Healthcare in America shouldn’t feel like a rigged game––but too often it does.
Leaving many people feeling swindled by confusing insurance plans, surprise medical bills, and endless fine print. To help navigate this complex system, I’m joined by Dan Weissmann, journalist and host of the NPR podcast An Arm and a Leg. Dan explains why U.S. healthcare feels broken––and how to get the most out of a flawed system. He’ll share strategies to protect your finances and well-being, from selecting the right health insurance during open enrollment to identifying billing errors, challenging unfair charges, and saving hundreds on prescriptions.
Key takeaways:
The U.S. healthcare system is designed for profit—not patients.
Dan explains that navigating healthcare is like playing poker against billion-dollar companies that “are all playing for our chips.” Insurance firms, hospitals, and pharmaceutical giants aren’t competing to serve you—they’re competing for investor dollars and profit margins. Understanding this dynamic helps you approach the system strategically rather than emotionally.
Choosing the right insurance means looking beyond the monthly premium.
Many people make the mistake of picking the plan with the lowest monthly cost—but Dan urges listeners to consider deductibles, co-pays, co-insurance rates, and in-network care. “The cheapest plan up front could cost you thousands more later,” he warns. Creating two lists—your regular healthcare needs and your worst-case scenarios—can help you see the real costs.
Medicare and Medicaid are not as simple—or free—as many think.
Dan breaks down common misconceptions about government programs. Traditional Medicare still comes with premiums, deductibles, and out-of-pocket expenses. Meanwhile, new work requirements for Medicaid add “administrative burden” that often pushes low-income Americans out of coverage altogether. His advice: stay informed, meet deadlines, and get help from free counseling programs like SHIP before enrolling.
You can—and should—fight medical bills and insurance denials.
At least half of all medical bills contain errors, according to Dan. Always request an itemized bill, check for mistakes, and confirm that insurance claims were processed correctly. If you receive a huge hospital bill, look into charity care programs (many nonprofit hospitals are legally required to offer them) or use resources like DollarFor.org to see if you qualify for financial assistance.
There are proven ways to save on prescriptions and out-of-pocket costs.
From using tools like GoodRx or Mark Cuban’s Cost Plus Drugs to asking your doctor for free samples, Dan shares a tactical playbook for reducing medication costs. “Ask questions like, ‘What if I paid cash?’ or ‘Is there a generic version?’” Small actions can result in massive savings over time.
Being proactive and prepared is the best way to advocate for yourself.
Healthcare conversations can be intimidating, but Dan reminds listeners to come to every appointment with questions, know your coverage details, and never feel rushed into agreeing to a procedure. “Don’t get sold anything in the first conversation,” he says—especially when it comes to your health or your money.
Notable quotes
“We are the sucker at the table. When we enter this system, it’s not a level playing field.”
“If your insurance company says no, think of that as their opening offer. Appeal it.”
“The insurance contract you’re signing is every bit as much a piece of finely tuned financial engineering as a derivatives contract.”
Episode at-a-glance
01:15 Why Healthcare Is So Expensive
03:00 The System Is Confusing by Design
06:00 Understanding What You Actually Owe
08:30 What To Do When You Get a Medical Bill
10:45 How To Talk to Your Insurance Company
13:00 The Hidden Traps in High-Deductible Plans
15:30 Should You Pay Your Bill Right Away?
18:00 How Medical Debt Affects Your Credit
20:15 How To Negotiate a Medical Bill
22:00 What To Do If You Can’t Afford Care
24:30 The Emotional Cost of Healthcare
27:00 Why Women Carry More Medical Debt
30:00 The Future of Healthcare Transparency
36:00 How To Be Your Own Healthcare Advocate
38:00 How To Find a Fair Price for Care
41:00 Quick Wins To Save on Medical Costs
43:00 What True Financial Wellness Means
Dan’s Links:
Website: www.armandalegshow.com
Additional Resources:
Healthcare Marketplace: https://www.healthcare.gov/
SHIP (State Health Insurance Assistance Program): https://www.shiphelp.org/
Pharmacy Checker: https://www.pharmacychecker.com/
Dollar For: https://dollarfor.org GoodRx: https://www.goodrx.com/
Mark Cuban’s Cost Plus Drugs: https://costplusdrugs.com
Visit herfirst100k.com/ffpod to stay up to date and find any resources mentioned on our show!
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Meet Dan
Dan Weissmann is the host and executive producer of An Arm and a Leg — the award-winning podcast about why health care costs so freaking much, and what we can maybe do about it. As a reporter, Dan likes a challenge, so the job he’s chosen is to take one of the most enraging, terrifying, depressing parts of American life, and produce a show that’s entertaining, empowering and useful. Dan and his team also produce First Aid Kit, a newsletter that distills lessons for surviving the financial hellscape that is the American healthcare system.
Prior to creating “An Arm and a Leg,” Dan was a staff reporter for public radio’s “Marketplace,” and Chicago’s public radio station, WBEZ– so he brings an investigative journalist’s savvy and a storyteller’s ear for a compelling tale to the project of understanding how we got so screwed, and how we can help ourselves and each other.
The show has won awards, and features in outlets from the New York Times to Money Magazine — but what makes Dan proudest are the messages the show gets every week from listeners: About how the show saved them money, helped them fight back, and made them feel less alone.
Transcript:
Tori Dunlap:
Donald Trump wants to make your healthcare more expensive, and you need to know exactly how to navigate those changes. Healthcare in the US costs an arm and a leg, sometimes literally. And my guest today would know because that’s literally what he named his podcast. Journalist and podcast host, Dan Weissman, joins us to unpack why our healthcare system feels like walking into a casino where the house always wins and what you can actually do about it.
Dan Weissmann:
We’re not just playing against the house. We’re kind of being ushered straight to the table where the World Series of Poker is being played. And around the table are people who belong at this table, the health insurance companies and the pharmaceutical companies and the big hospital chains and all the other people who really know how to make money on healthcare. We are playing against them and they are basically all playing for our chips.
Tori Dunlap:
We talk about everything from choosing the right health insurance during open enrollment to what Medicare Advantage really means to how to challenge unfair medical bills and save money on prescription. Can you walk me through what people should look for when choosing a health insurance plan during open enrollment?
Dan Weissmann:
Yes. You’re going to look at all the plans in front of you and here’s what you’re not going to do.
Tori Dunlap:
If you’ve ever looked at a hospital bill and thought, “This can’t be right,” this episode is your guide to fighting back and protecting your wallet and your health, especially amidst all of the crazy changes. Let’s get into it. But first, a word from our sponsors.
Okay. So Dan, people say that healthcare costs an arm and a leg in the US. I mean, you named your podcast after this. And you once compared it to walking into a casino where the house always wins. Can you break down that analogy for us? Why are we losing so much money just to get basic healthcare?
Dan Weissmann:
So we’re walking into this casino and we’re not just playing against the house. We’re kind of being ushered straight to the table where the World Series of Poker is being played. And around the table are people who belong at this table because they’re really good and they have lots of chips. And it’s the health insurance companies and the pharmaceutical companies and the big hospital chains and all the other people who really know how to make money on healthcare. We are playing against them and they are basically all playing for our chips. We are the sucker at the table. And so that’s the metaphor. I mean, we’re just screwed because when we enter this, it’s not a level playing field. You get a bill from a big entity. They’ve got a huge team of people who have kind of designed the process to get the most money out of you they can.
