The Clark Howard Podcast

05.06.26 Negotiating Medical Bills / Use Gift Cards ASAP

31 min
May 6, 202625 days ago
Listen to Episode
Summary

Clark Howard discusses strategies for negotiating medical bills upfront, highlights the critical importance of using gift cards before retailers close, and addresses listener questions about health insurance decisions, warranty purchases, credit freezes for minors, and property tax appeals.

Insights
  • Healthcare pricing remains opaque until after service delivery; proactive upfront negotiation can save 8-20x costs compared to hospital-owned facilities, particularly for imaging services
  • Retail instability is accelerating with furniture stores closing at unprecedented rates; consumers must use gift cards immediately and pay furniture deposits via credit card to dispute within 60 days if businesses fail
  • High-deductible health insurance plans require consumer-driven decision-making; dropping coverage to avoid premiums creates uninsurable risk for people in their 50s despite current good health
  • Professional property tax appeal services create market imbalance where commercial investors reduce taxes while homeowners pay full assessments; contingency-fee models align incentives better than upfront fees
  • Warehouse club clearance signals differ by retailer: Costco uses .97 or .00 endings, Sam's Club uses penny endings; .00 indicates aggressive local manager clearance below cost
Trends
Accelerating retail and restaurant closures driven by tariff volatility and consumer financial strain at middle-income levelsGrowing consumer awareness of healthcare pricing disparities between hospital-owned and independent providersShift toward contingency-based professional services (tax appeals, medical billing) that align provider incentives with consumer outcomesIncreased financial precarity for middle-market consumers despite overall economic stability at higher income levelsFurniture industry experiencing unprecedented closure rates due to supply chain and financing pressuresInsurance companies expanding preventive monitoring programs (electrical fire detection) as win-win risk mitigationGift card liability becoming critical consumer protection issue as business failures accelerateHealthcare system resistance to price transparency despite consumer-driven deductible model implementation
Topics
Healthcare cost negotiation strategiesMedical billing dispute resolutionGift card liability and retailer closuresHigh-deductible health insurance decision-makingHealth insurance premium affordabilityProduct warranty evaluationCredit freezes for minorsProperty tax appeal servicesFurniture purchase deposit protectionWarehouse club clearance pricing signalsElectrical fire prevention monitoringHealthcare pricing transparencyRetail industry instabilityCredit card dispute timing and proceduresHSA eligibility requirements
Companies
Kroger
Nation's second-largest supermarket chain closing multiple locations due to retail instability and market pressures
Walmart
Mentioned as retailer where listener purchased electronic toothbrushes with warranty option
Costco
Warehouse club discussed for clearance pricing signals (.97 and .00 endings) and return policies
Sam's Club
Warehouse club competitor using penny-ending prices (.01, .41, .61, .91) to signal clearance items
Aldi
Discount retailer selling compatible generic replacement heads for electronic toothbrushes at lower prices
Lidl
Discount retailer selling compatible generic replacement heads for electronic toothbrushes at lower prices
Oral-B
Electronic toothbrush brand mentioned as popular option with expensive proprietary replacement heads
State Farm
Insurance company offering free Ting electrical fire monitoring devices to homeowners nationwide
People
Clark Howard
Podcast host providing financial advice on healthcare negotiation, retail closures, and consumer protection
Krista
Co-host discussing electronic toothbrush warranties and Costco clearance pricing
Hans
Michigan listener asking about dropping health insurance for himself and wife in their early 50s
John
Colorado listener asking about electronic toothbrush warranty decision at Walmart
Jonah
Connecticut listener running 15-person business influenced by Clark's employee-first philosophy, asking about credit ...
Roberta
Washington listener asking about Costco clearance pricing signals (.97 vs .00 endings)
Paul
Pennsylvania listener asking about State Farm's free Ting electrical fire monitoring device
Tim
New York listener asking about property tax reduction services and contingency fee models
Quotes
"Healthcare is the only thing we do in our daily lives where we find out after the service has been rendered what it's going to cost."
Clark HowardEarly segment
"A hospital may charge $5,000 with your copay being who knows what. When you go free market, it might be $200."
Clark HowardHealthcare pricing discussion
"Find your gift cards. Don't remember where you put them? Find them. Use them. I have been burned by this when I've received gift cards as a gift and didn't use them on a timely basis, and the business went bust."
Clark HowardRetail closure warning
"When you see a zero, zero, that is a very aggressive clearance item where that manager is like, we got new stuff coming in. I don't care what corporate said. We got to get this out of here."
