Medi-Share and health sharing participants, I want to discuss...

[Ginevra]

We have been looking into the possibility of dropping our traditional health insurance and joining a health sharing expenses pool. DH is more interested in this than I am, but he also has not yet read the documents; we only just discussed this yesterday. It might allay my fears if I can work through it with someone who has experience working with health sharing.

 

I am not a person who thrives on uncertainty. This is the most significant reason why I would rather stay wih our health insurance company, giant beurocracy and shocking increases notwithstanding. I have not been left high and dry by traditional insurance.

 

Here is my top concern: while I personally do not have vices that are likely to negatively impact my health or safety, and while thusfar I have not had a problem with my teens/young adults, I cannot be *certain* that my young people could not possibly have a “health event†arising from a poor choice or impropriety. What happens in this case?

 

When you get your “share request†or whatever vernacular for “payment†do you know the story? Is that how people in the share decide whose expenses may be rejected? So do you get a letter that says, “Quill’s son fell down the stairs while drunk at college and his medical expenses are $26,987.23. If you are willing to share, the contribution suggested amount is $237.98.â€

 

Anything else people who have actually done or been in a health share in leu of health insurance can advise me of?

[G5052]

I have the same concerns. This year a family member had over $500,000 of expenses that would not have been covered by a health sharing program. 

 

I actually added it all up, and it's cheaper for us to remain on regular insurance because of the ongoing specialists and medications we need, even excluding anything catastrophic.

[Ottakee]

I can see that concern but have no experience there.

 

I would also check out the preexisting clauses and height/weight ratios (if the plans you are looking at have either of them) as one or the other or both excluded me from plans a few years ago when I looked.

 

If you have a college student for real you might check with the college to see if they have a plan for students that might work.

[Cindy in FL.]

They are probably not going to allow sharing of an accident involving alcohol. They don’t pay for anything related to alcohol, illegal drugs, or tobacco as far as I know.

 

We’ve been members for 2 1/2 years, and I look at it as coverage in case something bad happens. It allows us to say we have coverage, it’s a little over $600 per month for the six of us, and it frees up funds to pay for meds and appointments. It does help with negotiating pricing somewhat, but other than that it really hasn’t done much for us. YMMV.

[Guest]

They are probably not going to allow sharing of an accident involving alcohol. They don’t pay for anything related to alcohol, illegal drugs, or tobacco as far as I know.

 

We’ve been members for 2 1/2 years, and I look at it as coverage in case something bad happens. It allows us to say we have coverage, it’s a little over $600 per month for the six of us, and it frees up funds to pay for meds and appointments. It does help with negotiating pricing somewhat, but other than that it really hasn’t done much for us. YMMV.

I’m assuming you haven’t faced a significant health event yet?

 

Do you know if they would provide sharing if an unmarried child became preganant?

 

Do you receve a statement with any details, or, in other words, does it detail items available for sharing or is it just a general statement of “your monthly share recommended amount this month is $600.�

[creekland]

We're not Medi-Share, we're with Samaritan Ministries ($500/month for our family).  When my boys went to college, like you, I wasn't certain what choices they would make.  We opted to buy the college health insurance plan for them.  In NY it was required all four years since health shares don't give coverage for self-inflicted injuries.  Such is life.  In GA and FL, we switched off the college plan once we saw the choices my guys were making.  The college in FL allowed it once the NCAA approved it as an option, so the timing was good.  In GA it was fine the whole time.

 

Both my NY and FL lads used their health insurance for basic things (leg injuries).  Like other insurance, it was a piece of cwap.  So, we paid more and got less (paying more for coverage itself and then adding on co-pays or whatever they call them since they don't cover 100%)  and in hindsight didn't need to do it, but that's hindsight.  Going forward I would still choose the same thing, 'cause one never knows.  It definitely costs more though.

[Guest]

We're not Medi-Share, we're with Samaritan Ministries ($500/month for our family). When my boys went to college, like you, I wasn't certain what choices they would make. We opted to buy the college health insurance plan for them. In NY it was required all four years since health shares don't give coverage for self-inflicted injuries. Such is life. In GA and FL, we switched off the college plan once we saw the choices my guys were making. The college in FL allowed it once the NCAA approved it as an option, so the timing was good. In GA it was fine the whole time.

 

Both my NY and FL lads used their health insurance for basic things (leg injuries). Like other insurance, it was a piece of cwap. So, we paid more and got less (paying more for coverage itself and then adding on co-pays or whatever they call them since they don't cover 100%) and in hindsight didn't need to do it, but that's hindsight. Going forward I would still choose the same thing, 'cause one never knows. It definitely costs more though.

Do you by any chance remember what the college health plan premiums were? (Though I am 101% certain they are more expensive now...)

