00;00;00;11 - 00;00;46;23 Cary And now America's Healthcare Advocate, Cary Hall. Hello, America. Welcome to America's Healthcare Sdvocates show broadcasting coast to coast across the U.S., from Alaska to Florida all the way to Hawaii. My producer, Mr. Darren Wilhite. I'm your host, Cary Hall. This is your show, America. Thank you for joining us and making us one of the most listened to talk shows throughout the United States. 294 affiliates strong. As I always say, thanks to all of you out there in the listening audience. If you want to follow me on Twitter, Facebook, Instagram or LinkedIn, it's AHARadioShow, that’s aharadioshow. That's how you can connect with me on any of those platforms if you choose to do that. Also, our podcasts, which have become very, very popular, are on the following Apple Podcasts. 00;00;46;23 - 00;01;08;20 Cary Google, Spotify, Spreaker. Tune in iHeart, Amazon Music, Pandora, Stitcher, SoundCloud, and YouTube. That's a lot of platforms. So every one of these shows, after they are done or posted up on those podcast platforms, so you hear this show today is going to be very interesting. We're going to be talking with some folks from Blue KC about ACA, Obamacare, open enrollment period. 00;01;08;20 - 00;01;28;20 Cary Some of you call it ACA, some of you call it Obamacare, individual and family insurance. This is the open enrollment period. That's what this show is about. So you're going to hear a lot of information today. Well, maybe you're on a different plan or maybe you need to get on a plan. You want to tell somebody about it, your wife, your husband, a friend, whatever the case may be, go back up to those podcast platforms. 00;01;28;26 - 00;01;51;26 Cary The show we posted up there under ACA, Obamacare, Blue Cross and Blue Shield of Kansas City, you can listen to the whole show over again. So that's an easy way to do this. And if you are looking for individual health insurance or you're looking for Medicare and you're chronologically challenged, you can call the lovely Joyce Thompson at RPS Benefits by Design at 877-385-2224. 00;01;51;29 - 00;02;07;13 Cary That's 877-385-2224. And if you want to send me an email, if you have questions, comment something I can help you with the website Health Radio dot U.S. Health Radio dot us. All right. In studio with me, Andre Hunter. Welcome, Andre. 00;02;07;16 - 00;02;09;03 Speaker 2 Thank you. Thank you. Thank you for having me. 00;02;09;04 - 00;02;12;13 Cary From Blue KC and Angela Cheathem back. It's been a while, Angela. 00;02;12;14 - 00;02;13;07 Speaker 3 It has. 00;02;13;08 - 00;02;31;00 Cary Hi, Cary. We're glad to have you in here. So as I talked about in the opening monologue there, Andre, this is the opportunity that people have to either change if they're on a policy they don't like and they want to move to something else, or if they're not on a policy, maybe they don't have health insurance anymore. 00;02;31;00 - 00;02;39;01 Cary They got laid off. Their company canceled the policy, whatever the case may be, this is that opportunity. So how long does this run? And when's it start and when does it end? 00;02;39;02 - 00;02;59;17 Speaker 2 Yeah, so open enrollment, it's going to start on November 1st and it'll run through January 15th. However, if you're looking for a January 1st effective date, you would need to make your plan, selection or choice prior to December 15th. So from December 16th to January 15th, that would give you a February 1st effective date. 00;02;59;17 - 00;03;14;00 Cary Okay. So now that's a little confusing to all of you out there. We're going to go through it one more time. Okay? Okay. So the open enrollment period starts on the very first. It runs all the way through January 15th. But if you want a policy to start on January one, they have to be signed up by when? 00;03;14;04 - 00;03;23;02 Cary December 15th. Okay. So you want a January 1st policy, people? You've got to get it done by December 15th. If you wait past that. Now, we're looking at. 00;03;23;02 - 00;03;24;25 Speaker 2 A February 1st effective date. 00;03;24;25 - 00;03;41;14 Cary Okay. So that they're your choices. So that's important to understand. So, you know, it's better not to procrastinate in this case because if you want it for first of the year, this is a great way to get it done. And the folks at Blue KC can do that. That's during this open enrollment period. That's how all of this works. 00;03;41;14 - 00;04;04;25 Cary So, Andre, let's talk a little bit about, you know, these plans. When they first came out, there was a lot of controversy and a lot of issues around them with different things, but they've taken hold. Now we've got, I think, about total across the country, about 7 million people on these policies. So there was a need. The need is being filled and there's a subsidy involved that allows these to become much more affordable. 00;04;04;25 - 00;04;09;03 Cary So number one, how does the subsidy work? And then number two, how do people find out about it? 00;04;09;03 - 00;04;29;02 Speaker 2 Andre Great. So the subsidies are credits. They are applied to your monthly premium. It's solely based off your annual income, your household size, as well as if you're offered health insurance are what's called minimum essential coverage through another platform like work or a spouse. 00;04;29;11 - 00;04;31;29 Cary That that's basically how this operates, right? 