Healthcare sharing ministries good or bad? Early retirement health insurance options?

[iblearning]

When I retire in a couple of months at age 63 1/2, I am looking into all options for health insurance.

Will stop receiving health insurance from my employer. The company only has 7 employees so do not qualify for COBRA.

Option 1 - Healthcare sharing ministries, does anybody have any good or bad experiences, recomendations.

Option 2 - Pay the very high premiums.

Option 3 - Hold down my income below $51,040 to get tax credit on an ACA plan. I can afford to do that, could use savings if I need to.

What do you all recommend?

 

[jazz4cash]

Option 4- pay the ACA premiums w/o the subsidy.
I have no experience/opinion on the healthcare ministry option.

 

[pb4uski]

Option 3.

How much do you need to live on? What do you have for taxable, tax-deferred and tax-free savings that you might use? How much will you get for SS? Any other income streams like a pension?

 

[LXEX55]

Cobra

I retired at 63.5 and went on my companies COBRA plan till I was 65 and Medicare. My wife is still on my COBRA plan and when that expires she will go on ACA plan for the few months she will have remaining till she is 65. I would look into the afforeable care act if I were you.

\

 

[zinger1457]

Agree that option 3 would be the best choice if available. An HSA compatible plan can provide an additional tax deduction if needed.

There have been a few older threads discussing healthshare ministries, as I recall a couple posters were members and seemed happy. Did read that Liberty Healthshare was having issues, increase number of complaints, raised their rates. Don't follow it closely so not sure what the current situation is.

 

[RetMD21]

The healthcare ministries are a gamble. Nyt had an article about people who hit limits of had problems. https://www.nytimes.com/2020/01/02/health/christian-health-care-insurance.html

 

[njhowie]

Healthcare ministries are not health insurance. If you can understand that, then you can begin to understand and extrapolate what the issues are.

Bottom line - if you care about your health or the health of your loved ones, stay away from them. Penny wise pound foolish - the savings are nowhere near worth the risks you take. The healthcare ministry will not pay out on a big claim. You get a bad case of cancer where treatments and surgeries can easily run well over a couple $100k and watch how it doesn't get paid. There are enough stories out there proving the point, just search for them.

 

[nhcycling]

Healthcare ministries are not health insurance. If you can understand that, then you can begin to understand and extrapolate what the issues are.



Bottom line - if you care about your health or the health of your loved ones, stay away from them. Penny wise pound foolish - the savings are nowhere near worth the risks you take. The healthcare ministry will not pay out on a big claim. You get a bad case of cancer where treatments and surgeries can easily run well over a couple $100k and watch how it doesn't get paid. There are enough stories out there proving the point, just search for them.

+1

 

[zinger1457]

The healthcare ministry will not pay out on a big claim. You get a bad case of cancer where treatments and surgeries can easily run well over a couple $100k and watch how it doesn't get paid. There are enough stories out there proving the point, just search for them.

The healthcare ministries that were allowed by ACA have been around for >25 years. Your saying they never paid out a big claim?

 

[njhowie]

The healthcare ministries that were allowed by ACA have been around for >25 years. Your saying they never paid out a big claim?

I am saying for any of them you may be considering, you should go and review their financial statements - which all of them by law are required to make public. Most provide them right on their websites. Others you'll have to go digging to locate. What you'll see is that most all of them cannot handle large claims - it is financially impossible. The finances of most are stretched thin, with annual cashflow from premiums (or maybe they're termed "donations" since it isn't insurance) barely covering payouts. Their balance sheets are atrocious.

Many require the participant to go and negotiate with the healthcare provider. Beg and plead and claim they are destitute. Make excuses why they cannot pay. The ministry drags their feet, does not pay the claims (even the valid ones) in a timely fashion, and then the participant is financially obligated for the total bill. Read the NYT article linked above - there are many other horror stories online. When you have a claim denied by the ministry and exhaust all appeal options, you don't have the "luxury" of appealing to your insurance regulator - because they will not be there for you, as it is not insurance and is not regulated by your state as insurance companies are.

Most all participants are looking at it as insurance, because they cannot afford standard health insurance or are looking to skrimp and save some money, and see it as a cheap way to get coverage. That's the fact. Most would be better off getting a catastrophic plan and paying for the routine stuff out of pocket. The catastrophic plan from one of the major insurers will pay out the valid multiple $100k claim. There's absolutely no guarantee the ministry will. If/when the ministry doesn't, then the participant is left to deal with it and most cannot afford it, for the same reason they joined the ministry in the first place.

