How To Crush Medical Debt with Dr. Virgie Bright Ellington

Crushing Medical Debt! 🏥💸

Have you ever been overwhelmed by astronomical medical bills? You're not alone! Today's convo is with Dr. Virgie Bright Ellington, an expert on navigating medical debt, and she has some game-changing advice. 🩺🔍 

Medical bills are the leading cause of debt & bankruptcy in the U.S.—& they don't discriminate by age. If you're over 18, you're at risk. But guess what? Dr. Virgie says there's hope, & she's armed with 3 life-saving steps to tackle those bills! 💪📑 

Step 1: Get a REAL bill. Demand a copy with CPT codes, just like what’s sent to insurance companies. This helps avoid hidden fees & errors. 🚫🧾

Once you have the CPT codes, Step 2: Use AI or Google search to check what Medicare pays for them. These are typically most fair rates and your new benchmark. 🌐📊 

Step 3: Call the billing department with your new number & confidently say, "In my case, I am willing and able to pay [your total]." Trust me, this is negotiating on stealth mode! 😎📞 

Dr. Virgie also highlights incredible FREE resources, like the Patient Advocate Foundation, which can guide you through the medical bill maze. Consider them your financial ally! 🆓🤝 

Planning ahead is key! Can't afford traditional insurance? Look into accidental or critical illness coverage to protect against catastrophic costs. Some coverage is better than none. 🛡️📋 

Feeling anxious about medical costs & financial health? Bring a support person to appointments for a second set of ears, and reach out for help when negotiating or appealing insurance denials. You're not alone! 👫🗨️ 

Remember, knowledge is power. Question those big bills, use negotiation hacks, & don't hesitate to seek assistance. Your financial health is just as critical as your physical health. 💡💰 

Dive deeper and crush medical debt with Dr. Virgie by visiting CrushMedicalDebt.com or her podcast "Medical Bills Uncovered." 🎧💊 

For additional information about Kelly, check her out on Linkedin or www.SteadfastAgents.com.

To explore your options for long-term care insurance, click here.

Steadfast Care Planning podcast is made possible by Steadfast Insurance LLC,
Certification in Long Term Care, and AMADA Senior Care.

Come back next time for more helpful guidance!

Chapters

• 0:00 Intro
• 2:59 Hospital discharge dilemma
• 6:58 Request real bill with CPT codes
• 10:39 Negotiating medical bills without insurance
• 16:01 Medicare rate negotiation myths
• 18:58 Insurance appeal guidance tips
• 20:55 Young woman struggles with insulin costs
• 24:05 Bring support for medical visits
• 27:58 Hospital bills: explore financial aid
• 29:58 Resource limit misconception clarified

Transcript

Kelly Augspurger [00:00:02]:
Hi everyone. Welcome to Steadfast Care Planning, where we plan for care to live well. I'm Kelly Augspurger, long-term care insurance specialist and your guide. With me today is Dr. Virgie Bright Ellington, an internal medicine physician, medical billing expert, podcast host of "Medical Bills Uncovered," and author of "What Your Doctor Wants You to Know to Crush Medical Debt". Dr. Virgie, welcome. Thanks for being here.

Dr. Virgie Bright Ellington [00:00:27]:
Thank you so much for having me, Kelly. I'm excited to be here and talk with you.

Kelly Augspurger [00:00:31]:
Likewise. We are going to be talking about how to navigate medical bills and debt today. We know that this can be a serious problem for people in general, but I think especially older adults. So I'm really excited to learn from you, Dr. Virgie, to hear how people can navigate this and really be able to get a good handle on these medical bills. So can we jump right in?

Dr. Virgie Bright Ellington [00:00:51]:
Absolutely. And Kelly, you're reminding me of actually an important point, just as you're saying, we think that the myth is most of us think that medical bills are just like an old people problem. And the problem is, is that it's a huge problem. It's the number one cause of debt and bankruptcy in the United States. Medical bills are the most common cause of folks going into debt and declaring bankruptcy. If you are over the age of 18, you're at risk.

Kelly Augspurger [00:01:21]:
Yeah. And why are you so passionate about helping people crush this medical debt, Dr. Virgie? I know you have a story, so can you briefly share why you're so passionate about helping people with this?

