Author Topic: Health Insurance Alternative?  (Read 13449 times)

Richie Poor

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Health Insurance Alternative?
« on: September 04, 2015, 11:54:35 AM »
Has anyone else tried a Christian healthcare sharing organization and given up insurance?

It is clearly not for everyone, as you have to be Christian to join, but I think for some people in similar situations as me it can save quite a bit of money. I'm self-employed and wife is a Youth Minister/Church Secretary with no benefits. Our income is too high for ACA subsidies. We used to be on a plan that cost us almost $400 month with a $3000 deductible. My wife found a hard time finding doctors she liked that would accept the plan. I canceled my policy and joined a Healthcare sharing group. The family plan for that is $405/month. I think singles pay $180. One giant perk is you can see any doctor you want.

The way it works (condensed version) is you pay your own doctor bill in cash and then "publish" your need to get reimbursed. Now that I've had 2 "claims" and seen the process work I'm pretty convinced it can be a cost saver. In April my wife and I had our first child and the bills (after a cash discount was applied) came out to be about $15,700. It took me about 2 months to collect and organize the bills and I submitted them to the group. Soon I had checks reimbursing me for the full amount. I was always jealous of my friends nice company-provided insurance plans but when I realized we had a baby at virtually no expense I realized we didn't have it too bad. We had a similar experience when my wife had a ER trip after a car accident.

The downside is you only get reimbursed on medical issues that cost over $300. If we go to the doctor with the Flu and it cost $200 we don't get reimbursed. Luckily trips like that are so rare that its easy to eat that cost to save on the major problems. If we get stitches and it costs $600 then we only get reimbursed for $300. You can get reimbursed for the full bill if the doctor gives you a $300 discount for paying cash. That is why our baby expenses were covered in full.

The other big downside is they will not cover your pre-existing conditions. That sucks but from there point of view it probably wouldn't be fiscally possible to allow that. Some people with pre-existing conditions still join but they have to pay for those treatments out of pocket. They get listed as "Special Needs" and I donate a little extra every month to help those people. Many others do as well. It isn't required but hopefully it helps a little.

One cool thing about the group I joined is I no longer send checks to an Insurance company. I mail my check every month to someone else across the country that had a medical need. There is something very satisfying about that.

So the plan will not be a fit for non-Christians, people with great workplace insurance, and people with pre-existing conditions. But for everyone else it might be worth learning more about, especially the self-employed. I think it is a great tool for my FIRE plans.

sstants

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Re: Health Insurance Alternative?
« Reply #1 on: September 04, 2015, 03:23:18 PM »
How does this coverage work in the case of a large medical bill? What if someone needs a transplant? Are the funds there to cover this sort of situation?

protostache

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Re: Health Insurance Alternative?
« Reply #2 on: September 04, 2015, 05:24:53 PM »
How does this coverage work in the case of a large medical bill? What if someone needs a transplant? Are the funds there to cover this sort of situation?

A more common situation would maybe be cancer that requires long term chemo or radiation treatments. This kind of thing gets really expensive, really fast, and can stay expensive for a very long time. How do they deal with that kind of risk?

powskier

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Re: Health Insurance Alternative?
« Reply #3 on: September 04, 2015, 05:28:36 PM »
I once belonged to a not for profit organization like this ( secular) it was shut down in the late nineties when Congress required that health insurance companies have x million in reserves ( don't remember exactly the number) precisely to prevent smaller self insured groups from operating.This was a registered, legal, above board group with transparent finances and structure and only covered for small expenses under $1000.
It sounds like you do not actually have coverage for major occurrences, I would be curious to see this org's finances, I would not be surprised if someone is pocketing a bunch of tax free illegal cash.



bacchi

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Re: Health Insurance Alternative?
« Reply #4 on: September 04, 2015, 05:48:42 PM »
How does this coverage work in the case of a large medical bill? What if someone needs a transplant? Are the funds there to cover this sort of situation?

A more common situation would maybe be cancer that requires long term chemo or radiation treatments. This kind of thing gets really expensive, really fast, and can stay expensive for a very long time. How do they deal with that kind of risk?

Right. Insurance makes sense for large, very expensive, incidents. If you have $500k in the bank, you don't need burial insurance, for example. A long-term, serious, illness would wipe out $500k in no time.

Without a catastrophic plan also in place, this is a Bad Idea.

regulator

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Re: Health Insurance Alternative?
« Reply #5 on: September 05, 2015, 12:32:10 PM »
There is basically nothing to keep this from being a Ponzi scheme.  I think you would be crazy to rely on this nonsense.  Go buy real insurance.

Thegoblinchief

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Re: Health Insurance Alternative?
« Reply #6 on: September 05, 2015, 04:51:17 PM »
A friend of mine bought into one of these. If this is how they're actually organized I hope they don't get screwed down the road.

Bucksandreds

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Re: Health Insurance Alternative?
« Reply #7 on: September 05, 2015, 07:15:19 PM »
There is basically nothing to keep this from being a Ponzi scheme.  I think you would be crazy to rely on this nonsense.  Go buy real insurance.

