Health Shares - Need your opinion!?

[thcguy12]

This is a question for all you agents out there ---

I am a member of MediShare right now.
We recently had a week long hospital stay, five ER visits, etc - the bill was $70,000+
MediShare covered and paid everything except our ADA (deductible) which was $3750.
Worked great. I would highly recommend them!

But they are raising prices and I have to switch - I also want more things like office visits, wellness exams, etc and they don't offer any of that until you meet your deductible (ADA). So I am trying to decide between OneShare, Solidarity Healthshare, Altrua, or just a basic Anthem Blue Cross plan.

---

OneShare has best benefits (3 fully paid office visits, 1 urgent care paid, 1 wellness visit per year, and 1 ER visit - all paid in full). But then the deductible for any other services (hospital, MRI, CAT scan, surgery, disease, etc is $10K. Then they pay in full after that - so it's basically a catastrophic plan with some office visits, etc thrown in. $211 a month.

Solidarity says we just have to pay the first $500 (that is our deductible) - then everything else is covered at 100%. Seems great BUT I heard they pay slow - 1-3 months. $199 a month

Altrua sounds great but my insurance agent said people are flocking away because of slow paying and bad customer service. So not going to consider that one. Also heard Liberty Healthshare pays horribly slow so staying away from that.

Anthem Blue Cross (we all know them). You pay a bunch per month, pay some copays, and still pay even more when the bill arrives until you reach deductible. They you still have to pay some till you reach $6000 and finally they cover everything - hopefully. But it's real insurance and probably best option is something crazy happened. $240 a month

ANY THOUGHTS ON WHAT TO DO?!
I AM HEALTHY, 38 YEARS OLD, MALE - never had a stitch or been to ER or hospital or anything - no pre-existings. Maybe see doctor twice a year for minor stuff like prescription refills, aches and pains, flu, etc.

[BruDude]

Just be aware that the health share plans are not insurance and have no obligation to pay your claims. If your claim was $700k would they still have paid it? Who knows. What about $2M? Insurance companies are required by law to pay your claims. Health sharing companies are playing with fire IMO.

[sawhorse]

I know that it's not uncommon for health shares to pay for 45 days of a prescription, and then you're on your own. Prescription drugs can run several thousands of dollars a month. Something to look into when researching plans.

[stlutz]

How much was the price increase on MediShare? Whatever you pick the price will go up every year.

[Tamarind]

In your shoes I would switch to ACA bronze coverage. It's real insurance, and has the benefit of a cap to premiums based on your income. It'll have a similar deductible, several K but not back breaking. And you'll get some tax benefit from a family HSA that you don't get with the health share.

You are healthy and seldom need care, but someone else in your family clearly can generate large medical bills and probably needs actual insurance to reduce risk. The truth is, you can too. I understand healthshares's cheapness is attractive, but I just can't bring myself to recommend them, particularly not for kids or someone with a known health condition.

Perhaps you could find a healthshare for yourself while putting other family members on ACA?

[thcguy12]

Sally the bronze plan is out of budget too.

[Nate79]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

[BruDude]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

The issue isn't lack of experience with them, it's the what if scenario for a very large claim amount. I'm sure it's fine for a doctor's office visit here and there, but if you had a claim for $1M+, are they just going to stroke that check no questions asked?

[Phineas J. Whoopee]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

We are not against health sharing ministries. We are only against misunderstandings about them, including that they are the same as state-regulated health insurance.

Of course any individual, and many individuals, will have had positive experiences with them.

They're just not health insurance. They're legally allowed, a small number of them which were pre-existing, under the Affordable Care Act.

But they're not insurance products and have no legal obligation to pay claims.

So long as one fully understands them choosing one is up to the individual. Of course.

PJW

[Nate79]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

The issue isn't lack of experience with them, it's the what if scenario for a very large claim amount. I'm sure it's fine for a doctor's office visit here and there, but if you had a claim for $1M+, are they just going to stroke that check no questions asked?

