Pod Insights The Clark Howard Podcast 04.18.25 Clark Answers His Critics on Clark Stinks / Guide: Appeal Insurance Denial About this episode Friday - Clark Stinks day! Christa shares Clark Stinks posts with Clark. Submit yours at Clark.com/ClarkStinks. Also today, when it comes to medical insurance denials, companies count on people just paying up. But those who appeal are often successful. Clark shares a new guide that makes the appeal process easier. Clark Stinks: Segments 1 & 2 Appeal Health Insurance Denial: Segment 3 Ask Clark: Segment 4 Mentioned on the show: Certificate of Deposit (CD): What Is It, Best Places To Open One Buy U. S. Treasury Bonds: A Conservative Way To Beat Your Savings Account 23andMe Bankruptcy: Why You Should Erase Your Data Now What Is a Solo 401(k) and How Does It Work? When Is the Best Time To Collect Social Security? What Is an ABLE Account? Find Out Why Health Insurance Denied Your Claim What Should You Do if Your Insurance Claim Is Denied? Can a Patient Advocate Help With Your Medical Bills? What's the Best Way To Send Money Overseas? Clark.com resources Episode transcripts Community. Clark.com / Ask Clark Clark.com daily money newsletter Consumer Action Center Free Helpline: 636-492-5275 Learn more about your ad choices: megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices
Transcript 0:04 Speaker 00 It's my pleasure to welcome you here to the Clark Howard Show where our mission is to serve you with advice and information that empowers you so you make better financial decisions in your life. If you only listen to the podcast, you don't watch the YouTube show, you don't know what that is, an inside joke. I point at Krist every time, who's smarter about money than I am anyway.
0:30 Speaker 01 Yeah, now we know you're a liar, too.
0:32 Speaker 00 No, you're awesome with money.
0:34 Speaker 01 I am not awesome with money.
0:35 Speaker 00 Yeah, you are. And thank you for, yes, you are. Thank you for all your questions this week. And I especially want to thank you for your Clark Stinks submissions. Remember, to ask a question, go to Clark.com/ask. And so today, I get to hear the stinks you have, you sent in about me, where I may have gotten it wrong, and later, something that really stinks. Health insurers who deny a claim, paying on a claim, just because they do it without any reason. And guess what? Most people say, oh, well, guess I just have to
1:17 Speaker 00 pay the bill. No, no, no. I want to talk to you about what you should do when that happens. But now it's time for Clark Stinks.
1:26 Speaker 02 I should have never encouraged you to speak.
1:29 Speaker 03 You almost think I'm pretty stupid.
1:31 Speaker 04 You should be ashamed of yourself. Well, maybe I'm wrong. Maybe I'm wrong.
1:34 Speaker 05 Maybe you're right, pal.
1:42 Speaker 01 Okay, not a matter of stinking, but perhaps a matter of not fully understanding. We retired at 58 because we were able to take advantage of Obamacare. Insurance prices are based on gross income, and if you exceed the limits by $1, the increase in pricing is massive. However, since Roth IRA income is not taxable, it isn't included in calculations for insurance pricing. Unfortunately, some states, such as Florida, have minimum income that is necessary to qualify for coverage access. So if we had the bulk of our money in a Roth, we would not have been able to get insurance coverage through the marketplace because we would have had insufficient gross income. For us, it was a balancing act of understanding how much that we had to draw down from our
2:23 Speaker 01 IRA while at the same time ensuring we had sufficient income in our Roth and other savings instruments to be able to live day by day. Someone having too much in their Roth and not enough in taxable accounts could find themselves locked out of the online marketplace and unable to take early retirement. I'm not mentioning the lunacy that someone could have a million dollars in their Roth account and still be considered low income for Marketplace's health insurance calculations. That's for a different segment, Joe.
2:50 Speaker 00 Joe, thank you. Gosh, doesn't it show how crazy ridiculously complicated health coverage is in the United States? I mean, really, that you'd have to have money in a traditional just so you'd have some taxable income that would make you eligible on the marketplace. Why?
3:12 Speaker 01 Clark stinks like old winter boots being pulled out of storage in the middle of a hot summer attic.