The only way something like this could work is if the church bought a hospital and your premiums just paid the hospital overhead and then anyone who pays the premium could be treated free at the hospital.  That actually sounds like a decent idea.  Why don't 100,000 people get together and buy a private hospital and operate it that way?

regulator

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Re: Health Insurance Alternative?
« Reply #8 on: September 05, 2015, 09:39:55 PM »
There is basically nothing to keep this from being a Ponzi scheme.  I think you would be crazy to rely on this nonsense.  Go buy real insurance.

The only way something like this could work is if the church bought a hospital and your premiums just paid the hospital overhead and then anyone who pays the premium could be treated free at the hospital.  That actually sounds like a decent idea.  Why don't 100,000 people get together and buy a private hospital and operate it that way?

Remember how dumb/spendthrift the average 'Merican is?  50,000 will be even dumber and spendthriftier than that average boob.

sunday

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Re: Health Insurance Alternative?
« Reply #9 on: September 05, 2015, 10:30:35 PM »
Are you sure there's no lifetime limit as to the amount they will pay out, as insurance companies used to do?

Hamster

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Re: Health Insurance Alternative?
« Reply #10 on: September 05, 2015, 10:42:19 PM »
Since this doesn't appear to cover ACA mandates do you have to pay the penalty?

protostache

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Re: Health Insurance Alternative?
« Reply #11 on: September 06, 2015, 06:50:21 AM »
Since this doesn't appear to cover ACA mandates do you have to pay the penalty for not having health insurance?

Looks like they don't qualify as minimum essential services but there's a specific exemption to the penalties for members of qualified organizations.

http://obamacarefacts.com/healthcare-sharing-ministry-exemptions/

Paul der Krake

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Re: Health Insurance Alternative?
« Reply #12 on: September 06, 2015, 06:53:49 AM »
Sheesh, talk about uncertainty! Do they have any bargaining power in order to deal with the ridiculously inflated cash price of the hospitals?

Ichabod

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Re: Health Insurance Alternative?
« Reply #13 on: September 06, 2015, 08:17:15 AM »
I use one of these. The skepticism is warranted given all the other Christian / Charity / healthcare scams.

I hope you do some research on your own though. The New York Times, Wall Street Journal, and other reputable sources have covered these ministries.

What I've found, they have been able to cover expensive illnesses. Most of them do have a lifetime or incident cap, but with options to get coverage above that. They focus a lot on negotiating with providers and not paying full price (discounts often go towards your deductible), they don't face many of the regulatory hurdles (for good or for ill), and they exclude things outside their moral rules (you usually can't smoke or drink, doesn't cover STDs or pregnancies from extra-marital sex).

It's not for everyone, but I think of it as the kind of catastrophic coverage I want.

Richie Poor

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Re: Health Insurance Alternative?
« Reply #14 on: September 08, 2015, 05:08:15 PM »
How does this coverage work in the case of a large medical bill? What if someone needs a transplant? Are the funds there to cover this sort of situation?

There is a $250,000 limit per need. They have a voluntary side program ("save to share" to cover needs greater than $250k. I belong to that program and if the need arises I will have to contribute $400 to the person that needs it. In the year and a half I have been a member I haven't had to pay it. So I guess the 40,000 households that are members have been fortunate.

There is no lifetime limit.

It sounds like you do not actually have coverage for major occurrences, I would be curious to see this org's finances, I would not be surprised if someone is pocketing a bunch of tax free illegal cash.

We have coverage for major occurrences. The org is Samaritan Ministries. I'm not sure if they publish there finances online or not but you could try. I think it would be hard to pocket the money since you mail your monthly check to the members themselves with medical bills. Only once a year do you send your monthly payment directly to Samaritan ministries for organizational expenses. So that is how they get you but since they seem to have quite a few employees I'm going to assume there expenses are legit.

Right. Insurance makes sense for large, very expensive, incidents. If you have $500k in the bank, you don't need burial insurance, for example. A long-term, serious, illness would wipe out $500k in no time.

Without a catastrophic plan also in place, this is a Bad Idea.

It will cover $250k incidents and bigger if you belong to the "save to share" program . It looks like they have been in existence since 1994 have had big incidents in the past. Cancer treatments don't usually bill $500k at once so it all gets spread out. Coincidentally if the members have a remarkably healthy month then we get a discount on the next months payments. It has happened I think 3 times in the last year and a half.

A catastrophic plan would be an interesting addition for the skeptical people. I wonder if you can get plans with a massive deductible, like $50k or more. They would probably be cheap if they exist.

There is basically nothing to keep this from being a Ponzi scheme.  I think you would be crazy to rely on this nonsense.  Go buy real insurance.

There is basically nothing to keep this from working exactly as it has since 1994. Medicals bills are spread out amongst a big group. It has worked for my families medical needs so far and probably will into the future.


radtek2112

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Re: Health Insurance Alternative?
« Reply #15 on: September 08, 2015, 05:36:19 PM »
"It is clearly not for everyone, as you have to be Christian to join,"


How does one prove he or she is a Christian to join?  Why Christian? 

bacchi

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Re: Health Insurance Alternative?
« Reply #16 on: September 08, 2015, 06:50:36 PM »
A catastrophic plan would be an interesting addition for the skeptical people. I wonder if you can get plans with a massive deductible, like $50k or more. They would probably be cheap if they exist.

