Author Topic: Let's talk about health share  (Read 25560 times)

Stash Engineer

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Re: Let's talk about health share
« Reply #50 on: January 19, 2017, 09:40:16 AM »
Subbed.  Good info FIREby35.  Thanks for posting that.

zhelud

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Re: Let's talk about health share
« Reply #51 on: January 19, 2017, 09:42:55 AM »
Going to be a "devils advocate" here- but how is an insurance plan that specifically excludes people who are sick a "Christian" health care plan?

boarder42

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Re: Let's talk about health share
« Reply #52 on: January 19, 2017, 09:51:33 AM »
Going to be a "devils advocate" here- but how is an insurance plan that specifically excludes people who are sick a "Christian" health care plan?

It doesnt exclude you... after a certain number of years your pre existing conditions will be covered up to certain levels. 

I'd guess all the religious part is just so they dont have to follow all the damn regulations of insurance and the ACA allowing them to provide better more cost effective coverage.

zhelud

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Re: Let's talk about health share
« Reply #53 on: January 19, 2017, 09:57:41 AM »
Going to be a "devils advocate" here- but how is an insurance plan that specifically excludes people who are sick a "Christian" health care plan?

It doesnt exclude you... after a certain number of years your pre existing conditions will be covered up to certain levels. 

I'd guess all the religious part is just so they dont have to follow all the damn regulations of insurance and the ACA allowing them to provide better more cost effective coverage.
I would say that not covering pre-existing conditions for a certain number of years is pretty much the same as excluding people who have a pre-existing condition.  And the reason that the costs are lower is that people who are sick don't sign up.

boarder42

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Re: Let's talk about health share
« Reply #54 on: January 19, 2017, 10:05:21 AM »
Going to be a "devils advocate" here- but how is an insurance plan that specifically excludes people who are sick a "Christian" health care plan?

It doesnt exclude you... after a certain number of years your pre existing conditions will be covered up to certain levels. 

I'd guess all the religious part is just so they dont have to follow all the damn regulations of insurance and the ACA allowing them to provide better more cost effective coverage.
I would say that not covering pre-existing conditions for a certain number of years is pretty much the same as excluding people who have a pre-existing condition.  And the reason that the costs are lower is that people who are sick don't sign up.

yes it would be like walking into nationwide after your house had burned down and saying hey can you cover me ... i havent had insurance but i'd like some now that my house is gone.  will they insure you nope.  Its not in the interest of the private sector to lose money on things.  so the govt has to take over and make it the single coverage for basic healthcare it has to be socialized otherwise the burden on the people with out good work sponsored coverage will be insane. 


as i said in my OP lets not make this about pre existing conditions.  this isnt for people with those.  Some one is paying.  if you're getting insurance now and its saving you money b/c you have a pre existing condition some one is supplementing you.  i as a healthy person have this as an option to not supplement you. 

But lets not make this about Pre existing conditions.  and i think Fire by 35 has made an excellent post on how this can work for 90%+ of the people here with out those conditions.

Gin1984

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Re: Let's talk about health share
« Reply #55 on: January 19, 2017, 10:21:29 AM »
Going to be a "devils advocate" here- but how is an insurance plan that specifically excludes people who are sick a "Christian" health care plan?

It doesnt exclude you... after a certain number of years your pre existing conditions will be covered up to certain levels. 

I'd guess all the religious part is just so they dont have to follow all the damn regulations of insurance and the ACA allowing them to provide better more cost effective coverage.
I would say that not covering pre-existing conditions for a certain number of years is pretty much the same as excluding people who have a pre-existing condition.  And the reason that the costs are lower is that people who are sick don't sign up.

yes it would be like walking into nationwide after your house had burned down and saying hey can you cover me ... i havent had insurance but i'd like some now that my house is gone.  will they insure you nope.  Its not in the interest of the private sector to lose money on things.  so the govt has to take over and make it the single coverage for basic healthcare it has to be socialized otherwise the burden on the people with out good work sponsored coverage will be insane. 


as i said in my OP lets not make this about pre existing conditions.  this isnt for people with those.  Some one is paying.  if you're getting insurance now and its saving you money b/c you have a pre existing condition some one is supplementing you.  i as a healthy person have this as an option to not supplement you. 

But lets not make this about Pre existing conditions.  and i think Fire by 35 has made an excellent post on how this can work for 90%+ of the people here with out those conditions.
That is not actually true.  The full price for the ACA plans (in NY and Ca) are the same what I paid for COBRA (on average, a few are more, a few less).  My pre-existing condition often does not cost anyone money.  I locked my trapezius in college.  For years I had no treatment and yet, I could find NO coverage, for any price, for insurance.  People lost insurance when they had any sort of medical treatment, which to me, is not insurance. 
If you want to talk supplements, going in and saying I have no insurance and getting something for free does not mean it is free, it means the rest of us are paying for it.  That is being supplemented.  ACA costs are the costs of actually being covered by insurance.  Some years it protects you and other years you just pay in.  I have paid car insurance.  I don't want them to pay me, I pay the money so that in case of emergency I'm covered. 
And with health share, I'm not.  It is as simple as that.  Having a cap on the costs and not being insurance (meaning that when the GOP gets to pulling the pre-existing conditions which is something they have been very clear they want to do), you will have nothing. 

boarder42

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Re: Let's talk about health share
« Reply #56 on: January 19, 2017, 11:07:02 AM »
not a debate on pre existing conditions. 

