Max’s Back Pocket Vol. IV

Well, another work week in the new world of COVID-19 has come and gone. It’s a stressful time for everyone. I need to start this the same as I did last week by recognizing all of the first responders and frontline healthcare workers dealing with this crisis. This is going to get much harder before it gets easier. My health system is doing a great job preparing for a potential surge. I may get pulled away from my cushy desk job to provide support in any capacity that I can. That’s okay though, I am here to help. I am not above cleaning and disinfecting if that will help with the efforts.

As for the Max Out of Pocket crew, we are doing just fine. Where last week went at a turtle’s pace, this week seemed to fly by. I think the interruption to my gym routine was making me tired at the end of each day last week. I felt much better after getting in a modified weight lifting routine on Wednesday. Working out has been pretty regular for me for well over a year now and I didn’t realize how much I depended on it for stress relief. My gym officially closed yesterday, but I have been keeping my distance. It reminds me of when my last gym closed.

Aside from that, we have been laying pretty low. This is one of those times I am thankful we have chosen to live in a rural area. Mrs. Max OOP continues to teach from home. COVID-19 may delay her census job. Last we heard she would get trained at some point in April. The gig is supposed to last about 8 weeks and pay $20 per hour plus mileage. Mrs. Max OOP is a statistics teacher and is doing this more for the experience than the money. As I have said before, sometimes your interests accidentally generate income. In other cases, pandemics get in the way of best-laid plans.

Max’s Back Pocket

Welcome to the 4th edition of Max’s Back Pocket.

Over the last several years, I have absorbed a ton of great content from a lot of talented people in and around the internet. A lot of those ideas even got implemented into my personal finance strategy. Some of these people are professionals, but a lot of them are just amateurs throwing their weight around in a random niche. I like to think I am pretty good at healthcare and personal finance, but there are plenty of people out there much smarter than me.

Up until now, most of these ideas just landed in my back pocket. There they would sit for my own benefit whenever needed. They were rarely shared or exchanged with anyone in my personal network. These days, that is no longer the case. Max will start scouring the entire internet for these ideas in a weekly effort to not only spread but recognize the wealth of knowledge that is out there. This weekly check-in will also give me an excuse to catch up on what’s going on around here more often. What are we calling this idiomatic experiment?

Max’s Back Pocket.

Any better ideas on the new logo? It still needs something.

Personal Finance

The mind behind Stop Ironing Shirts put out a decent write up about one of my favorite investments, REITs. Long time readers know I have an interest obsession with individual healthcare REITs. In his latest post, he discusses the REIT index vs individual REITs. This is an interesting read and makes some good points on why investing in the REIT index (VNQ) may be suboptimal to investing directly into individual REITS. It also mentions that the required return for equity risk has changed over the last few weeks with COVID-19. I definitely agree and I am certainly seeing that trend with healthcare REITs.

Personally, I have made some allocation corrections through rebalancing over the last few weeks. It hasn’t been an exact science, and I definitely need to map out my process a little better for the next downturn. Some of those adjustments included some significant additions to my medical office building portfolio.

On the non-technical side of things, Brent from The Scope of Practice talks about the top 5 mistakes families must overcome to move their finances in the right direction. My favorite happens to be number 2, “Failure to live within your means“. I chose to live far below my means in my 20s and that was one of the single most important strategies that got me to the flexible position I am in today. Brent and I also got into a little jousting match in the comments over whose cars are older. The Max Out of Pocket crew won with a combined age of 25 years for both of our vehicles. I drive a 2008 and Mrs. Max OOP drives a 2007 vehicle.


Here at Max Out of Pocket, we took a close look at the Families First Coronavirus Response Act. There is a lot in that bill, but we zeroed in on how it would impact the out-of-pocket costs for commercial medical insurance carriers. The short answer is it mandates coverage for the COVID-19 lab test for virtually all payers. It also requires them to waive all out-of-pocket costs on the test. But it goes even further than that.

It has a requirement for the out-of-pocket costs to be waived for the encounter with the provider of care when a COVID-19 test is ordered. This would include things like the clinic or emergency room visit. The bill fell short of requiring any out-of-pocket costs to be waived for the treatment of COVID-19.

It didn’t take long for a payer to step up, though. Just this week, Aetna said they would cover inpatient admission for the treatment of COVID-19. Now, Max knows very well that no good deed goes unpunished. People will find a way to attack this and turn it back on Aetna. My guess is they will jump on the “in-network” requirement. I personally think we need to commend Aetna for being one of the first (if not the first) moving in this direction and I think others will follow. Every storyline doesn’t need to be controversial.

Aetna, a CVS Health company, will waive member cost-sharing for inpatient admissions at all in-network facilities for treatment of COVID-19 or health complications associated with COVID-19. This policy applies to all Aetna-insured commercial plan sponsors and is effective immediately for any such admission through June 1, 2020.

Aetna/CVS Release 3/25/2020

Frankly, I’m impressed with how many of our most powerful companies are stepping up to meet COVID-19 head-on.


Did you ever wonder what the difference is between Program Managers and Product Managers? I have. Well, The Engineer Seeking Fire laid it all out on his blog and even covered other things like Engineering Managers and Marketing Managers. My brother works in the automotive industry in Michigan and I believe he is a Program Manager. Now I officially know what he does. I think we could use more of these positions in healthcare.

Talk about social distancing

Last Sunday, Mrs. Max OOP and I decided we had a case of cabin fever. The ski resorts were all closed for COVID-19, so we hit a hike we have never done in the wintertime. We were, of course, mindful of social distancing for the few people we encountered on the hike. Everything seemed normal in the mountains. Almost like COVID-19 didn’t exist. It was a nice break from reality. Please, remember to take time for yourself during these challenging days.

Happy Saturday!

How was your week?


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