501: The Most Comprehensive and Affordable Health Coverage
In Episode 501 of the Learn True Health podcast, the host, Ashley James, introduces Megan Williams, who discusses a better and more affordable alternative to traditional health insurance in the United States. Megan explains that she discovered a system that offers comprehensive and affordable coverage aligned with holistic and preventive healthcare values. They discuss the challenges of navigating the healthcare market and the benefits of this alternative system. Megan highlights that the system is non-profit and aims to provide a solution without someone profiting from it. They address concerns about coverage limitations and the simplicity and effectiveness of the program.
- The importance of having access to holistic and preventive medicine that aligns with our values
- Introducing a system that offers affordable and comprehensive health coverage
- The challenges faced by self-employed individuals and the flaws in the current healthcare system
- A non-profit, non-insurance alternative that aims to provide a solution for healthy individuals seeking alternative healthcare options
- The system offers freedom and control over healthcare choices, including access to chiropractors, naturopathic doctors, and telemedicine services.
- The need for accessible and affordable healthcare options
[00:02.1] Ashley James: Welcome to the Learn True Health podcast. I'm your host, Ashley James. This is Episode 501.
I am so excited for today's guest. We have Megan Williams on the show of the system. I've been looking high and low, for years, for a better way to do health insurance because I'm self-employed. My podcast is my income and all the other things I do like holistic health coaching. I'm self-employed, and so for years, I've had to buy my own health insurance, which usually our family of three pays $1,400 a month for an okay health insurance. It's not that great because we still have to pay $9,500 out of pocket before we really start getting coverage. It's just been very expensive, and we can only see our chiropractor ten times a year. We can only see our naturopath a few times a year. We get one free visit a year, and then everything else is just pretty much out of pocket. It's been very stressful to have to pay for our own health insurance.
Talking to a lot of my friends, even their health insurance is covered by their jobs, and it's really not that great. A lot of my friends either end up buying secondary health insurance to try to pat on and compensate for what they have, or some of my friends simply don't have health insurance at all. I have one who just had surgery to remove a benign tumor, and she doesn't have health insurance. It's really scary out there. Her husband's work provides health insurance, but the insurance they sell to the employees is so incredibly expensive and has way worse coverage than I have at $1,400 a month.
I'm from Canada, originally, so this concept of paying for health insurance and having to go on the market every year and go on the exchange — I have a broker that I talk to — and having to shop for your health insurance to get locked into for a year; it's been super stressful. I look at spreadsheets and compare them all. But at the end of the day, I've never had a good experience with any health insurance company since I've been self-employed back in 2010, so I've been looking and looking and looking.
I have a friend who was in a health share system, and she had some good experiences, she had some bad experiences. I've talked to a few other friends that have done more alternative styles. Some had really great stories; some were okay. And nothing was as bad as the traditional health insurance that we have now. But I've been looking. There's got to be a company out there. There's got to be a better way. Because I want to have access to preventive, holistic medicine. This is what I invested in. I invest in my health. So I want my health insurance to also be something that reflects my values. I know that a lot of my listeners want a type of health insurance that reflects their values of focusing on freedom of choice, focusing on being able to make holistic preventive medicine affordable.
That's how I found Megan Williams. So in walks, Megan teaches me all about this amazing company, and I'm really, really, really excited. This is for people in the United States. I get it, my Canadian listeners. Maybe you'll just find this interesting simply because it's like looking at a different planet when it comes to how it works in America. But most of my listeners are in the United States, and even if you do have adequate coverage through your work, you might have kids that have outgrown your system. If they're 27 years old, that can't be in your coverage anymore. And there are so many people that don't have good health insurance simply because it's unaffordable.
Megan, I'm really excited to have you today because you're going to teach us about your system that helps us to have affordable coverage that's comprehensive and that aligns with our values so that we can go see a chiropractor. We can see our licensed naturopathic doctor. We can get the lab work once a year to look at everything and make sure that we're on the right track — everything that I normally go to, all the cool stuff I normally go to. And then, of course, having the whoopsie daisies in life, like the ER visit because your kid broke his arm or something like that; that's all covered as well. So I'm very excited to talk to you today because I think that this is a tool that's going to help so many of my listeners, and it's so needed. And it's so frustrating and heartbreaking for people who don't have the coverage, especially the coverage that rewards them for making good healthy choices, like holistic and preventive health care.
Now, listeners can go to learntruehealth.com/healthcare to check out this system and see if it's right for them. I was first amazed by the amount of money I would save. It is like a fraction of the cost, and I actually thought the numbers were wrong. I was like, this can't be right! There's going to be a glitch or something. It's way more affordable. And I've always kind of looked at health insurance like it's a racket, like there's someone at the top making a ton of money, jumping into piles of bills and swimming in it, like that cartoon duck that swims through his money. I just imagine there's this evil billionaire sitting at the top of the food chain, collecting all the money because health insurance is so crazy expensive. And so here we have the system that you provide and teach us about, which allows us to pay a fraction of the price and yet have more coverage and better coverage than what I've been paying for years. So I'm really excited to get into it at learntruehealth.com/healthcare. Definitely, for listeners, this is a need. I know you'll love it.
Megan, please share with us how you have been doing with this and with all of your clients, helping them. I know you have a ton of stories. I'd love to hear a bit about how you got into all this.
[0:06:34.5] Megan Williams: Absolutely! Well, first, Ashley, thank you for having me today. I love sharing and giving value, and you have been doing this for years, which is so exciting that you've got so many people who have been blessed by your insights. And just listening to you, you are an expert already at all about it. You know, even though I know you claimed to be Canadian, you definitely have the terms down as we Americans do. That, dang it, it stinks when you are an independent contractor, and you have to pay for yourself. And you hit so many points that I think are difficult points for so many of us. You hit how much it costs every month, and then can we even afford the out-of-pocket deductibles and copays that come along with that. Even when employers are offering it to try to retain their clients, they're getting priced out of good plans, so you're getting subpar. And many providers, doctors, and hospitals don't even want to work with it. Then the fact that you even mentioned that there are brokers out there that are trying to be solution-oriented and make a little bit of money trying to help people like you and me in the marketplace. But the problem is if you're looking at the price point, you're cutting out all the care. And so this has been something that really is difficult, and just like you, I've been an independent contractor for the last 17-plus years. Prior, I taught high school, and my husband was in law enforcement. So those are “jobs that give you benefits,” right? So you're thinking, “Oh, this is great. I get these benefits.” But there are so many fine little gotchas in those contracts that we've learned over the years.
Let me just give you a little background. I have been offering solutions for high prices for a lot of different essential services for the last 20 years. My husband and I really love helping people. We love bringing them more value. We love getting to have great relationships, just like you. And what was so interesting is we were introduced to our healthcare option here with Impact, and we knew that we were not going to offer something that would not really be a solution. Like, money is number one. It's like a house payment; you have to pay for it, right? Or you have to knock on wood and pray nothing happens. Like you just said, so many people go without it. And Ryan and I were not going to even say one word about it unless we knew it was going to be a good solution.
So I would love to hit some of the points that you talked about and why this is so great. But I do want everyone to understand that I get it. I get what people are paying for. I get what people are not wanting to pay for. I'll give a great personal example, and then we'll get into the benefits of this. So we had healthcare through our great providers, that are the ones paid for, and I had twins back in 2010. I had to take one of my boys to get an x-ray because he was crying, and he never cried. He was like the happiest baby ever. He's about ten months old. We got there; I called the insurance company and said, okay, where should I go? What's your “in-network”? And we go over to this facility to get an x-ray. The doctor saw us for literally maybe 8 minutes after the x-ray. He told us he just needed a sling, and his little collarbone was broken, but that's how you repair it. A few weeks later, I got a bill for $13,000, and I was like, are you kidding me? So I called up this big major insurance company that's supposed to be included. All the stuff is supposed to be included. They're like, “Oh, well, if you have gone to the hospital at this entrance, then you would have been a network. But because you went to their outpatient on the other side of the building, that wasn't in our network.” And I said to them, I am paying you $2,400 a month to have healthcare, and you're telling me that you're not going to help me work this out? They're like, “No, it's out of network. So you're responsible for this.” Now that's normal. Out-of-network for a family can be close to $22,000 a year. I was ticked. I canceled my insurance that day. I called the little outpatient I thought hospital and worked with them, and I ended up paying cash and renegotiating prices. Mind you, this was 13 years ago, and I thought this was ridiculous. Well, I was like, I don't want healthcare. I'm not paying for this; I'll just pay cash with cash as king. At that point in 2010, you could just pay cash. You didn't have to do it. And then the government changed the rules, and you were fined if you didn't have health care. At first, the fines were not that expensive, and then once you made too much money, the fines became out of control. And so they then instilled this idea of affordable health care. But the problem is anybody in this country who makes a decent living cannot get the subsidies. Or they can get subsidies until they show that they made more income, and then again, you have more fines. So it's this broken system.
