My experience with alternative health insurance to Obamacare
A few months ago, I shared about how to survive without health insurance. To recap, I belong to a healthcare sharing ministry (HSM) called Christian Healthcare Ministries (CHM), just one of several ministries that are ACA-approved alternatives to health insurance. But I also want to share about my experiences with alternative health insurance to Obamacare.
What we belong to is not healthcare insurance; therefore, we don’t pay a premium (although we pay a “gift” each month or what amounts to a deductible, except it’s called a “personal responsibilty”). We chose this option because neither my husband nor I have access to an employer-sponsored plan. The most important consideration for us was cost, followed by coverage options. We opted for the most expensive level, which means that we have a $500 personal responsibility for each medical event that each of our family members experience on an annual basis.
Family of Five Pays $450 per Month for Health Insurance
At the time of the previous article, I was the only member of my family to belong, and I paid $150 per month. Now our entire family of five belongs for $450 per month. Even if our family size were to double, that is the maximum monthly contribution we’d have to make.
This amount covered me up to $125,000 per event; but, as some readers pointed out, medical bills can exceed that in the blink of an eye. Because of that, we felt that becoming part of our ministry’s extra program would be valuable. For an extra $75 per quarter (and an annual fee of $40), we have no reimbursement cap per diagnosis.
How Alternative Health Insurance Works
Shortly after becoming a member, I had the opportunity to try out this way of paying medical bills when I learned that I was pregnant. I called the HSM right away to let them know and ask for instructions. As instructed, I called my doctor’s office and the hospital where I planned to deliver to get an estimate of delivery charges. These documents were submitted to our HSM right away.
Throughout my pregnancy, as I received bills, I called each provider and asked for a discount. Most often, the discount was 20 percent. The greatest discount I received was 25 percent, and some places didn’t offer discounts at all. But I learned not to take the first answer. One place in particular told me they did not offer discounts. When I called back and asked specifically for a 25 percent discount with an offer to pay the entire balance that day, I got what I asked for.
Once I received bills and itemized statements, I sent them to the HSM, although not always in a timely manner (but I’ll explain why in a little bit). Usually, I was reimbursed within 60 days of submitting my bills, although the HSM says they will usually reimburse within 60 to 90 days. However, several months before my due date, I got a check from the HSM with instructions to pay my OB’s charges in full and $1,000 to the hospital as prepayment for the delivery charges.
Up to that point, my pregnancy had gone smoothly. Then I was diagnosed with gestational diabetes, resulting in weekly fetal monitoring. I was induced, had a C-section, and my son developed jaundice. All these things resulted in expenses that were higher than the original estimates.
What I Like About It
I like paying only $450 per month, to be sure. I also like how the personal responsibility is handled. You are responsible for the first $500; but if you secure a discount, you are responsible only for the total minus the discount. So, as long as the remainder of my medical bills are reimbursed, I have paid $400 out of pocket for delivering a baby because I got a 20 percent discount on my first $500. The price is right.
I also liked being able to pay my OB early, as well as to start paying on the hospital bill.
What I Don’t Like About It
I encountered a few difficulties as well. I am not a very organized person; so keeping track of all my bills, asking for discounts and itemized statements, and knowing which bills had and hadn’t been reimbursed was tricky for me. By the end, I had created a system that made it more manageable, but it still caused me headaches.
I also wish I would have submitted some bills more quickly. I was having a $255.20 test every week; and since it was only (haha) $255.20 a week, I paid the bill and collected each itemized statement. After all, I didn’t want to be sending off a letter every week. Wasn’t it better to batch them? Well, as you know, $255.20 a week is over $1000 a month, not exactly pocket change. That caused us to feel quite pinched. And snail mail? By the end, I was emailing them. Duh, Lisa.
In addition to sending bills in more quickly, I also wish I would have utilized the providers’ payment plans, just to give me some breathing room until the reimbursements came in.
But using the payment plans weren’t my favorite thing either, and I didn’t use them until I had to. Therefore, our savings accounts were dwindling. I felt — I am not sure — maybe irresponsible that I didn’t pay each bill in full as I received it. My hospital bill was over $13,000, and while I could have taken money from our emergency fund to pay it, I didn’t want to risk it. Our total bills were over $30,000, so if I had started this with that in mind, I think I would have planned better.
However, every single provider was very helpful as I explained our circumstances. And setting up the payment plans was simple; I just felt stressed about it. I think that doing this requires some savings — if you don’t want to be completely stressed out, that is.
Is Alternative Health Insurance to Obamacare Effective?
As of today, I just have around $4,000 yet to be reimbursed. I am feeling relieved as I paid off three bills and have just a couple more to go. Working with the HSM was definitely a pleasure because they were so kind and helpful.
If I were able to get health insurance for my family with a small deductible, I might consider going back to conventional health coverage. However, now that I have had some experience, I know how to make it easier next time. So for as long as possible, our family will probably be paying for our eligible medical expenses in this way. So I guess I’d say yes, this type of alternative health insurance to Obamacare has been very effective at keeping our costs down.
Have you had experience with an alternative to Obamacare? How did you manage your medical bills and getting reimbursed?
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There are 95 comments to "My experience with alternative health insurance to Obamacare".
I hope you and your son are doing well, now. It’s refreshing to hear about health “insurance” that cares.
We are both doing great. Thank you!
I am curious about the financial structure of this organization. Are they able to pay without fighting you over claims because, as a co-op of sorts, the profit motive is reduced or eliminated? Perhaps they don’t have executives being paid millions in annual compensation? Perhaps they get some preferential tax treatment as a religious organization? Would love to know more.
It is intriguing but still sounds unwieldy and labor intensive for the patient. I envy my Canadian and European friends who just bring their health-care card to the doctor and get treated. I am paying $215 a month for ACA coverage for my son and myself, and my Canadian friends just shake their heads in disbelief when I tell them I think I have a good deal.