You sign up for health insurance. That insurance contract you’re signing is every bit as much a piece of finely tuned financial engineering as a derivatives contract. The health insurance people have made sure that’s true. All of these people have experts whispering in their ears and we are here never having played poker before. That’s how it is. Why is it this way? The metaphor may break down a little bit there.
Tori Dunlap:
Capitalism? That’s my answer to everything-
Dan Weissmann:
[inaudible 00:03:12].
Tori Dunlap:
… is capitalism.
Dan Weissmann:
Yeah. And United States is kind of the only major developed country where healthcare is pretty fully integrated into our kind of whole capitalist deal. So lots of people will have the opportunity to make lots of money and they keep getting better at it.
Tori Dunlap:
You have shared that this work is deeply personal to you. You’ve made career decisions over health insurance. I think that’s something all of us can relate to.
Dan Weissmann:
Yeah.
Tori Dunlap:
Can you talk a little bit more about that and what made you want to get to the bottom of this system?
Dan Weissmann:
Oh, sure. I mean, I was born with a little congenital heart condition. I have to get seen every year. It doesn’t bother me. I can do whatever I want, pretty much. I’m not supposed to lift heavy, heavy weights, but I can do whatever I want. I get seen once a year. There’s tests. When I first left a regular job 20 years ago, and I was like, “I’ll freelance.” I was like, “And I’ll buy my own insurance. It’ll be cool.” And the insurance companies were like, “No, you won’t.” This was before Obamacare. They were like, “You’re not insurable, dude.” I was like, “I can do whatever I want.” They were like, “No, you can’t. You can’t have health insurance and do that.” That was a bummer. So I kind of structured things in my life like lots of people do to make sure I can have health insurance through work.
A bunch of years ago now, before I started making this podcast, I left a job and I didn’t know what I was going to do next. And I was like, “Hmm, I might need another career.” I’m a reporter, being a reporter is not like a growth field for sure. And I thought I need another career. And I was like, “And it’s okay. Maybe I don’t have to do this particular thing anymore.” And a friend asked, “Well, isn’t there something that you’d want to do, some story?” I was like, “Well, yeah, there’s this one thing.” Because as a reporter too, and as just a person walking around, you talk to people whose lives are just turned completely upside down. And I was like, “This is underwitnessed and we don’t understand enough about it and we don’t hear enough about it.”
While I was getting ready to try to make the first season of this show, we were like, my wife who also runs a small business and I were like, “Well, what do we do? We’ll need to get insurance. Obamacare now exists. We can do this.” And I looked up the plans and there’s tape of me doing this in our very first episode. I was like, “Oh man, to get these tests,” I get a couple of scans, “I got to go to a specific place where they see people like me with my little condition.” There’s like one in Chicago where I live and I was like, “Did any of the plans on the Obamacare marketplace include them in their network?” Yeah. The answer was no. And I was like, “Well, okay, how much do these tests cost out of pocket? How much is this going to cost? We have to pay for it.” And I look back at the statements I’d gotten the previous year and the answer was at that time, $20,000.
And I was like, “All right, well, but there’s this thing called out of pocket maximum, right? There’s some maximum that I have to pay,” and you can hear me doing this on the show. I was like, “Okay, so no, out-of-pocket maximum only applies to in-network services. So there is no out-of-pocket maximum, even under Obamacare for things that are out of network.” I was like, “We are hosed.” We had a shot that we were taking at buying health insurance as a business through my wife’s business. And one of the kind of narrative hooks of that first season was like, “Is it going to work?” And it did, and it worked for us, and that’s how we’re here. But yeah, that’s my personal little story, and I’m just a super, super lucky person.
Tori Dunlap:
It’s really a full-time job, and then you turned it into… I think about all of the people, I mean, everybody listening to the show, you have jobs, you have lives, you have kids, you have things going on, and on a good day, you might not need your health insurance. On a okay day when your kid gets sick or you get sick, you need health insurance. And then on a really bad day, you need it. And it’s like, where is the time and energy and knowledge coming from to be able to navigate this very complex thing that shouldn’t be complex? And we talk a lot on this show about how, to your point, about reading dividend reports, it’s very similar where if you are in debt, they keep you in debt by making it as complicated as possible to get out.
Dan Weissmann:
Oh yeah. Right.
Tori Dunlap:
If you want to invest, they make the stock market and the platforms that you invest in the stock market on extremely complicated so that you hand over your money to a wealth advisor manager who’s going to charge you 2% a year. All of this is on purpose. So when you’re thinking about the healthcare system in the US, why is it so expensive compared to other countries? Where is the money actually going?
Dan Weissmann:
Oh, well, a lot of places, the important place it goes is to a lot of profits, right? A lot of shareholders are very happy investors in pharmaceutical companies and insurance companies and for profit healthcare. It’s going to profits. It’s going to people who have high paying jobs, making sure those profits stay there. And interestingly, people who work in these systems will tell you sometimes that some of it goes to kind of accommodate the friction of what regulation we have on healthcare. It’s like, “Oh, we got to have a lot of compliance. We got to do a lot of this.” And some of that’s true. Largely, another big chunk of it is going towards these players fighting each other.
I’m a pharma company, what are called the pharmacy benefit managers, the kind of pharmacy side of the insurance world is always trying to take a piece out of my action and I got to find other workarounds and I got to pad my profits over here in case they take a piece of me over there. And if I’m an insurance company, it’s the exact same thing. And if I’m running a hospital chain, it’s the exact same thing. I’m swimming in a pool where everybody else is a shark and I got to make sure that I don’t get eaten.
And so when… I remember, and I don’t remember the numbers here, but when Bernie Sanders was running for president in 2020, there was a story in Politico that was like, “Look, he could really hurt Democrats in Pennsylvania,” because Pittsburgh, so many jobs are in this kind of healthcare administration world. He outlined, “This is how much money we could save if we did Medicare for All. We’re cutting out all of this infighting and doing all this stuff,” and a lot of people have those jobs. And so Politico was like, “Democrats could totally lose Pennsylvania because the Republicans are going to be like, ‘Bernie Sanders is going to put you out of work by putting in Medicare for All.'”
Tori Dunlap:
Well, I mean, it’s very similar to the conversation about clean energy, right? As it’s like the coal jobs are going away and it’s like, yeah, they are, and that sucks. And also, maybe this is better for the collective. And I think that one of the things that you just mentioned, which I think is so important to think about is that it almost is like… I mean, it is. It’s private companies competing for your business, just like anything else. Nike and Adidas have marketing budgets, they have project managers, they have Facebook ads and whatever. And I don’t know the legality or if anybody, I don’t know if big pharmas, but they probably are. Ozempic, I’m getting the Ozempic ads, so I know they are, but it’s like-
Dan Weissmann:
They are.
Tori Dunlap:
… that’s something that’s so interesting is that they have to make all this money because they are in competition with every other healthcare company or every other pharmaceutical company.
Dan Weissmann:
I mean, yes and, right? Because unlike Nike and Adidas, we’re like, “Well, I want to be a performance athlete,” or, “I want to look cool.” We all have bodies and we all need help keeping from getting sick and dying before we need to. This is a money or your life proposition and there is not robust competition in it. There are some insurance companies that are competing to sell you plans, but not that many. These industries all keep getting more consolidated. There’s fewer insurance companies than there used to be. There’s fewer everything than there used to be. Hospitals have been glomming together in giant chains regionally and nationally. So yeah, I mean, there’s competition, but they’re competing with each other for who can be the most profitable. In some ways, I think they’re really competing for investor dollars. How do we show that we have the biggest market share?
