Health Care Sharing Ministries and Medical Repricing

[nvestysly]

Several years ago I came across medical repricing as a means of paying reasonable and customary rates for medical services even when the individual does not have insurance. At the time (nearly 12 years ago) this seemed like an alternative to simply going to the doctor or hospital and not knowing what you would pay for a diagnosis or procedure.

A friend recently told me about health care ministries. With a name like that you can imagine that most of the agencies are run by and for those with one religious affiliation or another. However, there is at least one organization that simply requires (maybe the wrong word) you to support religious liberty.

I searched the E-R forum and didn't find any threads on the subject. I don't want to head down the road of inflammatory discussion - I'm hoping we can remain in a positive direction and avoid having this thread become bacon.

Both health care sharing and medical repricing have their place I suppose. Now that I've seen health care sharing I like the idea in principle and would like to know more about it.

Does anyone have experience with health care sharing or medical repricing. I'd like to hear your comments.

So here are a few links that you might find interesting:

1) http://selfpaypatient.com/ lots of interesting information in a blog format

2) Several health care ministry web sites

https://mychristiancare.org/

Home - Liberty HealthShare

Samaritan Ministries International - Samaritan Ministries International

3) Medical repricing web sites:

How the Plan Works

A&G Claim Repricing Solution

 

[Brat]

When I purchase insurance I need to know that the insurer is financially able to manage and pay claims. My question would be whether or not the insurer is registered and entitled to sell insurance in my state. Then you really need to know what is covered.

My other issues is whether or not even if you negotiate for the usual and customary charge would you have the financial resources to pay in the event of a health crisis. The usual and customary cost for cancer treatment exceeds the ability for all but a small % of Americans to pay. For medical services Americans typically pay out pocket such as dentistry or cosmetic treatments knowing the usual and customary would be a real benefit.

 

[brewer12345]

You would have to be on dope to trust this type of nonsense. These things look just like a mutual or fraternal insurer except they do not have to have any capital to back their promises and they do not have to comply with all of the consumer protection-laden insurance regulations that real insurers do. This stuff ought to be illegal.

 

[razztazz]

Lots of people think the insurance companies shouldn't have any of those consumer protection regulations. They think they should be able to operate as the plans described above because those protections only run up the cost. Could we trust insurance companies under those circumstances?

 

[brewer12345]

Lots of people think the insurance companies shouldn't have any of those consumer protection regulations. They think they should be able to operate as the plans described above because those protections only run up the cost. Could we trust insurance companies under those circumstances?

You seem to have misunderstood: insurance companies don't have consumer protection regulations, they have to comply with them (on pain of lots of things, starting with fines and going from there). The protections do far more than run up cost. I have seen bank regulation and insurance regulation up close and personal (for my sins). Insurance regulators are far, far more effective than the bank regulators could ever dream of. Name me 3 large (top 20) insurers that failed in the financial crisis.... Still waiting. Everyone in a cocktail party could name you 4 or 5 banks.

Consumer protection regs are also better at the insurance level. Insurers are largely forced to honor the terms of their contracts and the regulators ensure that they have the funds to do so. With the religious mumbo-jumbo things you have none of that. For all you know these things are some dude in a closet stacking up Benjamins who will escape to Andorra as soon as anyone comes looking for them to pay a big claim.

 

[razztazz]

You seem to have misunderstood: insurance companies don't have consumer protection regulations, they have to comply with them

We know. That was my point.

 

[brewer12345]

We know. That was my point.

So you would rather take an unsecured promise to pay from some clown in a shoebox that has no oversight, capital, etc.? You should look at Mongolian bank deposits. They offer really high interest rates...

 

[nvestysly]

Okay, I'm resurrecting this thread. DW and I recently received a 30% increase in premium from United Health Care. We are currently enrolled in a "grandmothered" insurance plan with UNH and like the coverage and benefits but the premium is becoming a burden. We're 7 - 10 years away from Medicare.

Let's avoid the topic of current legislation that's being considered by the U.S. Congress - that subject is for a different thread.

Does anyone have experience with Health Care Sharing Ministries? Know someone who does? I'd like to hear from you.

 

[MichaelB]

In case you didn't see this thread http://www.early-retirement.org/forums/f38/healthcare-ministries-and-selfpay-options-83112.html

 

[nvestysly]

In case you didn't see this thread http://www.early-retirement.org/forums/f38/healthcare-ministries-and-selfpay-options-83112.html

Thanks. I had not seen that thread. Scanning it I do see some useful information. Looks like at least one e-r.org member is using one of the cost sharing groups.

With our current UNH plan we have a $10k deductible so in some ways it's a catastrophic plan in some ways but it still covers annual visits and similar once a year exams.

Another way to think about cost sharing and negotiated pricing would be to use them for basic coverage and buy a truly catastrophic plan for high-cost medical emergencies such as car crashes. I'm not even sure you can buy such policies at this time.

 

[MichaelB]

Another way to think about cost sharing and negotiated pricing would be to use them for basic coverage and buy a truly catastrophic plan for high-cost medical emergencies such as car crashes. I'm not even sure you can buy such policies at this time.

pb4uski has catastrophic coverage and posted lots of details about his policy. Most recently, here http://www.early-retirement.org/forums/f38/seeking-aca-examples-87434.html#post1902681

 

[Carpediem]

I hope I'm not violating forum rules but here is a link to one person's experience with a Ministry Healthshare. I too am considering it as an option.

https://esimoney.com/picking-right-early-retirement-health-insurance-selecting-winner/


(Mods, please remove if this isn't allowed and accept my apologies.)

 

[MichaelB]

I hope I'm not violating forum rules but here is a link to one person's experience with a Ministry Healthshare. I too am considering it as an option.

https://esimoney.com/picking-right-early-retirement-health-insurance-selecting-winner/


(Mods, please remove if this isn't allowed and accept my apologies.)