Clark HowardWarehouse club pricing discussion
"If your insurer offers it, say yes, please. And in some states, it's free and others you have to pay depending on your insurer."
Clark HowardTing monitor discussion
Full Transcript
It's my pleasure to welcome you here to the Clark Howard Show. You know, our mission is to serve you with advice and information that empowers you to make better financial decisions in your life. Okay, who doesn't know healthcare costs are out of control? I can't solve the country's healthcare problem. I've got some ideas what I would do if I were your emperor, but I'm not your emperor. So we got to deal with what we've got. And that is what you can do about your own health care spending that's really important. And later, I got a homework assignment for you because a lot of stores are closing their doors and there's some things I want you thinking about. So healthcare, one in every $6 spent in our economy going to healthcare. This is so much more than any other country. I mean, it's just off the charts. And our spending on healthcare has gone up. Okay, listen to this stat. It's gone up over 1,300% over two generations. Now, that's three times faster than inflation. We've been through a couple of really bad cycles of inflation. And try to picture this number. Two years ago, we spent almost $5 trillion collectively on health care. Bonkers, bonkers, bonkers. You know, this past year was higher. It'll be higher again this year. So that's collectively. How is it affecting you? Well, if you are paying for your own insurance, the premiums for that insurance don't go up by some magic genie amount because a greedy insurance company wants to rip you off, even though there are issues with insurance companies. It's all about the cost pressures with health insurance. That's why so many people have dropped health insurance here in 26, because at the end of a lot of the subsidies that were available for individuals and families buying health coverage, they can't afford the premiums. But the good news is most of us do have health coverage, either through an employer or we have it from the government. about half of all health care in the country is paid for by government, by the way, of all different levels. But even with that insurance coverage of whatever kind, there's a lot of out-of-pocket. And the out-of-pocket and the deductibles and all that have gotten so much higher. So this is where you come into the picture. Because the economic theory of you and me having much higher deductibles and much bigger co-pays for health coverage is they would make it consumer driven health care. But the health care industry is fighting you and me tooth and nail on having to disclose prices. And so it's a black box that when it opens up is often going to be pretty ugly because healthcare is the only thing we do in our daily lives where we find out after the service has been rendered what it's going to cost. So this is where the rubber meets the road. This is your and my part. When you're going to have to have a doctor says, well, I think you should have a test for this thing or you should have this other thing or whatever. That's the point at which you ask, I'm sorry, I don't have a lot of resources. I probably can't afford it. What's it going to cost? That's where the exploration and negotiation comes. Not after the fact, although you can, from a weak position, negotiate bills after the fact. It's up front. I mean, think about the examples of when a doctor wants you to have imaging done, that you'll pay from 8 to 20 times the cost at a hospital-owned imaging facility than if you go free market for it. Isn't it weird? Think about this. Most people with insurance pay less paying cash for outside imaging, like an MRI or something like that, and an independent where you pay cash than what your share is with insurance at a hospital-owned facility. Just process that for a second. That a hospital may charge $5,000 with your copay being who knows what. When you go free market, it might be $200. Yeah, and so much of medicine is like that. You know, I've talked your ears off about all the money you save on prescription drugs by buying them the right ways. Same thing is involved with medical. And having that conversation up front where you say, I don't know, I can afford this. Medicine needs to adapt. If we're going to be in free market where so much of it comes out of your and my pocket, it needs to adapt to where we know up front what something's going to be. Now, obviously, if you're riding in an ambulance and you're not conscious, that's not when you're going to be able to negotiate the price of something. But very seldom, even when something is urgent, it's not an emergency. And that's where you use the time to find out where you can get the best deal or what the price is going to be or negotiate that price first for something that you're going to get. And if you ever want me to fix health care, I'm willing to fail like everybody else who's tried to fix health care. No, but I've got some very, very strong recipes that would involve overcoming all the dirty money that flows to politicians that keeps the rotten system we have in place right now with all the lobbying money flying around everywhere. That would be the first thing you'd have to fix if you were emperor. Okay, we'll go to questions. Hans in Michigan sent this one in. I have a question about possibly dropping health insurance for myself and my wife. We're both in our early 50s and healthy. We purchase our coverage through the marketplace and take about half the subsidy that's offered. Our bill is still over $700 a month and it's a high deductible plan. What are your thoughts on dropping coverage and putting the monthly premium in an HSA through the bank or credit union We have full coverage through our auto insurance in the event of an auto accident We