How do we show that we’re the best investment? Well, we have to be bigger and more consolidated than the other guy out there so we have the biggest moat around us compared to them. I remember one of the first stories we did, and this… I mean, because it goes down to a more micro level too, was about a drug that came on the market priced at $500,000. And I was like, “How did that happen?” And this was a drug that was in wide use in Europe for decades, but nobody had run it through clinical trials in the United States. It treated a fairly rare condition.
And I talked to the guy who developed it in the US, which basically meant ran it through the clinical… Got the money from investors to run it through clinical trials here. And he was like, “Look, it does cost X millions of dollars to run that clinical trial to get the FDA approval. The people I’m hitting up for those X millions of dollars are hearing pitches from people just like me who are saying, ‘I’m going to get you a hundred X. I’m going to give you 150X,’ right? Your investments can be paid a bajillion to one. And so if I didn’t promise my investors that kind of return, I would never have gotten this many millions of dollars,” which is why there are policy folks who are like, “Right, these FDA approval trials should be paid for by some other mechanism than getting investors to pony up for them.”
We could have a pool of public dollars. That sounds good to me. I’m not an economist. I haven’t done it, but okay, that makes sense, but it certainly makes sense in the context of that story. And if you’re Eli Lilly or any of the other companies, you’re in that boat where you’re running that company, your company’s stock price is the most important thing to keeping your job.
Tori Dunlap:
I just have this picture of a bunch of Dr. Evils in a dark room somewhere stroking their cats and putting their fingers together. And it’s like, this is not unserious shit. Like you just said, it’s literally your life. It is your health. And for the thousandth time on this show, it’s like, it pisses me off so much. It’s like you’re playing Monopoly of how do I get as much property as possible? How do I get as many assets as possible? But with people’s healthcare and lives.
Dan Weissmann:
Absolutely. Absolutely. I mean, it makes me very sad, honestly. When the CEO of United Healthcare was killed, colleagues of his were like, “He was one of the good guys. He wanted to make things better.” And I think they were serious. But their idea better is like, what are some-
Tori Dunlap:
Define better.
Dan Weissmann:
What are some incremental ways we could make things a little better within the context of while maintaining shareholder value? That’s always first. But could we find things that would make things a little better for people within that context? And the answer’s always going to be not nearly enough, right? Not if your shareholders come first.
Tori Dunlap:
So let’s get into some of the information and the questions that a lot of people have. So let’s talk about Medicaid. So the Medicaid work requirement, it’s coming fast. It sounds like it can kick millions of people off their coverage. What is the real impact here for everyday people, especially people in rural areas or who are already juggling low wage jobs?
Dan Weissmann:
For sure. And I’ll just say this kind of macro question is not my beat so I can tell you generally what I know.
Tori Dunlap:
Sure.
Dan Weissmann:
We looked at Medicaid for the first time last year. Medicaid, Medicare, having done… But because it took me a long time to feel like I knew enough about healthcare to go into this more complicated area. And here’s what we learned. During COVID, in the early part of COVID, one of the things that happened was they loosened up some things that they could stay on Medicaid without having to kind of pony up a million documents all the time. And so after a few years, that ended. The COVID public health emergency ended and that loosening kind of hit the sunset and people had to re-up. And I talked to folks who were like, “Yeah, we’ve seen this happen before,” because Tennessee had done something similar 10 years prior where they’d loosened things and then tightened them. And what happened was people couldn’t stay on Medicaid.
It got so hard because of all of the bureaucratic requirements. And of course, there’s one, do you understand all the things you’re being asked to do? Two, do you have time to do all the things you’re being asked to do? And three, does the system on the other side accurately understand what you’re telling them? And if any of the answers are no, like in one case, one family was kicked off of Medicaid for not responding to an email that had been sent to the wrong address.
So this happens all the time. You add more stringent work requirements, you’re adding to what people call administrative burden. This was the burden of just showing like, “Yes, my income’s still low. I still need this.” You add the administrative burden of like, now I got to somehow find a way to prove to you that I still have this job, that I still work this many hours a week. I got to navigate through your system in my spare time. And by the way, being poor and working a low wage job that means I still qualify for Medicaid keeps you pretty busy. I can’t tell you off the top of my head the numbers of people they say are going to lose Medicaid, but that’s basically the why.
Tori Dunlap:
It’s so expensive to be poor in the United States. It’s so expensive to be poor. Your time, your energy, your money, your resources, all of that. When you’re just trying to get by, it’s the same with the way people feel about banks or the access to banking product. It is a million hoops to jump through in order to just get by.
Dan Weissmann:
And it’s so stressful, right?
Tori Dunlap:
Yes. Yes.
Dan Weissmann:
To a certain degree, being activated by the flight or fight response can kind of give you a jolt of energy, but like chronically-
Tori Dunlap:
Right, that’s not sustained.
Dan Weissmann:
Yeah. And we don’t operate at our best when we’re under that kind of pressure all the time.
Tori Dunlap:
Okay. So Medicare. People assume it’s this magical free healthcare that starts at 65. Nope, that’s not the reality. What is the biggest surprise about Medicare generally, but specifically costs that you wish everybody knew before they turned 65?
Dan Weissmann:
Yeah, this is a really big one. And this also, it took me several years before I was like, “Okay, now I can start to understand Medicare.” And there’s kind of two things and they’re related. One is signing up for Medicare is kind of complicated. There’s a lot of choices to make and Medicare is not free. You pay a premium for part of it and under what we call traditional Medicare where the government runs it, kind of the way it started in 1966, there are things that are not fully covered. And so you need to take out a second policy. People call it a supplement or Medigap. So to do regular Medicare means you’re paying some money out of pocket and there are deductibles and other things. Medicare doesn’t mean that you’ve kind of drawn the curtain on the question of like, “Now I never have to pay for healthcare again. I don’t have to think about medical bills again.”
It helps a lot. It helps a lot, but it’s not free. And there’s like the most surprising thing that I learned is that there’s deadlines when you sign up for Medicare and there’s one of them where if you miss it, if you don’t sign up within a year, I think of turning 65, you pay a penalty, like a fine every year for the rest of your life. And the longer you miss the deadline by, the bigger it is. I mean, it’s like, what? Really? Really? So stay on top of it. So that’s one is that Medicare doesn’t mean healthcare is completely free. Now here’s the other really important thing, is that if you or someone you love is approaching Medicare age, they’ll probably see a lot of people being like, “Hey, come to my free seminar. I’ll tell you all about how to sign up for Medicare.” That person is likely to be an insurance broker and they are likely to say, “Look, regular Medicare, it’s super expensive. You’re going to have to buy this supplement policy, you’re going to pay these other things, or you could sign up for Medicare Advantage. And here, I can offer you this plan with almost no premium or maybe no premium, and I can offer you things that Medicare doesn’t cover at all, like vision and dental and hearing,” which yeah, Medicare doesn’t cover those things, so that’s a whole thing.
