AutoInsuranceMM.Info – Health insurance for self employed – Medi-Share Review (2018 Update): The Affordable Alternative to Expensive Health Insurance
What is Medi-Share?
Medi-Share is a non-profit, medical expense sharing program for Christians. Members share in each other’s health expenses.
Essentially, each month, we all place our monthly share (like a premium) into one big pot (technically a credit union account), and those with expenses use that money to pay their bills. It’s not insurance. But for some, it is the ideal replacement for health insurance.
Here’s more from Medi-Share:
“Medi-Share is a healthcare sharing program where Christians share financial resources to pay each other’s medical expenses. Since 1993, over $875 million has been shared and discounted among Medi-Share members. It’s a proven biblical model of healthcare–Christians helping Christians.”
How Medi-Share Works
Annual Household Portion. Members choose an annual household portion (AHP), which works a little like an annual deductible. The size of your portion determines how much money you will have to pay out-of-pocket for covered medical expenses before the health share kicks in. The good news is that there is flexibility for members in deciding how much they can afford for both the AHP and the monthly share. The size of the AHP you choose will determine your monthly share.
For instance, for my family of five, we have chosen a $10,000 AHP. That higher AHP/deductible amount pays off in a lower monthly share (which is currently at $235 per month). Our family can handle the possibility of having to pay $10,000 all at once, and we enjoy the savings that offers us in our monthly share. If your family would struggle with such a high AHP, you could choose to lower your portion but pay more per month with your share.
Provider fee. As with traditional insurance, you will still pay a provider fee (like a co-pay) of $35 for doctor visits and $135 for emergency room care. Routine well patient care—such as annual physicals—and dental and vision care are not covered by Medi-Share, so you need to be prepared for those expenses throughout the year.
Preferred provider organization (PPO). Medi-Share is partnered with the preferred provider organization PHCS, and members are encouraged to seek care from providers within the PHCS network—but you are free to choose treatment with an out-of-network doctor. However, if you do so, a penalty may be applied for going out of network.
Doctor visits. When you need medical care, you will hand over your Medi-Share card and pay your provider fee, and the provider will bill Medi-Share. The medical bill will be processed and discounted, and then your doctor will bill you for the amount you owe. Once the amount you pay meets your AHP for the year, your eligible medical bills will be approved for sharing.
Health incentive. Families may take up to 20% off their monthly share amount by qualifying for the health incentive. To qualify, all adult Medi-Share members in the household must meet certain health criteria, including blood pressure and BMI and weight/waist measurement. It was this health incentive which has helped spur me to lose some weight over the past couple of years—and it put money back in my pocket in addition to improving my health!
Advantages of MediShare
Let’s explore some of the positives of this sharing program.
Escape the current health insurance market. If you’re like me – self-employed and making a solid income – the implementation of Obamacare was likely a major bummer on a financial level. Obamacare took away my low-cost, high-deductible health insurance plan.
I used to pay $300 a month for a $10,000 deductible policy. Obamacare took that away and replaced it with a $1,100 a month plan.
Like me, you may also fundamentally disagree with Obamacare – the completely partisan implementation, the administration’s half-truths, selective enforcement, collusion with insurance companies, and wasteful rollout, as well as, how your health insurance premiums are being used under Obamacare.
And with the future of American health insurance still being unclear, you may feel uncomfortable trusting to a system that is being tinkered with in real time—so that it is difficult to know what to expect from a traditional health insurance company from one year to the next.
Medi-Share allows you to leave all that behind. I cannot express the joy of being able to check out of the system and not having to face a penalty or high premiums for the rest of my life.
Significantly lower cost than the current unsubsidized health insurance market. Compared to unsubsidized health insurance under Obamacare, Medi-Share is a huge money saver. My own family’s switch has shown very significant savings. (See below for details)
Medi-Share is affordable compared to health insurance because they are still allowed to discriminate.
Disadvantages of Medi-Share
Let’s explore some of the challenges of the program—and to be fair, there can be many.
Currently unable to participate in a Health Savings Account (HSA). Since Medi-Share is not insurance, you can’t qualify for an HSA (yet). HSA’s as you know, require you to have a high-deductible health insurance plan. This is a major bummer for me. I was really enjoying the annual tax deduction from contributions to our HSA.
Medi-Share is currently working with Congress on a bill that might allow HSAs to be used with sharing programs. I’m contacting my Representative to ask him to support this.
Don’t worry if you already have funds in an HSA. You can still use them for qualifying medical expenses. We plan to use ours for expenses that aren’t covered by our particular Medi-Share plan.
No tax deductions. Health insurance premiums are tax-deductible. Medi-Share contributions are not. That said, medical expenses are still deductible, subject to a threshold based on a percentage of your adjusted gross income.
Medical providers may be reluctant to bill Medi-Share. There have been a few anecdotal cases of doctors and hospitals refusing to bill Medi-Share and instead asking the patient to pay out-of-pocket. In some cases, this may stem from the fact that the PHCS network that Medi-Share uses is not the universal PHCS provider network. It’s incumbent on Medi-Share Members to call PHCS directly to confirm that the provider you want to see is covered under the Medi-Share PHCS system.
