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

[HenryD]

I had to LOL at the 'moral & ethical' requirements of membership in that pdf. Whose morals & ethics? Smoking a joint, frex, specifically disallows you from cost-sharing. This is one of the problems with these setups IMO, they can basically deny you for anything if they think you're not Mr. Rogers.

I had some friends on this. Middle-aged, married many years. They denied her claim for birth control.

 

[RobbieB]

I like plans with max out of pocket defined. Once I hit that number I'm done.

 

[ivinsfan]

Doctors have to treat everyone without judgement, they take an oath to that effect. So these moralists get to decide who gets treatment or not? Then, it's not health insurance; it's biblical judgment

Hold on a second, no one is forced to sign up for those exclusions and no one says they can't get treatment...if you don't like the conditions, buy other coverage...no one said these groups were health insurance.

Why don't you calm down a little.

 

[ivinsfan]

I had some friends on this. Middle-aged, married many years. They denied her claim for birth control.

I call BS on that one.

 

[ivinsfan]

Ah. but I'm not an MD, I get to judge

You're good at it too..

 

[zinger1457]

I like plans with max out of pocket defined. Once I hit that number I'm done.

The problem is out of pocket limits don't cover out of network billing. It's not uncommon for in network hospitals to have doctors working there that are out of network and bill separately. Congress is working on a bill to address 'surprise billing' but it hasn't passed yet and not sure what all the details are.

 

[jollystomper]

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?

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

For 18 months, keep it simple and go with either option 2 or the suggested option 4. My guess is that neither will put a dent in your assets for that period of time. No need to gamble with the sharing ministries. I have nothing against them, but I would rather pay more for good, complete health care coverage.

 

[ncbill]

I call BS on that one.

I would think birth control would normally not be enough to meet the cost sharing limit...unless you're talking surgery for permanent sterilization.

Which I can see not being covered as elective as opposed to being medically necessary.

 

[grayv]

fwiw, I recently heard a radio advertisement for one of these plans.

 

[DawgMan]

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?

Man, this conversation went off the rails in a hurry. Appears to be allot of health share haters out there.

OP, since you asked for opinions, here's mine based on experience. I have been self-employed for over 32 years so shopping HI has been an annual function of mine. Over the years I have had company HI through "associations", private insurance, high deductible catastrophe insurance, ACA, and now have been on a health share plan for the last 3 years. I look at insurance (including HI) like any other business decision and size up the risks/rewards, do my homework, and then make a decision. For me, what finally did it, was my ACA plan year after year got worse in coverage, dropped all of our regular docs, added more hoops to jump thru to see certain docs, and the cost was getting ridiculous. I did my research, looked at our current health/pre-existing conditions, etc. and pulled the trigger and chose a health share plan. Like you and many of us, I have to solve my HI issue until I hit 65 (currently 56) and will continue to evaluate the options year by year. So far, my 3 year experience has been great. We have had procedures/medical expenses from $1000 - $10,000 and so far everything has been covered as expected. Based on the quoted ACA premiums 3 years ago, I was saving $18K/year in premiums alone. I also have evaluated the worse case scenario should the 25 year old health share company not come thru on a catastrophe (I have assets to self-insure and can jump back on ACA again at some point if need be). You could also look at it as I have banked $18K/year in savings for the last 3 years which goes in my emergency fund. The trade off to me is I am in control of my health care and choose the docs and facilities I want to go to... that is valuable to me. Do these plans require some faith... you bet. But guess what, we all put our faith in something.

Is a health share plan right for you? Consider the following...
- Are you comfortable being part of a Christian plan and it's by laws... they do have some?
- Are you and those covered in decent health with minimal pre-existing conditions? These plans work best for the more healthy.
- Do you have the ability to cover some out of pocket costs for a few months until you are reimbursed?
- Are you comfortable dealing directly with doc offices about procedure costs, asking for 'Cash pay" discounts?
- Do you like saving $10K - $18K/year in premiums/costs?
- Are you comfortable taking some risk since it is not insurance?

Good luck on finding a solution!

 

[HenryD]

I call BS on that one.

Wow, thanks for that

 

[HenryD]

I would think birth control would normally not be enough to meet the cost sharing limit...unless you're talking surgery for permanent sterilization.

Which I can see not being covered as elective as opposed to being medically necessary.