And so, again, Ryan and I were looking. We have been praying for solutions, and we have tried everything. We've gone with big disabilities. We've gone with low payments, but then it has a lot of piecemeal coverage, and then we pay cash for things. But ultimately, with three boys, there's no way we can live life like that. And so when we were introduced to this, we were blown away. I will tell you, first off, everybody, the neat thing about this option in this group share program is that it is a non-profit. So there isn't someone at the top trying to make all the money on us. That got me really excited that nobody owns it because it's not a company. It's a non-profit, non-insurance alternative that gives us a solution. And so, just like you were saying, Ashley, that for most of us who are generally healthy, we were paying into a broken system — a system that is 3% or maybe 5% of the country that really needs health care. But the rest of us, we are healthy and are looking for alternatives. We want to use chiropractors. We want to use holistic ways. And even today, I had a good friend call me. She's been in our program, but she's been so afraid to use it because she thought there were gotchas. And then she used our telemedicine which we have unlimited access to everyone with $0 provider fees, and she was blown away. She's like, “In two minutes, I was talking to a doctor, and I told her what was going on, and they got me two prescriptions in one hour. I was worried for nothing, and it was so simple.” And I started laughing, and I said, “I know. We are brainwashed to think it is going to be complicated, and it's going to be difficult.” And what our group has done is modernize this, made it affordable but giving us, just like you said, the freedom and control back to us.
[0:14:05.2] Ashley James: Right. So there's a monthly fee that you pay which is a fraction of normal health insurance like I'm paying $1400 a month for ‘okay' health insurance, which is not that great. I'm frustrated that we have to pay out-of-pocket $9,500 before we start really getting coverage. Our family, knock on wood, or knock on my Sunlighten sauna, which is right beside me — that's wood; I know that's wood — thank God, we're in good health. You know we have the oopsies that happen once in a while, and that is why we have insurance. But like I said, I want to go to my chiropractor. I want to go to my acupuncturist. I want to go to my licensed naturopathic physician and to my holistic providers, and I want them paid for. I'd love to have access to quick telemedicine to speak to a doctor, just to be like, “Hey, should I go to the clinic with my son? He's got a weird rash.” And you know that it's free. I'd love that. The gotchas are something that is looming in my mind; like that sounds too good to be true because it costs so little, and you're getting way better coverage. I have a friend with a different company who is in a sort of a healthcare thing. And it was like, “Well, if you do this, then we'll drop you.” And so the fear is, is this something that is in a regulated industry? Can they just drop you if they decide to? So we definitely want to talk about those red flags, these elephants in the room.
But one thing that I first want to talk about though is this idea of in-network and out-of-network. What you described happened to us similarly, but this is back when my husband was a foreman union carpenter. This was about 13 years ago, also in 2010. And so the carpenters' union, I thought, had good health insurance. He had an oopsie, and we went to the hospital. He had to have an emergency experience at the hospital, and it was a hospital that was in-network. Then we get the bill. And the anesthesiologist, although working at the hospital at the time, was out-of-network. How is this possible? So we had to pay the entire everything for the anesthesiologist because they wouldn't cover that bill. And yet I'm like, how is this possible? We went to a hospital that was in-network, and my husband got rushed off to an ER, and any of the practitioners in that ER could not be covered by the insurance. And I hate that. And when I gave birth to our son, we got a $5,000 bill within weeks of giving birth. I'm like, I did all the work. What is going on? You guys didn't do anything. I did all the work. So I hate it that you have to pay every month. I don't use the word ‘hate' often, but I just loathe this system that makes us feel like we're indebted slaves. It is not freedom, and you get surprise bills, and if you don't pay them, they're going to send you to collections really quickly. And it's a surprise! We get to charge you with whatever we want because it's out-of-network, and we decide what's in there, and you don't know beforehand, even though you do all the research. We could switch out an anesthesiologist and put in one that was out of network, and you don't get to decide.
So this idea of in-network and out-of-network feels like a total scam. So the company that you're working with, that you're telling us about, there's no such thing as out-of-network?
[0:17:57.3] Megan Williams: Correct, and it's amazing! So the main point that I'm just going to hit, and then we're going to hit all these points you just said, is yes, there are no network providers. And now, no provider network in general. So if something happens and you end up on a vacation at a hospital with your finger cut and they've got to do stitches, there's no triple the price because it “was out-of-network.” You can go to every doctor, every provider that you like and you're used to. And even if they've never heard of our group, Impact, what's neat is we have what's called an EDI number, and that EDI number is what they have in their systems for every network. So we have our own licensing. Currently, we are in 47 states, so that we can have service then in all states and all the countries around the world if something should happen. But the neat part is that they will not triple the price because you're “out of network,” and that is really nice. The other great thing is because it's comprehensive medicine, anything you go to the doctor for, even before your deductibles are met, they do what's called reference-based pricing. And so, again, they are working to be our advocates.
So that's what's so neat about it. It is that we've got an amazing price point, and we're going to explain how that works. We're going to answer that question that you just asked about. Could they kick you out for no reason? No, because we've got guidelines that are our legal standing, that makes this work for everybody, and you go in totally transparent, and you know exactly what you're going to get without any gotchas, no provider restrictions, which is huge. So again, no double or triple prices, and we've got this advocate with Impact that's going to work with us and help us every step of the way, which is so unique in this industry. It just doesn't happen anymore. You know, it's just all about the bottom line, and for us, it's not. And so I think the neat thing is when we really are trying to help as many people as possible, and it's inclusive.
So a lot of the background about sharing groups that we've heard is they're all religious-based, while ours is under the umbrella of love thy neighbor because that can be any religion. So we have no religious affiliation. Everybody is welcome. And really, there is no denying being part of our group. The big thing is we do have a 36-month pre-existing, and we'll get into that in a little bit. But what I want to explain to everybody is we're looking for generally healthy people. All of us who don't go all the time and will love the idea of alternatives. Well, because of that, the only thing they look at is the oldest member of the household's age and how many members are going to be part of the group. So it will be one, two, or three and more. So you could be a family of eight, and it's the same price if you're a family of three. If you add more children, it doesn't hurt you. Again, that's kind of unheard of too.
So like you said, the average American's paying $1,800 a month for decent health care coverage, with a $10,000 family deductible and $22,000 out-of-network. That's what we're used to. Usually, you get a 20/80 split when it comes to your co-shares and things like that. Well, let me explain how ours works.
[0:21:28.9] Ashley James: Could you just explain what 20/80 is? So let's just slow it down. Normally what people are paying — so like I said, our family of three is paying $1,400 a month, and we have to pay out of pocket $9,500 in a year before they start really covering things, and we have a few things. Like I can go to see a chiropractor ten times a year, and after that, it's out of pocket. Like, I have to pay 100% of it, basically. So I've got a few things, but it's like you're just buying car insurance. You're just hoping you don't get into an accident, but you're glad if you have it because it's going to sort of help for the big stuff. So the 80/20 split, can you just explain that? That's the standard health insurance that we are not happy with. It's like a train wreck. It is a broken system. Okay, broken system explanation.
[0:22:23.9] Megan Williams: Yes. So the way it works in traditional health care is you have it as a deductible, and usually when you go to the doctor, you have to pay a copay or provider fee upfront. So then you get the full bill. So you pay your provider fee then they send the bill to the insurance. The insurance reprice as is. If you have not met your deductible, then you pay that repriced bill to the doctor, and they apply it. The problem is, as you are starting to utilize that, then you get to a place where now you've met your deductible, and you have to pay 20% of the bill, and they then will cover 80% of it. Well, normally, that doesn't have a limit.
So let's say a child, heaven forbid, gets cancer, and you meet your in-network deductible of $10,000 for the year and even some out-of-networks because, again, like we just heard with sweet Ashley, is that the anesthesiologist was not in-network, so you have to pay that price. So they try to tell you, “Oh, max out of pocket, it would be $12,000.” Or, in her scenario, it was $9,500 if it was in-network. Out-of-network, that max might be $22,000. Well then, after that, heaven forbid, your child has to continue getting therapy and continue being in the hospital off and on, you then pay 20% of those bills, and if a bill comes to a million dollars, you are now responsible for 20% of that. And what we've found is most of the bankruptcies in the United States come because we cannot afford this healthcare. When something tragic comes, and, like you said, these oopsies turn into something really big; now we're in a big bind.
Well, the neat thing with our guidelines and the way that they have set us up for price point is it is the oldest member of the household. So in my family, I'm the oldest member of our household, and we have five members of our household. And so, our price point is determined as I age, not by what medical expenses have happened in our family, which is huge. But we also know that no matter what threshold we pick — I'm going to explain in just a minute how this works — you get to pick four options. One is the amount of your deductible, which we call a primary responsibility amount, and then you pay your monthly rate, or what we know in traditional health care is called premiums, and you decide if you want to pay less every month and have more exposure on the backend with our deductible. Or would you like to pay a little bit more for your monthly premium or standard rate and then have a household deductible that's much lower? And then once you meet that, we would then have a 10/90 split, but it maxes at $5,000 for the whole family for the year. So that same million-dollar incident would not cost a family more than the amount they picked for their deductible, which thresholds are $2,500, $5,000, $7,500, or $10,000 and $5,000 in your kosher amount. So you could be as little as $7,500 for the year to $15,000 for your whole entire family. And you know going in that if something happens, this is all that I would come out of pocket besides my monthly rates. And that is a huge place to start from, where most of the time, we start at, like you said, $1,400 a month. It's piecemeal. We don't really know what they're going to cover and what they're not going to cover. And then all of a sudden, we have bills coming out because some were in-network and some were out-of-network, and it is a colossal tough situation.