I think there are catastrophic plans but only for those under 30. (I don't qualify so I never did any research.)

Was your wife's birth guaranteed to be covered? Or was it a "publish and hope" scenario? If someone else has a large expense the same month, such as $100k for bypass surgery, is there a chance that you'll play second fiddle?

This is in some ways a cool idea -- a co-op health insurance. It would need to rely on numbers, though, just like any other health plan. I, too, worry about the potential for fraud.

Richie Poor

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Re: Health Insurance Alternative?
« Reply #17 on: September 09, 2015, 09:12:30 AM »
How does one prove he or she is a Christian to join?  Why Christian?

I'm not sure how everyone organization handles the "proof" of being Christian but our group requires your pastor/priest to be a reference. I think secular organizations like this existed in the past but were legislated away but religious groups have an exemption. I've never looked to see if any Jewish or Muslim organizations exist.

Was your wife's birth guaranteed to be covered? Or was it a "publish and hope" scenario? If someone else has a large expense the same month, such as $100k for bypass surgery, is there a chance that you'll play second fiddle?
There is a legal disclaimer that participation is voluntary so it is not legally guaranteed. I think since they are not any insurance company that disclaimer is required. But it is a little better that a "hope" scenario as they have never had a need go unfulfilled, according to them (and the one other member I know). That might keep some people up with worry at night. I feel more likely to get legally screwed by an insurance company than I do this place.

I believe what happens when they have more needs than funds some get rolled over to the next month. So instead of me getting $15k reimbursed in one month they may spread it out of 2 or 3 months. If they go 3 months with more needs than funds then every member gets to vote on whether to raise the monthly dues. It hasn't come up since I joined. Even if they ad to spread a reimbursement back over 2 months it usually doesn't matter since you can generally pay medical bills to hospitals in interest free installments.

regulator

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Re: Health Insurance Alternative?
« Reply #18 on: September 09, 2015, 08:00:52 PM »
I am sure OP is a true believer and will not hear anything to the contrary, but for the record:

THIS SHIT IS CRAZY!

Let's review.  Crazy religious affiliated Ponzi scheme: no published financial statements for the organization.  No required reserves or capital.  No regulation to make sure this isn't a house of cards.  No third party you can even appeal to if your claim is denied.  No impartial third parties reviewing the Ponzi scheme and expressing an opinion on creditworthiness (a rating).

Actual health insurance:  Legally required reserves and capital.  Conservatively stated regulatory financial statements available to the public.  An extensive framework of regulation armed with more than a stick with a nail in it.  Consumer protection regulation in place so that you can appeal denied claims and even sue.  Generally, every actual insurer is rated by one or more impartial rating agencies to help you separate the goats from the sheep.

There did indeed used to be (100+ years ago) secular and even religious organizations that did similar things (back then they were more focused on life insurance).  They are not around any more.  Why?  They became fraternal and mutual insurers with real reserves and capital and subject to regulation like any other insurer.

Staking your net worth on one of these mumbo-jumbo pseudo insurers is fucking nuts.

heitzrun

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Re: Health Insurance Alternative?
« Reply #19 on: September 11, 2015, 04:41:37 PM »
I think it actually speaks to the underlying good of the organization and trustworthy people running it. Enrollee's seem to be using it, paying premiums, getting medical care, and having it paid for. 

With all the regulation and mandates you still aren't guaranteed that your insurance company will have a plan that covers your medically/dentally service  (Ask if medicaid will cover a crown! (Dental)).  I'm thinking Enron, etc. 

Also most diseases are preventable with good diet and regular health behaviors - ie. riding your bike everyday.


beltim

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Re: Health Insurance Alternative?
« Reply #20 on: September 11, 2015, 04:49:16 PM »
Also most diseases are preventable with good diet and regular health behaviors - ie. riding your bike everyday.

This is straight up false, and dangerous misinformation.  Please don't spread lies.

Paul der Krake

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Re: Health Insurance Alternative?
« Reply #21 on: September 11, 2015, 05:07:04 PM »
How do they deal with people not paying their premiums?

tuckred

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Re: Health Insurance Alternative?
« Reply #22 on: September 11, 2015, 05:23:48 PM »
I am also looking into this. I have looked for negative reviews online and have only found 1;  I have found lots of positive ones. They seem to work well. As OP stated, they are not for everyone. Here is an article that does mention one healthshare program that is secular, and talks a little about how they work.


http://www.nytimes.com/2015/02/01/opinion/sunday/onward-christian-health-care.html?_r=0

bacchi

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Re: Health Insurance Alternative?
« Reply #23 on: September 11, 2015, 05:42:56 PM »
I am also looking into this. I have looked for negative reviews online and have only found 1;

Was it the Christian Brotherhood scandal?

sunday

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Re: Health Insurance Alternative?
« Reply #24 on: September 11, 2015, 06:26:20 PM »
My concern is that insurance is supposed to mitigate risk. But with these organizations, because they are allowed to bypass regulations like having x reserves and you are dependent on other people voluntarily contributing extra in case of a catastrophe, the organization can't be properly assessed to determine if it actually mitigates your risks. If fact, joining this type of organization is a risk in itself, which is the opposite point of buying insurance.

franklin w. dixon

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Re: Health Insurance Alternative?
« Reply #25 on: September 13, 2015, 12:17:03 PM »
I am sure OP is a true believer and will not hear anything to the contrary, but for the record:

THIS SHIT IS CRAZY!