The claim was for an IUD removal and replacement. Beyond it being denied I don't know any details. They may well have excluded when they signed up. It speaks to the unregulated nature of these programs, and how some basics which are covered by law with real health insurance are not guaranteed.

 

[RunningBum]

I admittedly don't know much about Health Care sharing ministries, but it sounds like anti-catastrophic insurance to me. Paying $10K/yr, which is about what I have in non-subsidy years + high deductible is pretty stiff, but won't break my plan. A major illness or accident that's not covered by whatever HI I have definitely could.

 

[zinger1457]

The claim was for an IUD removal and replacement. Beyond it being denied I don't know any details. They may well have excluded when they signed up. It speaks to the unregulated nature of these programs, and how some basics which are covered by law with real health insurance are not guaranteed.

There are 'real' insurance plans don't cover contraceptives, religious employer plans are exempt from the requirement. From what I've seen the healthcare ministries are up front whether they cover those types of claims, it shouldn't come as a surprise.

 

[ivinsfan]

There are 'real' insurance plans don't cover contraceptives, religious employer plans are exempt from the requirement. From what I've seen the healthcare ministries are up front whether they cover those types of claims, it shouldn't come as a surprise.

AFIC they use the term "health share" not "health care". A whole different ballgame. There is huge difference and no one should sign up for a health share without understanding exactly what they are getting into.

Of course they don't cover everything "required" by regulated insurance, that's why they charge considerably less money.

 

[ncbill]

Man, this conversation went off the rails in a hurry. Appears to be allot of health share haters out there.

OP, since you asked for opinions, here's mine based on experience. I have been self-employed for over 32 years so shopping HI has been an annual function of mine. Over the years I have had company HI through "associations", private insurance, high deductible catastrophe insurance, ACA, and now have been on a health share plan for the last 3 years. I look at insurance (including HI) like any other business decision and size up the risks/rewards, do my homework, and then make a decision. For me, what finally did it, was my ACA plan year after year got worse in coverage, dropped all of our regular docs, added more hoops to jump thru to see certain docs, and the cost was getting ridiculous. I did my research, looked at our current health/pre-existing conditions, etc. and pulled the trigger and chose a health share plan. Like you and many of us, I have to solve my HI issue until I hit 65 (currently 56) and will continue to evaluate the options year by year. So far, my 3 year experience has been great. We have had procedures/medical expenses from $1000 - $10,000 and so far everything has been covered as expected. Based on the quoted ACA premiums 3 years ago, I was saving $18K/year in premiums alone. I also have evaluated the worse case scenario should the 25 year old health share company not come thru on a catastrophe (I have assets to self-insure and can jump back on ACA again at some point if need be). You could also look at it as I have banked $18K/year in savings for the last 3 years which goes in my emergency fund. The trade off to me is I am in control of my health care and choose the docs and facilities I want to go to... that is valuable to me. Do these plans require some faith... you bet. But guess what, we all put our faith in something.

Is a health share plan right for you? Consider the following...
- Are you comfortable being part of a Christian plan and it's by laws... they do have some?
- Are you and those covered in decent health with minimal pre-existing conditions? These plans work best for the more healthy.
- Do you have the ability to cover some out of pocket costs for a few months until you are reimbursed?
- Are you comfortable dealing directly with doc offices about procedure costs, asking for 'Cash pay" discounts?
- Do you like saving $10K - $18K/year in premiums/costs?
- Are you comfortable taking some risk since it is not insurance?

Good luck on finding a solution!

I think the concern is not so much will they cover a $10,000 bill, but a $100,000+ one...

 

[FatBob]

Option 5: Go abroad for several years until you hit medicare age. We have it all worked out to live in Europe/travel between retirement and medicare. A Gold Insurance plan in the EU through Allianz is about $2500 annually for my wife and I. If I wanted to go with a Silver plan, it is about $1500 for the two of us.

 

[jeffmete]

When my cobra ran out, I found the ACA to be anything but affordable (over 2,000 month). So I turned turned to Medishare and paid 600/month for similar coverage. It would not cover existing conditions, so my wife’s high blood pressure medicine was on us. And it won’t pay for stupidity (specifically said if you don’t wear your seat belt and in an accident your on your own). Wouldn’t cover substance abuse issues. Basically you had to walk the straight and narrow to be covered. But for us, alcohol and drug abuse aren’t a problem. It was interesting every month getting a memo of who your funds were going to. At least for us it worked fine,

 

[indiajust]

look up sedara. almost as good as insurance and vastly cheaper.
https://sedera.com/sedera-faqs-2020/

goodrx and similar for discounts on drugs.

