Author Topic: Let's talk about health share  (Read 15186 times)

boarder42

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Let's talk about health share
« on: January 14, 2017, 09:33:29 AM »
With all the talk of the ACA going belly up etc. 

Why aren't more mustachians looking at health share

I know the big caveat with these is they don't take pre existing conditions. So lets not debate that here. Let's assume you have none

Another great thing is they don't accept obese or smokers.

http://www.medicalcostshare.com/liberty-healthshare-program-options.html

Anyone doing this ?  Seems like a great option for catastrophic coverage. A family pays 449 per month plus the first 1500 out of pocket and the parent company does the negotiations for everyone including your initial 1500.

6888 per year for a family doesn't seem extreme

The operate as a non profit think insurance = bank - health share = credit union

boarder42

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Re: Let's talk about health share
« Reply #1 on: January 17, 2017, 05:26:19 AM »
Anybody? 

Comments?

Info?

rulesofacquisition

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Re: Let's talk about health share
« Reply #2 on: January 17, 2017, 05:54:42 AM »
We have belonged to Samaritan Ministries since 5/15. It is the only one of the 4 Christian health sharing groups that has you pay other people directly. The office sends you (I'm signed up to do everything online) a notice to send this month's share to John Doe in Texas, and you mail him a check for your "premium" amount, $440 currently for me and DH. The last 2 months the needs have been less than the total that would have come in, so we paid less. The also have "special prayer needs" so you can voluntarily send money, usually $20 or $25, to people to cover preexisting conditions or other things like dental that aren't covered - we send this, too. If you don't pay your regular amount you are dropped (I've heard people say this can't work because nobody will pay). Their website has details on what's covered and the requirements for membership.

I was in the ER twice in December so have sent in my first bills. The hospital would not negotiate the price, so a third party negotiator is dealing with that part. I'm responsible for the first $300, if the bills are discounted at least $300 I pay nothing. I'll repost to update how things are working.

boarder42

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Re: Let's talk about health share
« Reply #3 on: January 17, 2017, 05:57:04 AM »
awesome thanks for the information. looking forward to hearing how it goes. 

acroy

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Re: Let's talk about health share
« Reply #4 on: January 17, 2017, 07:00:26 AM »
Awesome!
We need more choices like this. All the accursed regulation/legislation is limiting our choices! grrrr... 'Insurance' was originally just a group of people sharing risk. Fire insurance, crop insurance - they'd all pitch in a small amount, and when something bad happened, the victim was covered.
I hope we can go back to that model. Buy what you need, even if that's nothing at all. My grandparents had true 'catastrophic' insurance (something like $20k deductible) for around $200/yr for the 2 of them through their professional society. It came in handy for them once or twice. Good luck!
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Gin1984

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Re: Let's talk about health share
« Reply #5 on: January 17, 2017, 01:03:30 PM »
I won't do it because it is not considered insurance which means even if you don't have any now, if you get one, no other insurance will cover you. 
Also, the religious stuff bothers me, I already don't want someone telling me to live according to Christian values, I don't need my imitation insurance company doing the same. 
And then we get to the lack of oversight and out right fraud with those ministries. 
No thanks.

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boarder42

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Re: Let's talk about health share
« Reply #6 on: January 17, 2017, 01:05:57 PM »
I won't do it because it is not considered insurance which means even if you don't have any now, if you get one, no other insurance will cover you. 
Also, the religious stuff bothers me, I already don't want someone telling me to live according to Christian values, I don't need my imitation insurance company doing the same. 
And then we get to the lack of oversight and out right fraud with those ministries. 
No thanks.

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at its heart its litterally what insurance was when it started before it became a profiteering business.

caracarn

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Re: Let's talk about health share
« Reply #7 on: January 17, 2017, 02:43:49 PM »
With current employer they would not cover my wife since she if eligible for insurance through her job.  She is a teacher making $35,000/year and her insurance would have been $1,400/month to just cover her through her school's plan so we said no thank you.   We moved her to Liberty in April but have not had any claims so cannot say much about it other than the cost is $199/month which is much better.

I've not heard the "it's not insurance" point before.  I understood the ACA allows it to be used instead but did not understand it precludes you in anyway from getting covered again.  Is this in reference to pre-existing conditions?  Where can I read more about this?

boarder42

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Re: Let's talk about health share
« Reply #8 on: January 17, 2017, 02:51:13 PM »
With current employer they would not cover my wife since she if eligible for insurance through her job.  She is a teacher making $35,000/year and her insurance would have been $1,400/month to just cover her through her school's plan so we said no thank you.   We moved her to Liberty in April but have not had any claims so cannot say much about it other than the cost is $199/month which is much better.

I've not heard the "it's not insurance" point before.  I understood the ACA allows it to be used instead but did not understand it precludes you in anyway from getting covered again.  Is this in reference to pre-existing conditions?  Where can I read more about this?

i dont think it precludes you from ever being covered again. not the way the current ACA is written but who knows with a future one.

seattlecyclone

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Re: Let's talk about health share
« Reply #9 on: January 17, 2017, 02:58:15 PM »
I've read that these schemes are under no contractual obligation to provide any payment to members whatsoever, so if something happens that's too expensive they could just decide not to pay for it and you would have no recourse. I don't know how common this is in practice, but it would give me pause.
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boarder42

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Re: Let's talk about health share
« Reply #10 on: January 17, 2017, 02:59:18 PM »
I've read that these schemes are under no contractual obligation to provide any payment to members whatsoever, so if something happens that's too expensive they could just decide not to pay for it and you would have no recourse. I don't know how common this is in practice, but it would give me pause.

yes this is 100% true though most have never not paid a claim.  and you can look all that up.

caracarn

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Re: Let's talk about health share
« Reply #11 on: January 17, 2017, 03:24:14 PM »
I've read that these schemes are under no contractual obligation to provide any payment to members whatsoever, so if something happens that's too expensive they could just decide not to pay for it and you would have no recourse. I don't know how common this is in practice, but it would give me pause.

