Lili chats with Carey Blackburn: actor and Licensed Independent Healthcare Agent. They discuss how Carey has used this time to help artists learn more about healthcare, and they discuss tips for getting enrolled in health insurance for 2021. Open enrollment ends Dec. 15, 2020!
Carey's instagram video with info on how to enroll in health insurance
Carey’s calendar for scheduling appointments (scroll to the bottom)
Carey's website
Kevin Schuering’s episode of TDQ
TDQ’s Website
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Email: thedreadedquestionpodcast@gmail.com
TDQ Carey Blackburn
[00:00:00] Lili Torre: Hello listeners, and welcome back to The Dreaded Question podcast. I'm your host, Lili Torre and I'm very excited to share this special episode with today's guest, Carey Blackburn.
During COVID, Carey has been licensed as an independent healthcare agent so that she can help people sign up for health insurance.
She agreed to take some time out of her busy schedule during open enrollment to come on TDQ to share not only how she started this new parallel career journey and where it's taken her, but also to fill us in on some information about signing up for health insurance. As a reminder, open enrollment started on November 1st and goes until December 15th.
On the day that this episode is being released, you only have a few more days to sign up. If you're listening to this episode after open enrollment is over. There's still incredibly valuable information for next year. And if you're listening and you've already signed up, you can still make changes to your plan until December 15th, so I definitely recommend listening to Carey's advice to [00:01:00] make sure you're still happy with your plan.
So let's jump right in and find out what Carey Blackburn is up to.
So Carey Blackburn, what are you up to?
Carey Blackburn: I think more than anything else I am up to recalibrating. And I know that that is probably a word that people have heard relatively often these days. Maybe not so much as, I don't know, "unprecedented" per se, but it's, it's wild because there are so many things that... It's kind of like unconscious incompetence, you know, like you, you don't know what you don't know until life makes you just face it upfront.
And I think this is super duper common for performers and artists of all kinds, but just thinking that as an interpreter of [00:02:00] media, as opposed to a creator of it, that you are not someone with anything to offer if there isn't something for you to interpret.
And that presents itself in a lot of ways, because it's, it's definitely not COVID-specific. It's also that sinking feeling in between contracts when you're not super fulfilled by your audition music or anything like that. And you just have this feeling that you're, that you're not an artist, that you're not doing what you wanted to be doing. And of course now the past nine months is that times absolutely a million.
Lili Torre: Right.
Carey Blackburn: So I, the biggest thing that's been happening for me is, is discovering what does make me feel like an artist at a time when it's not something that somebody else is deciding for me. [00:03:00] And just being super surprised by that, because as it turns out what really makes me feel like I am contributing to my field and being someone who makes a difference is not as glamorous as I once thought maybe, and what's working for me right now and what's making me feel like I have something to offer and what's making me feel excited to get up and talk to people is something that maybe seems fairly boring, but something that I was scared to talk about or just looking for new and different ways to be creative that are also serving the community.
Lili Torre: Yes. Oh, you know, you're speaking my language that is exactly what I want everyone to be up to.
It's funny, you said you feel like we've probably all heard the word "recalibrating" a lot. I actually don't feel like I've heard that a lot, but maybe, [00:04:00] maybe other people listening would disagree. I feel like I've heard, as you said, "unprecedented," or, "pivot," a lot in this time, but recalibrating there's something I really like about that because it feels very intentional to me.
It's funny, just a few episodes ago, I was talking to Kevin Schuering and we were talking about how we felt about the word pivot. And to me, there's just something sort of sudden, or I don't know if I want to say haphazard, but like, not as intentional as something like recalibrating, which feels like taking in new circumstances and reconfiguring a plan from there.
And I, I think that is such a great word for what we're all experiencing in this time in a variety of ways. And I love that for you, this has led to a parallel career path and something that makes you feel creative and like you are [00:05:00] contributing to our community, which is amazing. So I would love to hear more about what you've been doing!
Carey Blackburn: Absolutely! So I want to also touch on, the feeling of like you were saying with pivot, but feeling ownership of what you're doing, because that's what I've discovered is such a big part of what I want and what I want to accomplish for other people is, this applies definitely to finances, but also to a lot of artistic things as well, that there's a lot of feeling, a lot of feeling rushed, a lot of feeling like if you don't do a certain thing by a certain age, which we've all definitely heard a lot of.
