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Episode 1933 Transcript:

00;00;01;14 - 00;00;05;17

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;05;22 - 00;00;26;19

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across USA, 201 affiliates strong thanks to all of you in the listening audience. A little shout out today to AM 1400 KLIN and FM 99.3 KLIN in Lincoln, Nebraska. We've got listeners up there. We're happy to say hello to them.

00;00;26;19 - 00;00;46;22

Cary Hall

I got a phone call from the folks up there the other day and we're happy. They're all listening in Cornhusker country. Also, we are now on 14 podcast platforms and on YouTube, and we have 61,000 downloads of the podcast. This is really quite remarkable so far this year. So here are the podcast platforms, every one of these shows.

00;00;46;25 - 00;01;07;25

Cary Hall

After Dave Thiessen, my producer on the video side, puts all this stuff up on the podcast platforms and on YouTube. And so let me tell you, the podcast platforms we’re on, so if you hear a broadcast like today's and you know somebody that may need help with something regarding health insurance, this is an opportunity. We got the folks from Blue Cross and Blue Shield in studio today.

00;01;07;25 - 00;01;26;27

Cary Hall

We're going to talk about Obamacare, ACA, whatever you know it as the open enrollment period. What's going on. So if you want to tell us, maybe it's your husband, maybe it's your wife, maybe it's your mom, dad, you know, I don't know, son, daughter, whatever. This is an easy way for them to understand what we're talking about. Just go up on the podcast platform, listen to the show.

00;01;26;28 - 00;01;55;09

Cary Hall

So Amazon Music, Audacy, Overcast, Pandora, RSS Podcasts, Stitcher, Spotify, Apple Podcasts, Google Podcasts, Pocket Casts, Rumble, Spreaker and SoundCloud. So that's all the ones we're on. And in addition to that, we're on YouTube. Okay, So we're on all of those podcast platforms. The shows go up there every week and it's we're getting a lot of downloads. I think we're at, what is it, 273,000, about 273,000 on the YouTube side.

00;01;55;09 - 00;02;07;06

Cary Hall

So a lot of folks are paying a lot of attention to these shows, and that's one reason why we do them. So we're just happy that you're paying attention to it. So if you are looking for other information, have questions about anything I can help you with.

00;02;07;06 - 00;02;23;21

Cary Hall

The website is americashealthcareadvocate.com. If you've got a question or comment, you have an issue. I'm happy to help you off. I can't go to the website. Send me an email and I will get back to you. All right. Joining me in studio today, how many of these have you done now, Ryan? This has got to be like it's been.

00;02;23;21 - 00;02;24;22

Ryan Roth

Several, three or four.

00;02;24;23 - 00;02;26;06

Cary Hall

Months at least, maybe more this year.

00;02;26;13 - 00;02;27;06

Ryan Roth

This year, yet three or.

00;02;27;06 - 00;02;45;03

Cary Hall

Four. Ryan Roth from Blue Cross and Blue Shield and Sheri Blankenship. And we are here to talk about ACA, Obamacare, whatever the name is, you know it as open enrollment period, which starts in the month of November. We're going to talk about the plans. We've got some really great information to share with you a little later in the show.

00;02;45;03 - 00;02;59;04

Cary Hall

I'm going to make you wait. You're going to be very happy to hear this. It's something you don't normally hear an insurance carrier get to do. So I think you're going to enjoy hearing that part of the show. But we're going to start by explaining what is the open enrollment period and who can apply. So who wants to start?

00;02;59;05 - 00;03;00;12

Cary Hall

Ryan, you want to start with the opening?

00;03;00;12 - 00;03;18;12

Ryan Roth

Yeah, Yeah. I'll start with the open enrollment period. The open enrollment period is the window of time in which individuals and families can evaluate health plans for the coming year, determine what the best benefits are for them and their situation, and then enroll for those benefits for the coming year.

00;03;18;14 - 00;03;22;23

Cary Hall

So we're talking November 15th, is that right, Sheri? When we start the process.

00;03;23;00 - 00;03;25;16

Sheri Blankenship

So November 1st is going to be the start.

00;03;25;17 - 00;03;26;27

Cary Hall

Got that wrong already. There we go.

00;03;27;02 - 00;03;35;14

Sheri Blankenship

Yeah. So November 1st is going to be the start of open enrollment. It is going to end on January 15th, maybe.

00;03;35;16 - 00;03;48;14

Cary Hall

Yes, because every year we say that and every year the President decides, well, we're going to go ahead and extend that into February. So I disagree. This is going to we're getting close to the election year. I'll make a prediction. It's going to get extended this year.

00;03;48;17 - 00;03;49;19

Sheri Blankenship

That could very well be.

00;03;49;19 - 00;03;58;15

Cary Hall

I wouldn't count on that. I'm just telling you, based on past experience, what has happened. So so November 1st through January 31st, that's.

00;03;58;18 - 00;03;59;27

Sheri Blankenship

January 15th.

00;03;59;27 - 00;04;18;05

Cary Hall

January 15th. See, I got it wrong twice. Okay. November 1st to January 15th is the prescribed open enrollment period. It may get extended. It has in the last couple of years. So but I wouldn't count on it. So if you if you're if you're on a plan or in a plan or want to get into a plan, this is your opportunity to change.