That is accurate, but the major three have consistently paid their claims.  Since it is a pooling process when we looked that was a prime things we looked at was the total members, because if you have 30,000 members and you have $100,000 bill you can get that $3+ for each member who has paid, versus the smaller companies that have many fewer members and may not have the funds.

Gin1984

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Re: Let's talk about health share
« Reply #12 on: January 18, 2017, 06:58:46 AM »
With current employer they would not cover my wife since she if eligible for insurance through her job.  She is a teacher making $35,000/year and her insurance would have been $1,400/month to just cover her through her school's plan so we said no thank you.   We moved her to Liberty in April but have not had any claims so cannot say much about it other than the cost is $199/month which is much better.

I've not heard the "it's not insurance" point before.  I understood the ACA allows it to be used instead but did not understand it precludes you in anyway from getting covered again.  Is this in reference to pre-existing conditions?  Where can I read more about this?
Here is a law journal article:
http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1341&context=jlh

canisius

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Re: Let's talk about health share
« Reply #13 on: January 18, 2017, 12:36:01 PM »
We signed up for Liberty this year.  I'm a teacher and my health premium is only $70.  However, my wife would raise the premium to $950, and family to $1300.  This is with a $6000 deductable.  Now, to make matters more interesting is two of my three children are covered by CHIP, but because my adopted / step daughter is a permanent resident and has been a PR less than five years (Permanent Residency is calculated by when it was approved, not when one landed in the country, she legally immigrated to the U.S. when she was six months, but USCIS didn't approve her application until three years later) she doesn't qualify for benefits in Texas.  So, went to Liberty because to be frank, we cannot afford to devote a third of my salary to health insurance with a de facto catastrophic deductible.  We haven't used it, but we also called many times beforehand to be clear what the riders and exceptions were.  In addition, we also called the doctors and hospitals around to get their cost list and to explain the program to have an idea of which ones to use.  Luckily all our doctors and preferred hospitals said they did not have a problem with it.  One reason we went with Liberty over others was their allowance of ambulances and medical devices in home up to the 1 million limit. 

Are we taking a risk?  sure.  Do I feel comfortable with it.  After a lot of research, and understanding the limits and exceptions.  Yes.
« Last Edit: January 18, 2017, 12:49:39 PM by canisius »

boarder42

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Re: Let's talk about health share
« Reply #14 on: January 18, 2017, 12:46:05 PM »
With current employer they would not cover my wife since she if eligible for insurance through her job.  She is a teacher making $35,000/year and her insurance would have been $1,400/month to just cover her through her school's plan so we said no thank you.   We moved her to Liberty in April but have not had any claims so cannot say much about it other than the cost is $199/month which is much better.

I've not heard the "it's not insurance" point before.  I understood the ACA allows it to be used instead but did not understand it precludes you in anyway from getting covered again.  Is this in reference to pre-existing conditions?  Where can I read more about this?
Here is a law journal article:
http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1341&context=jlh

anyone want to summarize the 67 pages of legal jargin.

Gin1984

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Re: Let's talk about health share
« Reply #15 on: January 18, 2017, 01:01:06 PM »
With current employer they would not cover my wife since she if eligible for insurance through her job.  She is a teacher making $35,000/year and her insurance would have been $1,400/month to just cover her through her school's plan so we said no thank you.   We moved her to Liberty in April but have not had any claims so cannot say much about it other than the cost is $199/month which is much better.

I've not heard the "it's not insurance" point before.  I understood the ACA allows it to be used instead but did not understand it precludes you in anyway from getting covered again.  Is this in reference to pre-existing conditions?  Where can I read more about this?
Here is a law journal article:
http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1341&context=jlh

anyone want to summarize the 67 pages of legal jargin.
Not health insurance, they don't want to be health insurance because then they have to follow those rules.  Some states want them to be considered health insurance, some don't.  Some think even if it is, it should not have to follow the laws because religion.  Then religion, religion, religion. How healthshares relate to ACA, and why those statements means states cannot treat them like insurance.

caracarn

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Re: Let's talk about health share
« Reply #16 on: January 18, 2017, 01:07:19 PM »
With current employer they would not cover my wife since she if eligible for insurance through her job.  She is a teacher making $35,000/year and her insurance would have been $1,400/month to just cover her through her school's plan so we said no thank you.   We moved her to Liberty in April but have not had any claims so cannot say much about it other than the cost is $199/month which is much better.

I've not heard the "it's not insurance" point before.  I understood the ACA allows it to be used instead but did not understand it precludes you in anyway from getting covered again.  Is this in reference to pre-existing conditions?  Where can I read more about this?
Here is a law journal article:
http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1341&context=jlh

anyone want to summarize the 67 pages of legal jargin.
Not health insurance, they don't want to be health insurance because then they have to follow those rules.  Some states want them to be considered health insurance, some don't.  Some think even if it is, it should not have to follow the laws because religion.  Then religion, religion, religion. How healthshares relate to ACA, and why those statements means states cannot treat them like insurance.

My interest and concern is more about the claim that once you have this you cannot be covered under insurance again. 

I understand it is not insurance, but  nowhere have I ever seen a problem moving back to standard insurance if the opportunity presents itself.

boarder42

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Re: Let's talk about health share
« Reply #17 on: January 18, 2017, 01:07:37 PM »
With current employer they would not cover my wife since she if eligible for insurance through her job.  She is a teacher making $35,000/year and her insurance would have been $1,400/month to just cover her through her school's plan so we said no thank you.   We moved her to Liberty in April but have not had any claims so cannot say much about it other than the cost is $199/month which is much better.