But it also shows up in... What your finances are supposed to look like and what your life looks like. And a lot of it is feeling like you're being blown by the wind and people feel like, "Oh, if I want to live in one place, or if I want to do something [00:06:00] else..." Or heaven forbid the thing that we hear in acting classes absolutely all the time, which is "If you can do anything else, go do it."
Lili Torre: Oh, yes.
Carey Blackburn: Oh I've heard it a million times. It's the worst. I heard it again, like last week in a class. I was like, man, are we still saying that right now?
Lili Torre: That's crazy. How can someone say that with a straight face to a group of actors right now in this pandemic? That is wild.
Carey Blackburn: Yeah, it's an excellent question. So that's, that's a really big thing that motivates me. So, what I have been doing, is when I graduated from my BFA program, just for a little bit of backstory. I had been on the school's health insurance plan. And, you know, it's, it's one of those things you absolutely don't think about until you have to, as with most, I hate to say "adulting things," but adulting things.
Lili Torre: It's [00:07:00] true
Carey Blackburn: So then I graduated college and I went to an acting apprenticeship, which is also not an uncommon thing to do right out of school. So I went there and was making the, the sad, sad amount of money that you usually make at an apprenticeship like that. And, I was the only person in my apprentice class who did not have health insurance.
We were working, you know, 50, 60 hours a week doing lots of shows per day. And some of them being musicals. And it was all at once that I realized that I had no idea how to go to the doctor. I had no idea how to, besides that, go to an ENT, get scoped, get a prescription, any of these things that your voice teacher tells you, if you're on a [00:08:00] contract in college, to go do these things, to go get checked out, and there's not a whole lot of explanation past that. It's just "Go do this." Never how.
Which is wild, because it's such a huge thing for freelancers in general. So it was on top of definitely the stress of being in freshman year of life, as my best friend Gabby and I like to call it...
So on top of that, just not feeling like I could get any kind of medical care. And I was also beyond anything else, just too scared to ask.
Lili Torre: Yeah, that's real.
Carey Blackburn: Because it felt like acknowledging that I wasn't about to join Equity, more than anything else, because that was what I heard all the time. That Equity has great insurance, which... what. (Lili laughs)
No, no, it's, it's real. [00:09:00] So that's, that's all that I had heard. I'd never heard of any other options past that. So I, I didn't want to ask because it felt like acknowledging that I wasn't at the stage of success that I felt like I should be at as I was turning 23, which is also wild in itself.
So then I was, I was doing the freelance contracts, just praying nothing happened knocking on wood, all the things. So then I ended up working as a singer for Tokyo Disney for all of 2019. And I went there and they had universal health insurance and it was absolutely wild. So it costs me, you know, 10 US dollars to go to the ENT, five more dollars to get scoped. Anything like that, which, of course, this is a crazy expectation to be met.
[00:10:00] But, I was floored by how big of a difference it made in my day-to-day life to know that if something happened, I was okay.
And with all of the wildly unknown things within our career, that there was one less thing that I had to think, well, "What if this," or "What if that?" And there is no way for that to completely go away. But I realized how important it was to my performing career, but also how I operated as a human being.
And so then I came back, and the ironic thing about all of this is I come from a family insurance background and I still didn't feel comfortable asking anyone what to do.
Lili Torre: So your family all worked in insurance?
Carey Blackburn: Yes. [00:11:00] My grandfather started a super local, really tiny family insurance business, mainly for home and auto, in 1957. So, I had no reason not to just ask someone what to do, but I wanted to seem like I had it all together and that everything was fine.
So then I ended up finally getting around to asking and deciding that for the year 2020, God bless, that I, that I wanted to have health insurance. And I applied and found that I couldn't get the best care in the world, but I could definitely get way more than I ever knew for a cost that was not crazy. And during the time at my apprenticeship, I probably could have gotten that too. I could have saved so much time and so much mental and emotional energy, by just feeling like I had someone to [00:12:00] talk to.
So, so then fast forward, during COVID I, as, as most people did thought about, " What else can I do? What else makes me excited? Or even just motivated?" And I think that's a big thing that I've found that you don't necessarily have to think that something is glittery and beautiful for it to be valuable. And sometimes it's the impact that you make, that's what makes you excited.
So I decided to get licensed in my home state of North Carolina. And then I was staying in New York for a while, doing some masterclasses with theaters, just helping them figure out, Affordable Care Act enrollment in North Carolina, and then a, a day job at a tech startup fell into my lap, kind of.