[0:26:25.5] Ashley James: You said the million-dollar — God forbid, knock on wood and knock my Sunlighten — medical bill, which would be over $200,000 for average healthcare, your health care caps off after you pay your deductible. It caps off at that $5,000.
[0:26:47.0] Megan Williams: Yes.
[0:26:47.5] Ashley James: Per family.
[0:26:49.3] Megan Williams: Yes, which is so incredible.
[0:26:51.5] Ashley James: It's amazing! So like you said, the 20/80 split, it's a 10/90 split that gets capped at $5,000. That is insane, and I love it. It's so freeing for so many families. I just looked it up; 66.5 percent of all bankruptcies in the United States are caused by medical bills.
[0:26:51.5] Megan Williams: That's right.
[0:27:14.9] Ashley James: Really, it's really sick. It is a broken system that keeps us so stressed out and so stuck. The way the financial system is going, the way our food costs have risen, we've got to get more creative when it comes to saving money and still being healthy. This is a perfect system to do that. This system is the perfect system because I order, for example, as your standard — I'll make sure the link is in the show notes — as your standard is a produce company that gets organic fresh from the farm kind of thing, and you can also do both. I buy brown rice and beans in bulk. I save a ton of money doing it. I buy my sprouting seeds in bulk. I get frozen organic produce and fresh organic produce through them, and they get it directly from the farm, and they promised that it's not radiated, that there's no Bill Gates spray, that new kind of spray they called Apeel, which has been around for a while for the last few years. That's not sprayed on their produce. So they're fantastic. I've been buying from them for years, but when my friends were like, “They're a Christian-based company,” I love it when a company is like, “Hey, these are our values, and we just want you to know that we're not going to poison you.” That's how I save money because even though I'm pinching pennies, money's tight, and I'm not going to sacrifice my family's health. So I will still continue to buy organic, and I'm just going to find more and more creative ways to do so. I'm throwing my own potatoes in my backyard. That kind of thing. So I'm buying from companies that I can buy in bulk and save money and looking at how I can cut costs, but not cut care, and not cut quality. And what I love about your company is that it's a fraction of the price, and we're getting even better care.
Now, I know you have so much to talk about. But I got to tell you my absolute favorite part, besides the fact that you're not going to get surprised by $200,000 bills. So there are no surprises when it comes to bills. But what I love is that you have so much more access to holistic health providers. So, let's talk about what you do get to do with this insurance. Do you call it insurance?
[0:29:53.4] Megan Williams: We don't. We call it healthcare or health sharing or a non-insurance alternative. And it's very nice because the only thing about our platform is it's a five-year-old group that's been around for five years. But what's so neat about it is they took this modern approach, and the CFO and the board have come together from past experience of what works and doesn't work — what are people wanting, what are they looking for, what do they need. And even to this day, there are some things holistically that we can't share yet. But there is so much more available here than I've ever seen, which is incredible. I absolutely love it. So I'll give a great example of that.
With our group, everybody in the entire group gets a wellness visit, and they get $150 of labs without having to pay into their PRA or deductible that comes first. And then, as you are getting treatments and you're working with new situations, they will actually share or apply visits up to fifty per member for either chiropractic, physical therapy, mental health, things that they might need like respiratory therapy, the things that sometimes are overlooked. And if we were doing them, it would prevent other things from happening, right? And I really like that because my chiropractor and I had worked out a way to be affordable and be able to use him because my children are so athletic. We tend to have things pop out and hurt. My knees have popped out. We've been in and out of the ER for a lot of stuff, and we have found that utilizing our chiropractor has prevented a lot of these issues. Well, when we came to Impact, we were really thrilled to know that each person got to come by and visit. So let's just say we pay cash $200 for our chiropractic visits as a family every month — I'm just going to use that number because it's a round number. It is easy, right? Maybe it was $100 a visit. Well, what we worked out with Impact is we pay the hour $100, and then our chiropractor's staff then sends the paid invoice with the correct codes of treatment to Impact. Well, Impact then worked with him and said, okay, listen, this is a new treatment, so we need these codes. They worked out the correct code, so everything was right. And then, they could take that bill of $100 and apply it to our deductible. So things that I had been paying cash for years, 10-15 years now, actually got applied to our PRA. So then one of my sons needed physical therapy, a new therapy for an injury that he had. Again, we were able to take that physical therapy bill, get the code, submit that to Impact, and have it applied to our PRA. Before, we would just go and have that therapy done without getting any type of application to it. So it actually went to something, and that was huge. Oh my gosh, that was huge.
And then, over time, we had other preventive care that when you're in your forties, you need. And those were getting applied. But the amazing part was, in some of the scenarios, they would readjust those prices, and in some of them, it was just what we paid cash. But it got applied. And so, very quickly, we had chosen as a family, we were paying, just so everybody knows of our background; we had gotten it whittled down to about $1,800 a month for healthcare with a $10,000 family deductible. Now on Impact, we pay $605 a month with a $2,500 household PRA or deductible. So very quickly, $2,500 between five people and little incidents adds up quickly. And it just made it so nice because as things were coming in and different processes and bills were coming in, Impact kept all that transparent. They worked with all the different providers. Over the last year, we have seen checks come back for things we paid for in cash with that 10% taken out because they're like, “No, you've met this PRA now. We got to make sure you guys get your money back.” So everything's doing the right by us, and that was huge.
[0:34:35.2] Ashley James: As I said earlier, when I looked into how much our family of three would be paying, it came out to be about $600 with, like you said, the $2,500 household deductible. Now with the insurance I had, it was $9,500. So that was a huge difference. And I was paying $1,400 a month, and now they're closer to $600 with you guys. I was sitting there going, something was wrong. I didn't input something correctly. There's got to be a glitch.
This is amazing paying for it, and I love that you called it a non-health insurance alternative because that sounds like my latte. It's like I'm going to have the non-dairy alternative. It's better, and it's healthier. This is like that — the healthier, non-insurance alternative. This is the holistic non-insurance alternative. It just sounds like my entire diet. It's like, I'm going to have the non-meat alternative or whatever.
[0:35:42.2] Megan Williams: Yes, it's so true. It feels like that. You're absolutely right. So for those of us who are used to non-traditional, this is a perfect solution. Now, there are scenarios, Ashley, 100%, that we're not the right fit. But it's not all or nothing. And that's some of the things that really blew my mind as I was helping families trying to find solutions. I'll give a great example — we had a mom who has been diabetic since she was born, and she needed very specific medicine, and it was very, very expensive. And so, on the marketplace, there are some great plans that are out there. But again, it's nice. Like you said, there are brokers who actually helped. And so, in our hunt for helping people find solutions and really trying to find the best so people can come to our group, we have made some really great strategic partnerships. So this family comes, we look at the price point, we look at everything it covers, and she goes, “Oh my goodness, this is perfect for my husband and kids. They don't have any issues. This is what we've been looking for.” Well, they were a family of four, and what we did was we were actually able to put the entire family in our group with Impact. She worked with a broker that we knew and got great diabetic coverage for what she needed because that was pre-existing for her. But she can utilize our group as her secondary. So she gets her wellness visits, you know, included. She gets her normal thing. She gets all the benefits of the discounts for our prescriptions, but she gets what she needs with traditional. So, yes, they're paying a little bit more. But if they had kept the family on that traditional plan for the four of them, it was going to be $2,800 a month. Instead, she could have that plan for right around $600, and the family, including her, could be with us. They were a little older than us. So it's about $650 a month with a $2,500 deductible. Well, that was still $1,200 less than the $2,800 they would be paying if they were all on traditional. So it's not an all-or-nothing scenario.
We've had people who have high blood pressure. It's pre-existing. With us, any of those bills or doctor visits about high blood pressure would not be applied to the deductible or to sharing. But if they had a heart attack, or they ended up in the hospital thinking they were having a heart attack, that would be shared with the group because that pre-existing does not affect future cardiac and vascular events that could come up. So again, it's not an all-or-nothing for individuals with us. It just is; what do you feel comfortable with? We sometimes have where the parents don't even come to Impact. They stay with their employees' coverage, and their children come to us because it's so much more affordable to mix-and-match per se. So again, this is the non-traditional approach, folks. It's not all or nothing. It's crazy, right? I mean, they pay into any type of chiropractic, physical therapy, vision therapy, occupational therapy, speech therapy, or respirational. They look at mental health. They want to help us. With preventative ladies, we all get our preventative care and work with all of those things, and they'll share in it. It is big. They have limitations, but the limitations can be for a favor and/or protect us from people abusing the situation. So it's really neat how they word our guidelines. And when you go to Ashley's link, you can look at the guidelines and see the transparency of it, which is huge. It's fantastic, so we love that.