I've not heard the "it's not insurance" point before.  I understood the ACA allows it to be used instead but did not understand it precludes you in anyway from getting covered again.  Is this in reference to pre-existing conditions?  Where can I read more about this?
Here is a law journal article:
http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1341&context=jlh

anyone want to summarize the 67 pages of legal jargin.
Not health insurance, they don't want to be health insurance because then they have to follow those rules.  Some states want them to be considered health insurance, some don't.  Some think even if it is, it should not have to follow the laws because religion.  Then religion, religion, religion. How healthshares relate to ACA, and why those statements means states cannot treat them like insurance.

well yes that is their loop hole out of the ACA.  I think there are reasonable risks with using one.  and i'm not "religious" but many dont require that anymore.  but thats what  insurance is about mitigating risk for a price.  is there a risk paying into this if they fold yes.  If the law for insurance ever says you must have what we classify as insurance from age 2x on or you wont have any pre existing conditions covered i think the risk with using something like this increases.  on the flip side i think the costs are much more reasonable and provdie a cap to the level of catastrophic coverage available.  but i wont have to cross this bridge til i'm FIREd so we have 7 years to see what unfolds in the health coverage market place.

boarder42

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Re: Let's talk about health share
« Reply #18 on: January 18, 2017, 01:09:03 PM »
With current employer they would not cover my wife since she if eligible for insurance through her job.  She is a teacher making $35,000/year and her insurance would have been $1,400/month to just cover her through her school's plan so we said no thank you.   We moved her to Liberty in April but have not had any claims so cannot say much about it other than the cost is $199/month which is much better.

I've not heard the "it's not insurance" point before.  I understood the ACA allows it to be used instead but did not understand it precludes you in anyway from getting covered again.  Is this in reference to pre-existing conditions?  Where can I read more about this?
Here is a law journal article:
http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1341&context=jlh

anyone want to summarize the 67 pages of legal jargin.
Not health insurance, they don't want to be health insurance because then they have to follow those rules.  Some states want them to be considered health insurance, some don't.  Some think even if it is, it should not have to follow the laws because religion.  Then religion, religion, religion. How healthshares relate to ACA, and why those statements means states cannot treat them like insurance.

My interest and concern is more about the claim that once you have this you cannot be covered under insurance again. 

I understand it is not insurance, but  nowhere have I ever seen a problem moving back to standard insurance if the opportunity presents itself.

correct.  see my post i just made as you were posting this.  thats my only real risk concern ... is IF you dont have "real insurance" coverage non stop with no gaps from age 2x on in your life you will not be covered under the pre existing conditions clause. or something to that effect.

caracarn

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Re: Let's talk about health share
« Reply #19 on: January 18, 2017, 01:17:20 PM »
With current employer they would not cover my wife since she if eligible for insurance through her job.  She is a teacher making $35,000/year and her insurance would have been $1,400/month to just cover her through her school's plan so we said no thank you.   We moved her to Liberty in April but have not had any claims so cannot say much about it other than the cost is $199/month which is much better.

I've not heard the "it's not insurance" point before.  I understood the ACA allows it to be used instead but did not understand it precludes you in anyway from getting covered again.  Is this in reference to pre-existing conditions?  Where can I read more about this?
Here is a law journal article:
http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1341&context=jlh

anyone want to summarize the 67 pages of legal jargin.
Not health insurance, they don't want to be health insurance because then they have to follow those rules.  Some states want them to be considered health insurance, some don't.  Some think even if it is, it should not have to follow the laws because religion.  Then religion, religion, religion. How healthshares relate to ACA, and why those statements means states cannot treat them like insurance.

well yes that is their loop hole out of the ACA.  I think there are reasonable risks with using one.  and i'm not "religious" but many dont require that anymore.  but thats what  insurance is about mitigating risk for a price.  is there a risk paying into this if they fold yes.  If the law for insurance ever says you must have what we classify as insurance from age 2x on or you wont have any pre existing conditions covered i think the risk with using something like this increases.  on the flip side i think the costs are much more reasonable and provdie a cap to the level of catastrophic coverage available.  but i wont have to cross this bridge til i'm FIREd so we have 7 years to see what unfolds in the health coverage market place.

That I can understand.  If the law CHANGES, from what it is now, and there is a pre-existing condition you'd be back in the same boat, but that's what the people now on ACA plans are worried about anyway.  I get we need to monitor the rule changes and unless they are entirely irresponsible about how they go about making these changes, you would assume there will a grace period to re-establish traditional insurance coverage.  I had understood that under current conditions there was something that forbade you from ever moving back to traditional insurance.  I understand that is not the case now, which is what I had thought.

Gin1984

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Re: Let's talk about health share
« Reply #20 on: January 18, 2017, 01:23:43 PM »
With current employer they would not cover my wife since she if eligible for insurance through her job.  She is a teacher making $35,000/year and her insurance would have been $1,400/month to just cover her through her school's plan so we said no thank you.   We moved her to Liberty in April but have not had any claims so cannot say much about it other than the cost is $199/month which is much better.

I've not heard the "it's not insurance" point before.  I understood the ACA allows it to be used instead but did not understand it precludes you in anyway from getting covered again.  Is this in reference to pre-existing conditions?  Where can I read more about this?
Here is a law journal article:
http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1341&context=jlh

anyone want to summarize the 67 pages of legal jargin.
Not health insurance, they don't want to be health insurance because then they have to follow those rules.  Some states want them to be considered health insurance, some don't.  Some think even if it is, it should not have to follow the laws because religion.  Then religion, religion, religion. How healthshares relate to ACA, and why those statements means states cannot treat them like insurance.

well yes that is their loop hole out of the ACA.  I think there are reasonable risks with using one.  and i'm not "religious" but many dont require that anymore.  but thats what  insurance is about mitigating risk for a price.  is there a risk paying into this if they fold yes.  If the law for insurance ever says you must have what we classify as insurance from age 2x on or you wont have any pre existing conditions covered i think the risk with using something like this increases.  on the flip side i think the costs are much more reasonable and provdie a cap to the level of catastrophic coverage available.  but i wont have to cross this bridge til i'm FIREd so we have 7 years to see what unfolds in the health coverage market place.