I'd really like some of the people opposed to this plan to present a case of a healthcare cost in 1 calendar year for 1 condition exceding 1MM dollars after your insurance negotiated it down. 

Everyone keeps saying good luck if you get this or that.  well whats the number and what are the odds i get it. and furthermore what are the odds i get it in the first few months of the year.

"But what if" with out data to back it up isnt a good arguement on a finance forum IMO.


boarder42

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Re: Let's talk about health share
« Reply #57 on: January 19, 2017, 11:12:40 AM »
http://www.therichest.com/rich-list/the-biggest/the-10-most-expensive-medical-procedures-in-america/

10 most expensive procedures.  only 2 over 1MM which i assume you can get reduced some. 

there were 212 people on the 1.2MM dollar procedure waitlist in 2008 so highly unlikely you'd need it.

heart-lung trasplant has 100 performed annually  so highly unlikely youd get it regardless of your insurance type.

SimpleCycle

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Re: Let's talk about health share
« Reply #58 on: January 19, 2017, 11:35:21 AM »
http://www.therichest.com/rich-list/the-biggest/the-10-most-expensive-medical-procedures-in-america/

10 most expensive procedures.  only 2 over 1MM which i assume you can get reduced some. 

there were 212 people on the 1.2MM dollar procedure waitlist in 2008 so highly unlikely you'd need it.

heart-lung trasplant has 100 performed annually  so highly unlikely youd get it regardless of your insurance type.

It's not common, but it is devastating.  Remember that some procedures are billed per day, like ECMO, which easily runs in the $100k/day dollar range NOT counting all the hospitalization costs associated with such a devastating illness.

You are right that it is quite rare though.  According to MEPS, the best data we have on patient-level expenditures, the top 1% of people spend $107k or more on health expenditures per year.  This is actual spending/reimbursement, not charges, so reflects the negotiated rate.  https://meps.ahrq.gov/data_files/publications/st497/stat497.pdf

It is impossible to talk about this issue without talking about pre-existing conditions though.  Your biggest risk in a non-ACA system is you will become uninsurable.  It's great for people to have affordable catastrophic options, but over time it takes away our ability to provide insurance for people with high health needs.  As someone who has a well over $1M illness (charges incurred over many years, worst single year was $300k negotiated) and is now uninsurable in underwritten products, an "affordable" option like this is simply out of reach.

notactiveanymore

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Re: Let's talk about health share
« Reply #59 on: January 19, 2017, 11:39:38 AM »
I know you say you don't want to make this about pre-existing conditions, but if ACA is repealed without a replacement plan which guarantees coverage of pre-existing conditions, then you can't ignore that in this conversation.

The thing is, I'm a perfectly healthy person, maybe 5 pounds overweight, no ongoing prescriptions outside of birth control, and no health conditions. But before ACA, my parent's (they have been privately insured my entire life) insurance did not cover any medical costs above my shoulders. I had a one-off seizure in 2009 with clean EKG, clean EEG, clean CT, clean MRI, and no further seizures in the 8 years since. When I had migraines in 2010, they wouldn't cover doctor's visit or meds for it or chiropractic visit which really helped relieve the debilitating migraines.

You have to remember that pre-existing conditions are defined by insurance companies. If ACA goes away and it goes back to that, they may deny you coverage for any number of ridiculous supposed pre-existing signs. Despite the fact that I definitely did not have a brain tumor at that time, if I'd developed something like that before/without ACA, the insurance simply would not have covered any of my care.

It sounds like this option might work for your family currently. But I don't think anyone can say with any certainty what our insurance markets will look like in 6 or 12 months. Most of this conversation is YMMV based on your risk tolerance to political and insurance changes as well as the level of insurance you feel comfortable with.

boarder42

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Re: Let's talk about health share
« Reply #60 on: January 19, 2017, 11:44:43 AM »
I know you say you don't want to make this about pre-existing conditions, but if ACA is repealed without a replacement plan which guarantees coverage of pre-existing conditions, then you can't ignore that in this conversation.

The thing is, I'm a perfectly healthy person, maybe 5 pounds overweight, no ongoing prescriptions outside of birth control, and no health conditions. But before ACA, my parent's (they have been privately insured my entire life) insurance did not cover any medical costs above my shoulders. I had a one-off seizure in 2009 with clean EKG, clean EEG, clean CT, clean MRI, and no further seizures in the 8 years since. When I had migraines in 2010, they wouldn't cover doctor's visit or meds for it or chiropractic visit which really helped relieve the debilitating migraines.

You have to remember that pre-existing conditions are defined by insurance companies. If ACA goes away and it goes back to that, they may deny you coverage for any number of ridiculous supposed pre-existing signs. Despite the fact that I definitely did not have a brain tumor at that time, if I'd developed something like that before/without ACA, the insurance simply would not have covered any of my care.

