How Benefits Advisors Can Help Employees Avoid Medical Debt and Bankruptcy | EBA

Bankruptcy? What is bankruptcy?

That’s what came to mind when my parents sat me down at 17 and told me they had just filed for bankruptcy because my dad’s medical bills were too much to handle.

“But, you both have jobs. You both have health insurance. How could this happen?”

As a teenager, I was so confused. My parents both had jobs and health insurance. How could this happen? My mind was spinning: What am I going to tell my friends? And the baseball camp? summer? And a limo for the ball?

Come to think of it, it was all trivial. I can’t even imagine how ashamed, embarrassed and heartbroken my parents felt that day to have to tell me, fully admitting financial defeat.

In a article I wrote for EBN in April, I explained that a single drug called Revlimid was the cause of my parents’ financial problems. My dad had multiple myeloma, bone marrow cancer, and that’s the medicine the doctors gave him to keep it at bay. My parents were financially ruined trying to keep him alive.

Read more:How data can bring clarity to health plan management

Their experience is not unique. We all know that the choice between drugs and food is a reality for far too many Americans. Knowing what I know now, most of these painful scenarios can be avoided.

There are Manufacturer/Patient Assistance Programs (commonly referred to as MAPs or PAPs) available to prevent some of these difficult financial outcomes. Today, Revlimid has one that a significant number of Americans would qualify for.

For example, the MAP of a drug has the following criteria:

  1. You must be a US citizen.
  2. You cannot be on another government-sponsored health program (eg, Medicare or Medicaid).
  3. A family of four can earn close to $150,000 a year.

Advisors, I ask you, how many of your clients’ health plan members would be eligible for this program?
Tools like these are available to employees if their employer has a self-insured health plan that uses transparency as a core element. These types of programs are great for employees and the employer sponsoring the health plan, but they take money away from “status quo” players like big insurance companies and their drug benefit management partners.

Read more: Embracing J-codes: how to navigate this class of drugs to save money and improve patient care

Which brings us to the point of this article: Be proud. Do more. Impact lives.

If you answer the question “What do you do for a living?” with “I sell insurance…”, you sell your potential and your impact short.

These programs, and others like them, can be an important key to your new job title: Lives Impactor.

All it takes is advisers to stand up against a failing system and guide employers towards a method that will not only improve their bottom line, but also allow them to make a massive positive change in the quality and cost of health care. As advisors, we can help employers reduce costs, improve quality of care, reduce copayments and deductibles, and make prescription drugs more accessible and affordable.

The road is right in front of you, but only if you change your mindset and explore options outside of the traditional insurance plans you’ve accepted as your go-to solutions.

Ask yourself these questions:

  1. Do I have the ability to reduce health plan costs for my clients? What have the costs looked like for the past three years for my clients?
  2. Am I creating health insurance plans that help employees and their families navigate the healthcare system to get the best quality?
  3. Would I stay with my personal financial advisor if they lost me the same amount of money year after year as the results I bring to my clients?

If you answered “no” to these questions, why are you doing what you are doing?
If we keep doing things the same way, we admit defeat. We admit we can’t do better. We expose employees and their families to health and financial risks, and we limit the impact employers can have on the world. Let’s take out of the equation the pain and suffering that my family and thousands of others face every year (67% of annual bankruptcies due to health care debt).

Read more: For clients, benefits advisors can play the role of superheroes

It is essential that employers take back control of their health care expenses and only you can do this for them and their employees. It may be more difficult to come up with a new solution, but in doing so, everyone wins. You love your job again because you know you’re advising (selling) a plan that isn’t going to cause an employee to spend thousands in premiums on a plan that has them spending $5,000 to $10,000 in deductibles before they get coverage on a serious illness or procedure, which opens the door to financial ruin.

You save your clients hundreds of thousands or even millions each year by avoiding premium increases. You are also enabling them all to be better informed and to have more choices in their health care. Employees are happier, healthier and less at risk, employers have a significant competitive advantage in talent acquisition and retention, and you are the hero – an impactor on lives.

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