Episode 69: Health Insurance


Episode Summary:

Health Insurance continues to be a very complex, difficult to understand, and in many instances less than a transparent entity. 

This episode explores health insurance from multiple perspectives (individuals, employers, health care providers, and care delivery organizations. 

The role of Pharmacy Benefit Managers (PBM’s) is also explored.

Dr. Jeffrey Frankel, MD,  Is a Past President of the Washington State Urology Society, a Past President of the Western Section of the American Urological Association, a Past President of the American Association of Clinical Urologists, and he currently chairs the Government Affairs Committee for the Washington State Urology Society He has practiced Urology in the King County area since1985.

During This Episode, We Discuss:

What is your responsibility regarding your insurance coverage prior to visiting a medical provider’s office, undergoing a procedure study, or surgery?

How does your coverage differ from someone else who might be under the same plan?

What happens when you are in Network or out-of-network? What does that mean?

What happens when your care provider becomes employed by a healthcare entity, clinic, or insurance company

How do Medicare, and Medicaid work? How is it different from private insurance?

What are Medicare Advantage plans?

What are Pharmacy Benefit Managers? 


Medicare Advantage plans are a form of Medicare, approved by the government, and put out by insurance companies….. If you go with an advantage plan, they pick a system and your provider may not be part of that plan or system.

Dr. Frankel

You have to be quite careful when you sign up for a plan with a lower/ less expensive premium…  as there are consequences for that lower premium cost such as restrictive access to care and they also deny more procedures and prescriptions.

                                                                                                     Dr. Frankel 


Recommended Resources:

Episode 17: Understanding and Navigating the Health Insurance System, The Original Guide to Men’s Health

Episode Transcript:

Coming soon!

More To Explore

image of lower half of man with posing with his jacket and a road bike

Episode 72: Real Talk on Men’s Health Part 3

The latest podcast episode wraps up the ‘Real Talk on Men’s Health’ series with two informative presentations. The first part emphasizes the early detection of Prostate and Testicular Cancers, offering crucial information. The second presentation delves into new treatments for obesity, including insights on Obesity, Diabetes, and Metabolic Syndrome.

Happy, fitness or friends fist bump with goals bonding after workout, training or running exercise. Motivation, mature runners or healthy group of senior men with support or target ready for running

Episode 71: Real Talk on Men’s Health Part 2

In our latest episode, we focus on two critical areas of men’s health as presented during the October 25 live event, ‘Real Talk on Men’s Health.’ These areas are Cardiovascular Disease and Its Management and Understanding and Managing Prostate Enlargement. This episode is an invaluable resource for anyone interested in gaining a deeper understanding of these key men’s health issues.

This episode not only provides vital information but also serves as a comprehensive guide for men to understand and manage their health effectively. Tune in to stay informed and take proactive steps towards a healthier future.

Silhouette of male doing push ups.

Episode 70: Real Talk on Men’s Health Part 1

Discover insights from the ‘Real Talk on Men’s Health’ event in Seattle, featuring expert discussions on men’s health prevention, longevity, sexual health, heart health, and more. This episode of the Original Guide to Men’s Health highlights key presentations, including the need for a state commission for boys and men, and explores updates on vital health topics like ED, testosterone, and prostate cancer.

Leave a Reply

Your email address will not be published. Required fields are marked *