And so then I was like, kind of all at once. I also just. I [00:13:00] want to be as transparent with people as possible. And the idea of all of my income coming from actually enrolling people, even though the Affordable Care Act enrollment, that like the amount that you get paid from the marketplace is absolutely nominal and not really live-off-able.
But still I, I realized that the thing that was missing was that I just wanted to be able to provide a service. And that felt more like it aligned with just putting it out there to absolutely anyone who needed it and also moving more into the world of cost maintenance and just researching all of the other more mutual aid and advocacy type routes to help people make sure that they can not go bankrupt if something happens, no matter if they have [00:14:00] insurance or not, that's such a teeny tiny piece of the puzzle.
So that was... that was the biggest realization that I had. That was kind of the final straw that made me go, okay, this is what I can do. This is what I can offer. I can just be an advocate for people and be someone for them to talk to and not feel any kind of judgment, of course, but, but also just someone un-involved with, with their lives, people who live all over, I've been meeting with, which is also great because I get to meet with people from all over.
And also just the amount of stories that I've heard from not only artists, but also so many other independent contractors, real estate agents, hairstylists, anything like that, that there is so much unknown that people don't really know where to start.
And even though I don't have all the [00:15:00] answers, I want to be someone who is willing to say, "I don't have the answer, but I want to, and we're going to talk again next week and I'm going to have four answers for you."
Lili Torre: Yes. I mean, what a great way to learn.
Carey Blackburn: Exactly. So then that's like, everyone is benefiting from this and it's absolutely not something that's going to go away. Especially with the changes in the union insurance and people having questions about Cobra and the Supreme Court case with the Affordable Care Act. There are so many questions that people have and especially in an industry that employer-based coverage is never guaranteed, essentially. And an art form that is so central to being able to use your body to whatever capacity serves you best.
Lili Torre: Yeah, the irony of the fact that in order to be a [00:16:00] successful, especially musical theater actor, but you know, artist in general, you need to be in pretty peak physical health, in order to succeed and yet it's the most difficult to get health insurance. I mean, that is just an irony that I will never fully understand.
But I'm curious to know a little bit more... so, so these people that you're talking with and you're discussing their healthcare needs and all of that and answering their questions so generously. Is this through the work that you've been doing with the tech startup, or is this something that you're doing kind of on your own or where does that play into this?
Carey Blackburn: No. So this is just something that I do on my own outside of the work day.
Lili Torre: Oh, my gosh.
Carey Blackburn: So before 8:45 AM or after 6:00 PM or on the weekends, since the open enrollment period is from November 1st to December 15th, it's a really urgent need during that [00:17:00] time. And then, after that things get slower, it's mainly just if someone's employer based coverage drops off, if they turn 26, anything like that.
So it's just people making Zoom appointments from a calendar that I have on my website and in my Instagram bio. And we're just talking to go through what your income is, what kind of conditions that you need care for, where you want to be able to go...
Something I had a lot of questions about when I was first looking into it was what's going to happen if I take a contract somewhere else? And the answer is with a lot of plans, you can't do anything if you are in a different city. Which of course, because of COVID has become less of a thing than maybe it normally would be for actors as far as their concerns going into 2021.
But also just [00:18:00] making a list of what people need to feel, feel prepared.
And again, feel like people have ownership of this part of their lives.
Lili Torre: Yeah. You know, I love that in a way sort of reversed your way into, into the work that you're doing right now. So like you, you identified a problem based on a problem that you had had and, you know, a change that you wanted to see. You wanted the process of being able to get insurance, to be clearer and easier.
And then you got licensed to do this, you figured out that wasn't like a hundred percent the way that you wanted to go about it, but the information was still valuable. And then, you know, having that experience allowed you this opportunity to have this job with this, insurance, tech startup.
And then now [00:19:00] that offers you the opportunity to basically essentially volunteer your time to help people get health insurance. It's sort of like, like a three-point turn into utilizing purpose and intention to then find a job that supports you so that then you can do the change making work you want to do.
I mean, it's... what a crazy journey.
Carey Blackburn: You have 100% articulated that in the way that I was always trying to put into words, when people have asked me what I've been doing lately. So I'm absolutely going to listen back to this and steal what you just said.
Lili Torre: Just send them the recording.