That said, the anecdotes of providers being unwilling to bill Medi-Share have still had happy endings. In particular, this mother’s cancer treatment was prepaid by Medi-Share at self-pay rates after the provider initially refused to accept the plan. The health share ministry made sure to come through for her. However, receiving a huge out-of-pocket bill from a provider can come as a shock to a family who has already paid their full portion. Since you want to be focused on getting well rather than on finances, this bears keeping in mind.
As you can see, MediShare is not for everyone. But it’s seeing massive growth across the U.S.
It’s important to understand how Medi-Share works. It’s not a charity or a way for Christians to help the needy. My tithe to the Church or individual giving through certain charities is how I take care of that.
Medi-Share is simply sharing among believers. So to have the right to share, you have to be a believer and living an active Christian lifestyle.
No coverage for medical expenses related to unbiblical (i.e. not Christ-like) activities. Get injured in an accident where you were driving drunk? No coverage. Get an STD from an extra-marital affair? No coverage. When you join Medi-Share, you agree to live your life according to biblical principles.
You must have a Christian faith and be attending Church regularly. To participate in the program you’ll need to sign a form professing your faith and share your Church information.
Restrictions for maternity expenses. Expecting? Don’t expect to just jump on MediShare six months in and get full coverage. You can have children on the plan, but to get full coverage you will have to be participating in the plan before you get pregnant. Otherwise, coverage has limitations.
Restrictions for pre-existing conditions. Common sense dictates that to make Medi-Share work, you can’t just have people jumping on the program after they discover a major medical need. If you do have a major medical issue (or have one in remission) you might be allowed to join Medi-Share with limitations.
How Much is Medi-Share?
My plan – I’m in my early 40s with a spouse and 3 kids – currently costs $235.00 a month with a $10,000 Annual Household Portion (i.e. deductible). When we first started a few years ago, we were paying $277.00 per month, which included a monthly share (i.e. premium) of $197.00 and a Health Partners fee of $80 (i.e. premium increase due to weight). Thanks to my weight loss, we’re now saving money!
A similar plan with a $2,500 deductible will run you $506.00 a month for the basic premium. Here’s a chart based on my age and number of people on the plan:
Even before we reduced our monthly share from $277 to $235 per month, we were already ahead compared to our financial standing with Humana insurance. In the just first seven months of Membership, we saved $4,388!
Here’s how that breaks down:
- With Obamacare we would have paid a minimum of $7,700 ($1,100 x 7 months) in premiums.
- With Medishare we’ve paid $1,960 ($280 x 7 months) in premiums.
- Copays are roughly the same under both plans.
- With Medishare we’ve paid roughly $70 each for five sick visits for the kids, and $475 each for the two well visits (six months and nine months) for our son. This totaled up to roughly $1,352.83. The well visits were a shock, but still not as shocking as an Obamacare premium.
Here’s a quick screenshot of our deductible (or “annual household portion”) usage as of our first year with Medi-Share:
My Experience with Medi-Share
I’m happy to be a part of Medi-Share. Making a $277 payment (which has since been reduced to a $235 payment) vs $1,100 is a huge boost to our monthly budget, to say the least. Given the recent rise in premiums through the Obamacare exchanges, I know we’re continuing to see even greater savings by being a part of this program. We’re still with our same doctors and we’re still getting the care we need.
My daughter had to go to the pediatrician this week (cold and fever) and the experience was not unlike what we’re used to. We went to our same doctor, paid a $35 co-pay, and left. We will get a bill from Medi-Share if, based on our plan and AHP, we owe more. Medicine was paid out of pocket but will be reimbursable after I submit a form.
We may now pay a bit more for our doctor visits than we did under our traditional insurance plan, but it doesn’t compare to the premium savings we’ve experienced. We also continue to use the same medical professionals we’ve been using for years.
Is Medi-Share for You?
There’s a lot on the line when it comes to your family’s medical needs. Take plenty of time to evaluate all of the pros and cons of the program and don’t forget to consider your long-term concerns. Are you having more children? Will you get married soon? Are you about to retire and qualify for Medicare? All these things and more make a difference.
Medi-Share makes sense for my family because:
- We are self-employed Christians and don’t mind being obligated to the coverage restrictions related to lifestyle.
- Our income will likely exclude us from being subsidized in the Obamacare health insurance marketplace. Medi-Share gives us considerable monetary savings.
- We don’t have pre-existing conditions and we don’t plan on having any more children (i.e. we don’t have maternity care needs).
How to Join Medi-Share
It takes a while to go through the application process so leave yourself plenty of time. Here are the major steps:
- Request information about the program.
- Complete the medical forms and testimony of faith.
- Complete the power of attorney for the share account (set up with a credit union).
- Make your first share payment.
Are you a Medi-Share member? Please share your experiences in the comments!
- significant cost savings over Obamacare
- excellent customer service
- promotes Christian values
- easy to sign up
- not HSA eligible
- not tax deductible