00;04;31;29 - 00;04;48;05 Speaker 2 So if you let's say you have a two person household and the annual income is $50,000. So when we run the quote, we put in to $50,000 income. And based off that information, it'll tell us how much of a subsidy that you will qualify for. 00;04;48;17 - 00;04;54;16 Cary And that's subsidy. So now we've got husband, a wife and two kids. Right. Does that change the equation to. 00;04;54;16 - 00;05;11;23 Speaker 2 Qualify for a subsidy, you have to make a minimum amount based off your household. So depending upon where you fall, with Medicare being expanded in Missouri, depending upon where you fall, you may not be the children may not be eligible for that subsidy because they will be eligible for Medicaid or. 00;05;12;04 - 00;05;34;06 Cary One of the other programs they are eligible, and that's all factored in. So it's a lot easier for people. I know over the years when I was doing this directly as a broker, that people got very confused by this. They would go up on the government website and they'd try to figure it out and they'd call you up and they just be fit to be tied because they couldn't figure out what if they call the folks at Blue KC directly, you will walk them through this process, explain that. 00;05;34;06 - 00;05;45;03 Cary So it kind of takes some of the fear out of it. And and if I make a mistake, they'll have got to pay it back. Well, that's what happens. If you guys do it for them, then that helps them not have those situations. 00;05;45;03 - 00;06;05;25 Speaker 2 Definitely. Definitely. So what you want or don't want to do is try and calculate your income to where you receive a more favorable subsidy because it's all based off your taxes when you file your taxes. So the information that you put on your application is going to be compared to the information that's on your tax withholding at the end of the year. 00;06;06;04 - 00;06;29;26 Speaker 2 If you make more than what you put on the application, you could potentially owe some of that subsidy amount back. However, the amount that you put on the application isn't set in stone. So if during open enrollment you say, I'm going to make $60,000 during the year and then come March, it's a up year down year, you have the ability to go in, update your annual income, and then your subsidy will be. 00;06;30;08 - 00;06;44;25 Cary Adjusted, whatever it's going to be. So if you made less, you're going to get more. And if you made more, then you're going to be just exactly the end of the year. You're not stuck with the big fat penalty. The folks over at the IRS, it's in that now. You got to pay more because you took more money you should have taken. 00;06;44;25 - 00;07;08;29 Cary Yes. Yeah. And that's why, you know, I always tell people it really makes a lot of sense just to call the folks at Blue KC. You know, somebody that knows what they're doing and kind of walk people through this. Angela So they, you know, so they're not trying to do this on their own, right? Absolutely. Yeah. And that and again, folks, you know, this is one of the beauties of the Blue KC right down here on Main Street. 00;07;08;29 - 00;07;23;21 Cary They're local folks and they can help you. They can. We're going to talk about plan designs and all the rest of that here as we go through the show. But you're not going to get high pressure sales tactics. And these people, if you call Blue KC and say, I just need to know how this works, you'll walk them through it, right? 00;07;23;24 - 00;07;24;05 Cary Yes. 00;07;24;14 - 00;07;42;25 Speaker 2 We walk them through all of the the quoting, the plan options, other options, if there are any for that individual. But more or less, you will get every question that you have to some extent answered, or at least a very good understanding of how this works in your options. 00;07;42;25 - 00;08;06;01 Cary Yeah. And you know, as I said earlier in the in the opening remarks, don't wait until the last minute. You're shaking your head so that people do this. Yes. And then the phones lock up and then the websites lock up and the government website will crash. I mean, this has happened almost every year, I think, where at some point, if, you know, everybody's trying to get on and get these things, that thing just freezes up and they start to. 00;08;06;02 - 00;08;11;18 Cary But if you really want that January one start date, it really is a good idea. You know, do it now. 00;08;11;18 - 00;08;36;29 Speaker 2 Now is always better than later. You don't want to procrastinate, especially now with health care, thinking that, you know, it won't happen to me or I don't have any health conditions and then come January one, you find out something's going on and now you have to wait until February one. If we're still in open enrollment, if you move past it moves past that open enrollment period, then you're kind of stuck with no insurance or a catastrophic are non minimums. 00;08;37;00 - 00;08;53;16 Cary So go back to that for a minute because I think that's important. You you don't do this, okay. And yeah, I don't need health insurance. It's not a big deal. And then you wind up diagnosed with a significant illness and. Okay, well, now it's it's March and I'm going to go get an A policy. No, you're not. 00;08;53;16 - 00;09;12;12 Speaker 2 No, no. You have to do it during open enrollment or during a special enrollment, which would include some type of loss of minimum essential coverage, like you said, through an employer or a spouse's employer or something like that. But if you don't have that special enrollment period now, you would not be able to get a ACA policy or Affordable Care Act policy. 