Medi -Share and Others Are Baffling

[INSUREGEEK]

I looked into Medi-Share at the request of my preacher's daughter mother who is 64.

It looks like a giant Ponzi scheme to me. She would have to pay about $200 "share" per month and have a $7500 annual deductible. There were options to choose from. I think the $2500 deductible was a $400 share per month. Every bill has to be submitted to count toward the $7500 of course, but it's still a hassle. Once you've exceeded that $7500, you still pay your bills but submit them for reimbursement.

They operate through a credit union. They set up an account where you deposit your monthly "share". They can move that money to another member's account at will. When your bills qualify to be reimbursed, they simply move other people's money to your account. They claimed to have member assets of about $18M if I recall correctly.

Momma is better off staying with what's already in place. I could possibly see it being an option for folks with objections to certain things required by ACA, and folks that can afford to front a lot of cash for their own medical care.

 

[HealthGuy]

cant afford a lot of cash? sounds like you could have some extreme out of pocket on these plans!

 

[jmarkk1]

I looked into Medi-Share at the request of my preacher's daughter mother who is 64.

It looks like a giant Ponzi scheme to me. She would have to pay about $200 "share" per month and have a $7500 annual deductible. There were options to choose from. I think the $2500 deductible was a $400 share per month. Every bill has to be submitted to count toward the $7500 of course, but it's still a hassle. Once you've exceeded that $7500, you still pay your bills but submit them for reimbursement.

They operate through a credit union. They set up an account where you deposit your monthly "share". They can move that money to another member's account at will. When your bills qualify to be reimbursed, they simply move other people's money to your account. They claimed to have member assets of about $18M if I recall correctly.

Momma is better off staying with what's already in place. I could possibly see it being an option for folks with objections to certain things required by ACA, and folks that can afford to front a lot of cash for their own medical care.

So if they go to hospital and bill is 100k they have to pay that first before reimbursement?

 

[Captiveguru]

How can Christian 'cost sharing' members get around the ACA law?
I was reading on the Samaritan Ministries website and the Medi-Share website that members are:

1. NOT subject to the ACA law or penalties and

2. Supposedly members do get some pretty high out of pocket 'coverage'..I saw one plan that was like $250K of coverage (like a crappy short term plan) and another plan with 'unlimited' coverage

I seriously wonder how these groups actually 'cover' claims after the deductible.

Any folks here have any recent experience with people on these cost sharing plans. I'm not trying to dog them, but I just lost another insured family to them.

I refuse to debate clients buying these plans. Like talking to a brick wall.
I know there have been some threads but I am AMAZED that they are supposedly working though a work around on the ACA penalty if you are a member of one of these.

The family that dropped their insurance was by no measure "Biblical" or even religious. I guess they are now.

Insights please, and I"m not trying to bust on these concepts.
It just amazes me that they really provide any level of security AND now they get around the law.

Essentially is there anything truly 'insurance like' about these plans?
Such as repricing, any real extensive coverage? Hard to believe they have 'unlimited coverage'...This isn't even insurance!

I have been a member of Medi-Share (MS) since 2012. I am also a licensed insurance agent. I have been active in the alternative risk financing field since 1992.

MS is, at its core, a risk pool and it operates under the same insurance principles as any licensed insurance company (i.e. the Law of Large Numbers).

Members make monthly payments, like "premiums" but we call something different. If my covered expenses exceed my agreed-to annual maximum ("Deductible"), then my covered expenses are paid by the payments collected from other members. In order to avoid being regulated (and taxed), as an insurance company MS transfers funds from my account to pay your claim. The funds are never actually "pooled."

The biggest differences between MS and an insurance company is the lack of an explicit promise to pay claims "no matter what." MS has no surplus and will pay claims only if the member accounts have the funds. I am not concerned about this because MS has more than 100,000 members. All are in better than average health thus the actuaries can easily predict the claim costs. Also, monthly payments are ACHed from member checking accounts. If your ACH "bounces" you lose coverage.

 

[HoosierLife]

I know some folks who use these types of plans and my pastor is looking at it.

I was wondering what you guys thought if you combined a bunch of ancillary products with a medishare product.

Like CI, DI, HI and maybe even short term?

 

[AllenChicago]

I was wondering what you guys thought if you combined a bunch of ancillary products with a Christian Medishare product. Like CI, DI, HI and maybe even short term?

Might work. I'll have to pray on it. Maybe even ask the Pope since he's in the neighborhood.

 

[Captiveguru]

I know some folks who use these types of plans and my pastor is looking at it.

I was wondering what you guys thought if you combined a bunch of ancillary products with a medishare product.

Like CI, DI, HI and maybe even short term?

Medi-Share also has a Disability program called "Manna."

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So if they go to hospital and bill is 100k they have to pay that first before reimbursement?

No. Medi-Share will pay the hospital directly. I had the happen in 2013. Fall. broken wrist and elbow. Unconscious. Ambulance to Hospital. Emergency surgery. Total bills about $120,000. I wrote a check for $2,500 to the surgeon (my deductible). MS paid the rest directly to the hospital, surgeon, etc....

 

[OregonDave]

There's a company in Texas that is enrolling people in Medi-Share and then selling them ancillary as part of their "Wall of Protection" sales process. Looks pretty kooky, and it looks like they were shilling Mega prior to their "Awakening."

 

[mudhound]

There's a company in Texas that is enrolling people in Medi-Share and then selling them ancillary as part of their "Wall of Protection" sales process. Looks pretty kooky, and it looks like they were shilling Mega prior to their "Awakening."

I wonder if the program knows this??
Mine (CHM) says that if you have other insurance it must pay 1st. Sounds like someone might be paying money for nothing and getting tricked for free. LOL!!

 

[somarco]

MS is, at its core, a risk pool and it operates under the same insurance principles as any licensed insurance company (i.e. the Law of Large Numbers).

Looks like they have about 150,000 members. Not exceptionally large. Certainly would not compare them to an insurance carrier where even the smallest carriers have over 500,000 members and REINSURANCE.

Don't know if Captive will return or not, but started looking at the MS website for details ............... which are surprisingly (or maybe not so surprising) sparse. At least Christian Health Ministries puts a benefit summary on their site.

Is there a per illness (or accident) maximum? Annual maximum? Lifetime maximum? Is Rx a covered claim?

Their Senior Assist program is not impressive. Ages 65 - 70 pay $70/month for a maximum $1250 benefit.