As an insurance agent who sells all kinds of insurance to include health insurance, this renewal year my family was personally faced with yet again a large health insurance increase (38% Increase) in insurance premiums for my family. This is just one of many large increases that we have faced each year. For my family of 5 premiums ranged from $1010 for the H.S.A. Bronze plan to $2,158 per month for the platinum plan. Over the years I have decreased my coverage from the platinum all the way down to the Bronze H.S.A. plan in an attempt to combat the large year over year increases. Now that we are at the lowest plan level option out available on market when I was faced with a 38% increase I was faced with two options. Option 1 was was cancel our insurance and pray we don’t have any insurance needs that come up. Option 2, I looked up any possible alternative options online.
Here is what I uncovered in the alternative market place. I found several good options that were available which are: Christian Care Ministry – Medi-Share, Samaritan Ministries, Liberty Health Share, and Christian Health Share Ministries. It is important to mention that none of these programs are insurance companies, but rather they are nonprofit organizations. They are not regulated by the department of insurance so there is no guarantee they will pay for your medical cost. They do require that you abide by their standards and they also have pre-existing condition clauses. I say this as this is not meant for everyone. All of these organization will require you to agree with their statement of Faith in God and abide by a specific standard of living.
As I reviewed each plan here is what I found from a monthly Cost basis.
(Cost for all 3 Share Ministries is based on an age of 40 years old and 3 or more covered individuals)
Christian Care Ministry – Medi-Share:
|ANNUAL HOUSEHOLD PORTION||STANDARD MONTHLY SHARE||HEALTHY MONTHLY SHARE|
This organization will feel the most like insurance. It has built in co-pays and all bills are taken care of like a normal insurance plan. They are part of the PHCS network (Broad access to nearly 4,400 hospitals, 79,000 ancillaries and more than 700,000 healthcare professionals) so your Doctors should be familiar with how to bill for their services. This also ensures the bill will have pre-negotiated rates (verses you have to negotiate on your own). If your Doctor is not under the network you can still go to that Doctor. This would mean that the rates would not be pre-negotiated, so you would be responsible for the higher cost until you have met your Annual Household Portion (unless you can negotiate a lower cost on your own).
Office Visit Co-Pay: $35.00
Tele-medicine Co-Pay: $0.00
Emergency Room Co-Pay: $135.00
Hospital Co-Pay: $35.00
Medi-Share has no lifetime maximum shareable caps/limits.
Once your Annual Household Portion (Family deductible/Max Out of Pocket) is met your sharing amount is 100%
If you have a healthy family you can qualify for “Healthy Monthly Share” and your monthly share amount (premiums) can be reduced by 20%
This organization, you will be responsible for paying the doctors or hospital directly. You will be responsible for negotiating directly with each Doctor or Hospital in an attempt to lower the overall bill. You would then submit the bill to Samaritan Ministries and they would notify all members of the shareable amount and each member would write a check directly to you. At which time you would write a check directly to the Doctor or Hospital for their services. The good news is for each dollar you lower your bill Samaritan Ministries will decrease your share amount, so you could owe no money for that bill depending on the amount of the savings.
Samaritan Basic shares range from $100 per month for an individual 29 years old or less to $400 for a family of 3 or more with the oldest active Head Of Household 60 years old or older. There are 10 different amounts between those depending on household size and age of oldest active Head Of Household.
Initial Unshareable Amount (Sharing starts once a Need exceeds this threshold): $1,500
Sharing Percentage (The amount shareable once past the initial unshareable): 90%
Maternity Limit (The maximum that can be shared for a maternity Need): $5,000
Max Shareable (The maximum that’s shareable per Need): $236,500
Samaritan Classic shares range from $160 per month for an individual under 30 years old to $495 per month for a family of 3 or more. There are 3 different amounts between those depending on household size and age of oldest active Head Of Household.