00;09;12;22 - 00;09;17;27 Speaker 2 The only plans that will be available at that time would be a short term policy, but they don't cover preexisting. 00;09;18;06 - 00;09;32;07 Cary That's right. And you may not be able to get a short term policy because it doesn't cover preexisting. So the message here, folks, is really simple. If you're if you're thinking you're want to do this, if you're thinking you want to change, you don't like where you're at or you just want to see what blues has got to offer at Blue KC 00;09;32;07 - 00;09;40;29 Cary You pick up the phone and give them a call. 888-892-8220, 888-892-8220 is the phone number. The website is.Blue KC For You Dot Com, 00;09;40;29 - 00;09;42;01 Speaker 3 bluekcforyou.com. 00;09;42;01 - 00;09;54;21 Cary Yeah. Okay, blue KC. I know there was a piece to it. I didn't know what it was. So it's BlueKCForYou.com, All the information is up there, but do give them a call. They'll be happy to chat with you. We'll be right back. After the break, we'll talk a little more about, you know, what's being offered. 00;09;54;21 - 00;10;04;25 Cary We're going to focus on Spira Care a little bit and then we'll talk about plan designs, broadcasting here on the HIA radio network coast to coast across the U.S.. Stay right there. We've got more. 00;10;05;10 - 00;10;18;09 Speaker 4 ### 00;10;18;09 - 00;10;38;07 Cary Welcome vack you're listening to America's Healthcare Advocate Show broadcasting coast to coast across the U.S. You're on the HIA radio network. You can find out more about us by going to the website. Health Radio dot U.S. Health Radio Dot US. If you have a question, send me an email. I'm happy to answer them. I get them all the time. And if I can help you in any way I can, I'll be happy to do so. 00;10;38;12 - 00;11;02;24 Cary My producer of the always perfect Mr. Darren Wilhite, I'm your host Cary Hall in studio with me, Andre Hunter from Blue KC and Angela Cheathem, also from Blue KC. We are talking about ACA, Obamacare, whatever you want, you know it as and call it. This is the time when you can enroll in an individual or family plan. This is the open enrollment period, November 1st through November 1st through January 15th is when you can do this. 00;11;02;24 - 00;11;07;27 Cary If you don't sign up by December 15th, by. 00;11;07;27 - 00;11;08;23 Speaker 2 December 15th. 00;11;08;23 - 00;11;18;05 Cary December 15th, you will not get a January one start date. So December 15th is the cutoff for January one start date. You can sign up after that, but your plan doesn't start until. 00;11;18;05 - 00;11;18;25 Speaker 2 February. 00;11;18;25 - 00;11;38;00 Cary First. So there you go. That's it. If you want a January one date, you've got to get this done before December 15th. If you don't and you miss it, you can still get the policy. But it won't be effective until we get to February 15th. All right. So, Angela, let's switch gears here. Spirit cares in what, its fourth year, fifth year now here, I. 00;11;38;00 - 00;11;40;29 Speaker 3 Think, where is it? Fifth year? I think it's fifth year. 00;11;41;04 - 00;12;00;26 Cary So this is you know, this was when when Blue Cross first rolled this out, this was basically unheard of. Okay. Especially for a health insurance company to be opening these kind of care centers. And then the model that spire care has, which is very interesting, we've got we've got a lot of invitations out there now coming our way from some of the other carriers. 00;12;00;26 - 00;12;20;08 Cary But they're not. They're not what Spira Care. No, they're not. No. And they're not going to be. But so so let's just talk about the Spira Care Clinic, the model. What what is offered, in Spira Care. And then when we get into plan designs, there are four plans now in the model this year on the ACA, plans that you can get Spira care as your primary care center. 00;12;20;08 - 00;12;23;07 Cary But let's just start, Angela, with how does Spira Care work? 00;12;23;17 - 00;12;53;19 Speaker 3 Thank you, Cary I'm so glad that you started with the beginning because I think it helps to tell the story of where we started. So SpirA Care started really based on the feedback of our communities, our members with concerns around the complexity of health care, how to navigate health care, and then just access to care, affordable care. And so we really got together with with focus groups, with our members to come up with a solution. 00;12;53;27 - 00;13;21;24 Speaker 3 And out of that, out of feedback from our members, we developed spire care. And that model is really based around what's called advanced primary care. And you may say, what does that mean? That is really primary care on steroids. You have spirit care members have access to a four doctor led team of professionals that are there to support the whole person. 00;13;22;16 - 00;13;56;07 Speaker 3 That includes your doctors, that's MD’S, DO’s, that's nurse practitioners. That is behavioral health consultants, that's diabetes educators. That is most importantly really is the care guide that with a with a clinical and a benefits background that are there to help you navigate your care. I mean, they will like hold your hand through that process if you need help finding a specialist outside of spire care, if you need help navigating your explanation of benefits. 00;13;56;07 - 00;14;07;16 Speaker 3 We've all received those bills that are confusing even to me at Blue Cross, but those care guides are there in place to walk you through that. Make sure you understand that experience. 