And that sounds super, super good, but here’s the thing. In most states, once you’ve signed up for Medicare Advantage, it’s like a no backsies thing. You can’t go back and be like, “Actually, I’d rather do traditional Medicare.” And the reason that’s important is because, well, Medicare Advantage is run by private insurance companies like United Healthcare, all the people that we love so much to deal with as non-retired people, with all the administrative burdens and the pre-authorizations and the denials and all the time you spend on the phone with them. And this is as people who are like, “Hopefully we’re not needing a ton of medical care all the time.” You are signing up the oldest, sickest version of you to deal with those people if and when you’re really hurting.
And I talk to people who are like, “Oh my gosh, I developed a big health condition and United Health Group or Cigna or whoever it was was like, ‘No, we don’t think you really need it.'” And I talk to people like that who are younger and I’ve talked to people like that who are on Medicare Advantage and they were like, “I can’t do this. I can’t get the healthcare I need.” So that’s a huge consideration for me is like as I look toward hoping Medicare is there and that traditional Medicare is there when I’m ready for it, I hope traditional Medicare is there because I don’t want the oldest, sickest, weakest, tiredest version of myself who’s the most in need of good medical care to have to engage in the kind of battles that I chronicle all the time.
Tori Dunlap:
So what is your advice for someone navigating that? How do they not get totally overwhelmed? How do they make smart insurance decisions?
Dan Weissmann:
Oh, actually I have an answer for this.
Tori Dunlap:
Great.
Dan Weissmann:
Which is… Yeah.
Tori Dunlap:
I’m like, give me answers because all of this feels so-
Dan Weissmann:
Pretty overwhelming.
Tori Dunlap:
I just want to walk into the ocean.
Dan Weissmann:
Yeah, at least for now, because this is a federally funded program. So who knows what’s going to happen going forward. Every state has a program called SHIP, S-H-I-P. And what it stands for is actually a little bit different, but state is usually the S and health insurance is the P, but is the I, you get the idea. But it’s basically free counseling for people who are signing up for or dealing with Medicare and like counseling meaning like advice. Like you call somebody and I had a friend a couple of weeks ago who was like, “Hey, I’m coming up on Medicare. What’s your advice?” And I was like, “Get in touch, make an appointment with a counselor for your local SHIP office.” And she was like, “Will do.”
And after she texted me and she was like, “Okay, that was a two and a half hour phone call and I’m still kind of like putting myself back together, but thank you so much.” Can you imagine? I mean, God, saying this, I’m like, “Well, who the heck knows what any government program’s going to look like coming up?” But to put it in the other way, the idea that you could call somebody and get somebody who does this every day to talk to you for two and a half hours, about this process and what it’s like for you, what your options are, right? Because again, you’re going to sign up for a Medigap plan. Well, there are… There’s literally an alphabet soup of those. There’s like a type A, B, G, F, and D. There’s letters that are missing from the sequence. I don’t remember which ones they are. And then they’re each offered and they cover different things and they’re each offered by different carriers. So am I choosing regular traditional Medicare or Medicare Advantage? Oh, traditional Medicare, I need a supplement. Well, which kind of supplement? All of that.
So yeah, having somebody you can call who’s not the insurance broker who’s… I mean, they’re like, “I can set you up with a Medicare Advantage plan and get a commission when you do.” The people at SHIP are just there to help you out. And by the way, they’re also there when you’re on Medicare. So I talked with a woman recently who runs one of these programs and she’s like, “Every year we invite seniors,” because one thing you never get away from working with private insurance is drug coverage. That’s its own part of Medicare. There’s a whole separate alphabet soup, there’s Medicare A, B, C and D is for drugs.
And that’s entirely run by private insurance companies. There are often multiple that’ll offer you a plan in any given year and you got to choose among them and every year they change. Every year you got to re-up. And so she’s like, “People come in and I’m like, ‘Let’s look at, there’s a list called the formulary that says which drugs, which plans cover at what rates and you want to pick the right one for you,'” because otherwise life gets very hard.
Tori Dunlap:
That brings me to-
Dan Weissmann:
You look really tired.
Tori Dunlap:
I’m just like… Thank you first of all for doing this work. And second of all, I’m like, I am so scared to get old.
Okay. So before we move on to just general health insurance questions, we’re kind of dancing around it, but what does happen if he is doing the thing he says he’s going to do with passing the Big Beautiful Bill, which is that Medicare gets… Is it Medicaid gets cut? What happens if… You just said this lovely public service, which is like a phone line, you can call and get questions answered. And I was like, I literally had a thought where I was like, “That sounds like Donald Trump’s worst nightmare.” That sounds like the thing that he would cut first. So what happens when these things start going away?
Dan Weissmann:
I don’t know, but it’s really bad. I mean, that’s all I can say. I mean, I have not yet heard that SHIP is being cut the way some other things have been cut, but this is year one of this presidency, so we don’t know.
Tori Dunlap:
Three more years, baby.
Dan Weissmann:
What’s coming down the pike? Yeah.
Tori Dunlap:
Call your reps. That’s my answer to that. Call your reps, do what you can do. Okay. Let’s talk about health insurance generally because we get so many questions about it. I’ve done some content and some helping people navigate like negotiating medical bills or just like looking at their bill to see what’s covered and what’s not. I have a video that went viral when I first started on TikTok in 2020 about how I went into the gynecologist and that was a routine visit, but they didn’t bill it as such. And if I wouldn’t have caught it would’ve cost me I think a couple of hundred dollars. So first of all, can you walk me through what people should look for when choosing a health insurance plan during open enrollment?
Dan Weissmann:
Yes. You’re going to look at all the plans in front of you and here’s what you’re not going to do. If there’s any way to avoid it, you’re not going to be like, “What’s the least amount of money I have to shell out per month for this?” Note that. They all have different premiums. Set that aside for a second. Don’t just look at that and circle that one and go because you need to make a couple of calculations because the one that is the least out of pocket for the premium per month could cost you a lot over the course of the year. So you want to make basically two little lists, two spreadsheets, two whatever, like two columns in it. And one is, what do I need in terms of healthcare? What might things cost in a normal year for me? And a normal year for you is just different from anybody else.
I see this therapist every week and if I didn’t, that could be bad. Are they covered? Or in the case of I have type one diabetes, I need to make sure that my endocrinologist is covered or like, I’m planning to have a kid this year or I need knee surgery next year. Whatever you know is your deal, what’s that going to cost you? And on healthcare.gov, you can look to see like which doctors and which whatevers are in network and also at what level. Because the other question is like, okay, there’s going to be out of-pocket costs and what are they going to be from me? When is my insurance actually going to kick in? What’s the deductible? I have to shell out this much for most things. Some routine doctor’s appointments supposedly know before the insurance kicks in at all. And that number can be like on Obamacare marketplace plans typically is in the thousands of dollars per person per year.
And that’s hard to get away from. But then the question is like, okay, I’ve paid that. Then what? Then what are my copays? Am I seeing someone all the time? That’s going to add up. And then there’s my favorite term that I learned in making the show, co-insurance. It’s like dig me. I’m co-insuring myself. If I, God forbid, go to the hospital or whatever, this is a percentage of the total that I’m paying. Like an 80/20 split, meaning I’m paying 20% or a 90/10 split or a 70/30 split or a 60/40 split. And again, for most of us in the kind of normal year, I’m not worried too much about that because I’m not planning to spend a lot of time in the hospital. But now you got to look at the other side, which is, what happens if I get hit by a bus this year?