It sounds like this option might work for your family currently. But I don't think anyone can say with any certainty what our insurance markets will look like in 6 or 12 months. Most of this conversation is YMMV based on your risk tolerance to political and insurance changes as well as the level of insurance you feel comfortable with.

the pre existing conditions clause and 26 year old clause cannot be repealed the current congressional setup doesnt have enough people to overturn these. all they can do is change the laws that are effected by budget

so no more subsidies and no more you have to have it or you pay a penalty.

again i have 7 years before i even have to consider this but i wanted to put it out here for others who may be healthy and are retiring soon.  as another option bc the costs of those plans are out of control already.

notactiveanymore

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Re: Let's talk about health share
« Reply #61 on: January 19, 2017, 12:05:24 PM »
I know you say you don't want to make this about pre-existing conditions, but if ACA is repealed without a replacement plan which guarantees coverage of pre-existing conditions, then you can't ignore that in this conversation.

The thing is, I'm a perfectly healthy person, maybe 5 pounds overweight, no ongoing prescriptions outside of birth control, and no health conditions. But before ACA, my parent's (they have been privately insured my entire life) insurance did not cover any medical costs above my shoulders. I had a one-off seizure in 2009 with clean EKG, clean EEG, clean CT, clean MRI, and no further seizures in the 8 years since. When I had migraines in 2010, they wouldn't cover doctor's visit or meds for it or chiropractic visit which really helped relieve the debilitating migraines.

You have to remember that pre-existing conditions are defined by insurance companies. If ACA goes away and it goes back to that, they may deny you coverage for any number of ridiculous supposed pre-existing signs. Despite the fact that I definitely did not have a brain tumor at that time, if I'd developed something like that before/without ACA, the insurance simply would not have covered any of my care.

It sounds like this option might work for your family currently. But I don't think anyone can say with any certainty what our insurance markets will look like in 6 or 12 months. Most of this conversation is YMMV based on your risk tolerance to political and insurance changes as well as the level of insurance you feel comfortable with.

the pre existing conditions clause and 26 year old clause cannot be repealed the current congressional setup doesnt have enough people to overturn these. all they can do is change the laws that are effected by budget

so no more subsidies and no more you have to have it or you pay a penalty.

again i have 7 years before i even have to consider this but i wanted to put it out here for others who may be healthy and are retiring soon.  as another option bc the costs of those plans are out of control already.

It only takes 51 votes to eliminate the filibuster. And if they end up in a corner where they are facing either death spiral or using the nuclear option, I know where my money is.

For that matter, if they don't pass a replacement and we end up in a death spiral, insurance premiums in the private market could quickly become literally unaffordable, not just expensive. You simply cannot know right now what insurance will look like in a year. If you're comfortable using healthshare until or after the dust settles, go for it.

boarder42

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Re: Let's talk about health share
« Reply #62 on: January 19, 2017, 12:26:06 PM »
I know you say you don't want to make this about pre-existing conditions, but if ACA is repealed without a replacement plan which guarantees coverage of pre-existing conditions, then you can't ignore that in this conversation.

The thing is, I'm a perfectly healthy person, maybe 5 pounds overweight, no ongoing prescriptions outside of birth control, and no health conditions. But before ACA, my parent's (they have been privately insured my entire life) insurance did not cover any medical costs above my shoulders. I had a one-off seizure in 2009 with clean EKG, clean EEG, clean CT, clean MRI, and no further seizures in the 8 years since. When I had migraines in 2010, they wouldn't cover doctor's visit or meds for it or chiropractic visit which really helped relieve the debilitating migraines.

You have to remember that pre-existing conditions are defined by insurance companies. If ACA goes away and it goes back to that, they may deny you coverage for any number of ridiculous supposed pre-existing signs. Despite the fact that I definitely did not have a brain tumor at that time, if I'd developed something like that before/without ACA, the insurance simply would not have covered any of my care.

It sounds like this option might work for your family currently. But I don't think anyone can say with any certainty what our insurance markets will look like in 6 or 12 months. Most of this conversation is YMMV based on your risk tolerance to political and insurance changes as well as the level of insurance you feel comfortable with.

the pre existing conditions clause and 26 year old clause cannot be repealed the current congressional setup doesnt have enough people to overturn these. all they can do is change the laws that are effected by budget

so no more subsidies and no more you have to have it or you pay a penalty.

again i have 7 years before i even have to consider this but i wanted to put it out here for others who may be healthy and are retiring soon.  as another option bc the costs of those plans are out of control already.

It only takes 51 votes to eliminate the filibuster. And if they end up in a corner where they are facing either death spiral or using the nuclear option, I know where my money is.

For that matter, if they don't pass a replacement and we end up in a death spiral, insurance premiums in the private market could quickly become literally unaffordable, not just expensive. You simply cannot know right now what insurance will look like in a year. If you're comfortable using healthshare until or after the dust settles, go for it.

the filibuster just kills the funding it doesnt kill the two things i stated above.

as i said i've got 7 years.

notactiveanymore

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Re: Let's talk about health share
« Reply #63 on: January 19, 2017, 12:45:45 PM »
I know you say you don't want to make this about pre-existing conditions, but if ACA is repealed without a replacement plan which guarantees coverage of pre-existing conditions, then you can't ignore that in this conversation.

The thing is, I'm a perfectly healthy person, maybe 5 pounds overweight, no ongoing prescriptions outside of birth control, and no health conditions. But before ACA, my parent's (they have been privately insured my entire life) insurance did not cover any medical costs above my shoulders. I had a one-off seizure in 2009 with clean EKG, clean EEG, clean CT, clean MRI, and no further seizures in the 8 years since. When I had migraines in 2010, they wouldn't cover doctor's visit or meds for it or chiropractic visit which really helped relieve the debilitating migraines.

