『Bill of Health』のカバーアート

Bill of Health

Bill of Health

著者： Core360 Benefits Group
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10月19日まで。※適用条件あり
The podcast designed to help everyday Americans make smarter healthcare and financial decisions. I’m your host, Bill Fi, The Health Insurance Guy.2026 個人ファイナンス 経済学 衛生・健康的な生活 身体的病い・疾患
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  • Health Insurance Isn’t Your Only Option — The Health Share Alternative (Bill of Health Ep.7)

    Health Insurance Isn’t Your Only Option — The Health Share Alternative (Bill of Health Ep.7)
    2026/09/21
    Healthcare keeps getting more expensive. Premiums rise, deductibles increase and many families feel like they are paying more every year without getting a better healthcare experience in return. In this episode of the Bill of Health Podcast, presented by Core 360 Benefits Group, I’m joined by Richard Walton, CEBS, of Sedera to talk about an alternative that still flies under the radar for many consumers: medical cost sharing. Richard spent years working in traditional employee benefits before moving into the health share space. We talk about what a health share actually is, how it differs from traditional health insurance and why consumers frustrated with the current system are beginning to look outside the insurance model for other options. We also get into the role of cash-pay healthcare and direct primary care, why health shares are designed primarily around larger and unexpected medical needs, and what families, self-employed individuals and employers should consider before deciding whether the model fits them. Health shares are not insurance, and they are not the right solution for everyone. The goal of this conversation is to understand how the model works so you can make a more informed decision about your healthcare. In This Episode of Bill of Health: Richard and I discuss: • What a health share is and how medical cost sharing works• Why health shares are different from traditional health insurance• Common misconceptions about health sharing and why due diligence matters• How becoming a cash-pay patient can change the way you shop for healthcare• Why direct primary care and health sharing can work well together• How health shares may fit freelancers, families and self-employed individuals• What to consider before deciding whether a health share is right for you What Is a Health Share? A health share is a community of members who voluntarily contribute money to help with eligible medical needs according to established sharing guidelines. Instead of paying premiums to a traditional insurance company, members contribute to a medical cost-sharing community. That community then helps members with eligible larger and unexpected healthcare expenses. The distinction is important: medical cost sharing is not health insurance, and sharing is governed by the organization’s membership guidelines. Healthcare Without the Traditional Insurance Model One of the biggest differences is how consumers interact with healthcare. Traditional health insurance often places a third party between the patient and the provider. Health share members generally operate more like cash-pay patients, which can encourage them to ask what something costs, compare options and make decisions based on value. That does not mean consumers have to navigate everything alone. Health shares can provide tools and support to help members understand pricing and manage medical expenses. Direct Primary Care + Health Sharing Richard describes direct primary care as a natural complement to medical cost sharing. Routine and predictable healthcare can often be handled through a direct relationship with a primary care provider, while the health share is designed to help with larger and less predictable medical expenses. For consumers who are comfortable taking a more active role in their healthcare, combining the two can create a very different experience from a traditional insurance plan. Who Should Consider a Health Share? Health sharing may be worth exploring for self-employed individuals, freelancers, families facing expensive traditional coverage or employees looking at alternatives to their employer plan. It is not automatically the right choice simply because it may cost less. Preexisting conditions, membership guidelines and the way eligible medical needs are shared all need to be understood before making a decision. Richard’s advice is to compare the models side by side and determine what actually makes sense for your family, healthcare needs and budget. Jargon Jar: Initial Unshareable Amount An Initial Unshareable Amount, or IUA, is the amount a health share member is responsible for paying toward an eligible medical need before the community begins sharing expenses. It can sound similar to an insurance deductible, but the two should not be treated as interchangeable. How an IUA applies depends on the health share’s membership guidelines and structure. About Richard Walton Richard Walton, CEBS works with Sedera and has spent more than two decades in the employee benefits industry. His work focuses on medical cost sharing, direct primary care and alternative approaches to paying for healthcare. Connect with Richard: LinkedIn: Richard Walton, CEBSEmail: rwalton@sedera.comPhone: 806-679-0816Sedera: www.sedera.com Learn More Interested in exploring Sedera medical cost sharing through Core360 Benefits Group? Use the Core360 Sedera affiliate link: http://www.1enrollment.com/950517 To learn ...
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    26 分
  • What If Your Doctor Worked for You Instead of Your Insurance? (Bill of Health Ep.6)