Where does that leave me? How wrecked does that leave me? And that’s where it’s like, well, that co-insurance, 40% of whatever it costs to be recovered from being hit by a bus, that’s a lot. So you kind of do those two calculations and then you kind of… For most of us, we’re really mainly going to look at that number for what’s a normal year look like because that’s going to be scary enough. The hit by a bus year, I mean, that’s going to be scary enough. What do I got to shell out every month for an insurance policy that lets me… Last time we did this, we did this last year. We were looking at policies that were… I could pull it up, but I’m not going to, because it’s too awful. But it was too awful. But we could save a hundred bucks a month on this premium, but it would cost us an extra $5,000 across the course of the year just doing our normal thing.
And I was like, “That’s not good. We have to pay this extra money.” And the total between the insurance premium and what we expect to pay out of pocket is our biggest single expense. And the premium itself, I think is our single… It’s more than our mortgage, and it’s going to go up again this year. So again, for most of us, thinking about the, what if I get hit by a bus thing? We can’t afford to get hit by a bus. But looking at the question of like, what’s a normal year look like for me, you should do that calculation because that’s what your year’s going to be and that’s your budget.
Tori Dunlap:
I think that’s really, really smart is to make sure that you’re not just prioritizing, okay, what am I going to pay now? What is my monthly premium versus, yeah, what are the copays? What do I need in an average year? You keep saying hit by a bus. And I think that is important to think about.
Dan Weissmann:
I’m not trying to put an evil eye on you or anything.
Tori Dunlap:
No, no, no. It’s more that I think about like, yes, there’s the hypothetical of hit by a bus, but there’s the more real hypothetical for a lot of people listening because we have mostly women listening, which is I’m going to have a kid. And that is financially very similar to I got hit by a bus, but much more realistic. That is something that a lot of us will navigate. So that is just something I want to highlight is…
Dan Weissmann:
Absolutely.
Tori Dunlap:
Yes. We’re thinking about, oh yeah, what happens if I get hit by a bus? But what also happens if the much more realistic version of this, which is-
Dan Weissmann:
Spend time in a hospital.
Tori Dunlap:
Yeah. Right.
Dan Weissmann:
Giving birth.
Tori Dunlap:
I’m pregnant or I have a kid. That’s incredibly expensive. So if you know that that is something you want to do or something that might happen, plan accordingly.
Dan Weissmann:
100%. 100%. Yeah. And that’s where it’s, looking at the network is really important. It’s like, I want to give birth over this hospital. Okay. Find yourself an insurance plan that covers that hospital. It is. Yeah, it is wild. I often say, I think parents are the folks who are my kind of like target listeners in a way because by the time, one, yeah, having a kid is most, for most people who are generally healthy, it’s your first encounter with like how much things really can suck you for.
Tori Dunlap:
And they cost a lot.
Dan Weissmann:
Oh my God. It’s insane. And-
Tori Dunlap:
I think like a non-complicated pregnancy costs at least 30 to $50,000.
Dan Weissmann:
Oh my gosh.
Tori Dunlap:
That’s just a normal pregnancy. You haven’t had to go in and get tests every week because you’re having morning sickness. Your baby came out completely healthy and fine and didn’t have to receive any non-normal aftercare. That’s a lot of money. And then you add just one variable in there and it starts getting more expensive.
Dan Weissmann:
It’s enormous. Yeah. And you come out of it and now you’ve got a new human who is at risk for having… There’s another body that may need care and babies get sick.
Tori Dunlap:
Okay. I have to keep us actionable because that’s the only way I’m going to keep us positive.
Dan Weissmann:
Okay. That’s my whole show. I’m just like, “No one would listen to my show twice, let alone once if,”… We make the commitment to like, it’s got to be entertaining and empowering and useful because otherwise you’re not coming back. Nobody wants to sign up to like want to crawl under their mattress for the rest of their lives and listen to that again.
Tori Dunlap:
Some people who listen to the show do, but that’s okay. We try to not keep it that way because every show, every episode, I feel like we get to a point where we’re just like, “Fucking capitalism.” Okay. So if you’re evaluating a job for its health insurance, what coverage or what things am I looking for? Put yourself in 22-year-old Dan’s shoes. The first time he had a job, I’ll put myself 22-year-old Tori. What should I be looking for? What do these numbers mean? What is all of this?
Dan Weissmann:
Well, I mean, the first… if I’m really 22, then I’m evaluating them against my parents’ health insurance and what they could cover.
Tori Dunlap:
Yeah, valid. Very true.
Dan Weissmann:
Till I’m 26.
Tori Dunlap:
So late 20s. 28. 27, 28.
Dan Weissmann:
It’s kind of the Logan’s run scenario. You turn 26 and now it’s all you. Yeah. I mean, it depends on you. Some people are like, “I’m type one diabetic,” or, “I’m bipolar,” or, “I have other things that just require ongoing treatment, ongoing access to specialists. I can’t have my life without these things.” So you’re looking for like, okay, what am I getting? And similarly, there’s certain medicines that I take. I got to have them. Then you are going to HR and you’re saying, “I need to see the policy and I need to see the drug formulary.” This is a very long PDF that lists all the drugs out there and for each drug, each drug is placed on a tier. You just like tier one, two, three, four, and then there’s often a tier called specialty for things that are super expensive.
And it’ll tell you like, this drug’s tier one, you pay five bucks. This drug’s tier two, you pay 20 bucks. This drug’s tier three, you pay 50 bucks. And again, the numbers vary depending on your policy. This drug, you pay 50% of whatever it is and whatever it is can be thousands of dollars. This drug is off formulary for us. We don’t cover it. So you got to get that formulary and you got to hit control F and find your drugs. And you got to do that for every policy that’s available to you. So that’s probably number one. And then yeah, you’re looking at like, again, what’s a normal year look like for me? It’s all this process. What does it look like for me? I’m going to maybe go to the doctor once next year to get a checkup because my mom bugs me and I’m going to go to the dermatologist, get a skin check because my mom bugs me and that’s it. That’s it. That’s me. I’m a 26-year-old marathon runner. I’m all good. Other people, not so much. So it’s just going to completely depend on you.
Tori Dunlap:
When you first are interviewing for a job and they’re like, you get an offer, are you having those conversations with HR? Are you like, “Can I see the healthcare plans?”
Dan Weissmann:
Me personally? Man-
Tori Dunlap:
Or just, should somebody-
Dan Weissmann:
That’s anawesome idea.
Tori Dunlap:
I’m trying to think about, again, you’re getting the benefits and it’s like, okay, you get a 401k maybe, or you get this. And it’s like 85% healthcare coverage premium, which I think what we offer at Her First $100K, the company’s going to cover 85% of that. What does that mean for somebody in very basic layman terms?
Dan Weissmann:
Basically, I mean, I looked this up this morning, the last time this got documented was coming up on a year ago. Employer health insurance for a single person is like $9,000. For family, it’s like $25,000. So it’s like 85% of that. That’s money out of your pocket, but it’s also like, yeah, what does it look like? I mean, I’d say you want to get as much information as you can as soon as you can. If you know somebody… I mean, and again, it depends on you and you’ll know it. If you are a person who has essentially a chronic health condition where you need access to specialists, you need access to certain medicines, you don’t need me to tell you this. You know this. You may have chosen your career based on the idea that I got to be in a job that’s going to make it possible for me to live my life.