Dr. Virgie Bright Ellington [00:01:32]:
Yeah, Kelly, I have a ton of stories. So I am happy to say I'm a two time breast cancer survivor and after my second breast cancer diagnosis, I had multiple surgeries and I didn't listen to my doctor's advice. I tell folks, always listen to your doctor's advice. And I was told no lifting. One of the surgeries I had was an abdominal surgery. And I thought, you know, he says no lifting more than like five pounds or something. And I thought, I said, "Well, you know, I have chickens."

Dr. Virgie Bright Ellington [00:02:03]:
And his response was, "What?" Rightfully so. Like looking at me like, I'm just...I said, "Yes, I have chickens and their feed comes in these big 35 pound bags and they have to eat. So, you know, I have to lift more than five pounds." He says, "Have someone decant the feed into five pound bags or five pound portions and don't lift more than that." And he walks away. You know, he was done with me, understandably. So I'm like, "Oh, whatever." So you know where this is going.

Dr. Virgie Bright Ellington [00:02:33]:
So I did it anyway. I did lifting. And the problem is, is when you have an abdominal surgery and you lift, the sutures can come apart, which is what happened. And the bile got caught in it and so I was rushed into emergency surgery. It was really scary and dangerous. And so that's the rule. I have many mottos, but one of them is, "Listen to your doc, folks."

Dr. Virgie Bright Ellington [00:02:53]:
So anyway, so I wake up and I have this really wonderful hospital roommate. And after the emergency surgery, we're talking and she's telling me that she's thinking about leaving the hospital against medical advice because the last time she had been here for the same issue, she had been in the hospital a year prior. Young mom, two very young children. And she says, "You know, the last time I was here, I got a huge bill that I just can't afford." She said, "You know, the day I was leaving, I'd been in for like a week. And this person comes in from the billing department and says, 'Before you can leave, you have to sign this agreement saying that you'll pay whatever your insurance doesn't pay.'" And so, Kelly, I tell this story all the time. It just, it was like the curtain literally dropped.

Dr. Virgie Bright Ellington [00:03:43]:
You know, something snapped in my little brain and I was instantly outraged because I knew she had been tricked, probably into paying something she probably didn't owe, but guaranteed what she couldn't afford. I'm pretty sure that she didn't owe that money. It sounds like she was tricked into signing an agreement to be balance billed. And we can talk about what that is later.

Kelly Augspurger [00:04:03]:
Okay.

Dr. Virgie Bright Ellington [00:04:03]:
So I thought, "You know what, Virgie, don't get mad, don't get angry, get to gettin', do something." And that's how "Crush Medical Debt" was born. So, you know, to get that information out.

Kelly Augspurger [00:04:20]:
That's right, because people don't know what they don't know. And so, you know, lay people, if you're not in the medical field, we have no idea how these systems work. The hospital system, the doctor system, it's so complex and it feels like convoluted that if you don't have someone that can speak truth and this is really how we need to handle the situation. You're not going to know and you're just going to pay the bill, or try to pay the bill.

Dr. Virgie Bright Ellington [00:04:43]:
Correct. Exactly. Folks living in the United States, we love our nurses and we appreciate our docs and we really try hard to pay our medical bills. And we assume, like you said, we trust that this is right. They would never send us a bill that's not correct. Well, folks, the thing is, is that the front office is very different than the back office, meaning the folks who are providing the care with you in the middle of the night and went to school to do all this just to take care of you, you would be outraged if they knew what was being done in their name. In terms of billing, going after folks by the back office, folks, they're two completely different separate universes.

Dr. Virgie Bright Ellington [00:05:23]:
And the docs don't know, and I would say the physicians, whether you're in a large hospital setting or if your doc is in a large medical group, even so, they don't know what's being billed in their name. I'd say 90% of docs don't.

Kelly Augspurger [00:05:39]:
Okay, so if someone does have medical debt, Dr. Virgie, how can people get out of that debt and hospital bills? And I know you have, 3 simple steps without going into bankruptcy. So what are those steps?

