Health Share - why not?

KenZ71

Recycles dryer sheets
Joined
Jan 6, 2018
Messages
190
Been reading and searching about Health Share options from what I can see they sound appealing. Anyone have experience good or bad?

ACA Coverage for me as a single male age 52 with an annual gross income of about $80,000 to 120,000 will be steep.

I like the health share model where you tell provider you are a uninsured cash payer - they tend to give generous discounts. A few weeks ago with no insurance I had a CAT scan done cash price paid in full price was $2,500 that is about 3X less than I paid when insured by Optum as an employee a few years ago!

So anyone have rational reasons to go Health Share vs ACA ? From what I've seen it might be possible to still contribute to a HSA which would be fantastic for the tax free growth and relatively easy access to the money.

Two I am considering:
ZionHealthShare.org
 
Been reading and searching about Health Share options from what I can see they sound appealing. Anyone have experience good or bad?

ACA Coverage for me as a single male age 52 with an annual gross income of about $80,000 to 120,000 will be steep.

I like the health share model where you tell provider you are a uninsured cash payer - they tend to give generous discounts. A few weeks ago with no insurance I had a CAT scan done cash price paid in full price was $2,500 that is about 3X less than I paid when insured by Optum as an employee a few years ago!

So anyone have rational reasons to go Health Share vs ACA ? From what I've seen it might be possible to still contribute to a HSA which would be fantastic for the tax free growth and relatively easy access to the money.

Two I am considering:
ZionHealthShare.org
It’s easier to negotiate with a physician than a hospital, and it’s much easier to negotiate before a service has been rendered than afterwards.

I’m doubtful a Health Share option satisfies the HSA policy requirement needed to contribute to an HSA.
 
With all respect to opinions above I am still considering a Health Share over traditional Health Insurance.

Seeing some good reviews here
also some of the RV forums that I frequent have good things to say.

The more I think about my desire for a HSA that is most likely not going to happen in large part because nearly all my money is already in an IRA so the need isn't their. If I do return to the corporate world with a health plan then this discussion is moot for me at least.
 
Forget about negotiating with a hospital.

Years ago when mom was sick pre-ACA as cash customer she (well, I) paid their maximum rate for anything.

And since the organizations that own local hospitals now increasingly are adding local physician practices forget about negotiating with the latter as well.

BTW, the main complaint with health share organizations is that they refuse to pay for serious conditions, as in 6+ figures, which is an easy figure to hit with cancer.

Medi-share had the most complaints last time I looked.
 
BTW, the main complaint with health share organizations is that they refuse to pay for serious conditions, as in 6+ figures, which is an easy figure to hit with cancer.

Medi-share had the most complaints last time I looked.
Thanks for the info. Do you have a citation regarding the refusal to pay?
 
Local hospital here actually has a new Facebook posting that they offer discount pricing for lab services for cash-only and those with high deductible health care plans.

Of course, that's not going to help with all of the other services. With in-network coverage, the discounted cost is always considerably less than the "billed" amount prior to discount. Seems cash customers would still usually be paying extra.
 
Local hospital here actually has a new Facebook posting that they offer discount pricing for lab services for cash-only and those with high deductible health care plans.

Of course, that's not going to help with all of the other services. With in-network coverage, the discounted cost is always considerably less than the "billed" amount prior to discount. Seems cash customers would still usually be paying extra.
Based on my current experience (DW serious health crisis requiring multiple specialists, in-patient and outpatient procedures, etc, etc) "considerably less" is really the understatement of the year. Pretty much ALL services, labs, diagnostics, etc are routinely discounted 10x to 50x compared to billed amount. In other words a procedure that costs the insurance $500 will cost a cash customer anywhere from $5000-25000. So what if you can negotiate even half off (seems unlikely, but luckily, I have not had to try...), you still pay through your nose. It is a truly crazy system that will ruin even fairly well-off individuals. No way in heck would I voluntarily expose myself to this racket.
 
Based on my current experience (DW serious health crisis requiring multiple specialists, in-patient and outpatient procedures, etc, etc) "considerably less" is really the understatement of the year. Pretty much ALL services, labs, diagnostics, etc are routinely discounted 10x to 50x compared to billed amount. In other words a procedure that costs the insurance $500 will cost a cash customer anywhere from $5000-25000. So what if you can negotiate even half off (seems unlikely, but luckily, I have not had to try...), you still pay through your nose. It is a truly crazy system that will ruin even fairly well-off individuals. No way in heck would I voluntarily expose myself to this racket.
This is our experience as well. We chose a high deductible ACA plan. Then had a bunch of medical stuff happen. Seeing the difference on the bills between full rate vs and negotiated rate was super eye opening. Basically, the HDHP guarantees us the negotiated rate with a max out of pocket .

I thought we'd be low medical users based on history... I retired with two teenagers. Both rarely got sick. As soon as we switched to high deductible younger son had a series of sports broken bones. Older son took a baseball to his orbital socket. Then he developed Ameloblastoma and had to have major jaw surgery. We hit the deductibles two years and came close a third year. But we paid a LOT less than the non negotiated rate.
 