[0:39:38.2] Ashley James: So it's learntruehealth.com/healthcare. You definitely want to check that out. I love that I can go to my chiropractor every two weeks and not have to worry about it. I like to see my naturopath once every six months. I don't have major health issues, but I really like to check in twice a year. I like to do some blood work if we feel like we need to. Pretty much I like to do blood work once a year. But if there's anything coming up, I like to just check in on it. I like knowing that I have access to these other services, like physical therapy. I got to tell you physical therapy for women after giving birth is the most life-changing thing. I have an interview about pelvic floor therapy, and it's not just for women. If men are having trouble urinating, have pain during sex, and pain during evacuation, they can also have a disruption in their pelvic floor. So I had this great interview about pelvic floor therapy. I've seen three different pelvic floor therapists. I had one before my second pregnancy and two after. And one of them did a type of massage. Yes, it's a vaginal massage. They wear gloves and everything. What she did was she broke up scar tissue. I didn't even realize that this was the problem, and it corrected everything. It was amazing. I could walk properly. My chiropractor pulled me back together because my pelvis was twisted. But it's really interesting how scar tissue, after giving birth vaginally, can throw off the whole pelvic floor, which throws off the glutes, which throws off the hips, which throws off our gait. It is all connected, and I ended up because my crappy expensive health insurance wasn't covering it. I had to pay $5,500 out of pocket for all the PT I got, and it was so frustrating. I am paying so much money for health insurance, and on top of that, I have to pay for the care I need because I was in pain, and this might be TMI. Well, my listeners know me. But intercourse for seven years was painful, which doesn't make it fun for the husband because he's like, “I don't want to hurt you.” But that was the scar tissue left behind, and that was the stitches that the doctor did without really consulting me, and it caused so much scar tissue that it wasn't fun. It was no fun experience for the last eight years. And then I had the PT, and it was like everything down there was reset to pre-having kids. I couldn't believe it. And then, finally, there was no pain during intercourse, and it was like, I didn't realize how much I missed not having pain down there until it was reset. But this is pelvic floor PT, not covered by a lot of very expensive health insurance companies, and here we have something. These are licensed physical therapists. This is a legitimate service. This is a legitimate physical therapy, and it can be covered by this non-insurance, healthier alternative.
[0:42:55.3] Megan Williams: That's right. No, it's really true. So let's talk about maternity because that's one of the big questions. I have a new member family that is young. They have two children. They want to have another one, and they have been looking. Her husband changed jobs, and with the new job, healthcare wasn't really a viable option for them and their family. They're like, “It's not really providing us care. It doesn't do what we want.” And she just happened to see one of our posts on Facebook, and she sent me a message. Her mom and I have been friends for years, and she's like, “We really want to have another baby.” I said okay, stop right there. If you come to us, we need to get you in the system fast because you need to be a member for one year before that baby is born. So she's like, okay. So she's been a member for one month, and she's been waiting for three months. “So four months total before we started trying for another baby,” and I started laughing, and I said, “Yes, because with our program, you guys, you get up to $150,000 towards any single pregnancy event that is shared in the group.” The neat part, just like you said. Afterwardsafterward, physical therapy would be something that would definitely be shared with the group. You can also pick which kind of doctor you can be performed with. So you can go to a facility. You can have a midwife come to your house. You can have a water delivery as long as the midwives/PA are all certified and registered in that state for delivery as long as they're properly licensed.
Now this is a huge option because so many people now are looking for alternatives for that. It is great. And then, of course, the newborn will become a member and be added right when they're born. So it's perfect. And then they get extra visits that first year and then up to the age of six. They get all their visits, and all that stuff included that is shared with the group to make it very affordable for us. And so I think that that is a really huge blessing because, like you said, these doctors, in and out of network, all of a sudden emergencies happen, and you get these extra bills. And that's not what you want to be focused on when you have a baby. That is a fantastic added benefit. For our members, they really want us to recover, and they want us to have great options. And absolutely, that type of therapy would be included because it would fall under physical therapy. So it's fantastic.
[0:45:29.8] Ashley James: Absolutely. I'm so excited. As far as people with pre-existing conditions like asthma, for example, they can still use your non-insurance healthier alternative, but when it comes to their pre-existing condition, it is not covered for the first 36 months.
[0:45:52.5] Megan Williams: Correct. In our guidelines, let me just say it exactly right so everyone understands — so pre-existing medical conditions are conditions that are known signs, symptoms, testing, diagnosis, treatment, or other use of medicine occurring within the last 36 months. Now asthma would be something that would be pre-existing because it's been diagnosed. But at the same time, the nice thing about asthma is that besides having a prescription and being aware of it, there's no long-term effect. So a lot of people would say, okay, I could come to this group. I know my prescriptions are going to be discounted because I'm not part of the group anyways, but maybe if I have a special respiratory scenario, if they've just been recently diagnosed prior to coming to the group, that would be considered pre-existing. But some people haven't had treatment. They may have just been on medicine for the last ten years but have not had any type of diagnosis or treatment per se in the last 36 months. So anything new coming up would not be considered pre-existing.
I'll give an example that happened to me personally. So I have acid reflux from having twins. They always say when you're pregnant, you have heartburn. Well, let me tell you, when you have twins, it has nothing to do with the hair on their head because my two are bald. But it definitely was something that I got, and then I continued to have it off and on for the last thirteen years. Well, when I was with my last traditional insurance, they saw on my doctor's notes that I had gotten a prescription for heartburn, and they told me that it was pre-existing. And if anything ever comes up — an ulcer, esophagus cancer, anything — we will never cover those things because you have a pre-existing. Now mind you, I've gotten medication once in the last six years, but it was in my records. So I came to Impact, and at that point, I was so mad that I didn't get prescriptions for it. So I haven't had a prescription for that for years. I just use over-the-counter stuff every once in a while because it's there. Well, on my application, when we become members, you fill out things that, have you had any issues? So I put in acid reflux because I'm honest. Well, then later, I talked to Impact, and I said, listen, I have acid reflux. I take medicine for it every once in a while. I said, is that a pre-existing? They said, no, it's not a pre-existing condition in a sense; it's for your future care. So I thought, okay. Well, I went in to be scoped for both my colonoscopy and endoscopy. I think it's how you say it, through your throat, to make sure you have no cancer. Guys, when you're in your forties, they care. They want to make sure, and it runs our family, so I had to go get checked. And I've been avoiding this for years, by the way. Well, the doctor goes in and realizes I have a herniated esophagus. He did some different things during the procedure that helped immensely. And I'm sure he put it on the bill, but what I did realize on my bill is I got all of that shared “covered” with the group, and it was not considered a pre-existing.
And so that was a huge thing for me to see that they said, “Okay, you might have gotten that prescription years ago, but we're not going to hold it against you even though I'd still take medicine for it.” And I think that that was huge. That was a really big thing. So again, it's not all or nothing. And when anyone joins our group or wants to even ask, they can talk to Impact prior to joining and ask all their personal questions and feel super comfortable about those answers just in case. So it's really nice for them.
[0:49:56.3] Ashley James: So they can go to learntruehealth.com/healthcare, and that's where a lot of the information is, and they'll be able to find the phone number to talk to someone.
[0:50:09.6] Megan Williams: To request, absolutely.
[0:50:12.5] Ashley James: To talk about pre-existing. So I'm a little confused, and if I'm confused, then there's got to be a lot of listeners who are confused. Again, I'm a Canadian here.
[0:50:20.9] Megan Williams: Yes, I know. I know.
[0:50:22.4] Ashley James: That's making sense to me, right? You know an American can walk into a Canadian hospital and get care and not be kicked out. But I'm not saying their system is any better. The healthcare system is broken because it's all about pharmaceuticals and profits. And in Canada, it's not about profits. It's about cutting costs. So, it's, again, a broken system. But we're doing the best we can to navigate a broken system by choosing freedom of choice, which is why I love this non-insurance healthy alternative to insurance because we can have the freedom of choice to choose our practitioners. There's no network. And I want to talk about this. You can go to a different state, and if you're in a different country. You'll get coverage, and you're protected under this umbrella, which is what insurance is supposed to do. But I love that you have the freedom to choose your holistic, licensed practitioners, and that makes me so excited.
So let's just talk about this just so we can fully understand it. If someone has a pre-existing condition, and then they join this wonderful non-insurance healthier alternative to insurance after being with you guys for 36 months, are there pre-existing conditions that are covered or pre-existing conditions that are never recovered?
[0:51:46.7] Megan Williams: Okay, so let's use an example. So the condition has to not have had a treatment or a diagnosis or any signs and symptoms testing in 36 months. So I'll give an example of my friend who had shoulder surgery. So she just had a treatment. She had a shoulder repair a year and a half ago. She joins Impact. She knows if anything comes up with this left shoulder of hers, physical therapy, or she goes and gets more treatment on it, that would not be shared with the group. Now, Impact would help reprice any of those expenses. They would help be the liaison. But because that experience happened within 18 months, it's still in that 36 months. Now, let's say she doesn't have any issues. Her shoulder's been fine, and we finished 36 months, even though she's only been a member for that 18 months because now the total amount has been 36 months of that time of treatment, diagnosis, surgery, whatever — now, anything that comes up from that shoulder would be shared with the group. It would be able to not be all out-of-pocket expenses. And so, it's not about being a member for 36 months. It's when did that sign, symptom, and diagnosis happen.
So, I have a friend who had a heart attack, and he has a big family. They were paying $3,200 a month for the health care for their family of eight, and they were able to come to Impact for $700 a month. And his biggest concern was I had this heart attack. While he gets a screening every year, he has not been on medications. He has not had a diagnosis. He has not had treatment for that heart attack for more than thirty-six months. So, according to Impact's guidelines, it's as if it never existed.
