Health insurance

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.