Friday, November 10, 2017

What is a Healthshare and What is the Best One For Me and My Family?

What is a Health Share?

A heath care sharing ministry is an organization that faciliates sharing of health care costs among individual members who have common ethical or religious beliefs (Wikipedia).

As health care costs are rising to ridiculous amounts, and more and more people are weighing the options of not having insurance at all and facing the tax penalty, I finally decided to do something about it for myself.

Back in 2015, the monthly premium for one of the cheapest Blue Cross Blue Shield (BCBS) plans for my husband and I was over $800 and that was with a $12,000 deductible! That was crazy!! (And I know so many others have much higher premiums these days!). So, I spent weeks researching health shares, and then got a list of questions that I had, and started calling them all.

And after all my research, I chose Liberty Healthshare.

Here is why.

Liberty Healthshare Is The Most Affordable

There are multiple plans that each of these places offer, but in my examples below I am choosing the best and most comprehensive plan at each healthshare ministry, for as close to an apples to apples comparison as I can get. 

Samaritan Ministries

$440/Mo for my husband and I (see how much it would cost for you here)
$300 PER INCIDENT deductible (they won't pay anything unless it is over $300 so regular doctor's appts are not covered)
An extra $266 PER YEAR to have coverage over $250,000

This company has some pretty stringent guidelines on joining -- you have to get a signed letter submitted from your ecclesiastical leader (Pastor, etc) that states you follow the guidelines. They also may nor may not recognize certain Christian denominations as actually Christian. You can read their guidelines here.

Christian Healthcare Ministries

$300/Mo for my husband and I (see how much it would cost for you here)
$500 PER INCIDENT deductible (they won't pay anything unless it is over $500)
An extra $200 PER YEAR to have coverage over $250,000 (unlimited maximum)

This company has easier requirements to join, and they even give you benefits for referring friends (I think each friend you refer gives you a free month of premiums once they join). However, there are things I DO NOT LIKE at all about CHM. First, let me tell you what I DO like. If you are thinking about NOT having insurance at all, and facing the tax penalty due to costs, CHM does have a bronze plan that costs $45/mo per "unit" (so $135/mo per family). This does have a $5,000 PER INCIDENT deductible, but it is better than not having any insurance.

Ok, here is what I do not like. First of all, I really don't like the per incident deductible, because that is not how I roll. But what I REALLY do not like about CHM can be found here in their "What To Do When You Need Medical Care" guidelines.  #4 under "General Information" says:
"4. Apply for any financial assistance available. Many members are surprised to find that they qualify for financial assistance, which is money set aside for the express purpose of helping patients. Ask to speak to a financial counselor or decision-maker and complete any forms they give you."
When I called them back in 2015 and asked all the questions I had, they told me that when you go to the hospital, there is a financial assistance office there and they allow you to apply for financial aid -- GOVERNMENT financial aid!! Yes, from your FELLOW TAXPAYERS!! So before CHM will pay your medical bills, they want you to provide all your PERSONAL information to see if you are eligible for your fellow neighbor's tax dollars to pay what CHM really should be paying.

That does NOT sit right with me and morally and ethically I do not like it. I do not divulge my private information. So even if they had the best deal out of all the health sharing ministries, I couldn't join CHM because this is against my principles. And this is the #1 reason why I DO NOT recommend CHM.

Medishare (Christian Care Ministry)

I don't know what the best option is with Medishare -- whether it is the lowest monthly premium or the lowest deductible, but you can see based on our ages (40s) and the number of people in our household (2) we have different options for our premiums and deductibles. (You can find out your costs here at this link)

Medishare doesn't include routine care, so keep that in mind. They also have an in network and out of network provider base, and if you use an "out of network" provider and they charge more than the usual and customary amounts for that service, YOU are responsible for the difference. I don't like that!

They do have a "co-pay" of $35 per office visit and $135 for emergency room visit, they call it a "provider fee". This doesn't count against your annual deductible ("annual household portion")

They do have a referral service of $100 per member who joins based on your referral.