00;04;18;05 - 00;04;34;07

Cary Hall

This is your opportunity to enroll. This is a chance for you to look at what's out there in the marketplace and then make a decision. So let's just talk a little bit about that, Sheri, and the good folks at Blue Cross and Blue Shield that they can call because this is you know, we talked about this off air a minute ago.

00;04;34;10 - 00;04;43;09

Cary Hall

This is confusing to people. There's a subsidy involved. It's called the tax credit. How does that all work? So let's just start with a little bit about that, Sheri.

00;04;43;11 - 00;05;08;08

Sheri Blankenship

Not a problem. That's, you know, a great question because there are a lot of factors that go into that. And one even being with an open enrollment period, if you need a January effective date, you've got to have your application submitted by December 15th and then December 16th to January 15th is going to catch you on a February 1st, 2024 effective date.

00;05;08;10 - 00;05;24;23

Sheri Blankenship

Now, when you call into Blue Cross Blue Shield, we're going to do a little bit of that legwork for you. We're going to look at your annual income. We're going to plug it into our calculator and your household size and how you file those taxes. And the system is going to determine whether or not you get a subsidy.

00;05;24;26 - 00;05;44;01

Sheri Blankenship

And the subsidy is going to be based upon your household income. And that could be used as a reduction in your health insurance premiums. And it will also advise us if you're going to get cost share reduction, depending on where you fall in the federal poverty line, we could have a reduction in your deductible levels for the silver plans as well.

00;05;44;03 - 00;05;53;29

Cary Hall

So not only are you going to get a subsidy, depending on where they fall in relationship to the federal poverty line, they can also have a reduction in the deductible.

00;05;54;06 - 00;05;54;29

Sheri Blankenship

That is correct.

00;05;55;06 - 00;06;11;26

Cary Hall

That's that. And trying to figure that out on your own is probably not something you really want to try and do. I'm just going to tell you how that works. Okay. You know, you see those commercials say don't try this at home. Well, I'm going to suggest you don't try this at home. You want to give these folks a call and you know, they've got world class customer service.

00;06;11;26 - 00;06;33;01

Cary Hall

They've won the J.D. Power Award three times in a row. Okay. So when you call Blue Cross, you're going to talk to a real person. They're not in Argentina or the Philippines. They're right here on Main Street in Kansas City. And if you want to reach out to them, 833 635 0052 is the number and they'll be happy to help you.

00;06;33;04 - 00;06;51;19

Cary Hall

You know, it is remarkable because people try to go up on that government website and they try to sort this stuff out and then they get scared and they're like, they don't understand. So I'll give you an example. I had a young couple, they were 22 and 24 years old. They just got married. Pretty sure they're going to be having a baby here in the not too distant future.

00;06;51;22 - 00;07;10;27

Cary Hall

And they're like, It's going to be 1100 dollars, you know, And and no, it's not okay. And by the time they got through the process, they reached out to Carolee Steele over at RPS Benefits by Design, the Blue Cross plan. It was going to cost $321. Yes. So the point I'm trying to make there is, is this subsidies impactful, Right?

00;07;10;29 - 00;07;35;14

Sheri Blankenship

It is. And if you do not fill out your application correctly, it could end up costing you a lot of money financially. And when you transition over to, you know, you give Blue Cross Blue Shield a call, we know how to plug that information in and know what to look for. Things that are going to fall on your tax return that you may not have thought about or even deductions that you could have used to help you, you save.

00;07;35;16 - 00;07;41;16

Cary Hall

And the other thing is, if you overestimate it and you take more money than you're supposed to, what happens then?

00;07;41;22 - 00;07;56;20

Sheri Blankenship

You'll pay it back when you file your taxes. So it's a sliding scale. The more you make, the less subsidy you receive, but the less you make, the more subsidy you receive in it. And it will adjust at the end of the year when you filed his taxes.

00;07;56;22 - 00;08;08;03

Cary Hall

So let's go back to something you said earlier. You want to get a plan in place by the first of the year. That's what this young couple that I was talking to. That's what they want to do. When do they have to have the application in and done by.

00;08;08;07 - 00;08;10;20

Sheri Blankenship

By December 15th of 2023.

00;08;10;23 - 00;08;25;09

Cary Hall

Okay. So if you want to hit January one, you want to tee off in 2024 with a brand new policy on January one, you have to get this done. Okay? By December 15th. Now, if they don't get it done by December 15th, what does it roll to?

00;08;25;16 - 00;08;26;16

Sheri Blankenship

February 1st?

00;08;26;18 - 00;08;37;07

Cary Hall

Okay, so then it's February 1st. Now, in previous years, when they've extended this, what winds up happening, if you wind up enrolling after first a year because they extend it out.

00;08;37;10 - 00;08;44;28

Sheri Blankenship

You just wait. Well, if you if they extend it out, then typically you go to the first of the month in which it.

00;08;44;28 - 00;08;45;04

Cary Hall

It'll be.

00;08;45;11 - 00;08;54;23

Sheri Blankenship

Next. Where would you be March. Yes. Unless they have a special enrollment period. Okay. Depending on their situation, we could find a different eligibility date.

00;08;54;24 - 00;09;13;01

Cary Hall

Yeah. So we'll talk about special enrollments when we come back from the break. But the point is, to recap that if you want to be in place with your plan and this young couple I talked to, you didn't have health insurance. This was an opportunity for them to get that policy in place by January one. They've got to have that application in by December 15th.