Carey Blackburn: So 100, 100% that. It's also hard because I have always felt, and that's really common too, for people who get into the arts to want to be in an industry that you believe in and that you trust. [00:20:00] And to be completely open and transparent, like I always try to be with people when I'm talking with them, that's not how I feel about this industry.
That's not the reality of it. And that was a huge moral barrier in trying to figure out what I was going to do with it, because so many people have been burned by this industry. Rightly so.
So a really big step and change that I had to make mentally was that even though I cannot vouch for this industry, I can be what I needed in this industry. I can be the kind of honesty that I would always want for myself and my loved ones. And I think a big part of that is being completely honest and working with people from all walks of life and changing it over [00:21:00] into more of an advising/consulting model.
So, so that ultimately I'm volunteering my time. Yes, I'm gaining knowledge. And if someone is in my state, great, fantastic. I want to get licensed in other States in the future, but ultimately I believe that healthcare is a right and I don't want to have to do this forever.
Lili Torre: That's a really interesting point that you bring up and it has me thinking about, you know, finding purpose driven or why-aligned work is something we talk about a lot on this podcast. And I feel like you're highlighting something that hasn't necessarily come up, that what exactly that means can be twofold.
It either means you find an industry, kind of like you were saying, that a lot of artists feel very aligned with the theatrical community and industry. Although I would argue that, not always, there's plenty to be ashamed of in our own industry. And there's [00:22:00] plenty that I think we're all trying to dismantle.
And so you can either look for something you already feel alignment with, or you can look for an industry where you see the potential to implement your purpose, your impact, and get in there and try to make some change. And I think that's what you were talking about before you were saying like the, the actual job itself isn't glittery, but the impact is, and, you know, I think that's true change-making. The work itself isn't glamorous or glittery or beautiful, but you do it because the impact is. The impact is the thing that really matters.
Carey Blackburn: Absolutely. And what you were saying about things to be ashamed of in our industry, I think that's a huge reason that people are feeling so abandoned. Honestly, right now.
Lili Torre: Yeah, that's a great word for it.
Carey Blackburn: Because people [00:23:00] almost entirely go into theater to believe in what they're doing and who they're doing it with and why they're doing it.
So then to get all of this overwhelming news about what people's ulterior motives have been, or the impacts that people have been having that are so not aligned with what people want out of that industry. It's so difficult to reckon with, and that is what I really admire about the individuals and the advocacy organizations who have been stepping up and saying "Wait, but we can be the people who change it. This is, these are the people that are in the industry right now. These are the people that have a whole future in it, and we can build what we want."
Lili Torre: Yes exactly.
Carey Blackburn: And of [00:24:00] course it is absolutely not that easy, but that's also going along with what I've discovered. And it's crazy because there's times in doing a contract, and you never want to admit it because it makes you feel icky that you can be doing something specifically in the commercial realm, but other things too, that you feel like what's missing?
I'm doing this thing that is supposed to be fulfilling me. And I think where I had been making a big mistake was thinking that I could get all of my personal fulfillment and feeling like I was making a change by just being in this industry that I loved on a very, on a very basic level.
And then when it happened in a real life context. And I was having those ups and [00:25:00] downs that you have in any job ever. I realized that there was something missing from what I wanted to be able to feel like at the end of the day I was doing something tangible to help people really above, above anything else.
So it's wild that the past year has happened, but it has made me learn so much about what I want the makeup of my professional life and how I spend my time to be. Because ultimately working on projects like this... I'm also working on another mutual aid project that I'm super duper excited about, which is involved in another industry entirely. But, so things like that are, are what make me thrilled and ready to [00:26:00] send those 30 emails that I have to send so much more than sending my headshot and resume off somewhere ever did.
Lili Torre: Yeah. That is a really great point. Yeah, I can imagine how much more fulfilling that must be. And I'm curious to know a little bit more about the process of getting licensed. You said specifically in North Carolina as an independent agent, what was that process like?
Carey Blackburn: Yes. So you first go through a pre-licensing course. You have to do a certain amount of hours of training in just how the industry works, all the compliance laws, things like that. And so then you take a certification exam and then sit for a state exam. I was the only person in the entire testing center, which is not super surprising due to COVID, but definitely felt crazy.
[00:27:00] And then you go through the, center for Medicare and Medicaid services training to get federally appointed as an Affordable Care Act navigator, which was the reason that I started doing this in general and definitely the training that ended up sticking with me a lot more.