Dr. Virgie Bright Ellington [00:05:52]:
Number one is getting a real bill. So a lot of the foolishness that happens, these crazy, outrageous bills that get sent, you can just nip it in the bud, a lot of it, if you just ask for a real bill. And this is because a real bill, unfortunately, isn't sent to patients by most of the providers. Meaning when I say provider, I mean usually a hospital, sometimes a physician's office. And the bill that gets sent to if you have insurance is called a claim. A bill from a provider to the insurance company is called a claim. Is different than what gets, I would say 8 to 9 times out of 10 gets sent to a patient.

Dr. Virgie Bright Ellington [00:06:28]:
Because what gets sent to an insurance company for payment has CPT codes. CPT codes are to medical services what barcodes are to products in a retail store. So every medical service you can think of, every test procedure you can think of, has its own unique office visit, has its own unique CPT code. ER visit, emergency room visit. They all have unique CPT codes. Well, for some reason, 8 to 9 times...I know it's not for some reason, when we have to ask why, follow the money, right?

Kelly Augspurger [00:06:58]:
Yeah.

Dr. Virgie Bright Ellington [00:06:58]:
A real bill with CPT codes don't get sent 8 to 9 times out of 10 to the patient, which is outrageous. Why do they do it? Because they know that they can get away with it. So the number one step, the first thing to do that just cuts out a lot of craziness, is to call the provider's billing department and ask for, quote, something with CPT codes, unquote. This is the number one thing you can do. The second thing is once you get this real bill with CPT codes, and by the way, you'll see on the top of a bill, something like CPT or CPT slash HCPCS. HCPCS, which is a subtype of CPT code. Make sure it's not something like service code, because service codes have nothing to do with anything. They're just usually unique to that particular facility.

Kelly Augspurger [00:07:48]:
Okay.

Dr. Virgie Bright Ellington [00:07:48]:
So just be aware that a CPT code is something that's usually five digits, five numbers. Sometimes they'll start with a letter. So anyway, just make sure you're not getting tricked into...because I've seen patients getting. "I got the CPT codes. Look." And it's a service code, it's not a CPT code.

Kelly Augspurger [00:08:05]:
The wrong number.

Dr. Virgie Bright Ellington [00:08:06]:
Yeah, so once you get a real bill with CPT codes, you're going to take those CPT codes and do an AI search is what I do now. Google search. But it's much faster now to do an AI search to find out, number one, what's the definition of that CPT code and very importantly, what Medicare pays for that CPT code. Because what Medicare pays for CPT codes for medical services are the most fair, lowest retail rates that providers will accept in the United States. That's a place that you're going to say, "Okay, this is a more fair price to pay." Okay, so once you get that number, you're going to total up your new bill. And this is the new number that you're going to say, "Okay, this is where I'm going to start from."

Dr. Virgie Bright Ellington [00:08:50]:
This is a start closer to what I actually owe. And so that's step three. You're going to take that new number, that new total of the CPT codes, what Medicare pays for them. You're going to call back the provider's billing department and say, "Hey, yeah, you know that bill you sent me? I was there for an emergency hernia surgery. I know you asked for $10,000, but," quote, "in my case, I am willing and able to pay..." And this is hypothetical example, "$3,000," unquote. Now, I use this example a lot, Kelly. It sounds outrageous to say, you know, 3,000 down from 10,000.

Dr. Virgie Bright Ellington [00:09:25]:
The numbers really are that crazy in terms of the differences and what's actually...Yeah...

Kelly Augspurger [00:09:31]:
Oh, my goodness. So, Dr. Virgie, those Medicare numbers, when we're using AI or Google, does it matter, though, if a person's not on Medicare, like if they're under 65, does that come into play?

Dr. Virgie Bright Ellington [00:09:42]:
Excellent point. You know, people's eyes just glaze over. Usually when I tell them that, they're like, "Well, Medicare, I'm not old. I don't have Medicare. That doesn't apply to me." Yeah, you don't have to have Medicare to say, "I'm not going to overpay."

Kelly Augspurger [00:09:55]:
Okay, great.

Dr. Virgie Bright Ellington [00:09:57]:
And this is really important. Don't tell the billing person that you're talking to AI saying, "Well, I looked up the Medicare rate and blah, blah, blah." That's TMI. That's too much information. They don't need to know that. They don't need to know the number that you're starting with. You're negotiating from. This is automatically negotiating.