Based on my current experience (DW serious health crisis requiring multiple specialists, in-patient and outpatient procedures, etc, etc) "considerably less" is really the understatement of the year. Pretty much ALL services, labs, diagnostics, etc are routinely discounted 10x to 50x compared to billed amount. In other words a procedure that costs the insurance $500 will cost a cash customer anywhere from $5000-25000. So what if you can negotiate even half off (seems unlikely, but luckily, I have not had to try...), you still pay through your nose. It is a truly crazy system that will ruin even fairly well-off individuals. No way in heck would I voluntarily expose myself to this racket.
Wow, you're seeing a much larger percentage of discounting than me. I have had various claims with my insurance company in 2024 so far, and the largest discount it shows for a service is close to 75%, but most are quite a bit less. My largest bill for outpatient upper GI hospital services (not physician) showed the discounted amount was less than 12%. The physician was about 50% discounted. I was left paying 30% of the discounted price out of pocket and am close to my max out of pocket limit for in-network services. I'm assuming these healthcare providers that I used aren't jacking up the pre-discounted billing cost as high to begin with, so the discounted amount is a smaller percentage compared to the 10X to 50X you're seeing.
 
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I used medishare for a few years. While they kept saying its not health insurance, it worked just like health insurance and they had the same kind of discounts for procedures that regular insurance did.
 
I think it would be foolish to risk a lifetime of savings and investing on a health share scheme. ACA insurance is pretty reasonable if one manages their income right.

If ACA insurance doesn't pay there are state insurance regulators that can make sure that the health insurer pays what they are contractually obligated to... no such thing with a health share scheme.
 
Wow, you're seeing a much larger percentage of discounting than me. I have had various claims with my insurance company in 2024 so far, and the largest discount it shows for a service is close to 75%, but most are quite a bit less. My largest bill for outpatient upper GI hospital services (not physician) showed the discounted amount was less than 12%. The physician was about 50% discounted. I was left paying 30% of the discounted price out of pocket and am close to my max out of pocket limit for in-network services. I'm assuming these healthcare providers that I used aren't jacking up the pre-discounted billing cost as high to begin with, so the discounted amount is a smaller percentage compared to the 10X to 50X you're seeing.
The major "Negotiator" is Medicare. I see figures like $2500 knocked down to $200 etc. If that $2500 has ANY validity with respect to reality, SOMEBODY else is paying the difference. For starters, those without insurance must be paying (when they actually pay) but mostly it's everyone else who consumes health care (who DO have insurance) who pay for those of us on MC.

I think someone said "What a system!" Indeed.
 
There are pros and cons, the link MB Austin posted gives a decent overview. I want a legally enforceable health insurance plan regulated by my state's Dept. of Insurance. We pay $20k++/yr for 2 of us for a national HDHP w HSA. That's a ridiculously high expense. I pay for health insurance because I don't want the exposure that health share (which is NOT insurance) potentially leaves us open to. It (health insurance) is the best choice for our circumstances.
 
What always turned me off is the whole idea that members can refuse to pay for certain treatments on religious/moral/personal grounds.
I'm sure that very idea actually appeals to some people. A lot of people in this country are very quick to judge illness as personal weakness. I know a lot of people here begrudge that the ACA covers pregnancy and birth control and mammograms, and I don't need to have that hassle in my life, even though two of those three are no longer relevant to me personally.
 
Some interesting comments above. Life itself is a gamble. Not to be flippant or carefree it seems insurance and health share plans both have their horror stories and "holy cow that worked better than I could have imagined".

I'm still looking at Zion as it has the best reviews, seems the most open about what is covered vs not and no hard sell cold callers.

Both insurance and share have theoretical max spend amounts. Insurance seems much higher worst case out of pocket plus higher upfront cost. That makes the share option quite compelling. Just my read on the situation.
 
We have too much income to qualify for ACA subsidies when we retired 8 years ago. My husband was on Medicare but I would have 12 years to go before reaching Medicare age. I did seriously look at Health Share and decided against it. I even spoke to my PCP and specialists and they all told me that they would bill me and it would be up to me to file a claim against the Health Share organization. The risk of having a catastrophic medical event and Health Share refusing to pay was just not worth it. My premium this year is about $16K and I have 3.5 years to go before reaching Medicare age. I simply bite the bullet.
 
I was a member of Medishare for a number of years. When we needed care we used a provider from their network and we were billed the negotiated rate. We paid the bill as we never reached our deductible. It all worked fine. Note, though, that we never really had a medical bill "shared" since we never covered our annual deductible.
 
A blogger I follow was singing praises about a Health Share group and a few days after reading his post a negative article appeared in ProPublica about the outfit.


John Oliver has also aired a segment about Health Share Ministries.

Buyer beware.
 
So far haven't seen any comments where someone actually had a bad experience with a health share besides Liberty. One bad actor in the industry is hardly enough to discredit all.

Countrywide mortgage and others screwed many yet we still have home loans being sold. Gov't oversight didn't help that train wreck.