Initial Unshareable Amount (Sharing starts once a Need exceeds this threshold): $300
Sharing Percentage (The amount shareable once past the initial unshareable): 100%
Maternity Limit (The maximum that can be shared for a maternity Need): $250,000
Max Shareable (The maximum that’s shareable per Need): $250,000
For their Save to Share addition, the annual set-aside amount ranges from $133 for an individual to $399 for a family of 3 or more, with a $15 annual fee for all. This is for needs over $250,000 in which you can sign up – So for us (a family of 5) we would add the annual fee of $399 plus $15 annual administrative fee which makes our monthly share $529.50
Liberty Health Share
This organization is similar to traditional insurance. You would be responsible for your Annual Unshared Amount (AUA) first and than if the bill exceeds your Annual Unshared Amount that amount would then be shared assuming the bill meets the guidelines.
Liberty Complete ($449 per month) – Share Eligible Medical Bills up to $1,000,000 Per Incident.
Liberty Plus ($424 per month) – Share Eligible Medical Bills up to $125,000 Per Incident
Liberty Share ($395 per month) – 70% of Eligible Medical Bills up to $125,000 Per Incident
*Annual Unshared Amount (AUA): $500 for an individual | $1,000 for a couple | $1,500 for a family
Christian Health Share Ministries
This organization you will be responsible for paying the doctors directly. You will be responsible for negotiating directly with each Doctor or Hospital in an attempt to lower the overall bill. They do not have a provider network with pre-negotiated fees.
Gold Program: $150 per unit, per month – $450 (for my family of 5) – $478 if purchase Brother’s Keeper (see below)
Silver Program: $85 per unit, per month – $255
Bronze Program: $45 per unit, per month – $135
|Personal Responsibility||No Personal Responsibility for medical incidentsexceeding $500; please see description and example above||$1,000 per medical incident||$5,000 per medical incident|
|Sharing limit||$125,000 per illness||$125,000 per illness||$125,000 per illness|
|Sharing limit w/Brother’s Keeper (more information)||Unlimited per illness||An additional $100,000 per illness, per year; up to $1 million||An additional $100,000 per illness, per year; up to $1 million|
|Surgery (Performed at a facility that meets accepted standards of care)||Included||Included||Included|
|Doctor’s office visits||Incident-related||Not included||Not included|
|Prescriptions (more information)||Incident-related||Not included||Not included|
|Physical therapy/home healthcare||Up to 45 visits per incident||Not included||Not included|
|Maternity||Up to $125,000 per pregnancy or unlimited w/Brother’s Keeper||Only hospital treatment (up to $125,000 per pregnancy) or up to $2,500 for midwife services per pregnancy||Only hospital treatment (up to $125,000 per pregnancy) is eligible for sharing|
|Alternative care||Not included||Not included||Not included|
You can also join GOLD PLUS BROTHER’S KEEPER which will provide additional share amounts depending on which program you sign up for.
Brother’s Keeper provides an added shareable amount against catastrophic illness or injury as long as it meets the CHM Guidelines.
Gold level members: Signing up for Brother’s Keeper provides unlimited cost support per illness (diagnosis).
Silver and Bronze members: Signing up for Brother’s Keeper provides an additional $100,000 of cost support. With each annual Brother’s Keeper renewal, participants receive an additional $100,000 of assistance, up to $1 million per illness.
Brother’s Keepers cost on average $100 annually per unit/member. They cap family units/members at three so annual cost would be $300 plus a $40 annual fee.
My family decided to go with Christian Care Ministries – Medi-Share. I liked the fact that it felt the most like insurance (requiring me to do the least amount of work). In addition, I like the overall cost of their program. By joining Charistian Care Ministries I lowered my max out of pocket down to $7,500 per year for my entire family and decreased my monthly cost down to $289 per month as we qualified for the Healthy Monthly Share. That is a total savings of $721 per month or $8,652 per year. Based on these savings if my family ends up in the hospital with a large bill I will still save $1,152 just in my old premiums not including my co-pays / co-insurance / Deductible of $9,600 / Max out of pocket of $13,100. At this point I am happy with my decision and I will keep you posted as we use this program. Again, please keep in mind that this is NOT insurance, but it does qualify under the religious exemption under the ACA. I understand that the program I picked may not be the best program for you and your family.
If you would like to save money on your Health cost please give me a call and I will help you and your family pick the best option for you.