federal law, it only applies to private employers

186
00:12:29.840 --> 00:12:32.840
with fifty or more employees, or to state, local, or

187
00:12:32.879 --> 00:12:36.879
federal government employees. So if you know that that's a

188
00:12:36.960 --> 00:12:40.080
benefit that you want to have access to, if you're

189
00:12:40.080 --> 00:12:43.200
looking to work for a smaller employer that might not

190
00:12:43.320 --> 00:12:47.039
be the right fit for you, or understanding what additional

191
00:12:47.080 --> 00:12:50.879
benefits that smaller employer might be willing to provide even

192
00:12:50.879 --> 00:12:54.440
though they're not legally required to do it. So you

193
00:12:54.519 --> 00:12:58.720
can be strategic in looking for employment opportunities.

194
00:12:59.000 --> 00:13:00.559
But in order to do that, you have to kind

195
00:13:00.559 --> 00:13:03.600
of understand the laws that would be helpful to.

196
00:13:03.600 --> 00:13:07.080
You in dealing with a chronic or serious medical condition

197
00:13:07.399 --> 00:13:10.639
and then look for employers that are actually bound by

198
00:13:10.720 --> 00:13:14.639
those laws. The same thing is true though when you're

199
00:13:14.679 --> 00:13:21.080
looking at benefits, so looking at employer health insurance benefits,

200
00:13:21.120 --> 00:13:24.360
for example, if you know that you have a chronic

201
00:13:24.480 --> 00:13:27.879
or serious medical condition, making sure that you have access

202
00:13:27.919 --> 00:13:32.559
to quality health insurance coverage is key. We sometimes assume

203
00:13:32.600 --> 00:13:36.519
that all employers have the same health insurance coverage or

204
00:13:36.519 --> 00:13:39.919
it's going to be good health insurance coverage because it's

205
00:13:39.919 --> 00:13:43.159
being provided by an employer, and that might not be true.

206
00:13:43.799 --> 00:13:48.200
So understanding how to look at those options and figure

207
00:13:48.200 --> 00:13:51.639
out if it's going to meet your needs is also

208
00:13:51.720 --> 00:13:56.159
something that employees can proactively do when looking at employment opportunities.

209
00:13:57.399 --> 00:14:00.799
Yeah, no, that's definitely because that is the time they

210
00:14:00.840 --> 00:14:03.559
can negotiate and they can make the decisions. You know,

211
00:14:03.600 --> 00:14:06.759
which company to even look for. So as you mentioned that,

212
00:14:07.080 --> 00:14:11.639
if you have that, you also talked about insurance. So

213
00:14:12.639 --> 00:14:15.480
there's so many different types of insurances. So let's kind

214
00:14:15.519 --> 00:14:18.799
of explore, like, you know, a couple of options. One

215
00:14:19.039 --> 00:14:24.000
is insurance given by the companies. One is there are

216
00:14:23.960 --> 00:14:27.639
a lot of contractors a lot of entrepreneurs, So in

217
00:14:27.679 --> 00:14:31.720
both situations, what options they can consider and what they

218
00:14:31.759 --> 00:14:32.200
can go with.

219
00:14:33.799 --> 00:14:37.600
For individuals who aren't working for an employer that is

220
00:14:37.639 --> 00:14:41.919
going to offer them benefit, there are specific options available

221
00:14:42.120 --> 00:14:45.399
and so then it might come down to where you

222
00:14:45.480 --> 00:14:50.840
live and your income level. But generally speaking, if you're

223
00:14:50.840 --> 00:14:56.279
not taking those two things into consideration. There are private

224
00:14:56.320 --> 00:14:59.720
health insurance plans that are offered through state health insurance marketplaces.

225
00:15:00.120 --> 00:15:04.799
So those marketplaces are often called exchanges or sometimes people

226
00:15:04.879 --> 00:15:09.440
call them ACA plans or Obamacare plans, but effectively, the

227
00:15:09.480 --> 00:15:15.120
government created a shopping mall for health insurance coverage called marketplace,

228
00:15:15.720 --> 00:15:20.039
and in going to the marketplace, you can find all

229
00:15:20.120 --> 00:15:22.840
of the private health insurance plans that are offered to

230
00:15:22.919 --> 00:15:27.120
you in your state that also have to provide some

231
00:15:27.159 --> 00:15:31.639
consumer protections, and depending on your income level, you might

232
00:15:31.720 --> 00:15:35.679
qualify for financial help to actually buy your health insurance

233
00:15:35.720 --> 00:15:38.279
plan or to lower some of your out of pocket costs.

234
00:15:38.919 --> 00:15:43.600
So depending on your employment, if you're in contract employment,

235
00:15:43.759 --> 00:15:47.200
or you're an entrepreneur, or even in some gig jobs,

236
00:15:47.759 --> 00:15:51.559
those are all times where you might not have access

237
00:15:51.559 --> 00:15:53.919
to employer sponsored insurance and you could look at the

238
00:15:53.919 --> 00:15:56.919
marketplace to see what health insurance options are available to you.

239
00:15:57.840 --> 00:16:01.759
And then depending on your state and your income level,

240
00:16:01.840 --> 00:16:04.559
you might also qualify for medicaid in your state.

241
00:16:06.559 --> 00:16:10.440
Yeah, these are some very important points in your experience.

242
00:16:10.519 --> 00:16:13.480
Are there any criterias that people need to keep in

243
00:16:13.519 --> 00:16:15.639
mind as they're making their selections.