Dr. Virgie Bright Ellington [00:10:13]:
Without really negotiating. You're just saying, "In my case, I am willing and able to pay blank." Don't get into any conversations about insurance or Medicare or anything like that, because that gives them the opportunity to say, "Well, you don't have Medicare," or "We don't accept Medicare here."

Kelly Augspurger [00:10:30]:
Yeah. Wow. I had no idea that you could negotiate that much, Dr. Virgie, with some of these. This is really groundbreaking, I think, for people.

Dr. Virgie Bright Ellington [00:10:39]:
It drives me crazy because there are personal finance experts that are, like, on TikTok and, you know, Instagram and all that, and they say, "Oh, negotiate. Call them up and say, well, if I give you such and such for a $10,000 bill, if I give you $5,000, will you accept it?" Yeah, they'll accept it. And it's more than what you probably owe. So these 3 steps, Kelly, I also want to point out, applies to everyone definitely, if you don't have insurance. But even if you have insurance, because the average deductible, I think, is now up to $1,500, just say between $1,200 and $1,500. So every year, when the clock strikes, you know, when the bell drops or the ball drops, whatever. Most of us January 1st are officially uninsured. Most of us with deductibles are uninsured until we meet that deductible.

Kelly Augspurger [00:11:33]:
Sure.

Dr. Virgie Bright Ellington [00:11:33]:
And most of us will not meet our annual deductibles in an average year.

Kelly Augspurger [00:11:38]:
Yeah.

Dr. Virgie Bright Ellington [00:11:38]:
So you go to the billing office and say, "Hey, you know what? I'm paying cash." And don't let them tell you, "Oh, you have insurance. So you have to use your insurance." No, you don't. Now, if you choose to use insurance, the provider has to bill the insurance first before they bill you. But just in an average year, start out saying, "You know what? I had pneumonia. I found out that, you know, this cough wasn't going away, and I'm told that I had walking pneumonia."

Kelly Augspurger [00:12:06]:
Right?

Dr. Virgie Bright Ellington [00:12:06]:
Yeah.

Kelly Augspurger [00:12:07]:
Right.

Dr. Virgie Bright Ellington [00:12:07]:
You know what? Even in that case, you're probably not going to hit your...even if it went through the family and everybody in the family got, you know, walking pneumonia this year. You're probably not going to meet your deductible. So. So start out paying cash.

Kelly Augspurger [00:12:18]:
Yeah.

Dr. Virgie Bright Ellington [00:12:19]:
Great.

Kelly Augspurger [00:12:20]:
Great tip, Dr. Virgie. What about, with these CPT codes, what are some definitions that people need to know in order to catch some of these common CPT code and medical billing mistakes?

Dr. Virgie Bright Ellington [00:12:31]:
Yeah, Kelly, I feel like this is not your first rodeo. These are awesome questions. Thank you for pointing out these issues. So people think they have to know, like, memorize the CPT codes and know what they are. No, no one...there is like, almost...actually, last I looked, there was more than 300,000 CPT codes in the AMA.

Dr. Virgie Bright Ellington [00:12:49]:
Yeah, you can't memorize. And people, those of us who do this line of work. Yeah. We know some of them that are really common, but not...There's no way you're going to know them. What you're doing is making sure that what is described sounds like the care you received, the services you received. For instance, let's say that your kid falls out of the tree and goes into the emergency room and finds out that he has a fracture, his arm is broken. And so you guys were on vacation, and they made a phone call to an orthopedist who's closer to your town, to your home.

Dr. Virgie Bright Ellington [00:13:22]:
And you're gonna go there in 3 days and see the orthopedist and have the arm set, or actually have any intervention done there. Okay. So in the emergency room, the doc is going to just put the arm in a sling and send you on your way. You get a bill from that emergency room a month later, Kelly. And it says, humoral fracture intervention. The CPT code for that. I won't bore you with whatever it is. All right? In your mind, you're like, "He gave my kid a sling."

Dr. Virgie Bright Ellington [00:13:51]:
He put my kid's arm on a sling. What intervention was done? There was no intervention done. So it keeps you from being tricked into upcoding, what's called upcoding, overcharging up billing. So just making sure you're not getting duplicate billed. Or again, most common is upcharging. Just make sure it sounds like roughly the services that you think that you received.

