5 Comments

  1. I think a very reasonable question you should ask is:
    What will happen if your RV goes off the road and you and Kathy are in some emergency department in nowhere you’re familiar with? That’s kind of a definition of “catastrophic event”. A couple of days in an ED and ICU can easily run up a bill of a half a million dollars.

    How much will you be out-of-pocket in each of these plans, including your ACA options?

    1. Author

      Out of pocket is a bit hard to calculate because the different Health Sharing plans exclude different things. I’ve tried to make an “apples to apples” comparison between three of them for a family of five for their most comprehensive plan with similar “personal responsibilities” (Deductibles):

      CHM –
      Monthly Share – $784
      Personal Responsibility – $1000/member
      No preexisting conditions covered for 36 months
      Has a preferred provider network (PPO)
      Maximum family annual expense for covered items, INCLUDING “Share” – $14,408

      MEDI-SHARE
      Monthly Share – $611
      Personal Responsibility – $5000 (various levels are available at different costs)
      No prescription medicine coverage
      PPO but no difference for out of network reimbursement
      Maximum family annual expense for covered items INCLUDING “Share” – $12,332
      20% discount available for those with healthy cholesterol, weight, etc.
      Preexisting conditions covered with percentage growing over three years, then 100%

      LIBERTY HEALTHSHARE
      Monthly Share – $449
      Annual Dues – $75
      Personal Responsibility – $1500/family
      Preexisting conditions not covered first year, $25,000 second year, $50,000 third year, then 100%
      Preventative care (eg colonoscopy) covered
      Go to any doctor/hospital
      Prescriptions covered 45 days before/after an incident
      Maximum family annual expense for covered items INCLUDING “Share” – $6888

      ACA
      Maximum PER PERSON out of pocket AFTER premiums ranges from $3250 to $5700, or $16,250 to $68,400. Premiums after subsidy, $258 to $1222/month. No out of network coverage.

      There’s a lot more to consider, but that’s a basic breakdown of the financials.

  2. Jeff and Kathy,

    Welcome to my world, the independently insured. I pay $900/mo for my daughter and I, with a $6000 deductible and basically pay for everything except hospital. That is pretty standard across plans I’ve looked into. And going up Jan 2017. I hope this blog turns up other options besides those you’ve mentioned.

    Sandra

  3. I gather that you will have to pay out of pocket and submit the bills for reimbursement? What limitations and exclusions do they have? For example, are blood transfusions, medical devices, any out patient rehab allowed for submission? What about private nursing care if needed and for how long? Also is there a limitation on hospital stays? How much would they reimburse you? Yes, I am thinking about our recent experience. Lastly, are routine annual tests covered? Mammograms etc?

    Just offering some other things to think about.

    1. Author

      With Liberty you present an ID card and the doctor can bill Liberty directly. If the doctor won’t or can’t do that, you send the bill to Liberty for payment or reimbursement.

      Some of the plans don’t cover routine annual tests, Liberty does. Those that don’t explain that this is NOT insurance, and that “sharing” is for large expenses, not for routine medical care. However they will help you negotiate for the greatest discounts available for those services.

      Good questions on some of those other particulars. I’ll study up on them and get back later!

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