Are you asking if they do cover large claims or are you stoking a fear on a maybe situation? Yes, I have heard anecdotal evidence that reputable health sharing services do pay when required, even large claims.

[Nate79]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

We are not against health sharing ministries. We are only against misunderstandings about them, including that they are the same as state-regulated health insurance.

Of course any individual, and many individuals, will have had positive experiences with them.

They're just not health insurance. They're legally allowed, a small number of them which were pre-existing, under the Affordable Care Act.

But they're not insurance products and have no legal obligation to pay claims.

So long as one fully understands them choosing one is up to the individual. Of course.

PJW

Sorry, this is BS fear mongering. Labeling something as "not insurance" and "no legal obligation to pay claims" just tries to stoke fear in users. There are 10x more threads on here of insurance companies not paying (whether or not they are legally required they fight tooth and nail to not pay) and I don't recall a single thread on BH of a health sharing plan not paying - and there have been a number of users of them on here. Real insurance plans create all these complicated rules to not have to pay and the insured is stuck with balance billing and other crazy things all thanks to these real insurance products. By the way, I have health insurance thru my work and have never used health sharing plans. The extreme negative opinion of them on BH is obscene.

[BruDude]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

The issue isn't lack of experience with them, it's the what if scenario for a very large claim amount. I'm sure it's fine for a doctor's office visit here and there, but if you had a claim for $1M+, are they just going to stroke that check no questions asked?

Are you asking if they do cover large claims or are you stoking a fear on a maybe situation? Yes, I have heard anecdotal evidence that reputable health sharing services do pay when required, even large claims.

I'm not stoking a fear of anything, I'm bringing up a legitimate reason against joining a health share (probably the most important reason). These products are not regulated by the states, do not have reserve money requirements like insurance companies, and have no obligation to pay any claims that they don't want to pay.

Perhaps they feel you are not complying with the religious requirements of the plan and decide to deny a claim. Perhaps they decide not enough members have contributed to cover your very expensive claim without putting the company's financial viability at risk. Perhaps they feel the procedure requiring such a large expense doesn't meet their code of conduct. With no oversight from state and federal regulations/requirements, you would not have a leg to stand on if one of these scenarios became reality. These are all very real possibilities.

[AerialWombat]

Since you are at least open to healthshares, take a look at one you didn’t mention: CHM. I have been with them a little over a year. I’m on the $45/mo plan. They have paid what I needed paid, and I like their admin process.

https://www.chministries.org

[HueyLD]

Michael Kitces has a blog on this subject. It is worth a read.

https://www.kitces.com/blog/healthcare- ... are-plans/

[JoeRetire]

Sally the bronze plan is out of budget too.

Out of budget?

Have you checked into premiums with subsidies?

[Phineas J. Whoopee]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

We are not against health sharing ministries. We are only against misunderstandings about them, including that they are the same as state-regulated health insurance.

Of course any individual, and many individuals, will have had positive experiences with them.

They're just not health insurance. They're legally allowed, a small number of them which were pre-existing, under the Affordable Care Act.

But they're not insurance products and have no legal obligation to pay claims.

So long as one fully understands them choosing one is up to the individual. Of course.

PJW

Sorry, this is BS fear mongering. Labeling something as "not insurance" and "no legal obligation to pay claims" just tries to stoke fear in users. There are 10x more threads on here of insurance companies not paying (whether or not they are legally required they fight tooth and nail to not pay) and I don't recall a single thread on BH of a health sharing plan not paying - and there have been a number of users of them on here. Real insurance plans create all these complicated rules to not have to pay and the insured is stuck with balance billing and other crazy things all thanks to these real insurance products. By the way, I have health insurance thru my work and have never used health sharing plans. The extreme negative opinion of them on BH is obscene.

Thank you for characterizing my factual post in the way you did.

Except, I don't think people should enter into agreements unless they understand them. The truth that doing so is common in our modern society, including and also very far beyond paying for healthcare, doesn't change the facts.