That I can understand.  If the law CHANGES, from what it is now, and there is a pre-existing condition you'd be back in the same boat, but that's what the people now on ACA plans are worried about anyway.  I get we need to monitor the rule changes and unless they are entirely irresponsible about how they go about making these changes, you would assume there will a grace period to re-establish traditional insurance coverage.  I had understood that under current conditions there was something that forbade you from ever moving back to traditional insurance.  I understand that is not the case now, which is what I had thought.
The problem is that if you have a pre-existing condition and are on a heathshare there is no transitioning back on transitional insurance and having your condition covered if the law changes (which seems likely).  I was unwilling to assume the law would never change which meant going without insurance was not an option for me.  Being aware that because it is not insurance you don't have the same protection, as you make your choice, seems important to me.


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bacchi

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Re: Let's talk about health share
« Reply #21 on: January 18, 2017, 01:37:36 PM »
What's the yearly and lifetime limits for these plans? There's a reason that limits were banned under the ACA.

Quote from: libertyhealthshare
MAXIMUM: For Liberty Share℠ and Liberty Plus℠ $125,000 per incident
<or>
Liberty Complete℠ MAXIMUM: $1,000,000 per incident

Do these plans cover prescriptions and is there a limit?

Quote from: libertyhealthshare
Prescriptions 45 days before and after each related medical incident

If the illness lasts longer than 45 days, you're SOL?

Underwriting is allowed. What's their stated policy of kicking someone out if they get a chronic illness and send in $5000 bills each month?


These plans might be good for a minor to serious accident/illness. For a serious and chronic condition, you're better off with a regulated plan. It then becomes, like all insurance, a numbers game -- what are the odds I'll get a chronic illness?

With good underwriting, these plans can exclude the sick and going-to-be-sick and avoid a death spiral. Kinda like regulated plans did before the ACA.


boarder42

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Re: Let's talk about health share
« Reply #22 on: January 18, 2017, 01:44:30 PM »
What's the yearly and lifetime limits for these plans? There's a reason that limits were banned under the ACA.

Quote from: libertyhealthshare
MAXIMUM: For Liberty Share℠ and Liberty Plus℠ $125,000 per incident
<or>
Liberty Complete℠ MAXIMUM: $1,000,000 per incident

Do these plans cover prescriptions and is there a limit?

Quote from: libertyhealthshare
Prescriptions 45 days before and after each related medical incident

If the illness lasts longer than 45 days, you're SOL?

Underwriting is allowed. What's their stated policy of kicking someone out if they get a chronic illness and send in $5000 bills each month?


These plans might be good for a minor to serious accident/illness. For a serious and chronic condition, you're better off with a regulated plan. It then becomes, like all insurance, a numbers game -- what are the odds I'll get a chronic illness?

With good underwriting, these plans can exclude the sick and going-to-be-sick and avoid a death spiral. Kinda like regulated plans did before the ACA.

well under the current system as it sits now you just go to an ACA plan.  not saying that wont change but its really the only reason someone wouldnt use this right now is if you have a chronic illness.  if you do jump over to the ACA as it sits right now the next open enrollment.

bacchi

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Re: Let's talk about health share
« Reply #23 on: January 18, 2017, 01:54:21 PM »
well under the current system as it sits now you just go to an ACA plan.  not saying that wont change but its really the only reason someone wouldnt use this right now is if you have a chronic illness.  if you do jump over to the ACA as it sits right now the next open enrollment.

True but there could as long as an 10+ month gap, right? You'd get diagnosed with breast cancer on 2/16 and have to wait until 1/1 for a regulated plan. In the meantime, you can send in your large and non-negotiated bills to the share and hope they get covered. Have you seen a $35000 mastectomy bill show up in your share? What about a $4500/month bill for Herceptin treatment? What about adding in Perjeta -- the combined monthly cost is now about $10k?

These plans are only for the young and healthy.

boarder42

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Re: Let's talk about health share
« Reply #24 on: January 18, 2017, 01:59:01 PM »
well under the current system as it sits now you just go to an ACA plan.  not saying that wont change but its really the only reason someone wouldnt use this right now is if you have a chronic illness.  if you do jump over to the ACA as it sits right now the next open enrollment.

True but there could as long as an 10+ month gap, right? You'd get diagnosed with breast cancer on 2/16 and have to wait until 1/1 for a regulated plan. In the meantime, you can send in your large and non-negotiated bills to the share and hope they get covered. Have you seen a $35000 mastectomy bill show up in your share? What about a $4500/month bill for Herceptin treatment? What about adding in Perjeta -- the combined monthly cost is now about $10k?

These plans are only for the young and healthy.

i dont know that hope they are covered is the right answer.  Liberty hasnt ever not paid a bill ... and based on the size and time they've been around someone got cancer.

boarder42

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Re: Let's talk about health share
« Reply #25 on: January 18, 2017, 02:57:43 PM »
its a cost ratio.

just like choosing and HDHP over a PPO etc.

if its 12k per year to insure my family of 4 on typical healthcare plus a crazy 10k deductible on top vs 6k per year to insure on health share.  the break even time on something thats 10k per month isnt that long.  even if you had to start using it in Jan and then wait to switch... its math. all insurance is a math risk game.  but you're talking extreme cases still which i think this type of "insurance" paired with possibly going on a regular plan could work well for a mustachian who is FIREd



bacchi

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Re: Let's talk about health share
« Reply #26 on: January 18, 2017, 03:28:25 PM »
well under the current system as it sits now you just go to an ACA plan.  not saying that wont change but its really the only reason someone wouldnt use this right now is if you have a chronic illness.  if you do jump over to the ACA as it sits right now the next open enrollment.