And that takes maybe a week or so after that, and then you have to go through and get appointed with individual companies. So that's the other thing that made me decide that maybe I wanted to expand beyond the traditional form of what an independent agent looks like.
An independent agent just means that you can sell for a bunch of different companies. You're not only giving people the rates of Blue Cross Blue Shield. Like that's not... absolutely no way. That's not what I want to be doing.
So when you get appointed with individual companies, sometimes they'll have [00:28:00] requirements of how many people you have to enroll per year, and you have to go through separate trainings through each one. There's a lot of different hoops that you have to jump through, which only makes sense because that's the case anywhere.
But that's the other thing, because I was looking at it and thinking about if I wanted to really make things happen fast and get licensed somewhere like New York that has an entirely different platform and a totally different method of training. All of it takes a lot longer because it's not through the traditional healthcare.gov website.
So, I was really wrestling because I was still thinking of it as something that I was going to do all the time. And that, that was going to be my main income source. And again, that didn't end up being the right fit.
But so there were all these different companies and all these different States. And I was like, I don't... I don't have the time... people don't do [00:29:00] this. I, also, there's no way to enroll 20 different people in every different company in every different state. That's not... the system is not set up for people to be able to give advice in a lot of different States with a lot of different companies, and get compensated for it. So I was like, no, whatever, I'm going to do it anyway, because I am employed. And so many people aren't.
So that's, that's all of the steps to getting licensed. And then, like I said in somewhere like in New York, it's, it's a whole separate process and... Funny enough, most of the people that I've been working with with are people in New York, because it's a different website, the plans are so confusing.
I talked to someone who was very, very recently in a Broadway show and had [00:30:00] always been on union insurance and just simply had never looked at it before. And then all at once, people are given the task of, "Okay, you're losing coverage, you better enroll, and you better enroll quick. And hopefully you can still see all of your same doctors."
And on top of the million other things that people are going through. Including the holidays also. And the struggle of being away from your family during these particular holidays. I know that if I was in that situation, I sure would not have the time to then go and spend a few hours looking at, at the in network providers of each individual marketplace plan that New York state covers. No way.
Lili Torre: Yeah. It really is unbelievably confusing and complicated, and I will never really understand why. How long did the [00:31:00] whole licensing process take you from start to finish?
Carey Blackburn: From start to finish. I would say it took me two months.
Lili Torre: Wow. That's that's relatively fast.
Carey Blackburn: Yeah, it's not too bad. You can do the pre-licensing courses on your own time. Most of it is just waiting for things like a federal background check with your fingerprints and... and then just going through a lot of little steps with the individual companies and, and with the center for Medicare and Medicaid.
Lili Torre: Sure. Well, thank you for sharing that because I was just curious, in case anybody listening thought that they might be interested in going down that path, you know, what exactly the investment of time is.
Carey Blackburn: The biggest thing is definitely to be totally honest, just finding, and this is not exclusive to this industry. It's also definitely a thing in real estate or [00:32:00] anything where you are marketing yourself, is just finding leads if you will. And that's, that's where I was running into the biggest amount of trouble in feeling like I was still doing the right thing.
I wanted to be able to reach out to more people than I knew in my state really, and that a lot of the people that I knew were struggling were outside of that. But I didn't really know anyone else or couldn't find anyone else who was doing something similar.
Because also one thing that changed with the Affordable Care Act was that the commission rates for agents went way, way down from like, Oh my gosh, I don't know, like 20% to 2% something crazy.
So a bunch of agents just left. Started doing something different, started selling [00:33:00] a different type of insurance, so that also means that A, there aren't that many people in the industry, B there aren't a whole lot of people in it for the right reasons. And because of that, it's not, it's not people trying to enroll people in the government marketplace plans. It's private plans, it's, uh, major medical indemnity policies, stuff like that. Which have their place for sure.
Lili Torre: That's super interesting. Yeah. There's... it just goes to show that there's so much that the average person just doesn't understand about healthcare and that healthcare as an industry in this country.
So, you know, that brings me to, I think, a very important question and something I definitely wanted to talk about today is, you know, this episode is going to air just a few days before the end of open enrollment.
So I'm curious what advice you have for people who still have [00:34:00] not secured their coverage for 2021.
