Health Share Question / Opinions

[Daniel J Topolski]

This is a question for all you agents out there ---

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. I would highly recommend them!

But they are raising prices and I have to switch - I also want more things like office visits, wellness exams, etc and they don't offer any of that until you meet your deductible. So I am trying to decide between OneShare, Solidarity Healthshare, Altrua, or just a basic Anthem Blue Cross plan.

OneShare has best benefits (3 fully paid office visits, 1 urgent care paid, 1 wellness visit per year, and 1 ER visit - all paid in full). But then the deductible for any other services (hospital, MRI, CAT scan, surgery, disease, etc is $10K. Then they pay in full after that - so it's basically a catastrophic plan with some office visits, etc thrown in. $211 a month.

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. $199 a month

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 per month, pay some copays, and still pay even more when the bill arrives until you reach deductible. They you still have to pay some till you reach $6000 and finally they cover everything - hopefully. $240 a month

ANY THOUGHTS ON WHAT TO DO.
I AM HEALTHY, 38 YEARS OLD, MALE - never had a stitch or been to ER or hospital or anything - no pre-existings. Maybe see doctor twice a year.

 

[kgmom219]

How are you going to switch mid-year? You don't qualify for a Special Enrollment Event.

IMO (and most agents who have any experience or conscience) these plans are crapola.

Wait til Nov, when the 2020 plans and rates are out, then decide.

 

[Chazm]

“We recently had a week long hospital stay, five ER visits, etc - the bill was $70,000+”


“I’m a healthy, 38 year old, male. Never had a stitch or been to the ER. No pre-existings”

Come again?

 

[Daniel J Topolski]

The hospital stay was for my wife who is now on her own insurance.

I go to doctor for a physical once a year. Maybe go in to get a refill approved or something. Maybe two visits a year. That is my extent of doctor visits. Never been to er, started in hospital, had a stitch or broken bone, had a scan, no surgery, etc. Ever.

 

[Chazm]

The hospital stay was for my wife who is now on her own insurance.

I go to doctor for a physical once a year. Maybe go in to get a refill approved or something. Maybe two visits a year. That is my extent of doctor visits. Never been to er, started in hospital, had a stitch or broken bone, had a scan, no surgery, etc. Ever.

Ok gotcha.

Then my next question is, if you have a plan that just worked out great for your wife when she needed it most, why would you leave it? Because of a premium increase? Is it doubling? I mean if I found a plan that worked great for me, I’m not screaming to find another option

 

[Daniel J Topolski]

When we were together it cost $370 for a plan with $3700 deductible.

Doing it solo the most I can afford is a $10000 deductible.

Now I'm okay with that only if I'm going to get extra perks like a physical, a few free office visits, a free urgent care visit, etc which they don't provide.

 

[SamIam]

It's not even close you go with Anthem Blue Cross, especially for that price difference. Keep in mind on the Health share which they state in the contract there is no guarantee that they will pay the claims.

 

[Chazm]

I know I told you this before in another post, but there’s no such thing as a free Dr. visit, free Urgent care visit etc.

 

[Daniel J Topolski]

Anthem is out. My boss has stopped sharing half the cost with employees. Not an option anymore. Way way out of budget without their help.

I know Healthshares are not guaranteed to pay. I am one hundred percent fine with that. I read posts and see tv shoes constantly about real insurance like anthem not paying too. If I've been in medishare for three years you know I'm not afraid of health shares like you all are. Just trying to pick the best one.

And I disagree. My dues in my mind are to have the safety net for catastrophic event. The bonus is with OneShare I walk into the doctor. Pay $20. And unlike regular insurance where is get a bill later I get nothing. They pay it 100% even if there are labs and xrays. Those are covered too. No deductible required for this to happen.

 

[Daniel J Topolski]

Here is ALL I WANT:

IF YOU HAD TO PICK ONE OF THESE TWO OPTIONS AND NOTHING ELSE WHICH WOULD YOU PICK?

--------------------

Option #1.

You get 1 free physical
Free online doc visits
You then pay everything yourself with cash till you get to $500. After that it's all free/paid/covered. So if your healthy and only see doc few times a year you pay everything yourself since each doctor visit is around $100 here. But if you have an ER visit or hospital or need tests or something major it's all covered after $500.
Cost is $199 a month.

------

Option #2

This one they pay for three doc visits in full minus $20 copay, 1 ER visit in full minus $400 copay, a free physical, and 1 urgent care in full minus $20 copay, and have free online medicine. Includes all xrays and blood tests if done during an office visit or physical. Everything else beyond that like hospital, surgery, specialists I have to pay myself. I have to cover the first $10,000 (deductible/max max of pocket). Then they start covering 100%.
Cost is $211 a month.

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Not sure which one sounds better if you had to pick.