PJW

[adamthesmythe]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

Perhaps the negativity is a consequence of an unusual amount of fear, verging on paranoia. Consider the discussion of maximum withdrawal rate (is 2% safe enough?); inflation (how many TIPs do I need?); and institutional failure (can I really trust my SPIA company?).

Having said that- I would be interested to hear why it is believed that healthshare is cheaper. Possible reasons are

- less administrative overhead
- no profit
- limited benefits
- reduced illness because of biblical lifestyle
- other?

[Nate79]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

Perhaps the negativity is a consequence of an unusual amount of fear, verging on paranoia. Consider the discussion of maximum withdrawal rate (is 2% safe enough?); inflation (how many TIPs do I need?); and institutional failure (can I really trust my SPIA company?).

Having said that- I would be interested to hear why it is believed that healthshare is cheaper. Possible reasons are

- less administrative overhead
- no profit
- limited benefits
- reduced illness because of biblical lifestyle
- other?

I think it is a combination of all of these but especially the limited benefits. They are clear on what they do and do not cover. It is certainly true that they cover less than normal insurance. They do not hide this fact (for example pre-existing conditions is a big one). Maybe they have less highly sick people as well which drives down costs.

The fact is that medical insurance (and the medical industry as a whole) is a abysmal functioning black hole in this country and the number of complaints on here is astronomical. It would be one thing if health insurance was faultless and there were no issues with it but it's not. It's an absolute mess and I believe people on heath sharing plans (for the majors like CHS) are far more happy than those with health insurance.

The Kites article was pretty good and pretty fair reading vs the fear mongering that is typical on this site and in this thread.

[Phineas J. Whoopee]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

Perhaps the negativity is a consequence of an unusual amount of fear, verging on paranoia. Consider the discussion of maximum withdrawal rate (is 2% safe enough?); inflation (how many TIPs do I need?); and institutional failure (can I really trust my SPIA company?).

Having said that- I would be interested to hear why it is believed that healthshare is cheaper. Possible reasons are

- less administrative overhead
- no profit
- limited benefits
- reduced illness because of biblical lifestyle
- other?

I think it is a combination of all of these but especially the limited benefits. They are clear on what they do and do not cover. It is certainly true that they cover less than normal insurance. They do not hide this fact (for example pre-existing conditions is a big one). Maybe they have less highly sick people as well which drives down costs.

The fact is that medical insurance (and the medical industry as a whole) is a abysmal functioning black hole in this country and the number of complaints on here is astronomical. It would be one thing if health insurance was faultless and there were no issues with it but it's not. It's an absolute mess and I believe people on heath sharing plans (for the majors like CHS) are far more happy than those with health insurance.

The Kites article was pretty good and pretty fair reading vs the fear mongering that is typical on this site and in this thread.

I see no point in insisting on impossible conditions. Nothing will ever be, to use your word, faultless.

The things that will never be faultless I refer to include health-sharing ministries. I do not demand they be faultless. I only want the people who choose them to understand the implications of their choice.

PJW

[bottlecap]

Just be aware that the health share plans are not insurance and have no obligation to pay your claims. If your claim was $700k would they still have paid it? Who knows. What about $2M? Insurance companies are required by law to pay your claims. Health sharing companies are playing with fire IMO.

People don't insure for $700k in medical bills. They file bankruptcy.

JT

[Patent Guru]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

The issue isn't lack of experience with them, it's the what if scenario for a very large claim amount. I'm sure it's fine for a doctor's office visit here and there, but if you had a claim for $1M+, are they just going to stroke that check no questions asked?

How would anyone accrue a million dollar hospital bill? Maybe over years and years? Maybe with very specialized unorthodox treatments. Even then how would a million dollars accrue? I had open Heart surgery. Hospital bill was 123k. Insurance paid 36k. Hospital wrote off the rest.