Carey Blackburn: Wow. 100%, so much. So I'm also planning on uploading a video to Instagram. I've done a few Lives talking about this, but I want to upload something really comprehensive of just going through the process. So I'm only going to hit the super-duper highlights.
Lili Torre: Yes. I'll definitely link that video in the show notes. When this episode airs.
Carey Blackburn: Dreams! So one big thing. I just want to make sure that I mention this before I even get to the plans is one thing that I found out as I was doing research that I super did not know about before was that if you have been paying a lot of medical bills or specifically, if you have a chronic condition, you can get a patient health advocate for free.
Which is someone who is assigned to you to be a consultant. A more detailed [00:35:00] version of what I do, kind of, just not insurance related. So someone who can help you go through the process of negotiating down any medical bills, maybe appealing something that was denied. You always hear about people getting stuff kicked back when they were in the hospital, things like that.
And a lot of these companies don't think that people are going to go through the steps of appealing it.
So also finding providers that are in your network or will let you pay a low cash rate if you don't have insurance or if your insurance doesn't cover it. So that's, that's a big thing that when I found out about, I couldn't believe I was like, I know so many people with, with chronic conditions and there's a lot of... this is opening up a whole other can of worms...
But there is a lot [00:36:00] of lack of education about how to go about treating artists with chronic conditions or disabilities with respect and in the actions of the work environment.
Like I have a couple of friends who are anemic and the perception of a lot of chronic conditions by employers in the arts is, like you were saying earlier, that if your body is not in peak condition, then it's not, it's not considered a properly sellable product, which is unbelievable, wildly outdated...
So part of what I also want to pursue, and this is more of a long-term goal, I guess, is giving people who make more of the higher up decisions, in theater [00:37:00] contracts, making sure that their artists know how and where to get the kind of care they need, and also the resources to be able to do it without having to do this huge run around and talk to the company manager, and everybody knows where you are, but... There's, there's so much that needs to be improved on that end too.
So, now that I've just, made that little speech. So as far as people securing their coverage for next year, the absolute biggest thing and where I've seen most people's unexpected and overwhelming bills come from is not fully understanding what the plan that they're signing up for covers and who it covers.
So..and a lot of that yeah is, I'm not [00:38:00] gonna lie, super boring, busy work. So going through, and, and this is also usually 70% of what I'm doing with people is going in and when you're looking at plans, there's a little place that you can put on at the side, like what prescriptions you take, what, what doctors you go to, and usually if you go to more than one doctor, chances are no one, but the plan you're currently with is going to let you see all of those people and do all of those things. Making that particular puzzle work is by far the worst part. And there's usually not really a way to get it right. But getting the most that you can, as many boxes checked as possible
After you have found the right combination of the best you can get provider-wise with the plan. Then going into on healthcare.gov, there should be a little plan details tab, and then it has a bunch of crazy stuff, like many, many pages, but toward the bottom, it has common occurrences. So going into the hospital to have a baby, or breaking your arm, or things like that.
So I found that to be a really helpful tool in showing people what... the kind of occurrences that you don't think about as much as, "Oh man, I think I have the flu. I need to go to the doctor," but still things that you want to be able to know are going to be okay.
So that's the kind of thing that I'll show people and say, "Okay, so does this number at the bottom for how much you would need to pay for this? How much does that make you sweat on a scale of [00:01:00] 1 to 10 and hopefully we're below like a 6. But if, if that sounds crazy, then maybe that's worth going back and paying $20 more per month to get something that covers more in the long run because everybody's financial situation is totally different. And that's a huge part of this.
Also, you can make any changes during the open enrollment period. So if anyone is listening to this and is thinking, "Hmm, I actually have no idea what any of this is." You can totally go in and look at it.
And if you want to change anything, you can change anything you want until December 15th, they can't stop you.
Lili Torre: Oh, wow. I actually didn't know that. That's so good to know.
Carey Blackburn: Yeah. So open enrollment fair game. So once you have initially found something, and are enrolling in it, so it's making a list or let's be real, maybe, maybe just a note in your [00:02:00] phone. The places that you would want to go in, any situation.
Once you find your plan, and it'll say what provider it's with, go to that provider's website and they should have a find a doctor, find care, find a provider search bar, and you can search for primary care, urgent care, specialist, anything. So making sure that you have a list of a primary care, family doctor, any kind of specialist that you need, whether they're the ones that you were seeing before or not, an urgent care, the pharmacy nearest you, or nearest like your partner's house or anything that could realistically be necessary.
