Christian Health Ministries

[mudhound]

Pay me 1/2 the medishare premium. I won't pay any claims either but you'll save some of your dollars (unless you get sick).

Junkman,

You are so wrong. I have been a member for almost 12 years now. Yes, I have used it twice in those years. Both times my bills were shared in the manor they were supposed to. The ONLY problem I have had is one med is a tad high. Meds are not covered under the CHM program (limited coverage on the Gold plan).

Plus, I have a good friend whose wife has cancer. They have amassed up over $250,000 in bill so far and CHM has paid EVERY one of them. I spoke with his the other day and to this day he says he owes nothing to anyone. This cancer has been going on for about 9-10 month (breast).

Some people just can not believe this. Well, I believe and I have seen it with my own eyes. Is the CHM or MS program for everyone? NOPE!!

 

[kgmom219]

I think its great that some people have had a good experience with CHM/MS plans.

But this is an AGENT'S forum. Personally, I don't want to sell anything that isn't a licensed product, so if there is a problem, you can go to the Department of Insurance for support.

These plans are a house of cards waiting to tumble. There are way too many loopholes. And I have serious concerns about the claims getting paid. $250K isn't that much. And cancer claims "end". One way or another. The issue is a catastrophic diagnosis: Chrons, RA, MS, Kidney failure (no Medicare before dialysis), ALS, etc. That $1K a month you are saving isn't going to be that much when they don't cover Remicaid or Humira.

But, HEY! You can jump into ACA the next year, right? Make the pool even sicker and more expensive for those who have been in it all along? "Love Thy Neighbor" doesn't seem to be working here.

Sidebar: We REALLY need a 30% surcharge for those who don't have MEC and jump into the pool the next year.

 

[junkman]

I'm hoping they work out as unsubsidized premiums are not affordable. However, I've seen many flavors of alternatives go belly up over the years. Carriers know how to run a block of business and neither Christian ministries or ACA in current form follow those guidelines.

Medishare for instance has a 3 year pre-ex limitation which requires a form of underwriting after the fact. I also never received a definitive answer to pre-ex definition when I asked. Their share was ~75% less than BCBST for 2018.

I've watched Christians for many years and they are no more reliable than anyone else. The healthcare system in this country is a cluster ***.

 

[kgmom219]

I've watched Christians for many years and they are no more reliable than anyone else. The healthcare system in this country is a cluster ***.

We need 4 things to stabilize the pool and lower rates (no one really wants the benefit changes to revert back to 2013. If you get the rates down, then its "fixed").

1. 30% Surcharge with no MEC
2. Fix the Family Glitch. We need more healthy people in the pool, and I have ZERO problems helping people that are employed get less expensive coverage
3. Give the carriers Stop Loss. Anthem wants $50K, so it should probably be $100K.
4. Tie MAPD counties to ACA. The carriers make a ton on MAPD. They need to offer ACA in the counties they offer MAPD. 2 plans per tier.

There. Fixed. I'll let you know when POTUS calls.

 

[leevena]

I hope your making a joke when you say playing lotto will get you kicked off your medi share plan ? I can't tell -- . Once again I will say I have no dog in the hunt here- I am an independent health/life agent selling many diff products .i just want to clarify a few things

I've heard it said in this forum that if you do not go to church you will be cancelled ?? Not true at all . You say Playing lotto will get your plan cancelled . Not at all true

Your comment about lotto has nothing to do with getting coverage or keeping coverage with a christian Ppo plan like Medi Share (MS) or CHM for that matter . With Medi Share as an example they use PHCS or Multi Plan so they pass along huge pre negotiated discounts . Then they pay the balance at 100% after the deductible although it's not called a deductible . I will confess that me nor my family have not filed any significant claims so I do not know how or at what percentage they would pay but I also never knew how Bcbs would have paid either when I was with them but I have a strong feeling if I called them and asked at what % do you pay claims - they would not tell me as that is proprietary data I would think ??

I've been told in Houston - it is not possible for a hospital to refuse service to anyone ? They may put you back together then move you to the " free hospital " but they can't say No . I am not 100% confident in this but this is what I'm told .

So how is it that you know this about Medi Share - or are you just genetically saying most christian Ppo plans do this ? I think that is dangerous if so -- CHM does not have a network tied to their plan and prolly resembles what you described however Medi Share does use the provider network I mentioned and that makes a huge difference .

I've been told by MS them over and over that they pay 100% of the Hopsital bill after the deductible and after the Multi Plan discount has been applied . I did do an outpatient procedure with dermatologist and as advertised I paid right around 50% of the network discounted amount out of pocket . This is what I was told prior to signing up and I was very happy how this worked out.

I would think it's hard to say ALL faith based plans are going to pay by the same philosophy ? I would simply advise brokers who decide to offer these Christian Ppo plans that they use one with a Hopsital /Dr network attached . Personally I am saving over $1000 a month by using MS and I am thrilled to save that money .