3:17 Speaker 00 That's very specific.
3:19 Speaker 01 In the previous episode, when discussing gift cards, Clark kept warning about businesses failing and named Jo-Ann's Fabrics as the latest example. To my surprise, Clark seems to have overlooked the involvement of private equity in the equation and their usage of leveraged buyouts. These PEs take out massive amounts of loans in the name of the company they buy out, leaving the company liable, not the private equity. They drain assets and cash reserves, boost their numbers by cutting staff and inventory, all for short-term gain. These companies aren't failing because of the free market dictates it. Jo-Ann's was mostly profitable and still likely would be, aside from the damage they took when the PE firm came in, drained them for everything they had, and will walk away unscathed while Jo-Ann's is forced to close its doors.
4:04 Speaker 01 Similar things happened to Toys R Us, Sears, Bed Bath & Beyond, and many more. If you're going to praise capitalism and the free market and all the upsides, you have to call out the pitfalls, too. Logan.
4:15 Speaker 00 Logan, gosh, that's funny. Logan must have missed the segment when I was trashing private equity, talking about Southwest. And in the segment about Southwest, I talked about how most PE firms operate behind the scenes. They don't get a lot of media coverage. What was different in the Southwest case with a private equity house, in my opinion, messing up my beloved Southwest Airlines, is that there's so much media coverage of airlines that people are fully aware of what happens when the private equity raiders come in and mess everything up. And as I said before, anybody from Elliott wants to
4:58 Speaker 00 come on, you know, that's not Elliott.org, the Elliott that is messing up Southwest, and explain why they're not messing up my beloved Southwest, they're welcome to have a say, right?
5:11 Speaker 01 Advising the person to keep on driving 11-year-old car with 200,000 miles because it saves money ignores something more important than money: your well-being. Cars in the last few years have added a bunch of great safety features that can prevent accidents and harm to both the driver, passengers, and pedestrians. My 2022 and 2024 cars, bought after replacing 10 and 9-year-old vehicles, have a variety of collision avoidance features, including blind spot warning, lane departure, and lane departure correction, automatic braking, and more than that are proven safety enhancements. And an additional economic benefit are five-year warranties. The year before, I got rid of my 2015 Audi with only 68,000 miles. I had
5:54 Speaker 01 a $5,000 repair bill and was looking at another $2,000 one. David?
5:59 Speaker 00 David, thank you. What you said is 100% valid. And you know, when Consumer Reports does its affordable used vehicle list for teenage drivers, you know, when parents are freaked about having a new driver in the household because, well, they're not that good behind the wheel, they concentrate on vehicles you can buy used that do have advanced safety features on them. 100% what you said is true. If you are in a very old car...
6:33 Speaker 00 You're not going to have any meaningful safety features. I had a rental car, though, that was almost brand new, had 6,000 miles on it two weeks ago. And it, the only safety feature that I knew it had was a backup camera. It had nothing. It had no lane departure. It had nothing at all. No blind spot warning. It didn't even have, this was a new car, a USB or USB-C to charge a phone.
7:06 Speaker 01 Wow.
7:06 Speaker 00 When's the last time you saw anything like that?
7:09 Speaker 01 How much did you pay a day?
7:11 Speaker 00 I was picking up in one city, dropping in another, and I had to pay, including junk fees, $58.
7:18 Speaker 01 Total, for the whole rental?
7:20 Speaker 00 That's a lot of money.
7:22 Speaker 01 I wouldn't say Clark stinks as much as Gorgonzola forgotten in a car trunk on a 90-degree day. However, he neglected to suggest other alternatives besides Treasury Direct to the Vanguard account holder who asked about how to purchase Treasury securities. Fidelity brokerage account holders can purchase Treasury securities. If the purchaser opts out of auto-renewing, when a security matures, the funds go into a sweep account with far quicker and easier access to the money than needing to do a transfer from a Treasury Direct account to an external bank. Moreover, the sweep account can be structured to earn interest or dividends and also be used for cash management activities such as bill payments, check writing, and fee-imbursed ATM withdrawals with no foreign transaction fees for international transactions.