And this is a big one. I spend a lot of my time telling people that it shouldn't be this way, but this is how we're going to make the best of how it is, which is universally relevant, but a big way that this shows up is [00:03:00] hospitals. So a lot of the really, really devastating bills that people get are from out of network, hospital care.
And again, you should be able to go to whatever hospital is nearest to you, but if you have been cutting carrots and you chopped off the end of your finger and it's midnight, and you need to go to the emergency room, now you need to already know where you're going to tell the Uber to go.
Lili Torre: Yeah, that's true. That's really good advice.
Carey Blackburn: As opposed to having to have a frantic Google in the moment, that is probably the least of your worries.
So then you're going to go to the place that's closest and then not find out until way later, if you're going to pay the $500 copay that is on your insurance, that you're thinking it's going to be, or just whatever bill they decide to give you.
Lili Torre: Yeah.
Carey Blackburn: Which is totally different. [00:04:00] And for most of us, it, the kind of thing that could put you in debt that you're dealing with for years and years and years.
So all of this is tedious to do. It's not fun. It's not fair, but ends up being a huge help if you need it.
And also the biggest way that I see problems coming up for people who are freelancers or who are in the arts, is people who are making over the amount for subsidies, but don't receive employer group coverage.
So that's, that's one of the big gaps, because if you make less than $12,760 you're in the Medicaid gap, not every state has Medicaid expansion. So then you just, you just can't get anything. But also if you make over that $50,040 number, [00:05:00] then you are also paying 100% out of pocket. You're not getting that subsidy.
But just because you make over $50K does not mean that you can afford what they cost. And that's a lot of the same people who are tasked with navigating Cobra and whether or not to enact it, which is also a big thing that I've been hashing out with people.
Because there's, there are a few different tax benefits to your monthly premiums, if you're self-employed or an independent contractor, but they all depend on really exact numbers with, your modified, adjusted, gross income. So there are things for people to talk about their accountant with, but not everybody has an accountant. There's also. There's a lot of talk about, if you hire somebody else, if you can technically get group insurance and one that's a good deal, and when it's not.
But ultimately the advice that I would give or the [00:06:00] short version of the advice that I would give as it applies to Cobra is if you cannot go on without being able to get the care that you're currently getting. Go for it. I do not know of, as I've been looking at, it plans that meet all of the person's needs that were being met on Cobra, that are outside of the marketplace.
And a lot of people, you know, if it's... if it's as simple as you don't really mind transitioning to a new doctor, you can still go to the, find my provider page and type those people's names into Google to make sure that they're not the worst.
But ultimately if, if it's a particular medication that you, that you can't do life if you don't have covered, and there are no plans that are going to cover that, then that's the kind of situation where Cobra is going to be appropriate. All of this [00:07:00] is assuming that you make over the threshold for the subsidy.
If you make less than usually you can get something that covers you for a good bit less on the marketplace. Albeit the, the providers still are not going to match up quite in the way that you want them to.
And then there are patient assistance programs, which help people pay for prescriptions specifically, or particular imaging tests that they can be done. So it's, it's a lot about. Going back to the idea of ownership that this is supposed to work for you, you are paying for it as a service to you and your health and best weapon you have, the best method that you have is understanding it as much as you possibly can and all of the resources that are available to you. So that, you know, where, where you're starting and that you can go from there. And [00:08:00] that it's, that it's not going to be just one more thing that surprises you in a bad way.
Lili Torre: Exactly.
Carey Blackburn: We've had plenty of that. So...
Lili Torre: Truly. There have been plenty of surprises.
Yeah. And you know, you were saying before, obviously I know you're not an accountant, but I know you were talking before about how difficult it can be for freelancers of any kind. And I think one of the things that trips, a lot of people up is having to estimate your income to... yes, in order to qualify for those subsidies.
And speaking from my own personal experience, it can be really difficult to do, especially right now. I'm sure a lot of people can relate to this. You know, my husband is unemployed right now. I have been lucky enough to still be able to work, but we had to estimate our income for 2021.
And of course he's hoping that in 2021, he will be employed. He will find some employment. [00:09:00] But at the moment, that is not the case. So do you estimate based on what you made in 2020 or what you're hoping will happen in 2021? So I'm curious again, knowing that you're not an accountant, if you have any advice on how people can go about doing that.