True but there could as long as an 10+ month gap, right? You'd get diagnosed with breast cancer on 2/16 and have to wait until 1/1 for a regulated plan. In the meantime, you can send in your large and non-negotiated bills to the share and hope they get covered. Have you seen a $35000 mastectomy bill show up in your share? What about a $4500/month bill for Herceptin treatment? What about adding in Perjeta -- the combined monthly cost is now about $10k?

These plans are only for the young and healthy.

i dont know that hope they are covered is the right answer.  Liberty hasnt ever not paid a bill ... and based on the size and time they've been around someone got cancer.

It was a trick question. :) Liberty only covers prescription drugs for 45 days before and after the incident.

Being part of a sharing club and also having a regulated very high-deductible plan might make sense. You'd be covered for minor to mid-range incidents and also covered for extreme illnesses. And if there was a scandal and a director was wasting money on hookers and blow, you'd have a fall back.

boarder42

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Re: Let's talk about health share
« Reply #27 on: January 18, 2017, 04:22:41 PM »
well under the current system as it sits now you just go to an ACA plan.  not saying that wont change but its really the only reason someone wouldnt use this right now is if you have a chronic illness.  if you do jump over to the ACA as it sits right now the next open enrollment.

True but there could as long as an 10+ month gap, right? You'd get diagnosed with breast cancer on 2/16 and have to wait until 1/1 for a regulated plan. In the meantime, you can send in your large and non-negotiated bills to the share and hope they get covered. Have you seen a $35000 mastectomy bill show up in your share? What about a $4500/month bill for Herceptin treatment? What about adding in Perjeta -- the combined monthly cost is now about $10k?

These plans are only for the young and healthy.

i dont know that hope they are covered is the right answer.  Liberty hasnt ever not paid a bill ... and based on the size and time they've been around someone got cancer.

It was a trick question. :) Liberty only covers prescription drugs for 45 days before and after the incident.

Being part of a sharing club and also having a regulated very high-deductible plan might make sense. You'd be covered for minor to mid-range incidents and also covered for extreme illnesses. And if there was a scandal and a director was wasting money on hookers and blow, you'd have a fall back.

It doesn't matter you didn't listen to what I said. Who cares if it's only 45 days before and after. Under the current system I can swap to a real plan during open enrollment. No reason to carry both. The cost of the ACA plans are more than 2x the price. We're talking over 6k savings per year.

SimpleCycle

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Re: Let's talk about health share
« Reply #28 on: January 18, 2017, 05:15:55 PM »
well under the current system as it sits now you just go to an ACA plan.  not saying that wont change but its really the only reason someone wouldnt use this right now is if you have a chronic illness.  if you do jump over to the ACA as it sits right now the next open enrollment.

True but there could as long as an 10+ month gap, right? You'd get diagnosed with breast cancer on 2/16 and have to wait until 1/1 for a regulated plan. In the meantime, you can send in your large and non-negotiated bills to the share and hope they get covered. Have you seen a $35000 mastectomy bill show up in your share? What about a $4500/month bill for Herceptin treatment? What about adding in Perjeta -- the combined monthly cost is now about $10k?

These plans are only for the young and healthy.

i dont know that hope they are covered is the right answer.  Liberty hasnt ever not paid a bill ... and based on the size and time they've been around someone got cancer.

It was a trick question. :) Liberty only covers prescription drugs for 45 days before and after the incident.

Being part of a sharing club and also having a regulated very high-deductible plan might make sense. You'd be covered for minor to mid-range incidents and also covered for extreme illnesses. And if there was a scandal and a director was wasting money on hookers and blow, you'd have a fall back.

It doesn't matter you didn't listen to what I said. Who cares if it's only 45 days before and after. Under the current system I can swap to a real plan during open enrollment. No reason to carry both. The cost of the ACA plans are more than 2x the price. We're talking over 6k savings per year.

His point is you could incur the entire chemo bill before you can do open enrollment and you'd be responsible for anything falling beyond 45 days.

boarder42

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Re: Let's talk about health share
« Reply #29 on: January 18, 2017, 05:25:54 PM »
well under the current system as it sits now you just go to an ACA plan.  not saying that wont change but its really the only reason someone wouldnt use this right now is if you have a chronic illness.  if you do jump over to the ACA as it sits right now the next open enrollment.

True but there could as long as an 10+ month gap, right? You'd get diagnosed with breast cancer on 2/16 and have to wait until 1/1 for a regulated plan. In the meantime, you can send in your large and non-negotiated bills to the share and hope they get covered. Have you seen a $35000 mastectomy bill show up in your share? What about a $4500/month bill for Herceptin treatment? What about adding in Perjeta -- the combined monthly cost is now about $10k?

These plans are only for the young and healthy.

i dont know that hope they are covered is the right answer.  Liberty hasnt ever not paid a bill ... and based on the size and time they've been around someone got cancer.

It was a trick question. :) Liberty only covers prescription drugs for 45 days before and after the incident.

Being part of a sharing club and also having a regulated very high-deductible plan might make sense. You'd be covered for minor to mid-range incidents and also covered for extreme illnesses. And if there was a scandal and a director was wasting money on hookers and blow, you'd have a fall back.

It doesn't matter you didn't listen to what I said. Who cares if it's only 45 days before and after. Under the current system I can swap to a real plan during open enrollment. No reason to carry both. The cost of the ACA plans are more than 2x the price. We're talking over 6k savings per year.

His point is you could incur the entire chemo bill before you can do open enrollment and you'd be responsible for anything falling beyond 45 days.

Maybe I don't get how chemo works but wouldn't the treatments be covered under the health share.

mskyle

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Re: Let's talk about health share
« Reply #30 on: January 18, 2017, 05:31:41 PM »
well under the current system as it sits now you just go to an ACA plan.  not saying that wont change but its really the only reason someone wouldnt use this right now is if you have a chronic illness.  if you do jump over to the ACA as it sits right now the next open enrollment.