So I think it’s individual, but as I’ve learned… And so I think then you may be thinking about these benefits more in the question of like, hit by a bus or get pregnant or have a baby, have a big unexpected expense. What’s the kind of downside risk of any given plan? Rather than like, what’s it going to do for me?
Tori Dunlap:
I mean, I think I can give the advice that you want your employer to cover as much as possible. That is a really, really great benefit. So if you are looking, one, do they offer health insurance at all? A lot of companies don’t. I think if you’re doing full-time work, that should be a requirement that you have, that your company offers you health insurance. I think the second thing is figuring out when is that health insurance going to kick in? Because a lot of places say, “Well, you can get health insurance, but after you’ve worked here for three months or six months or even a year, you can’t get health insurance from us.”
Dan Weissmann:
Really? That’s still a thing? They can make you wait a year?
Tori Dunlap:
It’s not as much anymore, but I have seen it and I’ve gotten questions about it. I think it’s less common now because people know it’s insane, but they’re doing that so if the job doesn’t work out, they haven’t paid health insurance for you for a period of time. And then I think the last thing, again, speaking as an employer, it’s how much are we going to cover versus how much we expect you to cover? A more candidate or employee friendly job is going to have… The company’s going to cover more of that premium. So again, for Her First $100K, I think we’re at 85%. We cover 85%. That’s a pretty liberal, generous policy. That’s hopefully what you’re looking for. And if you’re not at 85 or above, just be aware of that. It’s not like I’ve taken jobs that we’re not covering that much, but it’s just something to know.
Dan Weissmann:
I mean, I think of this a little differently, although I totally agree with what you’re saying. I think of it as like, well, this is all money, this is all cash. And what’s the premium on that health benefit? I mean, the thing that I think about with this is even if you have the most generous benefit in the world and your employer is paying that $25,000 to cover your family, that’s money your employer could be paying you. I mean, that’s just cash on their budget line for you. And in a world where we didn’t have this kind of horrible inflation in healthcare costs, because the cost of everything goes up, the price of everything goes up every year, and insurance premiums go up to reflect that. And if we weren’t living in this world that was so enragingly, so outrageously expensive and continues to get more expensive, we wouldn’t have to think about this.
Again, there was a story just last week about, we surveyed employers and we think they’re expecting this to be the rate of increase in their premiums and like 50% or 51% are saying like, “Our employees are going to have to take on some of that.” But it’s all just dollars. It’s all just dollars and it’s all going to… Even those of us who are in jobs where it feels like our employer takes care of us, like we don’t have to worry about this big system, it’s money out of our pockets. If our employer’s paying $25,000 for that, what would you do with $25,000? Because that number was below $20,000 not that long ago and it was below $15,000, not that long ago. What would you do with that extra $10,000?
Tori Dunlap:
It’s an interesting frame of reference because for me, I’m like, both as an now employer, but also as an employee, I’m like, I am okay getting a benefit as part of my total compensation package where I don’t have to worry about researching that benefit and the coverage and wondering if. I think one of the biggest reasons it took me so long to be my own boss and to be an entrepreneur full-time is because I had both my parents in one ear and the system and the other going like, “You need health insurance. You need health insurance.” That was a huge barrier to me making the right financial decision, which was quit my job, make as much money as possible, do impact driven work. But the health insurance thing was the reason, one of only two other reasons that I was like, “I don’t think I can do this.” It was just-
Dan Weissmann:
What were the other reasons?
Tori Dunlap:
Oh God. I mean, what if I fail? It’s like more the psychological shit, but I think that that’s a larger conversation about how we largely have tied in this country health insurance to employment. It’s like those two are pretty inextricably linked. Obamacare has helped a ton with that, right? But again, we have people in office now who want to get rid of that so badly and who are trying, it seems like every day to get rid of it. Most of other countries do not operate this way. It is not, you make money, you have employment, you get health insurance. So I think that that is one of many problems we’re talking about here where it’s like, it’s not a basic human right. It must be earned. It must be…
Dan Weissmann:
And it’s got to come with your job and it creates problems for employers. I mean, you’re on the employer side now.
Tori Dunlap:
Oh, it’s very complicated. It’s very complicated. And my COO is largely in charge of it. I don’t even touch it as much. And it’s so complicated and it’s very expensive for us to offer, but we offer it because it’s the right thing to do. Yeah.
Dan Weissmann:
And you’re investing a lot of your staff time, a lot of your COO’s time. I imagine she’s not… I hope she’s not badly paid. You’re investing a lot of-
Tori Dunlap:
She’s not.
Dan Weissmann:
… time and labor that you’re paying for in learning. I’m like, your parents and the world were telling you, “Well, you need health insurance.” I’m going to say they maybe weren’t wrong because you needed to have a kind of head of steam under you before you were ready to do what you’re doing now, which is like, you’re now responsible for essentially sitting down at that table at the World Series of Poker and negotiating with United Health Group and Cigna and Aetna and trying to figure out which of them is the least worst deal for you and the people you care and work with.
Tori Dunlap:
I know. So I have so many more practical questions for you and maybe we can do kind of a rapid fire.
So little rapid fire. Are there red flags or common billing errors patients should double check for?
Dan Weissmann:
Ooh, double check everything you get from any medical encounter, double check everything. I mean, anything that looks high to you, double check it. Even if it doesn’t look that high and you go, “I guess.” Double check it. Ask them. You can always ask for an itemized bill. Sometimes you can call it the super bill that has codes on it. And the first thing you do is just reality check it like, “Hey, I didn’t get an MRI. What are you talking about? I was there. That didn’t happen.” That happens a lot.
The estimates, there’s no real number, but people who do this estimate, like half or more of medical bills have errors on them this year. And similarly, do they run it through my insurance? My colleague, Claire, was working with her roommate who broke her arm and got settled with $14,000 in medical bills. And the biggest one, 10,000 bucks, she just did the due diligence and turned out like, “Oh yeah, I don’t have an insurance statement for that one.” And she called the billing department. They’re like, “Oh yeah, we never billed your insurance. We’ll do that now.”
Tori Dunlap:
Great. I do feel like that one’s super common of, “Yeah, we didn’t bill your insurance,” or something happened. And then the other one, which I was talking about at the top was it was a routine procedure or a routine annual checkup and they didn’t cover it. I’ve also heard that if you ask questions, like let’s say I’m going to my GP for a general checkup and I start asking very specialized questions, they can charge you differently. So just be aware of that. Okay.
Dan Weissmann:
True story. Don’t let it stop you from asking the questions you need to ask, but yeah, true story.
Tori Dunlap:
So many listeners are feeling powerless when they get that massive medical bill. What steps can someone take to challenge that bill or think about paying it in a way that’s more sustainable for them?
Dan Weissmann:
Absolutely. So two things. We just talked about one of them. Reality check it. Did this happen? Did they charge your insurance? That happens all the time. Second, if the biller is a hospital, see if you might be eligible for charity care, also called financial assistance, but it’s important to look for it as charity care. Nonprofit hospitals in the United States are legally required to offer charity care, which is to say we’ll cut your bill or forgive it entirely if you hit a certain income threshold, if your income is below a certain threshold. A very common threshold is like 300% of the federal poverty line, which is like, it turns out something like 60% of Americans have incomes below that amount, which say most of us. And depending on where you live, like I talked to a listener in New York City where the hospital she went to, the threshold was 600% of the federal poverty line, which makes sense.