Let's review.  Crazy religious affiliated Ponzi scheme: no published financial statements for the organization.  No required reserves or capital.  No regulation to make sure this isn't a house of cards.  No third party you can even appeal to if your claim is denied.  No impartial third parties reviewing the Ponzi scheme and expressing an opinion on creditworthiness (a rating).

Actual health insurance:  Legally required reserves and capital.  Conservatively stated regulatory financial statements available to the public.  An extensive framework of regulation armed with more than a stick with a nail in it.  Consumer protection regulation in place so that you can appeal denied claims and even sue.  Generally, every actual insurer is rated by one or more impartial rating agencies to help you separate the goats from the sheep.

There did indeed used to be (100+ years ago) secular and even religious organizations that did similar things (back then they were more focused on life insurance).  They are not around any more.  Why?  They became fraternal and mutual insurers with real reserves and capital and subject to regulation like any other insurer.

Staking your net worth on one of these mumbo-jumbo pseudo insurers is fucking nuts.
And if they arbitrarily determine your heart attack was caused by Sin you are cordially invited to eat shit, do not pass go, do not collect 200 dollars.

nobodyspecial

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Re: Health Insurance Alternative?
« Reply #26 on: September 13, 2015, 01:11:39 PM »
Crazy religious affiliated Ponzi scheme: no published financial statements for the organization.  No required reserves or capital.  No regulation to make sure this isn't a house of cards.  No third party you can even appeal to if your claim is denied.  No impartial third parties reviewing the Ponzi scheme and expressing an opinion on creditworthiness (a rating).

Isn't that the very definition of religion ?

paddedhat

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Re: Health Insurance Alternative?
« Reply #27 on: September 13, 2015, 02:25:21 PM »
There is more than enough info. out there on the viability and stability of the very small number of these organizations that were legitimately grandfathered into the ACA. I am not member, but took the time to learn about the concept and it's success. Unfortunately, a couple of posters here have decided that facts are inconsequential, but stupid comments and attacks are useful.

Kind of pathetic actually, and of the same caliber of the morons banging on their keyboards while posting in places like Reddit, or the comment section of my local hick newspaper.

regulator

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Re: Health Insurance Alternative?
« Reply #28 on: September 13, 2015, 04:01:27 PM »
There is more than enough info. out there on the viability and stability of the very small number of these organizations that were legitimately grandfathered into the ACA. I am not member, but took the time to learn about the concept and it's success. Unfortunately, a couple of posters here have decided that facts are inconsequential, but stupid comments and attacks are useful.

Kind of pathetic actually, and of the same caliber of the morons banging on their keyboards while posting in places like Reddit, or the comment section of my local hick newspaper.

If you can show me statutory financial statements for one of these mumbo-jumbo plans, I would be most eager to read them.

regulator

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Re: Health Insurance Alternative?
« Reply #29 on: September 13, 2015, 04:38:39 PM »
If this is typical of these kinds of arrangements, this is scary stuff: http://samaritanministries.org/

There is explicitly no risk transfer involved and if you run up a big bill you are basically just hoping that everyone else in the scheme will pony up.  There is no way I would risk my net worth on this.

nobodyspecial

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Re: Health Insurance Alternative?
« Reply #30 on: September 13, 2015, 05:25:15 PM »
If this is typical of these kinds of arrangements, this is scary stuff: http://samaritanministries.org/

There is explicitly no risk transfer involved and if you run up a big bill you are basically just hoping that everyone else in the scheme will pony up.  There is no way I would risk my net worth on this.

Quick clarification for non-Americans. These are NOT the same people as the very much good-guy http://www.samaritans.org/
« Last Edit: September 16, 2015, 02:53:08 PM by nobodyspecial »

paddedhat

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Re: Health Insurance Alternative?
« Reply #31 on: September 15, 2015, 05:31:42 PM »
There is more than enough info. out there on the viability and stability of the very small number of these organizations that were legitimately grandfathered into the ACA. I am not member, but took the time to learn about the concept and it's success. Unfortunately, a couple of posters here have decided that facts are inconsequential, but stupid comments and attacks are useful.

Kind of pathetic actually, and of the same caliber of the morons banging on their keyboards while posting in places like Reddit, or the comment section of my local hick newspaper.

If you can show me statutory financial statements for one of these mumbo-jumbo plans, I would be most eager to read them.