You have to remember that pre-existing conditions are defined by insurance companies. If ACA goes away and it goes back to that, they may deny you coverage for any number of ridiculous supposed pre-existing signs. Despite the fact that I definitely did not have a brain tumor at that time, if I'd developed something like that before/without ACA, the insurance simply would not have covered any of my care.

It sounds like this option might work for your family currently. But I don't think anyone can say with any certainty what our insurance markets will look like in 6 or 12 months. Most of this conversation is YMMV based on your risk tolerance to political and insurance changes as well as the level of insurance you feel comfortable with.

the pre existing conditions clause and 26 year old clause cannot be repealed the current congressional setup doesnt have enough people to overturn these. all they can do is change the laws that are effected by budget

so no more subsidies and no more you have to have it or you pay a penalty.

again i have 7 years before i even have to consider this but i wanted to put it out here for others who may be healthy and are retiring soon.  as another option bc the costs of those plans are out of control already.

It only takes 51 votes to eliminate the filibuster. And if they end up in a corner where they are facing either death spiral or using the nuclear option, I know where my money is.

For that matter, if they don't pass a replacement and we end up in a death spiral, insurance premiums in the private market could quickly become literally unaffordable, not just expensive. You simply cannot know right now what insurance will look like in a year. If you're comfortable using healthshare until or after the dust settles, go for it.

the filibuster just kills the funding it doesnt kill the two things i stated above.

as i said i've got 7 years.

If they eliminate the filibuster (which only takes 51 votes) for legislation, then they can eliminate the other parts of ACA with a simple majority.

boarder42

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Re: Let's talk about health share
« Reply #64 on: January 19, 2017, 01:10:00 PM »
based on all data i've seen i would still sign up for this if i were retired today. 

Guess what if they eliminate the pre existing conditions clause the insurance companies will go back to what they were doing before and dropping people so it wont really matter either way will it?

FIREby35

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Re: Let's talk about health share
« Reply #65 on: January 22, 2017, 01:52:08 PM »
I know you say you don't want to make this about pre-existing conditions, but if ACA is repealed without a replacement plan which guarantees coverage of pre-existing conditions, then you can't ignore that in this conversation.

The thing is, I'm a perfectly healthy person, maybe 5 pounds overweight, no ongoing prescriptions outside of birth control, and no health conditions. But before ACA, my parent's (they have been privately insured my entire life) insurance did not cover any medical costs above my shoulders. I had a one-off seizure in 2009 with clean EKG, clean EEG, clean CT, clean MRI, and no further seizures in the 8 years since. When I had migraines in 2010, they wouldn't cover doctor's visit or meds for it or chiropractic visit which really helped relieve the debilitating migraines.

You have to remember that pre-existing conditions are defined by insurance companies. If ACA goes away and it goes back to that, they may deny you coverage for any number of ridiculous supposed pre-existing signs. Despite the fact that I definitely did not have a brain tumor at that time, if I'd developed something like that before/without ACA, the insurance simply would not have covered any of my care.

It sounds like this option might work for your family currently. But I don't think anyone can say with any certainty what our insurance markets will look like in 6 or 12 months. Most of this conversation is YMMV based on your risk tolerance to political and insurance changes as well as the level of insurance you feel comfortable with.

the pre existing conditions clause and 26 year old clause cannot be repealed the current congressional setup doesnt have enough people to overturn these. all they can do is change the laws that are effected by budget

so no more subsidies and no more you have to have it or you pay a penalty.

again i have 7 years before i even have to consider this but i wanted to put it out here for others who may be healthy and are retiring soon.  as another option bc the costs of those plans are out of control already.

It only takes 51 votes to eliminate the filibuster. And if they end up in a corner where they are facing either death spiral or using the nuclear option, I know where my money is.

For that matter, if they don't pass a replacement and we end up in a death spiral, insurance premiums in the private market could quickly become literally unaffordable, not just expensive. You simply cannot know right now what insurance will look like in a year. If you're comfortable using healthshare until or after the dust settles, go for it.

Doesn't all this non-sense make medical bill sharing (at this particular moment in time) the more stable option? :)

boarder42

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Re: Let's talk about health share
« Reply #66 on: January 22, 2017, 05:57:59 PM »
Logic here says medical bill sharing makes more sense than anything else outside of reasonable employer sponsored plans.

ohsnap

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Re: Let's talk about health share
« Reply #67 on: January 22, 2017, 07:06:24 PM »
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.
 ...

The bolded sentence is not correct.  All health insurance policies under the ACA cover preventive care (check-ups and vaccines) 100%.  Physical exam in doctor's office, routine recommended preventive tests (PAP, colonoscopy), mammogram, flu shot, etc. are all covered at 100% with no deductible.

Modified to add a link to what's covered:
https://www.hhs.gov/healthcare/facts-and-features/fact-sheets/preventive-services-covered-under-aca/
« Last Edit: January 23, 2017, 07:44:35 AM by ehallison »

ohsnap

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Re: Let's talk about health share
« Reply #68 on: January 22, 2017, 07:18:08 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.
They say you are suppose to say you are self-pay and negotiate it yourself.  Where do you see they will negotiate it?