No problem. A forum search shows a couple of thread mentions of the Samaritan Ministries.

 

[zinger1457]

Another way to think about cost sharing and negotiated pricing would be to use them for basic coverage and buy a truly catastrophic plan for high-cost medical emergencies such as car crashes. I'm not even sure you can buy such policies at this time.

Not sure what your definition of a high cost medical emergency is but some of the healthcare ministries offer fairly high payout limits. If you went that route I would think you would want to use the healthcare ministry for all your healthcare needs and maybe use a catastrophic plan as insurance against the healthcare ministry business model failing and not paying claims.

 

[haha]

Okay, I'm resurrecting this thread. DW and I recently received a 30% increase in premium from United Health Care. We are currently enrolled in a "grandmothered" insurance plan with UNH and like the coverage and benefits but the premium is becoming a burden. We're 7 - 10 years away from Medicare.

Let's avoid the topic of current legislation that's being considered by the U.S. Congress - that subject is for a different thread.

Does anyone have experience with Health Care Sharing Ministries? Know someone who does? I'd like to hear from you.

Just go up a few posts from your resurrection and read what Brewer has to say. He is not certified PC, but he knows what he is talking about.

Ha

 

[Koolau]

Interesting that this topic has resurfaced so to speak. A couple I know recently lost their HI when they quit their secure jobs to form a small business together. They are using one of the Health Care Sharing Entities - I don't know which one. As luck would have it, just these few months later, he was diagnosed with cancer! He's pretty confident he will beat it but there's no guarantee AND it's going to be expensive. As yet he doesn't know how well this will work. He's kind of "out there" and trying to have "faith" so to speak. They went this direction as they simply could not afford the "traditional" insurance they would perhaps have preferred to purchase. I will try to keep this thread posted as I hear the outcome of his individual case. As always, YMMV.

 

[zinger1457]

Interesting that this topic has resurfaced so to speak. A couple I know recently lost their HI when they quit their secure jobs to form a small business together. They are using one of the Health Care Sharing Entities - I don't know which one. As luck would have it, just these few months later, he was diagnosed with cancer!

I would be interested in hearing how this turns out. I know the ministries have restrictions on pre-existing conditions and certain activities like smoking. Since it occurred soon after joining I wonder if they would try classify it as pre-existing. Or if they determined that the cancer was caused by smoking or some other restricted activity would you be hung out to dry?

 

[nvestysly]

Interesting that this topic has resurfaced so to speak. A couple I know recently lost their HI when they quit their secure jobs to form a small business together. They are using one of the Health Care Sharing Entities - I don't know which one. As luck would have it, just these few months later, he was diagnosed with cancer! He's pretty confident he will beat it but there's no guarantee AND it's going to be expensive. As yet he doesn't know how well this will work. He's kind of "out there" and trying to have "faith" so to speak. They went this direction as they simply could not afford the "traditional" insurance they would perhaps have preferred to purchase. I will try to keep this thread posted as I hear the outcome of his individual case. As always, YMMV.

+1 on keeping us posted on how your friend makes his way through this. His very personal journey with the disease and with the Health Care Sharing will be of great interest. Please add to this thread if you feel it's appropriate. Please let him know there are others sending some good karma his way.

 

[Koolau]

I would be interested in hearing how this turns out. I know the ministries have restrictions on pre-existing conditions and certain activities like smoking. Since it occurred soon after joining I wonder if they would try classify it as pre-existing. Or if they determined that the cancer was caused by smoking or some other restricted activity would you be hung out to dry?

He mentioned that there were restrictions which did not seem too outlandish to me - given the nature of the group involved. Smoking was not covered (he's never been a smoker) and conditions/events caused by excessive alcohol consumption were not covered (e.g., alcohol related accidents, etc.). I think he and his wife occasionally have a glass of wine with dinner which is not prohibited.

As far as pre-existing conditions, he has been a "member" (or whatever the process is) since near the beginning of the year. I don't think they would consider his current condition as preexisting - even though most likely he had the beginnings of it - cancer always starts before we know about it. He certainly was not diagnosed until just a couple of weeks ago. With his symptoms, I virtually guarantee he would not have put it off for 5 months - won't go into details. YMMV

 

[Koolau]

+1 on keeping us posted on how your friend makes his way through this. His very personal journey with the disease and with the Health Care Sharing will be of great interest. Please add to this thread if you feel it's appropriate. Please let him know there are others sending some good karma his way.

I'll try to keep the group informed. My friend did just have surgery and his doc seemed to think he was in good shape. The doc is adding one kind of treatment (not enough details over the phone) which sounds like maybe a single "booster" treatment with a chemical - but not really chemotherapy in the traditional get-a-shunt-get-infused-twice-a-week-for-two-months, etc.

My friend did say he would be submitting bills. By the way, he is not old enough for MC yet. Once you are on MC and IF you have a good supplement, you may never have to submit anything. I don't envy this process as it's a pain that I used to have to deal with even with my Megacrop HI system. Now, thank God, the doc's office just submits everything and I wait a month or three to see if I owe anything - usually not. Again, I'll let you know what I hear from my friend and if there are any "gotchas". YMMV

 

[Koolau]

Update update update

I'll try to keep the group informed.

<SNIP>

Again, I'll let you know what I hear from my friend and if there are any "gotchas". YMMV

UPDATE -

Just spoke with my friend and he informed me that he has received full compensation for his cancer treatment. The "catch" was that there was a 120 day waiting period (after the last bill submission - Not certain about that.) - not explained by my friend, but just the group's policy I suppose. In short, this was very good news. Apparently this particular Health Care Sharing Ministry is on the level. Naturally, YMMV.