00;09;13;03 - 00;09;35;14

Cary Hall

And the good folks of Blue Cross can help you get that done. Like I said, this stuff is confusing. You go up on the government website and try to figure it out. Good luck. So if you want information, the website is bluekcforyou.com. The phone number 833 635 0052. When we come back from the break.

00;09;35;19 - 00;09;51;06

Cary Hall

We'll talk about that special enrollment period, what it is and how it works and how that may affect you. Stay tuned. We've got more. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network Coast to coast across USA. We'll be right back.

00;09;51;09 - 00;10;24;14

Steve Kuker

The Golden rule, treat others as you want to be treated. I'm Steve Kuker and this is one of the founding principles of my firm, Senior Care Consulting. Since 2002, our value statement has included honor, our mother and father, respect our elders, care for those in need, and treat your family as our own. We've been honored to help hundreds of families make one of the most difficult decisions they could ever make, serving them in their greatest time of need.

00;10;24;17 - 00;10;52;20

Steve Kuker

If you're looking for someone who can provide you experienced and objective guidance when searching for a senior care community, reach out today and discover the services of Senior Care Consulting at 913 945 2800. Know your options and choose with care, at seniorcareconsulting.com.

00;10;52;22 - 00;11;18;16

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across the USA here on the HIA Radio Network. You can find out more about us by going to the website America's Healthcare Advocate dot com. You have a question or comment? Send it to me. I'll be happy to respond to you. My producer, Mr. Shawn Floyd on the microphone with the Audacy Broadcast System and behind the camera, Dave Thiessen putting all this together today, which will then go up on all of our podcast platforms.

00;11;18;23 - 00;11;39;22

Cary Hall

In studio with me, Ryan Roth and Sheri Blankenship from Blue KC. We're talking about the excuse me. We're talking about the ACA open enrollment period and what those Obamacare individual and family policies are going to look like, how you sign up for them. You know, we went through this in the last segment. I'm going to reiterate this again.

00;11;39;25 - 00;11;55;27

Cary Hall

You try to go up and pull this stuff together yourself. It's like this young couple tried to do this and reached out to me and I stopped them and sent them over to Carolee Steele at RPS Benefits by Design. They're getting a Blue Cross policy. That's how they're going do. But the point is, it's complicated stuff. If you want help with this.

00;11;56;02 - 00;12;22;21

Cary Hall

You can call the people down on Main Street. They're right here. Okay. And the number is 833 635 0052. And you could also go to the website bluekcforyou.com. Now, I'm going to hold up. This is what this is what you will see on the website. That is all the plans. We're going to talk about those in the third segment of the show.

00;12;22;29 - 00;12;39;00

Cary Hall

But I want to give you an idea of the information that's up there. You can look at that and get a feel for what you think. And then make that phone call and have somebody walk you through it. They'll show you, they'll do the calculation, help you get the subsidy and put it in place, and it won't be the wrong thing.

00;12;39;04 - 00;12;59;07

Cary Hall

You'll get the amount you’re due. You heard Sheri talk about some of the other things, like the deduction, reducing your deductible. Some of the other things that can happen. So they're the experts. They understand how to do it and they're happy to help you once again. 833 635 0052. So we have a little news, Ryan. We have this big news.

00;12;59;08 - 00;13;06;05

Cary Hall

It's big news because it's this doesn't happen very now. It is not. So let's share this with our audience, because I think they're going to be a little surprised.

00;13;06;07 - 00;13;17;24

Ryan Roth

Yes, we are excited to share that for 2024 Blue Cross Blue Shield of Kansas City. It has is rolling out rate reductions on our plan. He didn't say not increases reductions.

00;13;17;25 - 00;13;20;24

Cary Hall

He didn't double. That's what he said, rate reductions.

00;13;20;26 - 00;13;42;13

Ryan Roth

And so I'll go into that a little bit deeper in the state of Missouri. Our average decrease is 4.3% in the state of Kansas, our average decrease is 10.1%. Now, I do need to stress there that that is an average decrease. It varies by plan, so it can be more or less than that based on the plan.

00;13;42;14 - 00;14;03;19

Ryan Roth

So but we make it very easy for you. As Cary mentioned a moment ago, if you just call us at 833 635 0052, we have a team of people available for you all day to help you walk you through the various different plans, The different rates help you with subsidy calculations. It's all there for you to easy, easy going.

00;14;03;19 - 00;14;19;05

Cary Hall

And I'll make a prediction about the prediction I'll make is I bet you won't see any of the carriers reducing their rates. Okay. So this is a pretty good deal. And I led with it on the segment because I want people to see this. This is why I tell you, go to the podcast platform so you can listen to these shows.

00;14;19;05 - 00;14;35;21

Cary Hall

Maybe you're hearing this and you want to tell your husband, you know what, we need to look a Blue Cross this year. We're over here on another plan. We need to look. Yeah, you do. Because they just reduced the rate. If you're in Kansas, an average of 10.3%. If you're in Missouri, it's 4.0 excuse me, 10.1%. If you're in Missouri, it's 4.3%.