    What If Your Doctor Worked for You Instead of Your Insurance? (Bill of Health Ep.6)
    2026/09/14
    Most of us are used to healthcare working one way: find a doctor who accepts your insurance, schedule an appointment, show your insurance card and hope the bill makes sense later. But direct primary care offers a very different model. In this episode of the Bill of Health Podcast, presented by Core 360 Benefits Group, I’m joined by Melinda Lacy, MSN, APRN, FNP-BC, of Direct Family Healthcare in Harrisonville, Missouri, to talk about how direct primary care works and why more patients and employers are paying attention to it. Direct primary care uses a membership model rather than traditional fee-for-service billing. Patients pay a predictable monthly fee for access to primary care, often with longer appointments, easier communication and more help navigating the cost of labs, imaging and other services. Melinda also shares real examples of how price transparency and cash-pay options can make a significant difference. In one case, a patient facing roughly $2,600–$2,700 for two MRIs was able to get them for about $1,400 by using a different imaging option. The goal isn’t to replace every part of the healthcare system. It’s to give patients another way to access primary care, understand their options and make decisions that fit both their health and their finances. In This Episode of Bill of Health: Melinda and I discuss: What direct primary care is and how it differs from traditional fee-for-service medicineWhy smaller patient panels can mean more time and access for patientsHow cash-pay pricing can lower the cost of labs, imaging and other healthcare servicesWhy you may be paying more through insurance than you would by asking for the cash priceHow direct primary care can benefit employers and their employeesWhy having a financial safety net for catastrophic medical expenses still matters How Direct Primary Care Works Direct primary care is built around a membership relationship between the patient and the healthcare provider. Rather than billing insurance for each primary care visit, patients generally pay a recurring membership fee. That model can give providers more time with patients and make same-day or next-day appointments, phone calls, texts and other communication easier to provide. Melinda’s current practice, Direct Family Healthcare, is based in Harrisonville, Missouri. Price Transparency Can Change the Equation One of the major advantages Melinda sees is the ability to help patients compare options before receiving care. A doctor may recommend the right test or procedure, but that does not necessarily mean the first location offered is the most affordable place to have it done. Independent imaging centers, cash-pay arrangements and other options can sometimes reduce the cost substantially without sacrificing the quality of care. Sometimes the most useful question a patient can ask is simply: What is the cash price? Direct Primary Care for Employers Employers are also beginning to work directly with primary care practices. Giving employees easier access to routine and preventive care can help people address health problems earlier, spend less time waiting for appointments and potentially avoid more expensive care later. For smaller employers especially, direct primary care can become another component of a broader employee health benefit strategy. Jargon Jar: What Is Prior Authorization? Prior authorization is the process in which an insurance company requires approval before it will cover certain medications, tests, imaging or treatments. That can mean a provider has to submit information and wait for the insurer to approve the service before the patient receives it. Because direct primary care operates outside traditional insurance billing for primary care, many of those insurance-related administrative hurdles do not apply to the services provided directly through the practice. About Melinda Lacy Melinda Lacy, MSN, APRN, FNP-BC, is a family nurse practitioner at Direct Family Healthcare in Harrisonville, Missouri. Her experience includes pediatrics, intensive care, case management, family practice and women’s health. Direct Family Healthcare directfamilyhealthcare.com Email: contact@directfamilyhealthcare.com Phone: 816-793-0071 105C W. Wall St., Harrisonville, MO 64701 Learn More To learn more about individual health insurance options, Medicare planning and healthcare consumer strategies—or to schedule a consultation—visit: www.core360benefitsgroup.com Subscribe to Bill of Health: Apple Podcasts: https://podcasts.apple.com/us/podcast/bill-of-health/id6794142312 Spotify: https://open.spotify.com/show/033USIRkymMFYmmTDDzyAi Facebook: https://www.facebook.com/people/Bill-Filer-MedicareHealthLife-Insurance-Core360-Benefits-Group/61568058486052/ LinkedIn: https://www.linkedin.com/in/billfiler/ TikTok: https://www.tiktok.com/@billfiinsuranceguy Be smart. Shop smart. Protect your wealth. Disclaimer This podcast is provided for educational purposes only and ...
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    27 分
  • You Don’t Need to Be a Healthcare Expert to Stop Overpaying (Bill of Health Ep.5)