244
00:16:16.639 --> 00:16:18.799
I think there are definitely some key things that we

245
00:16:18.919 --> 00:16:22.759
want people to understand when looking at their insurance options.

246
00:16:23.000 --> 00:16:25.759
I would say there are three key things. The first

247
00:16:25.960 --> 00:16:28.840
is make sure you know all of your options, because

248
00:16:28.879 --> 00:16:32.320
you can't effectively compare your options and pick the best

249
00:16:32.320 --> 00:16:34.399
plan for you if you actually don't know.

250
00:16:34.320 --> 00:16:35.559
What all of your options are.

251
00:16:36.120 --> 00:16:38.679
And I think that's true of somebody who's shopping in

252
00:16:38.679 --> 00:16:42.559
the marketplace, but it's also true if somebody's getting different

253
00:16:42.639 --> 00:16:45.480
choices from an employer. So if your employer gives you

254
00:16:45.559 --> 00:16:49.679
three options for insurance, that's also an opportunity to actually

255
00:16:49.919 --> 00:16:53.799
compare your options. The second piece is, once you know

256
00:16:53.919 --> 00:16:56.320
your options, how do you compare them?

257
00:16:56.960 --> 00:16:58.759
And you do that by making.

258
00:16:58.480 --> 00:17:02.159
Sure that you're looking at the cost that you're looking

259
00:17:02.200 --> 00:17:06.119
at whether or not it actually covers your providers and

260
00:17:06.240 --> 00:17:09.279
your prescription drugs. So if you pick a plan that

261
00:17:09.359 --> 00:17:12.880
doesn't cover the doctors and the hospitals and the pharmacies

262
00:17:12.920 --> 00:17:15.920
that you go to or the prescription drugs that you take,

263
00:17:16.160 --> 00:17:20.680
it's a pretty ineffective plan for you. And so comparing

264
00:17:20.759 --> 00:17:24.359
those three things are going to help make sure that

265
00:17:24.400 --> 00:17:27.559
you're picking the best plan for you. The third thing

266
00:17:27.599 --> 00:17:29.759
that you have to do is to actually do the

267
00:17:29.799 --> 00:17:34.720
math because most people are only picking a health insurance

268
00:17:34.759 --> 00:17:37.359
plan by looking at the monthly premium, but that is

269
00:17:37.440 --> 00:17:42.400
only one small piece of the cost of health insurance coverage.

270
00:17:42.920 --> 00:17:46.839
If you're dealing with a chronic or a serious medical condition,

271
00:17:47.359 --> 00:17:48.519
the chances.

272
00:17:48.119 --> 00:17:51.519
Are you're going to have a lot of.

273
00:17:51.480 --> 00:17:54.559
Out of pocket expenses because when you're using healthcare, you

274
00:17:54.640 --> 00:17:57.279
have to pay those out of pocket costs like copays

275
00:17:57.680 --> 00:18:01.599
and co insurance amounts. So what most people don't realize

276
00:18:01.680 --> 00:18:04.400
is that there's something called an out of pocket maximum,

277
00:18:05.119 --> 00:18:08.039
and that is a cap on how much you have

278
00:18:08.160 --> 00:18:11.240
to pay out of pocket each year, and when you

279
00:18:11.319 --> 00:18:12.960
reach that cap, your.

280
00:18:12.759 --> 00:18:14.839
Insurance will kick in at one hundred percent for the

281
00:18:14.920 --> 00:18:15.559
rest of the year.

282
00:18:16.640 --> 00:18:18.960
So you could have a one thousand dollars out of

283
00:18:18.960 --> 00:18:22.359
pocket maximum, or you could have a ten thousand dollars out.

284
00:18:22.240 --> 00:18:24.519
Of pocket maximum, depending on the plant.

285
00:18:25.200 --> 00:18:28.720
And so when you have a chronic or serious medical condition,

286
00:18:29.079 --> 00:18:32.960
you want to take into consideration not just the monthly premium, but.

287
00:18:32.880 --> 00:18:34.000
The out of pocket maximum.

288
00:18:34.720 --> 00:18:37.240
So we have a pretty easy math formula to help

289
00:18:37.279 --> 00:18:40.440
people figure it out. You just take the monthly premium

290
00:18:40.519 --> 00:18:43.480
and you multiply it by twelve, because that's how much

291
00:18:43.519 --> 00:18:45.279
it's going to cost you to have the plan for

292
00:18:45.359 --> 00:18:47.559
the year, and then you add that to the out

293
00:18:47.559 --> 00:18:50.119
of pocket maximum, which is the most that you'll pay

294
00:18:50.160 --> 00:18:52.519
out of pocket for the year for your medical expenses,

295
00:18:53.000 --> 00:18:55.240
and that's going to give you the real cost of

296
00:18:55.319 --> 00:18:58.519
not just having insurance for the year, but also what

297
00:18:58.559 --> 00:19:01.039
you would pay out of pocket for your care, and

298
00:19:01.079 --> 00:19:04.400
that's the most that you would pay. So in doing

299
00:19:04.440 --> 00:19:08.160
that math, you can easily figure out which plan is

300
00:19:08.200 --> 00:19:10.599
going to actually cost you the most or the least

301
00:19:10.640 --> 00:19:11.559
by the end of the year.

302
00:19:12.200 --> 00:19:14.880
And that is really key in the work that.

303
00:19:14.799 --> 00:19:17.440
We do because most people are going to hit their

304
00:19:17.440 --> 00:19:20.000
out of pocket maximum if they have a chronic or

305
00:19:20.079 --> 00:19:23.519
serious medical commission right now.