If you can show me evidence that any of the very small number of these non-profits that were grandfathered in to the ACA. have had any significant issues in their decades of service, I would be most eager to read them. Until then your over the top rhetoric is of little value in this discussion.

regulator

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Re: Health Insurance Alternative?
« Reply #32 on: September 15, 2015, 06:26:03 PM »
There is more than enough info. out there on the viability and stability of the very small number of these organizations that were legitimately grandfathered into the ACA. I am not member, but took the time to learn about the concept and it's success. Unfortunately, a couple of posters here have decided that facts are inconsequential, but stupid comments and attacks are useful.

Kind of pathetic actually, and of the same caliber of the morons banging on their keyboards while posting in places like Reddit, or the comment section of my local hick newspaper.

If you can show me statutory financial statements for one of these mumbo-jumbo plans, I would be most eager to read them.

If you can show me evidence that any of the very small number of these non-profits that were grandfathered in to the ACA. have had any significant issues in their decades of service, I would be most eager to read them. Until then your over the top rhetoric is of little value in this discussion.

See, here is the thing: regulated insurance companies have recorded complaints with state regulators and anyone can look up the data and see how many complaints a given company has had, how many per thousand policyholders, what the trend is over a few years, etc.  With religious healthcare mumbo-jumbo, there is no transparency.  How would we know if a particular organization was screwing its supplicants (or whatever they are called) left, right and center?

Kroaler

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Re: Health Insurance Alternative?
« Reply #33 on: September 15, 2015, 06:48:02 PM »
Also most diseases are preventable with good diet and regular health behaviors - ie. riding your bike everyday.

This is straight up false, and dangerous misinformation.  Please don't spread lies.

The bicycle riding and diet  probably helps a good bit....

beltim

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Re: Health Insurance Alternative?
« Reply #34 on: September 15, 2015, 07:36:42 PM »
Also most diseases are preventable with good diet and regular health behaviors - ie. riding your bike everyday.

This is straight up false, and dangerous misinformation.  Please don't spread lies.

The bicycle riding and diet  probably helps a good bit....

Absolutely.  And exercise and diet are crucial to maintaining overall health.  But they won't reduce the incidence of disease by >50%, or even anything close. 

index

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Re: Health Insurance Alternative?
« Reply #35 on: September 15, 2015, 08:03:39 PM »
Real insurance companies can make money with a combined ratio (premiums collected vs payment) over 100. Essentially running at a loss. They can do this because they make money off their investment of the float (premiums waiting to be paid out) and purchasing reinsurance to hedge for large payouts. This organization has none of those structural advantages. Money in = money out minus the co-op management's cut. This runs well until something unexpected happens then either they ask for more money or your personal responsibility goes up. May work great for you but there is increased risk in it over traditional insurance.

obstinate

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Re: Health Insurance Alternative?
« Reply #36 on: September 15, 2015, 11:06:36 PM »
I read about these schemes. Honestly, I would guess that they will eventually collapse under the weight of the cost of unnegotiated care. To me, they seem like a pyramid scheme. Don't get me wrong, a well-intentioned one! But here's where it breaks down.

Go getters, trend setters, hip people join when they're young. Everyone's healthy, so the cost is no problem. Even if somebody needs a transplant, there are enough people that it doesn't feel like a problem.

Forty years later: everyone has cancer. The costs are enormous because the group lacks the negotiating power of a large insurance company to force doctors to keep costs down. The scheme collapses under the weight of out of control costs.

People who got sick while they were young win. Everyone else loses.

Workinghard

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Re: Health Insurance Alternative?
« Reply #37 on: September 16, 2015, 02:48:09 AM »
I imagine most people go on Medicare when they're eligible. As far as cancer, many of my elderly pts chose not to go through treatment. Don't forget they can always sign up for the ACA since preexisting conditions is no longer an issue.

paddedhat

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Re: Health Insurance Alternative?
« Reply #38 on: September 16, 2015, 06:47:07 AM »

See, here is the thing: regulated insurance companies have recorded complaints with state regulators and anyone can look up the data and see how many complaints a given company has had, how many per thousand policyholders, what the trend is over a few years, etc.  With religious healthcare mumbo-jumbo, there is no transparency.  How would we know if a particular organization was screwing its supplicants (or whatever they are called) left, right and center?

See, here is the thing: I asked if you could find any evidence that there are problems, and once again you go off with name calling (mumbo jumbo, supplicants) and ranting about how things are supposed to be in your well regulated world. (BTW, you sound like the kind who irons underwear, and snaps chalk lines before shoveling snow.)  These programs are geared to a very specific and small audience. IF they had all the issues that you claim, don't you think it just might show up ANYWHERE on the net, be it warnings from fellow churchgoers, or even articles about entire congregations leaving after a member suffered from financial ruin, since their Christian share program failed them?

Bottom line is successful programs like this are probably a lot more common than you think. The largest Amish community in my state runs a very substantial one. It a cost sharing program involving voluntary contributions from members, and cooperation from local providers. It's been going on for decades, and is based on a self insurance model that has gone on for centuries. It probably violates most regulations you cherish, yet manages to provide reliable low cost care for tens of thousands, without screwing anybody.