[BruDude]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

The issue isn't lack of experience with them, it's the what if scenario for a very large claim amount. I'm sure it's fine for a doctor's office visit here and there, but if you had a claim for $1M+, are they just going to stroke that check no questions asked?

How would anyone accrue a million dollar hospital bill? Maybe over years and years? Maybe with very specialized unorthodox treatments. Even then how would a million dollars accrue? I had open Heart surgery. Hospital bill was 123k. Insurance paid 36k. Hospital wrote off the rest.

I have seen million dollar claims from a single incident, it's not as hard as you think. One of my clients had two premature babies, the insurance company paid over $1M in claims on each. An air ambulance ride can cost $50-$100k for a longer distance, even a short trip can be $30k+. What does a 30-day stay in ICU cost? 60 days? 6 months? Living in a coma for a year in a hospital? A year's worth of cancer treatments?

Just be aware that the health share plans are not insurance and have no obligation to pay your claims. If your claim was $700k would they still have paid it? Who knows. What about $2M? Insurance companies are required by law to pay your claims. Health sharing companies are playing with fire IMO.

People don't insure for $700k in medical bills. They file bankruptcy.

JT

Not sure if you're serious....that's exactly why people buy health insurance. What's your plan if you have $2M in assets and $700k in bills? Can't file for bankruptcy for that.

[GlacierRunner]

How would anyone accrue a million dollar hospital bill? Maybe over years and years? Maybe with very specialized unorthodox treatments. Even then how would a million dollars accrue? I had open Heart surgery. Hospital bill was 123k. Insurance paid 36k. Hospital wrote off the rest.

I count among my acquaintance the following who have had $1million+ medical bills in a single year:
3 months in a burn center
premature baby in the NICU for months
heart transplant
liver transplant
hemophilia

Just be aware that the health share plans are not insurance and have no obligation to pay your claims. If your claim was $700k would they still have paid it? Who knows. What about $2M? Insurance companies are required by law to pay your claims. Health sharing companies are playing with fire IMO.

People don't insure for $700k in medical bills. They file bankruptcy.

JT

This is exactly why I have a health benefit plan. If people want to go uninsured and file bankruptcy that is there business...except that it increases the cost of everyone's care when the hospital shifts costs to the insured population.

Sorry, this is BS fear mongering. Labeling something as "not insurance" and "no legal obligation to pay claims" just tries to stoke fear in users.

It is a fact that HSM are not insurance and have no legal obligation to pay claims. If you read the disclosures on the HSM enrollment and plan materials you will know that they are not insurance and they have no legal obligation to pay. Consumers remain responsible for all of their medical bills and the HSM determines whether they will reimburse and how much. Not trying to argue, just providing information about the fine print of these products.

[runner540]

You can search for past threads on Health Shares. Unfortunately BH is extremely negative against these products even though almost none of the posters have actual experience with them. Generally I have heard very positive feedback and reviews about the major health share plans and would not be afraid to use them.

You can only afford what you can afford. If there is not a health insurance plan on ACA that is affordable then using a health sharing plan is a good choice so that at least you have coverage. Ignore the scaremongering.

The issue isn't lack of experience with them, it's the what if scenario for a very large claim amount. I'm sure it's fine for a doctor's office visit here and there, but if you had a claim for $1M+, are they just going to stroke that check no questions asked?

How would anyone accrue a million dollar hospital bill? Maybe over years and years? Maybe with very specialized unorthodox treatments. Even then how would a million dollars accrue? I had open Heart surgery. Hospital bill was 123k. Insurance paid 36k. Hospital wrote off the rest.

Consider yourself, family and friends very fortunate that you don't know.

Premature birth, a month or two or three in the NICU. 1/10 births are premature and the rate is rising https://www.cdc.gov/reproductivehealth/ ... mbirth.htm

That's why ACA eliminated annual and lifetime maximum benefits, so an infant wouldn't run out of coverage in their first months of life.

[madbrain]

People don't insure for $700k in medical bills. They file bankruptcy.