8:07 Speaker 01 I don't know if Vanguard has similar offerings, but Fidelity adds enough value to make it worth exploring purchasing Treasury securities there. Diane.
8:15 Speaker 00 Diane, thank you. You know, similar kind of thing from Schwab. Vanguard, years ago, decided to eliminate a lot, make their accounts more Spartan, eliminated a lot of the cash management capabilities, the equivalent of check writing you have with Fidelity and Schwab. And I've seen in media reports that they are now rethinking that. But yes, the point you make, buying Treasuries has a A little bit of cost through Vanguard or Schwab, but a lot of simplicity that you don't have buying treasuries direct.
8:50 Speaker 01 And there's one more about this. Clark, you missed out on a feature at Vanguard when asked about treasury bills. If you use the dropdown that shows buy and sell, it brings you to a page that will let you buy individual bonds and notes for an IRA or brokerage account from three weeks to 30 years. You can buy at auction for a small amount, or you can buy on the secondary market. The treasury puts out a schedule that shows all upcoming auctions. You can also buy CDs for weeks, months, or years, callable or non-callable. No commissions on anything. It makes it much easier for keeping all accounts together when a CD or bill matures. The full amount goes in the primary money market and not invested in something you don't want, Chuck.
9:30 Speaker 00 Chuck, thank you. And you know, I had a fail the other day when I got distracted when I was talking about buying CDs. I completely neglected to talk about buying CDs through Schwab or Fidelity that are able to place CDs many times at a higher rate than you can get direct from a bank, even an online bank.
9:54 Speaker 01 Clark, you stink like cooked cabbage that has been left in the fridge for a few weeks.
9:59 Speaker 00 Wait, wait, wait. I love these descriptions. Cooked cabbage, Gorgonzola, 90 degrees in a car trunk. These are really fun, how people think of these. Winter boots being pulled out of storage. Okay, that's really great stuff.
10:16 Speaker 01 All right. So you stink like cooked cabbage that's been left in the fridge for a few weeks. I read the article about 23andMe concerning their bankruptcy, and one of your team members who wrote the article is giving out bad advice advising people to delete their data, which you also advise on the podcast.
10:32 Speaker 00 I just did on the podcast.
10:33 Speaker 01 As an amateur genealogist, I must remind you that not everyone who tests their DNA does it for health reasons. Some of us are looking to find and connect with lost relatives. If people are that worried about their DNA being used against them, then they should not take any DNA tests in the first place. This kind of article makes people paranoid. By the way, I love your podcast, Deborah.
10:54 Speaker 00 Deborah, thank you. And something I added during the podcast, print your stuff out from the 23andMe database if you are interested in all the genetics, all the ancestry stuff, which I was talking about. Also, all the things I found out about My background, I didn't know, not health related. But, once you print it out, then you should delete it because there's no idea whose hands this data is going to fall into from the bankruptcy court. And usually, it's not a good thing.
11:29 Speaker 01 Your answer about solo 401ks was mostly right, but you listed Vanguard as an option. But, they have gotten out of that business and sent it to a census. Thanks for all you do, Drew.
11:38 Speaker 00 Drew, thank you. And I should have mentioned that Vanguard, a lot of small company plans. Our Vanguard plan is managed by a census, isn't it? That Vanguard, I was just talking a minute ago about how they became a more Spartan company. Now, they're rethinking that stuff, but they, they got rid of their annuity operation at one point. They got rid of small company plans. They got rid of the solo to a census. And so, you're in Vanguard funds at low cost, but the record keeping is done by this other company, a census, and thank you for pointing that out.
12:16 Speaker 01 Clark stinks worse than the green trash bin in summer. He said that those with a short life expectancy could claim social security as early as possible.
12:24 Speaker 00 Should claim.
12:25 Speaker 01 There are at least a couple of reasons why this stinks. Firstly, what if you're wrong about your life expectancy and you end up living a really long time? Then what? Well, you'd be looking at spending a lot less over your lifetime. But, the real reason this stinks is because if you're married, you need to be thinking about your joint life expectancy of the household and not just the life expectancy of any household earner by themselves in isolation. If you're the higher income earner of the household, delaying till age 70 almost always makes sense. That's because the lower household earner inherits the higher earner's retirement benefit when the higher earner passes. So, if the higher earner collected their benefit as early as, as possible, given a short life expectancy, Clark's suggestion on the podcast,
13:08 Speaker 01 then the surviving spouse would be inheriting a much smaller benefit and that surviving spouse could possibly live a very long time. This means living a long time on a much smaller benefit and that stinks, John.