If it's so great, why are there healthcare providers refusing to accept patients who come in with it?

I'm really not looking to debate this. The topic comes up a few times a year and the facts are all out there. I've reviewed it previously as there was a time when I was intrigued by the possibility. As I dug, I saw that it is not all that folks get excited about and there's a very dark side to it. Go digging and you'll see for yourself.

The ministries exist for the sole purpose of skirting the health insurance system and laws, and that's more for the benefit of the ministry and those who run them than for the participants.

If after reviewing all of the material available online about the ministries and still are interested, go for it - I wish you and everyone else who opts for it the best.

 

[Rianne]

Option 3 + HSA. Check your local healthcare alliance to find a broker (no cost to you) who will help you understand what you are responsible for. In 2021, we will pay $8.08/month with $6500 individual deductibles. Individually the most we will pay with a catastrophic event is $6500. We do pay for Dr visits and tests BUT the insurance discount makes those costs very affordable. We keep our income below the threshold.

 

[ivinsfan]

OK nj..not looking to debate either way, but I do have a couple comments. What are the stats on providers not accepting the health share patients, if you have any stats. Let's not gloss over the fact that insurance networks can be very narrow and you can pay full price of regular HI and be very limited in your provider pool.

There are lots of horror stories about people with "regular" insurance having terrible payment issues with "legit" companies.

And of course do you think the regular insurance companies run for the monetary benefit of the company or that they have altruistic goals to just "help" people.

As far as them "skirting" the laws many of the laws are what cost the money and actually help very few policy holders.

And last but not least, part of the preACA reason these groups gained traction was that regular insurance started to become completely unaffordable to lower middle class working people to the point that they couldn't pay for it and put food on their dinner tables. IOW it was almost a move of desperation to cushion the cost of HC.

Now ACA has certainly helped people obtain regular insurance..the OP has 18 months to fill his gap.

If his doesn't know about his cliff numbers. I'd suggest he get a regular ACA policy through the exchange, pay the rack rate and see where he sits at the the end of the tax year.

 

[Chuckanut]

The healthcare ministries are a gamble. Nyt had an article about people who hit limits of had problems. https://www.nytimes.com/2020/01/02/health/christian-health-care-insurance.html

I do not trust my medical insurance to a health sharing ministries. They are not real insurance and they are not backed up by any type of state system as far as I know.

Let me put it this way. If you inherited $250,000 would you feel OK depositing it into a bank that was not FDIC insured because they paid 2.5% today on a regular account? That's similar to what you are doing with these plans, IMHO. Except that you might also lose your health and/or life along with your money.

I would much rather buy a high deductible plan.

 

[EastWest Gal]

Short term insurance may be an option for 2021, then go to the ACA for the first part of 2022. Make sure you have enough cash assets before 2021 so you don't have to sell and pay capital gains, or touch a 401k. Watch out for pre-existing conditions though, and other restrictions.

I looked into a short term policy, and was administered by United Health Care. I ended up deciding to go with the ACA. Lowest unsubsidized premium was almost $1700 for the two of us. The short term premium was $535 monthly.

 

[brett]

Would you pay life insurance premiums for 20 years if there was no guarantee that the insurer would pay out on your death? Or only pay out on half the face value of the so called policy.

These healthcare ministries seem to me to more about co-ops than they are about insurance.

The premiums are considerably lower for a reason.....the claims payouts are much lower. It is not about God, it is about the math and the realities of the health insurance business IMHO.

 

[Chuckanut]

The premiums are considerably lower for a reason.....the claims payouts are much lower. It is not about God, it is about the math and the realities of the health insurance business IMHO.

+1

And I would add it's about costs. We won't see lower insurance premiums until the cost of medical care is driven down. How that can happen is beyond my pay grade.

 

[ncbill]

I am saying for any of them you may be considering, you should go and review their financial statements - which all of them by law are required to make public. Most provide them right on their websites. Others you'll have to go digging to locate. What you'll see is that most all of them cannot handle large claims - it is financially impossible. The finances of most are stretched thin, with annual cashflow from premiums (or maybe they're termed "donations" since it isn't insurance) barely covering payouts. Their balance sheets are atrocious.

Many require the participant to go and negotiate with the healthcare provider. Beg and plead and claim they are destitute. Make excuses why they cannot pay. The ministry drags their feet, does not pay the claims (even the valid ones) in a timely fashion, and then the participant is financially obligated for the total bill. Read the NYT article linked above - there are many other horror stories online. When you have a claim denied by the ministry and exhaust all appeal options, you don't have the "luxury" of appealing to your insurance regulator - because they will not be there for you, as it is not insurance and is not regulated by your state as insurance companies are.

