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California has a 3 year cobra program, not sure if any other states do?
Why aren't more using a Christian Plan?
- Thread starter Kelor
- Start date
Ed B
Recycles dryer sheets
A lot of people I know including a few health insurance concierge types have switched to the faith based medi-share type plans. They have mostly good experiences. The reason it might not work for some is preexisting conditions and they do not cover prescription medications. The ones who are on several prescription meds have signed up for supplemental plans just for the meds through Walmart or other sources. We may go this route for my 6 year old grandson. It seems perfect for him.
After reading this whole thread, I thought of an analogy. When I joint USAA, it was for officers and their dependents only. Basically they managed their risk by restricting the pool of membership. That constraint has now changed and to be honest, I've seen the customer service and returns slide as well (another story). In the case of the faith based 'insurance', I see a similar analogy: they manage the risk by restricting the pool of membership. With some vetting, many of the known habits and pre-cursors to high healthcare costs can be minimized, thereby allowing a lower premium cost.
I believe USAA started out as a group self-insure pool and then became regulated. The faith-based services could be looked at from that perspective; a self-insured pool for health care services- mainly catastrophic or those that are expected with the type of member in their pool: birth, preventive services, etc. Yes, the devil is in the details, however, it is well known that people with chronic diseases are the largest users and spenders on healthcare services: diabetes mellitus, chronic obstructive pulmonary disease and congestive heart failure. Many of these chronic conditions are due to lifestyle and behavior choices.
I believe USAA started out as a group self-insure pool and then became regulated. The faith-based services could be looked at from that perspective; a self-insured pool for health care services- mainly catastrophic or those that are expected with the type of member in their pool: birth, preventive services, etc. Yes, the devil is in the details, however, it is well known that people with chronic diseases are the largest users and spenders on healthcare services: diabetes mellitus, chronic obstructive pulmonary disease and congestive heart failure. Many of these chronic conditions are due to lifestyle and behavior choices.
HFWR
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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travelover
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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I'm waiting for the Christian Scientists to offer a plan. Premiums should be low.
Just wondering how this is going. COBRA will offer some coverage but not bridge all the way to Medicare.
njhowie
Thinks s/he gets paid by the post
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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/assets/public/latest_annual_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?
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/assets/public/latest_annual_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?
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JoeWras
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
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I have faith... but not in these plans. Not with the way our medical cost structure is going.
mamadogmamacat
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Dtail
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Excellent summary. I have read bits and pieces in the past stating as such and would never go this route.
Luck_Club
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I had signed up but ultimately canceled for the following exclusion:
1) Alcohol consumption
Though they didn't say it, you could sense that any injury claim that could be denied due to Alcohol consumption would be denied. With two young adults relying on our insurance, I couldn't take on that risk.
1) Alcohol consumption
Though they didn't say it, you could sense that any injury claim that could be denied due to Alcohol consumption would be denied. With two young adults relying on our insurance, I couldn't take on that risk.
These plans have been discussed a number of times. You can do a search here to find old threads. Or we can rehash it all over again.
I was just doing a quick check back to the beginning of this thread and found the above.
I have to commend you on your powers of prediction!
I do have opinions on the subject, but it looks like they've all been covered, so I'll say no more.