13:19 Speaker 00 John, thank you. All right, so John, when I said that whole thing, that was a counterpoint because I'm obsessed with people waiting till age 70 to take social security. Every time I talk about that, how many posts do you get on Clark's?
13:33 Speaker 01 So many.
13:34 Speaker 00 So, there's this counterpoint. People say, what if I'm terminally ill? I'm not going to make it to 70 anyway. And so I try to air out the complaints that people have about my obsession with age 70. Mathematically, generally it's a better idea to do what I'm doing, waiting till age 70. That's what is generally the smart math for both myself and for my wife, as you were pointing out here. So, yeah, but there are cases where people feel compelled to take social security earlier, even as young as age 62.
14:18 Speaker 00 And a lot of times they do it when they shouldn't mathematically. But I don't want people to feel guilty about the choice they've made.
14:26 Speaker 01 A mother stated she has a 20 something year old daughter who is bedridden and has income. She stated she has a 529 and an IRA. She was concerned about those assets not being protected if the child were to apply for social security disability. You missed the mark, my friend. You did not mention a state ABLE account. Our daughter is in a similar situation.
14:46 Speaker 00 I didn't?
14:47 Speaker 01 She, I mean, a few people write in about this. She had bank savings and a 529 account. Both of these would have reduced her social security income. The Washington state ABLE account allowed her to be, have a balance of up to $100,000 and it's protected and not visible in the social security income. In Washington state, it's invested in Vanguard funds. You can put more into it, but up to $100,000 is protected. It was a simple process to have her 529 transferred directly to it. We did a direct transfer from her savings account into it as well. There are many states in the country which have ABLE accounts available. And I'm pretty sure I heard about the ABLE account on your show sometime, Daniel.
15:26 Speaker 00 Yeah, Daniel, I just lost my mind that I didn't mention ABLE accounts because I'm so excited from the moment they started existing. And I scream about ABLES from the rooftop because it's a version of 529, but it's 529A for ABLE.
15:44 Speaker 00 And it allows, just as you said, 100 grand in it to not be counted as an asset that would eliminate government assistance that might be available to a disabled person otherwise. And that was definitely a fail on my part when I answered that question before. And thank you for correcting me.
16:05 Speaker 01 Clark doesn't stink, but insurance companies can be incredibly frustrating. When discussing dentists, he's often mentioned that dentists can verify patient benefits online. While this is true, the insurance company frequently provides incorrect information. Recently, my staff was told during a phone call that a patient had a $2,000 benefit, only for the insurance company to later admit it was a mistake and the patient had no benefits. This error was communicated to us only after the patient had received the treatment. If this had happened to Clark, he would likely be more understanding, but the patient blames us, never realizing that the insurance company works for them, not us. The phone call was recorded and the insurance company admitted their mistake, yet somehow we're still at fault. So yes, Clark, I can find the human genome sequence online, but I can't always
16:50 Speaker 01 verify patient benefits. Brandon.
16:53 Speaker 00 Brandon, thank you. Gosh, we started Clark stinks here, we're ending it. Insurance in the United States for health, in this case for dental, is a mess. And it should not be so complicated. It shouldn't be so opaque. We shouldn't have a hard time figuring out what we're going to have to pay. We shouldn't have a hard time being able to compare and shop. Unfortunately, it is a mess, Brandon. And I don't hear anybody, any of the politicians in Washington, talking about this at all. And it's too large a percent of our economy
17:35 Speaker 00 for us to just be looking the other way. And for consumers, having to spend more and more money because the system is so messed up. But that's like, healthcare in the United States and health insurance stink.
