Health Insurance For REALTORS® Doesn't Have To Be Hard With Margo Wickersham
Updated: Mar 1, 2022
Healthcare is one of the most important topics REALTORS® are concerned about. We worry about taking care of our own health and the health of our families and teams. Costs have skyrocketed and getting good care has become more challenging.
In this episode of the Agent Exit Podcast, we have some tips and strategies to help you plan and remove this worry from your list. Today we’re talking about healthcare insurance for real estate professionals with Margo Wickersham. Margo is the Senior Vice President of Strategic Partnerships at Clearwater Benefits.
This episode is for every real estate professional who wants to understand and access health insurance, no matter your broker. Grab a pen to take notes or listen to the episode a couple of times to get all the resources Margo will provide. Be sure to stay until the very end for Renee's time saving tip. Finding health insurance doesn’t have to be overwhelming.
Connect with Margo Wickersham:
For more on Healthcare plans go to Healthcare.gov
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Health Insurance For REALTORS® Doesn't Have To Be Hard With Margo Wickersham
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I am here with Margo Wickersham, Senior Vice President of Strategic Partnerships with Clearwater Benefits. Clearwater partners with eXp Realty to provide health insurance for agents and teams in the US. Don’t stop reading if you're not with eXp. This episode is for every real estate professional who wants to understand and access health insurance, no matter your broker. Read on to get all the resources that Margo will provide. Real until the end for my time-saving tip. Finding health insurance for you and your family does not have to be overwhelming. We're going to give you some great tools you can use to get there. Let's get into our conversation with Margo.
I am here with Margo Wickersham, Senior Vice President of Strategic Partnerships with Clearwater Benefits. Clearwater partners with eXp Realty to provide health insurance for agents and teams in the US. Welcome to the show, Margo Wickersham.
Your health is your wealth.
I'm so glad to be here. I'm thrilled to be here, Renee. Thank you for having me.
Margo, tell us about you and tell us about Clearwater Benefits and what it is that you do.
I work with Clearwater Benefits as the person who heads up strategic partnerships, specifically, our largest one is with eXp. We have other smaller regional brokerages that we also work with. What we do is provide consulting to agents across all 50 states to help them find out and understand which plans make the most sense for them to consider. We then help them get enrolled if that's what they decide to do. We have a wide variety of plans. We're licensed in all 50 states. We are subject matter experts on all things healthcare and healthcare plans across the country. That's important because they do vary by state and it's important to understand what evolves and changes. Not only do things change nationwide but they change by state.
We stay on top of that so that we can be your go-to resource to help you figure out what the best plans are because we've learned that 70% of Americans are on the wrong healthcare plan. In a way, that's not surprising because the terms and the amount of information are so confusing. Whenever I present, I ask people, “What adjective would you use to describe shopping for health insurance?” None of them are good. They're all confusing and overwhelming. I can't mention them in a public company. It's frustrating. We love helping agents solve this problem and get the best plan possible.
You're so good at what you do. My history with you is following everything that you've done through eXp. I am in the eXp workplace. I see all of your posts and the emails that you send out. The information is so helpful. Some of it is pure education. It’s not even about policies, programs and benefits. It's educating our agent population about what is going on in healthcare insurance.
I wanted to ask a couple of questions. Let's start with the types of insurance that are available. What comes to mind for me are life insurance, health insurance, disability insurance and accident insurance. There are other types of insurance and we probably won't cover them here like auto insurance, property insurance and so forth. We're not going to cover that because your expertise is around health insurance. Tell me more about that.
Health insurance is a broad category and one that includes many of the ones that you mentioned. I hear all the time people talk about how your health is your wealth. If you can't take care of your health and the rest of it, building your business, being there for your family and the people you love, you can't be there. It's not selfish to practice self-care and take care of not only our health but our finances as well. We hear all the time that the cost of healthcare is the second biggest concern that real estate agents have when it comes to their finances. The cost is so high for people who don't have access to a group plan through an employer either through their own employer or through a spouse or partner’s employer.
