Faith based medical expense sharing organizations

[CharlieBob]

I am a member of Medishare for me personally as well, and its been beneficial and a better financial option than Blue Cross Blue shield, which Im licensed with as well, but I am leary of the ones out there that are offering plans as a worksite benefit

 

[leevena]

I am a member of Medishare for me personally as well, and its been beneficial and a better financial option than Blue Cross Blue shield, which Im licensed with as well, but I am leary of the ones out there that are offering plans as a worksite benefit

I know very little about these plans, so my question is why do you not like the worksite option? Thanks in advance.

 

[TampaHound]

There is at least one thread and probably more that answer your questions. Try the search function.

There are also these posts . . .

InsureBlog: Bailing Out

InsureBlog: Shaking the Faith

Well I'm sure there are good faith based groups out there...this is the reason why I don't sell or recommend them.

 

[somarco]

The only plan that worked all the time was run by a man who walked the earth 2,000 years ago.

 

[David Block]

Most of these plans are faith based so if you are not of the faith, you probably would not qualify. Also, there are usually requirements to join (no smoking, drinking, etc.) and they often have you sign an affidavit to that effect so if a claim results from any of these there would no coverage/sharing available. In addition, if there are pre-existing conditions, from the plans I have seen, there is limited to no initial coverage.

To those brokers selling this as health insurance, I say beware. To those selling this as comprehensive coverage, also beware because there are limits based on each program.

 

[CharlieBob]

I have never offered a health sharing plan nor do am I a member. It is slightly better than no insurance in my opinion. Lot's of pitfalls not the least of which is the lack of Rx coverage (other than a discount).

Group plans can be extremely complex. Group employee presentations have challenges including those who do not listen and/or have selective memory.

Many years ago I did an employee presentation for a group health insurance plan. We probably had close to 100 people in the group. Several questions, mostly about how much it would cost them.

A few months after that meeting I had a call from an irate father. His unmarried daughter was pregnant and he wanted to know how I was going to pay for it.

At that time maternity coverage was only available to married women.

I had no idea who the woman was and only vaguely remembered the question.

I definitely did not sleep with the woman so I was not the father.

I explained the rules, not married, no maternity.

He said you never said that in the meeting. He was probably right. Any time you answer a claim question it is virtually impossible to cover the caveats. It is also counter-productive.

The father was not pleased. Said he was going to sue me.

He never did.

Point is, selling REAL insurance to a group is hard enough. I can't imagine pitching a sharing program that lacks regulation and guarantees to an employer grou.

What you said about the already complexities of health insurance plans coupled with all the liability issues makes good sense.

I have a family friend on one who didn't want ACA (no subsidy) when they lost their gf plan. They are in the middle of the negotiation process with an $10k ER bill. They are keeping me informed of the process and how it works out.

Of all the people I have talked to who had a sharing plan, this will be the most expensive bill I have seen, so interested to see how it pans out.

I have a family friend on one who didn't want ACA (no subsidy) when they lost their gf plan. They are in the middle of the negotiation process with an $10k ER bill. They are keeping me informed of the process and how it works out.

Of all the people I have talked to who had a sharing plan, this will be the most expensive bill I have seen, so interested to see how it pans out.

I know very little about these plans, so my question is why do you not like the worksite option? Thanks in advance.

k

I know very little about these plans, so my question is why do you not like the worksite option? Thanks in advance.

 

[Daniel J Topolski]

I am a member of MediShare right now.
We recently had a week long hospital stay, five ER visits, etc - the bill was $70,000+

MediShare covered and paid everything except our ADA (deductible) which was $3750.

Worked great.

But they are not raising prices so I am trying to decide between OneShare, Solidarity Healthshare, Altrua, or just a basic Anthem Blue Cross plan.

OneShare has best benefits (3 paid office visits, 1 urgent care paid, 1 wellness and 1 ER visit - all paid in full). But then the deductible for any other services is $10K.

Solidarity says we just have to pay the first $500 (that is our deductible) - then everything else is covered at 100%. Seems great BUT I heard they pay slow - 2-3 months.

Altrua sounds great but my insurance agent said people are flocking away because of slow paying and bad customer service.

Anthem Blue Cross (we all know them). You pay a bunch, pay some copays, and still pay even more when the bill arrives.

 

[David Block]

Daniel ... if your plan worked for you, why would you switch? It appears your share was reasonable and I doubt there are insured plans with a $3,750 family deductible that would be as cost conscious as what you are most like paying. There are issues with all plans in one form or another. Network versus non-network providers, premiums, co-pays, coinsurance, to name a few so just beware and adjust your expectations accordingly. As an insurance person, I just have issues with non-insurance based organizations offering insurance look-alike plans. I do hope that whoever was hospitalized is recovering and returning to full health.

 

[Daniel J Topolski]

Daniel ... if your plan worked for you, why would you switch? It appears your share was reasonable and I doubt there are insured plans with a $3,750 family deductible that would be as cost conscious as what you are most like paying. There are issues with all plans in one form or another. Network versus non-network providers, premiums, co-pays, coinsurance, to name a few so just beware and adjust your expectations accordingly. As an insurance person, I just have issues with non-insurance based organizations offering insurance look-alike plans. I do hope that whoever was hospitalized is recovering and returning to full health.

So the reason I have to switch is because my wife got regular insurance through her work and I can not afford hers and can not afford to do MediShare solo. If I wanted to stay with MediShare the best deductible I could afford is $6000. And they don't throw in any wellness, office visits, etc so that is all paid out of pocket till you reach $6k

 

[David Block]

I understand your situation ... so her employer does not pay any dependent cost? Is the cost to add you that much more than what you were paying for the two of you on the MediShare plan? Remember, she can pay for the plan pre-tax assuming her employer allows that option.

Look, it is a very difficult situation to be in where the cost of insurance is so high that it is unaffordable yet still a necessity. Unfortunately, I do not have any suggestions on the ministry sharing plans. Do you have an insurance broker in Colorado that you can turn to? If not, I can find someone from NAHU (www.nahu.org) that can help. Just send me an email and I will find someone that works the individual medical market.