What about $60k/year in medical bills for prescriptions ? You can't file bankruptcy for those.

[madbrain]

How would anyone accrue a million dollar hospital bill? Maybe over years and years? Maybe with very specialized unorthodox treatments. Even then how would a million dollars accrue? I had open Heart surgery. Hospital bill was 123k. Insurance paid 36k. Hospital wrote off the rest.

I had a 4 day hospital stay in january. I paid the $250 admission fee under my HMO. I never received an EOB. I went looking for it on Kaiser's web site. It was $37k. No surgery was involved. At this rate you would accrue $1M in 108 days in the hospital. I actually had a hospital day of this length as a teenager. But this was in a country with universal healthcare. My parents never mentioned any bill.

[LeeInTN]

OP, You might also wish to consider some of the new non-ACA health insurance underwritten by real insurance companies. The prices for those are competitive with the Healthshares' monthly amounts. Full disclosure: we have been members of a Healthshare for over 4 years and have been aware of slow-pay situations. Things do get paid; even major surgeries. Just don't be in a hurry, and follow all rules for pre-certs, etc.

[adamthesmythe]

Just be aware that the health share plans are not insurance and have no obligation to pay your claims. If your claim was $700k would they still have paid it? Who knows. What about $2M? Insurance companies are required by law to pay your claims. Health sharing companies are playing with fire IMO.

People don't insure for $700k in medical bills. They file bankruptcy.

JT

That works only if you have no, or few assets to lose. Because most of your assets will need to be gone before filing bankruptcy.

Many of the people on this board are concerned about having assets for a comfortable retirement. Losing all your assets because of a catastrophic medical event is exactly why good health insurance is so highly valued. Admittedly this is a fairly unlikely event...but so is tornado damage to your house, a million-dollar slip and fall lawsuit,...

I would agree that the risk is small, and maybe acceptable, for young people who have not yet accumulated significant assets. They might choose to run the (much smaller for them) risk. Of course, they might never be able to recover after a health-care induced bankruptcy if earning power was much degraded.

[AerialWombat]

OP, You might also wish to consider some of the new non-ACA health insurance underwritten by real insurance companies. The prices for those are competitive with the Healthshares' monthly amounts. Full disclosure: we have been members of a Healthshare for over 4 years and have been aware of slow-pay situations. Things do get paid; even major surgeries. Just don't be in a hurry, and follow all rules for pre-certs, etc.

This is what I did for a few years, before switching to CHM last year. At the time, short-term insurance was limited to three month plans, so every quarter I had to apply for a new plan. Now, with 12-month plans, they are much more attractive, and comparable to the health share monthly , as you said.

[Nate79]

How would anyone accrue a million dollar hospital bill? Maybe over years and years? Maybe with very specialized unorthodox treatments. Even then how would a million dollars accrue? I had open Heart surgery. Hospital bill was 123k. Insurance paid 36k. Hospital wrote off the rest.

I count among my acquaintance the following who have had $1million+ medical bills in a single year:
3 months in a burn center
premature baby in the NICU for months
heart transplant
liver transplant
hemophilia

Just be aware that the health share plans are not insurance and have no obligation to pay your claims. If your claim was $700k would they still have paid it? Who knows. What about $2M? Insurance companies are required by law to pay your claims. Health sharing companies are playing with fire IMO.

People don't insure for $700k in medical bills. They file bankruptcy.

JT

This is exactly why I have a health benefit plan. If people want to go uninsured and file bankruptcy that is there business...except that it increases the cost of everyone's care when the hospital shifts costs to the insured population.

Sorry, this is BS fear mongering. Labeling something as "not insurance" and "no legal obligation to pay claims" just tries to stoke fear in users.

It is a fact that HSM are not insurance and have no legal obligation to pay claims. If you read the disclosures on the HSM enrollment and plan materials you will know that they are not insurance and they have no legal obligation to pay. Consumers remain responsible for all of their medical bills and the HSM determines whether they will reimburse and how much. Not trying to argue, just providing information about the fine print of these products.