What we do is solve that problem especially focused on delivering the best options for the needs of a self-employed person, like a real estate agent. We have a wide variety of healthcare plans from those that are on the exchange, helping people figure out which one makes the most sense. Some innovative healthcare plans that we have created ourselves are popular and have dramatic cost savings and broader access to providers.
We have a third category of healthcare plans, included which are dental, vision and some other supplements that include critical illness and accident policies. Those are the kinds of policies that pay a lump sum when one of those events happens. We've introduced life insurance. This is exciting around health insurance and life insurance because there have been so few good options for self-employed people. We know small business powers this country so we need to do a better job of providing assets to help small business owners manage their businesses better. We feel good about what we're doing.
Life insurance is important. If you get sick, you can't work. If you can't work, you can't earn money.
Without going into boring details about life insurance, I can share with you that we know the best policies are available through groups. The big disadvantage of being a sole practitioner or a small business owner is you don't get access to those so we've found a way to bring that level of quality-of-life insurance and healthcare plans to agents. Same thing with critical illness and accident policies. They're not expensive. They pay a lump sum that helps a lot if something happens.
Finally, disability, which is virtually unheard of for individuals to buy. We're bringing that to the mix here. If you think about it especially for self-employed people, if we don't work, we don't make any money. If we are sick or in the hospital, we can't work or we can work a little. I had surgery and on the day of recovery, I was responding to texts. You're not your full self. You can't count on yourself to produce and work at the same level if you're battling a variety of different health issues. It's important to consider the whole picture. It's interesting that health insurance is also part of financial planning. It has to be because of the way it's structured in this country. It makes such a big impact on our finances. That'll give you a summary of everything that we're doing to help agents. Does that answer your question, Renee?
Can you tell me what types of coverage agents and brokers should have specifically? Not everybody is with eXp and I know not everybody who's reading will have access to Clearwater Benefits. If they're looking for their own types of coverages, what should agents, brokers and team leaders have? Is there like, “Here are the top three that you should have if you're in that category?”
HealthCare.gov is where the ACA or the Affordable Care Act plans are available. That also varies by state because a handful of them have their own exchanges. For example, Colorado and California do. The best place is to start there. President Biden's administration issued the American Rescue Plan that provides some deep discounts to healthcare plans available on the exchanges and broader access to those discounts with regard to income. There are subsidies, which is a different category of discounts. Go check it out. If you haven't since May 2021, it has changed dramatically and there's a lot of relief that’s available.
My understanding is that those discounts are available for healthcare plans for 2021 and no one knows beyond that but that's a good place to start. The second thing is that you can also check with independent brokers in your state for additional plans that might be available. The important thing is to understand what your use of healthcare looks like. Some people will have a few things they go see a specialist for and you want to understand what your needs are because there's no one size fits all.
What I can share with you is my experience with lots of agents who have a plan. For example, on one of the exchanges, they don't like the plan, it's expensive and they have to drive right past some doctors because they're not in-network to go to another town to get in-network. Figuring out which plans are the best fit for you is not easy so don't feel like you are dumb. It's just hard.
Our team helps people figure out the best plans for the exchange. Often, we’ll help them find a better plan that also saves them money and gets them the doctors and providers that they want in the network. Know that there are ways. You can search by physician. Let's say you have a pediatrician and you have three kids and you love this pediatrician. You can search on the exchanges for plans that include that provider.
I encourage you to think about what's important to you before you start looking for plans. Most of us know to look for price, rate and deductibles. All of those are sliders so it depends. If you really want the doctor, there are ways to search for that on the exchange and I recommend that you do it that way. Understanding your priorities and then looking for plans available that do the best job of meeting those priorities is a good approach.
I agree with that as far as the types of insurance that I'm going to be looking for. For my family, we have health insurance, dental and vision. Those are things that are available through my husband's employer. I'm blessed in that way that I'm able to be on his insurance and not have to find my own. Am I looking for health insurance then separately I’m looking for dental and then separately I'm looking for vision? Are those things that come in a package?
Nobody gave a thought to this until the early 2000s. It was included and you thought, “Great. Insurance, that comes with it.” I assume it has dental and vision and assumes nothing anymore. Everything is all à la carte. You are a consumer of healthcare. You are a consumer of healthcare plans in whatever state you live. You can choose whether to participate in just a healthcare plan, healthcare plan plus vision, plus dental, neither one of those, nor both of those. You can add life insurance, disability, accident and critical illness policies or whatever you'd like. All of that is up to you.
