Medishare offers an alternative to traditional, expensive health insurance. In our review, we dive into the details of this health care sharing program.
Health insurance has been a hot topic for a long time. The goal has always been to get healthcare to more citizens at a better price. But it hasn’t always worked out that way. No matter what health care plan the government puts in place, there are winners and losers. For the last handful of years, I’ve been one of the big losers.
As a result, I’ve done some shopping around and found a great alternative to Obamacare. Medishare is part of the Christian Care Ministry. It offers health insurance to individuals and families. Group sharing plans are exempt from the Obamacare mandate requirement, so if you’re signed up, you won’t face a tax penalty at the end of the year.
First I’d like to share with you my health care experience the last few years and showcase why Medishare is a fit for me and my family.
My Life Without Health Insurance
In 2009, I quit my job and began working for myself as an independent contractor. I lived alone, having graduated college just a few years prior. Losing my health insurance wasn’t that big of a deal. I was healthy, young and hadn’t seen a doctor since high school. If anything, not carrying health insurance allowed me to put a little bit more of my money each month toward paying down my student loans.
But then things changed. I got married in May of 2012, and my wife got pregnant in January of 2013. We had Aetna health insurance at the time, but no maternity coverage. So we paid out of pocket for just about everything. Initially the costs were not all that expensive. In fact, up until the actual delivery day, I believe we were out a total of $3,100. That was for all the exams, tests ,and monthly appointments to check the health of our child. Then delivery day came, and it all changed.
My wife had a few complications with the delivery, so after 17 hours of no baby, she was rolled in for an emergency C-section. Our daughter, Everleigh, was born healthy. My wife was healthy, too. Everything turned up roses. Then three weeks after we left the hospital (one day early because it was $3,400 a night), I received our delivery bill in the mail. The hospital got a little creative and charged us both for a regular delivery and a C-section delivery, and the bill came in just under $55,000.
After blacking out in my office from opening the envelope, I came to and couldn’t stop laughing. That’s typically how I deal with something like this I suppose. After a lot of back and forth between myself, Aetna, and the hospital, we all agreed to pay a third of the cost.
My Obamacare Nightmare
After that disaster, we signed up for Obamacare during the open enrollment period in 2013. Initially, everything looked reasonable. The $425 monthly premiums with a $4,000 deductible per person wasn’t so bad for our family. Everyone still healthy. So we dealt with nothing more than routine checkups and shots for our daughter in the first year. In 2015, the monthly premiums rose to $550 with a $5,500 deductible per person. In 2016, those premiums went up again to $610. And then my son Max was born in November. It was only a $10,000 hospital bill this time around. But once again, our 2017 premiums went up.
This year, we’ve been paying a $797 per month premium with a $6,500 per person deductible. And lucky us, we received a notice a few weeks ago that our premium cracks the $1,000 mark next year with the same deductible. In Connecticut, we have two providers available, and we’re on the cheapest possible Bronze plan. As my family is just outside the 400% poverty level in terms of annual income, we receive no credits from the government, so I thought I had just two choices: Pay the $13,000 annual premiums plus whatever costs we incur or go without health insurance.
But a third choice emerged: using a company like Medishare to insure my family’s health. So I’ve looked into the company to see if they can offer me a better overall package than Obamacare can for my family’s needs.
How Does Medishare Work?
The concept behind Medishare is simple. Every month you play into a pool of money that many other members pay into. In addition to paying into that pool, you also are responsible for a certain amount of your medical care each and every year (out of pocket). When someone gets sick and needs to pay a bill, funds from the group go to pay that bill.
For example, below you will find a list of options that a family of four has when deciding to join Medishare.
For example if I choose the fourth line, I would first be responsible for $3,750 of my family’s healthcare expenses before I could use the money in the group pool. I would also be responsible for paying $483 a month into the pool (or $408 for a healthy discount). Every time I paid a bill, I would submit it to Medishare as proof that my $3,750 out of pocket was reduced. Once I cross the threshold, I could submit my bills for payment.
The more I’m willing to pay out of pocket, the lower my monthly premium. For my family of four healthy individuals, I’m willing to take on more of an annual household portion and pay a smaller monthly deductible. Consider that in 2018, I’m on the hook for $13,000 in Obamacare premiums plus a $13,000 deductible.
If I select the $7,500 out of pocket plan, I will only pay $3,750 in health care premiums. Thus even if someone in my family gets sick and I have to pay the full $7,500 out of pocket, my total cost is still only $11,250 before Medishare picks up the full tab. With Obamacare, I could pay $26,000 before my insurance covered my bills.
When signing up with Medishare, there are a few fees you need to be aware of:
- One-time $120 approval fee. When you apply and are approved for the Medishare program, you will be charged a one-time $120 fee. This is added to your first monthly premium.
- One-time $2 membership fee, also payable with your first monthly premium.
- $3 recurring monthly fee if you do not sign up for automated ACH payments each month. If you do sign up, there is no monthly fee.
What Are The Rules?
In order to be approved for the Medishare program, you must agree to certain terms. One of the ways they are able to keep costs low is to screen the type of person before approving them into their sharing platform. In addition to signing your name on a document that attests to your Christian faith, you must also agree to the following:
- I do not engage in sex outside of traditional Biblical marriage, which is a union of one man and one woman. (Gen.2:22-24, Mat. 19:5, Eph. 5:22-32)
- I do not and will not use tobacco in any form or illegal drugs and have not for the last 12 months.
- I agree not to abuse legal drugs, including alcohol and have not abused them for the past 12 months.
- I understand that when any member of the family chooses not to live by these principles, I have a responsibility to notify CCM. I also realize the family member may no longer qualify to participate in Medi- Share and their membership will be cancelled and his or her bills will not be eligible for sharing.
One additional very important note to make. You must share your previous medical history with Medishare. This allows them to determine your risk (so they can place you in a proper pool). It also ensures the answers to the above questions are accurate.
Paying and Receiving
Before Medishare pays your medical bill and before the money you deposit is used to pay someone else’s bill, names are shared. So when your money is used to pay a bill, that person’s name is shared with you so you can pray for them. The same is true for bills paid for you.
Being a Medishare member also provides you two additional benefits. First, you’ll have access to their telephone physicians. I can’t begin to tell you how many times my wife consults Dr. Google, only to find out we have 13 different diseases. Oddly enough, they all turn out to be just colds.
Second, Medishare will give you a discount card which might help ease the burden on dental and vision costs. The trouble here is that some dentists/doctors will accept the cards and provide discounts, but others will not.
Is Medishare Right For You?
For our family, this makes complete sense. We’re four healthy individuals with no pre-existing conditions. So we don’t expect to visit the doctor much outside of routine physicals each year. Medishare will allow us to pay a much lower premium and save the rest of our money for medical expenses should we need them. If not, it’s money to put toward our children’s future and our retirement.
Getting ready to fork over $13,000 in annual premiums for lousy coverage we likely won’t use was the straw that broke this camel’s back. If your family is in a similar position where health care premiums are approaching unaffordable, have a look at Medishare. After spending 60 seconds answering a couple of basic questions, they’ll give you an idea of how much your premiums will be and how much your out of pocket costs will be.
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Topics: Health Insurance