 

I know you have had some health issues. Have you had difficulty getting costs shared?

[Tap]

For your 20 yo, have you looked to see if they qualify for state medicaid?  I don't know your 20 yo's living circumstance, but in our state if they are 18yo, have an income below a certain amount and are not claimed as a dependent on the parents taxes, even if they live at the parent's home, they can qualify for medicaid and everything is covered 100%.  In our state, they can have the parents insurance and still qualify for medicaid if they meet the above qualifications. 

 

In Washington you can apply through the Washington Health Plan finder.  When they ask for household income, it is only the person who is applying's income that is counted (since they are an adult and responsible for their own bills.)  If you apply through one of the exchanges, it can be worth talking to a person to help with the application because they know the nuances of qualification better. 

[LarlaB]

I’d suggest you read thru their paperwork- it covers all of these questions. You seem to have a good grasp that MediShare would not cover medical expenses resulting from choices that don’t align with the signed statement of faith which excludes illegal drugs, abuse of legal drugs, abuse of alcohol, tobacco and sex outside of marriage to name a few.

 

As I recall, an adult child aged 18-23 would need to sign and prepare individual statement of faith and lifestyle agreement as well- even while they are on parents plan they still have to be individually approved.

 

I’m a MediShare participant and we have not had major medical claims in the 3 years. But I have 3 families close to me who have- including back surgeries, broken femur and several childbirths. It has bolstered my confidence that MediShare is easy to work with, integrous and highly responsive.

[creekland]

Do you by any chance remember what the college health plan premiums were? (Though I am 101% certain they are more expensive now...)

 

I know you have had some health issues. Have you had difficulty getting costs shared?

 

Somewhere in the neighborhood of $1500 (FL) - $2000+(NY) per year, per lad.  Then there's a deductible and co-pays + networks to deal with.  I mistakenly thought everything was supposed to be covered at 100% ('cause it sure looked that way when I read the summary), but no, it definitely wasn't.  I could have taken what wasn't covered of their bills and had Samaritan's cover it (Samaritan's works that way if you have other insurance coverage), but in each case our cost was somewhere between $200 and $500, so I just grumbled and paid it rather than opening a new situation for that little.  (Our budget could handle it.)

 

And no.  I've had absolutely no problems with my issues getting paid for.  There's no way I'd switch to insurance now even if it were less expensive.  Health shares certainly don't work for everyone (pre existing conditions, expensive prescription meds, non-Christians, non-covered areas) but I love ours and it works very well for us. 

 

A big key is taking the money saved monthly and saving that for normal needs (mammograms, annual visits, typical "sick" visits, or whatever).  Way back when ACA started and we weren't sure if health shares were going to be allowed, I compared pricing to insurance offered.  We saved (at that time) $500/month just in monthly costs, then when something is wrong, coverage is usually 100% vs 80% for the plan I'd have signed up for.  That gives me 6K per year to use in non-covered costs + more if anything were wrong.  To date, we haven't come close to needing that much (even when I pulled from it to buy college insurance), but it's there if we need it.  Since then I'm pretty sure insurance has gone up in price more than health share costs, so we're probably saving a bit more annually.  I just haven't put our data in to know "for sure."

 

Technically, I don't "save" the 6K per year anymore either.  I just keep our emergency fund available and use the rest for other things at this point.  There's still plenty to get everything we want done, from flu shots to mammograms to dermatology checks to "I think that needs to be looked at."  

 

Everyone needs to consider their own situation to know what is likely to be financially best for them.

Edited November 19, 2017 by creekland

[kewb]

I have always been intrigued by health shares. As far as I can tell from my research a few years ago they are only good for healthy people who remain healthy.

Now we are a family of pre-existing conditions so we definitely could not do a health share even if we wanted to.

[Crimson Wife]

 

Do you know if they would provide sharing if an unmarried child became preganant?

 

Medicaid eligibility criteria for pregnant women is fairly generous and I believe it can be secondary for women who have other plans that don't cover maternity care.

[Guest]

Medicaid eligibility criteria for pregnant women is fairly generous and I believe it can be secondary for women who have other plans that don't cover maternity care.

Do you know if this is only true if the person has Medicaid coverage before the conception?

[Guest]

I’d suggest you read thru their paperwork- it covers all of these questions. You seem to have a good grasp [\b]that MediShare would not cover medical expenses resulting from choices that don’t align with the signed statement of faith which excludes illegal drugs, abuse of legal drugs, abuse of alcohol, tobacco and sex outside of marriage to name a few.

 

As I recall, an adult child aged 18-23 would need to sign and prepare individual statement of faith and lifestyle agreement as well- even while they are on parents plan they still have to be individually approved.