Kelly Augspurger [00:14:13]:
Okay. And that's probably where Google and AI come into play?

Dr. Virgie Bright Ellington [00:14:16]:
Right.

Kelly Augspurger [00:14:16]:
And where they're really helpful, because you can just put in those codes and it's going to give you some definitions of what this means and what it is.

Dr. Virgie Bright Ellington [00:14:22]:
Exactly. And there's usually multiple different kinds of definitions, like pieces, phrases, that kind of thing. So just keep googling the number, or do an AI search of the number until it sounds like something that you understand and sounds like services you received.

Kelly Augspurger [00:14:37]:
Okay, well, let's say we have these billing mistakes. How can people effectively communicate with their doctor to fix it? But I'm assuming your answer is going to be, "Well, we're not going to be talking to the doctor.

Kelly Augspurger [00:14:47]:
We're going to be talking to the billing department."

Dr. Virgie Bright Ellington [00:14:49]:
Thank you, Kelly. Exactly correct. You got it. We're going to be talking to the billing department. The docs have no idea what's going on with what's being billed in their name, and they would be outraged if they knew you're only dealing with the billing department.

Kelly Augspurger [00:15:01]:
And give us that quotation again, the verbiage that you gave us a few minutes ago.

Dr. Virgie Bright Ellington [00:15:05]:
Oh, for?

Kelly Augspurger [00:15:06]:
To the billing department. Like if you were...

Dr. Virgie Bright Ellington [00:15:08]:
If you're calling to find out, to get a real bill.

Kelly Augspurger [00:15:11]:
Right. And then if you feel like there are mistakes, you know, "In my case, I believe..."

Dr. Virgie Bright Ellington [00:15:16]:
Yes, all right, so in my case, and there may not be mistakes, just, you know, what we're doing is automatically negotiating without negotiating, because it sounds very scary. We think we have to know medical terms or we have to have, like, an assertive personality or have a gift of gab or be like a lawyer to be able to advocate for ourselves. And what we're doing is just applying the system, the 3 steps. You're automatically negotiating without negotiating. So once you get the number of that step sounds right, meaning you've got the CPT code. So it sounds like the services you received and you've totaled up your new total, meaning what Medicare pays, then you're going to call back and you're going to say, quote, "In my case, I am willing and able to pay..blank." Unquote.

Dr. Virgie Bright Ellington [00:16:01]:
Now, people who do this work, there are several that say, "You know what, Medicare is such a low number...", many hospitals and facilities will say, "Well, you know what? If everybody only paid what Medicare pays, we couldn't stay in business." Well, actually, there was a study done a year ago that shows that that's really not true. We suspected it's really not true. And we got some data that shows it's not true. But for that reason, some folks who do this work, Kelly, will say, "Okay, we start our negotiations at two times Medicare rate." So they'll say, "In my case I'm willing and able to pay two times blank," you know, in their head. So if the number that I come up with, I use Medicare rate. So if I come up with a number $3,000, they'll start at $6,000 as an example.

Kelly Augspurger [00:16:42]:
Okay, well what happens if people, let's say they have private insurance, or Medicare, but then those insurance plans won't cover their medical costs and so they have to come out of pocket, whatever it is.

Dr. Virgie Bright Ellington [00:16:54]:
No, don't say that. No, it doesn't come out of pocket if they don't pay for it. And you go to your physician, that's when you talk with your doc, your physician and say they're not paying for this. If you and your physician felt it was medically necessary. Now it's different if the doc said, "Look, you know, insurance is not going to cover this, this is likely not covered because it's experimental or considered cosmetic." No, but if you and your doc said this is something that was really medically necessary, you're going to appeal that denial. And there are insurance companies, unfortunately, that have business models that count on just, they do automatic denials and they know that less than I think like the numbers, like 1% of people appealed the denials.

Dr. Virgie Bright Ellington [00:17:37]:
So it's a business model. So no, we're not going to just automatically pay it just because the insurance says no, we're going to appeal it. And the best way to do that is actually to call your doc. Think about it. They want to get paid. Right?

Kelly Augspurger [00:17:51]:
Of course, yeah, right.