I know, this must be simply impossible, right?

nobodyspecial

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Re: Health Insurance Alternative?
« Reply #39 on: September 16, 2015, 06:52:43 AM »
I know, this must be simply impossible, right?
No just wildly profitable.
A group of people with a healthy outdoor lifestyle
A group that aren't going to demand all births are c-sections because they have a yoga class the next day
That don't demand a CT and MRI everytime their kid falls off a skateboard or they will sue for negligence
Or visit the doctor everyday because they are depressed/stressed/lonely and want drugs at every visit

mlejw6

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Re: Health Insurance Alternative?
« Reply #40 on: September 16, 2015, 07:59:03 AM »
If this is typical of these kinds of arrangements, this is scary stuff: http://samaritanministries.org/

There is explicitly no risk transfer involved and if you run up a big bill you are basically just hoping that everyone else in the scheme will pony up.  There is no way I would risk my net worth on this.

Quick clarification for non-Americans. These are the same people as the very much good-guy http://www.samaritans.org/

How are these organizations related? One is based in Illinois, the other is based in the UK....

index

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Re: Health Insurance Alternative?
« Reply #41 on: September 16, 2015, 09:41:52 AM »

See, here is the thing: regulated insurance companies have recorded complaints with state regulators and anyone can look up the data and see how many complaints a given company has had, how many per thousand policyholders, what the trend is over a few years, etc.  With religious healthcare mumbo-jumbo, there is no transparency.  How would we know if a particular organization was screwing its supplicants (or whatever they are called) left, right and center?

See, here is the thing: I asked if you could find any evidence that there are problems, and once again you go off with name calling (mumbo jumbo, supplicants) and ranting about how things are supposed to be in your well regulated world. (BTW, you sound like the kind who irons underwear, and snaps chalk lines before shoveling snow.)  These programs are geared to a very specific and small audience. IF they had all the issues that you claim, don't you think it just might show up ANYWHERE on the net, be it warnings from fellow churchgoers, or even articles about entire congregations leaving after a member suffered from financial ruin, since their Christian share program failed them?

Bottom line is successful programs like this are probably a lot more common than you think. The largest Amish community in my state runs a very substantial one. It a cost sharing program involving voluntary contributions from members, and cooperation from local providers. It's been going on for decades, and is based on a self insurance model that has gone on for centuries. It probably violates most regulations you cherish, yet manages to provide reliable low cost care for tens of thousands, without screwing anybody.

I know, this must be simply impossible, right?

What are you so upset about? I looked at several reviews and for the most part people really like share programs like this. It appears to have been working well for quite a while. I think some posters are stating that there is an increased risk with these types of sharing programs. They lack the structural advantages a of real insurance company. That is not a bash; just a fact. Money in has to equal money out. With these programs some will pay far more than they every receive and vice versa. The program cannot make up for shortfalls with reinsurance, investment proceeds, or reserves.

I think the biggest thing a lot of people are missing is your share-premium-gift whatever you want to call it is not tax deductible. This means your Share + Save to Share monthly premium for a family of $438 is the equivalent to $700/mo on a before tax basis (25% Fed. + 5% state + 7.2% FICA) which really doesn't save you anything over ACA.

Furthermore, when comparing this program to an HDHP, you cannot contribute to an HSA while on one of these sharing programs meaning you are missing out on ~$2500 of tax savings per year vs. how many on the forum are using an HSA as a long term savings vehicle. In my state a non-subsidized ACA Silver HDHP for a family is $448/month with 6400 deductible and 7600 max out of pocket. The sharing program is similar to an HDHP as well because they don't cover a lot of sub $300 office visits i.e. pretty much is catastrophic coverage. I would note however that HDHP's cover preventative care where the sharing program does not.

If you are planning on utilizing an HSA to help build your stache lets compare the two in after tax dollars:

Premiums:     HDHP - $3354/yr vs Samaritan -  $5256/yr
Save $6500:  HDHP - $4082   vs. Samaritan - $6500
Typical use for a family of 4 -  (5 unscheduled visits @ $300, 8 dental cleanings @$95, 4 physicals @150) - HDHP - $1500 vs. Samaritan - $2860
Max out of pocket in a yr  -   HDHP - 8126.8 (premiums + MoP) vs Samaritan -  $8416 (premium + typical care + $300 for cat. expense)

It seems like those who think the sharing programs are such a good deal have not taken the time to compare the plan on an after tax basis. It seems to have costs quite comparable to a HDHP without the added benefit of saving $2500/yr on your taxes when building your stache. 

mskyle

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Re: Health Insurance Alternative?
« Reply #42 on: September 16, 2015, 09:51:30 AM »
Yeah, it seems to me like these programs are probably right for you if you have some kind of moral opposition to health insurance (like say if you feel that it would be immoral if some of your money went to providing birth control, or if you find it gross that you have to pay for treatment for lung cancer caused by smoking) but if it's just a financial decision you really need to run the numbers; there's no guarantee you'll come out significantly ahead, and you are probably putting yourself at greater financial risk if you are unfortunate enough to require long-term, expensive care. Unless you plan on just switching to an ACA plan or Medicare if/when you get seriously ill...