306
00:19:23.640 --> 00:19:27.759
That's definitely a great point to consider. And also some

307
00:19:27.880 --> 00:19:32.319
of the plans having being through the Ringers myself and

308
00:19:32.359 --> 00:19:35.920
with some of my clients is that there is another

309
00:19:36.079 --> 00:19:39.079
catch if you can elaborate on that, like sometimes that

310
00:19:39.160 --> 00:19:42.039
out of pocket can be just for individual or for family.

311
00:19:43.000 --> 00:19:45.519
That's true, so you also have to understand how the

312
00:19:45.559 --> 00:19:48.880
out of pocket maximum works for your specific plan. So

313
00:19:48.920 --> 00:19:53.160
if we're talking about marketplace plans, those marketplace plans are

314
00:19:53.200 --> 00:19:57.720
actually the most protective from a consumer standpoint, because it

315
00:19:57.759 --> 00:20:01.160
requires those plans to include to the out of pocket

316
00:20:01.400 --> 00:20:05.039
in the out of pocket maximum, your copays, your deductibles,

317
00:20:05.440 --> 00:20:08.640
co insurance amounts that you pay both for your medical

318
00:20:08.680 --> 00:20:11.359
care and for your prescription drugs.

319
00:20:11.440 --> 00:20:13.960
So everything gets to help you meet your out of

320
00:20:14.000 --> 00:20:15.000
pocket maximum.

321
00:20:15.599 --> 00:20:19.599
Employer plans are allowed to carve things out, so they

322
00:20:19.680 --> 00:20:23.519
might say, we are going to not include the deductible

323
00:20:23.559 --> 00:20:25.559
in your out of pocket maximum, so you have to

324
00:20:25.599 --> 00:20:29.000
pay both your deductible and then you have to also

325
00:20:29.079 --> 00:20:32.200
meet your out of pocket maximum. Or some will say

326
00:20:32.319 --> 00:20:34.720
we're not going to include your deductible or your co payments,

327
00:20:35.039 --> 00:20:38.240
We're only going to include co insurance amounts in your deductible.

328
00:20:39.039 --> 00:20:39.960
And then some.

329
00:20:39.880 --> 00:20:42.440
Employer plans will say, well, we're going to give you

330
00:20:42.519 --> 00:20:45.319
a separate out of pocket maximum for your prescription drugs,

331
00:20:45.839 --> 00:20:47.720
So you not only have to meet an out of

332
00:20:47.759 --> 00:20:51.960
pocket maximum for your general medical care like office visits

333
00:20:52.039 --> 00:20:55.039
or hospitalizations, but you also have an out of.

334
00:20:54.960 --> 00:20:57.000
Pocket maximum for prescription drugs.

335
00:20:57.519 --> 00:21:02.319
So understanding how yours specific plan it deals with out

336
00:21:02.359 --> 00:21:04.440
of pocket maximums is key.

337
00:21:04.240 --> 00:21:05.440
To understanding it.

338
00:21:05.440 --> 00:21:07.480
It's also key to understanding how to do the math,

339
00:21:07.559 --> 00:21:10.559
because if you have two separate out of pocket maximums

340
00:21:10.599 --> 00:21:13.440
for prescription drugs and for medical care. You have to

341
00:21:13.519 --> 00:21:18.200
add those things together plus the premiums. And then if

342
00:21:18.240 --> 00:21:20.519
you do have a family plan, you not only have

343
00:21:20.599 --> 00:21:24.119
your individual out of pocket maximum, you also have a family.

344
00:21:23.759 --> 00:21:24.839
Out of pocket maximum.

345
00:21:25.559 --> 00:21:28.680
That is only really helpful if you have more than

346
00:21:28.720 --> 00:21:33.319
two people on your family plan because generally the way

347
00:21:33.359 --> 00:21:36.240
that it works is once two people on the plan

348
00:21:36.640 --> 00:21:40.160
meet their out of pocket maximum, the family out of

349
00:21:40.240 --> 00:21:43.400
pocket maximum is also met, So that means anybody else

350
00:21:43.440 --> 00:21:46.200
on the family plan for the rest of the year

351
00:21:46.359 --> 00:21:47.480
could basically get.

352
00:21:47.319 --> 00:21:48.680
Free access to medical care.

353
00:21:49.680 --> 00:21:52.200
So that's not helpful if you only have two people

354
00:21:52.200 --> 00:21:54.640
on the plan because you still have to meet your

355
00:21:54.720 --> 00:21:56.319
own out of pocket maximums.

356
00:21:58.000 --> 00:22:02.640
Yeah, and that's really good for nation. So now, okay,

357
00:22:02.759 --> 00:22:08.160
you've gone through looked at your options, and you've decided

358
00:22:08.200 --> 00:22:11.559
on your medical coverage, and like you know, the years

359
00:22:11.559 --> 00:22:14.279
are going through and sometimes you know the transitions. It

360
00:22:14.359 --> 00:22:20.880
could be people are changing jobs, people could be moving.

361
00:22:21.000 --> 00:22:23.680
There are some family changes, like you know, you'll get

362
00:22:23.720 --> 00:22:28.759
married or retired or getting eligible for many cares, so

363
00:22:28.799 --> 00:22:31.920
there's so different things. How can people navigate those changes?

364
00:22:33.799 --> 00:22:37.079
Unfortunately, picking a health insurance plan is not a one

365
00:22:37.160 --> 00:22:40.920
time chore for us to engage in, so.

366
00:22:42.400 --> 00:22:44.079
We think we've picked the best plan.