00;14;07;29 - 00;14;22;24 Cary You know, and you said, you know, health care is confusing. It's confusing as hell. Right? Right, right. People try to do the stuff I wrote and they call me up. I remember, you know, I did this for 26 years as a broker. And, you know, I would tell people, do me a favor, don't go up on websites and don't try to do this. 00;14;22;24 - 00;14;38;18 Cary Just come in and sit down. Let us do it because it is complicated. None of this stuff is that easy. And if you don't do it on a regular basis, it's hard to understand it. The beauty of spire care, it's just exactly what you said. The average time that a person spends with a primary care physician in this country is seven and a half minutes. 00;14;39;00 - 00;14;54;26 Cary Well, let me tell you how it works with Spira Care. Okay. Well, we've had the doctors on from Spira Care. We've had Dr Greg Sweat, M.D. on here. You know, you're chief medical officer. We've had different doctors on this. from Spira Care When you go in there, you sit down with the doctor. You're in there for 45 minutes to an hour. He's going through. 00;14;54;26 - 00;15;07;03 Cary You're shaking your head. Yes. Going through your medical history and being able to sit there and talk to him about who you are. Right. And then when we when you made that comment about treating the whole person, that's what this thing is built around. 00;15;07;06 - 00;15;36;21 Speaker 3 Yes. Yes, absolutely. And if you think about it, when you are treating the whole person, that helps reduce your chances of if you're dealing with a chronic condition, if you've got that chronic condition management right there, that helps to avoid it escalating to something more critical or more severe. So, yes, and that's from from head to toe. If you have a visit with a spirit care provider, they are you have that whole team that is invested in that whole person health. 00;15;36;25 - 00;16;00;29 Cary Yeah. And that is really important. So let's, let's talk a little bit about, you know, cost good, affordable health. One of the reasons it's in place, Danette Wilson, you know, CEO at the time, was he with your team? You know, this was her vision to do this. You've done it. It's become hugely successful. Hugely successful. Talk about the affordability of this because this gets rid of a lot of reasons. 00;16;01;08 - 00;16;05;23 Cary People don't go see their primary care physician or don't seek care. 00;16;05;23 - 00;16;33;17 Speaker 3 Angela I think this is my favorite part. The cost for care in a spiral care center for your primary care needs. Can I get a drumroll? $0 $0 for your care in the Spirit Care Center? So you may ask. Well, what services are in the Spirit Care Center? Those are your doctor's visits with your primary care physician. So that's your routine physicals, that's immunizations. 00;16;33;17 - 00;16;50;07 Speaker 3 That is your and this is for your children. So those with kids, the kids can go to spiral care. Your teens, they can go to spiral care. The adults can go to Spira Care. In addition to that, we have labs right there on site. So if you need a blood draw, you don't have to leave and go to a lab. 00;16;50;07 - 00;16;56;13 Speaker 3 You can get your lab drawn right there on site and how much is that cost? Zero $0. 00;16;56;27 - 00;17;06;14 Cary And here's the thing. It's right there. You don't have to leave there and go over to LabCorp or Quest or someplace. You're in the place where they're going to do it and it's done and it's over. 00;17;06;14 - 00;17;23;26 Speaker 3 Exactly. Exactly. And not only is it lab draws, but we also have X-ray rays in most locations. We have X-rays right there on site. And one more time, Andre, how much is the cost for care, including an X-ray at a Spira Care center? 00;17;23;26 - 00;17;25;20 Speaker 2 $0, $0. 00;17;25;20 - 00;17;26;04 Cary You can't be. 00;17;26;09 - 00;17;27;00 Speaker 3 You can not. 00;17;27;06 - 00;17;27;17 Speaker 2 Can’t beat Zero 00;17;27;23 - 00;17;46;09 Cary See, one piece before we go to break, because you mentioned it when we first started talking with this. This is one of the most unique features. And we've done shows on this before of spire behavioral health right there in the center. So this is another thing that people are reluctant to deal with. Talk a little bit about the behavioral health that's offered inside the Spira Care center right before we go to break here. 00;17;46;13 - 00;18;13;19 Speaker 3 So the behavioral health consultant is part of your care team. So if you think about it, if you're in with with your doctor and maybe you got a recent diagnosis, along with that diagnosis, it's often coupled with some behavioral health like stress. So you with the Spira Care center, there is a soft hand-off to a behavioral health consultant who can talk you through situational conditions to really aid you along that journey. 00;18;13;19 - 00;18;15;22 Speaker 3 So that really goes back to that whole person. 00;18;15;22 - 00;18;34;02 Cary And that's the whole idea. It's the whole person care here. You're not going to see that in in these other facilities to try to imitate this. This is what unique about Spira Care if you want maybe you want to learn about maybe you're on something else and what that really sounds kind of interesting to me call them at 888 892 8220 888 892 8220. 00;18;34;04 - 00;18;51;10 Cary Or go to the website. bluekcforyou.com, BlueKCForYou.com. All the information is up there. We come back, we're going to dove into the plan designs. I'm going to tell you what's being offered and how it all works. Stay tuned. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network, coast to coast across USA. 00;18;51;10 - 00;19;00;24 Cary We've got more. Don't go anywhere. 00;19;05;24 - 00;19;24;23 Cary Welcome back. You're listening to America's Healthcare Advocates show broadcasting coast to coast across the fruited plain here on the HIA radio network. You can find out more about us by going to the website. Health Radio dot U.S. Health Radio Dot U.S. My producer, Mr. Darren Wilson. I'm your host Cary Hall, in studio with me, Andre Hunter and Angela Cheathem from Blue KC 00;19;24;23 - 00;19;42;29 Cary We're talking about the ACA, Obamacare, whatever. You know it as these are the plans that are available for individual and family health insurance. The open enrollment period is November 1st to January 15th. If you want to get one of these plans, maybe you're on a plan you don't like and you want to find out if there's something better out there. 00;19;42;29 - 00;20;02;12 Cary Well, we just talked about Spira Care. You might want to take a look at that, especially when you realize it's going to cost you $0 to walk into a spire care center with your children, with your spouse, whatever the case may be for care, it's all being offered there. And you can get that kind of information and more by picking up the phone and giving them a call. 00;20;02;12 - 00;20;16;02 Cary 888 892 8220, 888 892 8220 or Blue KC For you dot com, that is the website Blue KC for You dot com, Angela How many spire care centers are they and where are they? 00;20;16;19 - 00;20;44;22 Speaker 3 We currently have eight Spira Care centers. They are conveniently located across the Greater Kansas City area and I'll just name them off their Spira Care, liberty, their spirit care, summit, Spire Care and Overland Park. Olathe. Shawnee Why not Tiffany Springs right in the heart crossroads and then opening late this year is our Spira Care Independence Center, and we're all so excited about that. 00;20;44;22 - 00;21;05;05 Cary Yeah, that's been a while coming. But that's really I mean, would you look at those locations you've got access to this anywhere. Exactly. Does it matter where you're at? If you're in Olathe, Overland Park in Independence, you know you're up in Liberty. Tiffany Springs for folks north of the river, or if you happen to live in the city, maybe you're in Brookside or something, right down the freight house district. 00;21;05;05 - 00;21;13;01 Cary I mean, it's pretty good. It's remarkable how they've expanded and how how convenient is for people to get into one of those facilities. 00;21;13;08 - 00;21;27;07 Speaker 3 Exactly. And so for someone like me, if I live out south, I can access one of the south locations. But I work downtown at the Blue KC building and I can go to crossroads. So you can access you have access to any of those locations. 00;21;27;12 - 00;21;28;20 Cary And the hours that they're open. 00;21;28;20 - 00;21;36;23 Speaker 3 Typically hours are Monday through Thursday, 730 to 630, Friday 730 to 5, and then Saturdays from eight to noon. 00;21;36;28 - 00;21;43;22 Cary So it's a great hours, great convenience, easy to do. You can schedule online, you can call or you can walk in. 00;21;44;27 - 00;21;48;27 Speaker 3 Cary We encourage you to call rather than walk in. 00;21;48;27 - 00;21;57;02 Cary I know people do that. Okay. Wow. So, so it's but it is much better to call or pick our ghost kids online. That's the easiest way to do it. 00;21;57;02 - 00;22;08;22 Speaker 3 We really encourage our Spira Care members to call, and we do that because you can work with a nurse triage who can determine the best location that can get you in the soonest. 00;22;08;22 - 00;22;09;14 Cary That's important. 00;22;09;14 - 00;22;10;01 Speaker 3 Exactly. 00;22;10;01 - 00;22;27;17 Cary Yeah. So you don't go to the wrong place. Yeah, you might be, you know, might be easier to get into Overland Park than it is Midtown. If you've got something you absolutely need to get done, that's a great way to do it. Let's switch gears. Andre, how many plan designs are being offered this year? Let's talk about those and then let's get into some of the some of the different plan designs. 00;22;27;17 - 00;22;33;15 Speaker 2 Andre Okay. So this year we're going to offer 16 plans total, 16. 00;22;33;16 - 00;22;38;16 Cary Holy cow. Yeah, they better call it get information that's confusing. 16 Plan design. 00;22;38;16 - 00;22;43;12 Speaker 2 16 Plan designs. 10 are in the metro area. Six are in our rural area. 00;22;43;22 - 00;22;59;08 Cary Okay, so you got ten here in the metro and then outside of the metro. So if you're up around Cameron, Bethany, Chillicothe, the Harrisonville etc., those are the six plans that are in the rural communities. Let's start with what's here in the KC Metro. 00;22;59;20 - 00;23;18;29 Speaker 2 Yeah. So that there are ten plan options. They're going to range between a $2,000 deductible plan all the way up to $8,700 deductible plan. So there's plenty of plan options in between their deductibles depending upon what you are needing with your insurance. 