Are you saying you have acquaintances who had huge medical bills and their Medi share plan didn't pay?

Or are you saying they had huge medical expenses on traditional insurance and their insurance company paid all as planned and no balance billing, surprise bills from out of network docs in the emergency room, etc?

[GlacierRunner]

Are you saying you have acquaintances who had huge medical bills and their Medi share plan didn't pay?

Or are you saying they had huge medical expenses on traditional insurance and their insurance company paid all as planned and no balance billing, surprise bills from out of network docs in the emergency room, etc?

Neither. The question was how does one have a $1 million medical bill.

[quantAndHold]

The question was how does one have a $1 million medical bill.

40% of the time, it’s a blood disorder. 30% of the time it’s cancer. The rest is “other.”

https://www.marketwatch.com/story/milli ... 2018-07-16

The people that I personally know who have had $1M+ in medical bills all have some form of leukemia or another.

[SandysDad]

I would surmise that 99.x% of Health Sharing Ministry participants are satisfied with their choice because 99.x% of their participants have not had six or severn figure claims to deal with.

If regular insurance companies were allowed to deny large claims, expensive prescription drugs and preexisting conditions their rates probably would not be all that different from the ministries perhaps? (this is because most insurance dollars go to the above).

Personally, I am not buying insurance for a 10K claim. I am buying it for a 100K or $1M claim.

[Broken Man 1999]

Are you saying you have acquaintances who had huge medical bills and their Medi share plan didn't pay?

Or are you saying they had huge medical expenses on traditional insurance and their insurance company paid all as planned and no balance billing, surprise bills from out of network docs in the emergency room, etc?

Neither. The question was how does one have a $1 million medical bill.

One way is to be hospitalized from March to October, undergo several operations, pick up a few nasties whilst in the hospital, etc.

Those charges were in 1999. A bit more today, I would wager. I didn't have a clue as I was under for one reason or another a great deal of the time, sometimes by doctors choice, sometimes not. The only thing I remember from the trauma center was a swallowing test. Nothing else. No idea why that memory stuck.

Fortunately I had great insurance, but the bills were over a mil. Apparently a lien was placed on the casa according to DW.

Broken Man 1999

[BruDude]

Just saw this article on Kaiser Health news, some food for thought:

https://khn.org/news/sham-sharing-minis ... 4paJBTZxeU

[ronno2018]

Can you get a job that provides some health insurance? Part time maybe?

I mean if you say ACA plans are too expensive what are your living costs?

Penny wise and pound foolish I say to you.

Hopefully USA health regs will change again to outlaw these crazy health "mysteries" and give us all affordable non-employer based coverage like normal countries do...

[Nate79]

Just saw this article on Kaiser Health news, some food for thought:

https://khn.org/news/sham-sharing-minis ... 4paJBTZxeU

The food for thought is don't sign up with sham companies which is not a problem with the major sharing programs?

Here is some more food for thought:

https://www.npr.org/sections/health-sho ... bill-probl

[BruDude]

Just saw this article on Kaiser Health news, some food for thought:

https://khn.org/news/sham-sharing-minis ... 4paJBTZxeU

The food for thought is don't sign up with sham companies which is not a problem with the major sharing programs?

Here is some more food for thought:

https://www.npr.org/sections/health-sho ... bill-probl

The food for thought is the "major" share companies have the same regulations as the sham ones - none.

Wonder if they will be covering this new $2.1 million drug - https://www.npr.org/sections/health-sho ... -drug-ever

[Silk McCue]

Just saw this article on Kaiser Health news, some food for thought:

https://khn.org/news/sham-sharing-minis ... 4paJBTZxeU

The food for thought is don't sign up with sham companies which is not a problem with the major sharing programs?

Here is some more food for thought:

https://www.npr.org/sections/health-sho ... bill-probl

The food for thought is the "major" share companies have the same regulations as the sham ones - none.