Dr. Virgie Bright Ellington [00:17:52]:
There's multiple insurance companies and they have different policies and they do this all day, every day in a billing office or their billing manager or person say, "Look, I just talked to my insurance person" or you know, "I called the number on the back of my insurance card. I talked to the customer service rep and it was denied because of this. And the doc believes it is medically necessary." Can you...not can, I always say don't ask closed ended questions. It just gives people an opportunity to tell you "no" because if they're overwhelmed or don't know how to help you, they'll say, "No, can't help you."

Kelly Augspurger [00:18:24]:
Yeah, good point.

Dr. Virgie Bright Ellington [00:18:25]:
So open ended questions. What, how, where, why. "Who can I speak with who can help me write an appeal to the insurance company?" This is what they do. And the doc will say, "This is why it's medically necessary," and ask the doc to write the letter supporting your appeal. To the insurance company and your physicians or the provider, if it's a hospital office, billing office, will help you with that.

Kelly Augspurger [00:18:52]:
Wow, that's fantastic. So you don't have to do it yourself. You don't have to go to Google and figure out, "How do I write this appeal? What kind of verbiage is necessary?"

Dr. Virgie Bright Ellington [00:18:58]:
Yeah, with insurance, because the provider is also not getting paid. It's really easy for them, and this is what they do. If you tell them, "Look, I don't have the ability to write this appeal of this denial. Please help me with the information that I got." For instance, some of us will say, "You know what, I feel comfortable when I talk to the customer service rep at the insurance company for them to tell me why specifically it was denied." Usually it's not medically necessary or things like that. And then you can say, "Okay, well, what clinical policy?" Meaning if it's not medically necessary, they have a clinical policy to say why the particular diagnosis or CPT code wasn't applicable and why they're not covering it. If you're comfortable asking that, you can say when you call your billing office, you can say, "You know what, I talked to the insurance company.

Dr. Virgie Bright Ellington [00:19:45]:
They said it was not medically necessary based on this clinical policy or for this reason. Can you write the letter the appeal based on this information? This is what the insurance saying, why they're not covering it."

Kelly Augspurger [00:19:57]:
Okay. So really the point is there are people that can help with the appeal process. You just need to ask, right? You just need to ask your doctor or provider.

Dr. Virgie Bright Ellington [00:20:06]:
The billing office. Exactly. Your billers.

Kelly Augspurger [00:20:09]:
Yeah. Okay. And then what about free resources? I know that you've talked about, you know, there are free resources and strategies that are available to help people manage and overcome medical debt. So what are those resources?

Dr. Virgie Bright Ellington [00:20:21]:
I really love the Patient Advocate Foundation, which does all of this help for you for free. I mean, they'll do everything up to...Unfortunately, there are cases in which...Then there are states in which facilities are allowed to garnish wages of people or put liens on their homes, unfortunately. So they'll do everything in terms of help you except going to court with you that they can't do. But they can do all the things I talked about, like help with writing an appeal and that kind of thing. That's a great resource and it's free. PatientAdvocate.org I can't recommend them highly enough.

Kelly Augspurger [00:20:55]:
Great.

Dr. Virgie Bright Ellington [00:20:55]:
There's also this came up recently, Kelly, that it just really gets me upset. So on TikTok, this young lady, like in her 20s, just diagnosed with type 1 diabetes, can't afford her insulin. And she had a subsidy for like the federal marketplace insurance, but lost it because she got a better paying job. But it's still not enough for her to cover the full freight for it was like 3 months supply of her insulin was like $600. And she's like in tears, you know, recording this and she shows the bill and you know, so she's just not making this up. One thing I really want folks to know is go to InsulinAffordability.com for resources and how to get...like Lilly provides. Eli Lilly, huge number one manufacturer of insulin, provides insulin for no more than $35 a month.

Kelly Augspurger [00:21:49]:
No kidding.

Dr. Virgie Bright Ellington [00:21:50]:
Yes, for US residents.

Kelly Augspurger [00:21:52]:
Wow.

Dr. Virgie Bright Ellington [00:21:52]:
So, you know, and then they have other resources, you know, if there's things that apply or don't apply. So please, you and I are having this conversation in November, which is National Diabetes Awareness Month. So I just thought it was very interesting that this came up that I saw this and it just again outraged me. And so anyway, that is something that I've been putting ads out on IG, "If you can't afford your insulin, please go to InsulinAfordability.com." So that's that resource. Then the other thing in terms of affording medications is when you go to, whether you have insurance or not, when you go to the pharmacy often actually they'll volunteer this, ask them to see if there are any discount cards that are applicable to the particular prescription that'll discount it.