basically only go to the doctor once a year for physicals Thanks to everyone at Team Clark for all your hard work. Hans, thank you. And so many families are facing the dilemma about what to do about premiums. You're talking about you're spending $8,400 a year. You go to the doc once a year by your telling. But there's a roll of the dice here. First of all, you're not eligible for an HSA unless you have an HSA-eligible health care plan. So if you go without health insurance, the way the law is structured now, and if there's a loophole, I don't know it, you can't get an HSA. So you wouldn't have that option. But the real thing is the roll of the dice. because at some point something's going to happen to one or the other of you. And even though you're in incredible health now, unexpected medical issues come up. And demographically, you're in the age category where those things start to happen. So this is a gambler kind of thing if you go without. You're already in a high deductible plan. If your resources can afford it, if you have a lot that could be at risk, as hard as it is to swallow paying that $700 a month with it being just-in-case money, I would spend the $700 a month. John in Colorado says, I recently purchased a set of two expert all-in-one toothbrushes at Walmart. I was offered a two-year warranty and declined. Did I make a mistake here? I'm a super fan and listen to your podcast religiously. My wife and I have been doing lots of road trips lately, and now she's also a Clarkie. Well, thank you for that. And educate me, Krista. What is an expert all-in-one toothbrush? I mean, I'm guessing that they are just those electronic toothbrushes. I got a two-pack from Costco of them, like the Oral-B ones is what I have. And you can buy the new heads that go on. You pay the national debt of a country for the refill things? Yeah, unless you buy them on sale at Costco, which is what I do. Yeah, but the refill. I know, the refills go on sale. You know who sells the refill such great prices? Who? Aldi and Lidl that are compatible with the most popular brands. Yeah, because they buy generic. Yeah. Right. And they're a tiny amount versus what you pay to the brand name. Would I buy a warranty? No way. Especially, I mean, think about it. You buy something like that from Costco and it dies. You bought it from Walmart, but you buy it from Costco, you can take it back. They'll give you your money back. I'm not a big fan on any kind of product warranty because you only warrant, you should only warrant in your life big things like the healthcare we were just talking about. A toothbrush, even if it was a bummer, if it died one minute after warranty, is usually not going to be a brutal thing for your overall wallet. Jonah in Connecticut says, I've been listening and absorbing all of your wisdom for 30 years, voluntarily tuning in as a teenager. Poor soul. I have taken so much of your advice over that time and can't fully put into words the immense impact you've had on me and my financial literacy. Today, I run a small business with about 15 employees. Your philosophy on treating employees well has strongly influenced how I lead. From our benefits package and vacation policies to creating a value statement separate from our mission, your voice has been a consistent guide in helping me build an employee-first culture. I'm truly grateful for that. My question is about credit freezes for minors. Following your advice, I froze the credit of my children several years ago. However, I don't recall hearing what happens to those freezes once they reach adulthood. Do they remain in place automatically or do they need to take action such as reestablishing or converting the freeze once they turn 18? So the kids get control of the credit freeze, I think on their 16th birthday. It's either 16 or 17. So the credit freeze stays in place. but till a kid becomes an adult both the child and you as the parent have dual control over it so either of you could thaw it or freeze it but once they're 18 it is under the control of the child as now an adult and it stays frozen unless they choose to act otherwise and credit freeze for kids is very hard to establish. It's not like for an adult, but worth doing because so many people engage in child identity theft because they have what's considered to be a clean sheet identity that they can use to impersonate for not always necessarily about credit, but for personal identity reasons when somebody is trying to be someone else other than who they actually are. So thank you for your kind words. It's funny because if somebody listened to me as an infant now from when I first started doing this, they're now middle-aged. Wow, I've been doing this a long time. Anyway, coming up ahead, there's a lot of instability right now in retail and any of a number of businesses. But retailers particularly have suffered a lot from all the various on-again, off-again tariffs and all the rest. And so there's stuff I want you to know to protect yourself in an unstable environment for business. Wow. I saw a list recently that I forget where it was compiled, But it was one company after another, after another chains of restaurants, retailers, supermarkets that had gone bust or were closing enormous numbers of locations to avoid a total shutdown. We are in a very, very unstable time for businesses selling to consumers. because although we have consumers that are doing quite well financially, generally at the higher end of the income ladder, if you will, a lot of people are short of resources and struggling month to month just with regular bills. And so that leading to a lot of dislocation in retail restaurants and supermarkets and supermarkets people don have gift cards for it I don know if a supermarket has gift cards Maybe somebody, some supermarket has it. But you're seeing it with a lot of supermarkets closing locations, particularly