True but there could as long as an 10+ month gap, right? You'd get diagnosed with breast cancer on 2/16 and have to wait until 1/1 for a regulated plan. In the meantime, you can send in your large and non-negotiated bills to the share and hope they get covered. Have you seen a $35000 mastectomy bill show up in your share? What about a $4500/month bill for Herceptin treatment? What about adding in Perjeta -- the combined monthly cost is now about $10k?

These plans are only for the young and healthy.

i dont know that hope they are covered is the right answer.  Liberty hasnt ever not paid a bill ... and based on the size and time they've been around someone got cancer.

It was a trick question. :) Liberty only covers prescription drugs for 45 days before and after the incident.

Being part of a sharing club and also having a regulated very high-deductible plan might make sense. You'd be covered for minor to mid-range incidents and also covered for extreme illnesses. And if there was a scandal and a director was wasting money on hookers and blow, you'd have a fall back.

It doesn't matter you didn't listen to what I said. Who cares if it's only 45 days before and after. Under the current system I can swap to a real plan during open enrollment. No reason to carry both. The cost of the ACA plans are more than 2x the price. We're talking over 6k savings per year.

His point is you could incur the entire chemo bill before you can do open enrollment and you'd be responsible for anything falling beyond 45 days.

Maybe I don't get how chemo works but wouldn't the treatments be covered under the health share.

Chemo is drugs. Prescription drugs. Chemo can often take more than 45 (or 90) days, depending on how you count it.

Also, jeez, you just have to have one kid get diagnosed with a serious congenital disease in February and you're in very real danger of reaching that $1,000,000 limit well before ACA open enrollment starts.


boarder42

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Re: Let's talk about health share
« Reply #32 on: January 18, 2017, 05:47:07 PM »
I really don't see a down side to these things. The negotiate on your behalf. They basically act like insurance but arent after profit. Obviously the 2 big negatives are
1. The pre existing law changing would effect it
2. Them not paying. Which really hasn't happened much.

Also with the Donald talking of letting everyone contribute to an HSA regardless of plan makes this look even better

SKL-HOU

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Re: Let's talk about health share
« Reply #33 on: January 18, 2017, 05:57:50 PM »
My son's NICU stay was 500k. Would health share cover that? Luckily I had insurance through work and only paid $1250 oop.

boarder42

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Re: Let's talk about health share
« Reply #34 on: January 18, 2017, 06:01:05 PM »
I think it would you can google it. And pay for the 1MM per incident. Also the 500k would be negotiated down just like your insurance does.

SimpleCycle

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Re: Let's talk about health share
« Reply #35 on: January 18, 2017, 07:25:02 PM »
I don't think they're a terrible option, but I think we need the alternative of regulated insurance plans.  It's hard to have two systems exist side by side without the full coverage option being subject to an adverse selection death spiral, which is why all insurance must be community rated and accept everyone.

At the end of the day these shares can be cheap because they don't bear risk for the sickest individuals.  And people can take that risk because they can always opt into the regulated insurance market.

Bimmy

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Re: Let's talk about health share
« Reply #36 on: January 18, 2017, 10:33:36 PM »
We have a medical sharing plan. We were not eligible for an subsidy under ACA. Monthly premium for the plans without a subsidy were over $1,000 a month (with 10k family deductible).

So- I researched medical sharing plans. We went with Christian Healthcare Ministries Silver plan.

Monthly Premium - $255 (that is for a family of 5 including me)
Annual enrollment fee - $40 per year
Brother's Keeper- $75 per quarter (This is the sharing part. Its a fluctuating number based on the claims they have received that quarter. Its our families "share." Its normally about $75 per quarter for all 5 of us.)

Limits: Up to $225,000 per incident
Deductible: $1,000 per incident
Prescription Coverage: None (I do pay Walgreens ~$32 a year for a family discount plan. I can also use HEB (Think Krogers) for a lot of medicines. HEB generics are normally $4 each
Doctor's Visits: No coverage
Ambulance: No coverage
Pre-Existing Issues: Not covered for first 3 years of the plan

(Note that they use incident instead of annually. If we each break a leg this year- I have to pay the first $1,000 for each broken leg. HOWEVER, each dollar I negotiate the bill down will count as a dollar toward that $1,000).

Its not a good fit for everyone. We were ok with accepting some liability in exchange for a massive saving on our monthly premium (Roughly $700 a month compared to ACA). CHM does have lifestyle requirements unlike any insurance company. Smoking and church attendance being the big two. We already dont smoke and go to church- so those were non issues for us.
Bimmy. Close relative to Billy and Jimmy Lee of the Double Dragon Series.

boarder42

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Re: Let's talk about health share
« Reply #37 on: January 19, 2017, 05:51:02 AM »
yeah i think liberty on the 1MM is what we would end up with we will have both of the children we plan to have before we retire in 7ish years.  so we will know if there are any current conditions that would make us need to be on the real insurance.  Also who knows what happens with all this in 7 years anyways. 

I think liberty is the best place for us based on what exists now. but we can see

I see the concerns but to me these are similar to the market may go down forever concerns so i'll pay off my mortgage.  its just a cost/risk analysis at the end of the day.

boarder42

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Re: Let's talk about health share
« Reply #38 on: January 19, 2017, 05:55:11 AM »
To me this just screams mustachian. 

1. negotiate the bills down
2. know what the bills are (you never know under existing systems)
3. its affordable
4. they almost all cover pre existing conditions after a certain time frame of waiting. 
     a. maybe some of you should look into this to supplement you insurance. 