00;23;19;06 - 00;23;36;19 Cary Yeah. So there's something there to fit everybody's budget and everybody's needs. But let's go let's go to the so here's one. This is the bronze plan. Okay. And here you're looking at an out-of-pocket of 80 $700, right? Right. But this is connected to Spira. And so let's go back to that a minute, Andre. You know what? You know. 00;23;36;20 - 00;23;42;29 Cary Oh, my God. 87. Well, wait a minute. You're not going to pay 80 $700. You've got spire care, right? Talk about it. 00;23;43;01 - 00;24;06;08 Speaker 2 So, yes, you have a better the $8700 deductible. However, as you mentioned, you do have access to Spira Care where again, any services done at spire care locations are going to be $0. So unless you have some type of specialist or God forbid, some type of emergency, that would apply to your deductible. But as far as just primary care, you can get that again and $0 and spirit. 00;24;06;08 - 00;24;23;17 Cary Cary, Yeah. And that, that, that is, you know, that that's really important. You've also got telehealth on there as part of it. So yes, if you don't want to if you don't want to go to the spire care center, you want to try to do it from home. Johnny comes home and he's got pinkeye. Conjunctivitis. You can pick up the phone and do. 00;24;23;20 - 00;24;35;20 Speaker 2 You can do a telehealth call with the Spira Care physician and that will still be at $0 as well. You can do it with any provider that's in your network and it will be a $10 co-pay. 00;24;35;20 - 00;24;51;08 Cary But if you do it with Spira it's zero zero. Yeah. And then they, they make up, you know, they call in the prescription, you get the medication, you're done. So it's, you know, it beats the daylights out of going to urgent care and sitting there for an hour waiting to be seen right in a room full of people that are coughing and hacking, carrying on. 00;24;51;08 - 00;25;03;23 Cary So this that telehealth has become extremely popular. One of the few good things that came out of COVID was getting people to actually start using it. And so let's talk a little bit about back to that bronze plan. What about prescription drug benefits? 00;25;03;28 - 00;25;26;00 Speaker 2 All of our plans do have prescription drug coverage, the prescription generics on that plan, they have up to a $50 copay. However, if the prescription is less than $50, obviously you pay the lesser amount. So if the prescription is a $10 prescription, you wouldn't pay $50 for a $10 prescription. You'll pay 50 or the lesser amount. 00;25;26;09 - 00;25;30;29 Cary Yeah. Or if it's a $5 generic, a low cost generic, then it's only going to be $5. 00;25;31;00 - 00;25;32;00 Speaker 2 Right. Exactly. 00;25;32;00 - 00;25;59;22 Cary And in today's world, 9% of what we take in prescription meds are generic. So, again, you know, what I'm trying to do here is get across the point that you can look at one of these lower cost plans like this bronze plan with this 8700. There's also a first bronze and a bronze choice. And if you're using spiro, you can contain the cost in probably you know, Angela, probably 80% of what people do is with their primary care physician. 00;26;00;07 - 00;26;10;18 Speaker 3 Yeah, it is scary. And like you said and like Andre has said as well, that it's all available at no cost. I mean, you really do want to work with your primary care physician to manage that care. 00;26;10;24 - 00;26;28;26 Cary So so now think about this, folks. Okay. So you get a subsidy, all right? And the subsidy is paying for in some cases, as much as 90%. Some cases it pays 100% of the premium. You get a subsidy, you've got spira care. Gee, your exposure here is pretty limited. Very, very. 00;26;28;26 - 00;26;30;28 Speaker 2 Minimal. Yes. Or very minimal. 00;26;30;28 - 00;26;47;03 Cary And the idea behind putting this place behind putting the ACA Obamacare plans in place was to make affordable health insurance for people that couldn't get health insurance because of preexisting conditions or they simply didn't have the money. And that's all change now, right? 00;26;47;08 - 00;27;04;01 Speaker 2 All change. So a lot of people are a lot more people are being eligible for those subsidies now. And again, the subsidies are going to bring those costs down quite a bit, just depending upon your income, but definitely makes it more affordable for a lot more people. 00;27;04;05 - 00;27;06;05 Cary And subsidies have gone up, haven't they? 00;27;06;05 - 00;27;07;22 Speaker 2 They have. They have gone up. 00;27;07;24 - 00;27;11;13 Cary And they've gone. Is it been substantial or is it kind of incremental or how's it going? 00;27;11;13 - 00;27;30;05 Speaker 2 You know, it's been it's quite a bit I don't know the exact percentages, but it is quite a bit. And there's no cliff. There used to be a cliff where if you made 400% of the poverty level, you just weren't eligible for a subsidy. That cliff has now gone. So it continues to go up, but your subsidy amount gets. 00;27;30;05 - 00;27;58;10 Cary Smaller and that you just heard Andre say that that that's a piece that you would not know. Okay. And you're not going to know that by going up on some website and trying to figure it out, which is why if you pick up the phone and give them a call at 888 928 2220, you will speak to Andre or Angela or one of the folks there that can help you and walk you through this process and say, Oh, no, you qualify for this, which means it's going to pay 70% of your health insurance premium. 00;27;58;10 - 00;28;13;09 Cary Okay. And then you look over here at one of these bronze plans and you've got there are two of them here that have spira care, right? The bronze. Yes, the bronze choice. And then and the choice. Bronze, rather. And the 7000 and the 8700 Yes, both of those are connected to Spira Care. 00;28;13;14 - 00;28;29;19 Speaker 2 Well. Yes. And there are also silver plans that have spire the spire option available. They have a $5,000 deductible and a $6,000 deductible. So as you mentioned earlier, there's plenty of options and choices for anyone and whatever their health requires. 