 

I’m a MediShare participant and we have not had major medical claims in the 3 years. But I have 3 families close to me who have- including back surgeries, broken femur and several childbirths. It has bolstered my confidence that MediShare is easy to work with, integrous and highly responsive.

Well, I have been reading through their documentation and their FAQs. So yes, I guess I do have a pretty good grasp of what it all means on paper. But this is also why I am having a hard time accepting this route. It feels like a lot of exposure to me, because, well, anything can happen.

 

I just recently had an IUD placed. What if a life-threatening event crops up due to the IUD? I don’t anticipate it, but crap happens. Stuff like that makes me feel vulnerable. Or what if DH dislocates his hip riding motorcycles? (It has happened.)

 

I need to feel like people are doing this without horrible consequences for me to even begin to feel like maybe this would work.

[Guest]

A big key is taking the money saved monthly and saving that for normal needs (mammograms, annual visits, typical "sick" visits, or whatever). Way back when ACA started and we weren't sure if health shares were going to be allowed, I compared pricing to insurance offered. We saved (at that time) $500/month just in monthly costs, then when something is wrong, coverage is usually 100% vs 80% for the plan I'd have signed up for. That gives me 6K per year to use in non-covered costs + more if anything were wrong. To date, we haven't come close to needing that much (even when I pulled from it to buy college insurance), but it's there if we need it. Since then I'm pretty sure insurance has gone up in price more than health share costs, so we're probably saving a bit more annually. I just haven't put our data in to know "for sure."

I understand this, and planned to do this, but what I’m not sure about is where that money can be legally saved. So currntly, the health insurance premiums are paid for from our company account and, of course, this is a legit company cost/employee benefit. I think but am not certain that our monthly health share could still be legotimately paid out of the compnay account, but I don’t know if an additional $500 or whatever amount could be legally saved out of the company account and legitimately used as an HSA unless it is actually designated an HSA by a legit insurance company.

 

Also, I do know that our health insurance negotiates costs so the amount we pay, even before the deductable is reached, is not equivalent to actual direct costs. DH had two skin biopsies this year. We paid $25/each, but I know this is not the lab’s actual direct cost if we were strictly self-paying. So -that is another thing that feels so uncertain to me.

[Sharpie]

We have Liberty Share and have been a member for about 4 years.  If I go online to our account, I can see that X amount of money was shared with Jane D. but it doesn't say the reason why.  They deduct the dues monthly and it happens electronically so I don't really pay attention. 

 

I know they have limits to what they will cover but I don't remember all of them.  The one I do remember is ATV accidents because we use an ATV nearly daily on our farm.  I can say that we are extra careful driving the ATV and it's a risk we take.  However, we could no longer afford the premiums for insurance and it was either this or nothing.  Happened to all of the self-employed friends we know. 

 

Self-employed friends of ours that also have Liberty have had a birth covered, and several medical issues.  We have had a colonoscopy covered in full despite finding finding issues.  That wasn't the case with traditional insurance as they no longer paid if anything was found.

 

 

[Sharpie]

I understand this, and planned to do this, but what I’m not sure about is where that money can be legally saved. So currntly, the health insurance premiums are paid for from our company account and, of course, this is a legit company cost/employee benefit. I think but am not certain that our monthly health share could still be legotimately paid out of the compnay account, but I don’t know if an additional $500 or whatever amount could be legally saved out of the company account and legitimately used as an HSA unless it is actually designated an HSA by a legit insurance company.

 

Also, I do know that our health insurance negotiates costs so the amount we pay, even before the deductable is reached, is not equivalent to actual direct costs. DH had two skin biopsies this year. We paid $25/each, but I know this is not the lab’s actual direct cost if we were strictly self-paying. So -that is another thing that feels so uncertain to me.

 

With Liberty Share, it is very similar to when we had traditional insurance.  We have a "card" that we hand to the doctor's office and they scan it.  Bills get sent to Liberty, they discount them very similar to what our traditional insurance did, and then it either gets paid by Liberty or Liberty notifies the doctor's office that we need to be billed for the lowered amount.

 

We used to have a HSA but after joining Liberty Share, no longer could add to it. 

[wonderchica]

Do you know if this is only true if the person has Medicaid coverage before the conception?

Not in my state. Most women get coverage after they get pregnant. Medicaid varies by states, so you should review your state's website.

[creekland]

I understand this, and planned to do this, but what I’m not sure about is where that money can be legally saved. So currntly, the health insurance premiums are paid for from our company account and, of course, this is a legit company cost/employee benefit. I think but am not certain that our monthly health share could still be legotimately paid out of the compnay account, but I don’t know if an additional $500 or whatever amount could be legally saved out of the company account and legitimately used as an HSA unless it is actually designated an HSA by a legit insurance company.