17:52 Speaker 00 Thank you all for your post today. I can't even begin to tell you how much I learn every single time we have Clark stinks. So please, if there's something you hear from me you don't like, please take the time to post your Clark stinks at Clark.com/ClarkStinks. Coming up ahead, speaking of health insurance, how do you handle a denial? We're going to talk about that.
18:21 Speaker 00 I like from time to time to be skeptical. I don't like to be cynical. I think cynical is an ugly thing that makes us look bad, makes us feel bad, and makes us look at the world in a bad way. And then there's health insurers. Gosh, it's hard not to be cynical about health insurers. When it's clear, and so many insiders have spilled the beans, that health insurers will deny a claim without even reviewing it many times. It is part of their whole structure to deny claims. And then the truth, when a claim is denied,
19:04 Speaker 00 the insurers know that almost everybody just says, "Oh, well, I'm out that money." That's the game they're playing. They know that most people just go away quietly and don't do anything about it because it feels overwhelming. You don't know what to do. And what you do is you appeal because the stats are clear. Almost no one out of 100 people, maybe one or two, will do anything to appeal a claim. But people who do even haphazardly overwhelmingly win that denial of claim. I mean, it's that simple. It's
19:46 Speaker 00 playing a numbers game. The insurers know that they can deny people over and over again and pocket that money as profit. It should have gone under the insurance contract to the provider and you don't get stuck with a balance bill. So what do you do if I've got you fired up to not take it anymore from the insurance company? ProPublica has done a wonderful, easy to understand, step-by-step guide how to appeal a claim denial. And does it mean you're 100% of the time going to win? No, but it means that most of the time you're going to win. And so we have a link at clark.com
20:30 Speaker 00 to the ProPublica guide. I don't want you just to roll over for an insurance company. And as I said before, now the feds are seeking the death penalty against the guy who killed the UnitedHealth CEO in brutal cold blood. I was so upset at the time that he was murdered. And then I was more upset about how many Americans were like, yay, somebody stood up to the health insurers. Taking somebody's life is not okay as a protest statement. At the same time,
21:14 Speaker 00 the health insurers is not in any way excusing what happened. I mean what I said. There is no equivalence to this. It is true that people are dying because of denials of care by insurance companies. And we need to fix that in the United States. But it's just one part of the puzzle. We've got to get our act together on healthcare. But if you get a denial, and in your case, it may not be a life and death thing, it may just be money. Use this ProPublica guide to properly file and process and appeal to get paid what your insurance was supposed to pay in the first place. Krista?
21:57 Speaker 01 Okay, CJ in Alaska says, "My profession is a pilot and I'm required to retire at 65, which will be in two years. My spouse is five years younger than me, and I'm wondering what will be the best way to get health insurance. I will qualify for Medicare, but my spouse will have five years before he qualifies. Is healthcare.gov my only option for my spouse? Also, my spouse hasn't worked for over 20 years. I plan to collect Social Security at 70, but I'm wondering if it would be advantageous for my spouse to collect at 60. Once I retire, we won't be able to continue to live in the manner to which we've been accustomed, so I want to be careful about my spending in retirement. You're the best."
22:37 Speaker 00 So CJ, this is a conundrum facing a lot of pilots married to a younger spouse. And what are you going to do about the health coverage? So you're going to be good at 65, you're going to have Medicare, your spouse is not going to have health coverage. And two years from now, we don't know exactly how healthcare.gov is going to work. But there is something that you can consider if you're interested at all. And I know a lot of pilots who age out of commercial flying at 65 and have a younger spouse will fly part-time, part 35. That means charter or something like that.
23:18 Speaker 00 Just enough hours to qualify in a month for healthcare coverage through the part 35 carrier. And so that's a possibility because you already said you're not going to be able to live in the manner to which you're accustomed. If you're picking up very part-time work, but enough to also pick up health coverage flying part 35, maybe also you'll be able to live the lifestyle to which you've grown accustomed. You've got the healthcare and you're able to live that lifestyle. I know some pilots at 65, you're just done. You've done it. It was great. You don't want to get in the cockpit anymore.
24:03 Speaker 00 But others miss flying so much. And this is an opportunity, an outlet where you can continue to fly passengers and earn really decent money and get the health coverage. Just an idea. But otherwise, you're right, depending on what happens with healthcare.gov two years down the road, that's likely going to be the alternative for your spouse. And by the way, social security starts at 62, not 60.
