CLEARly Beneficial Podcast
CLEARly Beneficial Podcast: Where We Rip Off the Band-aid and Explore What's Next
Welcome to the CLEARly Beneficial podcast - the show where we rip off the band-aid on healthcare and explore the future of benefits with the people driving innovation in our industry.
Host Vinny Catalano brings over 20 years of health insurance brokerage expertise to conversations that get to the real story. You'll discover what actually works, what doesn't, and what's coming next from the innovators brave enough to challenge how we've always done things.
Whether you're an insurance broker navigating carrier politics, an HR professional trying to make sense of complex plan designs, or an employer seeking practical solutions for your people, this podcast delivers the straight talk and actionable insights you need.
We rip off the bandage and give you the inside perspective that only comes from decades in the trenches. Ready to see what's really happening in healthcare? Let's explore the future together.
CLEARly Beneficial Podcast
Ep. 9 Vinny Catalano: Navigating Rising Premiums, Subsidy Loss, and Smart Strategies for 2026
What to Do When Your Health Insurance Costs Are Skyrocketing
Vinny Catalano tackles the anxiety-inducing reality of rising health insurance premiums as ACA subsidies face elimination, explaining what individuals and families need to know to make smart coverage decisions for 2026.
Vinny addresses the widespread panic as people receiving plans from ACA exchanges worry about losing subsidies that kept their premiums affordable. With subsidies disappearing, lower-income individuals are facing multi-thousand-dollar annual bills they weren't previously paying, creating a crisis that has everyone freaking out—not just consumers, but insurance companies and hospitals too.
The episode focuses on a concept most people overlook: the annual maximum out-of-pocket. Vinny explains that this is the magic number where insurance pays 100% of costs for the remainder of the year—typically around $7,000 for individuals and $14,000 for families. Understanding this number is crucial for evaluating whether to buy insurance at all and which plan level makes financial sense.
Vinny walks through the real math of insurance decisions. For example, a family bronze plan costing $2,000 monthly represents $24,000 annually. Add the $14,000 maximum out-of-pocket, and you're looking at a worst-case scenario of $38,000. He discusses the temptation to go uninsured and adopt a cash-pay strategy, warning that while emergency rooms must treat you regardless of insurance status, this approach has serious limitations for chronic illnesses and long-term care. Unpaid medical bills can lead to asset seizure if you own a home, car, or have bank accounts.
The conversation shifts to plan selection strategy. Vinny challenges the assumption that gold and platinum plans are always better, noting that many bronze, silver, and gold plans have identical annual maximum out-of-pockets. The only difference is that you pay more premium on higher-tier plans to reach that maximum slower—essentially throwing money away if you're relatively healthy.
For prescription drugs, Vinny strongly advocates for Mark Cuban's Cost Plus Drug Company for generics and GoodRx for price comparison across local pharmacies. He shares that he often pays less through Mark Cuban's platform than through his own high-deductible health plan, demonstrating how dramatic pharmacy price variations can be.
The episode concludes with a pragmatic message: buy the lowest-cost insurance you can afford, be strategic about drug shopping, and maintain the perspective that this situation will eventually work its way through the political system—though probably not in time for 2026 coverage decisions.
Disclaimer: This content is for educational purposes only. Please discuss your specific situation with your health benefits administrator or insurance provider for personalized guidance.