The naysayers are a bit like the Reo Speedwagon tune:

Heard it from a friend who
Heard it from a friend who
Heard it from another you been messin' around
 
So far haven't seen any comments where someone actually had a bad experience with a health share besides Liberty. One bad actor in the industry is hardly enough to discredit all.

Countrywide mortgage and others screwed many yet we still have home loans being sold. Gov't oversight didn't help that train wreck.

The naysayers are a bit like the Reo Speedwagon tune:

Heard it from a friend who
Heard it from a friend who
Heard it from another you been messin' around
Guess you didn't read the article carefully.. Besides the Beers family, the article named 2 other sharing organizations, :

" Sharity Ministries, once among the largest organizations in the industry, filed for bankruptcy and then dissolved in 2021 as regulators in multiple states investigated its failure to pay members’ bills. In January, the Justice Department seized the assets of a small Missouri-based ministry, Medical Cost Sharing Inc., and those of its founders, accusing them of fraud and self-enrichment. The founders have denied the government’s allegations."

I went a few years without any health insurance... no issue as I was lucky... Do you feel lucky :confused:

Medical costs are a major reason for bankruptcy, get cancer or in a serious car accident and costs will be bankruptcy high without medical insurance.
 
So far haven't seen any comments where someone actually had a bad experience with a health share besides Liberty. One bad actor in the industry is hardly enough to discredit all.

Countrywide mortgage and others screwed many yet we still have home loans being sold. Gov't oversight didn't help that train wreck.

The naysayers are a bit like the Reo Speedwagon tune:

Heard it from a friend who
Heard it from a friend who
Heard it from another you been messin' around
I'm going to make just this one post on this thread, because last time around on this topic it quickly spiraled out of control and was closed.

You appear to have made your decision, so you should just go ahead and do it. Hopefully it all works out and you reap the financial savings that you're ultimately looking for.

What I find ironic is that most of us on this site are financially in a very good position, many are purchasing umbrella insurance to protect their assets, and yet, some are open to taking a chance on their health insurance. Additionally, most of us have the carrot of Medicare waiting for us at age 65. So, it's generally that period between our current age and age 65. Under ACA, whether through our employer at the time or through the marketplace, what I've found is that the HDHP/HSA plans have worked out wonderfully for us. We've never reached the annual out of pocket limit, employers have contributed annual amounts to our HSA accounts, they have done well in safe investments, and will be there for future medical expenses. Keep in mind, the Health Share is not a HDHP and so going the Health Share route, you cannot use it to contribute to a HSA.

Personally, while employed and covered by traditional insurance back in 2006/2007, DW had breast cancer and there were lots of medical bills. It was a long 18 months for us. My megacorp employer was self-insured and covered most everything in full. DW beat her cancer and has been healthy ever since. However, towards the end of everything, after having a radical double mastectomy the insurance company was refusing to pay for reconstruction of one of her nipples! For some reason, their rules provided for paying for one, but not two. Can you imagine that? After appealing with the insurance company and getting nowhere, before preparing to escalate to the state insurance commissioner, I contacted our company ombudsman, and within a few days they had taken care of the situation. I was drained from the process and DW was simply in no condition to be pursuing it. When investigating and considering the Health Share option, I think of what might have happened if I didn't have various levels of appeals and folks out there who would be on my side.

As I said the last time around, to whoever originated that thread, if you are really sold on it, it makes sense to you, and you are willing to take the risks, more power to you. I hope it all works out. Insurance is all about mitigating risk. For me/us, I dug deeply, reviewed the publicly available financials of all the Health Share groups we were considering, and was not impressed. I was not comfortable with their ability or willingness to pay for major medical expenses and in the end decided it was simply not worth putting our health or financial well-being and future at risk.
 
I went a few years without any health insurance... no issue as I was lucky... Do you feel lucky
I actually did that for a few years in my 20's when I wasn't earning much income. I sure wouldn't want to risk that these days.
 
I did a lot of digging on healthcare ministries, and would have gone that route if it hadn't been for the ACA going into effect.

The fact that some have allegedly been caught with their hand in the cookie jar is to be expected because A: that happens, and B: they're taking business away from companies that can spend lots of litigation bucks.

People here are generally very conservative, so wouldn't want to risk any possibility of a huge medical bill. And you might get caught-out if you had a sudden onset medical issue, but depending on your luck, it might happen during ACA open enrollment :) and you'd jump in when you needed it! On average you'd have to deal with the ministry for less than 6 months. And they'd have to stiff you to be what people are talking about as the risk.

As to the huge medical bills, don't pay a dime until all the bills are presented to you. Then ask that they price the services with Medicare rates "just as a reference", or somehow find out that number. Then go to the entities and get agreement on a price, with the starting point the Medicare price. Play each entity off each other; tell the hospital mega that the physician mega has agreed to 10% over Medicare, and you're waiting for the hospital to play ball. Once you get the bottom line, in writing with assurance that it will clear the debt, write your checks. It's likely they'll send it to collections. Write one "drop dead" letter (see Clark Howard) and ignore all other attempts at communications. The medical mega will pull the account back out of collections if you are ready to write a check.
 
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