367
00:22:44.279 --> 00:22:49.000
Unfortunately, every single year those plan options change, the costs

368
00:22:49.119 --> 00:22:52.839
change with the cover change, the networks of providers change,

369
00:22:53.160 --> 00:22:55.839
So every single year, even if we're getting coverage through

370
00:22:55.839 --> 00:22:58.839
an employer, we should still be looking at our insurance

371
00:22:58.880 --> 00:23:02.480
options and making sure it still covers the things we

372
00:23:02.519 --> 00:23:05.440
need it to cover, and looking at that math to

373
00:23:05.559 --> 00:23:07.799
see which is most cost effective.

374
00:23:08.359 --> 00:23:09.119
But when you're.

375
00:23:08.920 --> 00:23:14.799
Trying to deal with changes in your other circumstances, if

376
00:23:14.799 --> 00:23:18.680
you're moving, then that adds an additional layer of complication

377
00:23:18.920 --> 00:23:22.519
because if you're moving even zip codes, so not even

378
00:23:22.519 --> 00:23:24.240
if you're moving out of state, but if you're moving

379
00:23:24.319 --> 00:23:28.319
zip codes, that might change your insurance options. So if

380
00:23:28.359 --> 00:23:32.440
you're changing if you have a marketplace plan and you

381
00:23:32.519 --> 00:23:35.599
change zip codes, the plan you have right now might

382
00:23:35.640 --> 00:23:37.640
not be available in that new zip code.

383
00:23:37.880 --> 00:23:40.839
Same thing if you're moving states. If you're moving states,

384
00:23:40.880 --> 00:23:42.559
you definitely want to take.

385
00:23:42.440 --> 00:23:45.880
A look at the new state's marketplace plans.

386
00:23:46.400 --> 00:23:48.880
But that's almost a true of employer plans. So if

387
00:23:48.920 --> 00:23:50.359
you are.

388
00:23:50.240 --> 00:23:53.240
Living in one state and maybe you're a remote worker,

389
00:23:54.200 --> 00:23:56.440
if you move to a new state, you want to

390
00:23:56.440 --> 00:23:59.960
make sure that whatever health insurance plan your employer provid

391
00:24:00.319 --> 00:24:03.200
you is going to cover you if you go to

392
00:24:03.319 --> 00:24:07.039
providers in that new state, So you have to actually

393
00:24:07.039 --> 00:24:09.319
pay attention to make sure.

394
00:24:09.759 --> 00:24:11.839
Some employer plans have national.

395
00:24:11.480 --> 00:24:15.440
Networks of providers, so that isn't a problem. But if

396
00:24:15.440 --> 00:24:18.960
your employer offers you an HMO, that's generally going to

397
00:24:19.000 --> 00:24:23.599
come with a limited network of providers that is geographically specific,

398
00:24:24.400 --> 00:24:27.839
So making sure that you can still use that plan

399
00:24:28.599 --> 00:24:32.559
is part of that analysis. If you're thinking about retiring

400
00:24:33.599 --> 00:24:36.880
and you haven't yet turned sixty five, then you're going

401
00:24:36.920 --> 00:24:39.640
to be looking at the marketplace and then, depending on

402
00:24:39.759 --> 00:24:41.640
your income level, medicaid.

403
00:24:41.720 --> 00:24:42.720
So the marketplace is.

404
00:24:42.759 --> 00:24:46.680
Really a place where we're seeing a lot more movement

405
00:24:46.880 --> 00:24:51.160
because we do see a lot of people in entrepreneur

406
00:24:51.279 --> 00:24:55.000
roles and contract work and in a gig economy, many

407
00:24:55.039 --> 00:24:59.000
more people are using the marketplace, but also because many

408
00:24:59.079 --> 00:25:04.039
employers are offering health insurance coverage, so it provides that

409
00:25:04.359 --> 00:25:09.640
additional way to get access to insurance if somebody has

410
00:25:09.680 --> 00:25:14.160
turned sixty five and is eligible for Medicare. Medicare is

411
00:25:14.200 --> 00:25:20.240
incredibly complicated, so trying to understand how you actually make

412
00:25:20.359 --> 00:25:24.720
good Medicare decisions is very difficult for the average person.

413
00:25:24.799 --> 00:25:26.359
I mean, I have a law degree and I do

414
00:25:26.440 --> 00:25:28.279
this work on a daily basis.

415
00:25:27.880 --> 00:25:30.200
And Medicare stumps us all the time.

416
00:25:30.400 --> 00:25:34.200
Because there's so much nuance to the way that it

417
00:25:34.240 --> 00:25:39.240
gets implemented. But on a very kind of basic introduction

418
00:25:39.400 --> 00:25:42.839
to Medicare, there's generally two lanes that people can drive

419
00:25:43.079 --> 00:25:45.559
down to get access to Medicare coverage.

420
00:25:45.799 --> 00:25:46.519
You can either.

421
00:25:46.359 --> 00:25:51.200
Get what's called traditional Medicare, which is basically fee for service.

422
00:25:51.279 --> 00:25:53.720
You can go to any provider across the country who

423
00:25:53.799 --> 00:25:55.039
accepts Medicare.

424
00:25:55.640 --> 00:25:57.839
But then you can also.

425
00:25:57.599 --> 00:26:00.960
Get access to your Medicare benefits through a managed care plan,

426
00:26:01.599 --> 00:26:04.680
which is sold by a private insurance company and has

427
00:26:04.720 --> 00:26:07.799
a specific network of providers that you go to and

428
00:26:07.960 --> 00:26:10.759
is usually geographically specific to where you live.