those geared towards the middle market. Kroger, the nation's second largest supermarket chain and operates under a few dozen different names regionally around the country. It's been closing location after location. No real risk for you there. But restaurants, retailers, from smaller chains to big chains, in danger. A lot start off as Chapter 11, hoping to be able to reorganize and continue to operate, and then liquidate as a chapter seven. I've said the gift card thing again and again. Please hear me on this. Find your gift cards. Don't remember where you put them? Find them. Use them. I have been burned by this when I've received gift cards as a gift and didn't use them on a timely basis, and the business went bust. And so did that money that a kind soul spent to give me that gift. And then it goes poof, goes to dust. Be very, very careful. An industry that's going through extreme hardship right now is the furniture business. Unbelievably difficult for furniture stores. They are closing at an unprecedented rate. And the danger with furniture is if furniture is not in inventory and you pay a deposit for something and the store goes bust, often they'll want you to pay that deposit not with a credit card. Danger, Will Robinson. Clear danger. That was a reference from the 1960s. Sorry. If you pay that deposit by cash and they go bust, you are the lowest level claimant. You're never going to get any of that money back. Let's say you pay a deposit by credit card and the furniture just mysteriously is not appearing. Once it's past 60 days, you have very little chance that you're going to be successful disputing that charge. So let's say you do pay deposit for furniture promised to you. Before that 60th day, you put that charge into dispute because you haven't received it. And that just starts the clock in your favor because you've done so before 60 days. And then if they end up coming up with the furniture and everything's good, you just waive your dispute. It's very easy with the credit card company to say, they've taken care of me now. Please remove my dispute. But if you just sit there and let them stall, stall, stall on you, and then they fail, you got no furniture and you got no money. Period. That was so negative. Oh, my goodness. Well, it's a warning. Yeah, but it was so negative. I hate being negative. I just went through my mother's wallet and found a bunch of me. Not that I was snooping through her wallet. She wanted me to go through. She wanted me to go through. That sounded so bad. And I found all these gift cards that are for places that are out of business or she's not going to go to again. Yeah, it was such a bummer. OK. Sorry. Roberta in Washington says, I know about the closeout deal when I see a price at Costco that ends in 97 cents. However, I occasionally encounter a similar deal at Costco where the price ends in zero cents. For example, today I bought a 14-link pack of bratwurst for $7. A month or so ago, I bought a sweater for $2. Do you know why a price is listed as ending in 97 cents versus zero, zero, zero? Okay. Just make it more fun for you after that negativity. Yeah, thank you. All right. So when it's zero, zero, that means local management, general manager of that store decided, hey, they got too many of these. They got to get sell through done. and they will arbitrarily and the managers are given the authority to cut the price even if corporate you know at costco has not cut the price when corporate does it it ends in 97 cents when it's the local store does it it's zero zero and i am kicking myself because there was a great Kirkland Signature hoodie that was on clearance and it was four dollars even 4.00 wow and they had one left in my size and I'm like do I really need another hoodie sweatshirt and so I'm going over to prescriptions pick up a prescription for our dog our dog named Kirkland Signature anyway And then I decide, you know what? I'm going to get that thing. And so, I mean, it'd been like six minutes. And I go back over. It's gone. And it was the last one in my size. So when you see a zero, zero, that is a very aggressive clearance item where that manager is like, we got new stuff coming in. I don't care what corporate said. We got to get this out of here. Now, at Sam's, items will end in one penny that are on clearance. So it isn't necessarily, it used to be 91 cents. Now they do any, it could be 41, it could be whatever they do. But when you see it end in one penny, 41, 61, 91, whatever, that means it's on clearance being sold below Sam's Club's cost. At Costco, you see zero, zero or 97. It's being sold below their cost. You know, I just have to ask you about this real quick. An asterisk at Costco means it won't be restocked normally. But there was an item with an asterisk, and I was waiting for it to go on sale because there were still a lot of them. I even asked a manager there one day, and he's like, I don't know. We'll see when we – and then it turns out it never went on sale, and now they're still stocking it again. There's no asterisk anymore. Did they, like, change their mind? I wonder if they changed the code on it or changed their mind because the asterisk is supposed to mean it's a sell-through item. Sell-through means, and warehouse clubs speak, that they're not going to stock that item anymore. Or, you know, it's got the asterisk. Sell-through is also meaning they want to sell whatever inventory they had of an item within so many weeks. And it's a fail for them if it doesn't sell-through in that time period. I don't know why they call it sell-through. Okay. Paul in Pennsylvania says, My homeowner insurance company is offering a free Ting monitor to check for electrical problems Does it work and should I accept the offer Yes and yes Poe thank you for asking about this I meant to talk about this State Farm's doing this around the country for