5. under the current system if something bad does happen you can figure out if a private insurance plan makes more sense.

boarder42

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Re: Let's talk about health share
« Reply #39 on: January 19, 2017, 06:18:08 AM »
So based on what we know today the subsidies will go away so my family of 4 based on a calculator i just pulled  up would pay 12000 a year on obamacare. - with a 12k deductible

or we could pay 449 a month plus a 125 annual membership fee to be on Liberty healthshare. - 5500 a year.  with at 1500 deductible .  This would give us 1MM in coverage. and includes 1 wellness checkup per person annually that doesnt count towards the deductible.

if we assume a checkup is 300 per person - likely low.   thats another 1200 out of pocket on the obamacare plan. 

so assuming we're all healthy all year we'll pay 13200 ... vs 5500 a difference annually of - 7700 dollars.

now what happens if someone needs extra care of say 50k.  well under obamacare we're gonna spend 25.2k to get there... under liberty we would pay 7k - 18200 difference.

Now what if this care exceeds 1MM dollars. - also i cant find good data on the type of care that would cost more than 1MM a year.  but i doubt there are very many or that this is very likely.  and at the same time this would have to hit early in the year.  but if someone could provide me a list of care that exceeds 1MM dollars i'd be happy to look it over and evaluate whether i think its relevant to be afraid of it happening to me to the tune of almost 8k per year and increasing. 

Not to mention the simple compounding effect of that 8k annually i'm saving. if it takes 10 years to get something over 1MM i have an extra 100k in the bank if it takes 30 i have an extra 800k in the bank. 

Can anyone provide concrete 1MM+ dollar costs after insurance did their negotiation that occured in 1 year from one person.


Gin1984

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Re: Let's talk about health share
« Reply #40 on: January 19, 2017, 07:01:34 AM »
I think it would you can google it. And pay for the 1MM per incident. Also the 500k would be negotiated down just like your insurance does.
They say you are suppose to say you are self-pay and negotiate it yourself.  Where do you see they will negotiate it?

Gin1984

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Re: Let's talk about health share
« Reply #41 on: January 19, 2017, 07:05:35 AM »
To me this just screams mustachian. 

1. negotiate the bills down
2. know what the bills are (you never know under existing systems)
3. its affordable
4. they almost all cover pre existing conditions after a certain time frame of waiting. 
     a. maybe some of you should look into this to supplement you insurance. 

5. under the current system if something bad does happen you can figure out if a private insurance plan makes more sense.
You don't know what the bills are until AFTER you get it.  And the current system is being destroyed, why should I assume it is going to be useful and potentially lose ALL coverage to save a few dollars.  I see it as being penny wise and pound foolish.

Helvegen

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Re: Let's talk about health share
« Reply #42 on: January 19, 2017, 07:05:45 AM »
I hadn't heard of this until the other day when I was listening to a podcast from Scott Allen Turner about it. He and his wife came to the conclusion it was just too risky. YMMV.

https://www.youtube.com/watch?v=EsUJ_9sJPBk



MoonLiteNite

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Re: Let's talk about health share
« Reply #43 on: January 19, 2017, 07:18:36 AM »
Awesome!
We need more choices like this. All the accursed regulation/legislation is limiting our choices! grrrr... 'Insurance' was originally just a group of people sharing risk. Fire insurance, crop insurance - they'd all pitch in a small amount, and when something bad happened, the victim was covered.
I hope we can go back to that model. Buy what you need, even if that's nothing at all. My grandparents had true 'catastrophic' insurance (something like $20k deductible) for around $200/yr for the 2 of them through their professional society. It came in handy for them once or twice. Good luck!

I agree, and your grandparents plan is basically like my HDHP. Everyone always asked if i am worried if i can get sick... i am like "no, i just pay 100$ to see the doctor, and 80$ for some meds" and they start preaching to me if i had health care i could only pay 10$ instead of 100, and the meds would be like 5$. Then i have explain to them that i only pay 4$/week for my health care and not 100$/week haha

boarder42

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Re: Let's talk about health share
« Reply #44 on: January 19, 2017, 07:28:36 AM »
I think it would you can google it. And pay for the 1MM per incident. Also the 500k would be negotiated down just like your insurance does.
They say you are suppose to say you are self-pay and negotiate it yourself.  Where do you see they will negotiate it?

http://www.medicalcostshare.com/comparison-of-major-healthcare-sharing-ministries.html?utm_term=2196ct

2 of the big 4 do.  they ask you to negotiate too.
snip
You don't know what the bills are until AFTER you get it.  And the current system is being destroyed, why should I assume it is going to be useful and potentially lose ALL coverage to save a few dollars.  I see it as being penny wise and pound foolish.

not true in all circumstances.  and its not a few dollars its thousands of dollars. 

again everyone here is saying but what if xyz. etc.   but no one has yet to list out medical needs that total 1MM plus for a given year after negotiating down the price by an insurance provider.  and the likelihood of these medical issues occuring. 

boarder42

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Re: Let's talk about health share
« Reply #45 on: January 19, 2017, 07:30:03 AM »
also at the end of the day if you're truly that scared you can tack on some of the older non ACA approved insurances for that huge what if the sky falls on me situation. as indicated for about 200/year above.

at the very least that combo makes more sense than any ACA plan.

Gin1984

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Re: Let's talk about health share
« Reply #46 on: January 19, 2017, 07:37:58 AM »
also at the end of the day if you're truly that scared you can tack on some of the older non ACA approved insurances for that huge what if the sky falls on me situation. as indicated for about 200/year above.

at the very least that combo makes more sense than any ACA plan.
No, I can't.  Literally, I won't be approved.  I am one of those people who would be unable to get health insurance because of pre-existing conditions.  So, it is not a sky falling kind of situation, it is my normal life.

boarder42

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Re: Let's talk about health share
« Reply #47 on: January 19, 2017, 07:45:53 AM »
also at the end of the day if you're truly that scared you can tack on some of the older non ACA approved insurances for that huge what if the sky falls on me situation. as indicated for about 200/year above.

at the very least that combo makes more sense than any ACA plan.
No, I can't.  Literally, I won't be approved.  I am one of those people who would be unable to get health insurance because of pre-existing conditions.  So, it is not a sky falling kind of situation, it is my normal life.

ok so this isnt for you ... for the 90%+ of the population that this probably applies to it could be beneficial... but it does create a problem for those on the ACA style plans with pre existing conditions if the healthy choose to move away to plans like this. 

i assume you're paying much less and have found a plan that benefits you at the expense of the rest on the plan.  otherwise you'd pay out of pocket for whatever you need continuous support for. 