00;14;35;21 - 00;14;50;26

Cary Hall

That's not the norm. Okay. So you want to take advantage that you want to look at that. You want to see what they've got to offer. And as Ryan said, you want to get on the phone and give them a call. So let's go back through you talked a little bit about special enrollment. What is that and how does that work, Sheri?

00;14;50;28 - 00;15;10;10

Sheri Blankenship

So for individuals who have a typically a qualified health plan and then a life change event like loss of employer coverage, child birth, maybe you moved into our service area, gained citizenship. Those are going to allow you to pick a plan outside of the open enrollment period.

00;15;10;13 - 00;15;22;01

Cary Hall

Okay. So you relocated here from Denver, Colorado. Okay. You stayed on your plan till you got here, but you now have this special enrollment period where you can move to the Blue Cross plan.

00;15;22;03 - 00;15;32;07

Sheri Blankenship

Yes, you are correct. And so depending on when you apply is when your effective date would be or when you have your loss of coverage.

00;15;32;10 - 00;15;43;08

Cary Hall

So if they were since they had a special enrollment period, if they were to sign up now, that would carry them through January 1st and then on January 1st, they would get the benefit of this rate reduction.

00;15;43;12 - 00;16;09;19

Sheri Blankenship

That's correct. And so we always even if you're an existing customer during the open enrollment period, we still like for you to give us a call so we can do an income update and then double check to make sure that what you need in 2024 is still what you needed in the previous years, because sometimes our life changes and our need for our health insurance can adjust based upon what we anticipate happening for the upcoming year.

00;16;09;19 - 00;16;14;13

Sheri Blankenship

And we always want to have that conversation with you so we can help you pick the right plan.

00;16;14;19 - 00;16;34;13

Cary Hall

So you also talked about there are other events that can affect your subsidy. What are some of those other things besides special enrollment that can affect your that can affect your subsidy? So that you get a larger subsidy, then what? This is a great reason why you call Blue Cross and do the income update and then talk about you just said life happens.

00;16;34;14 - 00;16;36;11

Cary Hall

Okay. So let's talk a little bit about that.

00;16;36;13 - 00;17;14;07

Sheri Blankenship

Yes. So different things that can affect your subsidy besides your normal wages through an employer or loss of employer per se. They could be stocks. Maybe that's something they hit your tax return in one year. Your stock is performing higher than another year. Or maybe you took a distribution from your 401k that's typically taxable. If you don't have that distribution in the next year, we want to make sure that we update that income to get that off of there, because we know a lot of times when people have loss of employer coverage, that's typically because they had a job change and maybe they had to take a distribution from their 401k, which was taxable that

00;17;14;07 - 00;17;39;02

Sheri Blankenship

year, but the next year that may not be there for them. And also some individuals who are offered health insurance coverage, maybe their premiums are more than 9.6% of their annual income. Those individuals could still possibly have a subsidy that is available to them on the ACA plans. And at that point, maybe we need to compare that against the group policy and see what's available.

00;17;39;09 - 00;17;57;29

Cary Hall

How interesting is That's something I never thought of, is comparing that against a group policy because it might be a better deal, it might make better sense to do that. They might even be able. That's another thing. You know, we'll get into this next segment, but depending on where you're at in that level, you know, I've seen people that I get a bigger subsidy.

00;17;57;29 - 00;18;08;20

Cary Hall

They'll upgrade their plan. They'll go from a bronze to a silver because they've got more money, they've got a bigger subsidy coming in so they can upgrade and go to a better plan. Is that does that happen frequently?

00;18;08;21 - 00;18;09;28

Sheri Blankenship

Yes, it does.

00;18;10;01 - 00;18;25;07

Cary Hall

Okay. So that that's really interesting. You know, and by the way, you met you heard her mentioned this is something you wouldn't have thought of. I certainly didn't think of it. So if you lost money in the stock market this year, like a lot of people did, you even see this is not been a good year in the market?

00;18;25;07 - 00;18;48;01

Cary Hall

Okay. You might want to ask that question and get on the phone and give them a call. This kind of thing I'm talking about when I say you don't know what you don't know, okay. And they do. I mean, you know, I've been doing this for, what, 24 years? And that's the first time I thought I've heard someone say, hey, if you took a hit in the stock market, you could probably use that to help change the subsidy equation of what you're going to get.

00;18;48;01 - 00;19;05;18

Cary Hall

If you if you took a distribution on 401k last year, you're you want to change that for this year so it doesn't count against you again, which is what would happen otherwise. So when we come back from the break. We're going to get into these plans now. We're going to talk about all the plans that they have available. We'll talk about the network.

00;19;05;18 - 00;19;30;26

Cary Hall

We'll talk about how all that works. The phone number, once again, 833 635 0052, the website bluekcforyou.com. Stay tuned. We've got more right after the break.

00;19;30;28 - 00;19;43;05

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across USA here on the HIA Radio Network. This show today is about ACA, individual and family health insurance.

00;19;43;05 - 00;20;02;13

Cary Hall

We have the good folks from Blue Cross and Blue Shield in studio with us. Ryan Roth and Sheri Blankenship are here talking about all things ACA / Obamacare. How do you get a subsidy? How do you qualify? What are the best plans to pick? This is all what these are the topics we're talking about today to give you the information to help you make a good decision.

00;20;02;15 - 00;20;07;26

Cary Hall

And the best part of the show so far is how much is the reduction Again, Ryan.

