Ever wonder how you can pay less for health insurance?
It seems no matter which way I turn, healthcare in general is expensive. It’s one of the major expenses that seems to increase with time and diminish in coverage. Insurance is confusing and coverage isn’t always ideal. Routine medical care due to illness or injury are huge financial burdens. Are affordable options to traditional health insurance even a real thing?
If your employer provides a medical benefit, or health insurance, consider yourself lucky. Out-of-pocket costs for private insurance is more common now days, and comes with a higher price tag. I’ve personally experienced private healthcare insurance and employer-provided health insurance.
Today I’m going to expose a few different options you may not have heard about.
Private Insurance Options
Before I get to some cost-sharing alternatives, I need to look at the cost of private insurance premiums outside of employer-provided coverage. According to www.healthcare.gov, premium costs depend on different factors, like geographical location, marital status, and age, to name a few. In general, the premiums range from $300-$500 per month, with different levels of coverage (bronze, silver, and gold). But of course, your specific information about your household will determine your premium amount.
To find out more about private health insurance plans and pricing, click here.
Alternatives
During a stage of life when I stayed home full-time with my children, I quickly realized the cost of private insurance would not fit in our family’s budget. Around that same time, a family friend told us about a cost-sharing group he and his wife used. I looked into it and couldn’t believe something like this actually existed.
What is medical cost-sharing? First of all, it’s not insurance. These groups consist of members who all pay a fixed, low monthly premium and share each other’s medical bill costs. Too good to be true, right? That’s exactly what I thought. Tuns out, it’s 100% legit and millions of people utilize this alternative to keep health care costs low. As the patient, you basically are a cash-paying customer for healthcare services.
What groups share medical bill costs?There are several, but the three most-common are Medishare, Christian Healthcare Ministries (CHM), and Samaritan’s Ministries. Each is slightly different, but all function about the same.
How does it work?
As a member of one of these cost-sharing groups, you select which level of coverage you need, and pay the monthly premium. If you incur a medical bill from services you needed, you then submit the bill to your cost-sharing group, and those services are paid for in full. Once eligible bills are submitted to your group’s online portal, you are reimbursed the payment after a short period of time (usually 2-3 months).
What’s covered?
There are a few services that some cost-sharing groups do not pay for. These cost-sharing groups are faith-based, and members consent to living a Christian lifestyle upon joining. Therefore, members agree upfront with the uncovered services that conflict with a Christian lifestyle.
What’s the cost?
Here’s a breakdown of each groups’ cost per level of coverage:
Christian Healthcare Ministries:
Gold = $178
Silver = $118
Bronze = $78
Medishare = ranges from $105-$491
Cost per month depends on marital status, age, out of pocket cost amount, and number of members on the plan.
Check out their membership calculator here.
Samaritan’s Ministries
The same concept applies with Samaritan’s Ministries. Medical bills are shared 100% after a minimum threshold is met, which is $400 as a Samaritan’s Ministry member. However, there are certain stipulations in place surrounding pre-existing conditions. This basically postpones bill-sharing, ranging from 12 months to five years. Find out more about pre-existing conditions and how it may the plan you choose.
For Samaritan Ministries monthly pricing and plans, click here.
Can I combine both?
In most cases – yes, depending on the group you are a part of. For example, if you have family coverage through Samaritan’s Ministries, but you or your spouse also receives health insurance through work, it is possible to utilize both. In this scenario, the most cost-effective strategies is to select the high-deductible option with the lowest premium. Once that’s established, you’d want to enroll in one of the cost-sharing family plans, based on your needs.
Additionally, the idea behind this strategy is to allow your work-provided insurance to cover services first. Then, instead of paying out of pocket for whatever insurance doesn’t cover, you would share those medical bills with the other members in your cost-sharing group. In this scenario, the only cost to you would be your employer insurance premium combined with your cost-sharing group’s premium. It can be a thrifty way to pay for medical services as they arise, especially if you utilize a high deductible plan at work. High deductible plans usually have the lowest monthly premium.
Pros
Becoming a member of one of the cost-sharing plans above may prove most beneficial if you are in good health, have no insurance offered at your job, and/or may be starting to family. Less confusing than insurance, because of no co-pays, out of pocket max, etc. One monthly payment, and services shared when medical bills are incurred.
Cons
If you do have pre-existing conditions, the timeframe to begin sharing is extended. Not all services are covered, and there is typically no coverage for eye and dental. More tracking involved in terms of providing proof of services (medical bills) in order to share the cost. Reimbursement for services may take several months to process.
Summary
In conclusion, when it comes to health, having a prevention mindset is good, but some aspects of health are out of our control. Running the numbers for your specific scenario may in fact save you money in healthcare costs. It is reassuring to know the burden of healthcare costs is being shared among all the members of the group. To me, that alone is worth taking a look.