00;28;29;19 - 00;28;46;25 Cary Yeah, and the good news is, you know, there's something that's going to fit your budget as well as your needs. So that's the key to this thing. That's why we're doing the broadcast today, is to remind you that these options are out there and how they work, and also to remind you that the open enrollment period is November 1st to January 15th. 00;28;46;25 - 00;29;02;03 Cary If you want to get coverage in place by January 1st, you've given. I get confused. Yeah, right. Right. You got to get it done by December 15th. Right. All right. Before you go, you can still get coverage, but you're not going to have a plan in place till February 15th. 00;29;02;03 - 00;29;03;11 Speaker 2 So February 1st. 00;29;04;02 - 00;29;19;29 Cary I did it again. So that's why it's a good idea to pick up the phone, call them, let them walk you through it. Let me explain it to you. And, you know, especially if you're really trying to manage your budget and a lot of people are right now inflation, there's a lot you know, the cost of everything is going up. 00;29;20;07 - 00;29;36;29 Cary This is one of the things that's going to make a lot of sense for you. Couple that with the subsidy couple up with spire care, it can make a big difference. Once again, the phone number eight, eight, 8892 a220 or the website blue cake for you and that you can go up on blue KC for EW.com. An information is up there. 00;29;36;29 - 00;30;04;00 Cary We'll be right back after the break. You're listening to America's health care advocate broadcasting here on the HIV radio network. Coast to coast across the U.S.. Welcome back. You're listening to America's health care advocates show broadcasting coast to coast across the U.S.. You're on the HIV radio network. You can find out more about us by going to the website. 00;30;04;00 - 00;30;20;13 Cary Health Radio dot us. Also remember. Okay, you drinking? This is like drinking out of a firehose. Listening to all these folks go back and forth. Even I get confused. Right. You know, you want to tell, hey, you know what, honey? You know, we need to look at that Blue Cross plan. We need to look at that spirit care thing. 00;30;20;19 - 00;30;45;09 Cary All right, you, here's what you do. Go to the podcast platform. I gave you all that. We're on every podcast platform out that there's one we're not on. Somebody needs to send me an email. Okay, listen. Right here and listen to this show that that way they can hear what's going on here and they can hear the benefits, as Angela talked about, all the things that you can do with spirit and how you can keep the cost down and have great health insurance. 00;30;45;09 - 00;31;02;03 Cary So that's a great place to go to do that. You can listen to it up on the podcast platforms that become very popular. We've got a lot of people listening. They shows up there, so you can do that. You can also call 888892 8220. If you just want to have somebody you know you can talk to Andre, you'll be happy to explain this to you. 00;31;02;03 - 00;31;21;01 Cary Yeah, with a lot of other folks up there. And the website is Blue Cake for EW.com and Andre. This is one thing that I think we really need to talk about, okay? Because we're service at Blue. Blue KC Right here on Main Street is world. You've won J.D. Power Awards for a number of years. It's great customer service. 00;31;21;04 - 00;31;40;19 Cary Yes, I call called The of the Day because I had to change the billing on one of our policies. My wife and I. Medicare policy phone rang four times live person there was no voice prompt. I got a live person told her what my problem was. She got another person on transfer to her. We got the problem solved. 00;31;40;24 - 00;31;53;26 Cary I didn't have to send 15 voice prompts in 12 languages. Okay. And talk to somebody in another state that didn't even know what the hell I was calling about. Okay. And try to explain it. So the customer service here, talk a little bit about it. 00;31;54;01 - 00;32;16;15 Speaker 2 Yeah, as you mentioned, world class customer service. And it's it's well-rounded. A lot of our people, me, myself, come from customer service. So you get that customer service feel even when you're speaking with the sales rep. But when you call in, you're going to speak to someone that could very well be your neighbor. Like you mentioned, we are right here local familiar with the area. 00;32;17;06 - 00;32;26;06 Cary Yeah. And you know you try try doing that. When you pick up the phone and call one of these national companies, you say, you know, I need to know about that hospital north of the river. What river? 00;32;26;14 - 00;32;27;14 Speaker 2 Yeah, right. 00;32;27;14 - 00;32;50;10 Cary Where are you? What are you talking about? That's the difference, people. Okay, you know it. It is your neighbor. It's somebody you go to church with or somebody you're on the PTA with. That's what I'm talking about. And that's why local customer service Blue KC is here in Kansas City throughout the metro to help folks and do what, you know, really gets you be able to understand what it is they do. 00;32;50;15 - 00;32;57;05 Cary You've got a gift card option for people on this in the little piece. Oh, cool. Let's talk about that. 00;32;57;05 - 00;33;26;23 Speaker 2 We do have a rewards program for our ACA members. Basically, all you have to do is get your annual visit and we'll give you a $25 gift card. You simply just have to register online for the rewards. You do that I blue KC dot com slash ACA rewards and then if you complete your annual preventative service between January 1st and December 31st, you'll get a $25 gift card simply for doing your annual visit. 