[0:53:49.8] Ashley James: Got it.
[0:53:51.3] Megan Williams: So even though he gets a screening for it, that's not a treatment or test. See the difference. So that's why this is so neat because, for example, if you've been diagnosed with cancer and it's in complete remission, and you're only undergoing testing for surveillance purposes, as long as that cancer hasn't been treated for 36 months, it is as if it never happened.
[0:54:19.7] Ashley James: Now, let's say he did, for example, had his heart attack and then immediately joined, and let's say it's an ongoing problem; it's a pre-existing condition because it's within the first 36 months he has joined. Is it like 10 years, 20 years, or 30 years that forever it's not covered, or is it just not covered for the first 36 months?
[0:54:50.5] Megan Williams: I'll give another example of someone who had a heart attack on New Year's Eve. He has joined Impact while still getting treatment and medicine for that. So that portion, he gets an employee stipend for his medical. But his wife does not. So they decided to both come to Impact because the medicine that they prescribed him was $700 a month. Through Impact, though, because he's a member, it's only $73 a month. So even though he has traditional health care that's going to cover his pre-existing heart attack scenario and all the testing and treatments he is still going through, he's almost done. The doctor's like, “I can't believe how well you're doing.” Let's just say that by October, he no longer needs to have treatment or medicine; they'll just do a screening because everything's looking great. From October now, the clock will start for 36 months. So even though he's been a member since January, that one condition, the clock starts once the treatment stops.
So it's not about membership. It's about when the treatment stops before you come. But he wanted to be a member, and it's his actual secondary as a member because he wanted the medication discounts that our group got him. So it was worth it because he saved $600 a month on the medication even though he's paying for a secondary with his wife with this. Actually, this is her full coverage, and it's his secondary. But they're both on Impact because he wants those benefits. So again, it's not all or nothing. But the nice thing is, yes, he has a heart attack, but if he had a stroke, that has nothing to do with the heart attack. Or if he got colon cancer, that has nothing to do with the heart attack. So all those things would be shared with the group and have “coverage.”
[0:56:53.6] Ashley James: And so in a few years, let's say he's heart attack free, the heart's fine, cleans up his diet, listens to my podcast, learns how to prevent and reverse heart disease — that's a really great episode with Dr. Caldwell Esselstyn, How to Reverse and Prevent Heart Disease. Just so you know, if you know anyone with heart disease, this is the book. The interview is amazing, obviously, but the book is phenomenal because he performed the world's longest study using food to reverse heart disease. Within two years, they've taken photos, and they show you that there are four blockages in the heart. These poor people who are too sick; they were on death's door and too sick to have stents put in or have surgery. They were within weeks of dying. Too sick to do anything else, so he was like, okay, well, let's just try a diet. And he gets them on a whole food plant-based, no salt, sugar, oil, flour, or alcohol diet. And there is also stuff you have to eat that increases heart health, that helps the endothelial lining of the cardiovascular system. It's like science. You're eating six times a day of all these different foods that are all heart-healthy, and he gets people to go from four blockages in the heart to zero blockages in the heart. Angina pain is gone in the first month. Blood clots in the leg are gone very quickly. It was absolutely amazing.
So anyway, let's say one of your guys has a heart attack, buys your non-insurance, healthier alternative to insurance, and gets this coverage, and then he cleans up his life. He doesn't have any heart health issues for 36 months, even though it was his pre-existing condition. But 36 months of no health problems around the heart, according to you guys, it's no longer a pre-existing condition, and should he have heart issues in the future, like five to ten years down the road, then it's covered?
[0:58:55.3] Megan Williams: Yes, that's exactly what I'm saying. You got it!
[0:58:59.1] Ashley James: Yey, I understood it! The Canadian's got it.
[0:59:02.7] Megan Williams: Now you did perfect. And I love that podcast because I have friends who need to listen to it too.
[0:59:08.4] Ashley James: Yes, all your friends need to listen to my show. Absolutely. It's amazing. Our body has a God-given ability to heal itself. We can heal ourselves. I reversed five major diagnoses, and so can you. Your body can heal itself. We just have to stop doing what everyone else is doing because everyone else is sick. Just go become a black sheep, go against the grain, cannot eat like everyone else, can't stress out like everyone else, right? Listen to my show.
[0:59:37.7] Megan Williams: It's so true. Well, that goes to this whole thing of thinking outside the box. So then a lot of people ask me all the time, and they go, “What about the providers? Will they even work with us? Because most people haven't heard of Impact.” Let me give you a little scenario. Most marketplace plans are just the bare minimum. So what that means is the provider might get 70% of what medicare pricing is, or 80% or 90. Sometimes they're lucky. With the Blue Cross Blue Shield, they still get 100% on certain things. Well, the new thing is when Impact looks at reference-based pricing, they're not trying to get the cheapest thing that nobody wants to work with us. They actually start their pricing with 150% of medicare pricing. So now, the doctors like working with us because the price point isn't insulting them, which is so good too. And again, when you're thinking outside the box, half of these medical professionals have just been beaten up. They've been told that they're not worth what they think they are. And we'll say, no, you're worth it, and we want to work together to find solutions. So when you are talking about how your body can heal, we can also heal these relationships with doctors and facilities. All of us, because we're coming to the table, not just trying to find solutions for us, but also for the providers. That's a really good place to be because it's about solutions, and that's what makes it so nice. You know what I mean? So I really love that. I love that your listeners listen to outside-the-box thinking, but in this scenario, just like in yours, it's a win-win because we got to be smart. We got to make everybody feel important. So we're cutting the cost but not the care. The providers are not getting gouged and say, “Oh, we don't care that you have 20 years of experience. We're not going to give you what you deserve.” No, we're going to help you get what you deserve.
[1:01:46.4] Ashley James: It's not a pyramid where there are these shareholders at the top going, “Mwahaha, I like sitting on and swimming through bags of money.” All the other traditional health insurance companies gouge the customers, and they gouge the providers. They keep the profits for themselves and are just evil. And we have you guys, who are the non-insurance, healthy alternative to insurance. Why should listeners go to learntruehealth.com/healthcare? You created a great website that explains this a lot. You can play with the quote and see how much your family would be paying, or individual. Maybe you're not a family member, just an individual. You're a single person. How much you'd be paying, play with the quote meter — but what else will they see at learntruehealth.com/healthcare?
[1:02:38.3] Megan Williams: Well, what we love is we really wanted everyone to understand why this is so different. And so, on the homepage, I do a 7-minute video that breaks down all the benefits of our program and helps you feel comfortable. But then we included videos that Impact has made over the years about important facts and why this is such a smart, different way of thinking. But on it, you could even see testimonials. You can see what groups could pay. We work with businesses where they've been priced out of healthcare options for their employees, and so they're losing employees to other companies. And we have an entire page where you can get a quote for your company. We also have wonderful videos that explain going to the doctor and how we work with everybody and their no-network restrictions. It is very transparent. But when you're on the guideline little page, the overview is directly linked with our share group. So it's updated as they make legal changes. Everything is transparent. Everything is there.
And what we love is that you don't have to try to figure it out. I have a lawyer who's in our group, and when he read the guidelines, he's like, “Oh my goodness. This is one of the best-written documents I've had.” Because if it's not in there, they're going to share it. They're very specific about what is a concern and what's not a concern. And as you said, we can play around with the pricing. Our individual starts at $73 a month, families at $250 a month with a family of two, and then, of course, three and more. We are not trying to make this difficult. We want everyone to feel very comfortable. So, when you're on our site, you can even request more information and hear from Impact themselves and/or our associates because we've had so much experience as members of the program to help out as well. We run live events that you can register for and learn more about. And, of course, working directly with Ashley's group and this community, we really know that we'll be able to give great solutions, and it's really nice for that too.
[1:04:58.5] Ashley James: I just love that you can get all the coverage you want, and it's cheaper than your car insurance. Well, at least it's cheaper than what I'm paying for car insurance. And I'm a good driver, and knock on my Sunlighten sauna; I haven't had any tickets. I don't know; I think I was in my twenties the last time. Oh, I mean, I had a parking ticket a few years ago. But other than that, I haven't had any traffic violations. Knock on my Sunlighten sauna; I haven't had any traffic violations. But car insurance is expensive, and you guys are cheaper than my car insurance. I'm shaking my head thinking about how many Generation Z people, young professionals — I'm friends with some of them — who don't have health insurance because they're like, “Well, I can't afford them.” $73 a month? Yeah, you can.
I have a friend who's a chef, and he's like, “I can't afford.” Half the year, he lives out of his truck because he loves to travel. He works at resorts, out in Vail ski resorts, and then the rest of the year, he is traveling and having fun, and he's just like, “I can't afford health insurance.” I can't wait to tell him it's $73 a month. He can absolutely afford it. And then when he cuts his thumb off or whatever, then he does something stupid while in the kitchen, or burns himself, or something. I mean, he's traveling, and what if he gets chased by a bear? He's traveling all throughout the country, living the van life half the year. I'm thinking he would love this type of insurance, so he could go to any licensed provider in any state and be covered.