New York is a crazily expensive city. So those policies are generally public. You can look it up. But you can also go to a website from a group called Dollar Four and they’re fantastic. They’ve educated me about charity care and they have built into their website. They’ve collected the charity care policies of like every hospital in the country. And by the way, for profit hospitals are not required to offer charity care, but most of them do. Maybe even all of them do. And you can plug in to their website. This is where I live. This is the institution where I was seen. This is my income. This is how many people live in my household and hit a button and it’ll be like, “We think you qualify for charity care at this institution. Here’s a link to how you apply. We can help you.” They did an estimate a year or two ago, just trying to add up how much charity care hospitals could give away that they don’t, but that their policies say people are eligible for.
And this is essentially using their own calculations, using their own, because they’re required to report to the federal government like, “Hey, how many bills did we write off last year and how much of that money could have been forgiven through charity care?”
Tori Dunlap:
And I’m scared.
Dan Weissmann:
And the answer conservatively, based on hospital’s own estimates, was $14 billion a year.
Tori Dunlap:
So see if you apply for charity care. See if you… Yeah.
Dan Weissmann:
See if you qualify for charity care. Because so many of us do. So many of us do. And as I’ve learned from Jared Walker and the folks at Dollar Four, if you’re on the edge or you missed a deadline or something else, don’t write yourself off. Make the call-
Tori Dunlap:
Call. Always call.
Dan Weissmann:
… find out, write a letter, make your case, tell your story. People don’t. And similarly, if your insurance is denying something that you need, appeal, because most people do not. And a surprising number, although I mean, appealing and insurance now can be the worst and their reflexes say no and you have to work your web and it’s a giant job. A good number of people win those appeals. So basically don’t take no for an answer. Don’t take like, “This is it for you,” for an answer. I talked with a guy, we were looking at how to pay less for prescription drugs. And I had one guy who was like, “Yeah, you want to take, when your insurance company says, ‘We’re not covering this,” or, ‘We need you to do what’s called step therapy to test out these other drugs you’ve already tried that don’t work for you,’ or whatever, think of all those as suggestions rather than a straight to no. Think of it as like, ‘That’s our opening offer.'” And I really like that way of looking at it.
Tori Dunlap:
Yeah. Yeah. I’ll echo that. Call about everything. And even if you don’t qualify for… Remind me the name of it.
Dan Weissmann:
Charity care.
Tori Dunlap:
Thank you. Even if you don’t qualify for that, even just saying, “I’m going through a financially difficult time. Is there anything you can do for me?” They have so many things they can do for you. The other tip I have is that if you do have financial flexibility to pay a bill, like I remember getting my wisdom teeth out and I did not do my research and did not realize that the dentist I chose was out of pocket or out of network. And so it was $1,400 and I was like 24 and that was so much fucking money. So what you can do is you can say, “Hey, I can pay this entire bill in full right now, but you’re going to discount it for me.” Because they don’t know if you might default on that or might only make four out of eight payments. So they would rather take bird in hand. So if you can say, “Yep, I can pay $1,000 right now.”
Dan Weissmann:
100%.
Tori Dunlap:
They will often take that.
Dan Weissmann:
100%.
Tori Dunlap:
So you mentioned saving money on prescriptions. Especially if insurance doesn’t cover them well, what are some ways we can save?
Dan Weissmann:
Oh boy. So we asked our listeners this year, like we’ve talked to experts, we know some things, tell us what you know. And what I came away with was like a playbook almost of what you can do. You show up at the pharmacy and they’re like, “That’s going to be 500 bucks.” And I’m like, “All right, what are some moves that I got here?” And there’s the easy ones, the quick ones anyway, and the longer term, dig in for a struggle. The easy ones go like this, like you’re at the pharmacy and they’re like, “That’s going to be 500 bucks.” “Oh, what if I paid cash?” Or, “Is there a coupon from the manufacturer?” And then you’re like, “Can you hang on a second?” And you pull up your phone and you pull up GoodRx and there’s a couple of competitor sites and you’re like, “Can I just get this for less someplace else paying cash outside of my insurance?” And if the answer to those is yes, then okay, cool, great.
If that’s going to solve your problem that day, and there’s no guarantees with any of this, but a lot of the times one of those things is going to work, right? So you can do it right there at the pharmacy counter. If not, well, now you’re going to have some questions. One of them is like, “Oh, this inhaler is 500 bucks. Is there another inhaler I could use for my condition that I could get for less?” And then you’re going to want to think about whether… And you ask the pharmacist, but if you can get somebody at your provider’s office on hold on the phone, you do like, “Okay, is this one going to work for me? Can I do this?” So then you kind of investigate because your insurance company may well be like, “We don’t like that one. We make less money when you get it. We prefer you take this one.”
If this one is fine for you, great. If not, now you’re in this other territory where you’re going to be calling your provider and saying, “Okay, help me appeal this. You and me, we think it’s medically necessary for me to get this one. We’re going to be fighting with the insurance company. Let’s gear it up,” and you can have some resources for them. And this is one of the things I learned from a listener who’s a pharma sales rep. He was like, “While you’re doing that, ask your doctor, ‘Hey, any chance you have any samples of this medication that I can use while we’re having this fight?'” I was like, “That is wild.” I mean, drug reps and free samples have not great reputations in many ways. The opioid crisis is a reason, was largely driven by those kind of samples and by aggressive sales tactics, but this made sense to me.
A lot of doctor’s offices and hospital systems don’t even allow their physicians to talk to drug reps, but they could go online and be like, “Can somebody drop off some doses of this, some samples of this drug for my office for this patient?” So I was like, “That’s really smart.” One listener took the also important to know about, built a spreadsheet, clocked like this is the price from GoodRx at various pharmacies near me. There was a couple other competitors, this is the price from them. Mark Cuban’s Cost Plus Drugs is a site that will sell most generic medications for super cheap, you pay like a $5 processing fee. But for sometimes a drug that your insurance says is going to cost you 50 bucks, you could get for like $5, worth checking. He put that on his spreadsheet.
There are Canadian pharmacies that will ship to the US and that will take orders online. There are also a lot of people operating websites that say, “I’m a Canadian pharmacy and we’ll ship to the US.” You don’t want to go to any of those. So there’s a website called Pharmacy Checker that actually presents you only actual pharmacies in Canada-
Tori Dunlap:
Legit.
Dan Weissmann:
… and what prices they charge for your meds. So those are all kind of routes to take. We took that listener spreadsheet and adapted it and kind of like amped it up a little bit and you can download it from our site and adapt it to your needs to check about like Mark Cuban and Canada and GoodRx and several of their competitors. I mean, it’s a real homework assignment and not everybody’s like, “Oh, sure, a spreadsheet. I use those every day.” Up until a certain point in my life, I was one of the people who’s like, “That sounds scary.” But ours is not so bad and it’s probably a good… If you’re trying to build wealth in your life, it’s not a bad skill to have.
Tori Dunlap:
Yeah. We’ll link it in the description. That’s great.
Dan Weissmann:
Thank you.