24:37 Speaker 01 Thomas in North Carolina says, "My friend was recently diagnosed with a brain tumor."
24:41 Speaker 00 Oh, I'm so sorry.
24:43 Speaker 01 "It was growing very quickly and applying pressure on his eyes. He was slowly going blind. They performed surgery to remove the tumor. Luckily, his vision was restored and the tumor was removed and he is now totally cancer-free."
24:56 Speaker 00 Wow.
24:57 Speaker 01 Yes.
24:58 Speaker 00 Is that phenomenal?
24:59 Speaker 01 Amazing. "We are all incredibly grateful for his full recovery, but now the medical bills are rolling in. So far, he owes over $35,000 and counting. He has just started back to work and his wife is a schoolteacher. They have two small children and one very unreliable car. They are currently paying the hospital $200 each month. My question is, can they work with a patient advocate at the hospital, or would the hospital ever consider reducing the total amount that they owe? They feel as if they will never dig themselves out of this hole."
25:32 Speaker 00 Yeah, so when you deal with the hospital billing department, the employees in it are only there to collect money. They are not there to work something out with you that actually means anything. A payment plan is not what I'm talking about. And if the hospital is a nonprofit, which most hospitals in the United States are, they are required to give some amount of charity care, which in order to not have to pay taxes. And that's why at a hospital, there will be the hospital social worker, or more often today, called the patient advocate. And you want your friend to go sit down, if they can get a face-to-face
26:17 Speaker 00 with the hospital social worker, or the patient advocate, or at the very least, like a Zoom call kind of thing, and see if they can get some charitable compensation with a reduction in the bill to a point where they can actually afford it. I mean, this is a wonderful, modern medical miracle. Cancer gone, vision safe, being able to live life going forward. What a wonderful thing. But at the same time, the financial burden is extreme that you described. And that's why there are patient advocates, hospital social workers.
26:59 Speaker 01 Jeff in Georgia says, "My elderly mom lives in Nashville, Tennessee, but her husband, who has Alzheimer's, is in Mexico City where they can get the best level of care for him. She needs to send him money once a month and had been using Western Union, but Western Union has just cut them off, apparently thinking it's some kind of scam. So our question is, what might be other good ways to send money from Tennessee to Mexico every month? Mailing a check being risky and unreliable. Thanks for any suggestions."
27:27 Speaker 00 Yeah, check in the mail anywhere, from one part of Nashville to another, is dangerous. From Nashville to Mexico, no. So what are the alternatives? Western Union is everywhere, but expensive. And there are more affordable alternatives. This may end up being a blessing in disguise. Two of the largest alternatives are Wise and Revolut. Revolut, R-E-V-O-L-U-T, a British bank, and also Wise. These two operate pretty much most places around the world, and you can send money
28:09 Speaker 00 at a much lower cost than you can with traditional outlets to send money. So try one of those two. I don't know what scam Western Union thought might be up to. And Jeff, I don't want to run past without noting that what's going on with your mom's husband is now a very common thing. People are having to go to other states, other countries, to receive end-of-life care that they can't afford in the United States. And I have talked to, I hate to waste
28:51 Speaker 00 Any money that could be a benefit to my family. And I've talked a lot, none of them believe me that if I end up with dementia or whatever, I don't know who I am, I don't know who they are. I want them also to take me to a very affordable country with really good care, rather than spending a lot of money on my care. That's just me. Everybody has to feel however they feel about it. But what your elderly mom has done with her husband being in Mexico City, because the care is great and more affordable, to me makes sense. Not to everybody, but to me it does.
29:35 Speaker 00 So I want to thank you so much for joining us on today's podcast. And I hope that you have an incredibly great weekend in front of you. And have a good time being with family and friends. And also know that all weekend long, we're serving you. Clark.com, Clarkdeals.com, our newsletters, social media, the TV stations that air me, air me all weekend long too. So we've got empowerment for you everywhere you can turn just about. So you can save more, spend less, and avoid getting ripped off. See you on Monday.
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