 

Also, I do know that our health insurance negotiates costs so the amount we pay, even before the deductable is reached, is not equivalent to actual direct costs. DH had two skin biopsies this year. We paid $25/each, but I know this is not the lab’s actual direct cost if we were strictly self-paying. So -that is another thing that feels so uncertain to me.

 

I have no idea on the HSA part.  Hubby is self-employed, but his company is set up as an S Corp (if my memory is correct) and we pay for our health share ourselves - not as a company expense.  I save the extra $$ just in our plain ole emergency fund in the bank (for some) and we have the rest in our retirement assets with plans on using a credit card to cover more if it were ever needed.  I could then either decide to rearrange fund to pay off the credit card or pay the interest for a month or two until reimbursed.  The only time we had to scramble was my first expensive visit with JH since they decided they wanted a pretty hefty amount up front to get the radiation I opted for, telling me they did the same with insurance companies since most wouldn't cover that type.  All other times have been fine.  I doubt the insurance we would have bought (aka cheap) would have covered that type of radiation at all based upon what the financial folks told me, but who knows?  Samaritan covered it at 100% without blinking an eye.

 

Self-paying is interesting too.  We almost always get a cash discount, but that won't lower things to $25.  Usual discounts are between 10 and 50%.  It brought last month's dr visit (regular visit) down to $105.  The cashier and I were talking - she was new to health share, so I was explaining how it works to her.  She told me she sees some people in with super cwappy insurance.  Their co-pay is $100/visit.  That would have saved them a whopping $5 on my visit and had them pay more on some other visits where my cost would have been $75.  Not all insurance is that bad (I hope), but some of those policies being sold are really fleecing people IMO.

 

What our country puts up with is... strange.

 

I also can't answer your IUD or motorcycle questions.  Neither apply to us.  I'd suggest calling and asking with specifics.

[Barb_]

At your ages and your kids' ages the risks would be too high for me to be comfortable with.

 

Your IUD question is a good one. What about hospitalization for mental illness or attempted suicide? Would that be covered? If someone is struggling with the tendency toward schizophrenia or bipolar or depression, the brain pruning and social pressures during adolescence will often tip a child into a full out mental health crisis that. Most of the time you don't see it coming.

[goldberry]

We are on Liberty.  I find it works best if you have the money to pay out of pocket and then get reimbursed.  They have covered DD's concussion, and my hospital visit due to dehydration from a stomach bug.  Yes there are things they won't cover, and you should fully investigate those things before making a choice.

 

DD switched to the college insurance when she enrolled a few month ago.  About $2000 for the year.  The main benefit to the college system is that her on campus clinic is a $20 copay only.  She has used it a couple of times.  

 

We only have Liberty because we could not afford anything else.  It was either that or be uninsured.

[creekland]

Adding in... with Samaritans we get notified at the beginning of each month who our share goes to and a super quick (few word) summary of what it's for.  It could be anything from a pregnancy to an organ transplant.  We send a card and check to them directly (and pray for them).  On their end they have a checklist of names to be certain they get everything expected.  If someone forgets to send something (for whatever reason - rare, but happened to us twice), Samaritan checks into it.  Once someone had dropped the program, so their amount got reassigned to someone else the next month.  Once it possibly got lost in the mail so we received it later with an apology note.  We never had to bother anyone for it - nor did we have addresses to be able to do so even if we had wanted to.

 

We submit bills to Samaritan and they decide if they are covered or not.  If a cost is out of line, they have a firm they partner with who does the negotiating - we don't have to.  I've never had anything not covered that I expected would be.  I have had a couple covered that I thought wouldn't be.

[goldberry]

. What about hospitalization for mental illness or attempted suicide? Would that be covered? If someone is struggling with the tendency toward schizophrenia or bipolar or depression, the brain pruning and social pressures during adolescence will often tip a child into a full out mental health crisis that. Most of the time you don't see it coming.

 

This is extremely important and why I would rather have DD on a full insurance plan.  I absolutely agree with others that for *most things* it doesn't make that much difference. But those things out there that could happen... Yes, it will make a difference.

[justasque]

Do you by any chance remember what the college health plan premiums were? (Though I am 101% certain they are more expensive now...)

 

I know you have had some health issues. Have you had difficulty getting costs shared?

 

For our kids (all NY, different schools) it was about $800-900 per semester.  I don't know how or if coverage works during school breaks or the summer if they are not enrolled.  (We didn't use the coverage, and instead tried to remember to waive it each semester.)  I assume you are also looking at coverage on the exchange.  Remember the deadline is earlier this year!

[goldberry]

I have always been intrigued by health shares. As far as I can tell from my research a few years ago they are only good for healthy people who remain healthy.

 

This is true in terms of chronic illness.  Liberty, at least, has done pretty well with a couple of hospital visits for acute situations.  