With regard to dental and vision, if it's not something that is baked into a plan you have access to like yours, you want to research that. Sometimes, the dental and vision plan is not cost-effective. Here's a couple of tidbits. I don't personally have a vision plan or a dental plan because I can negotiate with the dentist providers. Also, I ordered my contacts from 1-800 Contacts. They're not always worth it. The key is you want to run the cost versus the benefits and see if, at the end of the year, your projected costs are going to be worth it. Sometimes they are, sometimes they're not. It depends on how you consume, how often you go to see doctors and whatnot. Do you have to have expensive eye exams? Do you have regular eye exams?
Looking at what is your pattern of need for the different categories of plans that are out there is the key. You are blessed to have access to a plan through your spouse, which is awesome. We have seen people have plans for spouses that are so great. We will say stay right there. You shouldn't move. That is the best plan for you. We've also seen situations where agents have a plan through a spouse. There's a handful of other plans that are a better fit for them at a lower cost even. You never know. You can't assume anything. We see the variety of costs ranging from $200 or $300 for a single person to $3,000 for a family. If you say how much does healthcare cost? That's the range. It’s crazy.
Tell me a little bit more on the healthcare side about preexisting conditions. If I have a preexisting condition, do you know what the rules are about getting health insurance?
I do. That is a great question and it is a complicated answer. It depends on what the condition is and what other plans you're looking at. All the plans on the exchange are ACA-approved. That means none of them have limitations on preexisting conditions. If you or your family have some expenses to manage conditions going on or you expect that you will have those soon, like you know there are surgeries coming up then the plans on the exchange, you're probably going to be the better fit. If you are a healthy family and you do your annual exams, nothing's happened, you're not dealing with chronic illnesses or anything then some of the creative and innovative plans are going to be a better fit for you.
Understand that networks for doctor visits are a challenge across all health plans.
Now that I've said that as a top-level, we drill one other level down preexisting conditions, let me tell you what they aren't. For example, with our innovative plans, we have a combination of an insurance plan with a medical cost-sharing plan and this varies by plan. In our particular case, they're doing a 24-month look back. If you had brain cancer five years ago and you've been cancer-free for three years, this is not a preexisting condition. If you are taking medication to manage cholesterol or blood pressure, that is not a preexisting condition.
Let's say you have asthma. Now we're going to have a little fun. With asthma, most people don't have the risk of a big procedure or a big emergency. That's going to be a preexisting condition but here's what it means. We've combined health insurance with medical cost-sharing so the preexisting only relates to the big expenses. If you feel like, “It's not hospitalization. I just need to see my specialist. I need an inhaler. That's all I'm concerned about.” The insurance portion of the plan will include access to specialists for a copay both in-network and out-of-network, in our case, in the plans that we have.
If you have special needs children, we're not going to recommend these plans for you. We're going to help you find the best plan on the exchange or maybe even off the exchange. We will find one of those plans that have no limitations for pre-existing. Why don't we recommend everybody to get on one of those plans on the exchange? It's because they're expensive. That's why there's no one size fits all. It would be great if there was and we would be out of a job. It is complicated and you want to make sure you find the best fit. That's how you avoid overpaying for a plan that doesn't deliver what you think it's going to deliver.
One of the cautions I want to share with everyone, which is a great tip, is to understand that networks for doctor visits are a challenge across all plans. What happens is providers are constantly deciding whether to participate or not participate in a network and that changes more rapidly than most of us would like to have be the case. Always verify that your doctor is in-network and don't assume that because they were last year, they are this year because we see it happening a lot. Always double verify that they are in-network.
Another network piece of advice I want to share is if you have the recommendation to have a procedure or treatment, always get a second opinion and here's why. Seventy-five percent of surgeries and procedures are unnecessary or out of date. You don't want to be one of those people. You don't want to expose your physical or your financial health to that risk. Secondly, cancer diagnoses 70% of the time are wrong or the treatment protocol is wrong.