Yes, at least with some of these plans you have to negotiate for yourself and it's not fun.  I have a friend whose family's health care is "covered" this way.  She was in an accident which required a hospital stay. The hospital would only give a discount if they paid before she left the hospital - but friend didn't have the thousands in cash to do so, or have credit cards to float it.   The share plan (I don't recall which one it was) told her to set up a GoFundMe to get the money.  Which she did but it was embarrassing for her.  I didn't ask her what was going to happen once the share plan paid - would any friends who donated get their money back? (I didn't donate so it wasn't relevant to me). 

It just seemed scammy for the share plan to tell her to do this.
« Last Edit: January 22, 2017, 07:19:47 PM by ehallison »

MayDay

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Re: Let's talk about health share
« Reply #69 on: January 23, 2017, 04:56:35 AM »
Upthread someone asked about the likelihood of a 1 million plus event.

The ones that I know about personally:

2 people with babies in the NICU for months due to premature birth topped a million.

My grandfather had a massive stroke and the stroke ICU that he was in for a week was 100k a night (so not quite a million, and I'm sure it was negotiated down)

My H (healthy, young) went in for a routine heart procedure and came out with open heart surgery. No complications and total before negotiation was over 500k. No idea how high that can go if you have complications.

Of course it's rare, but if it happens, your entire non-retirement net worth will be wiped out in a single unlucky event. 

I haven't heard much said about the pregnancy coverage issue. Individual plans used to not cover pregnant for the most part. It seems like the most high risk thing that normally healthy people participate in all the time.  I am a total hippy dippy natural birth person who had a home birth with a midwife and I'd never have a kid without insurance to cover possible birth emergencies.

boarder42

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Re: Let's talk about health share
« Reply #70 on: January 23, 2017, 06:16:22 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?

Yes, at least with some of these plans you have to negotiate for yourself and it's not fun.  I have a friend whose family's health care is "covered" this way.  She was in an accident which required a hospital stay. The hospital would only give a discount if they paid before she left the hospital - but friend didn't have the thousands in cash to do so, or have credit cards to float it.   The share plan (I don't recall which one it was) told her to set up a GoFundMe to get the money.  Which she did but it was embarrassing for her.  I didn't ask her what was going to happen once the share plan paid - would any friends who donated get their money back? (I didn't donate so it wasn't relevant to me). 

It just seemed scammy for the share plan to tell her to do this.

A FIREd mustachian will have the cash/ credit available.

Upthread someone asked about the likelihood of a 1 million plus event.

The ones that I know about personally:

2 people with babies in the NICU for months due to premature birth topped a million.

My grandfather had a massive stroke and the stroke ICU that he was in for a week was 100k a night (so not quite a million, and I'm sure it was negotiated down)

My H (healthy, young) went in for a routine heart procedure and came out with open heart surgery. No complications and total before negotiation was over 500k. No idea how high that can go if you have complications.

Of course it's rare, but if it happens, your entire non-retirement net worth will be wiped out in a single unlucky event. 

I haven't heard much said about the pregnancy coverage issue. Individual plans used to not cover pregnant for the most part. It seems like the most high risk thing that normally healthy people participate in all the time.  I am a total hippy dippy natural birth person who had a home birth with a midwife and I'd never have a kid without insurance to cover possible birth emergencies.
Upthread someone asked about the likelihood of a 1 million plus event.

The ones that I know about personally:

2 people with babies in the NICU for months due to premature birth topped a million.

My grandfather had a massive stroke and the stroke ICU that he was in for a week was 100k a night (so not quite a million, and I'm sure it was negotiated down)

My H (healthy, young) went in for a routine heart procedure and came out with open heart surgery. No complications and total before negotiation was over 500k. No idea how high that can go if you have complications.

Of course it's rare, but if it happens, your entire non-retirement net worth will be wiped out in a single unlucky event. 

I haven't heard much said about the pregnancy coverage issue. Individual plans used to not cover pregnant for the most part. It seems like the most high risk thing that normally healthy people participate in all the time.  I am a total hippy dippy natural birth person who had a home birth with a midwife and I'd never have a kid without insurance to cover possible birth emergencies.

so seems like most of these would be covered by health share.   plus see Fireby35's post on his experience having 2 children with healthshare.  cheaper.

ohsnap

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Re: Let's talk about health share
« Reply #71 on: January 23, 2017, 07:22:59 AM »

A FIREd mustachian will have the cash/ credit available.


Yes, the saddest part of my friend's story is that they literally had no resources to tap for this accident.  But it illustrates the fact that under the share plans, the member will do all of the negotiating and paying - there's no insurance-negotiated rate that automatically chops 50% off the top. (which is another broken part of our whole system but that's probably a topic for another thread).

boarder42

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Re: Let's talk about health share
« Reply #72 on: January 23, 2017, 07:45:35 AM »

A FIREd mustachian will have the cash/ credit available.


Yes, the saddest part of my friend's story is that they literally had no resources to tap for this accident.  But it illustrates the fact that under the share plans, the member will do all of the negotiating and paying - there's no insurance-negotiated rate that automatically chops 50% off the top. (which is another broken part of our whole system but that's probably a topic for another thread).

incorrect thats a blanket statement.  under SOME share plans the member will do the negotiating and paying. they arent all the same.  liberty pays and negotiates.