How cool is that, that you can choose where you want to go. Your location doesn't matter. The insurance that I've had for many years, that I've been buying for many years, the traditional insurance — I couldn't even go to the other side of town. It wouldn't cover me. I had to only go to this one hospital network. It's just ridiculous. They say you're covered pretty much in every ER, but then if you're transferred from the ER into care, it's just ridiculous. The traditional system does not work. And I love that you can even do your non-insurance alternative to better insurance. You can do this as a secondary, which gives you even more coverage. So, anyway, I like the savings. I like the savings, and I like that I can now see more of my providers. That's super exciting. Tell us a little bit about traveling. So you could choose to go see a doctor or clinic in a different state. And also, what about traveling, like you're in Mexico or you're in Cancun? Tell us a bit about how that works.
[1:07:42.1] Megan Williams: Absolutely. So the neat thing is, there are no provider restrictions. We had a young member who was diagnosed with cancer in the Arkansas area, and the doctors just weren't a good solution for this type of cancer. And so, he ended up going to Dallas with his family and getting all of their coverage. Well, after the repricing and everything like that for the year — I mean, we're talking a couple of million dollars of procedures — the out-of-pocket for the group was only around $280,000 for the year because the markup is so absolutely insane. Well, the new thing is if you were just traveling and you have an emergency, that also is covered. So you can have planned trips in America and go to any provider as long as it is not elective. So still today in healthcare, elective surgery is not covered. So sorry, ladies. Facelifts, botox, and all the little fun extras that people might pick, like hormone therapy, those things are not covered. Same with out of the country. So if you planned a specific surgery out of the country because it was cheaper, those are also not covered. But if I'm in Mexico, which I was a couple of weeks ago, and having a situation with coral that I needed to go and run to an emergency room quickly, I got that bill, and I could submit it to Impact. And yes, it was shareable with the group, and yes, it would be covered. So you could be traveling anywhere in the world, and if you end up in an emergency situation, those bills are going to come back through the group and get shared. And the nice part is there is no lifetime limit. So if you end up having a big scenario, you're not kicked out the next year because you cost the group too much money. That's very important.
The other really great thing is, right now, we do have a yearly or annual limit per member, not per household, of $500,000. But what they found in the last five years, even with these huge expenses with the reference-based pricing, we aren't even getting close. I had a friend who was out golfing and all of a sudden had abdominal pain that he thought he was dying. They rushed to the emergency room to a hospital. He thought it was an appendix. Well, he ended up having a ruptured spleen, and he was in the hospital for five days. The entire bill came to over $152,000. It was actually four days, and then he was out on the fifth day. It was $152,000. Well, with the reference-based pricing, it came to $36,000. So he didn't even meet his max limit of the $5,000 10% co-share because they were able to reprice it so much lower.
And so, this is a really great thing because, again, you've got advocates. And he said the best part was the little lady in billing at the hospital who came in and said, “Don't worry, Mister Chris, we've got everything. We've talked to Impact, and everything's being paid for a hundred percent. You don't have to worry about a thing. I'm working with them. You just get better.” And then, when he got home, he had a message from Impact saying, “Hey, we know you've had the surgery. We hope you're feeling better. If there are any questions or any bills come, let us know. We'll help take care of everything.”
[1:11:08.1] Ashley James: What??
[1:11:09.9] Megan Williams: What is that? Because this is more personable, it really is about making it a better scenario.
[1:11:19.8] Ashley James: I love it. I was a little slow in catching the numbers. So it's a $150,000 hospital bill. How much did he have to pay out of pocket?
[1:11:31.0] Megan Williams: Well, I actually even have this on one of our Zooms, and we were working on some of these kinds of examples so people can see. While he was repriced to $36,000, he paid $150 for the provider fee for the ER. So he paid $150, and then he still had about $1,588 left on his deductible or his primary responsibility amount. He paid 10% of the co-share of that $36,000. So out-of-pocket for that entire expense, he paid $5,200 and not $152,000.
[1:12:14.4] Ashley James: So $152,000 — that's like buying three brand new cars — got down to a $5,200 hospital bill when the whole thing was said and done. Now let's say that happens to one of our listeners who joins, who goes to learntruehealth.com/healthcare and checks out the cool Zooms and the videos and does the quote. They join their whole family in. If something, God forbid, happens to them and they need this kind of emergency medical help, and then they get on the other side of it, and then they get the bill — so it's $52,000 — do they have to pay that all at once? Can they do a payment plan? How does that work?
[1:13:02.2] Megan Williams: Very good question. So the nice part is once Impact has negotiated and they send in their portion that they pay, then legally, the hospital — that includes all the providers; this list had everybody on it from the anesthesiologist to the pharmacy, when he was leaving the hospital — once they accept that reference-based price, then that bill is locked. They can never come back and ask for more amount. But Impact then would send you, “Okay, your portion is this.” And then they send you where to send the bill. And absolutely, you can call their facility and say, “Okay, I'm making plan payment.” And you might pay $1,000 for the next five months, and then you'll be done. So the nice part from my experience is, with them getting the lion's share of what they really needed and then you paying your percentage, they work with us as humans to make those payments.
[1:14:07.8] Ashley James: Who are you paying that to? Are you paying that $5,200 to the hospital, or you're paying it to Impact?
[1:14:11.4] Megan Williams: Yes.
[1:14:12.4] Ashley James: Okay. You're paying it to the hospital. So you can negotiate with the hospital and pay $200 a month instead of $1,000 a month?
[1:14:19.9] Megan Williams: Yes.
[1:14:20.5] Ashley James: You can make it manageable. Yeah. Okay.
[1:14:23.0] Megan Williams: But they got the big amount. So they are feeling the burden off their shoulders. So then they are so much better at working with us. The problem is when people say, “Oh, I have a two-million-dollar bill, and I want to pay you $200 a month.” No, that's not how this works. So absolutely, that's what's so nice about it. But the best part is that they legally can never come back and say we want more money from you. So the nice part of having someone like Impact as your advocate, and it's in the system legally, they can't come back and say, “Oh, we changed our minds. We don't want to just accept $36,000. We want you to pay $50,000.” They cannot do it because they accepted that price and took the money from Impact. So that's what's so nice about having a person like this and not just being cash-paying where you could get screwed because you don't have an entity that is your facilitator. Impact has a legal team, and they know all the rules. They know how the system works, and it's a fantastic peace of mind.
[1:15:30.9] Ashley James: Now, something you don't know about me is that twenty years ago, I was an insurance salesman. Funny enough, it took me this long to actually think about this and go, “Oh yeah, I used to sell insurance.” I mean, it was twenty years ago, a totally different lifetime ago. It was door-to-door. It was a combined, and this is in Canada. I don't know if you've ever heard of combined health insurance, but this is, again, twenty years ago. It was either they had accident insurance, and they had sickness insurance. For Canadians, our health insurance is like you pay almost half your paycheck to social services. It's like we get taxed through the nose. It was just crazy. It's like something between 46% and 48% of your paycheck is bye-bye every month, just paying all the social services. Healthcare is not so great in Canada, but again, pluses and minuses all across the board, I don't think Canada is better than the United States or vice versa because it's a very different system, and the system's broken no matter where you go. So you got to think holistically and go to the right providers.
But there I was in Canada, and I was selling door-to-door insurance. What it was is you paid $14 a month, and then if you broke a bone, they would give you $1,000, or they give you $1,500. If you had a car accident, until you've missed some work, for every day you're in the hospital or ICU, they would give you $5,000. They would basically be giving you money to get injured. Obviously, don't go buy the insurance and then injure yourself. I've actually met some people who had injured themselves and received the payouts. And they're like, “Yeah, this company is amazing. They really do pay out.” And then they had sickness insurance. So if someone was in the ICU because of an infection, or in the ER because of infection or whatever, if they had to miss work basically and that they live in the hospital because of the infection, they got paid every day a certain amount. There was a limit, though. There was a cut-off. It's like you can only have this many days in the hospital that we're going to pay. So we're going to pay thirty days, for example, because it wasn't a traditional health insurance. It was just more like an accident or sickness insurance. It was more like your paycheck insurance. It's what it was, which I thought was an interesting safety net. Because life happens not to everyone, but life happens, and it's great to have a safety net.
Anyway, that was an interesting experience. I got to see that world while I was kind of figuring out life, and I did it for a summer. It was interesting. It wasn't my cup of tea, but I'm meeting a ton of people and learning about the industry, which was interesting. And so the thought that came to mind, I know this is not that, but is there a limit to how many days someone could be in the hospital? Like you said, you get to see fifty providers a year with all these different services. So all these services are covered, but is there a cap, or they're like, “Sorry, you've been in the hospital for fourteen days now. You're cut off.” Is there any kind of gotchas like you said?
[1:18:53.0] Megan Williams: I love it. I was going to say, I know exactly what you're saying. So this is a great thing to be paired with something we call in the United States, disability insurance, or, like you said, paycheck insurance, like Aflac, where they'll match, or you can get reimbursed for those copay provider fees and things like that. But what's neat is if somebody is in the hospital, like we add another friend who's been in Impact and she was in the hospital for almost a month, and Impact shared everything with the group and repriced it all. So there isn't a limit to those kinds of things. There is an in-patient limit or things that are not eligible, like in-patient rehab or residential drug alcohol treatments. So they give a specific list that is not eligible at all, and it's normal things that they don't share or cover in normal insurance. But there are no limits if someone ends up in the hospital for a month because of whatever disease is going on. Like this little boy, who had been relocated to the hospital in Dallas for months at a time, there is no limit on that. Like I said, with a repricing, then they have not met that limit for the annual amounts either. And so I think that what we can really know is that they're going to do their very best to make sure that we're taken care of.