In my case, I got a second opinion on my cancer diagnosis. Had I not done that, I would not be here now. The second opinion found a second form of cancer that required a completely different treatment regimen. My local Austin, Texas doctors missed it because it's rare. I want to encourage people to always get a second opinion when they get a recommendation for a new procedure.
The third thing I want to share is if you do get a treatment plan or schedule a procedure, always ask the front office, “Who's going to send me a bill?” You think, “I've done my due diligence, smart consumer of healthcare thing. I found out that the surgeon is in-network and I've confirmed that the surgery center is in-network,” and then you recover from surgery. It's going great, you're doing physical therapy and then you start getting bills. You're like, “What is this? Why am I getting bills from a surgical assistant that wasn't in-network? Why am I getting bills from an anesthesiologist who's not in-network?”
They don't ask you upfront. The providers typically don’t, the doctors don't and the front office doesn’t say, “Do you want to pick an anesthesiologist in or out-of-network? Would you like to pay $3,000 or none?” When you're going in for something expensive like that, always ask, “Who's going to send me a bill? What's the name of the organization?” That is so you can verify that they're in-network or get somebody who is. Those are my three important pieces of advice to share.
Thank you for those three pieces. They were good. We need to know this. The next question that I have for you is about Medicare. How is Medicare different from the other types of health insurance that we've discussed so far?
For someone who says she doesn't know anything about this subject matter, you have good questions. Medicare is the healthcare plan provided by the government for people 65 and older that's separate from Medicaid. Medicare is so big and subsidized by the government so no other plan can compete with it. In fact, one of the ways that our Clearwater plans are especially cost-effective is because we do not put anybody over the age of 65 on any of the plans because you can't compete with Medicare. That reduces the total overall expense of the plan cost to manage because something like 75% of the healthcare cost each of us will need or incur over our life happens after the age of 65 so it makes a lot of sense.
We encourage everyone to hop on Medicare. You have to start that process a good 3 or 4 months before your 65th birthday. Definitely start that ahead of time. I do not find anything with the government or any process that’s quicker than it used to be. I find that it's longer than it used to be. Have some time to add a little extra to it and start the Medicare process.
What we see is that for most people, there is a gap between what Medicare does and what they want to provide for themselves. There are Medicare supplements and we can help you with that. That is something that insurance brokers like us can help with people figuring out which ones make the most sense, help you get enrolled in them and be a consultant to you to help you with that. Definitely adding supplements are key to making the Medicare solution work for you after 65 but while doing so, you save some money.
The supplements are great. There are different types of supplements that you can add on or tack on to your Medicare benefits so that if Medicare stops at a certain point but you want additional coverage then you can get that through your supplement.
Another question is healthcare-related but it's about mental health. Maybe you can answer this question generically. Should we be looking for separate plans for mental healthcare or is that something that Clearwater would cover for ourselves or for family members who may be either drug-addicted or experiencing some type of mental health challenge? How would you all help us manage that?
This is one of my favorite questions that you've asked. One of the positive things that have come out of the pandemic has been there's much more awareness and less shame attached to talking about mental health. It's great that we're talking about it a lot more than we used to and we should. It is not disconnected from our physical health. They're all interrelated. Not only is that true but the way plans provide for mental health has shifted. When I say shifted, mostly it's gotten worse.
The key is to understand what you're dealing with because you can't control what you can't control. What you can't control is how much you know and what you choose to do about it. Here's a couple of tips about looking into healthcare plans that include mental health options. First of all, I encourage everybody to have access to some mental health options. Those are key. There are some ways to do this.
Many psychiatrists are not participating with any health insurance plans. They're not going to file. They aren't playing. You can file but they're not part of a network and they're expensive. They have a lot of schools. They have a lot of education. It's a big problem for most Americans. Not everybody can afford to pay $300 or $400 an hour. If you need medication or you need to find out whether the solution to your mental health is to have medication then you can be in a little bit of a bind.
Know that that is a gap in a lot of health insurance plans. When you're shopping for plans, you want to look for mental health options and you want to look specifically for psychiatry. Those are the doctors who can prescribe medicines. There's psychology and also therapy and counseling. Those are the ones that are educated but they are helping you with talk therapy, listening, understanding and sorting through.
