Medical Cost Sharing Plans: Can They Replace Your Insurance?

Guest post by Kate Phillips

“Bear ye one another’s burdens.”
—Galatians 6:2

A few days ago, I wrote about Medical Cost Sharing programs, also known as Healthcare Sharing Ministries. I described my experience with the “Affordable” Care Act, detailing why I left Obamacare and how leaving has saved me thousands of dollars.

January 2019 update: I’m still with Liberty Healthshare and still very happy with my decision. The rates did go up in 2018 by about $50/month for my plan, and the annual unshared amount is now $1000/year. Prices quoted in this article are from 2017. Please fill out the form below if you would like to be contacted with a current quote. Kate

To recap briefly; when skyrocketing health insurance costs sent me searching for an alternative to Obamacare, I found Liberty HealthShare, a health cost sharing ministry. Liberty has slashed my healthcare costs by more than half with a monthly share amount of $199, versus $441 for a bare bones Obamacare policy. And should I encounter substantial medical costs, I don’t have to worry about paying a deductible of $7k or more, as my annual unshared amount is only $500.

This article will give you more details about health cost-sharing programs in general, and Liberty specifically. I’ll list the pros and cons and give you links to further information so you can decide if health cost sharing is the money-saving solution you’re been waiting for—or perhaps, just an interesting idea that’s not a “fit” for you.

Health Care Sharing 101

Modern day medical cost sharing began when a beloved Ohio pastor was involved in a terrible auto accident in the early 1980’s. His whole community banded together and paid his significant medical bills, in full, within 45 days. That pastor went on to begin the first health cost sharing ministry of its kind in modern times. Healthcare cost sharing has been practiced for decades by Anabaptist Christians (Amish-Mennonite), and has now taken root in Evangelical Christian and Catholic communities as well.

According to Wikipedia, a health care sharing program or ministry is “an organization that facilitates sharing of health care costs among individual members…. who have common ethical or religious beliefs.” Some of Liberty’s Statement of Shared Beliefs include:

  • We believe it is our biblical and ethical obligation to assist our fellow man when they are in need according to our available resources and opportunity.
  • We believe it is our spiritual duty to God and our ethical duty to others to maintain a healthy lifestyle and avoid foods, behaviors or habits that produce sickness or disease.
  • We believe it is our fundamental right of conscience to direct our own healthcare, in consultation with physicians, family or other valued advisors, free from government dictates, restraints and oversight.

Healthcare sharing ministries meet the requirements to opt out of the Affordable Care Act insurance mandate without a penalty, provided the programs have existed prior to 1999, undergo annual financial audits, and retain members after they develop medical conditions. Health cost sharing ministries aren’t technically “health insurance,” though, and they don’t cover everything the ACA policies cover (more on that in a moment), but they DO provide tremendous benefits for members, in addition to an escape from the spiraling insurance costs.

How Health Cost Sharing Programs Work

Joining a health cost sharing program generally works something like this:

First, prospective members are vetted to make sure they are a match. Typically, members commit to living a healthy lifestyle, including not smoking or abusing alcohol or drugs. Pre-existing conditions aren’t covered the first year, and only with limits the second and third year. Members may be asked to agree with a statement of faith or values, which is broad in some cases, and quite narrow in others.

Next, you choose your desired plan. With Liberty, I fall into the age 30-65 category, and I can choose monthly share amounts of $157, $181 or $199. I chose the highest level, which allows me to share medical bills of up to $1 million per incident. My annual unshared amount (similar to a deductible) is only $500 per year.

Finally, you fill out a health questionnaire and application. Be aware that not everyone is accepted without exclusions or requirements, although most are. (More on this below.)

Once a member, you contribute your monthly share amount. With Liberty HealthShare, this is collected and then distributed electronically to cover the medical expenses of other members. The process is hands off for members. With some other health cost sharing programs, such as Samaritan Ministries, you literally “pay each other’s bills,” which sounds potentially problematic.