 

No, they don't cover mental health, and no, they would not cover a pregnancy of an unmarried child.

 

Just a note, I really, really HATE participating in a group that doesn't cover mental health.  We don't happen to need it right now, but I am beginning to view it as a moral and societal issue.  Our society as a whole suffers as a result of poor mental health coverage and treatment.  I wish I could afford to choose otherwise.

 

Adding, which is why if one more single politician labels mass shooting a mental health problem, but votes against mental health coverage, I will be  :smash:  :willy_nilly:  :banghead: .

Edited November 19, 2017 by goldberry

[Ellie]

 

When you get your “share request†or whatever vernacular for “payment†do you know the story? Is that how people in the share decide whose expenses may be rejected? So do you get a letter that says, “Quill’s son fell down the stairs while drunk at college and his medical expenses are $26,987.23. If you are willing to share, the contribution suggested amount is $237.98.â€

 

Anything else people who have actually done or been in a health share in lieu of health insurance can advise me of?

 

A medical need is determined at the organization's office before it is sent out to the members. That is, the members do not decide whose expenses will be rejected or paid. Your share is always the same, every month. The office divvies up the  expenses among the members.

 

I was a member of Samaritan Ministries for awhile, when Mr. Ellie was unemployed. I submitted a couple of medical expenses, and they were covered. However, I have a pre-existing condition--Hashimoto's thyroiditis--and I don't think SM will pay for the necessary, periodic lab work and doctor visits. On the other hand, I am now old enough for Medicare, so maybe it will cover those expenses, and Samaritan Ministries will cover whatever Medicate does not; also, I have found other sources for doing the labwork that don't cost a fortune.

[creekland]

Just a note, I really, really HATE participating in a group that doesn't cover mental health.  We don't happen to need it right now, but I am beginning to view it as a moral and societal issue.  Our society as a whole suffers as a result of poor mental health coverage and treatment.  I wish I could afford to choose otherwise.

 

FWIW, this is not an automatic with insurance either.  I have two co-workers who have had to use large 5 digit sums of their own money to get treatment for their teen and young twenty something youngsters, one for a solid mental health issue and the other for a drugs/alcohol issue.  Both have school insurance, but what it pays for is pretty dismal.  After I saw that IRL, my mind figured it doesn't matter as much "difference" wise between insurance and health-share.  Like you, I'm still in favor of something that helps everyone, but that's not an option nor is it likely to be anytime soon.

 

Again, what our country puts up with is... strange.

[Guest]

For our kids (all NY, different schools) it was about $800-900 per semester. I don't know how or if coverage works during school breaks or the summer if they are not enrolled. (We didn't use the coverage, and instead tried to remember to waive it each semester.) I assume you are also looking at coverage on the exchange. Remember the deadline is earlier this year!

I do not know how to research coverage on the exchange. True story. I tried googling it but there are a bunch of sites that say they are Obamacare or something and I don’t believe that is true. I highly doubt we would qualify because we have made “windfall†bonuses from house or lot sales for years and years. Those are not continuing in the near future, but so far, we have this income above our regular salary that would, I imagine, disqualify us. But I actually don’t have a clue how to find out without 15 insirance sharks blowing up my phone.

[Guest]

Also, does a health share satisfy the Mandate?

[Sharpie]

Also, does a health share satisfy the Mandate?

 

Yes.

[Liz CA]

A medical need is determined at the organization's office before it is sent out to the members. That is, the members do not decide whose expenses will be rejected or paid. Your share is always the same, every month. The office divvies up the  expenses among the members.

 

I was a member of Samaritan Ministries for awhile, when Mr. Ellie was unemployed. I submitted a couple of medical expenses, and they were covered. However, I have a pre-existing condition--Hashimoto's thyroiditis--and I don't think SM will pay for the necessary, periodic lab work and doctor visits. On the other hand, I am now old enough for Medicare, so maybe it will cover those expenses, and Samaritan Ministries will cover whatever Medicate does not; also, I have found other sources for doing the labwork that don't cost a fortune.

 

Haven't read all the replies but wanted to comment on pre-existing conditions. I signed up with Liberty a year ago and they do cover  pre-existing conditions under certain circumstances and sometimes in a prorated fashion. I read and re-read all the documents before I made the decision.

You have a few choices these days, not just 3 share plans. They seem to differ in some areas, most notably in maternity coverage, etc. Some treat this as optional coverage which works for people like me who know I will not become pregnant again. There was at least one other plan that allowed you some customization depending on your situation.

If in doubt about anything, call them and talk to a person. I had a rather long convo with a rep of the share organization and went over a previously compiled list of questions.