This is why without having single payer for the country health insurance rates keep rising.  its not the same as buying car or home insurance with caps and known rebuild costs.  people can get continous support or have pre existing conditions ... and then allowing those people to pay the same as everyone else makes everyone pay astronomical rates for it to make sense. 

for the record i fully support a single payer govt/private non profit run plan that covers everyone but until that happens i'll figure out whats optimal for myself.  and this appears that way ... assuming my kids are born healthy. 

FIREby35

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Re: Let's talk about health share
« Reply #48 on: January 19, 2017, 08:20:30 AM »
Just thought I would chime in - we are using MediShare for my family of 5. We have a high income, so Obamacare was very bad for our family (not a political statement, just a fact). Our plan was cancelled, the new plans were WAY more expensive, we got no subsidies. Not exaggerating, we were going to be paying 15k per year for the bronze plan, with 10 k deductible and 50/50 after that until a 20k out of pocket. It was nuts.

So, we did the medishare thing and swallowed all the concerns mentioned here by everyone else. We are now paying 500 per month (6k per year). Total out of pocket max is $2,500.

We had our third child using this plan, it was by far the cheapest child we have had.

We have discovered some loopholes, children get vaccines from doctors. If you have insurance, they will make you pay $1,000+ dollars (per kid and we have 3!) If you say you are uninsured, which is true with medical bill sharing, they give you the exact same thing for free. What a racket.

I will say, negotiating medical bills, especially high ones, is very, very possible. I'm a trial attorney and do it for my injured clients all the time. Even so, if anyone here was to get a huge bill, they could go to a local plaintiff's attorney and pay by the hour for help. For example, if you get a bill for a million bucks, you don't have to write a check within 30 days to pay it. You  can fight that sort of stuff.

There are also other strategies that, we all hope, we never have to use. For example, certain states have unlimited homestead exemptions for bankruptcy (Texas, for example). It is legal to take all your assets and purchase a home. Live in the home for a year. Declare bankruptcy to clear all debts - but not be forced to sell your home - and then sell your home and free all your assets. Does anyone here want to do that? No. But, the point is there are asset protection strategies that exist if you get hit with a multimillion dollar medical event. Seek legal advice.

Also, I know certain people don't like the idea of medical care in foreign countries. However, I have lived in Mexico extensively. If I had a major issue that I needed care and could not get it. $100,000 goes A LONG WAY in Mexico City - for example. Mexico City has doctors as good as anywhere else in the world, it is a city of 20 million plus people and the richest man in the world, Carlos Slim gets his medical care here.

Finally, there is insurance for car accidents. Other than chronic illness, this is the most likely way any of us will be involved in a major unforeseen medical emergency.

If you get a chronic condition, under Obamacare you could enroll with your pre-existing condition during the next open enrollment cycle.

Anyway, just some thoughts.

boarder42

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Re: Let's talk about health share
« Reply #49 on: January 19, 2017, 09:07:26 AM »
Just thought I would chime in - we are using MediShare for my family of 5. We have a high income, so Obamacare was very bad for our family (not a political statement, just a fact). Our plan was cancelled, the new plans were WAY more expensive, we got no subsidies. Not exaggerating, we were going to be paying 15k per year for the bronze plan, with 10 k deductible and 50/50 after that until a 20k out of pocket. It was nuts.

So, we did the medishare thing and swallowed all the concerns mentioned here by everyone else. We are now paying 500 per month (6k per year). Total out of pocket max is $2,500.

We had our third child using this plan, it was by far the cheapest child we have had.

We have discovered some loopholes, children get vaccines from doctors. If you have insurance, they will make you pay $1,000+ dollars (per kid and we have 3!) If you say you are uninsured, which is true with medical bill sharing, they give you the exact same thing for free. What a racket.

I will say, negotiating medical bills, especially high ones, is very, very possible. I'm a trial attorney and do it for my injured clients all the time. Even so, if anyone here was to get a huge bill, they could go to a local plaintiff's attorney and pay by the hour for help. For example, if you get a bill for a million bucks, you don't have to write a check within 30 days to pay it. You  can fight that sort of stuff.

There are also other strategies that, we all hope, we never have to use. For example, certain states have unlimited homestead exemptions for bankruptcy (Texas, for example). It is legal to take all your assets and purchase a home. Live in the home for a year. Declare bankruptcy to clear all debts - but not be forced to sell your home - and then sell your home and free all your assets. Does anyone here want to do that? No. But, the point is there are asset protection strategies that exist if you get hit with a multimillion dollar medical event. Seek legal advice.

Also, I know certain people don't like the idea of medical care in foreign countries. However, I have lived in Mexico extensively. If I had a major issue that I needed care and could not get it. $100,000 goes A LONG WAY in Mexico City - for example. Mexico City has doctors as good as anywhere else in the world, it is a city of 20 million plus people and the richest man in the world, Carlos Slim gets his medical care here.

Finally, there is insurance for car accidents. Other than chronic illness, this is the most likely way any of us will be involved in a major unforeseen medical emergency.

If you get a chronic condition, under Obamacare you could enroll with your pre-existing condition during the next open enrollment cycle.

Anyway, just some thoughts.

thank you... real world experience is what i wanted to see.

So onto vaccinations.  if i tell my doctor i'm not inusred even if i am he will give me them for free?