I think of it as when you get stuck and you're dealing with some things, you're like, “I feel like I should be over this by now. Why am I not?” You might need some help there to help sort things out and move whatever the struggles are through the system. There are some options, as is the case whenever there's a big sea change. There are some new options that are popping up and available.
For example, Clearwater’s creative plans that we make available to agents include free and unlimited telehealth, which is for primary care and that's through our provider, Teladoc. It's amazing. A lot of plans like Blue Cross plans will include access to telehealth especially. In 2020, virtual health became the only healthcare there was. In some cases, the plans will include a copay. It might be $30 or $40 to talk to a primary care physician. With our plans, there is no fee. It's unlimited. It doesn't cost anything to use 24/7 in any state.
These are great. You talk to a doctor, they give you all the time you need and they ask if there's anything they can do to help you. It's a great experience if you haven't had that. The reason I mentioned that is not only is that a great way to do primary care. You can subscribe to primary care only Teladoc service. If you are strapped for cash and you want to have somebody to talk to, if you get a sore throat or you're vomiting and you need somebody to call a prescription in, that's what you think. You can get that through us for $100 a year for a family. Those options are out there.
I mentioned that also while we're talking about mental health because Teladoc has expanded what they have available and now they have mental health services available and here's what that looks like. It is for a copay and the copay is maybe higher than you might want it to be. It's $85 an hour for therapies, psychology so psychologists, therapists, not a psychiatrist. Most of them will charge $150 or more so that's good.
The pandemic brought more awareness and less shame attached to mental illness.
You do not get to look for your favorite therapist on the list. They're probably not going to be on the list. The way this works is they have contracted with a wide variety of therapists in every state. You get to look at that therapist, see what their area of expertise is and choose one to talk to. That's different than when you do primary care. You get whoever's on call in primary care but it makes sense that you get to pick one and stick with them. You're paying $85 an hour and it's unlimited, which is great. You don't have to file anything, no-nonsense.
The second thing that's available through Teladoc is that you can also access psychiatry and that is a $95 an hour fee. I know of people paying $140 a half-hour for psychiatrists so $95 is good. It's an option. I want to share that with you because sometimes, that's the best option. Know that that thing is available. There are different services out there that are making healthcare available in a different way than it has been before.
The other thing I want to share about that is let's say you have a plan already through a spouse and mental health isn't involved. Now, what do you do? We are not used to doing this but you can negotiate with providers as you do with anything else that you buy. I encourage you always, if you self-pay, in other words if your plan isn't covering something then say, “What is your self-pay rate? What is your self-pay discount?” Don't feel bad about it either. Think about it. The provider doesn't have to monkey around with an insurance company. They're happy. Less time, less complicated. A mental health provider will often have a 30%, 40%, 50% discount. Same thing for chiropractic, physical therapy and all kinds of other things. Think about discounting as part of the tool in your toolkit to help you get the care that you need.
It's great what you said about negotiating because sometimes, as women, some of us are hesitant to negotiate when it comes to things like that because we feel like we're not an expert in the area. We don't necessarily know how much things should cost so we feel guilty for asking to pay less. Ladies, if you're reading this, you have got to negotiate your healthcare expenditures when you are with those providers.
The information that Margo is giving us is priceless. It's gold as far as everybody in-network if I'm having a procedure done because I don't want any surprise bills. You would be shocked at how much they charge for some things. It's tens of thousands of dollars for the simplest things if they're out-of-network. We definitely want to be asking about taking care of ourselves financially, as well as taking care of ourselves physically when we're in the process of getting procedures, doctors and care.
The other thing too is we have a tendency to think, “Doctors are in the white coat.” We have this aura around them and the front office that represents them. If you think about it, they would rather deal directly with their patients anyway. You're asking, “What is your self-pay rate?” You're not asking for a favor. Practice it because you're right, we want to take care of everyone. We're women. That's how many of us are. You don't need to take care of your providers. You can just ask, “What is your self-pay rate?” without offending anyone.