 

My share amount is deducted from my account automatically on a monthly basis and I do not see where it's going. Honestly, this is not something I would need to know - I just hope it's helping someone who needs it.

 

ETA: We also have a FLEX card through dh's work. I think you guys are self-employed (don't know if I remember this correctly) but I think you can sign up for this as well. An amount is deducted pre-taxes monthly but as soon as you sign up you have access to the total on your FLEX. The max we can do is about $2,500 annually. This means other expenses like minor doctor visits, dentists, chiropractor, massage, naturopathic care, etc. can be covered by the FLEX card which looks like a credit card and is accepted at most medical facilities.

Edited November 19, 2017 by Liz CA

[Liz CA]

I do not know how to research coverage on the exchange. True story. I tried googling it but there are a bunch of sites that say they are Obamacare or something and I don’t believe that is true. I highly doubt we would qualify because we have made “windfall†bonuses from house or lot sales for years and years. Those are not continuing in the near future, but so far, we have this income above our regular salary that would, I imagine, disqualify us. But I actually don’t have a clue how to find out without 15 insirance sharks blowing up my phone.

 

BTDT. I was so frustrated with trying to get answers not to mention the sky-high premiums - which was one reason I decided on a share. It may not be for everyone but I feel I have at least some type of coverage in case of medical expenses.

 

[Crimson Wife]

Do you know if this is only true if the person has Medicaid coverage before the conception?

 

No, and there is retroactive eligibility back 3 months so if a woman goes to the doctor for another reason and learns she's pregnant at that visit, that visit can be billed to Medicaid once she's approved.

[cjzimmer1]

Do you know if this is only true if the person has Medicaid coverage before the conception?

DH lost his job (and insurance) during one of my pregnancies, medicaid, not only picked me up immediately, they backdated the coverage to the beginning of the pregnancy so all my co-pays from earlier in the pregnancy were also covered as well.  They also kept me on for 2 months after baby was born (even though by then he had a job and new insurance) and baby stayed on for a full year.  I have no idea if this varies by state, but I know for us medicaid has been a very good program for making sure mom/baby has good medical care.

[TechWife]

I do not know how to research coverage on the exchange. True story. I tried googling it but there are a bunch of sites that say they are Obamacare or something and I don’t believe that is true. I highly doubt we would qualify because we have made “windfall†bonuses from house or lot sales for years and years. Those are not continuing in the near future, but so far, we have this income above our regular salary that would, I imagine, disqualify us. But I actually don’t have a clue how to find out without 15 insirance sharks blowing up my phone.

Go to this site, it’s the true ACA site:

https://www.healthcare.gov/

[justasque]

I do not know how to research coverage on the exchange. True story. I tried googling it but there are a bunch of sites that say they are Obamacare or something and I don’t believe that is true. I highly doubt we would qualify because we have made “windfall†bonuses from house or lot sales for years and years. Those are not continuing in the near future, but so far, we have this income above our regular salary that would, I imagine, disqualify us. But I actually don’t have a clue how to find out without 15 insirance sharks blowing up my phone.

 

 

Go to this site, it’s the true ACA site:

https://www.healthcare.gov/

 

Remember there's a deadline, and it's earlier than last year's.  There are also several scheduled maintenance times when the site will be down during this year's enrollment period, and they've significantly cut both the advertising budget and the number of people employed to help folks navigate the system.  Check it out SOON so you have time to do the research and make an informed decision.  I think the deadline is Dec. 15.

 

 

[Guest]

A medical need is determined at the organization's office before it is sent out to the members. That is, the members do not decide whose expenses will be rejected or paid. Your share is always the same, every month. The office divvies up the expenses among the members.

 

I was a member of Samaritan Ministries for awhile, when Mr. Ellie was unemployed. I submitted a couple of medical expenses, and they were covered. However, I have a pre-existing condition--Hashimoto's thyroiditis--and I don't think SM will pay for the necessary, periodic lab work and doctor visits. On the other hand, I am now old enough for Medicare, so maybe it will cover those expenses, and Samaritan Ministries will cover whatever Medicate does not; also, I have found other sources for doing the labwork that don't cost a fortune.

That works fine for a couple hundred dollars worth of lab work every quarter. If your pre-existing condition is a heart issue, that coverage is useless.

[historically accurate]

Adding in... with Samaritans we get notified at the beginning of each month who our share goes to and a super quick (few word) summary of what it's for.  It could be anything from a pregnancy to an organ transplant.  We send a card and check to them directly (and pray for them).  On their end they have a checklist of names to be certain they get everything expected.  If someone forgets to send something (for whatever reason - rare, but happened to us twice), Samaritan checks into it.  Once someone had dropped the program, so their amount got reassigned to someone else the next month.  Once it possibly got lost in the mail so we received it later with an apology note.  We never had to bother anyone for it - nor did we have addresses to be able to do so even if we had wanted to.