00;20;07;29 - 00;20;08;12

Ryan Roth

You caught me off guard.

00;20;08;12 - 00;20;09;10

Cary Hall

Okay, I did.

00;20;09;16 - 00;20;17;05

Ryan Roth

In Missouri, an average of 4.3% and in Kansas, an average of 10.1%.

00;20;17;10 - 00;20;44;18

Cary Hall

There's some really good news, folks. I mean, you don't see that very often. So as I said in the last segment, I don't think you're going to see that matched by the other carriers. So I don't care what plan you're on. If you're on a United or an Aetna or wouldn't be Humana, they’re out of the business. But if you're on any of the other plans that are out there, you might want to take a look at Blue Cross this year, because that's a pretty competitive rate that they're going to be putting out in terms of how that plays in the marketplace, I think you can be a little surprised if you want information.

00;20;44;18 - 00;21;07;15

Cary Hall

You just want to talk to somebody 833 635 0052. Folks are standing by right down there on Main Street. They're not in Nicaragua or the Philippines like some of these other companies. And the website is bluekcforyou.com. And let me tell you something about their customer service, because I've used their customer service on multiple occasions.

00;21;07;15 - 00;21;25;16

Cary Hall

When you call there, you talk to a person, you don't get 15 voice prompts and that person will take you through whatever that process is to get it fixed, even if they have to hand you off to somebody else, they stay on the line until they get it done. And that is unusual in today's world. There really is excellent customer service.

00;21;25;18 - 00;21;30;03

Cary Hall

All right. So let's go, Sheri, to these plans, because how many of these are there total now?

00;21;30;04 - 00;21;30;22

Sheri Blankenship

11.

00;21;30;28 - 00;21;36;15

Cary Hall

Okay. That's a lot of plans. Okay. What do you want to start with? You want to start with the bronze?

00;21;36;18 - 00;21;37;14

Sheri Blankenship

Yeah, absolutely.

00;21;37;16 - 00;21;39;25

Cary Hall

Let's start with the bronze plans.

00;21;39;27 - 00;22;13;19

Sheri Blankenship

So our our bronze offering are five choices, we have three different networks to choose from within the bronze level. And that will also include where our HSA (health savings account qualified plan) falls and we have Spira Care access on two of the plans. So typically a bronze level plan is going to be your higher deductible, even though we still allow an affordable co-pay to primary care physicians and specialists, the deductible is just a little bit higher.

00;22;13;19 - 00;22;26;23

Sheri Blankenship

But what's unique is on our Spira plans, even though the the deductible may be higher, services inside the Spira Care facility or a zero co-pay structure on those particular plans that have access.

00;22;26;26 - 00;22;42;25

Cary Hall

In how many Spira Care facilities do we have now? Nine. Okay. So there's nine of these in and around the metro. I mean, they're everywhere, okay. And they're fantastic. If you’ve ever been inside of one of those places? They don't look like an urgent care or they don't look like a primary care facility. Look more like a hotel lobby.

00;22;42;27 - 00;23;04;18

Cary Hall

Right? They are great. You have a zero co-pay to go in there for your primary care. They've also got behavioral health in there. There are prescription drugs available, X-rays, labs, all the rest of it. That's all in one place. So it's like a one stop shop When you take a look at that on these plans, if you can, you know, go to the doctor with the zero co-pay and have all those services available to you.

00;23;04;22 - 00;23;06;27

Cary Hall

And the care guides are in there, too, right, Sheri?

00;23;06;28 - 00;23;26;16

Sheri Blankenship

Yeah, that's correct. So we specialize in the Blue Cross Blue Shield product because you have to have a Blue Cross Blue Shield plan with Spira Care access to go to this facilities. So those care guides can actually dive right into your contract. And if there are services that you need rendered and that they can tell you if it's subject to the deductible or if there's a prior authorization.

00;23;26;16 - 00;23;30;13

Sheri Blankenship

So you can get a lot of your questions answered right there with your care guides. Yeah.

00;23;30;13 - 00;23;47;15

Cary Hall

And the other thing is, if you try to get into a specialist, okay, I just went through this with my wife and we at KU we were told we'd have to wait until February next year. Now that got changed because we moved to St Luke's and got in in November. But the point is the care guides do that for you, correct?

00;23;47;17 - 00;23;59;10

Sheri Blankenship

Yes. They're your advocate. Yeah. They're going to make sure if you need a specialist referral there and network, you're not having to fumble through those directories yourself and they are going to walk you through that step by step.

00;23;59;12 - 00;24;07;05

Cary Hall

So talk a little bit about the networks, because you've got the blue, the Preferred Care Blue network, you've got Blue Select. So what's the difference in those networks?

00;24;07;07 - 00;24;15;17

Sheri Blankenship

So the Preferred Care Blue Network is our larger network. And on that particular one, there's about 6200 physicians.

00;24;15;20 - 00;24;17;25

Cary Hall

6200? Yeah, that's a couple.

00;24;17;27 - 00;24;24;12

Sheri Blankenship

Yes. Yeah, exactly. Yes. And there's a 50 in-network hospitals on the preferred care board.

00;24;24;19 - 00;24;28;03

Cary Hall

We had 50 and network hospitals there. Okay, that works all right.