Wonder if they will be covering this new $2.1 million drug - https://www.npr.org/sections/health-sho ... -drug-ever

As an insurance agent you have been consistent in sowing fear and doubt over these alternative offerings across numerous threads. I just hope that you don’t dissuade someone from joining a well established member of the market and then they end up with nothing whatsoever and would have benefited from a sharing program.

Everyone can’t afford traditional insurance. That’s just the way it is. Trying to make them believe these programs don’t work with reputable members of the market isn’t helping them. Telling them to make certain they understand the rules and limitations of the program before signing up is certainly reasonable.

Cheers

[highercall]

I have been with Medi-share over 20 years. They have paid all of my numerous claims throughout that time. Like any medical coverage their premiums continue to go up and I will be raising my out of pocket to $5500 to keep premium about the same as last year. I too am thinking of checking for other coverage but I have been satisfied except with the increase costs. I have recommended them to others and would continue to do so.

[BruDude]

Just saw this article on Kaiser Health news, some food for thought:

https://khn.org/news/sham-sharing-minis ... 4paJBTZxeU

The food for thought is don't sign up with sham companies which is not a problem with the major sharing programs?

Here is some more food for thought:

https://www.npr.org/sections/health-sho ... bill-probl

The food for thought is the "major" share companies have the same regulations as the sham ones - none.

Wonder if they will be covering this new $2.1 million drug - https://www.npr.org/sections/health-sho ... -drug-ever

As an insurance agent you have been consistent in sowing fear and doubt over these alternative offerings across numerous threads. I just hope that you don’t dissuade someone from joining a well established member of the market and then they end up with nothing whatsoever and would have benefited from a sharing program.

Everyone can’t afford traditional insurance. That’s just the way it is. Trying to make them believe these programs don’t work with reputable members of the market isn’t helping them. Telling them to make certain they understand the rules and limitations of the program before signing up is certainly reasonable.

Cheers

I’ve been around long enough to have seen the failures of unregulated health programs like these. Check into the history of companies like MEGA life and health. Just because you attach religion to it doesn’t make it any different.

The fact is that these companies are charging pennies on the dollar compared to the regulated health insurance market. They aren’t pulling money out of thin air to pay massive claims. Eventually something has to give. I wouldn’t want to be the person holding the bag when it does.

Having said all of that, something is better than nothing. The problem is that people think this is health insurance when it isn’t, and it’s often marketed as such which is why state DOIs have shut these down in the past. I can’t tell you how many people I’ve come across that thought these plans or similar ones were real health insurance.

Many of these sharing programs are now paying agents to sell these plans. Idiot agents that don’t know what they’re doing just tell people it’s health insurance at 30% of the cost of an ACA plan. Most people don’t do their homework. Hell, most people paying $1000+/month for ACA plans don’t even know what their deductible is.

[HueyLD]

This issue has been around for a long time.

Before the ACA, some good size companies were self insured. IOW, a company had a self funded plan and hired a third party administrator to process the claims. And employees were clearly informed that their "insurance" was not a real insurance; rather, it was a reimbursement program and claims were subject to the company's ability to pay.

I remember an older employee was laid off soon after he incurred major expenses due to a heart attack. And I guess that was how the company kept their expenses down. Of course his layoff was part of a restructuring and the company's lawyer knew how to dot the i's and cross the t's to do it legally.

It is o.k. to join a reimbursement program, but it is very important to understand what the program is. I think people whose large claims are declined because they choose to be in a reimbursement program should not have any right to complain about what they voluntarily sign up for.

It is still a free country and people have the right to choose and the obligation to understand their choices.

[AerialWombat]

The question was how does one have a $1 million medical bill.

40% of the time, it’s a blood disorder. 30% of the time it’s cancer. The rest is “other.”

https://www.marketwatch.com/story/milli ... 2018-07-16

The people that I personally know who have had $1M+ in medical bills all have some form of leukemia or another.