They are a 501(c)(3) organization. While their financial statements are available by email request, I haven’t checked them, so I am not sure how much their executives are compensated. It seems like a very modest organization, so I am guessing it’s not a huge amount. Not sure though.
The process is unwieldy, but I could have done things better.
On their tax return they listed the CEO’s salary as $250,000.
Each ministry works a little differently in distribution of funds. I am a part of Medi-Share. I submit my gift every month, it gets held in a Christian credit union, and is withdrawn and distributed by Medi-Share when needed. Medi-Share is also a part of a PPO network of docs (so I just make sure everyone, labs, hospitals, etc. are part of that network.) My OB/GYN, etc. just submits my bills like it was normal insurance. I get an EOB of sorts in the mail stating my portion. I then get billed by the medical professional or entity just like I did with my old insurance company. Just for information; my monthly gift is $175 for a $2500 annual out of pocket. If I wanted a lower annual amount I would pay more per month. Then everything is covered 100%, no limits on dollar amount for the year. There are no max limits for life either if I remember correctly. But, I do pay out of pocket for preventative care no matter what.
Love this article. I definitely find this interesting as we are in the beginning stages of researching new insurance. We have expensive and quite bad insurance as we pay $200 a month for a $12,700 deductible. We plan on having children within the next few years and we need to find something better than this.
I just received a letter in the mail stating that my plan will be increasing an extra $123 per month for the same bad plan. AHH!
My husband and I are now paying $1540 per month for insurance – a 30% increase from last year. Even last year it was too expensive as we are both VERY healthy. Needless to say we are looking for an alternative to BCBS. I’d love to hear from other members about their experiences.
Health Sharing is a great way for a healthy or minded person to take control of their medical costs. There are only 4 non-profits offering health sharing that is ObamaCare exempt. Liberty Health Share is one also. I am a member and love it. I have no network restrictions, and pay $299 for myself and my daughter with only $1,000 in unshared costs. So my total exposure to medical costs is my monthly share amount, $299 plus $1,000 in annual unshared amount up to $1 million per incident. Not to mention the incredible health and wellness platform, programs (like Telemedicine- 24/7/365 at no charge) health coaches, online forums for members and providers to communicate and collaborate. It is really a fantastic shift away from insurance bureaucrats deciding how I take care of my self and my family. Because it is a non-profit, their financials are fully disclosed to the members, and there are no million dollar CEOs on the payroll. No corporate jets, no high rise office buildings. Only 12% of members share amounts go to administration. The rest is payable only to cover medical costs. That is the way I want to take back control of healthcare costs!
Thank you Jacqueline!
Good point about Liberty being non-profit. I left a ACA insurance company for Liberty this year. I was researching my old ACA insurance company and the CEO made $25 million in 2016! I’m getting my premiums jacked up with a massive deductible and he’s making $25m!
I’ve heard about these plans, but never knew how they worked. To be honest, it sounds like a LOT of work. Not to say that it’s not worth it, but calling businesses is my least favorite thing to do, so I’d struggle with calling and asking for a discount on each bill!
I don’t really like calling companies, either, but after calling them a few times, I had figured out what to say to get what I needed and off the phone ASAP! I negotiated with one by email which was great, but actually took longer.
I’m curious how the cost compares to other types of plans. The $450 seems very low for a family of 5 but the costs are a bit high, the process sounds very stressful, and I wasn’t clear on the risk if something catastrophic occurred. I know that NICU can add up into the hundreds of thousands quickly.
Still, it’s a cool idea. I’ve often wondered why some do-gooder can’t create a non profit insurance company. Medical care is expensive and I understand why premiums are high but I’d love to know my money is going toward medical expenses and not paying for a company to make profits and make executives rich.
Sarah, the costs are actually reasonable, in my opinion. While I do have to wait for the checks to come in, I will end up paying less than $400 for my entire pregnancy, delivery, and any appointments that occurred during my son’s first three months.
Since we are covered under the “extra” program I mentioned in the article, the same thing would occur. For instance, if I developed cancer, and my bills totaled $500,000, I would still be responsible for only the first $500. However, if we were not part of the extra program, we would be responsible for everything after $125,000. Ouch.
My original article (link in today’s article) explains the process in more detail. If you have more questions, I will try to answer them.
Wow, that is a good price. But… do you have to be a Christian?
Sarah, for my particular organization, yes. I am not sure of the requirements for similar organizations.
@Lisa: Surely, as a 501c3, they are not able to discriminate based on religion???
ETA: Ugh. I am very disappointed to learn that legalized religious discrimination is a thing, and supported by our tax dollars. E.g. http://sarleslaw.com/news/NonProfitNewletter_04.pdf
imelda, it doesn’t make money so it doesn’t really matter if it’s tax-exempt. Basically, these organizations run a lean operation off of a small administration percentage and most of the funds are paid from members to members.
I know Samaritan uses their 501c3 status to vouch for donations but those are only for extra gifts to members beyond the monthly share (like if someone hears a member has a pre-existing condition and I want to kick in extra money to help them.) The regular member share is a quid pro quo so it’s not tax-deductible.
501c3s absolutely can be religious…churches are 501c3s. That comment didn’t even make sense.
There are many nonprofit health insurance companies. Some Blue Cross companies are nonprofit, Group Health Cooperative, Kaiser Health Plan, to name a few.
Sure, but then how is Lisa’s so cheap? Surely she’s not the only Christian having babies and other various expensive health problems?
HI Sarah,
I have no idea why it’s the price it is; maybe it’s in the providers they contract with? Maybe it’s that single members subsidize large families? That’s a way to manage limited resources. Maybe they’re subsidized by church donations? Maybe they reduce provider costs by prepaying them instead of forcing them to work hard to collect on their claims? I really don’t know.
In the end, there’s premium income and there are coverage payouts and they must balance out while allowing a net surplus after operational expenses. Profit or non-profit, no business can survive perpetual loss unless it’s subsidized by some other source.