429
00:26:10.920 --> 00:26:13.160
So when you make.

430
00:26:13.079 --> 00:26:17.200
Those initial choices about Medicare, there are pros and cons

431
00:26:17.279 --> 00:26:19.680
to each lane, and you have to figure out which

432
00:26:19.799 --> 00:26:20.480
is really going to be.

433
00:26:20.480 --> 00:26:21.200
The best for you.

434
00:26:22.559 --> 00:26:26.920
So, talking about Medicare, there you know so many people

435
00:26:27.160 --> 00:26:32.440
and who are retiring, and especially the baby boomers and

436
00:26:32.480 --> 00:26:35.480
all that you know. As they were saying, I think

437
00:26:35.480 --> 00:26:37.839
so I don't know where I read that. How many

438
00:26:37.839 --> 00:26:40.359
millions of people are going to be toning sixty five

439
00:26:40.440 --> 00:26:44.279
and retiring or whatever looking for the Medicare. So do

440
00:26:44.319 --> 00:26:47.960
you have any resources or options that can help people

441
00:26:49.559 --> 00:26:53.240
or do you help people across the whole you know,

442
00:26:53.920 --> 00:26:56.920
United States or is it different for different states?

443
00:26:57.400 --> 00:27:00.640
We do so Medicare options, depending on kind of which

444
00:27:00.720 --> 00:27:02.400
lane you're choosing to drive down.

445
00:27:02.319 --> 00:27:04.279
Are going to be specific to where you live.

446
00:27:04.960 --> 00:27:08.160
So at Stratage Cancer we have a lot of resources

447
00:27:08.200 --> 00:27:11.559
to help people navigate Medicare. We also have a program

448
00:27:11.599 --> 00:27:15.880
called Triage Health, which is for anyone trying to navigate

449
00:27:16.480 --> 00:27:19.880
healthcare related issues like trying to figure out what your

450
00:27:19.880 --> 00:27:23.680
health insurance options are. So at triageealth dot org if

451
00:27:23.720 --> 00:27:26.480
somebody wants to learn about Medicare.

452
00:27:26.519 --> 00:27:29.039
We actually have a Medicare Topics.

453
00:27:28.640 --> 00:27:33.799
Page where there are guides to help people understand the

454
00:27:33.799 --> 00:27:38.079
different types of Medicare options. We have a worksheet to

455
00:27:38.160 --> 00:27:41.359
help people do the math to make their Medicare choices.

456
00:27:41.759 --> 00:27:44.839
We even have some animated videos to explain that some

457
00:27:44.880 --> 00:27:48.559
of the key aspects of Medicare. But we do also

458
00:27:48.759 --> 00:27:53.480
have recorded and live events to help educate people on

459
00:27:53.599 --> 00:27:56.880
their Medicare choices. So really they're getting access to the

460
00:27:56.920 --> 00:28:00.960
care that they need and not experiencing the financial burden

461
00:28:01.160 --> 00:28:02.319
that can come along with.

462
00:28:02.240 --> 00:28:03.599
A serious medical condition.

463
00:28:05.279 --> 00:28:08.279
That's fantastic. You know, you're doing some great work out there.

464
00:28:08.839 --> 00:28:12.519
So now, coming back to the original scenario that we

465
00:28:12.640 --> 00:28:15.200
had talked about, somebody's in the corporation, all of a

466
00:28:15.240 --> 00:28:21.759
sudden they find out that, you know, they are experiencing

467
00:28:21.920 --> 00:28:24.799
life threatening disease, and it could be anything as you

468
00:28:24.880 --> 00:28:30.119
had mentioned earlier, cancer or otherwise, what's their best choice?

469
00:28:30.160 --> 00:28:33.279
I mean, you know, they are so bogged down during

470
00:28:33.680 --> 00:28:37.200
that time, So how can they keep their cool and

471
00:28:37.880 --> 00:28:39.880
what are some of the steps that they can take

472
00:28:39.960 --> 00:28:44.640
to ensure that they are aware of their rights and also,

473
00:28:44.759 --> 00:28:49.599
like you know, ensuring that they're forming that partnership with

474
00:28:49.640 --> 00:28:52.599
the employer to kind of work through this hard time.

475
00:28:53.759 --> 00:28:59.039
I think dealing with work and a serious medical condition

476
00:29:00.359 --> 00:29:03.680
and making decisions about what to do next involves a

477
00:29:03.720 --> 00:29:09.160
lot of factors. It might be about somebody's work environment

478
00:29:09.640 --> 00:29:13.519
and whether or not they feel comfortable disclosing if they

479
00:29:13.599 --> 00:29:15.559
have a supportive work environment.

480
00:29:16.359 --> 00:29:19.519
It could be about the size of their employer.

481
00:29:19.319 --> 00:29:22.799
And what laws and legal protections they have access to.

482
00:29:23.599 --> 00:29:26.039
It could be about benefits they have access to.

483
00:29:27.400 --> 00:29:30.400
It could also just be a very personal decision about

484
00:29:30.480 --> 00:29:33.200
whether or not somebody wants to focus on their health

485
00:29:33.480 --> 00:29:36.599
or try to balance work and their health.

486
00:29:37.640 --> 00:29:38.440
So there's a.

487
00:29:38.359 --> 00:29:43.000
Lot of pieces that go into those types of decisions, but.

488
00:29:43.000 --> 00:29:44.640
I think really at the core of.

