Health insurance

No not really, To use your example 10k procedure, Insurance allows say 5K, of that 5k. which would be applied your your deductible, because you belong to that ins, you will be charged at the allowed rate, for the remainder. Which just in general would say be a 2k cost to you, as the ins will reduce it to that rate, ( which, big surprise, hospitals have a nasty habit of not telling you that and hitting you for the whole cost, not the INS adjusted cost) And unless you call them on that, you will pay full freight

You sound young, having a kid or a broken leg, is nothing, and for you, at this time in your life, cost sharing may be a great deal. But at my age when the costs can run into the many hundred of thousands, for cancer etc it would not be. ( and why I would not want my care subject to a non regulated entity) And why I would suggest folks read the fine print.

Like I said, I have no dog in this fight, just make sure what you want is, what you are buying, and it works for you. And for the long term, if you get really sick concentrate on that, not the monthly premium

40 years in my own health care office, not the ultimate expert, but I do have a clue.

by the way, I really appreciated your post, you did not get defensive, and explained your point of view, something quite often lacking in todays world

winnietrey wrote:
Read with great care, exactly what a health sharing co-op is. It is not an insurance plan, it is not subject, to the laws of your state. basically they do whatever they want.

Read about preexisting conditions exclusion, read about limited drug coverage. Read about their ability to deny coverage, for any reason, they deem fit. Read about how disputes are resolved. Through their in house arbitration, no third party

WTP, if someone did not read closely what you said, one might get the impression, that somehow the cost sharing plan helped you negotiate the cost down. I am sure you would agree, reason you got the cost down, was cash at time of service.

yes the provider may have billed 10K, of which they may have hoped to get 2500, so 2K cash for them is a great deal.

It is not about a few K medical bills, it is about medical bills that run into the hundreds of thousands. And put you in the poor house

Risk assessment, versus reward. Save a few bucks a month lose the house. Not me, not my call, not for me to judge.

I am not saying it is a bad deal, all I am saying is understand what it is, and if you choose to go forward, good for you.

Lastly Wtp, you state these programs, have insurance, to cover folks if the program goes bankrupt. I can find no evidence of that. Would you be so kind as to supply the name of any one company that reinsures programs, like this?

Its possible that there may not be any insurance or reinsurance provisions. I thought there was, but honestly I haven't reviewed their policies in several years. I do recall, though, that they are subject to a number of governmental regulations to help ensure fraud prevention and stability.

My statement regarding the reduced cost should be mostly inferred to be due to up-front cash payment. However, that doesn't apply to all medical procedures. We've had multiple procedures over the years that we were billed for, then had to go and submit a claim for reimbursement. During those times, we don't pay the bill until the dust settles and a final amount is determined. The very good folks at CHM have negotiated many medical bills down to a level lower than we could have ever imagined...prior to us paying them and thus receiving reimbursement. All I can say is that the system works.

When we had our first child, we had a typical insurance policy. The next child was with the co-op. For the first child, we hit the deductible and max out-of-pocket. For the second child, other than a few minor misc. costs, the entire pregnancy and birth was fully reimbursed.

If you're deductible is $8K and the procedure is $10K, under traditional insurance, you will pay the deductible. Using baseline generalizations, the insurer will pay the remaining $2K. However, they may not pay it at all if they can negotiate the cost down to $8K with the provider. So in effect, you've just paid the entire cost. With our co-op, we would have paid ZERO.

Read with great care, exactly what a health sharing co-op is. It is not an insurance plan, it is not subject, to the laws of your state. basically they do whatever they want.

Read about preexisting conditions exclusion, read about limited drug coverage. Read about their ability to deny coverage, for any reason, they deem fit. Read about how disputes are resolved. Through their in house arbitration, no third party

WTP, if someone did not read closely what you said, one might get the impression, that somehow the cost sharing plan helped you negotiate the cost down. I am sure you would agree, reason you got the cost down, was cash at time of service.

yes the provider may have billed 10K, of which they may have hoped to get 2500, so 2K cash for them is a great deal.

It is not about a few K medical bills, it is about medical bills that run into the hundreds of thousands. And put you in the poor house

Risk assessment, versus reward. Save a few bucks a month lose the house. Not me, not my call, not for me to judge.

I am not saying it is a bad deal, all I am saying is understand what it is, and if you choose to go forward, good for you.