Now, there are some limits for home care as well. So, some of the things they do share into are forty visits for a member who has home care. So, let's say they have an RN who has to come to the house, and they're in their homes, that is limited to forty visits for the year per member. And if someone needs transportation, like air ambulance and things like that, they are limited to $25,000 lifetime limits for those kinds of things. Usually, an ambulance is about $500 to $600 of usage. So that gives you a lot to work with. But there are some specific limits. Anything that is a limit, they specifically tell us in the guidelines. And if it doesn't say in the guidelines, then there's not a limit, which is really cool.
[1:21:16.9] Ashley James: Oh, I like it.
[1:21:19.7] Megan Williams: Yes, it's very transparent that way, and that's a great question, Ashley.
[1:21:24.5] Ashley James: And all these details can be found at learntruehealth.com/healthcare. I love that you lay it out. You made the website so easy to understand, and you've got the videos, and people, like you said, can read through everything, see what the limits are, see what the limits aren't. And if it isn't listed, it's not a limit. Even though it doesn't provide rehab facilities, for example, it does provide mental health. So someone could go to a licensed mental health professional and work on healing through addiction.
[1:22:04.7] Megan Williams: That's right. Absolutely.
[1:22:06.0] Ashley James: It's not that we're saying those people are screwed. It's just you're not going to pay for the Betty Ford clinic experience.
[1:22:14.8] Megan Williams: Correct. As long as people are honest about it. We're looking for people who are making wise choices. So, for example, my husband always says if someone wants to go skydiving, good for them. There's no limit here. But some insurance companies won't care or cover any skydiving accidents. But my husband says, the way they worded it in Impact is, let's say I wanted to go skydiving and I decided to throw my shoot out first, then dive to my suit and put it on. Well, that was negligent behavior. And therefore, when you are hurt, injured, or killed, they're not going to share into that because it was stupid. Like if you're using illegal drugs, that's stupid. But if someone happened to get in a car accident and they had been drinking, yes, those are going to first go to your car insurance, but Impact is going to share in those medical expenses as well because those kinds of accidents do happen. They weren't trying to be grossly negligent, if that makes sense. So they do have a little provision that protects people like us who don't want people to do stupid things and think that then we'll share it. But I mean, hey, you got a little life. Have fun and go river rafting and do fun things, or have a life. It's really nice because even motorcycle accidents are covered up to $125,000 per incident, which is a big deal. It's a really big deal. We had a young man who's 17, whose friend ran into him and severed his toe, he almost lost his life, and Impact has shared to the whole entire situation, even though he was on a dirt bike. He wasn't being negligent, and it was an accident. And I think that that's also very important to understand that there is a difference between negligence and accidents, and they work with us and help us, which is fantastic.
[1:24:12.3] Ashley James: Love it, love it. And another thing, again, I've been looking for this solution for years, and I had not found and had not been satisfied by all the other companies I've seen until I found this company. I was like, finally, this is exactly what I've been looking for. I'm so excited. So, my friend who's in a health share, it's a Christian health share company, and at first glance, it looked good. And then I looked further, and it was like, well, you have to be this BMI — body mass index — meaning, you have to be skinny in order to be a member. We're going to weigh you. So I get it; they just want healthy people. And if your cholesterol is at this level, you can't be covered by us. And if you join us and you're skinny but then you gain weight, you're going to get kicked out. And so that kind of health share company, I felt, was too restrictive. It wasn't giving freedom of choice. What I love about yours is, let's say someone is obese and they're working on themselves to be healthier people — and one-third of the American population is overweight or obese, so that really limits you if you were to not allow those people to join — and so there is a small, increased fee. I saw that, and I thought that's amazing. It's worth it for someone who's overweight, who knows they're overweight. They're doing their best. They're looking at being as healthy as possible because weight loss should be a by-product of a healthy lifestyle. It's not the goal. It's the by-product of the goal being to be as healthy as possible.
[1:26:00.0] Megan Williams: That's right.
[1:26:00.6] Ashley James: So eat healthy, exercise, lower your stress, get good nutrition. The weight is going to come off, and you're living healthier and healthier and healthier. And even skinny people can die of a heart attack.
[1:26:13.5] Megan Williams: That's right.
[1:26:14.9] Ashley James: But the point is that you guys don't exclude people who are overweight. Or let's say everyone in the household, except for the dad, is overweight. You're not excluding the whole family because one member is overweight. The people who have some weight that they want to lose, they get to pay a little bit more, not an exorbitant amount. Just a little bit more, and then they get to be covered. And I thought, how inclusive is that? I love that you would include people of all faiths. You include people of all bodies and health. I love that you don't charge people more because they have a large family. So a family of eight or a family of three, they've got enough expenses if they've got five kids, or they've got six kids or seven kids. They've got enough expenses, and you're not going to continue to gouge people who have so many kids. Typically, kids don't have a lot of health issues compared to adults. Hopefully, fingers crossed, they will listen to my show and follow all the wonderful health tips. So I really love that.
I love that you can travel. You can travel to different providers in different states. You can go to different countries and feel rest assured. I used to buy travel insurance. Being Canadian, I used to pay for and buy for a few hundred dollars. I'd be traveling. Every three months, I go down to the States because I was doing different conferences and stuff like that. This is back in my twenties, and I would pay upwards of $500 for coverage, and I never had to use it. I never used it. But I didn't want to be in the States without health insurance because I just knew that that was a bad idea. So I bought traveler's insurance every time I went somewhere outside of Canada before I moved to the States. And just to know that you're covered is so reassuring. That is so cool.
[1:28:09.8] Megan Williams: Yeah. It really is peace of mind, and that's what we're trying to do with our group. And, Ashley, I think all of your listeners are the kind of people who want that. They want to have choices and freedom, and that's what we're really trying to give. And what we love is grassroots movements like this being able to share with people and let them make an educated decision for themselves. What is the right fit? I love it. You're individuals, and you're a tribe, I want to say, or educated. They want to have better options and solutions, and you are giving them that every single day and I love that. I think that's fantastic.
[1:28:50.1] Ashley James: I think I know the answer, but I want to check. So vision and dental supplements are things that are not included?
[1:28:58.0] Megan Williams: That's correct. A lot of times, everyone thinks in insurance, you have to have dental and vision. Well, you can get a policy for that very easily anytime, anywhere, from any group. So what Impact has chosen to do currently is that if it has a medical connotation, like you were injured and you need surgery on your eyes, or your mouth, or your jaw — I had a young man whose roommate hit him in college. He had to have jaw surgery. The dentist came in and did that reconstructive surgery. Those are, of course, all shared. But when we're dealing with just having our teeth cleaned and our eyes looked at, that is not part of this group. But it is definitely something that people can find in America with tons of different brokers, and that's not a concern. I use Costco for one of mine, and I've got a great family dentist that works out stuff as a small business owner for other business owners. So again, those are things that are not on our guidelines because they're not as expensive to manage for a family.
[1:30:06.6] Ashley James: But if it was like an abscessed tooth or like an eye infection, would that be covered?
[1:30:11.9] Megan Williams: Yes, because the eye infection would come from something that was medical usually. And so then it starts at a medical. Now, the neat thing is, you don't have to go to a doctor to get a referral to another doctor to have this be “covered.” If you were having infections, you could go right to that kind of doctor, like my sister, who has been a member, and her knee started bothering her. She went to a specific orthopedic that she had heard was the best, and she didn't have to see seventeen doctors beforehand and spend all the extra money. She just went right to him and started doing work with them.
[1:30:49.7] Ashley James: I love that. My friend is from a different company. She's with a health share company. She has stenosis in the neck. She was in a car accident years ago, and stenosis is like the bones are closing in around the nerves. So she had pain going down her arm, and every few years, she gets a CT scan. She has not gotten surgery for it, but she's debating and does everything natural to keep it at bay. She's doing a really good job managing the pain. But she found a search, and she's like, “I'm really interested in just cleaning up the bone spurs that are pushing on the nerves.” And their insurance is like, “No, you have to do it in this order. You have to see this doctor before you see this doctor. You have to get this scan before you see this doctor.” And it was so confusing and so annoying. She couldn't just go see the guy. She had to do all these other things first, and they wouldn't even cover her to see him until she had met their criteria.
So I love the freedom. Like we said at the beginning, this gives freedom of choice and allows us to navigate the whole medical system, which is weird. It allows us to choose the providers that are holistic that are preventive, that help us to gain our health, to build our health up. You should only ever see a doctor who believes that you can build yourself up and you can become healthier. And if they think that you're sick and you just need to be on drugs and you can't get healthy, then you need to get a second opinion or third opinion and see holistic doctors because they believe your body can heal itself. So the fact that we have the freedom to do it and the freedom to even cross state lines, I love it.