Carey Blackburn: For sure. So the biggest thing to remember about the subsidies in particular is that it is an advance on a tax credit. For when you are filing your 2021 taxes in the spring of 2022. So you can choose how much or how little of that credit to use on your monthly premium.
So you can do one of two things basically, so you can estimate on the lower side, and then you can pay the face amount per month and then know that if you end up [00:10:00] making more, A, you can go in and document on healthcare.gov that your income has changed.
Also a job change is a special enrollment period. So it's not, it's not like if your income triples you're going to be like completely out of luck, if suddenly you're above the threshold and you need to figure out something totally different. So you can go in and document that income change.
But if you estimate on the lower side, you can either know that you may have to pay the difference back on your taxes for 2021, basically paying the tax credit back to the government for what they gave you.
So you can do that, or you can not use it all. There should be something as you're getting to the end of your plan enrollment that says, "Would you like to use all of this credit per month?" [00:11:00] And so when I was doing my plan for 2020, as someone who had absolutely no idea what was going on, I paid about $15 extra per month. So I wasn't using. $15 of that subsidy in case I ended up making more in 2020 than I thought, because usually being an independent contractor, I have enough crazy things come about tax season. And I didn't want to add to that with another potential expense. So I would rather pay it gradually. And then if I made what I said I was going to make, then that would be a tax credit back to me.
Lili Torre: Totally, that's a great way to go about it.
Carey Blackburn: And then the same way, if you end up estimating your income higher and it ends up being different, they should refund you the difference.
Lili Torre: Oh, that's great.
Carey Blackburn: So it's, it's [00:12:00] not quite as scary as it sounds when you see that little box that says, "Hey, what are you going to make in 2021? You say, "huh?"
Lili Torre: And they're like, you have to like certify that what you said is true. And you're like, "Well, I don't know if it's true! I'm guessing!"
Carey Blackburn: Yes, exactly. I remember being there. About exactly a year ago. Yeah.
Lili Torre: Yes. Well that's super helpful. Thank you for that. And as we mentioned earlier, I will definitely put a link in the show notes to the Instagram video that you're going to make in hopes that it will help some people get even more information so that they can get the coverage that they need for 2021.
And I just want to say I'm so amazed by the work that you're doing and the path that you took to get there and where you are now. I think it's really admirable. And so purpose-driven, it's so cool to see.
And I also just want to shout [00:13:00] out for everybody who's listening that Carey tagged me on Instagram and a post when she sort of like announced to the world that she was doing this now. And that's how I even knew that she has been doing all of these amazing things. And I just want to thank you for doing that because that was so meaningful to me. And now you're here. So I hope that other listeners will follow suit, and please keep me posted in the amazing parallel pursuits that are coming up around this time.
Carey Blackburn: Yeah, you were a massive reason that I felt excited about this at all. That I didn't feel like I was giving up. I felt like I was growing. And that is absolutely not the approach that I would have felt even just a couple of years ago. So just know that the work that you are doing is making a huge difference in the way that people think about the longevity and all of the possibilities in their careers, both of them, any of them.
[00:14:00] Lili Torre: Well, thank you so much. That that is very meaningful to me. That means a lot. And I, you know, if the impact of that is that people create amazing, change-making parallel careers and pursuits for themselves like you are, then I'm pretty jazzed about that. Thank you so much for taking the time to share all that very helpful information with us today.
I will definitely be linking your information in the show notes so that people can reach out with questions. And I am just so grateful for everything that you shared.
Carey Blackburn: Yes. Ditto to you, Lili. Thank you so much.
Lili Torre: Isn't Carey the most generous person you've ever encountered? I can't believe how much of her time she dedicates towards helping people get the health insurance they need. I'm including a link in the show notes to her calendar so that you can sign up to chat with her if you need to. I'll also be linking the Instagram video she mentioned, which is also an incredible and generous resource to [00:15:00] check out.
Carey has a way of making insurance, a notoriously overwhelming and dry topic, digestible. And I'm so in awe of all that she has accomplished during this year. I admire her so much and I hope that you'll consider taking some time to reach out to her, to thank her for the incredible work she's doing. I'm linking her Instagram in the show notes if you'd like to send her some love.
I hope you'll share today's episode with anyone you know who is struggling to get signed up for health insurance. It goes without saying that this is an especially important time to get coverage.
As always, thank you so much for listening. I'm Lili Torre, and this has been The Dreaded Question.