489
00:29:44.599 --> 00:29:48.920
It is understanding how your medical condition is going to

490
00:29:48.960 --> 00:29:53.519
impact you and your ability to do your job. There

491
00:29:53.519 --> 00:29:57.240
are certainly types of medical conditions and types of jobs,

492
00:29:57.720 --> 00:30:00.440
and those medical conditions are going to prevent so from

493
00:30:00.480 --> 00:30:04.240
doing their job. But at Triash Cancer, our goal is

494
00:30:04.279 --> 00:30:07.240
to help people understand what their goals are and then

495
00:30:07.240 --> 00:30:09.359
how do we help someone meet their goals. So, if

496
00:30:09.359 --> 00:30:13.519
their goals are to stay at work, Understanding how the

497
00:30:13.559 --> 00:30:18.359
Americans the Disabilities Act provide someone access to accommodations so

498
00:30:18.400 --> 00:30:21.640
that they can get help in doing their job or

499
00:30:21.680 --> 00:30:25.319
even returning to work, if it's about taking time off,

500
00:30:25.400 --> 00:30:29.319
if that's their goal, Understanding how the ADA and the

501
00:30:29.359 --> 00:30:32.000
FMLA provides those legal.

502
00:30:31.640 --> 00:30:33.319
Protections to be able to do that.

503
00:30:33.880 --> 00:30:38.440
Maybe somebody has access to state disability insurance options and

504
00:30:38.480 --> 00:30:40.839
that makes it easier for someone to decide to take

505
00:30:40.880 --> 00:30:45.240
time off work or not so the decisions around what

506
00:30:45.400 --> 00:30:50.240
to do next, I think are really rooted in figuring

507
00:30:50.319 --> 00:30:53.880
out what your goals are with work, and then how

508
00:30:53.920 --> 00:30:58.759
you can meet those goals using the laws and protections

509
00:30:58.799 --> 00:31:02.079
and benefits and programs that are available to help you

510
00:31:02.119 --> 00:31:04.359
do that. And that's really the core of what we

511
00:31:04.440 --> 00:31:07.759
do at Triage Cancer is helping people understand what those

512
00:31:07.839 --> 00:31:10.960
laws are and what their options are so that people

513
00:31:11.000 --> 00:31:12.000
can make the best.

514
00:31:11.799 --> 00:31:12.640
Decision for them.

515
00:31:13.920 --> 00:31:16.519
And just like you had shed, like you know, there

516
00:31:16.519 --> 00:31:18.920
were like two to three points people could keep in

517
00:31:19.000 --> 00:31:23.079
mind as they were going and looking for different options

518
00:31:23.119 --> 00:31:26.240
for the insurance. Are there any key points that people

519
00:31:26.279 --> 00:31:31.200
need to keep in mind as they're making these decisions?

520
00:31:31.799 --> 00:31:34.519
I would say the first is talk to your healthcare team.

521
00:31:34.839 --> 00:31:38.119
So if you haven't yet maybe started treatment, and you're

522
00:31:38.279 --> 00:31:40.960
not sure how your medical condition is going to impact you,

523
00:31:41.200 --> 00:31:44.240
or even if you've just started, what the long term

524
00:31:44.279 --> 00:31:45.960
implications of that could look like.

525
00:31:46.759 --> 00:31:47.440
But talking to.

526
00:31:47.400 --> 00:31:50.799
Your healthcare team and understanding how your medical condition is

527
00:31:50.839 --> 00:31:52.799
going to impact you and the treatment.

528
00:31:52.440 --> 00:31:53.319
That you're going through.

529
00:31:53.920 --> 00:31:57.599
The second piece is understanding what your rights are, and

530
00:31:57.640 --> 00:32:00.240
then three figuring out what.

531
00:32:00.240 --> 00:32:02.400
Is important to you, What are your goals.

532
00:32:02.720 --> 00:32:05.400
So if your goals are to stay at work and

533
00:32:05.440 --> 00:32:08.079
to stay in your career, and you know, some people

534
00:32:08.119 --> 00:32:11.000
actually like their jobs and that's where they find their

535
00:32:11.039 --> 00:32:14.720
support system, and so it is sometimes very important for

536
00:32:14.759 --> 00:32:18.279
people to stay at work. Other people that is less important,

537
00:32:18.319 --> 00:32:20.319
and they're more focused about how can they take the

538
00:32:20.359 --> 00:32:21.079
time off.

539
00:32:20.960 --> 00:32:22.039
To focus on their health.

540
00:32:22.119 --> 00:32:26.960
So figuring out you know, how your health is being impacted,

541
00:32:27.240 --> 00:32:29.799
your rights, and then your goals I think would be

542
00:32:29.839 --> 00:32:33.279
the first three things to do. And then sorting through

543
00:32:33.319 --> 00:32:37.200
that information is actually why we came to our organizational name.

544
00:32:37.880 --> 00:32:42.880
The action of triaging through that information and then figuring

545
00:32:42.960 --> 00:32:44.720
out what needs to be dealt with first and what

546
00:32:44.759 --> 00:32:46.359
can be waiting until later.

547
00:32:47.279 --> 00:32:50.279
And what can people do if insurance denies coverage to them.

548
00:32:51.680 --> 00:32:53.799
I think this is something that we see a lot.