(And sorry for the double blockquote in my first answer, looks unreadable, I was too late to fix it.)
There is nonprofit,and there is “nonprofit” because they shuffle their excess profits into a for-profit arm of the organization. The Blues are “nonprofit.”
I’ve known several families over the years who have participated in these ministries, and I’ve never heard a negative word from any of the participants. About 10 years ago, a friend explained to me how these ministries work, and I remember thinking how easy I had it because I did little paperwork or negotiation with providers. We’ve always had good medical insurance through my husband’s employer, so we would just pay our copays and rarely had to deal with medical bills.
But the landscape is different now, even for those with “good” medical insurance. We are paying much more money for less coverage. I’m constantly on the phone with the insurer about why they didn’t pay the medical provider the correct amount. We frequently have one bill or another under “review” by the insurance company. I’m sure if I didn’t complain, they wouldn’t bother to check if they’d paid the right amount. It’s taking months in some cases to get the providers paid. And this is with one of the largest insurance companies in the U.S.
So, at least for our family, some of the disadvantages of the healthcare ministries have became part of the routine of having regular “good” health insurance.
If I recall correctly from when I was researching similar organizations 4 or 5 years ago, some of them do require that you have references from a pastor and stress that part of your commitment is to pray for the other members of the co-op and their medical needs.
$450 to me seems a little low, but not by much. Our family plan from my husband’s previous employer was $600/month and covered all of us and then I did not have to call and try to negotiate on my own and overall seems cheaper. For example, I paid $200 for giving birth and $150 for the OB visits coming up to that ($15/visit up to a max of $10, any above 10, free).
Are you factoring in whatever portion of the premium your husband’s employer paid? $600/month sounds way too good to be true for the plan you’ve described.
Yes, I am. I know the exact amount because when you COBRA you get the whole amount (well 102% of the amount) to pay and that was the number I referenced.
I was probably reading too much into your plan based on the maternity benefit. My wife had a baby in July, and your $350 total out-of-pocket cost made me very jealous :).
We had medishare insurance it is horrible! My husband had some major heart isssues and ended up in the hospital. They paid nothing, we ended up with a 10,000 bill. Every time we called all they wanted to do was pray. Prayers are great but doesn’t pay the collector and never gave us any reasons why or answers. It is affordable but for what we paid to them we could have just paid the hospital. I thought when we sat down with an insurance agent that I had asked all the right questions to make the right decision on insurance. Apparently he didn’t understand how this insurance works. We have a normal insurance policy now will never have Christian insurance again. Not very Christian at all for them to decide on a life threatening surgery whether or not they’ll pay. Makes me feel that they we’re saying “your husband is 60 so he can just die we’re not paying surgery not needed”. How Christian is that. Again horrible horrible insurance.
Out of curiosity, I looked into these once, and most of them have morality and health clauses, i.e. if you get lung cancer (even from second hand smoke), they won’t cover it. Pregnancy out of wedlock? No. Type 2 diabetes? You should have eaten better. They definitely won’t cover many forms of contraception or treatment for STDs, etc. I’m also not sure if they cover mental health.
Preventative care is also not covered at all. My neighbor with two kids has this type of “insurance,” and basically she only takes the children to the doctor when they are very sick. No well visits, no dental visits, etc. You could say she is an outlier and that many people on these plans still do pay for their preventative care, but I would prefer a system that covers preventative medicine.
Also, what happens if you or someone else bankrupts the provider? You think it couldn’t happen, but what if a critical mass of members became extremely ill and needed payment of in excess of $1 million each to pay their hospital bills? It’s not likely, but it’s possible. Does the organization have enough reserves to cover it? Will you be sent to collections before they pay?
The thought is to pay for your $200/year well visit, instead of an extra $200/month in insurance to cover preventive care. My dental coverage at work maxes out at $1500/year payout. While the cost of premiums is less than the checkups and cleanings that it covers, not everyone chooses to purchase this coverage because of the low limits.
But the thought behind covering preventative care is that you save money in the long run. That’s why annuals to the OB-GYN are free under my high deductible plan, since it’s a lot cheaper and better for the patient to catch things early. I hope these plans at least strongly urge their members to go to well visits and run routine blood work.
I remembered one more story I read about. Someone on one of these plans got hit by a drunk driver, and because of the morality clause, her care was initially denied because it involved drunk driving! She might have eventually gotten it covered, but imagine the anxiety in the mean time!
Plus I’m of the opinion that doo doo happens in life, even to those who don’t expect it. You could be as chaste and moral as you want, but what about your teenage daughter who has different values than you or who makes a mistake and gets pregnant at sixteen? Be prepared to foot that bill. I also wonder if the eventual baby (possible expensive NICU visits) would be covered, since the pregnancy wasn’t. What about pregnancies that are the result of IVF (i.e. from the creation of embryos)? There are so many variables and interpretations that enter the equation when you add religion. Plus ultimately they are not bound to pay your bills at all.
Some of the healthcare sharing ministries include well visits in your premiums- including Liberty Healthshare, the HSM I am going to sign up for.
With the new healthcare law, the cheapest plan now available in my state is more than $800 with a $12,000 deductible for my family of four. Getting “free well visits” doesn’t really do me any good when my old Pre-ACA plan was only $393 per month.
If we join a HSM like Liberty Healthshare, we can pay around $400 per month for coverage and pay for our preventative care ourselves. The $400 monthly savings is more than enough to pay for preventative care many times over.
And in fact, that’s how insurance was intended to work in the first place: by covering the cost of unexpected illness, and not preventative care. Part of the reason health coverage is so expensive is due to preventative care being covered, when it really should always be out-of-pocket.
