I've been reviewing the health share/faith-based plans for a short while and for most folks I believe it is not a good substitute for traditional insurance.
The primary draw is of course the cost. However, I believe that many folks are overlooking many important drawbacks:
1. As every health share plan's guide will indicate very clearly IT IS NOT INSURANCE! You are ultimately responsible for your medical costs. The health share plan may or may not decide to cover your claim.
2. As others have mentioned, there are sometimes exclusions or restrictions when it comes to pre-existing conditions. Some will not allow joining if you have a pre-existing condition, others may exclude coverage within the first few years, others will not cover the pre-existing condition or anything (which they determine is) related.
3. These plans/organizations exist solely for the purpose of skirting around insurance regulations. Because they are not insurance, they do not have to provide ACA mandated coverages. Likewise, as a faith-based plan, this absolves the member from being subject to the ACA mandate requiring insurance coverage or facing the penalty for not having insurance coverage. In this same regard, because these are not insurance companies, they are not regulated and your state insurance commissioner is not going to be there for you if you have a valid claim denied. I've seen some complaints on the BBB website when members become angered. Many times it is clear that the member did not grasp the concept that what they purchased is not medical insurance.
4. Folks considering any health share plan need to review their financials to be certain they are financially stable and aren't going to fold one day. These organizations are primarily operated as non-profits and as such are required to make their financials available. You can usually find them online through a number of means. Lots of folks mention Liberty Healthshare - and they are financially weak. Here is a link to their 2017 financials:
https://www.libertyhealthshare.org/a...nual_audit.pdf - pay particular attention to Note C on page 8 - they have less than $2 million cash and that's fallen about $1 million since a year earlier. Clearly, they are skating on thin ice, requiring the monthly contributions to cover current claims requests. Should they get hit with just a few large claims, they could find themselves insolvent. Minimally, I'd expect Liberty is going to need to be raising their monthly contribution amounts.
5. Many of the plans are slow to pay - they are playing with the float month to month looking to make the cash flow work. Instead of delaying paying providers, they delay paying members on their claims. Since most times you're going in as self-pay, you pay up front, file your claim, and are then reimbursed. Complaints online point out consistent delays in getting reimbursement. For those where a physician will direct bill the health share, members have indicated receiving a bill for "the balance" from the physician after receiving payment from the health share - because it is not insurance and the physician does not have any contract in place with the health share.
There are other issues, and prospective members should do extensive research before signing up with any of them. Granted, if you can save 50% (or more) annually over the ACA plans, it could be a significant amount. However, do you want to find out that they aren't going to share to cover the unexpected situation where you have a hospital visit totalling $100k or more?
Quote:
Linear Mode