549
00:32:53.839 --> 00:32:56.880
We're seeing it in the news, discussions around how health

550
00:32:56.920 --> 00:33:01.839
insurance companies are denying coverage for care and or denying

551
00:33:01.839 --> 00:33:07.440
coverage for prior authorizations to get access to care. And unfortunately,

552
00:33:07.759 --> 00:33:10.559
we know that most people take no for an answer,

553
00:33:11.680 --> 00:33:16.240
and that is really unfortunate because we know, based on

554
00:33:16.400 --> 00:33:21.200
data that when somebody is denied a coverage for care

555
00:33:21.799 --> 00:33:25.039
ninety nine point nine percent of the time, they're not

556
00:33:25.279 --> 00:33:29.759
appealing even to the first level of appeal. So even

557
00:33:29.839 --> 00:33:32.759
though we hear about appeals in the work that we do,

558
00:33:33.319 --> 00:33:37.279
very few people are actually taking advantage of that consumer

559
00:33:37.319 --> 00:33:40.119
protection where you not only have a right to appeal

560
00:33:40.200 --> 00:33:44.119
that insurance company's decision if they say no, and you

561
00:33:44.200 --> 00:33:47.559
have a private insurance plan, like through an employer or

562
00:33:47.559 --> 00:33:52.079
an individual plan, you can go outside the insurance company

563
00:33:52.240 --> 00:33:57.160
to an independent entity, to what's called an external medical

564
00:33:57.240 --> 00:34:01.920
review or an independent medical review, and they decide whether

565
00:34:02.039 --> 00:34:04.400
or not the care that you've been prescribed by your

566
00:34:04.400 --> 00:34:08.639
healthcare team is medically necessary. And if they decide that

567
00:34:08.679 --> 00:34:11.599
it is, that decision is binding on the insurance company

568
00:34:11.599 --> 00:34:14.400
they have to cover it. And we know based on

569
00:34:14.519 --> 00:34:17.840
data that about on average fifty percent of the time

570
00:34:17.920 --> 00:34:20.760
patients are successful when they go through that external appeal.

571
00:34:21.440 --> 00:34:24.280
So if ninety nine point nine percent of people are

572
00:34:24.320 --> 00:34:27.119
taking no for an answer, but if they got to

573
00:34:27.159 --> 00:34:31.000
the external appeal stage, they would actually win their appeal

574
00:34:31.199 --> 00:34:33.920
fifty percent of the time, that's a lot of people

575
00:34:34.519 --> 00:34:37.320
who That is a lot to how long here.

576
00:34:37.760 --> 00:34:41.639
That people can receive Yeah, and really that.

577
00:34:43.159 --> 00:34:46.880
God, what that translates to is that people either aren't

578
00:34:46.920 --> 00:34:51.239
getting care that their healthcare team prescribed or they're paying

579
00:34:51.280 --> 00:34:54.559
for it out of pocket. So that just contributes to

580
00:34:54.599 --> 00:34:57.920
the financial burden if they're paying for something out of

581
00:34:58.000 --> 00:35:00.440
pocket that their insurance company should have covered.

582
00:35:01.360 --> 00:35:06.039
Right, Yeah, and I'm assuming that you help out with

583
00:35:06.119 --> 00:35:06.760
that as well.

584
00:35:07.400 --> 00:35:07.840
We do.

585
00:35:08.039 --> 00:35:11.440
So your ability to appeal depends on the type of

586
00:35:11.480 --> 00:35:14.639
insurance that you have, but across all types of insurance

587
00:35:14.719 --> 00:35:17.480
you have the right to appeal. It's just that the

588
00:35:17.599 --> 00:35:20.360
details of how you actually go about doing that are

589
00:35:20.400 --> 00:35:23.599
different based on the different types of insurance that are available,

590
00:35:23.639 --> 00:35:27.639
whether it's an employer plan or Medicaid or Medicare or

591
00:35:27.679 --> 00:35:30.159
maybe even VA Healthcare.

592
00:35:30.519 --> 00:35:33.119
So the process is different based on the plan.

593
00:35:35.079 --> 00:35:43.039
Absolutely, So quick question for you, given all of this,

594
00:35:43.039 --> 00:35:46.800
this is very very important topic that you brought it up.

595
00:35:47.760 --> 00:35:51.280
Thank you for that. How can people connect with you

596
00:35:51.400 --> 00:35:58.239
and Monica? How can access the Initially it's strategicancer dot org.

597
00:35:58.760 --> 00:36:01.440
Outside of that, like you know, just reach out to

598
00:36:01.480 --> 00:36:04.440
you through your website or any other venues.

599
00:36:05.639 --> 00:36:08.840
Yes, absolutely, you can visit triage cancer dot org or

600
00:36:09.000 --> 00:36:12.760
Triage health dot org and you will find a plethora

601
00:36:13.039 --> 00:36:16.760
of information about a variety of different topics that come

602
00:36:16.840 --> 00:36:20.440
up when navigating healthcare, whether it be health internt GO,

603
00:36:20.519 --> 00:36:25.440
our employment issues, or disability insurance, but also finances and

604
00:36:25.519 --> 00:36:30.559
consumer rights and managing medical bills or maybe estate planning

605
00:36:30.599 --> 00:36:34.840
documents and medical decision making documents like advanced healthcare directives.

606
00:36:35.239 --> 00:36:37.880
We provide information about all of.

607
00:36:37.800 --> 00:36:42.679
Those legal issues that are also state specific, and then

608
00:36:43.039 --> 00:36:46.239
if somebody would like to learn more, they can attend

609
00:36:46.239 --> 00:36:48.920
our free educational events, which they can sign up for

610
00:36:49.079 --> 00:36:51.800
on our website. And then we also have a free

611
00:36:51.840 --> 00:36:56.440
legal and financial navigation program where we will answer people's one.

612
00:36:56.320 --> 00:36:57.320
On one questions.

