A couple weeks ago, Blue Cross sent me the notice of my 2016 premium amount. It was $1,600/month for my wife and me. For many people that is a mortgage payment. And, it will go up a lot again next year. That’s for 70/30 sharing and a $5,000 per person deductible.
After doing a lot of research I decided to fire Blue Cross after a decades of using them. I replaced them with a medical cost sharing program with premiums of $449/month plus the costs of medications. And, it is 100% coverage, not 70/30 and the deductible, which they call a “non-shared amount” is about $1,200, not $5,000 and it is by family, not per person. I figure we will save $1,000 a month. And, we will have far better coverage.
They call it sharing because you are part of a large pool of people that voluntarily pay each other’s medical expenses according to the program guidelines.
There are three medical sharing programs I know of. All are run by Evangelical Christian organizations. My two daughters have been in the Samaritan program for a year or two and it has worked very well for them. I chose the Liberty HealthShare program.
These are cost-sharing programs rather than insurance but the Affordable Care Act creates an exemption for them because they are so much like insurance. So, there is no fine for not having traditional health insurance.
I don’t see a big difference in practice, but because they are not insurance they get around a lot of regulatory costs and cut costs by excluding pre-existing conditions and only covering a pool of people (Christian Evangelicals) that tends to have better health. Liberty HealthShare does cover preexisting conditions after 12 months.
According to their websites, Samaritan has 50,000 members while Medishare has 164,000 members and has paid out more than $1 billion. I don’t have a size for Liberty HealthShare.
Samaritan Ministries http://samaritanministries.org/costs/monthly
Some details on Liberty:
1) Family plan cost for the Complete option is $449/mo, though they may add $80 for a member with serious health conditions. Premiums don’t vary by age except for those in their early 20s.
2) Sharing on preexisting conditions starts after 12 months, with up to $25,000 in coverage, then $50,000 the third year. After that there is no cap.
3) Coverage is 100%, not the normal Blue Cross 80/20 or 70/30 splits on medical costs.
4) There are no co-pays for things like doctor visits.
5) The first $1,200 per family of expenses each year are not shared.
6) Prescription meds are not covered except for 45 days on either side of a hospitalization, but there is a discount card from Envision which they say discounts meds by 40%. I would also consider using WalMart, Costco or GoodRx to keep med costs down, maybe even a compounding pharmacy
7) They will not cover any medical expenses resulting from alcohol or tobacco use. Light or moderate drinking is OK, they just won’t cover medical expenses like if you get drunk and get in an accident
8) There is an Evangelical statement of belief to sign
9) There is $10,000 of life insurance included
There is no longer any reason to be insurance poor if you are self-employed or your employer doesn’t provide health insurance. You are welcome to call me about this. However, I don’t sell anything related to the program or get any compensation related to them. As my website explains (see Why Fee-Only?), I don’t receive commissions from anyone, ever. And on this, I don’t charge my normal quarterly fee. It’s my contribution to lowering health care costs for people that are tired of being insurance-poor and don’t need to be.