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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