Dr. Virgie Bright Ellington [00:22:36]:
There are free discount card programs that do advertising on TV and they're actually not always the lowest one. Usually they're not in terms of... There's a bunch of different ones. One that I actually found it is not always...None of them are always the lowest. But SingleCare.com has the lowest most often.

Kelly Augspurger [00:22:56]:
Okay.

Dr. Virgie Bright Ellington [00:22:56]:
Prices for prescriptions. Now what will happen is if you don't download a card from Single Care, or any of the other providers free discount card programs, when you go to the pharmacy, they'll usually say, "You know what, before you pay that, let me run it through some of these discount cards and see what the lowest rate is. If I can get it down to a lower rate."

Kelly Augspurger [00:23:16]:
That's fantastic. I haven't heard of that one before. I've heard of GoodRX. I think that's probably common one.

Dr. Virgie Bright Ellington [00:23:22]:
People probably know of there's reasons why they have the most funding. So they have the resources, do this big PR campaign, but they're usually not the lowest price.

Kelly Augspurger [00:23:33]:
Okay.

Dr. Virgie Bright Ellington [00:23:33]:
But it's Single Care. And there are other ones. Just ask the pharmacist, "Hey, are any of the free prescription discount plans covering this, you can get it down to a lower price?"

Kelly Augspurger [00:23:45]:
Okay, well, good tip there, Dr. Virgie. What about how can people navigate complex emotions that come with an emergency medical procedure or chronic diagnosis while at the same time dealing with their financial health? And I know you know this all too well with probably your breast cancer diagnosis and treatment. So help us here.

Dr. Virgie Bright Ellington [00:24:05]:
Yeah. The number one thing I tell folks is when you're going in to talk to a doc, to your physician, and there is a possibility of you think there's something serious going on, you're worried, or maybe not worried, but there's a possibility. Possibility if there's something serious that you're going to have to address that you're looking into. I always say if there's a remote possibility of hearing difficult news or bad news, bring an extra pair of ears. Bring somebody with you. Because it's kind of like we kind of turn into like the Charlie Brown show...cartoon, you know, after you hear something is just brain when we're stressed.

Kelly Augspurger [00:24:41]:
Yeah.

Dr. Virgie Bright Ellington [00:24:42]:
You know, just...It is life. And so the number one suggestion I give folks is that if you're worried about anything, you're not worried, but you're not really sure that you're getting all the information that you think you need, bring somebody with you.

Kelly Augspurger [00:24:56]:
Yeah. Having that support person and another set of ears to actually listen to make sure you really understand what's going on. Because when emotions are high, our brain tends to kind of shut down and you're probably not going to absorb everything that the doctor's saying. Yeah, great tip there. Okay. Dr. Virgie, how can people plan ahead for their medical costs? So maybe we're not in debt now, but we want to avoid that medical debt. How can they plan ahead?

Dr. Virgie Bright Ellington [00:25:21]:
It's just the human condition. No one buys life insurance, frankly. No one thinks..."You know, death is what happens to other people. I'm going to, you know, die in my bed at the age of 104. You know, die in my sleep at the ripe old age 104. I'm never going to have an accident. I'm never going to fall."

Kelly Augspurger [00:25:39]:
Right.

Dr. Virgie Bright Ellington [00:25:39]:
"I'm never going to have an illness. Nah," it's just the human condition. We don't plan for things. And the belief is that, okay, well, if everybody has insurance, then things will be more affordable. And that's not the case. In 2010, when the ACA, the Affordable Care act was put in place, it meant that preexisting conditions were not allowed, so the insurance companies had to take all comers. And that meant that they couldn't not give policies to those that are high risk.

Dr. Virgie Bright Ellington [00:26:09]:
More likely to file a claim. So that's how they make their money, is by not paying out on claims.

Kelly Augspurger [00:26:14]:
Right.