This subject is being addressed is a couple of threads and I find it both hilarious and sad at the same time. So what if someone wants to sell this type of product, or if someone does not want to sell it. We all have our own unique business models with products and services we market. But the constant rebuttals and emotions is a joke. Make your statement and go on, minds are not being changed here.

Johnnybean, I must say that your statement about not being employed/associated with any of these plans would be more believable in the absence of your constant and emotional defense.

As for some of your comments. Hospitals in Houston...this is true throughout the country, due to a law passed in the mid-80’s I believe. Your comment about PHCS Multiplan passing along Hugh discounts is laughable. Their “discount” is average at best. A better “discount” can be found when you ask the provider for the cash/self-pay cost.

 

[junkman]

We need 4 things to stabilize the pool and lower rates (no one really wants the benefit changes to revert back to 2013. If you get the rates down, then its "fixed").

1. 30% Surcharge with no MEC
2. Fix the Family Glitch. We need more healthy people in the pool, and I have ZERO problems helping people that are employed get less expensive coverage
3. Give the carriers Stop Loss. Anthem wants $50K, so it should probably be $100K.
4. Tie MAPD counties to ACA. The carriers make a ton on MAPD. They need to offer ACA in the counties they offer MAPD. 2 plans per tier.

There. Fixed. I'll let you know when POTUS calls.

Unfortunately, that will not get participation where it needs to be. People making $10 to $15/hr do not consider a $5,000 deductible to be worth anything AND, the copay plans or lower deductible plans are prohibitively expensive. Those people will only participate if someone is there to hold their hand or the process is very simple and rates are low with copays or low deductibles.

The top 3-4% of members on a normal large employer group incur 40% of total claims. That means we need the bottom 96% enrolled to offset the top 4%. The only way that will be accomplished is to auto enroll. We can't auto enroll and charge money voluntarily because it won't be paid voluntarily. That implies tax. Lower incomes do not pay much federal tax which leads to a requirement that the tax be similar to medicare.

The alternative is to admit that some people don't get access to healthcare unless through the ER which is the most expensive distribution channel there is and the ER doesn't addressing do a good job of low level services. The cost is passed on and paid for by those who have insurance.

We (as agents) used to go into a garment factory that had low participation with high and getting higher rates. It was easy to modify the plan design slightly and cover everyone for only slightly more than the current total premium. The per member rates dropped almost 50%. We have the same option now under ACA but there is absolutely political will.

I hold Congress accountable because they are educated and have access to at least the same information any agent has access to. Any Congressman could easily call any of the higher ups at any carrier and get access to any level of detail necessary. It ain't rocket science. Insurance premium is average expected claim adjusted for expected trend + admin - nothing more.

We have enough money to keep more people in jail than China at $50,000/yr and spend more than twice as much as the rest of the world maintaining our war economy but we can't figure out healthcare. I note that China's population is 4x ours. Like I said we have a cluster ***.

 

[ABC]

Johnny Been, let me clarify a couple of things for you. MS states they are using PHCS & Mutli Choice networks, awesome if they were a health insurance company. The very same thing first attracted me to start selling one of the products. It still goes back to referenced based pricing, they are reimbursing a medical office 25% above Medicare and a Hospital or surgical center 50% above Medicare. They are used to making 300%. Will an ER take you, yes, will a surgical center accept you for a knee replacement, No. Will a chemotherapy center accept you, maybe but how long before treatment start? What kind of doctors are going to treat you, Medicaid providers, because they have federal funding to help fund their operations.
Until the medical community accepts reference base pricing using Medicare as the benchmark, I would go with a short policy before a medshare.

You are drinking the MS cool aide, I wish you the best of luck! I will be playing Powerball this weekend, don't get caught buying a ticket

 

[mudhound]

Now, as far as selling it? No way. You are just asking to have problems. I have it for myself. Period! Over the past 10-12 years I have “told” maybe 6-8 people about it in a way that they might get it themselves. The program is NOT for everyone. Matter of fact, my own pastor does not have the CHM or MS plan. He is on a BCBS of TN plan. To each and everyone his or her own.

 

[junkman]

I don't have a problem with PHCS. It was originally started and owned by carriers that eventually decided to manage their own networks. PHCS is still used by small carriers and TPAs. Providers agree to accept the network price as reimbursement and it matters not who the pauer is - carrier, Employer, CHM or whoever. The weakness with CHM plans is more with the contractual arrangements between CHM and the insured not with the agreement between PHCS and CHM. You also have no way to know whether there will be enough money to pay claims. That issue is similar to trust products that used to be so prevalent and,are making a comeback. At least the trusts had a contractual requirement to pay and would unless they folded.

 

[Johnnybeen]

agree with Leevena , I will leave this topic alone . But I must say I only started commenting when I saw so much false info on this Christian plan topic . i am new here. I assume new agents will come here looking for advice or wisdom and I know how hard it is to get started in this biz.

I am not employed by any insurance company/Medi Share - that would not work out and surely I'd get fired after a few weeks ! After 34 years of doing it my way I'm unemployable !! Happy new year to everyone !!