00;24;28;07 - 00;24;49;12

Sheri Blankenship

Yeah. Since we service 32 counties and 30 in Missouri and two on the Kansas side, and we have to have a wide variety for our rural individuals. And then we have the Blue Select network. It's going to be a little bit more streamlined. You're going to have 11 hospitals in network that's typically going to be your metro area.

00;24;49;19 - 00;24;57;29

Sheri Blankenship

And then we have the Blue Select Plus, which will be 12 hospitals because that's the one that's going to include Children's Mercy for those of you with a younger household.

00;24;58;03 - 00;25;16;22

Cary Hall

And so there are price variations in all of these. And the point that Sheri’s making is you've all these choices, but you need to talk to somebody so they can explain this to you and make sure, for instance, you don't need the plan if you're let's say you're chronologically challenged, you're 60 years old, okay? You probably don't need Children's Mercy.

00;25;16;27 - 00;25;33;27

Cary Hall

It's highly unlikely. Okay. So it would be nice to know that you can get a plan without Children's Mercy. And it's less money. That's the point. Also, you know, if you want to learn about Spira Care, what do they offer? How does it work? How do I get an appointment? What's it like? That's part of what you can do when you call them and talk with them.

00;25;33;27 - 00;25;37;26

Cary Hall

And they're happy to do that for you. Let's move to the Silver Plans.

00;25;37;28 - 00;25;49;02

Sheri Blankenship

Yes. So on the Silver Plans, we offer four different plan selections on those. This is where you could get cost share reduction depending on your income level.

00;25;49;02 - 00;25;50;14

Cary Hall

OK.

00;25;50;16 - 00;26;00;05

Sheri Blankenship

And some of the deductibles that we see there could be reduced down to. In the past, we've seen them in the $500 to $800 range, depending on your level.

00;26;00;06 - 00;26;04;20

Cary Hall

That's a really big deduction, folks. Yeah, that's amazing.

00;26;04;23 - 00;26;14;16

Sheri Blankenship

So it's very important that you understand the income projection and the subsidy. So then that way you're not leaving money on the table. Even on the deductible side of things.

00;26;14;19 - 00;26;21;00

Cary Hall

Yeah, and that's part of what you all do when you calculate these things. Now, is Spira Care offered on the Silver Plan?

00;26;21;06 - 00;26;26;07

Sheri Blankenship

Yes, we have two plans that offer the Spira Care accessibility.

00;26;26;09 - 00;26;37;15

Cary Hall

And you've got nine facilities in and around the Kansas City Metro. We've got them north of the river now, right? That's correct. You've got them out in, lets see. You've got them in Independence, Missouri.

00;26;37;16 - 00;26;39;00

Ryan Roth

Newest locations in Independence.

00;26;39;00 - 00;26;40;00

Cary Hall

That's the newest one. Yeah.

00;26;40;00 - 00;26;48;10

Ryan Roth

We really have the metro really covered. You're never too far from a Spira facility as long as you're in the metro Kansas City area.

00;26;48;10 - 00;27;11;02

Cary Hall

Yeah, like, right next to Blue Cross Blue Shield on Main Street is the Spira Care facility. So. So wherever you are, Overland Park, it doesn't matter. North of the river. These facilities are available. You know, I urge you to take a look at this. You can save money. It also saves a lot of frustration. Repeat it again. Try to get in to see a doctor sometimes can be a little difficult these days.

00;27;11;09 - 00;27;25;06

Cary Hall

This is a great way to avoid that whole problem. They have the time. They take the time to sit down with you and understand what your medical issues are. And it's a great they're just a great place to go for care. And they're available to you on all these plans that we just mentioned.

00;27;25;06 - 00;27;44;04

Cary Hall

So there's two of the silver plans and two of the bronze plans where they're available that you can that you can enroll in the plan and have access to Spira Care, save money and get great service. Real quickly, let's talk about that HSA plan for people that like a lot of seasoned citizens like those HSA plans. So let's talk a little bit about that.

00;27;44;04 - 00;27;45;18

Cary Hall

HSA that’s available.

00;27;45;20 - 00;28;09;05

Sheri Blankenship

So typically on an HSA policy, your services are going to be subject to your deductible first and then your co-insurance, and then that will allow you to contribute money into a financial institution depending on your household size and where that money can be accumulated with some tax savings to help offset any medical expenses that you have throughout the year in 2024.

00;28;09;10 - 00;28;24;06

Cary Hall

And so the and and the other thing about the HSA is it's not a use it or lose it. Sometimes people confuse this with other plans that are out there. The HSA, if you don't use the money rolls over to the next year. I think it's $600. But I could be wrong and this has been a while. Okay.

00;28;24;12 - 00;28;44;06

Cary Hall

Or as the young folks like to say, it's been a minute, okay, since I've actually done this. So but it's a significant number and it's been raised every year and it's not a use it or lose it. So whatever you don't use rolls over to the next year and you continue to accumulate. So it's pretty cool what you can do with it and you can do a lot of things with it that you can't do with other funds.

00;28;44;06 - 00;29;04;14

Cary Hall

So this is something you might want to again, if you want to know, you want to understand is that something I should take a look at? Give them a call at 833 635 0052 and they'll be happy to help you and walk you through that. Now we have the plan for the Invincibles. So let's talk about the plan. I'm going to name that the invincible plan, the catastrophic.