Dr. Virgie Bright Ellington [00:26:15]:
So the traditional health insurance premiums may not be the answer because many people, Kelly, can't afford the traditional health insurance premiums. To say, "Okay, you should have an emergency plan." Well, should I say don't use the word should, you know, don't should on others and don't should on yourself. Don't use that word. It's very judgmental. We all know we should have an emergency plan, but life happens and we...

Dr. Virgie Bright Ellington [00:26:39]:
So it'd be great if we had those resources. What I suggest is that if you cannot afford regular insurance, health insurance premiums, traditional health insurance premiums, then look into getting an accidental coverage. It's historically called supplemental because you would get them as a supplemental policy through your employer. But this is something you get on your own. Accidental, critical illness, and or hospitalization insurance. That's what you're looking for because it's the big bills are going to really hurt you and, you know, the accidents that happen in life, you know, things that we don't expect.

Dr. Virgie Bright Ellington [00:27:13]:
Most people who are diagnosed with breast cancer have no family history. I have zero family history and I was diagnosed twice with two separate breast cancers, two separate breasts. Take it from me. Like I said, "Listen to your doc."

Kelly Augspurger [00:27:26]:
Yeah, right.

Dr. Virgie Bright Ellington [00:27:27]:
Always listen to your doctor, your surgeon's advice, your doctor's advice, and don't go without insurance. At least if it's not traditional insurance. What I call catastrophic event insurance, Kelly.

Kelly Augspurger [00:27:39]:
Some coverage, better than none.

Dr. Virgie Bright Ellington [00:27:41]:
Just for the catastrophic stuff. That's really going to take you out.

Kelly Augspurger [00:27:44]:
Rack up a lot of debt.

Dr. Virgie Bright Ellington [00:27:45]:
Take out your finances and destroy your financial future.

Kelly Augspurger [00:27:48]:
Right. Yeah. Wise advice there, Dr. Virgie. Well, any final advice on how people can plan for care or plan for medical expenses to live well?

Dr. Virgie Bright Ellington [00:27:58]:
Yes, the biggest cost, when you're really racking up big medical bills, it's usually because they're related to a hospitalization. If you've gotten a big bill from a hospital visit or hospital stay, whether the hospital is nonprofit or for profit, no matter if you think that you make way too much money, alwaysplease call the hospital's billing department and ask for a financial aid or charity care or financial assistance application. Because by federal law, nonprofit hospitals, medical centers and facilities have to give sliding scale income discounts to those in the communities in which they operate. But sometimes for profit hospitals for the very same reason, for tax write-offs, they have just as generous, if not more generous, financial aid applications, or I should say financial aid programs where they discount a bill depending on your income. Now, again, many people will say, "Well, gosh, there's no way I make like 100,000 or $150,000. There's no way that I'm going to qualify."

Dr. Virgie Bright Ellington [00:29:04]:
And for most things you wouldn't. But I had a case where there was a woman who had, I think her gross salary is almost like $150,000 and she had a $10,000 bill left over. That was her share after insurance from a hospital stay. And this was an academic facility, by the way. Most academic, not all, but most academic facilities are nonprofit facilities and they tend to have the most generous, in my experience, the most generous financial aid programs and most generous discounts. Okay, so anyway, this particular academic facility and the $10,000 bill that she owed after the insurance paid their part was completely wiped away. Wow!

Dr. Virgie Bright Ellington [00:29:46]:
Yeah. Now, not every facility, you can have two different facilities in the exact same town and they have very different formulas that they apply for determining how much and who gets financial aid.

Kelly Augspurger [00:29:58]:
Okay, understood. So even if you think you make too much, you might not. There might be some kind of resource. Yeah, doesn't hurt to ask. Well, Dr. Virgie, thank you so much for being here. Where can people find more information about you and your book?

Dr. Virgie Bright Ellington [00:30:11]:
You can find everything at CrushMedicalDebt.com and you can also find me at, Voice America has a great podcast platform, but in any place you like to listen to your podcast, we have "Medical Bills Uncovered." We talk about these issues every week.

Kelly Augspurger [00:30:26]:
Okay, well, fantastic. Dr. Virgie, thank you so much for your time and expertise. Really appreciate it. I learned a lot today and I think our listeners and viewers will as well. So thank you so much and have a wonderful day.

Dr. Virgie Bright Ellington [00:30:36]:
Thank you for having me, Kelly. Have an awesome one!