The cost of health insurance skyrocketed to new heights this year. And next year doesn’t look any better. On top of that, fewer insurance carriers offer coverage, and provider networks are smaller than ever. That’s why many are now considering health care sharing ministries, such as Medi-Share.
For many, desperation to curtail insurance costs led them to search for something -- anything -- more affordable than traditional individual health insurance. However, even those families who technically can afford $10K, $15K, or even $20K each year for health insurance premiums find themselves searching high and low for a “better way.”
In this post, I do not intend to cover or review every minute aspect of Medi-Share. Instead, I will highlight several critical items so that you can make a quick and informed decision about whether or not you should consider Medi-Share. I will also assume you have visited the Medi-Share website and read through most of the quick overviews, so my comments here will surface the aspects you need to consider but will not find easily.
In fact, this post has one purpose: help you decide if you should read the Medi-Share “Program Guidelines & Frequently Asked Questions.” In my opinion, you should only proceed with Medi-Share once you have a grasp on the guidelines. This suggestion is not because I believe you will find hidden “gotchas.” I simply conclude that if you understand the guidelines you will have a more pleasant experience, reduce your out-of-pocket costs, and realize how well-thought-out the Medi-Share program has become.
THE AUTHORITY FOR MY PERSPECTIVE
- From 2008 to 2011, I helped implement individual health insurance for business owners with 100% of my working time. During those three and a half years, I implemented plans for business owners in 55 counties across Georgia, North Carolina, and South Carolina.
- My family has been a member of the Medi-Share community as our primary health “insurance” resource for 2015, 2016, and 2017. We welcomed our youngest child, and we “used” Medi-Share to help cover this cost in 2016--just as you would normally expect with traditional health insurance.
- The team at Catalyst Wealth Management and I work with high income and/or high net worth business owners, and we hold to a high standard of care for clients at risk of significant financial loss without proper protection.
- I have been a Certified Financial Planner™ since 2012.
- I am not posting an affiliate link to generate a referral fee. I have no beef with the Medi-Share Refer-A-Friend program, but for the purpose of this review, you need my unbiased perspective.
SHOULD YOU CONSIDER MEDI-SHARE?
Notwithstanding the potential barriers (and possibly others) listed below, you should consider Medi-Share for two main reasons:
- Your monthly savings (the difference between traditional health insurance premiums and your Medi-Share monthly share amount) may be significant--even astounding.
- You will participate in a healthcare management program that aligns with your values, beliefs, and faith.
The Medi-Share program is not for everyone. Here are a few common reasons why:
- Not everyone will agree with the Statement of Faith as described by Medi-Share.
- Not everyone will agree to maintain a healthy lifestyle as defined by the Medi-Share guidelines (examples of unhealthy lifestyles include the use of tobacco and the use of illegal drugs).
- Certain pre-existing medical conditions may lower or limit the medical bills eligible to be shared
This list may leave out another reason that is important to you, but even if any of these seem to be a barrier, don’t give up. I suggest that you Google “Healthcare Sharing” and see if any of the other healthcare sharing organizations might be a better fit. For example, Liberty Healthshare employs a less restrictive statement of faith while maintaining a similar focus on healthy lifestyle guidelines.
DOWNSIDES TO CONSIDER
Here are several downsides to the Medi-Share program (compared to traditional health insurance) along with ways to overcome each:
- Well-visits, routine care, and preventative care are generally not “shared.”
- How to get past this: Most likely, your monthly savings on the difference between traditional health insurance and your Medi-Share monthly share amount will make up for this so you can easily pay out of pocket--many times over.
- Since the Medi-Share program is not a High Deductible Health Plan, currently you cannot contribute to a Health Savings Account (HSA). Even so, you can disburse funds to pay for out of pocket medical expenses FROM any existing HSA account until it’s depleted.
- How to get past this: Again, your monthly savings should offset the HSA deduction tax savings you might have otherwise.
- Medi-Share is not insurance, therefore you do not have the same consumer protections and legal requirement of a state or federally regulated insurance carrier to fulfill their side of an insurance contract.
- How to get past this: Medi-share recently stated that all eligible needs had been shared to date.
- Members are eligible to receive up to only $50,000 of their eligible medical bills shared during their first month of membership. So, if you have medical bills exceeding this amount right off the bat, you may be in a tough spot.
- How to get past this: You can sign up a month before your other coverage runs out. You’ll be paying “double” for one month, but you might find that worth it. In reality, I’ve found that many are willing to take the risk for one month.
- Injuries resulting from motorized vehicle accidents may have limited sharing for certain situations. Here are two that you should be aware of: 1) Diagnosis and treatment of injuries will not be eligible to be shared if the following applies: “There was abuse of alcohol or legal drugs, or the use of Illegal Drugs.” 2) Also, “because the likelihood of serious injury is significantly greater when riding a motorcycle rather than in an automobile, Members agreed in 2007 that sharing should be limited to $100,000 for injuries sustained while riding a motorcycle (except in the cases of missionaries when performing mission work outside the U.S.).”
- How to get past this: Don’t do drugs; Don’t drink and drive; Don’t ride a motorcycle.
OUR PERSONAL EXPERIENCE
2017 will wrap up our third year on Medi-Share. We started as a family of four and added a third child last year. We also had an emergency room visit this year for our five-year-old (January 2nd--two days after the year we hit our “annual household portion” because of our third child pregnancy and delivery. Terrible timing!).
We love the significant “premium” savings first and foremost. We were also pleasantly surprised at how well the pregnancy and delivery of our child were addressed and how reimbursements above our “annual household portion” were handled. And we’ve finally learned how to most effectively manage our care, which gives us great confidence going forward.
We now conclude that for most routine and minor healthcare visits and expenses (including outpatient emergency room visits), we will simply tell the healthcare providers that we do not have insurance and ask for the best cash-pay price. Not having insurance is the truth, and we’ve found that we have more control over our healthcare decisions.
You receive a discount card as a Medi-Share member that allows providers to “file claims” on your behalf, thus minimizing the amount of paperwork you might need to do later--very similar to traditional insurance. However, we’ve found that the cash pay price is significantly lower than even the negotiated discount rate that results when providing the card to your doctor or hospital emergency room.
We always ask for a receipt showing the medical billing codes so that later, if we do indeed hit our “annual household portion (AHP),” we can file these claims all at once with Medi-Share and receive reimbursement for eligible expenses above the AHP. For the calendar years in which we do not exceed the AHP, this should continue to lower our out of pocket expenses.
Additionally, we find that by “not having insurance,” pediatricians and physicians have special rates, programs, and even state-mandated arrangements that lower preventative care costs. This is especially true for pediatric routine well-care and immunizations prior to age six.
YOUR NEXT STEPS
I recommend that you go to the Medi-Share home page, scroll to the bottom, click on “MEDI-SHARE GUIDELINES,” and download the print version for your reading pleasure.
If you need more cost-saving ideas, check out my post “A Five-Point Checklist for Business Owners to Declare War on Income Taxes.”