For a parent, the health care mandate has caused mayhem. Some of us lost our insurance while others could not afford it after the premiums rose. For Susie and I, we were in limbo. I made to much for subsidies but not enough to afford insurance itself. This left us having to pay the individual mandate penalty every year. This wasn’t really feasible, however, it was cheaper than paying for health insurance. During this period I had heard of and looked into Health Sharing as an alternative to health insurance.
A Primer on Health Sharing
There are 4 big health sharing providers. These seem to be the only ones written into the ACA (ObamaCare) law. These 4 providers are Liberty Healthshare, Samaritan Ministries, MediShare, and Christian Health Care Ministries. All 4 of these are ACA exempt, meaning that if you are a member of any of them you will not have to pay that dreaded Individual mandate tax/fine.
What is Health Sharing?
Health Sharing, simply put, is sharing your medical bills between you and all other members. This is not pooling risk, this is actually you helping to pay others medical bills and them doing the same thing. The mechanism by which this happens is different for each provider. Some might, like Liberty Share, have you send in your money and put it in escrow and pay the bills from there. Others will send you another members bill and you pay it directly. Either way, you will be paying and sharing each other’s medical bills.
What about Pre-existing conditions?
With pre-existing conditions, each provider has the right to deny your membership. It is up to each individual health share to determine what they will and will not allow. Each has a section on their website dealing with pre-existing conditions. In most cases, however, each health share will phase in the pre-existing condition. Year after year they will allow you to share more of the cost. All 4 cover maternity cost but if you are pregnant before you start your membership it will be considered a pre-existing condition.
Liberty Share and MediShare both have programs you are enrolled into if you have high blood pressure or if you are obese. This is to get you to mitigate the cost that comes along with these conditions. This is simply a way to try and get the member healthier to mitigate cost.
Do You Need to be a Christian?
It looks that way. I haven’t seen on that is ACA exempt that does not require you to be a Christian.
What About Prescriptions?
Each of the 4 major health share providers offers prescription service. With that being said, each has their own set of limitations and restrictions. Each program varies on what they share and what they will in regards to prescriptions. As a money saving tip, you can check out websites like GoodRx.com or Pharmacychecker.com to see who has the best prices on the prescriptions you need.
What About Price Shawn
Each provider has a different price structure that varies based on level purchased, pre-existing conditions, and any add-ons that you purchase. The price range for each of the big 4 goes like this. Liberty Health Share $107-449, MediShare $64-627, Christian health ministries $90-450, and Samaritan $180-405. That is the general break down of their price structures. It is vague but it is best if you check it out and see what you need as they have varying degrees of coverage dependent upon what you want or need. These prices also differ based on if you are single, married, or have a family. There is an enrollment fee to be aware of. It is between $125-200 for all of them except Christian health ministries which does not appear to have a fee at all.
Things To Be Aware Of
You need to make sure you understand what they will and won’t share. Like insurance, read the fine print. This includes any pre-existing conditions, birth control or any other incident. They have a set of guidelines they follow and a list of things they do not cover. Read those things and then read them again. If you need prescription coverage, again, read their policy on it and make sure you clarify any questions you may have.
Each of these providers has a personal responsibility portion. This acts similar to a deductible. Make sure you know how much it is if it is for each individual and if it is an annual limit or a per-incident limit. One last thing to be aware of is that Samaritan and Christian healthcare ministries have you receive the bill as well as try and negotiate the bill down. Liberty Health Share receives the bill and discounts it on your behalf.