BeanCounter

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Re: Let's talk about health share
« Reply #73 on: February 03, 2017, 07:16:40 AM »
posting so I can find it later. Interested to know more about this.

boarder42

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Re: Let's talk about health share
« Reply #74 on: February 03, 2017, 07:22:14 AM »
welcome bean counter. 

The goal of the thread was to get people with actual experience using it.  so here's hoping more show up.

Personally if the state of healthcare is similar to what it is today i will be using liberty healthshare when i FIRE in 5-7 years dependent on our bun in the oven and future yet unconceived child being born healthy.

BeanCounter

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Re: Let's talk about health share
« Reply #75 on: February 03, 2017, 07:26:42 AM »
welcome bean counter. 

The goal of the thread was to get people with actual experience using it.  so here's hoping more show up.

Personally if the state of healthcare is similar to what it is today i will be using liberty healthshare when i FIRE in 5-7 years dependent on our bun in the oven and future yet unconceived child being born healthy.
Thank You. Obviously I don't have experience using it, but I have been in the health insurance business for >10 years. So I might be able to pick it apart.

boarder42

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Re: Let's talk about health share
« Reply #76 on: February 03, 2017, 07:32:56 AM »
welcome bean counter. 

The goal of the thread was to get people with actual experience using it.  so here's hoping more show up.

Personally if the state of healthcare is similar to what it is today i will be using liberty healthshare when i FIRE in 5-7 years dependent on our bun in the oven and future yet unconceived child being born healthy.
Thank You. Obviously I don't have experience using it, but I have been in the health insurance business for >10 years. So I might be able to pick it apart.

feel free to try. i have yet to see a case where regular insurance really beats this esp when adding a super catastrophic plan for just charges over 1MM dollars.

It has efficiency and healthy people on its side.

rulesofacquisition

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Re: Let's talk about health share
« Reply #77 on: February 07, 2017, 11:35:40 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.


I just received my first check yesterday. I managed to negotiate most bills by 30%, 2 by about 50% and one by about 70%. No news on the negotiation on the hospital bills yet...

boarder42

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Re: Let's talk about health share
« Reply #78 on: February 07, 2017, 11:43:40 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.


I just received my first check yesterday. I managed to negotiate most bills by 30%, 2 by about 50% and one by about 70%. No news on the negotiation on the hospital bills yet...

this is amazing and valuable information i look forward to hearing more if you care to share the actual numbers when its all final.

Rewdoalb

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Re: Let's talk about health share
« Reply #79 on: February 07, 2017, 07:14:32 PM »
Been on medishare since 2014. Wife and I pay less than $1000/year. Our annual deductable is $10k but we've never really scratched the surface on that. Not sure how it'll go when we start having kids. But I figured a few years of avoiding Obamacare would help us get financially stable, whilr we are young and insurance (should be) cheap.


v8rx7guy

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Re: Let's talk about health share
« Reply #80 on: February 07, 2017, 10:02:40 PM »
its too bad no new health share ministries are allowed.  I think they are an amazing opportunity, and it would be cool if a group like followers of MMM could start their own sharing ministy with our own set of healthy lifestyle criteria to participate.

boarder42

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Re: Let's talk about health share
« Reply #81 on: February 08, 2017, 06:05:00 AM »
yeah this truly is how health insurance should be run.

boarder42

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Re: Let's talk about health share
« Reply #82 on: February 08, 2017, 06:10:54 AM »
Been on medishare since 2014. Wife and I pay less than $1000/year. Our annual deductable is $10k but we've never really scratched the surface on that. Not sure how it'll go when we start having kids. But I figured a few years of avoiding Obamacare would help us get financially stable, whilr we are young and insurance (should be) cheap.

does medishare have a cap i cant find that on their site.

rulesofacquisition

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Re: Let's talk about health share
« Reply #83 on: February 09, 2017, 11:49:38 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.


I just received my first check yesterday. I managed to negotiate most bills by 30%, 2 by about 50% and one by about 70%. No news on the negotiation on the hospital bills yet...

this is amazing and valuable information i look forward to hearing more if you care to share the actual numbers when its all final.

Sure, it's going to be a couple months but I'll post all the totals here when everything is paid.

Rewdoalb

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Re: Let's talk about health share
« Reply #84 on: March 23, 2017, 05:20:34 AM »
Been on medishare since 2014. Wife and I pay less than $1000/year. Our annual deductable is $10k but we've never really scratched the surface on that. Not sure how it'll go when we start having kids. But I figured a few years of avoiding Obamacare would help us get financially stable, whilr we are young and insurance (should be) cheap.

does medishare have a cap i cant find that on their site.

By cap do you mean deductable or maximum amount that they'll help with? Yes to the former, no to the latter.

So I recently had a consultation w a doctor and decided to follow medishare procedure for prenotification even though I'll be nowhere near the deductible this year. So when I checked out that day, she charged me the $35 copay and said the rest would be billed later. I said how much, response was $210. Well...Several weeks later I got a bill for like $70. Medishare negotiated my price down, presumably because of my high deductible they could persuade the doctor's office that I'd be more likely to pay if it was reduced...