A large part of healthcare sharing ministries (HSM) are about personal responsibility. Since it is not actually health insurance they don’t have to provide coverage for things that considered outside of Christian morals and values (Medical expenses covered by Medi-Share HSM are voted on by members.) For instance, pregnancy out of wedlock, gotta be married. With Medi-Share HSM they also (currently) will cover a rape or incest pregnancy (since these are against the women’s will.) Get into a car accident while you were intoxicated or distracted (ie phone), not covered, speeding and get into an accident, not covered–that personal responsibility thing again.
I am a member of Christian Healthcare Ministries. They have been operating for 35 years and have a system in place to avoid going into bankruptcy from too many catastrophic medical bills. Specifically:
1) They put a cap of $125K per illness that they share through their regular program. This cap alone protects the Ministry from being swamped with catastrophic bills they can’t share. A member with $1M catastrophic bills would not even be processed under this program. BUT, see point number (2) below for what happens in those catastrophic instances.
2) For catastrophic medical needs that exceed the $125K per illness cap, they have an additional (optional) program called ‘Brother’s Keeper’. Members of their lower tier plans who join this program in addition to their regular membership are entitled to up to $1M of funds sharing per illness, while their top tier plan members are entitled to unlimited sharing per illness through this program. The way it works is that members who wish to join this program pay a $40 annual admin fee plus a quarterly fee as determined by CHM. Every quarter CHM reviews the total amounts of bills accumulated for sharing through the Brother’s Keeper program (typically in the $1-2M range per quarter) and divides them equally across the number of members participating in the program. We then get a letter notifying us of our amount due for that quarter for Brother’s Keeper and we pay said amount based on the actual needs of the program – not an estimate, so we are never overcharged. Because the Ministry has some 35,000+ members nationwide, most of whom also participate in Brother’s Keeper for peace of mind, quarterly amounts due from us members are typically very low. On an average quarter they are about $25 per unit (1 unit=1 person, and families pay a max of 3 units no matter if they have 1, 3 or 10 kids). In the 1 1/2 year that we have been members, the highest we’ve ever been asked to pay in one quarter was around $35/unit, while there was one quarter where Brother’s Keeper had very low amounts to share and we were only billed for $11/unit.
The only caveat is that members who don’t join Brother’s Keeper and only sign up for the regular sharing program can unfortunately be left ‘uncovered’ if their bills exceed the cap per illness amount. However, this is made very clear to members both in the Ministry’s Guidelines and literature (monthly letters and newsletters we receive) and members are frequently reminded and strongly encouraged to join Brother’s Keeper on top of the regular program for additional peace of mind. Since participation costs are quite affordable, most members should be able to join the program without much burden. If one decides to forego Brother’s Keeper participation and take their chances, this again comes down to personal responsibility and the Ministry can hardly be blamed for it.
I have a really hard time wrapping my head around the idea that somebody (an insurance company or a health ministry) can approve or deny the health care that my doctor and I decide is best for me.
The Canadian system isn’t perfect but I wouldn’t give it up for anything. I can’t imagine the stress of thinking about health care costs, arguing with insurance companies, negotiating bills, or tracking paperwork in the midst of an illness.
My FIL lives in BC and was hospitalized in March for breathing problems (he has COPD). He couldn’t get into his regular doctor to see if he could finally qualify for the home oxygen and eventually ended up in the ER. It was really the only way he could be seen and after he stabilized a bit he had to have a quick departure in order to qualify for the home oxygen that he needed. The inability to qualify for it beforehand is what sent him to the hospital in the first place, and after a two day visit, he was still bedridden for weeks and unable to work. Getting the heart surgery he needs has also been a pain and it still hasn’t been approved. I know that anecdote does not equal evidence, but it makes me wonder if the Canadian system is great only if you don’t actually really need it.
I agree that the Canadian system is not perfect and I’m sorry your FIL is having a difficult time.
I DO need the Canadian system, however, and my experience has been fantastic. I have a serious lung condition and I have never had to wait for any test, scan, or treatment. I see my GP and two local specialists, and have seen out-of-province specialists for second opinions within 6 weeks of the referral. I’ve had 12 medical appointments in the last 8 weeks, believe me, I use the system.
The American system works for people who can afford it. Everybody else is screwed.
Michele: Exactly. One of my Canadian friends lost her father due to the crappy health care in Canada and she’s pretty bitter about it. Cancer isn’t one of those things they put a top priority on, apparently. The process to get medical help moves too slow, and by the time her father was seen, it was too late. Had he lived in America, he might still be alive.
A Canadian friend of mine ended up traveling to the US for a simple surgery that continued to be delayed in Canada. She paid cash here. Our US system isn’t perfect, but at least the government doesn’t ultimately control when you get or do not get care.
(This comment came from Hrant, a reader of our daily newsletter.)
Is there anyone out there who has tried the Liberty Healthcare? Which has better coverage?
(This comment comes from Brian who emailed his question to Get Rich Slowly.)
Hi Lisa,
I came across your very informative post about health sharing and I had a few questions. With Liberty Healthshare, do you have to pay your medical bills out of pocket first, and then Liberty reimburses you, or do you just send them the bill and they cover it? Thanks!
Brian
Brian, we’re actually using Christian Healthcare Ministries, not Liberty. However, with CHM, we pay the bills and then we are reimbursed. Not sure how it works with Liberty, though!
To everyone for feedback who has this type of plan. Do your plans require an in depth questionnaire and medical background check on what chronic health problems you already have? How are they checked out? Seems like several high risk patients could easily drain the funds and leave nothing to cover other plan members bills. Is it first come first serve, after all there is no guarantee of bill payments or reimbursements. Any feedback is appreciated.
For Christian Healthcare Ministries, there was no in-depth health questionnaire. When filling out their application for joining, there is one section of the form where they ask about any pre-existing conditions, and that is that. They don’t check – they rely on you to tell them the truth as a Christian to other Christians 🙂
That being said, when you submit medical needs for sharing you also sign a HIPAA medical info release form for them, which allows them to discuss your medical matters with your health providers as needed. This also allows them access to your medical records if needed. If one lied about a pre-existing condition and they found out when processing their medical needs for sharing, I imagine that could be grounds for denial or disruption of membership. Not sure what their exact policy would be in such a case, but I don’t imagine it happens very often. Plus, CHM does have a program that shares funds for pre-existing conditions and they don’t deny anyone based on pre-existing conditions, so there’s no reason for a prospective member to lie.