 

We submit bills to Samaritan and they decide if they are covered or not.  If a cost is out of line, they have a firm they partner with who does the negotiating - we don't have to.  I've never had anything not covered that I expected would be.  I have had a couple covered that I thought wouldn't be.

So does that mean that you receive a whole bunch of little checks to cover the bill? For example, if you have had surgery that costs about $25,000, you'll receive a stack of 50+ $300-$500 checks in the mail to cover it? It's a little thing, but it would bother me to have to get all of those to the bank while recuperating or with a newborn or whatever. 

[TechWife]

A medical need is determined at the organization's office before it is sent out to the members. That is, the members do not decide whose expenses will be rejected or paid. Your share is always the same, every month. The office divvies up the  expenses among the members.

 

I was a member of Samaritan Ministries for awhile, when Mr. Ellie was unemployed. I submitted a couple of medical expenses, and they were covered. However, I have a pre-existing condition--Hashimoto's thyroiditis--and I don't think SM will pay for the necessary, periodic lab work and doctor visits. On the other hand, I am now old enough for Medicare, so maybe it will cover those expenses, and Samaritan Ministries will cover whatever Medicate does not; also, I have found other sources for doing the labwork that don't cost a fortune.

 

Samaritan ministries isn't a Medicare supplement, so unless something falls within their coverage guidelines, they still would not cover it. If it is a Medicare covered service, then Medicare would cover their portion of the allowed amount and the patient would have to cover the remainder. 

 

https://samaritanministries.org/blog/smi-chalk-talk-how-does-medicare-work-with-samaritan-membership

[Cindy in FL.]

No significant event under Medi-Share. We had Good Samaritan when our youngest was born prematurely and they paid the bills.

 

With Medi-Share you have to sign a statement of faith and agree to certain standards of living. I do not think they would share a pregnancy out of wedlock, except maybe a rape situation. All children age 18 and older have to sign their own statement of faith/testimony.

 

We get billed a set amount each month which goes into our account at the financial institution they use (can’t think of the name right now). They send monthly statements with your balance and amounts withdrawn to pay others’ expenses. You also get a notice with the people’s names and contact info so that you can send them a card, pray for them, etc.

 

I’m assuming you haven’t faced a significant health event yet?

 

Do you know if they would provide sharing if an unmarried child became preganant?

 

Do you receve a statement with any details, or, in other words, does it detail items available for sharing or is it just a general statement of “your monthly share recommended amount this month is $600.�

[KrissiK]

Quill, we’ve been doing Medi-Share for 2years now. And yes, the uncertainty bothered me for a while because you get so used to an insurance company and since the $ is taken out of the paycheck before you even see it you forget that you actually paid for it. One thing, though is getting over the mindset of “coverageâ€. We went on Medi-share after DH’s premiums went to $1100/month + copay + $3500 family deductible. We pay a little over $300/month for Medi-share. I then budget $400/month for medical expenses. This is much less than we would pay if we had insurance. That $400/month is my coverage for whatever. Some months we don’t even go to the doctor. We are a pretty healthy family. But,I got a sinus infection this month, I went to the doctor, paid cash, got my prescription from Walmart for $4 and we’re good. I do have a history of melamona, but since I’ve had clear biopsies for 5 years Medishare doesn’t have a problem with that. I pay cash for dermatologist appt., biopsies, even a deep excision, and it’s still cheaper than insurance. Being on Medishare has caused us to be much better consumers of our health care. We shop around for prescriptions ($4 @ Walmart vs. $70 @CVS). Medishare is not for everyone and it is not perfect, but it is working well for us.

Edited November 19, 2017 by KrissiK

[Liz CA]

So does that mean that you receive a whole bunch of little checks to cover the bill? For example, if you have had surgery that costs about $25,000, you'll receive a stack of 50+ $300-$500 checks in the mail to cover it? It's a little thing, but it would bother me to have to get all of those to the bank while recuperating or with a newborn or whatever. 

 

Don't know about Samaritan but this is not supposed to be the case with Liberty. The reimbursement / pay methods are quite varied among the different plans.

 

[KrissiK]

So does that mean that you receive a whole bunch of little checks to cover the bill? For example, if you have had surgery that costs about $25,000, you'll receive a stack of 50+ $300-$500 checks in the mail to cover it? It's a little thing, but it would bother me to have to get all of those to the bank while recuperating or with a newborn or whatever.

Not with Medi-share. We pay our monthly Family Share to the company and they, then, pay the disbursement.

[Cindy in FL.]

Good Samaritan paid the bills directly in our situation.