You visit your doctor as needed, and yes, the cost for annual physicals can be shared. Show your member ID and ask the office to send bills electronically to Liberty HealthShare. (It is a bit confusing telling receptionists that it’s “not insurance,” but I’m learning that it really works much the same.)

If it’s something out of the ordinary, call for pre-approval first. I see a naturopathic doctor (ND) instead of an MD, and I called first. My annual physical exam and my annual gynecological exam were both eligible, but at first, there was a question as the good folk in Ohio weren’t really familiar with naturopathy. Any alternative treatments should be verified beforehand, as not all will be shareable, although Liberty does cover chiropractic care and acupuncture when medically indicated and with a treatment plan.

Liberty HealthShare then processes bills for discounts, eligibility, and sharing. You are notified if there is a problem. After an injury, I learned that medical massage was not covered. (However, they did negotiate my bills downward.)

Payments are then made from the monies that other members have contributed. Lastly, an Explanation of Sharing statement (much like an Explanation of Benefits) is sent to you and your doctor to confirm payment explain what was covered.

What to Know About Healthcare Ministries and Liberty HealthShare

Founded by the Mennonite church, Liberty HealthShare is one of the larger healthcare ministries. It has helped like-minded people share medical bills since 1995, offering members a way to lower costs and share risk without all of the government overhead, red tape, and regulations.

However, it’s not technically “health insurance,” and you should read the fine print. Healthcare sharing programs, which are ministry-based non-profits, work to keep costs down. They also prioritize coverage for what is in alignment with their values.

Birth control is also not covered, but maternity care is, provided that your pregnancy begins after enrollment. (I understand some other health share ministries don’t pay for pregnancies out of wedlock, so be warned and aware if that is a possibility for you or a dependent.) Abortion is only covered in cases where the mother’s life is endangered by the pregnancy. You may not be covered for injuries from driving drunk, nor if you need rehab for drug addiction. Mental health services are not shared. And you won’t get any assistance with a sex-change (I believe most traditional insurances also exclude this), but if you need an organ transplant, heart surgery, or other major operations, you’re covered.

If you’re not healthy by Liberty’s standards, you may be accepted, but with conditions. If you don’t qualify due to health habits, weight, or a pre-existing condition, programs such as Liberty provides health coaching for those who wish to stop smoking, lose weight, or better their lifestyle to improve a pre-existing condition such as high cholesterol or hypertension. (There is be an additional fee for this, although it seems like a real win-win to me.) Certain pre-existing conditions may be ineligible for sharing for the first year, and subject to limitations in years two and three.

I also found a surprising “bonus” benefit in Liberty’s sharing guidelines: “End-of-life Financial Assistance” of $3,000 to $10,000 for surviving family members. This is paid if a Liberty HealthShare member dies who has been continually enrolled for over two years, and they have immediate family (even if the beneficiaries are not Liberty HealthShare members). It can be used for medical costs, pharmacy, burial, etc., and is a truly amazing benefit I didn’t even realize I had!

There is an initial membership fee of $135 and an annual renewal fee of $75. After the membership fee, the only expense not shared to pay medical bills of other members is administration cost of $24/month per member or family, which is taken from your shared amount. The rest pays for healthcare!

Healthcare Sharing Pros and Cons

On the plus side, some of the advantages and benefits of a medical bill sharing program like Liberty HealthShare include:

  • Health care is not dependent on the government.
  • Health care is not dependent on employment or an employer.
  • No networks; you choose your doctors with Liberty HealthShare.
  • No enrollment periods—join anytime.
  • Affordable! (My payments are 44% of what ACA plan premiums would be.)
  • Low “deductibles” (called the annual unshared amount) of $500/individuals, $1000/couples, $1500/families with Liberty.
  • Babies born to members can be enrolled without exclusions or limitations for “pre-existing conditions.”
  • Available in all 50 states.
  • Health coaching can help members improve their health.
  • It’s transparent, subject to a publicly available annual audit by an independent CPA.
  • After 2 years, membership provides “end of life financial assistance” to dependents.
  • My Liberty HealthShare plan covers medical costs outside of the U.S.
  • Covers complementary and alternative treatments when medically/financially justifiable.
  • Includes “VideoMedicine” option to consult with a doctor using an app similar to Skype or Facetime.
  • Medical bills are often significantly reduced, as members are considered cash-pay patients.
  • It’s more personal than insurance; many appreciate the ministry foundation of the plans and the opportunity to post a note (via the website) or pray for the person whose bills you are helping with.