As for your drainage of funds question, this is unlikely to happen because they have a system in place to avoid that. See my response to Midwest Jane above for full details.
I don’t typically comment on websites, but anytime I see a health share article I feel compelled to warn people as my family had such a horrible experience with Good Samaritan “insurance”. My father passed away nine years ago (at age 53) from congestive heart failure. His doctors said the heart failure stemmed from a virus which attacked his heart. He was otherwise completely healthy and a perfect candidate for heart transplant. Until reading the fine print of the group share policy my parents didn’t realize transplants were not covered. They were “kind of” covered — $100k for a surgery that would cost $500k. When my dad’s physician called Good Sam to try to plead with them to cover the procedure he was told they would vote on the procedure at the next board meeting. My dad unfortunately did not have long enough to live to make it to the board meeting date. My mom said she had never been so embarrassed as to have these faxes denying coverage coming into the hospital with Bible verses at the top. The experience only got worse after my dad passed and the insurance refused to cover his care prior to his death. My mom had to get a lawyer to have those bills paid. Anyway long story but please buyer beware. Maybe these have gotten better but I would never entertain one of these policies. I am thankful every day for good insurance coverage through my husband’s work.
Truly sorry this happened to your father with Samaritan Ministries! I truly hope they have amended their policy by now to cover such treatments.
My husband and I are members of Christian Healthcare Ministries (CHM) and CHM does cover transplants. As a matter of fact, there was a feature in their newsletter a month or two ago about a member needing a stem cell transplant for cancer treatment that the Ministry covered in full (about $350K after discounts). CHM also prides itself of covering new and up-and-coming treatments if a member’s doctor recommends them, same treatments that are often denied under commercial insurance because they are not yet considered ‘established’ treatments. Again I seem to remember a newsletter feature a while ago with a member’s story along those lines. Had this person been with a regular insurer, most likely they’d have been denied this treatment.
That being said, CHM does not cover alternative treatments like naturopathy, acupuncture, chiropractic etc. (which Samaritan does to my knowledge), only treatments obtained through regular MDs or DOs and conventional hospitals, clinics and ambulatory centers.
Again, very sorry to hear about what happened to your father!
Dear Erika and Christina:
On behalf of Samaritan Ministries, I think there may be a case of mistaken identity here. There was (I think they’ve shut down since) an insurer called Good Samaritan which was actually insurance, not a health care sharing ministry like Samaritan Ministries or CHM. We have done a thorough search of our records and cannot find a heart transplant need any time from 2004-2009 where the member was not part of our optional ministry called Save to Share (even CHM has an optional add-on for needs over $125,000, so this is not unique to Samaritan). We are very sorry for your father’s poor experience, especially so since it occurred around the time of his passing, but would like to make clear that this was not a problem with Samaritan Ministries or even likely a health care sharing ministry to begin with. We are confident we would remember anything involving lawyers or faxes to a hospital, since neither is a part of our regular operating procedures.
If you think our assessment is in error we’re happy to talk to you, but we don’t want to be blamed for something done by another organization.
James Lansberry, executive vice president
309-689-0442
Apologies for the confusion and thank you for clarifying. Samaritan Ministries has a very good reputation indeed and I was surprised to read Erika’s comment, but glad to hear it actually concerned another organization (as much as this doesn’t do anything to alleviate the pain from the traumatic experience Erika’s family went through).
Hi Lisa,
Love reading other people’s experience with Christian Healthcare Ministries. My wife and I joined in December 2014 because traditional healthcare was too expensive as I’m self-employed and my wife does PRN work and does not qualify for health insurance through her work.
4 months after joining CHM we found out we are expecting our second child in December 2015! Its exciting and can be stressful since we don’t have traditional health insurance. We will be going down this same path you did with your pregnancy. So far we’ve submitted all of our bills, gotten discounts where we could and now are just in the waiting period for re-reimbursement.
We are thankful for this alternative to traditional health insurance. I think it will help us more than when we had insurance for our first baby (April 2014), where it felt like we were constantly shelling out money for medical bills as well as our monthly insurance premium.
Its great to read other people’s experiences, helps calm the nerves 🙂
Congratulations on expecting a second child!
I am currently pregnant as well (first child) due September 2015 and going through the maternity sharing process with CHM. For me it’s not the first time I’ve had to rely on CHM for medical bills sharing – I had a minor surgery for a pre-existing condition back in May 2014 (CHM shared the total of $5,500+ after discounts within about 90 days), as well as a pregnancy that ended in miscarriage back in July/August 2014, for which CHM shared a total of $4,400+ after discounts within about the same time frame. In both of those cases my husband and I paid $0 out of pocket, as we were able to obtain discounts that exceeded the $500 personal responsibility amount for the Gold level. So this is really my third time submitting a need to CHM and by far our biggest need so far (total bills submitted to date are just under $10,000 and there will probably be more by the time I’m done with the whole maternity process).