Liberty Healthshare

Now, on to Liberty Healthshare and why I LOVE them so much! (here is the link to their site )

$299/mo for my husband and I - yes, this is all!!!
$1000 ANNUAL deductible (then all qualifying expenses are covered 100%)
There is a $1 Million maximum per incident

For a family, the annual deductible is $1500 and for a single person the annual deductible is $500. It is super easy to submit bills for reimbursement. It is super easy to understand the process. It works like insurance. The major hospital and medical network out here in Idaho (St. Alphonsus) goes ahead and bills Liberty directly. When our deductible is met, Liberty pays St. Al's directly and we don't have to worry.

They also cover NDs, chiropractic care (12 visits per year per person) and acupuncture. They cover holistic treatments (you do need to have your doctor submit a treatment plan for them to approve). They cover home births and midwives and even thermography.

YOU get to choose who you see, no referrals needed. It is awesome.

Things to Consider

You have to remember to look into what each of the healthshares covers, to determine which one is best for you. The first year, I believe none of them cover pre-existing conditions. I know the second year, Liberty covers up to $25,000 of pre-existing conditions. And maternity coverage is different across the board so you want to make sure you know what they cover before you join, if you are planning on adding to your family. Also, they don't cover abortion or birth control (except for medically necessary reasons).

Prescriptions. Most healthshares, including Liberty Healthshare, don't cover long term prescriptions. The ones you take every day. And the criteria for the prescriptions they DO cover usually have a $75 limit per prescription. So if you take expensive prescriptions to keep you alive - healthshares may not be for you. I take two long term prescriptions, and they are under $25/mo combined, so that is something I am willing to pay out of pocket for.

You also have to take into consideration their religious views and whether you fit. They require you to not smoke, and that you go to church regularly. You have to take care of your body. And the rest of us as health share members appreciate when you do your best to stay healthy, because that is why these healthshares work with the prices more affordable than regular insurance.

What about the tax penalty? If you are a member of a healthshare, you are waived from paying the penalty. This is awesome!

Step By Step Example of Using Liberty Healthshare

The first year was a year of learning for me. Here are some things that I experienced:

1. I went to the doctor as normal. I was lucky that they billed Liberty as if they were a regular insurance company. I then received an EOB (explanation of benefits) just like it was regular insurance. They put it toward my deductible and the provider billed me.

2. In some cases, the EOB stated that it was "ineligible" and I freaked out!! I was so new to this I was so worried. In the notes section it requested medical notes.... so after calling I found out I needed to send the medical chart notes from my doctor's office, to Liberty. They wanted to make sure that it wasn't a pre-existing condition. That is all. But it did take a couple phone calls. Be aware of this.

3. When I go to the chiro or an ND who doesn't take insurance, I pay up front, take my statement / receipt and scan it in. Then, I upload it to Liberty's sharebox on their website and it gets assigned to a processor. Then they reimburse me. It has taken as little as 3 weeks for me to receive payment, up to 4+ months (because they are waiting on more information from my physical therapist, before they send me the reimbursement check -- another incident where I had to be on top of it to get reimbursed))


You HAVE to be on top of things when using a healthshare. It does require a little extra paperwork and a few phone calls. Some things require a pre-authorization ("pre-note" they call it) like my husband's EGD. Naturopathic treatments require a treatment plan submitted to them. If you are aware of this and know how to work with the system, it is an AWESOME option!

Every single time I hear bad experiences with a health share -- ANY healthshare, not just with Liberty -- it is because they didn't understand something: a pre-existing condition, the doctor's medical notes, etc.

It may be hard to learn and navigate the system in the beginning, but the folks at Liberty Healthshare are helpful and knowledgeable. They are super nice. Just knowing that we are dealing with each other as Christians I think makes customer service a lot nicer and easier to deal with.

You can switch anytime throughout the year. I think it usually takes about a month to get things rolling. I started the process at the end of October, and my plan coverage started December 1st.

Here is site that compares the 4 healthcare sharing ministries as well, and gives a pretty decent comprehensive overview.