“I don't owe you anything.” Let's talk a little bit about the pitfalls of not having insurance coverage because many of us, as real estate business owners, we're taking care of so many people but we don't necessarily consider the finances or the financial side of not having insurance coverage. We will have an expectation, “If something bad happens then I'll take care of it then or if I need to go to the doctor then I'll take care of it when I get there because I can't afford it on a monthly basis to pay for insurance. It's too expensive.” I'd like to speak to that.
The numbers we've seen is that 30% of real estate agents across the country are uninsured or self-pay if you want to put it another way. We, as brokers, want to see the agents have options and they get some coverage. Sixty-six percent of bankruptcies in this country are caused by medical bills. This surprised virtually no one because everybody knows how expensive it can be. You talked about how these surprise bills can pop in and they're $1,000 or they're $10,000. You're like, “I don't even know what you did. You could have done nothing. Who knows?” We all know. We've heard horror stories.
About 2/3 of bankruptcies in this country are caused by medical bills. That's important to know. Here's the thing that is shocking to me. Sixty percent of those had health insurance. There are gaps, pitfalls and landmines so it's a good question to ask. That's how bankruptcies happen. That's how many people are in financial straits because they don't have a plan. Having no insurance works great as long as nothing happens but you don't know if you're going to be the one. Statistically, you don't want to roll those dice. What we'd like to see is at least get something in place that will help you avoid financial ruin if you have a large healthcare event that is expensive.
I wanted to say that the moral of the story is you have to have an insurance company to put pressure on to pay for stuff if they weren't going to pay for it. The second part of that is you have to have insurance so that when you do have things that you can plan for or procedures that you need or doctors that you need to visit, when you have healthcare insurance in place then when things are normal, you can control where you go. If it's in or out-of-network, you can certainly control your finances that way.
Let's say you need a total shoulder, for example. There are a host of options available to you. You can either pay directly because if you self-pay, let's say you have no insurance then the thing to know is there are, in some states, providers who will charge you directly. If you can afford it, you can have a total shoulder for about $25,000 but that's a lot of money. I'm picking this because this is a surgery I’ve had and until I know. You can go through your insurance and they will charge $25,000 for the part and then $60,000 for four hours in a surgery center. If you're in a hospital, it'll be $80,000. It becomes like Monopoly money.
The moral of the story is definitely to get the information and comparison shop. You want to find the people who are good. You also want to find the providers who will work with you, depending on what your plan is. If you have a great insurance plan then make sure that you're in-network and make sure that everybody who's going to send you a bill is in-network. Make sure that happens. If you have no insurance then negotiate and comparison shop. They are not all the same.
It’s an amazing illustration of how wacky it’s gotten and how important it is for us to be informed and be your own advocate. Women would tend to want to say, “I don't want to be too bossy or directive.” It's your health. It's important. Taking control of what you can control, there's a lot more that you're in control of with healthcare than most of us realize. Being informed and being your own advocate is important.
A lot of this, when it comes to insurance, gets so overwhelming. I can see you ladies out there that are working, you're team leaders, brokers and agents and you're trying to run a business. You don't have either the time or the wherewithal to try to figure out this insurance thing. I'm going to take a little tangent, go off on the side here and talk about the importance of having an assistant. The reason why it's important is that as you are trying to have the highest and best use of your time, perhaps doing the research that Margo and I are discussing is not the best use of your time.
You physically have to go to the appointment or you physically have to go to the procedure but finding the best programs, best policies and best insurance coverage to use, you can hire or have an assistant to look through that information for you. You'd have to give them some parameters. “This is the number of people in my family. This is the budget that I have.” As far as doing the actual work of digging through and finding out who's in-network and who's not, a lot of us avoid this because we don't have time for it. We just let the chips fall and then catastrophe happens. We never did what we intended to do, which was to find the best policy for us and for our family.
To wrap this up on my soapbox, get an assistant to help you with this. Pay somebody. You can get a virtual assistant, pay $20 an hour for 2 hours or 3 hours of work and get somebody to help you with this. Once it's done, you may have to do it annually. Maybe every year, you have to relook at programs, plans, policies or whatever but hire help. If you don't have time, that's not an excuse. Hire help to get you through this. It's too important not to do. That's it for my soapbox moment, Margo. My next