sure, yeah. Yeah, I mean, this is a great thing because, okay, you think insurers are always that they never offer something that they didn't have an ulterior motive for. Not always. This is a case where clearly you save them money and save you money and hassle. Well, that's their motive, right? They're saving money. So that's good. Yeah. But usually when an insurer is offering something like when they want to monitor you or driving, it's to charge you more money. Oh, gotcha. So in this case, this is win, win, win. Because you don't want to be in a fire. You don't want your place burned up in a fire. and the TING monitor helps give an early warning that there's something wrong that could cause an electrical fire. If your insurer offers it, say yes, please. And in some states, it's free and others you have to pay depending on your insurer. Tim in New York says we often receive solicitations in the mail from property tax reduction companies. They claim to submit all the legal paperwork on our behalf to the town's property assessment board and represent us in person at the hearing. to claim that our assessed value is higher than it should be and get this corrected, which will lower our property taxes. For this service, their fee is 50% of the first year savings. If the assessed value is not reduced, then there's no charge. Is this a legitimate service and not a scam? And how likely is it that they will succeed in getting our assessment reduced and therefore our property taxes reduced? We know we can do this ourselves and save the fee, but we prefer to avoid the hassle and would rather have a professional do it for us. After all, 50% of something is better than nothing. Right. So I'm so glad this question as well. Okay. So what happens is commercial enterprises, let's say a hotel owner, a shopping center owner, office building owner, anything like that, apartment complex owner, they all hire professionals that handle the appeals. And the result of this is taxes are really unbalanced in most of the country on property where professional investors hire these professional tax appeal services who know exactly how to handle the appeals and their taxes end up being lowered and the average consumer with his or her own home doesn't know how to play the game and you don't get the reduction you're looking for. So doing this where you pay a service is a great idea, and they tend to work a couple of ways. You gave a very common way where normally, depending on the state and how taxes are set on property, if you win an appeal, it then holds position for a few years. So the idea is you split the first year's savings, but you're paying nothing up front for their expertise, and then you pay nothing for the subsequent years that are covered by the appeal. The other way it's done, and if you have a property that's worth a lot of money that has a really significant tax bill, is you do what the commercial, the professionals do. You pay a fee up front, win or lose. You pay the appeal service for their effort, and then you pay a much lower win fee, usually maybe 25%, 30% instead of 50. So again, if you've got a very large property tax bill, you're best off picking a company and paying them a professional fee up front. If you have a relatively modest amount of money they might be saving you, then you do no fee up front, but in your case, the 50%. I did the thing where I hired, I paid them up front and they weren't able to do anything. And so I just lost the money. So I kind of regret that I didn't, I felt like they weren't as incentivized as they would have been if they were getting more money up front. I don't know. I mean, it depends on the property. And if it's big money at stake, they're going to have to spend a lot of time to do the appeal. And they want to get additional business by word of mouth. I have had appeals before where I just flat out lost using a professional. And I've had others where it's been an enormous benefit using a professional. So, I mean, you're talking about why do we have tipping in the United States in order to create incentive for better service, right? So that's what you're saying. Hey, nothing if you don't get anything done, 50% if you do, may be more incentive. But to me, the real incentive with these firms is that they want business ongoing. They want you to say, hey, you know, somebody's complaining about their property tax appraisal. You say, I used so-and-so company and it was great and they saved me all this money. You're only going to say, I paid all this money and I got nothing. Don't use those people, right? For sure. Yeah. So that's the marketplace speaking too. But anyway, I hope that you are successful with your appeal. You're treated fairly on the amount of tax. And we, as a country, generally, state by state, jurisdiction by jurisdiction, people have faced big increases in property tax because of the increase in the value of real estate and has created burdens for a lot of people on fixed income that they can't afford to stay in their home because of what the taxes are. So we've never been able to come up with what would be the right way to handle property tax reassessments so that it doesn't force people out of the house they love living in. So don't have the answer to that, but that is a problem we must address. And thank you so much for joining us today. And you know what's coming up? Our next edition of the Clark Howard Podcast and YouTube show is Clark Stinks. I can't wait. So tune in Friday and you get to hear where I failed to deliver the best advice I could. we all learn from each other I so look forward to what I've learned from you because everything we're about is about giving you actionable knowledge that empowers you so you can do things to benefit yourself your family your friends so you can save more spend less and avoid getting ripped off and I'll see you Friday Thank you.