Most all participants are looking at it as insurance, because they cannot afford standard health insurance or are looking to skrimp and save some money, and see it as a cheap way to get coverage. That's the fact. Most would be better off getting a catastrophic plan and paying for the routine stuff out of pocket. The catastrophic plan from one of the major insurers will pay out the valid multiple $100k claim. There's absolutely no guarantee the ministry will. If/when the ministry doesn't, then the participant is left to deal with it and most cannot afford it, for the same reason they joined the ministry in the first place.

If it's so great, why are there healthcare providers refusing to accept patients who come in with it?

I'm really not looking to debate this. The topic comes up a few times a year and the facts are all out there. I've reviewed it previously as there was a time when I was intrigued by the possibility. As I dug, I saw that it is not all that folks get excited about and there's a very dark side to it. Go digging and you'll see for yourself.

The ministries exist for the sole purpose of skirting the health insurance system and laws, and that's more for the benefit of the ministry and those who run them than for the participants.

If after reviewing all of the material available online about the ministries and still are interested, go for it - I wish you and everyone else who opts for it the best.

To be fair, the last time I looked many health care ministries were structured so payments go directly from members to other members...the ministry itself never handles the payments, so it would not pass through their balance sheet.

Though I would also avoid them...for us it would be easier & cheaper simply to go on the ACA & "manage" our mAGI for the maximum subsidies possible.

So I'd pick option 3...but I'd setup a HELOC before quitting & use that to meet current expenses, keeping mAGI as low as possible after quitting to maximize ACA subsidies.

Though on another forum a few years ago I recommended that a couple in AZ roughly the same age as the OP complaining about facing ~$30k in unsubsidized ACA premiums take an extended vacation south of the border, where at the time a policy with $5 million in coverage "outside the U.S. & Canada" with a $1000 deductible/max OOP was ~$150/month each.

 

[RetMD21]

The healthcare ministries that were allowed by ACA have been around for >25 years. Your saying they never paid out a big claim?

Actually nobody said that from what I can see

 

[Aerides]

With only 18 months to cover, I'd look at this as you would with investments: For a short term approach you go with the guaranteed sure thing, even if it costs a bit more.

Go for the ACA. Even if you can't manage your income (which is a bigger argument in FAVOR of the ACA in your case).
C, if not C, then B.

If you were 43 and going really early, sure, try different approaches. But at 63 with Medicare on the horizon, you're at the finish line, don't take on unknowns.

 

[zinger1457]

Actually nobody said that from what I can see

I asked the poster if that's what was meant from the statement that was made.

The healthcare ministry will not pay out on a big claim.

 

[MichaelB]

In the discussion between traditional insurance and healthcare ministries people forget a key detail. Health care providers have agreements with traditional insurers, giving them preferential prices. Healthcare ministries do not. The difference between “list” price and preferential insurer price has been growing steadily and can be as high as 90%. With healthcare ministries, prices are negotiated after the fact, and there is no guarantee the amounts negotiated will be affordable.

 

[zinger1457]

The difference between “list” price and preferential insurer price has been growing steadily and can be as high as 90%.

It can be a lot higher than 90%. Just had my annual physical, the lab that I had the blood test done at billed my insurance company $610, the insurance company allowed/paid $51.

 

[slappy52]

Some states have Farm Bureaus which give their members access to real health plans. Indiana for example offers a united healthcare plan (not short term) at a very reasonable price. The only catch is that it requires underwriting (blood tests, medical history, etc). They will not cover a pre-existing condition for the first year. But it is a legitimate PPO plan with a nationwide network through united. You can join the bureau for something like $30.

 

[SmallCityDave]

We have a Christian cost sharing plan and really like it, we've recently had a surgery with a 5 day hospital stay that will cost $70-90k it will be interesting to see how this works out.


I find the general sentiment of this forum interesting - Don't trust the costs sharing ministries because they aren't insurance yet they don't want to pay the high premiums of insurance companies and will go out of their way to earn less so they don't have to pay the regular premium.


I do wish that I was charged what the insurance companies pay, we pay upfront I try to get a discount when possible and it is so much easier for the provider. When someone has insurance they may bill $1000 but the insurance company may only pay $250 and the provider is happy but when it's cash pay I'm happy to get 25% discount.

 

[REWahoo]

We have a Christian cost sharing plan and really like it, we've recently had a surgery with a 5 day hospital stay that will cost $70-90k it will be interesting to see how this works out.

Please let us know how it works out. Wishing you all the best.