nobodyspecial

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Re: Health Insurance Alternative?
« Reply #44 on: September 16, 2015, 02:54:13 PM »
How are these organizations related? One is based in Illinois, the other is based in the UK....
Sorry typo I meant to type "NOT the same". The UK samaritans are a long running widely admired anti-suicide organisation

regulator

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Re: Health Insurance Alternative?
« Reply #45 on: September 16, 2015, 03:40:43 PM »

See, here is the thing: regulated insurance companies have recorded complaints with state regulators and anyone can look up the data and see how many complaints a given company has had, how many per thousand policyholders, what the trend is over a few years, etc.  With religious healthcare mumbo-jumbo, there is no transparency.  How would we know if a particular organization was screwing its supplicants (or whatever they are called) left, right and center?

See, here is the thing: I asked if you could find any evidence that there are problems, and once again you go off with name calling (mumbo jumbo, supplicants) and ranting about how things are supposed to be in your well regulated world. (BTW, you sound like the kind who irons underwear, and snaps chalk lines before shoveling snow.)  These programs are geared to a very specific and small audience. IF they had all the issues that you claim, don't you think it just might show up ANYWHERE on the net, be it warnings from fellow churchgoers, or even articles about entire congregations leaving after a member suffered from financial ruin, since their Christian share program failed them?

Bottom line is successful programs like this are probably a lot more common than you think. The largest Amish community in my state runs a very substantial one. It a cost sharing program involving voluntary contributions from members, and cooperation from local providers. It's been going on for decades, and is based on a self insurance model that has gone on for centuries. It probably violates most regulations you cherish, yet manages to provide reliable low cost care for tens of thousands, without screwing anybody.

I know, this must be simply impossible, right?

I will thank you to leave the personal comments out of it.

I think it is clear from the antics of dirtbag equity indexed annuity sellers that sufficiently motivated crooks can be very good at quashing negative reviews on line.  Not long ago this forum got edited with extreme prejudice because MMM was threatened with a lawsuit.  An effective tactic, and there are others.  So I do not believe that random crap you can google up tells you much on this sort of thing.

The problem with these unregulated mumbo-jumbo sharing schemes is that there is no transparency and no backstop.  When I buy health insurance I am not insuring my health, I am insuring my net worth.  I am parting with a certain sum of money to ensure that if a possible negative outcome shows up I will not be bankrupted by the loss (just like liability/umbrella insurance).  As such, it is very, very important to me that the entity I am paying to cut the downside tail off the distribution of outcomes has the wherewithal to stand up to their guarantee.  Other than feel-good stuff and a lack of bad reviews when you google, there is absolutely no way to determine whether the mumbo-jumbo plans will actually be there if bad stuff happens.  Simple as that.  Yep, things have (allegedly - nobody really knows) gone swimmingly in the past.  Will they in the future?  Who knows?  Contrast this to actual insurance issued by a creditworthy insurer.  Failures are EXTREMELY rare, you can generally figure out they are coming with a tiny bit of due diligence, and when they do happen the losses to policyholders tend to be very small.  I can also tell what the service levels/complaint ratios look like.  All of this means that I can actually have some confidence that my counterparty will stand up to their guarantee if the shit hits the fan.  Nobody rational can say the same about the mumbo-jumbo sharing schemes without deluding themselves.

I understand that some people are touched in the head like to live dangerously.  Great for them.  I take risks I am comfortable with, too (fooling around with gunpowder by the pound and primers by the thousand, for example).  I am not at all interested in taking material counterparty risk when I pay up for a guarantee.  You prefer a cheaper/riskier alternative that may or may not turn out to be a religious Ponzi scheme?  Have at it, but don't say you were not warned.

hops

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Re: Health Insurance Alternative?
« Reply #46 on: September 16, 2015, 03:51:43 PM »
Quote
This is in some ways a cool idea -- a co-op health insurance. It would need to rely on numbers, though, just like any other health plan. I, too, worry about the potential for fraud.

The second-largest health insurance co-op in the US went under not that long ago:

http://www.npr.org/sections/health-shots/2015/01/14/376792564/health-insurance-startup-collapses-in-iowa

bmiles62

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Re: Health Insurance Alternative?
« Reply #47 on: September 16, 2015, 04:35:21 PM »
"The second-largest health insurance co-op in the US went under not that long ago:"

That is a Coop not a Health Care Share so it is not comparing apples to apples. The Coop that you referenced actually worked more like regular insurance.  http://www.healthcaresharing.org/coops-vs-health-care-sharing/

paddedhat

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Re: Health Insurance Alternative?
« Reply #48 on: September 16, 2015, 05:14:59 PM »

See, here is the thing: regulated insurance companies have recorded complaints with state regulators and anyone can look up the data and see how many complaints a given company has had, how many per thousand policyholders, what the trend is over a few years, etc.  With religious healthcare mumbo-jumbo, there is no transparency.  How would we know if a particular organization was screwing its supplicants (or whatever they are called) left, right and center?