To calm your nerves, I can tell you from experience that CHM will absolutely come through for you and your family. It does take a little while to receive the check/checks in the mail (around 90 days from submission is a fair estimate in my experience), but they will share all your eligible bills. In my case, once my pregnancy was established as viable (I had to wait for the end of the first trimester for that due to my previous miscarriage), my OB gave me a package price including prenatal care for the remainder of the pregnancy, his fee for labor & delivery and post partum visits, which I submitted to CHM. I requested a similar package price from the hospital where I’ll be delivering and also submitted that to CHM (I was lucky to receive well in excess of $500 in discounts, so that met my personal responsibility portion once again). In the meantime, I had also incurred a bunch of other bills for labs, ultrasounds and individual OB visits that I had to pay in the 1st trimester, which I submitted as add-ons. About 90 days after my initial submission, CHM sent me a check reimbursing the full amount for my doctor’s payment as well as the hospital fee for labor & delivery (which wasn’t even due until my admission), and about 90 days after I sent the add-on bills, I received another check covering those expenses. The only thing they did not cover was about $200 worth of labs for blood tests done through the State of California for prenatal screening, as these are considered genetic testing and are not shareable. I didn’t know at the time that they were ineligible, but in the big scheme of things, $200 isn’t going to bankrupt us 🙂
To date CHM has shared about $7,500 for my maternity need and I currently have about $2,000 worth of bills in the pipeline awaiting reimbursement (most of which was incurred due to an emergency 24-hour hospitalization for complications back in June – luckily all was good, and I was delighted to obtain very big discounts again from the hospital). Barring any complications with labor and delivery and assuming our little one doesn’t need to spend any time in the NICU, the only other expense we are anticipating (which CHM has confirmed they’ll share) is our baby boy’s circumcision. Otherwise, there may be additional expenses for possible use of anesthesia and/or if I end up needing a c-section, all of which I know CHM will share within about 90 days. Knowing this gives great peace of mind.
I hope this helps put your mind at ease and reinforce your faith that CHM will come through as promised.
Best of luck and prayers for you and your wife for an easy and safe delivery and a healthy baby!
I wanted to add an update to my comment above as I have now gone through the whole maternity process with CHM. Our son was born on September 9, 2015 and unfortunately we had complications. I ended up requiring an emergency c-section and anesthesia was used as well (of course). Having a surgical delivery also prolonged my hospital stay, so even after significant discounts the total cost of my maternity incident (including post partum visits) came up to around $15,000. I am happy to report that CHM has now paid us this full amount to the last cent and we couldn’t be happier with their service. They covered 100% of all eligible bills as they pledge. Hope you too have a good experience with this Ministry!
I am looking to do this. I pay almost 400 a month for private insurance. I have little restriction on who I can see/ where I can go. However, it is just too much. I dont want to go into all the reasons I dont want to go through ACA. I am self employed as well. In reference to self pay, you’d be suprised at what you can do to get your bill down without insurance. It does take patience.
I was in the ER a while ago and needed transfusions and was placed in a room for overnight observation. At the time I had no insurance. Prior to this, if i had to go in for something it was either out of pocket urgent care clinic or a free clinic. Before ER services were given, I was coherent enough to tell them I was uninsured. They treated me anyway. Later I waited for the bill to come. Over 10k! I called their financial assistance/billing office and spoke to them. I prayed! I then proceeded through the financial assistance paperwork. Btw… Any supporing documents I sent I blotted out my account information/ss#. Long story short. They covered it 100%. I owed the hospital nothing. I used the letter from the hospital to reduce/work out managable payments for the doctors bill and I think the other was radiology/labs.
One more thing is try to shop around. For example, It might be cheaper to flight to another city, stay with friends and have a procedure done there than have it done in your hometown. Also, some hospitals will do a financial assistance/hardship application before you have a procedure/surgery – if you can hold off until it is processed. This can drastically reduce the cost if you are self pay or your insurance isn’t sufficient. I paid roughly 4k with family help for a procedure so I could return to work. I found out later that if I could have waited, the bill could have been much lower – the price paid was still several thousand less than other locations offering that procedure. This is what I have found. I understand that when we are sick we are often tired and overwhelmed. That does effect what we can accomplish. God bless.
do anything you can to avoid commercial insurance. I am now paying almost 10,000 dollars American per year to cover 4 healthy adults–2 children under 25. I could cry. I am going to try one of these healthshare policies.
My Blue Cross health insurance with deductible is now at $24,500/ year for 4 healthy adults and has doubled since Obamacare. I am in the process of switching to Liberty. We are self employed. You know the system is broken when your premium is more than a typical mortgage… or the equivalent of several car payments.
I understand all of your concerns with traditonal ACA plans the taxes the government has added on to them to pay for this plan is crushing the industry. I am a broker and am looking for alternatives to tell clients about, love all the comments and am always looking.
Carol, Altrua HealthShare (one of the five HCSMs with an ACA exemption) now pays insurance brokers commissions. Check it out at my website if you want contracted. There is a lot of demand for this.
Hi Lisa,
Thank you for this detailed and honest post. I am currently researching the 4 main healthcare sharing ministries (HCSMs) for my family. We are self employed and have to make a decision soon. We have a small group employer plan (because we own our own business) and have been informed our plan will no longer be grandfathered so we have to choose an ACA compliant plan. Our premiums were already quite high but the new ACA plan that we would be shifted into would cost 43% more! It’s insane how much we have already been paying but this increase is enough for me to call it quits on traditional insurance. We are a family of four and have been healthy, thankfully. We rarely need to seek medical care. I just can’t justify the cost anymore. HCSM’s seem to be a very good option.
CHM is the one I am leaning towards. They’ve been around a long time, seem well structured and I can’t seem to find anything other than positive reviews about them.
Other than CHM, I have also looked at the one that has its members send their shares/checks directly to one another (I won’t name it here). The spirit of this is nice but I think I prefer a different approach. Also, this other ministry requires that your pastor sign your needs request paperwork. I really don’t like that. While I’m sure it is a way to be more spiritually supported at the local church level, I really don’t like the idea of bringing my pastor a bunch of paperwork for signature. I also wonder if this can become a burden on the pastor if many people in the congregation are members of this HCSM. Does CHM require this kind of pastor involvement when you submit each need for sharing? I have been reading their guidelines and even looked at their needs processing package. It does not appear CHM requires this, though I do see that the needs processing form asks for your church and pastor’s contact information. Does CHM call the church/pastor every time you submit a need? Just wondering if it’s required, and if it is, what is your opinion and experience with this part of the process?