On the minus side, health care sharing program disadvantages include:

  • Monthly shared amounts are not tax deductible as a medical expense or as health insurance premiums.
  • Pre-existing conditions (chronic or recurring in the previous 3 years) are not eligible the first year, subject to restrictions (currently a $50,000 cap) the 2nd and 3rd years.
  • Adopted children with pre-existing conditions may not be fully covered under all health cost-sharing plans.
  • Coverage for prescription drugs is extremely limited and only applies in the first 45 days after an acute illness.
  • Birth control and, in certain situations, maternity care are not covered. (Different healthcare ministries differ on requirements, read the fine print.)
  • All healthcare sharing plans are not open to all people. Sponsoring ministries require agreement with statements of values or faith. (Liberty HealthShare accepts people of all faiths who support religious liberty and the right of Christians to worship in their own way.)
  • Same-sex couples can join Liberty (I can’t vouch for other programs) but are considered individual members rather than a couple for pricing purposes.
  • Liberty doesn’t sign up “groups” such as businesses, but there are ways to ensure employees by bonusing employees the amount of their monthly share and inviting them to sign up as individuals.
  • Plans do not cover dental or vision care (same as ACA policies.)
  • Currently, the plans are not eligible for HSA savings plans, but a co-sponsored bill is gaining support which may change that.
  • Sometimes doctors’ offices are unfamiliar with plans and it takes a bit of explaining or an extra call to confirm coverage.

Even though Liberty HealthShare hasn’t covered every bill, the fact that I am saving nearly $3,000/year over ACA insurance premiums AND I no longer have a frighteningly high deductible has made me a big fan. Plus, I like their philosophy and have been impressed with their customer service. I personally think it is the perfect health “insurance” solution for health-conscious people who are self-employed or self-insured. Liberty HealthShare is real, proven, and legit, and I expect that medical cost-sharing programs like Liberty will only become more popular as more people realize that they have options!

Explore Your HealthShare Options

Want to know more about Liberty HealthShare?

Download the Liberty HealthShare Decision Guide

Explore the Liberty HealthShare website.
If you choose to get more information or sign up, please mention me—Kate Phillips Pritchard—as your referral. (I don’t receive money for a referral, nor does Partners for Prosperity benefit in any way, but members can earn gift cards for referrals.)

Even better—simply fill out the form below and I will make the referral for you. Liberty HealthShare will then get in touch with further information. I won’t personally contact you, but you will automatically receive a confirmation email with helpful links to learn more.


(click here if you don’t see the form above)

Some other health care sharing options:

Solidarity HealthShare is extremely similar to Liberty, except it is sponsored by the Catholic church and is designed for practicing Catholics.

Christian Healthcare Ministries has very affordable options for “Christians living by biblical principles,” especially for those comfortable with a higher unshared amount (deductible) of $5000. (However, note that without adding on their secondary program, coverage stops at $125,000.)

Medical Cost Sharing is also designed for Christians, has a strong focus on prevention and includes a “Tele-Medical” program that gives you 24/7 access to doctors by phone.

Be well and I hope I have helped you find YOUR affordable healthcare solution!

This article is from Kate Phillips, our marketing coach and writer and founder of Total Wealth.

More Innovative Financial Solutions from Kate Phillips and Kim Butler:

Partners for Prosperity founder Kim Butler and Kate Phillips wrote Busting the Financial Planning Lies together in 2015, an ebook that details why typical financial advice is failing Americans, and how we can do better by building wealth outside of Wall Street, big banks, and the 401(k) machine. Get your copy as part of P4P’s complimentary Prosperity Accelerator Pack here.

 

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