Anyway I am very happy with how that process went.

themagicman

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Re: Let's talk about health share
« Reply #85 on: March 23, 2017, 10:46:13 AM »
Following!

canisius

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Re: Let's talk about health share
« Reply #86 on: March 24, 2017, 07:48:02 PM »
We're with Liberty. We had to use their prescription discount first time for antibiotics. Went down from $60 to $4. We'll be putting in our first big claim for pre-natal and pregnancy in a few weeks. I'll post updates.

canisius

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Re: Let's talk about health share
« Reply #87 on: March 27, 2017, 12:10:17 PM »
We're with Liberty. We had to use their prescription discount first time for antibiotics. Went down from $60 to $4. We'll be putting in our first big claim for pre-natal and pregnancy in a few weeks. I'll post updates.

We just finished setting up our appointment for the first pre-natal.  The office manager was familiar with it and everything will be forwarded to Liberty.  We did have to call, to warn them that we would begin maternity visits, but that wasn't a problem.  Once we get more into the billing, I'll continue here or in a new post.

powskier

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Re: Let's talk about health share
« Reply #88 on: March 28, 2017, 11:53:42 PM »
We make too much for subsidies under ACA, but for a healthy couple would have had to pay $2200/month ( 26k /year). That's a second mortgage payment...
For a while we just kept stringing together some HDHP and the cost kept going up and up for basically emergency coverage.

A friend told us about Liberty Health share and it seemed like a good option, $299/month for both of us. We have yet to "use" the service.
Personally I find the religious part disturbing, but am choosing to ignore it. Other than that, as pointed out previously this is the basic model of "insurance" , risk and cost is shared over a large group.

Healthcare in this country will eventually end up single payer from the sheer weight of ever growing Medicare and Medicaid and the ways in which insane amounts of money that could grow the rest of the economy are swallowed up by healthcare costs. It would be smarter to head down that path in a deliberate fashion IMO.

Side note, they sent us an email last week urging us to call our Congress people because Trumpcare or Wealthcare as I called it , would eliminate the health sharing companies. Moot point now I guess......

jacquespluto

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Re: Let's talk about health share
« Reply #89 on: March 29, 2017, 05:16:10 PM »
Interesting thread.  Following as we are looking for options with a lot of unknowns at the moment with healthcare.

Does anyone have an example / suggestion of a non ACA super catostrophic plan that might be a good supplement to healthshare?


canisius

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Re: Let's talk about health share
« Reply #90 on: June 13, 2017, 09:53:29 AM »
We're with Liberty. We had to use their prescription discount first time for antibiotics. Went down from $60 to $4. We'll be putting in our first big claim for pre-natal and pregnancy in a few weeks. I'll post updates.

We just finished setting up our appointment for the first pre-natal.  The office manager was familiar with it and everything will be forwarded to Liberty.  We did have to call, to warn them that we would begin maternity visits, but that wasn't a problem.  Once we get more into the billing, I'll continue here or in a new post.

We mentioned that we would comment as things went along.  Unfortunately, my wife had a miscarriage after three months and she needed a D & C.  We called the health share for pre-notification, before the surgery, and the doctor filled out a form.
About a month and half later we got our equivalent to the EOB and it's exactly as it said.  We pay our $1000 unshared bit, and the rest is taken care of by the healthshare.  Now we haven't seen any bills from the providers yet, so there might be surprises.  However, we also got a reimbursement for the prescriptions that were related as well.  We didn't want to use the service this early on, especially for a matter like that.  However, for those following, so far, Liberty has delivered on what they say.

boarder42

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Re: Let's talk about health share
« Reply #91 on: June 13, 2017, 11:39:14 AM »
We're with Liberty. We had to use their prescription discount first time for antibiotics. Went down from $60 to $4. We'll be putting in our first big claim for pre-natal and pregnancy in a few weeks. I'll post updates.

We just finished setting up our appointment for the first pre-natal.  The office manager was familiar with it and everything will be forwarded to Liberty.  We did have to call, to warn them that we would begin maternity visits, but that wasn't a problem.  Once we get more into the billing, I'll continue here or in a new post.

We mentioned that we would comment as things went along.  Unfortunately, my wife had a miscarriage after three months and she needed a D & C.  We called the health share for pre-notification, before the surgery, and the doctor filled out a form.
About a month and half later we got our equivalent to the EOB and it's exactly as it said.  We pay our $1000 unshared bit, and the rest is taken care of by the healthshare.  Now we haven't seen any bills from the providers yet, so there might be surprises.  However, we also got a reimbursement for the prescriptions that were related as well.  We didn't want to use the service this early on, especially for a matter like that.  However, for those following, so far, Liberty has delivered on what they say.

so sorry to hear about that.  We actually just went thru the same thing on our work provided HDHP with an HSA earlier this year.  our out of pocket costs were around 4k or so.  I was shocked to hear how common they were when we lost ours, again sorry to hear about that. 

AZDude

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Re: Let's talk about health share
« Reply #92 on: June 13, 2017, 12:36:53 PM »
Quote
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.

Fuck.... this is not true. Its not. Vaccines are considered preventative and are covered 100% by any "real" insurance plan in the United States...

FIREby35

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Re: Let's talk about health share
« Reply #93 on: June 13, 2017, 07:08:01 PM »
Quote
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.

Fuck.... this is not true. Its not. Vaccines are considered preventative and are covered 100% by any "real" insurance plan in the United States...

If you don't have insurance, which we didn't, they will charge you $1,000+ dollars. I can tell you, from experience, they will in fact charge you that money if you don't have insurance. Or you can go to the health center and get it for free.