Thanks again for your post on this topic. It is refreshing to read something that includes like and dislikes.
Emily, I did not need pastor involvement for any of our maternity bills, but since we have not had any other needs, I am not sure about anything else. I think that you do need pastor involvement for non-maternity needs, but I am not sure. Our HCM welcomes questions, so I recommend calling them. Sorry I am not more helpful!
Hi Lisa,
Thank you for answering my question. I am still researching everything. I will call CHM with my questions. I like to hear from others who have actual experience too so I’ve been searching the internet for posts like this one. Thanks again!
I like the idea of this plan to get around the ACA and their extremely high ripoff premiums with huge deductibles for coverage that is marginal and includes things I can’t use such as maternity care (I’m a man!!!!!), or do not need (mental health care, chiropractic care, acupuncture, etc, etc). Someone needs to teach the government about biology!!!!! BUT I understand the goals of the ACA – it’s welfare for those who will not work, and it’s welfare for health care companies that you are now FORCED to pay.
BUT I see a problem with this healthshare business. I do not like the idea of sending your money to an individual, particularly when the disclaimer says “there is no guarantee your bills will be paid”. That is really a deal breaker. I’d go for the $199 plan, but what if I’m messed up in the hospital for a year and can’t submit my bills? This healthshare idea is good but it MUST be set up to actually be like insurance. And like most insurance plans it MUST say in the literature before you sign up what it covers, and what it doesn’t, and must clearly state all limitations.
Good idea; but it’s not ready for prime-time IMHO.
There are several share programs out there so do a little more digging. My BCBS bill for this year is now up to $24,500 for a healthy family of 4 adults (our girls are 18 and 21). Good friends of ours just switched to Medi-share (family of 5 was paying 28K to BCBS) and we are looking at Liberty. Both seem to function a bit more like traditional insurance in how bills are submitted and paid. It’s not a one size fits all industry so look for the plan that works best for you.
Hi Jen,
I liked your testimonial it was direct. My wife and I are faced with ridiculous rising Health Care with UNITED. We are filling out application today for Liberty’s Premium plan. We thank you for explaining better.
Can you share an update with how things are going with your Liberty and your friend’s Medi-share over the course of a year? We are considering Liberty right now. Thanks
Steve, not all healthcare ministries have members send money directly to other members. Mine doesn’t, in fact, so if you’re still interested, you can try to find one that operates more like you’d prefer.
As a person said in one of the articles they spend as time with conventional insurance and claims as you would with Christian Health Ministries. The discount on billing is huge.The truth is providers only get about 40% to 60% of thier money from conventional insuinsurance providers. Even when providers give you a 25% discount they are still getting more from you than they are from some conventional insurance companies.
How did you find a health care provider? Where did you select your obgyn? I need to go to a doctor but don’t know where to start as my area doesn’t have a list of doctors who accept chm yet. Thanks in advance!
Billie – I went to the same OB/Gyn that I’ve seen for a decade. Since I’m really a “self-pay” patient, I can go to any doctor I want to go to. CHM isn’t really accepted by doctors, you’re just reimbursed for eligible medical costs. Maybe doctors in your area don’t understand how CHM works? There is an explanation on the chministries.org website, I think, that should help you explain it to doctors. I hope that helps, but I’ll also try to answer any other questions, too.
We, too, use CHM! I love the entire concept and totally despise regular insurance! We have been members since the ACA first went into effect.
We have only utilized it one time…when my wife got bit by a rattlesnake a couple of years ago!! Merely by being self-pay – the hospital bill was reduced from $38,000 to $18,000! They knocked off $20 Grand because they would not be dealing with any insurance company!!
Due to the massive growth of CHM at the time, it took a little longer than the normal 60-90 days for payment. We paid several bills off in full and made payments on some until we received a check.
I love CHM! (And pray I never have to use them again!)
About 10 years ago my adult, single, son who lives in another state was in a wreck. Many bones from jaw to ankle were broken, he had other injuries as well, and a tracheotomy allowed him to breathe. He was in a coma for 6 weeks, then more weeks before hospital discharge. Hospital was followed up with months of physical therapy. The total bill was was close to a million dollars. He had good insurance through his employer. Still, his responsibility was $300,000.
How would he have fared under a health share plan? He could not negotiate, or fill out paperwork.
His NON SHARE COST would have been $500, then a total of one million per incident. He may have had good health insurance but what about what his auto insurance covered?? If you don’t know, you need to find out!
$300K does not meet the definition of ‘good’ insurance! Your son’s policy should have an annual out of pocket maximum around $10K with most policies. I read your post again and see that was some time ago. If he hasn’t, I would still talk to the plan administrator of the employer and investigate.
Good points.
What about maintenance drugs? Are they covered under the health share as well? How does this work?
I was glad to find this article. I am a member of Christian Healthcare Ministries, and am having anxiety about a upcoming surgery and the deposits required by the hospital and doctor. I feel better knowing they pay; also I am OK with asking about discounts.
Anyone who is self pay will likely get a discount any way. I have found this out. You don’t always have to ask. So don’t be shy about it.