See, here is the thing: I asked if you could find any evidence that there are problems, and once again you go off with name calling (mumbo jumbo, supplicants) and ranting about how things are supposed to be in your well regulated world. (BTW, you sound like the kind who irons underwear, and snaps chalk lines before shoveling snow.)  These programs are geared to a very specific and small audience. IF they had all the issues that you claim, don't you think it just might show up ANYWHERE on the net, be it warnings from fellow churchgoers, or even articles about entire congregations leaving after a member suffered from financial ruin, since their Christian share program failed them?

Bottom line is successful programs like this are probably a lot more common than you think. The largest Amish community in my state runs a very substantial one. It a cost sharing program involving voluntary contributions from members, and cooperation from local providers. It's been going on for decades, and is based on a self insurance model that has gone on for centuries. It probably violates most regulations you cherish, yet manages to provide reliable low cost care for tens of thousands, without screwing anybody.

I know, this must be simply impossible, right?

I will thank you to leave the personal comments out of it.

I think it is clear from the antics of dirtbag equity indexed annuity sellers that sufficiently motivated crooks can be very good at quashing negative reviews on line.  Not long ago this forum got edited with extreme prejudice because MMM was threatened with a lawsuit.  An effective tactic, and there are others.  So I do not believe that random crap you can google up tells you much on this sort of thing.

The problem with these unregulated mumbo-jumbo sharing schemes is that there is no transparency and no backstop.  When I buy health insurance I am not insuring my health, I am insuring my net worth.  I am parting with a certain sum of money to ensure that if a possible negative outcome shows up I will not be bankrupted by the loss (just like liability/umbrella insurance).  As such, it is very, very important to me that the entity I am paying to cut the downside tail off the distribution of outcomes has the wherewithal to stand up to their guarantee.  Other than feel-good stuff and a lack of bad reviews when you google, there is absolutely no way to determine whether the mumbo-jumbo plans will actually be there if bad stuff happens.  Simple as that.  Yep, things have (allegedly - nobody really knows) gone swimmingly in the past.  Will they in the future?  Who knows?  Contrast this to actual insurance issued by a creditworthy insurer.  Failures are EXTREMELY rare, you can generally figure out they are coming with a tiny bit of due diligence, and when they do happen the losses to policyholders tend to be very small.  I can also tell what the service levels/complaint ratios look like.  All of this means that I can actually have some confidence that my counterparty will stand up to their guarantee if the shit hits the fan.  Nobody rational can say the same about the mumbo-jumbo sharing schemes without deluding themselves.

I understand that some people are touched in the head like to live dangerously.  Great for them.  I take risks I am comfortable with, too (fooling around with gunpowder by the pound and primers by the thousand, for example).  I am not at all interested in taking material counterparty risk when I pay up for a guarantee.  You prefer a cheaper/riskier alternative that may or may not turn out to be a religious Ponzi scheme?  Have at it, but don't say you were not warned.

Obviously, you have a serious need to keep banging on the keyboard with absolutely no idea about WTF you are speaking of. I'll cover it as slowly as possible, and hopefully you can take a breather and pay attention. First the rational folks here are discussing a cost sharing plan for a very limited audience, not, as you created in your mind, some big new scam. Second, this type of cost sharing has a long history of success in many religious communities, be they Christians in general, or smaller specific groups. Third, a very small number of these programs were grandfathered into the ACA based on the fact that they have a decades long history of legitimate performance. 

All your stupid shit about this being a Ponzi scheme, there being zero transparency, mumbo-jumbo, decisions that I have made, and a whole host of other assumptions, are just that. They are based on your desire to attack something you know fuck- all about. I researched it, and given my situation, decided that it was not in MY best interest. Others have used the program with great success for many years. Get over yourself and let go. I only jumped into to this thread to address the fact that it was becoming tainted with inflammatory bullshit from a small handful that have no idea what they are talking about, and haven't let that fact stop them in the least. You then decide to become a poster child for this behavior. Why?


paddedhat

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Re: Health Insurance Alternative?
« Reply #49 on: September 16, 2015, 05:22:36 PM »
I know, this must be simply impossible, right?
No just wildly profitable.
A group of people with a healthy outdoor lifestyle
A group that aren't going to demand all births are c-sections because they have a yoga class the next day
That don't demand a CT and MRI everytime their kid falls off a skateboard or they will sue for negligence
Or visit the doctor everyday because they are depressed/stressed/lonely and want drugs at every visit

"Wildly profitable"  Seriously?  You have a religious sect (the Amish) that self insures with cash out of their own pockets, and medical providers that are happy to do business with them at greatly reduced rates for the benefit of both parties, and you see huge profits? LOL, where?  Maybe, the pastor is pocketing some of the cash as he rides his buggy from house to house collecting funds. Stop by next spring when they are having huge auction of quilts, horses and other goods to raise money for their clinic, and fund the cost of the community's health care. Yea, they are just rolling in profit.