Lastly Wtp, you state these programs, have insurance, to cover folks if the program goes bankrupt. I can find no evidence of that. Would you be so kind as to supply the name of any one company that reinsures programs, like this?

mudhound wrote:

WTP-GC wrote:

westernrvparkowner wrote:
We have not been able to find anything better than what you are getting quoted. One possibility would be to manage your income so you do qualify for subsidies. It sounds kind of like cheating, but the government set up the system and if you use all the tools available you might be able to use the system to your advantage.
Things like contributing the max to all the potential retirement accounts to lower your taxable income. If self employed, stack your expenses so you have a low income year and get substantial subsidies one year to offset the unsubsidized income the following year.
If you are retired, invest in instruments that do not generate dividend or interest income and sell a combination of winners and losers to obtain a taxable gain income that qualifies for subsidies.
I don't like medishare for two reasons. First, it is not insurance, it is a cost sharing program. To me, that is one step short of a Ponzi scheme. I won't take chances with the potential of having catastrophic health expenses and being out in the cold if they run out of other peoples money.
Second, they have a bunch of gotchas in the fine print. Things like you must practice good Christian Behavior. I won't take a chance that somewhere there is a photo lurking of me drinking a beer at a football game that will disqualify me for coverage of a heart transplant.

As a business owner, we use a highly renowned CPA that advises us regarding taxes, retirement planning, etc. According to them, the tactic of income adjustment in order to change how you qualify for certain benefits and tax brackets is very useful for the ultra-wealthy and potentially momentarily useful for the poor. At the end of the day, most people find themselves going through hoops to move money around and play games merely to save a few bucks or nothing at all. In this case, unfortunately the lack of a competitive insurance market and age will play against the OP's favor.

Regarding Medishare, my family has participatd in a similar health cost sharing CO-Op for nearly 10 years. We pay cash at the doctor (ends up being just a few dollars more than the average Joe's co-pay) and our out-of-pocket cost for any medical event over $750 has been fully reimbursed. Spend a few hours in the ER and you'll be guaranteed to incur more cost than $750. The program we participate in is basically the same as Medishare, just has a different name. And while I can't speak for them, our co-op is nowhere close to a Ponzi scheme. Take for example a recent procedure we had to have. The cost for the procedure was over $10,000. This is what the medical provider was prepared to bill the insurance company. We paid around 80% less up front at the time of the procedure. We will be fully reimbursed for this. If the OP had the similar procedure and it was billed to insurance, this would have led to them hitting their deductible. The insurance company would have then negotiated the cost down to a point where their cost would be virtually nothing.

And you don't run out of other people's money. That's not how it works. The company will become rapidly insolvent long before that happens. Even these programs have be insured and re-insured.

In short, health sharing co-ops can be a smart move. There are a lot of them out there, so I'll stop short of saying that they're all good companies.

I too went away from normal health insurance. LOL! I happen to be an insurance agent!
I went to Christian Healthcare Ministries out of OH. I love being able to pick and choose where and when i go to the dr or hosp

That's the group we selected as well. We've been completely happy with it and recommend it frequently. The more we talk about it, the more we're surprised to learn that so many people also choose CHM or similar groups. I've never met anyone who switched back.

FWIW, as an employer, I provide actual health insurance to my employees through United Healthcare. In our market (FL), they were the most affordable and seem to offer pretty decent coverage. As for myself, I do not participate in the group plan that we offer LOL.

All insurance is a bet you make that you hope to lose.

OP here I ended up going with the MediShare, all I needed was a catastrophic plan. I did not want to manipulate my income in order to get affordable insurance. Side benefit is no out of area penalty which fits with RV travel and I have more money for travel.;)

Insurance is one thing I pay for I never hope to use. LOL

WTP-GC wrote:

westernrvparkowner wrote:
We have not been able to find anything better than what you are getting quoted. One possibility would be to manage your income so you do qualify for subsidies. It sounds kind of like cheating, but the government set up the system and if you use all the tools available you might be able to use the system to your advantage.
Things like contributing the max to all the potential retirement accounts to lower your taxable income. If self employed, stack your expenses so you have a low income year and get substantial subsidies one year to offset the unsubsidized income the following year.
If you are retired, invest in instruments that do not generate dividend or interest income and sell a combination of winners and losers to obtain a taxable gain income that qualifies for subsidies.
I don't like medishare for two reasons. First, it is not insurance, it is a cost sharing program. To me, that is one step short of a Ponzi scheme. I won't take chances with the potential of having catastrophic health expenses and being out in the cold if they run out of other peoples money.
Second, they have a bunch of gotchas in the fine print. Things like you must practice good Christian Behavior. I won't take a chance that somewhere there is a photo lurking of me drinking a beer at a football game that will disqualify me for coverage of a heart transplant.