00;29;04;14 - 00;29;15;11

Cary Hall

But this is for people that are 25 years old, 20 years old, you know, think they can leap tall buildings in a single bound and they're faster than a speeding bullet. So let's talk about what that plan is, Sheri?

00;29;15;16 - 00;29;37;09

Sheri Blankenship

So that's more of a major medical type policy, even though we follow the same rules of the Affordable Care Act, but that's going to carry a higher deductible. It's going to be the more streamlined, smaller network of the Blue Select, but that allows people to save as much money as possible but still have their preexisting conditions covered.

00;29;37;14 - 00;29;56;28

Cary Hall

Yes, it does. And, you know, for younger people, you know, you don't have a lot of medical issues, etc.. This is a good choice if you want to take a look at that. Might make a lot of sense for you. One quick thing before we go to break. They have telehealth on every one of these plans and the co-pay on these runs from like $30 down to zero on a lot of these plans.

00;29;56;28 - 00;30;14;19

Cary Hall

So you've got telehealth across the board here. If you can't make it to a doctor, you just want to call and find out whether you've got a problem. Maybe your child's got pinkeye. Okay, Conjunctivitis. Well, that's a great way to find out. You call it, put your on the telehealth and get the prescription. You don't have to go all the way in to one of the one of the clinics into urgent care or Spira Care.

00;30;14;25 - 00;30;47;19

Cary Hall

You can get it done right there. If you want information, give them a call. They are happy to help you at 833 635 0052 folks are standing by to help you out and the website is bluekcforyou.com. All of these plans are up there on bluekcforyou.com. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network Coast to Coast across the USA.

00;30;47;22 - 00;31;11;13

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across the fruited plain here on the HIA Radio Network. My producer, Mr. Shawn Floyd, the man behind the camera, Dave Thiessen, in studio with me, the good folks on BlueKC, Ryan Roth and Sheri Blankenship. We are talking all things ACA, Obamacare, open enrollment. If you're looking for individual or family insurance, this is where you want to go.

00;31;11;20 - 00;31;28;23

Cary Hall

The phone number 833 635 0052. And the website bluekcforyou.com. And once again, Ryan, tell people what their reductions could be done is in every segment.

00;31;28;23 - 00;31;37;21

Ryan Roth

The reduction in the state of Missouri on our rates is an average of 4.3%. And in the reduction in the state of Kansas, 10.1%.

00;31;37;21 - 00;31;55;03

Cary Hall

So if you're on one of those other plans you better call Blue Cross this year and see what their numbers look like, because you're going to be a little surprised. $4150 is the contribution level for individual and for a family. It's $8300 that you can contribute to your HSA each and every year. All right. So let's just go through.

00;31;55;04 - 00;32;06;20

Cary Hall

Sheri There's a whole host of new benefits here that are in addition to this that are pretty cool. So let's just kind of start with this rewards program and what that looks like. What are we rewarding them for?

00;32;06;21 - 00;32;19;08

Sheri Blankenship

Yeah, absolutely. So once you're a member, you can go on to your member portal and you can do an electronic wellness questionnaire for each member of your household. They would receive a digital $25 gift card. Okay.

00;32;19;08 - 00;32;26;21

Cary Hall

So if you've got four members, that means mom can get 100 bucks that she can go use for something. That's pretty good. How about that? Think about that one. Okay.

00;32;26;23 - 00;32;28;15

Sheri Blankenship

Yeah. Just for, you know, answering.

00;32;28;19 - 00;32;29;08

Cary Hall

a simple form.

00;32;29;25 - 00;32;44;02

Sheri Blankenship

Absolutely. All right. And of course, we have virtual care, which we've already discussed. And “Mindful by Blue KC” is a behavioral health tool where you have access 24 hours a day, seven days a week to licensed clinical therapists at a $0 copay for you.

00;32;44;03 - 00;33;06;16

Cary Hall

You know, and that's a great program. You know, we had Ryan Lefever come on and do two shows with us about this topic and this is a big deal at Spira Care. They have behavioral health. So if you're having an issue, you can go literally see a behavioral health therapist right there at Spira Care. So if there's an issue, that's a great way to get it solved in that program.

00;33;06;16 - 00;33;08;16

Cary Hall

It's a really good program. Let's keep going.

00;33;08;18 - 00;33;34;12

Sheri Blankenship

So we have chronic condition management so that support for chronic conditions. And but to piggyback off of that, the diabetes management side of things, we coordinate with Livongo and depending on your A1c level, you could have access or asked to be participated 24 hours a day, seven days a week to an advocate that will help you with your diabetes management.

00;33;34;14 - 00;33;42;13

Sheri Blankenship

You get the glucose meter, lancets and test strips at zero cost to you. That's another savings in your pocket.

00;33;42;15 - 00;34;04;08

Cary Hall

That's huge because, number one, you know, diabetes is an epic of diabetes in this country. Type two diabetes and type one diabetes. It's from kids all the way up. And, you know, you walk the line on that A1C and you don't know where you're at. You've got an opportunity here. If you're type two diabetic, Type two diabetes can be reversed.

00;34;04;08 - 00;34;10;22

Cary Hall

Okay. But okay, it's got to be done through lifestyle changes and other things. And these coaches can help them with that.