613
00:36:57.800 --> 00:37:01.800
So if somebody was going through of those healthcare transitions

614
00:37:02.079 --> 00:37:06.320
or is newly eligible for Medicare and isn't sure how

615
00:37:06.320 --> 00:37:09.880
to make the right decision, we can help someone understand

616
00:37:10.000 --> 00:37:12.719
their options so that they can make the best decisions

617
00:37:12.719 --> 00:37:15.000
for them.

618
00:37:15.039 --> 00:37:19.519
Absolutely. And if also y'all have written a book, correct.

619
00:37:20.360 --> 00:37:20.760
We have.

620
00:37:20.960 --> 00:37:24.159
So Monica and I have both taught law school classes

621
00:37:24.599 --> 00:37:28.559
on cancer rights law and there wasn't a book. So

622
00:37:28.800 --> 00:37:31.960
teaching a law school class without a book is a

623
00:37:32.000 --> 00:37:34.920
lot of work because we have to compile the readings

624
00:37:35.480 --> 00:37:36.719
for each class.

625
00:37:37.599 --> 00:37:42.599
So seeing that gap in the literature. We actually co.

626
00:37:42.519 --> 00:37:46.000
Wrote cancer rights Law that was published by the American

627
00:37:46.039 --> 00:37:49.920
Bar Association, so that not only we can use the

628
00:37:49.920 --> 00:37:51.320
book in class, but that.

629
00:37:51.199 --> 00:37:52.880
Others can as well.

630
00:37:53.119 --> 00:37:56.920
But we also wrote it in a way that it's interdisciplinary,

631
00:37:57.320 --> 00:38:02.239
so healthcare professionals can also use this information to support

632
00:38:03.280 --> 00:38:07.239
patients and caregivers, but also advocates and others who just

633
00:38:07.280 --> 00:38:11.039
want to understand their rights in many of those areas

634
00:38:11.079 --> 00:38:13.559
I mentioned are covered in that book.

635
00:38:16.079 --> 00:38:19.800
Any last thoughts you would like to share, I would

636
00:38:19.800 --> 00:38:24.800
just encourage people to understand what their options are even

637
00:38:24.840 --> 00:38:27.280
if you're not dealing with the serious medical condition.

638
00:38:27.559 --> 00:38:30.400
One of the reasons we created Triage Health was to

639
00:38:30.440 --> 00:38:33.800
try to help people understand these issues before they need it,

640
00:38:34.519 --> 00:38:38.280
so that they have a good health insurance plan so

641
00:38:38.320 --> 00:38:41.159
that if they are diagnosed with a serious medical condition,

642
00:38:41.400 --> 00:38:45.199
they're already prepared and certainly to understand what your employment

643
00:38:45.280 --> 00:38:49.880
rights are because in looking at job opportunities, you can

644
00:38:49.920 --> 00:38:54.480
take that information into consideration when making employment choices as well.

645
00:38:56.360 --> 00:38:59.960
Very powerful, Well, thank you for joining us and share

646
00:39:00.000 --> 00:39:03.559
hearing all these details, and like you know, Joanna and

647
00:39:03.599 --> 00:39:06.880
Monica Yola doing such great work, so thank you for

648
00:39:06.920 --> 00:39:17.599
doing it. And keep helping people and so listeners, I

649
00:39:17.719 --> 00:39:20.119
pray to God that none of you have to face

650
00:39:20.199 --> 00:39:23.639
any of these, but if you do, you know where

651
00:39:23.679 --> 00:39:28.320
to go. You know, definitely check out their website and

652
00:39:28.440 --> 00:39:31.039
our prayers and thoughts would be with you through the

653
00:39:31.079 --> 00:39:36.239
tough times. So thank you for being part of our show,

654
00:39:37.039 --> 00:39:40.679
and be careful you. We want you to have happy,

655
00:39:40.719 --> 00:39:48.039
healthy life and that also means good healthy financial life

656
00:39:48.079 --> 00:39:52.480
as well, So take care of yourself and also want

657
00:39:52.639 --> 00:39:56.320
thank you for making the show technically possible. Until next time,

658
00:39:56.400 --> 00:39:57.320
be well and take care.

659
00:39:58.400 --> 00:40:01.000
Thank you for being part of Beyond With your host

660
00:40:01.239 --> 00:40:03.639
v Park, we hope you have learned more about how

661
00:40:03.639 --> 00:40:06.199
to start living the life you want. Each week on

662
00:40:06.320 --> 00:40:09.800
Beyond Confidence, you hear stories of real people who've experienced

663
00:40:09.800 --> 00:40:14.000
growth by overcoming their fears and building meaningful relationships. During

664
00:40:14.000 --> 00:40:17.239
Beyond Confidence, Dvpark shares what happened to her when she

665
00:40:17.320 --> 00:40:19.719
stepped out of her comfort zone to work directly with

666
00:40:19.800 --> 00:40:22.880
people across the globe. She not only coaches people how

667
00:40:22.880 --> 00:40:26.639
to form hard connections, but also transform relationships to mutually

668
00:40:26.679 --> 00:40:30.199
beneficial partnerships as they strive to live the life they want.

669
00:40:30.599 --> 00:40:32.480
If you are ready to live the life you want

670
00:40:32.639 --> 00:40:37.000
and leverage your strengths. Learn more at www dot dwpark

671
00:40:37.079 --> 00:40:40.719
dot com, and you can connect with vat contact at

672
00:40:40.840 --> 00:40:43.960
dvpark dot com. We look forward to you joining us

673
00:40:44.000 --> 00:40:44.559
next week