    You Don’t Need to Be a Healthcare Expert to Stop Overpaying (Bill of Health Ep.5)
    2026/09/07
    Being a smarter healthcare consumer doesn’t mean earning a degree in medical billing, memorizing CPT codes or spending hours fighting with hospitals and insurance companies. It starts with asking a few better questions. In this episode of the Bill of Health Podcast, presented by Core 360 Benefits Group, I break down what I really mean when I talk about becoming a smarter healthcare consumer. For years, many of us have simply shown our insurance card, received care and hoped the bill wouldn’t be too painful. Changing that habit does not have to make healthcare another full-time job. Instead, becoming a smarter consumer can mean questioning the sticker price, comparing where you receive care, reviewing medical bills and knowing when resources are available to help you. In This Episode of Bill of Health: I discuss: What it actually means to be a smarter healthcare consumerWhy healthcare shopping doesn’t have to be complicatedWhy the first price you see may not be the price you ultimately payHow shopping around can help lower healthcare costsWhen medical bill advocates and negotiation services may be able to helpWhy cash-pay patients and health share members should understand their options Start With the Healthcare Sticker Price The price you initially see for healthcare may not be the final price. Cash-pay discounts, prompt-pay discounts and other negotiated pricing can sometimes change what you ultimately spend. The important first step is simply knowing that you can ask. The same applies to where you receive care. Your local hospital may be the most convenient option, but it may not always be the most affordable. Help Is Available for Large Medical Bills A five- or six-figure medical bill can feel impossible to deal with on your own. Healthcare advocacy and medical bill negotiation firms can help review bills for errors, duplicate charges and opportunities to negotiate costs. You do not have to become a medical billing expert yourself to become a better healthcare consumer. Jargon Jar: What Is a Chargemaster Rate? A chargemaster rate is essentially a hospital’s retail or sticker price. Think of it like a furniture store putting a $10,000 price tag on a chair even though negotiated buyers may pay significantly less. Insurance companies negotiate discounts from those prices, and cash-pay patients may also have opportunities to negotiate or access lower rates. The takeaway is simple: We don’t pay sticker. Learn More To learn more about individual health insurance options, Medicare planning and healthcare consumer strategies—or to schedule a consultation—visit: www.core360benefitsgroup.com For more practical healthcare tips, price-comparison strategies and consumer advocacy insights: Subscribe to Bill of Health: Apple Podcasts: https://podcasts.apple.com/us/podcast/bill-of-health/id6794142312 Spotify: https://open.spotify.com/show/033USIRkymMFYmmTDDzyAi Facebook: https://www.facebook.com/people/Bill-Filer-MedicareHealthLife-Insurance-Core360-Benefits-Group/61568058486052/ LinkedIn: https://www.linkedin.com/in/billfiler/ TikTok: https://www.tiktok.com/@billfiinsuranceguy Be smart. Shop smart. Protect your wealth. Disclaimer This podcast is provided for educational purposes only and should not be considered legal, tax, investment or insurance advice. Individual circumstances vary, and listeners should consult qualified professionals regarding their specific healthcare and financial situations. Opinions expressed by the host and guests do not necessarily reflect the views of any insurance carrier or affiliated organization. Chapters 00:00 What Is a Healthcare Consumer?00:45 You Don’t Need to Be a Healthcare Expert01:20 Why This Podcast Exists02:00 Healthcare Doesn’t Need to Become Another Job03:05 How to Become a Smarter Healthcare Consumer03:45 Don’t Automatically Pay the Sticker Price04:20 Start Shopping for Healthcare05:00 Getting Help With Major Medical Bills05:40 Health Shares and Cash-Pay Healthcare06:05 Jargon Jar: What Is a Chargemaster Rate?07:30 We Don’t Pay Sticker07:50 Simple Steps Can Make a Difference08:15 Subscribe and Follow Bill of Health The post You Don’t Need to Be a Healthcare Expert to Stop Overpaying (Bill of Health Ep.5) appeared first on Core360 Benefits Group.
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    9 分
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