00;34;10;22 - 00;34;30;24

Sheri Blankenship

Absolutely So when you when your glucose meter reads a high number, it's going to automatically report back over to the coaches on their system electronically and they may reach out to you and, you know, inquire, is everything okay? Let's talk about what you know, you had to eat. Let's see if we can make some changes to help you out.

00;34;30;29 - 00;34;48;11

Cary Hall

You know, it's interesting because we did a really great show with the folks of Medtronic on their pump and their pen And one of the things that one of the nurses, Ron Hoyler who has been in this field for 20 some years, talked about was the management of children with type one diabetes is not as difficult now.

00;34;48;11 - 00;34;57;20

Cary Hall

I got to believe that if you're a parent and that program is available, that's going to be that's going to be a real help to that mom or dad trying to manage that disease with that child. Does that makes sense?

00;34;57;23 - 00;35;03;23

Sheri Blankenship

Absolutely, because it's electronic. So when they go into their doctor's office, they can pull up their readings and it's right there.

00;35;03;29 - 00;35;15;06

Cary Hall

So that's key because what happens is the doctor will typically say, well, what's your A1C? Well, I don't remember. I didn't get it checked. This automatically feeds that data to the doctor's office.

00;35;15;14 - 00;35;17;18

Sheri Blankenship

Yeah. To where the doctor could have access to it.

00;35;17;18 - 00;35;21;28

Cary Hall

Yes. That's a really big deal. Now, let's keep going. So what is Blue 365?

00;35;22;01 - 00;35;38;26

Sheri Blankenship

That is the opportunity to have savings at fitness locations and maybe some athletic wear and Lasik eye surgery. There's discounts, teeth whitening. So a plethora of organizations that we work with that are providing discounts to our members.

00;35;38;28 - 00;36;02;14

Cary Hall

And they have them. For those of you that are chronologically challenged, Blue 365 actually discounts hearing aids. I know because I'm wearing one. Okay. You can't see it, but I've got it on. Okay. So that that's there's a lot they do with that. That's a great program and it really can make I mean, it can make a big difference in difference it made me for was about $1,000 off of the hearing aid that I wear.

00;36;02;14 - 00;36;14;23

Cary Hall

So it made a big difference. So that's a great program. It's available on all these plans, right? It's available to anybody that wants to use it. It's on the Blue Cross networks. That's pretty cool. Let's keep going. The RX Saving Solutions now. What is that?

00;36;14;25 - 00;36;36;03

Sheri Blankenship

So the RX Saving Solutions, which is really nice about our member portal, is it gives our the ability to look at cost savings in a couple of different areas. And with the RX solutions you can plug in your prescriptions that you're taking and it's actually going to tell you which pharmacies and it could give you some cost share reduction or lowest cost and maximize your savings there.

00;36;36;10 - 00;36;53;25

Cary Hall

So instead of you having to go shop it, this does it for you, correct? That's a big deal. I mean, I just checked up one for my wife. Just say it was $330. Okay. So that's really interesting that I didn't know we could do it. So we're on the Blue Cross Medicare plan. We're a little past this. Okay.

00;36;53;27 - 00;37;03;23

Cary Hall

But the point is that's available for everybody is called RX Solutions, RX savings and solutions. That's the last one we'll talk about is Smart Shopper. What is that?

00;37;03;27 - 00;37;24;19

Sheri Blankenship

Yeah. So to piggyback off of the member portal on the prescription side of things, we can do that with certain medical conditions that you may have to have treatment for. And so maybe you have an MRI or a CT scan, you can plug it in and it will tell you whether or not you are going to be subject to a deductible, maybe prior authorization.

00;37;24;21 - 00;37;38;21

Sheri Blankenship

And but the nice part is, is it's going to give you a list of facilities where you can see savings and between the different facilities. And if you use certain facilities, you actually get some reimbursement from the insurance company.

00;37;38;23 - 00;38;02;17

Cary Hall

It's pretty cool. So that that kind of wraps it up if you're if you want information on this. Once again, 833 635 0052. The website bluekcforyou.com. I want to see if you can find any other carrier out there this year that will reduce your rates by 4.3% in Missouri and 10.1 on average in Kansas. So you might want to take a look at that.

00;38;02;17 - 00;38;22;15

Cary Hall

And so if you're on one of those other plans, I strongly suggest you give those folks a call down on Main Street and see if they can help you and show you the options, because they've got some great options this year, some great plans, a huge network. And don't forget Spira Care, with 11 clinics in and around Kansas City, they're really great facilities and it's an opportunity if you want help.

00;38;22;15 - 00;38;27;07

Cary Hall

833 635 0052. Thank you both for being here today.

00;38;27;07 - 00;38;27;24

Ryan Roth

Thanks for having us.

00;38;27;26 - 00;38;28;06

Sheri Blankenship

Thank you.

00;38;28;06 - 00;38;46;08

Cary Hall

And now, ladies and gentlemen, I leave you with this thought from Dr. Martin Luther King. Americans must learn to live together as brothers and sisters or we will surely perish together as fools. Truer words were never spoken. Thank you for listening to America's Healthcare Advocate. Broadcasting here on the HIA Radio Network. Coast to coast across the USA.

00;38;46;09 - 00;38;47;14

Cary Hall

Goodbye, America.