Now, another thing you do is you also help companies to create plans. So it's the whole company. Suppose you have someone, like, for example, a listener who has ten employees, or fifty employees, or five hundred employees; they can talk to you. And also, if we have a listener who is an insurance broker, they can talk to you. We can hook you guys up with Megan, and she can talk to you because insurance brokers love to provide this. And also, small businesses love to provide this because it's cheaper for everyone and gives better care, gives better coverage, so everyone wins. So Megan can talk to you. In addition, you've been doing this for twenty years. This company has been around for five, but what you've been doing even before this is you help business owners, you help families, you help professionals to cut costs of other services. And so I'm excited about there too because we're living in a day and age right now where I am unwilling to eat conventionally-grown food. They call it conventional. It's the weirdest thing. It's like conventionally grown should be organic. They should call conventional food pesticide-laden. But it's all marketing. Obviously, we're all paying more for food. I'm paying more for organic, clean food, and prices of everything have gone up, and they're going to continue to rise. Unfortunately, this is just the state of affairs.
So for us to be able to afford being healthy, we have to figure out how to save money. And Megan showed me how to save hundreds of dollars on other things that I paid for already, which I'm really, really excited about. So, Megan does that. That's what she does for businesses; she does it for families. And this one thing, though, is what I was looking for, which is the ability — the learntruehealth.com/healthcare — to get the coverage that you want at a fraction of the price and take those several hundred dollars that you would be saving. Like, for me, it goes from about $650 for my family that I used to pay for $1,432 or something. So I take that savings of hundreds of dollars, and I put that aside in my savings account, and I then get to put that money towards the things that are healthy for us, like supplements, and just to save it for a rainy day. Because it's in my budget, keep it for when our family needs the help it needs. And just a peace of mind that we get that we're not shelling out $1,400 plus a month to a broken medical health insurance system.
[1:35:31.4] Megan Williams: It's so awesome. That's it, exactly.
[1:35:32.4] Ashley James: Yeah, I love it. I love it so much. Yes, exactly. Megan, it's been so wonderful having you on the show.
[1:35:37.4] Megan Williams: Thank you.
[1:35:39.5] Ashley James: I love the stories that you shared. I feel like this was God-driven. Bring me to you at the right time, and I think this message is landing for people at the right time. Now, here's another question. Usually, to buy insurance because this isn't insurance; it is an alternative to insurance. It is better than insurance in many ways. The insurance industry has an open calendar period where you can only purchase, like in January. You could only purchase from December 15th to January 15th. That's the open calendar. And if you get dropped coverage, you don't have coverage until January or until the end of December. So you're SOL if you're not able to stay covered. And some people lose coverage halfway through the year because they're changing jobs or it got too expensive; they lost their job. This covers you right away, right?
[1:36:36.1] Megan Williams: That's right. Yeah, there is no open enrollment. There is no time frame. You can sign up on the last day of the month and have coverage the very next month as long as you do it by 10:00 at night. But the nice thing is, yes, absolutely. We don't have to be worried. Now, there are people, even with small businesses, that may have signed contracts, and they have to wait until open enrollment to turn that off and bring their whole company to us. But we can start with new employees that are coming in, and we can get them coverage right away. We can also do it with families. So I started the minute we got it. I started June 1st. I didn't have to wait until October or November to get on it again. And it's just amazing that they look at every scenario that can happen for families, individuals, and businesses, and they are finding that solution. So absolutely no restrictions. Let's get you signed up right away, everybody, and get you the best plans. And you can cancel your other health care the next month. So you can pick a four-month window when you go in to sign up for when you want it to start, and it gives you time to turn off your other insurance that you had before.
[1:37:50.7] Ashley James: Oh, that's so cool. So you say next month. So let's say it's the end of June, and I sign up, then at the beginning of July, I am covered, or do I have to wait until August?
[1:38:01.3] Megan Williams: Nope. It's the next day.
[1:38:06.3] Ashley James: If I signed up on the last day of June, let's say at 6 pm, I go to learntruehealth.com/healthcare and I sign up, then the next day, which is the 1st of July, I'm covered?
[1:38:24.2] Megan Williams: That's right. Absolutely. It's that good. It's that quick, and it's amazing. And the process to sign up takes less than ten minutes for an individual. When you have a family of more, then they have a few questions about everybody's health, and you do need to know your kids' heights and weights. But that is about what takes the longest. What we love is that it can work for anyone who's a resident of the United States legally and is welcome to be a member as well. So there are no restrictions on that either. So, you can get signed up right away, your kids can, and it will take you about 15 minutes to be in the system, and you're good to go for the next month.
[1:39:06.0] Ashley James: That was actually a question I didn't think about. So you can be abroad, just living in the States, and you don't have to be an American citizen?
[1:39:15.1] Megan Williams: Yes, as long as you're here with the correct documents, like a green card.
[1:39:21.7] Ashley James: Or a visa, a student visa. Can it be students from abroad?
[1:39:25.9] Megan Williams: Yup.
[1:39:27.0] Ashley James: Oh my gosh.
[1:39:28.3] Megan Williams: Yup, employees. All sorts of things, and even in scenarios where the oldest member of the household isn't a citizen and maybe their spouse is not, but they're younger, that household can get coverage, including the non-resident. It's kind of crazy. It's very, very good. So Impact will help in any of those scenarios. Get the right documentation uploaded so they can have coverage for sure.
[1:39:53.9] Ashley James: Awesome. Listeners, go to learntruehealth.com/healthcare. Check it out. Share with all your friends who need this kind of coverage. I'm very excited that this is something that we can use to go to the kinds of practitioners we want, that we're not restricted by networks or by state lines, and that we can go and see that amazing naturopath in other states. Or we can go get the care we need in a different state, in a different county, or whatever, and that we can get telemedicine. There are just so many things that we can get, and it's just amazing that it's way better and also way cheaper. That's what I want from everything. I want everything to be way better and way cheaper.
So, thank you, Megan, for coming on the show. This has been so exciting. I just know this is going to help. I can feel it. I can see my listeners. I know that this is going to be the answer to so many people's problems. Like we've discovered, 66.5% of bankruptcies are from medical expenses. How many people are suffering, either spending too much or they don't have any coverage at all, and not having coverage is dangerous because then we ignore the little thing. We should do blood work every year. We should look at the labs but with a good holistic practitioner that can examine them and go, “Okay, you're not optimal. Let's get you optimal. Let's make these slight changes to diet, lifestyle, and exercise. Let's make these changes and help you get optimal.”
So, my thing is holistic health is about addressing every part of our life, including preventive medicine, and helping us become optimal in every aspect of our health. And we can't do that if we keep our heads in the sand. We can't keep our heads in the sand. We have to look. And they say women live longer than men. I think it's because we're willing to look, and men are like lalalala. No, if I don't look at it, it doesn't exist. Lalalala. I'm just going to ignore it. You can't do that. We can't ignore what's going on. We have to listen to the symptoms of the body because that is the way our body communicates things to us. Then we also get labs just to check and see what's going on. But when you go to a holistic practitioner that's licensed, they can help guide us and keep us healthy and make the right choices so we can have optimal health and get so healthy we don't need medications. That's my goal for everyone, and we can accomplish that. Now we can accomplish it with cheaper coverage. So love it, love it.
Thank you so much, Megan. I'm so excited. Definitely, check out all the videos that Megan made at learntruehealth.com/healthcare. And then, for those who want to contact you directly, should they be business owners that want to get all their employees, they want to offer it to their employees?
[1:42:57.3] Megan Williams: There will be a place on your site in the link where they can request information, and we will work directly with them to help them. But definitely, through your link, everyone utilizes the link to get connected. So we can know what kind of mindset you're coming from, and we'll have the best solutions for you.
[1:43:16.1] Ashley James: Because you're going to take care of my people.
[1:43:18.1] Megan Williams: That's right.
[1:43:19.1] Ashley James: My listeners, you're going to take care of them. Thank you, Megan. Thank you for taking care of my listeners. I want to make sure that we help those in need, and that's why we're here. So, I appreciate you and what you do. And I know that I really want to have your husband on at some point because he's got some amazing stories. So I will be hearing from him at some point. I'm just telling you I'm going to interview him, so now you know.
[1:43:48.4] Megan Williams: Perfect. You know I love that, and he'll give us a whole different insight into this. For those of you who aren't convinced yet, you'll want to be part of this group when it's all said and done. It'll be great. So thank you again for having me, Ashley.
[1:44:00.7] Ashley James: I appreciate you, Megan. Thanks so much.
Get Connected with Megan Williams
Health Coach, Podcast Creator, Homeschooling Mom, Passionate About God & Healing
Ashley James is a Holistic Health Coach, Podcaster, Rapid Anxiety Cessation Expert, and avid Whole Food Plant-Based Home Chef. Since 2005 Ashley has worked with clients to transform their lives as a Master Practitioner and Trainer of Neuro-linguistic Programming.
Her health struggles led her to study under the world’s top holistic doctors, where she reversed her type 2 diabetes, PCOS, infertility, chronic infections, and debilitating adrenal fatigue.
In 2016, Ashley launched her podcast Learn True Health with Ashley James to spread the TRUTH about health and healing. You no longer need to suffer; your body CAN and WILL heal itself when we give it what it needs and stop what is harming it!
The Learn True Health Podcast has been celebrated as one of the top holistic health shows today because of Ashley’s passion for extracting the right information from leading experts and doctors of holistic health and Naturopathic medicine
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