Tori Dunlap:
We’ve partnered with GoodRx before and it’s kind of incredible how much you can save on just the things you need. Just checking to see if you can get a different pharmacy or a different… The not name brand medication, but the exact same thing. Okay. My last question for you, how can people advocate for themselves in the doctor’s office, both for the right care, but also for clarity on costs and what sort of questions should we be asking before we agree to anything? This test, this procedure, this prescription, how do we advocate for ourselves there?
Dan Weissmann:
Yeah. This is big and it’s a little bit beyond my pay rate, but I do know a couple things I can say. One is come prepared, have your list. These are my questions. Write them out in advance. Talk to them, talk about them with a friend or a loved one so that you really have your list and bring them in writing. And when you see the doctor, the first thing you say is like, “Hey, doc, you and me are a team. I want to make sure we do the best job we can. I got all these questions for you.” Which hopefully your provider will appreciate, right? I mean, you’re coming in. I mean, there’s all kinds of people in this world and some of them are doctors, and so you just don’t know what you’re going to get, but you want someone who’s going to answer your questions and make sure you get your questions answered. And about things that they recommend, I think that’s really complicated.
A doctor recommends a procedure, I think a reasonable thing to say is, depending on how serious the procedure is, how big a deal, it’s like, “Hey, thanks. Tell me about information. Tell me about what’s the latest literature on this and give me a minute. I may go seek out another opinion. This sounds like a significant decision.” Questions about anything they want to do for you. I mean, you can ask them. If they were like, “I’m going to do this procedure.” There’s all kinds of questions. “How many times have you done it?” If you’re concerned about, are they the right person to do this for you? That could also lead to a question about, well, if they do this all the time, is it a business model to churn people through that procedure? Ask good questions. Don’t commit to anything. Like anything else, don’t get sold anything in the first conversation.
Tori Dunlap:
Yeah, you can always get a second opinion, especially if it’s something big, something more serious. You should get a second and maybe even a third opinion. Okay. I lied. Last question for you. If someone is uninsured or underinsured, what options do they realistically have for accessing care without going broke?
Dan Weissmann:
Yeah. I mean, one thing about charity care programs at hospitals, I’ll do this again, is that you can apply to be part of that program before you go get seen…
Tori Dunlap:
That’s great.
Dan Weissmann:
… in many cases. So then you become a kind of certified patient there. Then you’re not getting bills for gajillions of dollars and calling somebody to ask, “How do we knock this down?” You know what you’re getting into upfront and they know who you are. So that I think is the best situation. There are places, there are community clinics like some called federally qualified health centers, some of which are terrific. And they offer care on a sliding scale basis. They see everybody without insurance and their commitment is that care is affordable to people. So if there’s one near you, there are search engines where you can find that out, like see what’s available. So I think those would be my top two, like the fastest things. Is there a hospital or hospital system where you qualify for their charity care program? Because they probably also run a lot of doctor’s offices. You can probably do most of your care in that system.
Tori Dunlap:
Yeah. Dan, thank you for all of this. Plug away. Where can people listen to the show? Give us your resources.
Dan Weissmann:
Thank you so much. Thank you so much. The show is An Arm and a Leg. You can listen to wherever you get podcasts. You can find our website. Our website is armandalegshow.com. And there, you can also find installments of our newsletter, which is called First Aid Kit, which is our best tips for surviving the health system financially. Basically, after a few years, people were like, “Hey, that’s really good advice. I don’t have a pencil with me while I’m driving to work or doing the dishes. Could you write that down someplace?” So this is our attempt to do that. All those archives are on our website. And we’ve recently, because we were able to remake our website, started creating what we call starter packs that answer specific questions like, “Help. I got a giant medical bill. What now?” Or, “Help. Insurance denied my claim.” And we’ve curated collections of our reporting that are our best answers to those questions.
So that’s our stuff. We’re armandelegshow.com. Our handle is Arm and a Leg Show on most social media platforms. So you can find us there. But yeah, the podcast and the newsletter are main thing. Everything’s free. We don’t charge anybody for anything because this is information everybody needs.
And we are powered by listener donations. So our goal is to do the most good for the most people. And what we found is a certain percentage of people will be like, “I’m really glad you’re doing this. Yes, I will support it.” Our business model and our mission are exactly the same. We reach more people. We help more people. More people are there to say like, “Yeah, I want to help out with that.” So yeah.
Tori Dunlap:
And I know people are going to have more questions because again, this is such a personalized experience. I know that there’s going to be people out here who are like, “Why didn’t you talk about this? Or how did you get to here?” And it’s like, there’s a literally entire show and platform for this because it is so complicated. We can’t cover it all in an episode. So I think those starter packs are going to be really helpful for people. Thank you so much for being here.
Dan Weissmann:
Thank you so much for having me.
Tori Dunlap:
Thank you so much to Dan for joining us. You can check out his podcast, An Arm and a Leg wherever you get your podcasts, especially if you need more information. It’s hard to take the entire American healthcare system and just digest it and do one episode, especially when there’s so many different healthcare costs and different healthcare needs. So his podcast is a great resource for you, especially as we navigate all of the upcoming changes. We’ve also linked some of the resources that Dan mentioned below, and you can go to herfirst100k.com/ffpod to get even more of our resources. We have free guides, we have free workshops, we have debt payoff challenges. We also have our show notes that have even more resources and guides. So again, herfirst100k.com/ffpod. Thank you so much for joining us, Financial Feminist. We appreciate you being here. We appreciate your support of feminist media and we’ll see you back here soon. Bye.
Thank you for listening to Financial Feminist a Her First $100K podcast. For more information about Financial Feminist, Her First $100K, our guests and episode show notes, visit financialfeministpodcast.com. If you’re confused about your personal finances and you’re wondering where to start, go to herfirst100k.com/quiz for a free personalized money plan.
Financial Feminist is hosted by me, Tori Dunlap. Produced by Kristen Fields and Tamisha Grant. Research by Sarah Sciortino. Audio and video engineering by Alyssa Midcalf. Marketing and Operations by Karina Patel and Amanda Leffew. Special thanks to our team at Her First 100K, Kailyn Sprinkle, Masha Bakhmetyeva, Sasha Bonar, Rae Wong, Elizabeth McCumber, Daryl Ann Ingman, Shelby Duclos, Meghan Walker, and Jess Hawks. Promotional graphics by Mary Stratton, photography by Sarah Wolfe, and theme music by Jonah Cohen Sound. A huge thanks to the entire Her First 100K community for supporting our show.
Tori Dunlap
Tori Dunlap is an internationally-recognized money and career expert. After saving $100,000 at age 25, Tori quit her corporate job in marketing and founded Her First $100K to fight financial inequality by giving women actionable resources to better their money. She has helped over five million women negotiate salaries, pay off debt, build savings, and invest.
Tori’s work has been featured on Good Morning America, the New York Times, BBC, TIME, PEOPLE, CNN, New York Magazine, Forbes, CNBC, BuzzFeed, and more.
With a dedicated following of over 2.1 million on Instagram and 2.4 million on TikTok —and multiple instances of her story going viral—Tori’s unique take on financial advice has made her the go-to voice for ambitious millennial women. CNBC called Tori “the voice of financial confidence for women.”
An honors graduate of the University of Portland, Tori currently lives in Seattle, where she enjoys eating fried chicken, going to barre classes, and attempting to naturally work John Mulaney bits into conversation.
