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الجمعة، 6 مايو 2016

Should You Consider Medi-Share for Health Insurance? Here’s Our Take

Health insurance can be incredibly expensive, especially if you don’t have coverage through your employer.

And now that you can get fined under the Affordable Healthcare Act (ACA) for not being insured, some frugal families — particularly those who aren’t interested in Obamacare — are checking out other options.

If you’ve heard ads for Medi-Share, you might be intrigued by its promises to cover your health care costs, so you don’t have to get government-mandated insurance.

Curious? We looked into the details to find out how Medi-Share works — and whether it’s a good option for you. Here’s our honest, unbiased review of the program.

What is Medi-Share?

Medi-Share is a health-care sharing ministry made up of members united by their faith.

This program and similar medical-sharing ministries are exempt from the rules of the ACA. They rely on their members to take care of one another through financial contributions, as well as prayer.

The details work much like typical health insurance. Like having a deductible, members choose an amount they’ll contribute as a household before they can submit bills to the community for payment assistance.

A monthly share payment works like a premium, ensuring your eligibility for assistance, should you need it.

There’s no guarantee your medical expenses will be covered through Medi-Share, and there are plenty of exemptions to consider before you apply.

But if you’re particularly religious — and healthy — you may want to consider this alternative to traditional health insurance.

How Much Does Medi-Share Cost?

First, the up-front costs: It costs $50 to apply, and you’ll pay a $120 one-time member fee with your first monthly payment.

You’ll pay another one-time fee of $5 to have America’s Christian Credit Union (ACCU) set up your “sharing account,” and you can then save $3 per month by choosing to receive ACCU electronic statements.

As for your monthly payment options, Medi-Share’s system is sort of like choosing a health insurance deductible and monthly premium.

As an example, we calculated costs for a 30-year-old woman seeking membership for herself only. Share amounts change annually, based on the oldest member of the household.

If she chose a $1,250 annual household portion — the amount of medical bills you have to pay completely before you’re eligible for sharing — her standard monthly share would be $235.

If she met certain health and fitness requirements, she could qualify for a Healthy Monthly Share, which would lower her cost to $207 per month.  

When you need medical care and visit a Medi-Share provider, you pay $35 for doctor visits and hospitalizations, and $135 for emergency room visits.

A search for providers near The Penny Hoarder HQ in St. Petersburg, Florida, turned up 171 doctors, including plenty of nearby options for internal medicine, pediatrics and even specialties like sports medicine.

You submit the rest of your bills to Private Healthcare Systems (PHCS) for payment consideration.
“We do not collect premiums, make promise of payment, or guarantee that your medical bills will be paid,” the Medi-Share website explains. “Sharing of medical bills is completely voluntary.”

Christian Care Ministry, which operates Medi-Share, is a 501(c)3, but your payments aren’t tax-deductible.

We asked personal finance blogger Philip Taylor (no relation to our founder Kyle Taylor), about his Medi-Share costs for his family of five. He signed up for Medi-Share in 2014, and has updated his review of the service several times since joining.

Taylor initially signed up with a family share of $277 per month, which was a huge savings over his old insurance premium of $1,100 per month.

“My share cost is now $288 per month,” he says. “So we’re still experiencing a tremendous amount of savings.”

Do You Need to Be Religious to Use Medi-Share?

Just as Medi-Share embraces the idea of a community of members supporting one another, it also believes in having a membership that embraces Christian lifestyles.

The organization may even interview a church leader to verify your involvement before granting you membership. In addition to eschewing tobacco and illegal drug use, applicants “must only engage in sexual relations within a Biblical Christian Marriage.”

And as you might suspect, Medi-Share doesn’t cover abortions or treatment for sexually transmitted infections.

Medi-Share also assumes that if you’re willing to take care of your Christian community by sharing the burden of medical bills, you’ll do your best to take pretty good care of yourself.

Some health conditions, like obesity, high cholesterol or diabetes, put applicants in the mandatory Health Partner program, which pairs you with a health coach and costs an extra $80 per month.

What If You Have an Ongoing Health Condition?

While this might be an appealing option if you’re healthy, anyone who suffers from a chronic health issue is probably better off turning to an ACA health insurance program for coverage.

“The primary purpose of Medi-Share is to help share members’ burdens,” the program explains.

“Burdens are those unexpected medical bills you are unable to plan for (ie. broken bones, cancer, etc). Low monthly share amounts enable you to budget for your family’s routine care, which can be planned.”

Prescription drugs can be eligible for cost-sharing, but only for up to six months for the lifetime of the member.

Likewise, if you have mental health conditions, you probably won’t benefit financially from Medi-Share.

“Those with persistent mental health conditions, who need expensive prescriptions and therapy, would likely not see much benefit from becoming a member,” The Atlantic explained in a report on Medi-Share and similar programs.

But here’s the big catch: Routine health screenings aren’t eligible for cost-sharing either.

Well-patient care like annual physicals, pap smears and well-child checkups aren’t included. Dental and vision care aren’t eligible, either.

For instance, if your doctor recommends getting a colonoscopy because you’ve reached a certain age, you can’t submit the test for Medi-Share payment. If you have symptoms warranting the same test, the program might grant payment.

So, Is Medi-Share Legit?

Here’s our conclusion: Medi-Share isn’t a scam.

It’s totally legal and there’s a strong membership base to support it and similar programs.

But it’s likely not the most affordable health care option for most people. The ideal candidate for Medi-Share is in excellent health and also has a robust savings account to pay out of pocket for routine medical care.

One risk: Medi-Share and other cost-sharing programs aren’t subject to regulation like typical ACA programs.

So while a typical health insurance benefits booklet might clearly explain what’s covered and guarantee coverage up to a certain amount or percentage, Medi-Share participants might not be able to figure out ahead of time which medical bills will be paid by the program.

In addition, the cost-benefit analysis might not work in your favor. For example, let’s look at what one of our writers pays for health insurance.

She has coverage through her state’s ACA exchange and pays $220 per month. She has a deductible of $1,500 and pays $25 each time she visits any doctor’s office. Medication for her ongoing conditions costs her less than $10 per month with her plan’s coverage.

She might not be as wholesome as the typical Medi-Share member, but she’s paying about the same to stay in pretty good health.

While Medi-Share probably isn’t the best financial choice for most people, it does at least serve as an option for anyone who doesn’t have access to a job-sponsored health insurance plan or who finds individual ACA coverage options prohibitively expensive.

Taylor explained the magic combination of factors that makes Medi-Share worth considering:

If you: Don’t have access to an employer-based group health insurance plan, don’t mind being held to the lifestyle standards, make enough money to miss out on Obamacare subsidies, and don’t have ongoing major medical issues.

He noted that a Medicaid or ACA plan probably better serves those with chronic conditions.  

For Taylor, the numbers definitely work out. “I feel bad for those that don’t have this choice,” he said.

Your Turn: Have you tried Medi-Share? We’d love to hear about your experience.

The post Should You Consider Medi-Share for Health Insurance? Here’s Our Take appeared first on The Penny Hoarder.



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