The point is that we didn't have health insurance and they tried to make us pay. We didn't have health insurance because we had Medi-share. Medi-share isn't considered "real" insurance and sometimes people can't wrap their head around the fact that you are, in fact, not insured.

retiringearly

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Re: Let's talk about health share
« Reply #94 on: June 13, 2017, 07:21:28 PM »
IN!!
Thanks!

SKL-HOU

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Re: Let's talk about health share
« Reply #95 on: June 14, 2017, 09:32:24 AM »
Quote
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.

Fuck.... this is not true. Its not. Vaccines are considered preventative and are covered 100% by any "real" insurance plan in the United States...

If you don't have insurance, which we didn't, they will charge you $1,000+ dollars. I can tell you, from experience, they will in fact charge you that money if you don't have insurance. Or you can go to the health center and get it for free.

The point is that we didn't have health insurance and they tried to make us pay. We didn't have health insurance because we had Medi-share. Medi-share isn't considered "real" insurance and sometimes people can't wrap their head around the fact that you are, in fact, not insured.

You are contradicting yourself. Which is it? I am confused.

AZDude

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Re: Let's talk about health share
« Reply #96 on: June 14, 2017, 11:59:59 AM »
Quote
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.

Fuck.... this is not true. Its not. Vaccines are considered preventative and are covered 100% by any "real" insurance plan in the United States...

If you don't have insurance, which we didn't, they will charge you $1,000+ dollars. I can tell you, from experience, they will in fact charge you that money if you don't have insurance. Or you can go to the health center and get it for free.

The point is that we didn't have health insurance and they tried to make us pay. We didn't have health insurance because we had Medi-share. Medi-share isn't considered "real" insurance and sometimes people can't wrap their head around the fact that you are, in fact, not insured.

Also confused. Makes a difference if you say "have insurance" versus "do not have insurance". The two statements are irreconcilable. Makes me think you are making shit up, lying, etc... I could be wrong, but you would have to explain yourself first.

SKL-HOU

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Re: Let's talk about health share
« Reply #97 on: June 14, 2017, 06:51:28 PM »
Quote
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.

Fuck.... this is not true. Its not. Vaccines are considered preventative and are covered 100% by any "real" insurance plan in the United States...

If you don't have insurance, which we didn't, they will charge you $1,000+ dollars. I can tell you, from experience, they will in fact charge you that money if you don't have insurance. Or you can go to the health center and get it for free.

The point is that we didn't have health insurance and they tried to make us pay. We didn't have health insurance because we had Medi-share. Medi-share isn't considered "real" insurance and sometimes people can't wrap their head around the fact that you are, in fact, not insured.

Also confused. Makes a difference if you say "have insurance" versus "do not have insurance". The two statements are irreconcilable. Makes me think you are making shit up, lying, etc... I could be wrong, but you would have to explain yourself first.

I thought of that too but if you read the rest and the following sentence he wrote exactly what he meant so he is just contradicting himself. If you have insurance, vaccines are free. If you dont have insurance, they are free I believe. So i dont see under what circumstance a vaccine would cost thousands. Besides even if you paif out of pocket, regular vaccines dont cost thousands. The only one i know of in the thousands is the rsv vaccine.

boarder42

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Re: Let's talk about health share
« Reply #98 on: June 15, 2017, 05:49:43 AM »
Quote
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.

Fuck.... this is not true. Its not. Vaccines are considered preventative and are covered 100% by any "real" insurance plan in the United States...

If you don't have insurance, which we didn't, they will charge you $1,000+ dollars. I can tell you, from experience, they will in fact charge you that money if you don't have insurance. Or you can go to the health center and get it for free.

The point is that we didn't have health insurance and they tried to make us pay. We didn't have health insurance because we had Medi-share. Medi-share isn't considered "real" insurance and sometimes people can't wrap their head around the fact that you are, in fact, not insured.

Also confused. Makes a difference if you say "have insurance" versus "do not have insurance". The two statements are irreconcilable. Makes me think you are making shit up, lying, etc... I could be wrong, but you would have to explain yourself first.

I thought of that too but if you read the rest and the following sentence he wrote exactly what he meant so he is just contradicting himself. If you have insurance, vaccines are free. If you dont have insurance, they are free I believe. So i dont see under what circumstance a vaccine would cost thousands. Besides even if you paif out of pocket, regular vaccines dont cost thousands. The only one i know of in the thousands is the rsv vaccine.

we're getting really nit picky over one comment in this thread here.  if you'd like to debate the cost of vaccines feel free to start a different thread.

FIREby35

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Re: Let's talk about health share
« Reply #99 on: June 15, 2017, 06:53:00 AM »
What happens is the health care providers don't understand that your Medi-share is not insurance and they treat you like you have insurance when you actually don't. Your confusion is the same confusion the healthcare providers have. So, they bill Medi-Share (who denies it), then you get a bill and you go tell the doctors you are uninsured and they say, "What about medi-share." You are then forced to explain to them, "It's not insurance." But they don't really get it. They try to stick you with a $1,000 bill.

The way to avoid it is to go to the health department for the free vaccines. Never say, "I have something like insurance." Never assume the health care providers understand what health care sharing is. On medi-share you should always say, "I am uninsured."

Sorry for any confusion based on my writing.