Get a direct primary care provider for access and regular contact point. Cash prices are 50% to 85% discount from insurance.
https://www.mrmoneymustache.com/2020/11/09/direct-primary-care/

Travel a bit. Oklahoma City has the lowest prices in the US. They have serious competition.

https://www.independent.org/aboutus/person_detail.asp?id=1556

 

[Dynaflash]

I have had the faith based health care for 1 year now. Have only had one claim and it was 100% paid. I can’t say if I get cancer and the bill is 100000. But I believe that it will be handled properly. So far my experience is it’s better than insurance. I plan to keep if for 2 more years then go on Medicare

 

[meleana]

I was forced to resign my job in 2018 at age 62 and my husband retired this year. I paid 2 months of expensive high deductible COBRA and switched to a Silver ACA (EPO) plan for $40 per month (going to $50 in 2021) No deductible. Extremely low copays, good network in my area.

We essentially are living off cash - no SS yet and no pension for me and hubby took a lump sum on his small one. So very low income from interest and dividends and a small IRA withdrawal to keep me off Medicaid.

I will come off this coming June when I turn 65 and go on expensive Medicare and supplement. I wish I could stay on the ACA plan! Lol!

 

[LakeRat1]

https://www.chministries.org/ --- I joined 5+ years ago and saved over 60K between my wife and I. I highly recommend this program..... A friend joined after talking with me, two weeks after joining he had to have surgery on a torn retina ..... after about 90 to 100 days later he received $$$$ to pay all his medical bills from this incident ...... My wife is now on medicare, so my monthly payment is $172 per month ..... Was $150, but this year they raised the rates.....Rates had not gone up for the past 10 years ...... Christian Healthcare Ministries is as good as it gets ...... You will be money ahead ..... I also utilize GoodRx ..... This has saves me approximately $1600 for my arthritis drugs ..... I am 58, 2021 on the exchange is over $1000 per month for a crappy plan, I will stick with the $172 a month and continue to self pay, when needed I will utilize CHM

 

[PointBreeze]

I retired at 58 three years ago and the ACA has been very good to me. I am able to live on a combination of after-tax and tax-deferred funds, and so can keep my MAGI low enough to get a good subsidy. And for some reason, although my MAGI stayed the same and I have the same plan, my premium dropped by 46% for 2021. Of course the deductible and co-pays go up each year, but I still am super grateful for the ACA.

 

[samcat]

I had some friends on this. Middle-aged, married many years. They denied her claim for birth control.

We have been members of Christian Healthcare Ministries for three years. More on that later when I have time to write. But,

Birth control is not covered under CHM because it is a maintenance medication. It could have something to do with preventing pregnancy but in the guidelines, no daily medication is covered. No blood pressure, no anti-depressants.

I'm on anti-depressants. I get a 90 day supply at Costco for $70 (member price). Between premiums for a bronze policy that cover nothing along with a $12k deductible, I'm saving almost $30k per year by not having traditional insurance (when our boys were still on our plan, it was almost $50k per year). I can afford to pay $70 four times per year to fill my prescription.

I have to walk the dog. I'll write more about CHM later - why it works and why we switched (besides the cost).

 

[ivinsfan]

We have been members of Christian Healthcare Ministries for three years. More on that later when I have time to write. But,

Birth control is not covered under CHM because it is a maintenance medication. It could have something to do with preventing pregnancy but in the guidelines, no daily medication is covered. No blood pressure, no anti-depressants.

I'm on anti-depressants. I get a 90 day supply at Costco for $70 (member price). Between premiums for a bronze policy that cover nothing along with a $12k deductible, I'm saving almost $30k per year by not having traditional insurance (when our boys were still on our plan, it was almost $50k per year). I can afford to pay $70 four times per year to fill my prescription.

I have to walk the dog. I'll write more about CHM later - why it works and why we switched (besides the cost).

Great come back and fill us in. It's always about people's personal bias on subjects like this. For example, if you make a claim for something that is listed as non-covered from the get go..how does that translate into CHM "denying" your claim?