 

So does that mean that you receive a whole bunch of little checks to cover the bill? For example, if you have had surgery that costs about $25,000, you'll receive a stack of 50+ $300-$500 checks in the mail to cover it? It's a little thing, but it would bother me to have to get all of those to the bank while recuperating or with a newborn or whatever.

[TechWife]

At your ages and your kids' ages the risks would be too high for me to be comfortable with.

 

 What about hospitalization for mental illness or attempted suicide? Would that be covered? If someone is struggling with the tendency toward schizophrenia or bipolar or depression, the brain pruning and social pressures during adolescence will often tip a child into a full out mental health crisis that. Most of the time you don't see it coming.

 

Treatment for self-inflicted injuries when a member is over the age of 12 is not "sharable." Only period of involuntary commitment (IVC) is sharable, and then only up to $50K. Psychiatric medications and therapy are not "shareable." 

 

https://samaritanministries.org/help/guidelines

 

ETA: The above info is for Samaritans only. I have read info from one sharing organization that "shares" expenses relating to saving the physical life of someone who has attempted suicide, but no  mental health treatment. I can't lay my hands on the info that shows which one it is, though. If I find it, I'll come back. 

 

 

Edited November 19, 2017 by TechWife

[TechWife]

 

I just recently had an IUD placed. What if a life-threatening event crops up due to the IUD? I don’t anticipate it, but crap happens. Stuff like that makes me feel vulnerable. 

 

 

It's my understanding that complications from a "non-sharable" event are not "sharable." Birth control isn't "sharable" so if you have complications from the IUD, they would not be "sharable." 

 

 

A motorcycle accident appears to be sharable, but not an ATV accident. 

 

https://samaritanministries.org/help/guidelines

[Liz CA]

It's my understanding that complications from a "non-sharable" event are not "sharable." Birth control isn't "sharable" so if you have complications from the IUD, they would not be "sharable." 

 

 

A motorcycle accident appears to be sharable, but not an ATV accident. 

 

https://samaritanministries.org/help/guidelines

 

These guidelines are quite different from one organization to the next. If anyone is considering making a choice, I'd recommend reading each organization's plan carefully and even speak with a representative. I remember there was a website which compared the largest organizations.:

http://www.medicalcostshare.com/comparison-of-major-healthcare-sharing-ministries.html

 

And keep in mind the ones listed here are not all of the share organizations. There are also some lesser known ones.

 

Edited November 19, 2017 by Liz CA

[creekland]

So does that mean that you receive a whole bunch of little checks to cover the bill? For example, if you have had surgery that costs about $25,000, you'll receive a stack of 50+ $300-$500 checks in the mail to cover it? It's a little thing, but it would bother me to have to get all of those to the bank while recuperating or with a newborn or whatever. 

 

Yes for Samaritan Ministries.  We didn't find that to be a hardship at all.  One doesn't have to go to the bank daily.  In my case back then, hubby usually did it anyway.  I created a state list to check off where all the support came from and we enjoyed knowing there were folks from (literally) all over helping us with our needs - usually sending notes too.  One really cool dude (yes, a dude) sent us an extra $10 and told me to treat myself to ice cream or whatever I wanted.  ;)

 

I fell in love with the system - far more personable than insurance.  I enjoy sending out monthly checks for various needs too - to real people - not just a named company.

 

Whether one likes it or not is probably related to their personality - meaning neither is right nor wrong, but add that into your pros or cons as desired.

[Chelli]

We use Medishare and have since the ACA first rolled out. The only major incident we've needed to use it for was when my oldest had foot surgery due to a fibroid tumor. We wound up paying around $1,000 out of pocket with Medishare covering the rest (how this is done was explained very well by a PP). We never saw any of the bills as they were all sent directly to Medishare. IMO, Medishare acts the most like traditional insurance except the cost is shared among the members instead of being paid out by a corporation. For doctor's visits, there is a $35 co-pay and the rest is billed to Medishare. Because of this system, you do have in network and out of network doctors, but even in our tiny town of 10,000 almost every doctor here is listed as in network.

 

Oh, and Medishare found a bill where the anesthesiologist double charged us for my dd's surgery and gave us a heads up, so we actually got a $300 reimbursement check from the hospital. 

[Erica in OR]

It's my understanding that complications from a "non-sharable" event are not "sharable." Birth control isn't "sharable" so if you have complications from the IUD, they would not be "sharable." 

 

 

A motorcycle accident appears to be sharable, but not an ATV accident. 

 

https://samaritanministries.org/help/guidelines

 

Agree with another poster that this can vary and to specifically check details. Back when I researched several medi-share organizations, one specifically excluded motorcycle accidents. This was a deal breaker for us, since my husband was using his motorcycle for his daily commute at that time. He's a safe, defensive rider, but that doesn't mean something won't happen.

 

Erica in OR