00;33;26;23 - 00;33;44;00 Cary Not bad. $25. We're going to do what you should do anyway. And by the way, those are all covered with no co-pay, no co-insurance. You go to the spire care that's 100% covered, the whole nine yards. All right. Two plans we didn't talk about. Let's start with HSA plans. HSA plans are popular with folks that are a little older. 00;33;44;12 - 00;33;56;06 Cary Okay. Because they you know, they all they all they're empty nesters. All the kids are gone. And you don't you know, you don't have a lot of medical issues. You're in pretty good health. And so let's talk about HSA and how they work. 00;33;56;09 - 00;34;19;22 Speaker 2 Right. So we do have one plan that would offer you the capability of getting a HSA, our health savings account, $6500 deductible, 7500 out of pocket max. Um, the plan, it doesn't come with the HSA, but you have the ability to speak with the final financial institution and sign up for one to sign up for our HSA. 00;34;20;16 - 00;34;37;21 Cary So the beauty of the HSA is they can put money in that plan every year if you don't use it. This isn't like your flexible spending account. People or if you don't use it, you lose it. These roll over every year. So let's say you can put $5,000 in there. All right. You only use 4500, 500 of it, 4500 rolls over the next year. 00;34;37;26 - 00;34;56;00 Cary You can put another 5000 in there. It's tax deductible. Yep. Which is another reason why people like to use it, because they're able to sock that money away over a period of years. You can take it out and use it for all kind dental vision. There are all kinds of things you can use it for relating to health care, right? 00;34;56;00 - 00;35;07;14 Speaker 2 That is correct. That is correct. Use it for anything related to health care from, you know, your dental appointments, our co-pays for prescriptions, even band aid over. 00;35;07;14 - 00;35;25;06 Cary The counter Band-Aids all covered under the HSA. So that again, that's not for everybody. Okay. But it is for folks that, you know, really don't need all of the daily doctor visit services and all the rest of it. You know, this may be a way it makes a lot of sense for you, and that plan is offered as part of Blue. 00;35;25;06 - 00;35;28;11 Cary KC There's also a catastrophic plan. Talk a little bit about that. 00;35;28;22 - 00;35;54;21 Speaker 2 The catastrophic plan, that's a new plan to Blue KC this year. It's a little more specific. So people who are eligible for a catastrophic plan, one are people under 30. So, you know, those college students who are pretty healthy, doesn't have any health issues. That may be a look for them. People older than 30, you would have to have a hardship exemption or affordable exemption from the marketplace. 00;35;54;21 - 00;36;03;10 Speaker 2 So basically your job insurance are the marketplace and insurance is too expensive. So you may be eligible to get the catastrophic plan. It's just another option. 00;36;03;10 - 00;36;13;06 Cary So somebody coming off their parent's plan because they're 26, right. This is a very affordable option for somebody to do that and it makes more sense for them, right? 00;36;13;17 - 00;36;14;07 Speaker 2 Yeah, it. 00;36;14;17 - 00;36;19;00 Cary Kind of reminds me the old affordable blue back in the day. Well, that one. Yeah. I think. 00;36;19;21 - 00;36;20;05 Speaker 2 You're going. 00;36;20;05 - 00;36;22;08 Cary Far now. Yeah, yeah, I know what you. 00;36;22;09 - 00;36;22;23 Speaker 2 Are, but. 00;36;23;21 - 00;36;42;26 Cary Okay, yeah. So this is kind of like that. So again, you know, the whole purpose in going through all of this today is if you listen to this, look at all the different plan designs. I said this earlier, there's something there. It's going to fit the budget and the needs of just about everybody out there. So it's an option that can make a lot of sense for folks. 00;36;43;05 - 00;36;50;15 Cary We're going to wrap it up here in a minute, but Angie, let's go back to the Spira Care location so people know where they're at and the options with spire care. 00;36;50;25 - 00;37;09;14 Speaker 3 Sure thing. So remember, folks, for your primary care services, you can go to Spira Care. Any of the Spira Care centers. There's one SoiraCare, Liberty Lee's Summit, Overland Park, Olathe, Shawnee Wyandotte, Tiffany Springs, Crossroads. And then the end of 2022 and independence. 00;37;09;15 - 00;37;14;13 Cary Okay, that's it. So there you go. That's where everything's at. Thank you both. Thank you, Angela. Thank you. 00;37;14;13 - 00;37;14;25 Speaker 3 Thank you. 00;37;14;25 - 00;37;37;08 Cary Carrie. It was great to have you both in here. The phone number 888892 8221 of their folks would be happy just to chat with you if you want to learn more about Spire or any of these plans, like the catastrophic plan, whatever, call them 888892 a220 the website blue KC for you dot com. And now I leave you with this thought from Dr. Martin Luther King. 00;37;37;16 - 00;37;59;07 Cary Americans must learn to live together as brothers and sisters, or we will surely perish together fools. Truer words were never spoken. Thank you for listening to America's health care advocates show broadcasting coast to coast across the US. Say goodbye, America.