This is just my opinion. I don't expect any other person in the developed world to agree with it. But here's my take: My participation in a health sharing ministry is to provide what I call "broken leg coverage", not cure something that should rightfully kill me.

When ACA went into effect, I was one of the people that *lost* his affordable major medical insurance. Shortly after, while uninsured, I was hit by a car while on my motorcycle (hit and run, very low speed, thank goodness). The resulting knee injury resulted in over $20,000 in medical bills, which I paid out of pocket over time. This was in 2011.

In 2012-14, I was out of the country extensively, and relied entirely on traveler medical policies for backpackers. Only affordable option I had.

I then spent three years rolling from one 3-month short-term plan to another. In 2018, I switched to CHM.

All along the way, I chose the most affordable option that provided the coverage that *I* wanted. Even after I was financially recovered from my Chapter 7 bankruptcy brought about from the 2007-08 real estate crash, I kept doing this.

Again, just my opinion, and just for my circumstances, but what I need is "broken leg coverage". I don't need exhaustive levels of coverage to fight life-ending diseases, because I have no desire to fight them. I have written directives in place to this effect. When it's my time to go, it's my time to go. I also don't want all the minimum essential coverage benefits that are bundled into ACA plans, and even after I was able to finally afford them, I refused to do so out of spite for having it forced down my throat.

I should be free to make my own health care choices. A health sharing ministry meets my needs perfectly, based on my choices. No individual should be chastized for choosing the free market option that meets his/her needs.

/rant

[Patent Guru]

How would anyone accrue a million dollar hospital bill? Maybe over years and years? Maybe with very specialized unorthodox treatments. Even then how would a million dollars accrue? I had open Heart surgery. Hospital bill was 123k. Insurance paid 36k. Hospital wrote off the rest.

I count among my acquaintance the following who have had $1million+ medical bills in a single year:
3 months in a burn center
premature baby in the NICU for months
heart transplant
liver transplant
hemophilia

Just be aware that the health share plans are not insurance and have no obligation to pay your claims. If your claim was $700k would they still have paid it? Who knows. What about $2M? Insurance companies are required by law to pay your claims. Health sharing companies are playing with fire IMO.

People don't insure for $700k in medical bills. They file bankruptcy.

JT

This is exactly why I have a health benefit plan. If people want to go uninsured and file bankruptcy that is there business...except that it increases the cost of everyone's care when the hospital shifts costs to the insured population.

Sorry, this is BS fear mongering. Labeling something as "not insurance" and "no legal obligation to pay claims" just tries to stoke fear in users.

It is a fact that HSM are not insurance and have no legal obligation to pay claims. If you read the disclosures on the HSM enrollment and plan materials you will know that they are not insurance and they have no legal obligation to pay. Consumers remain responsible for all of their medical bills and the HSM determines whether they will reimburse and how much. Not trying to argue, just providing information about the fine print of these products.

Are you saying you have acquaintances who had huge medical bills and their Medi share plan didn't pay?

Or are you saying they had huge medical expenses on traditional insurance and their insurance company paid all as planned and no balance billing, surprise bills from out of network docs in the emergency room, etc?

What were the medical bills after insurance adjustment ?

[bottlecap]

People don't insure for $700k in medical bills. They file bankruptcy.

JT

That works only if you have no, or few assets to lose. Because most of your assets will need to be gone before filing bankruptcy.

This is a few month old thread that has been recently revived, but this is obviously a common reply, based on the multiple responses saying the same thing.

Most of my assets are in retirement accounts. How does a creditor get to those in bankruptcy?

The other big thing is the house, which is owned with my spouse, as a spouse. Under my state's law they can't get to that, either.

Rather than pay $12,000 per year for a large deductible plan, I could risk a $700,000 bill, file bankruptcy and move on.

In reality, I probably wouldn't even have to do that. The hospital would work with me rather than get nothing or close to nothing.

This should be pretty standard financial knowledge for a forum such as this.

JT