As a business owner, we use a highly renowned CPA that advises us regarding taxes, retirement planning, etc. According to them, the tactic of income adjustment in order to change how you qualify for certain benefits and tax brackets is very useful for the ultra-wealthy and potentially momentarily useful for the poor. At the end of the day, most people find themselves going through hoops to move money around and play games merely to save a few bucks or nothing at all. In this case, unfortunately the lack of a competitive insurance market and age will play against the OP's favor.

Regarding Medishare, my family has participatd in a similar health cost sharing CO-Op for nearly 10 years. We pay cash at the doctor (ends up being just a few dollars more than the average Joe's co-pay) and our out-of-pocket cost for any medical event over $750 has been fully reimbursed. Spend a few hours in the ER and you'll be guaranteed to incur more cost than $750. The program we participate in is basically the same as Medishare, just has a different name. And while I can't speak for them, our co-op is nowhere close to a Ponzi scheme. Take for example a recent procedure we had to have. The cost for the procedure was over $10,000. This is what the medical provider was prepared to bill the insurance company. We paid around 80% less up front at the time of the procedure. We will be fully reimbursed for this. If the OP had the similar procedure and it was billed to insurance, this would have led to them hitting their deductible. The insurance company would have then negotiated the cost down to a point where their cost would be virtually nothing.

And you don't run out of other people's money. That's not how it works. The company will become rapidly insolvent long before that happens. Even these programs have be insured and re-insured.

In short, health sharing co-ops can be a smart move. There are a lot of them out there, so I'll stop short of saying that they're all good companies.

I too went away from normal health insurance. LOL! I happen to be an insurance agent!
I went to Christian Healthcare Ministries out of OH. I love being able to pick and choose where and when i go to the dr or hosp

Health care sharing is really no different than health care insurance, in my opinion, except maybe depth of pockets. They both run on OPM (Other People's Money). The insurance company charges what they believe they need to in order to cover anticipated costs of claims payout plus whatever profit is demanded by the shareholders and board.
The health care co-op does the same (except for the profit portiion) and with a smaller base are more restrictive in their membership rules.

westernrvparkowner wrote:
We have not been able to find anything better than what you are getting quoted. One possibility would be to manage your income so you do qualify for subsidies. It sounds kind of like cheating, but the government set up the system and if you use all the tools available you might be able to use the system to your advantage.
Things like contributing the max to all the potential retirement accounts to lower your taxable income. If self employed, stack your expenses so you have a low income year and get substantial subsidies one year to offset the unsubsidized income the following year.
If you are retired, invest in instruments that do not generate dividend or interest income and sell a combination of winners and losers to obtain a taxable gain income that qualifies for subsidies.
I don't like medishare for two reasons. First, it is not insurance, it is a cost sharing program. To me, that is one step short of a Ponzi scheme. I won't take chances with the potential of having catastrophic health expenses and being out in the cold if they run out of other peoples money.
Second, they have a bunch of gotchas in the fine print. Things like you must practice good Christian Behavior. I won't take a chance that somewhere there is a photo lurking of me drinking a beer at a football game that will disqualify me for coverage of a heart transplant.

As a business owner, we use a highly renowned CPA that advises us regarding taxes, retirement planning, etc. According to them, the tactic of income adjustment in order to change how you qualify for certain benefits and tax brackets is very useful for the ultra-wealthy and potentially momentarily useful for the poor. At the end of the day, most people find themselves going through hoops to move money around and play games merely to save a few bucks or nothing at all. In this case, unfortunately the lack of a competitive insurance market and age will play against the OP's favor.

Regarding Medishare, my family has participatd in a similar health cost sharing CO-Op for nearly 10 years. We pay cash at the doctor (ends up being just a few dollars more than the average Joe's co-pay) and our out-of-pocket cost for any medical event over $750 has been fully reimbursed. Spend a few hours in the ER and you'll be guaranteed to incur more cost than $750. The program we participate in is basically the same as Medishare, just has a different name. And while I can't speak for them, our co-op is nowhere close to a Ponzi scheme. Take for example a recent procedure we had to have. The cost for the procedure was over $10,000. This is what the medical provider was prepared to bill the insurance company. We paid around 80% less up front at the time of the procedure. We will be fully reimbursed for this. If the OP had the similar procedure and it was billed to insurance, this would have led to them hitting their deductible. The insurance company would have then negotiated the cost down to a point where their cost would be virtually nothing.

And you don't run out of other people's money. That's not how it works. The company will become rapidly insolvent long before that happens. Even these programs have be insured and re-insured.

In short, health sharing co-ops can be a smart move. There are a lot of them out there, so I'll stop short of saying that they're all good companies.

$8,700 is a relative bargain (I assume you mean annual); As was stated, manage your income so you qualify for the subsidy.