I was thrilled when I found out about Health Share and felt all my prayers were answered regarding honest, affordable healthcare coverage. Unfortunately, 2 months after signing up I had a terrible trip and fall accident and ended up in the ER with follow up dental visits. I did a face plant onto a solid concrete bench damaging, displacing and chipping my front teeth along with a host of other injuries. The hospital and dentist accepted the health share card, so I paid nothing out of pocket. I did pay out of pocket for other medical care and was promptly reimbursed. As soon as possible after the injury, I called my health share company and inquired about dental injury and orthodontic needs as this was in my near future, per my dentist. I was reassured (by phone staff and a nurse) they would cover ALL expenses relating to the accident – including orthodontics (braces). When I decided to get a second opinion from another dentist/orthodontist (comparing prices), I called health share to ask if they would cover a second opinion and explained who I was going to see and why. Again, they said yes – everything is covered even second opinions. When my dentist of choice submitted the treatment plan for the occlusal guard (to stabilize my jaws before putting the braces on), it was denied and so were the braces. Needless to say, I was in shock!! Even their guidelines clearly state they will repair injury (from an accident) to sound natural teeth (which mine were) and nowhere did it say with the exception of braces and occlusal guards. My teeth were in perfect condition before the accident and now they are crowded, hard to clean, displaced, pushed back into my mouth causing difficulty in pronouncing certain words, and the lower front teeth are popped up causing them to hit against my upper front teeth causing discomfort. Per my dentist, this is clearly a medical need caused by an accident! Also, in their guidelines it states cosmetic care and treatment provides for disfiguration caused by accident and(again)nowhere does it say except for dental disfiguration. Needless to say, I feel crushed and let down by people I felt were honest and trustworthy. Please be sure you have a clear understanding what is covered and what is not even after reading the guidelines and talking to phone staff and nurses.
what health share are you with?
Does anyone know if we sign up for a health sharing plan and decide we hate it after a few months, can we drop it and get back onto the traditional plan offered at my spouses’ business as a qualifying event?
I have been looking into this option also but from what I can see is that it does not, since it is not considered “insurance”. Our thoughts are to try it for a year and then we can always opt back in during open enrollment next year.
I believe the Liberty Health Share has a 60 day trial and if you don’t like it you can drop it.
Read all fine print on all health share plans. You can cancel but may have to pay another month’s fee plus they will not refund your membership dues even if you cancel 10 days before the renewal year.
I do not understand your comment, I also want to say my wife and I use another alternative plan and we pay just over 400 a month and with Obama plan we were paying close to 1700.00 per month and with much higher deductible. These alternative cost sharing plans do work well bot do require the individuals to do more paperwork and phone calls. By the way the largest discount we received was an 80% from the hospital when my wife had an issue with her heart rate and blood pressure the bill went from over 35,000.00 to a little over 7,000.00.
Thats seems like a lot to have to cover and then “hope” they reimburse you. And your still waiting for $4000? seems a bit of a gamble. I’m not opposed and I have looked into it too but just don’t want to sign up, get pregnant and go broke paying bills that we thought would have been covered and weren’t to the same amount we expected.
-Ben from UTAH
what’s the difference between ACA approved and paying the penalty? thanks.
I have Liberty and am trying to figure out how to use it. This article and all the comments have given me reassurance, I will now set up appointments. Thank you.
We have Liberty HealthShare and they are anything but Christian. Beware BEWARE everyone before you buy into it!! They have in their “Expenses Eligible” sharing list, that it covers Chiropractic Services. A customer service person just told me it is NOT covered and NEVER HAS BEEN COVERED. Warning: Do not trust a “Christian” organization that lies to your face. While they send lots of “feel good” organization long winded updates, they somehow think it is too much of a hassle to send a 2 month renewal notice which would give members enough time to cancel, upgrade, add family etc. Instead, you get a notice a couple of DAYS ahead of renewal to remind you – but a 30 day notice is required to cancel. So it is way too late and they get your renewal dues. Guess what – all about gettin’ your money.
There is so much that so many people who complain do NOT understand about Liberty Health Share and how to work with them.
Before I signed up I contacted the business office of the medical group we use regularly. They said they WOULD bill a heath sharing ministry but in their experience the ministry would want them to write off most of the bill which they would not/could not do because of their contracts with insurance companies and, of course, the government. HOWEVER, they did say when we check in as patients to say WE ARE SELF PAY. I recently went to the doctor, told them I was SELF PAY. They added a slip to my chart for the doctor fill out, I brought the finished slip back to the desk when I was finished and BINGO: 40% off for my medical services. I can now submit that receipt to Liberty.
This is not rocket science- TELL your provider when you make your appointment that you are SELF PAY and ASK what the SELF PAY discount is. It is incumbent on YOU to do the paperwork rather than the doctors office – WHICH IS EXACTLY WHAT CAUSES THE COST OF MEDICAL CARE TO SKYROCKET!
We have had one provider discount as little as 10% but most in the 40%-50% range.
It is YOUR JOB to manage YOUR finances as well as health care, whether you are insured or not.
My son broke his leg during the Obamacare discussion, before it was rammed through. He had NO insurance. The hospital said 122 minutes of surgery wouid cost $18,000 and my adult,uninsured son dissolved into tears. The hospital then said they would give us 50% discount if we financed the $9000 balance with them. BUT if we could pay it RIGHTTHEN, they would knock off another 50% from the $9000. Needless to say I whipped out my VIsa. And after paying the $4500 with my Visa, we NEVER saw another bill from the hospital. The orthopedic surgeon and his group knocked of 50% for the surgeon and ALL follow up, the anesthesiologist knocked off 20% as did the physical therapy group. All total, his broken leg cost us about $10,000, which I agree is a frightening number, but it was FAR LESS than the original cost of JUST the hospital! I have no doubt my son would have been on the hook for close to $35,000-$40,000 had we not ASKED,
Is it possible to use Kaiser and will they give a self-pay discount if asked? We currently have Kaiser and are actually very happy with them, but do not wish to pay the new rate for 2018 ($1650 per MONTH for a healthy family of five before the maximum legally allowed copay and deductibles – and yes, that is the least expensive option available)
If we can join CHM and still use Kaiser we would do that. Does anyone do this (with Kaiser I mean)?
Wouldn’t be possible because Kaiser is an HMO and you can’t use Kaiser services unless you are a member of Kaiser
Our 2018 quote with Anthem BC BS is $2226.04! We are 63 and 61 and pretty healthy. We haven’t reached our $6300 each deductible for the last 2 years so we’ve basically paid almost $60,000 in 2 years since we have to pay for every Dr visit, MRI etc. We are looking into going with CHM and saving $1800 a month. Thank you for all of your comments. We’re trusting God with our decision.