Episode 23: Health Care Before Medicare- Medi-Share Programs
Over the past few weeks on the Healthcare Before Medicare series, we have been taking a look at some different ways to answer the question of how to pay for medical insurance before you reach Medicare age.
On this week’s episode, were going to explore a different kind of option! We are thinking outside the box of regular insurance and we are exploring the idea of ‘Medi-Share’ arrangements.
Medi-Share is not typical insurance, so we will learn what the difference is between these programs and traditional medical insurance. So, if you are thinking of retiring before Medicare age or simply interested in insurance alternatives you will want to see if this is a good option for you.
Disclaimer: Please do not take advice from me on this show. As a licensed Fiduciary I am only allowed to give advice to clients. Unless you’re a client I can’t give you advice because I don’t know you. Think of this as helpful hints and education only! And please, before implementing any information or ideas you hear on this show always consult your legal adviser, your tax adviser, and your financial adviser.
(1:30) Practical Planning Segment: Last week, we had a pretty thorough discussion on the ACA commonly referred to as Obama Care and what you need to consider when checking into the ACA.
I feel that Spending lots of time on the ACA website can really help you find clarity in the muddy pool of the U.S. healthcare system.
The biggest factors in premium costs are:
Your MAGI which is your modified adjusted gross income and which state you live in. If you want to get the best deal that works for your family, it will take a lot of diligent research and some income planning.
Today is about looking at some other alternatives available that many people may not be aware of. One of those other options are Medi-Share programs.
If you kind of conduct your own personal poll, if you will, and you ask folks if they’ve heard of these types of programs, many will, most likely, tell you they have no idea what you’re talking about.
(3:40) Let’s define what Medi-Share is and where folks can find more information on these programs. To Be very clear; Medi-Share is not insurance. They are Christian Health sharing ministries
Medi-Share is an alternative to traditional health insurance. Medi-Share is a medical cost-sharing program, an arrangement between a group of people to share medical expenses.
Although it is not traditional health insurance, there are some similarities between the two. There is a monthly fee similar to a health insurance premium and there is a yearly out of pocket portion that your family is expected to reach before asking the Medi-Share community for help.
They call the monthly fee the “monthly share amount” which in traditional insurance would be called the premium
They call the upfront portion that you have to pay before coverage begins “annual household portion” which in traditional insurance is called your household deductible.
(6:00) Again, Medi-Share is not insurance, it’s more of a community.
Correct………The biggest difference between health insurance and a Medi-Share ministry is that the money you pay each month goes to help another member of your community.
When you pay your “monthly share” amount, this money goes directly to another member who needs care.
Healthcare sharing companies are nonprofit Christian-based cost-sharing programs. There are quite a few of these organizations, each with a few different rules. Some of the most popular are
(10:00) These ministries sharing programs are non-profit. With…….
(13:30) What kind of experience would you have as a Medi-Share member if you go for care?
Each sharing program mentioned above will have some differences.
With the 1st one “mychristiancare.org” it seems likes the experience is very similar to typical of normal health insurance.
You would have a membership card, pay a provider fee, and the provider sends the bill directly to Medi-Share. However, I noticed some of these programs require the insured (patient) to pay upfront and then get reimbursed by the community. So, check that out first.
Members are encouraged to use an in-network provider due to lower costs (CHM has over 700,000 providers in their PPO network)
(15:40) Check into each organization and how they handle prescriptions. For example:
Christian Healthcare Ministries, chministries.org, members receive a CHMRx prescription savings card, which can be used immediately and as often as you visit the pharmacy. The card provides substantial savings on prescription costs.
Gold level members: Incident-related prescription costs are eligible for sharing.
Silver and Bronze members: Silver and Bronze do not include provision for any prescription medication.
All programs: Prescriptions used for maintenance treatment cannot be shared by CHM members.
This is obviously a major consideration when choosing a sharing program!! To see what and if prescription medications are covered in any capacity.
(18:10) There are some disadvantages to Medi-Share, for example;
No Health Savings Account (HSA)……..
Since Medi-Share is not insurance, you can’t qualify for an HSA. HSA’s as you know, require you to have a high-deductible health insurance plan. This is a major bummer.
Medi-Share is working with Congress on a bill that might allow HSAs to be used with sharing programs but who knows how long, if ever, that will take to get into place.
Don’t worry if you already have funds in an HSA. You can still use them for qualifying medical expenses.
So, if you already have funds in an HSA account and you decide to switch to a Medi-Share plan, you could use those funds for things that may not be covered like prescription drugs?
No Tax Deductions!
Health insurance premiums are tax-deductible. Medi-Share contributions are not. That said, medical expenses are still deductible, subject to a threshold based on a percentage of your adjusted gross income. > 10% of AGI.
If you Have a business with a few employees? You may be able to deduct the cost of reimbursing them for their Medi-Share monthly share. Something to speak to your CPA about.
(21:30) Medical Providers may not want to Bill Medi-Share
There have been a few anecdotal cases of doctors and hospitals refusing to bill Medi-Share, and instead, asking the patient to pay out-of-pocket. It’s incumbent on Medi-Share Members to call PHCS directly to confirm that the provider you want to see is covered under the Medi-Share PHCS system. You can also go to https://www.multiplan.com/ccm. And see if your doctor is in the network.
The Medi-Share network of doctors and specialists (known as a PPO) is called PHCS, which stands for Private Health care Systems. It includes over 700,000 healthcare professionals.
I can tell you from experience that if there is a particular doctor or healthcare facility that you normally use, the odds are very good that it is part of the PHCS network.
So that was a brief overview of how these programs work…………Lets go wrap it up and get coachable!
(22:40) The bottom line is… do your homework on all these options and compare them to the more traditional insurance options available. And a word of caution, when searching on the net you can find anything you are looking for whether you are pro Medi-Share or anti Medi-Share.
If you go into it with a pre-conceived bias one way or the other…………. you can find an opinion on the net that will support your viewpoint!! So, it’s difficult, but try to keep an open mind when researching all your health care options and read a lot of reviews!
There are a couple of articles I found helpful.
One article I would characterize a pro to neutral on these medi-share programs and the other article is definitely not pro. It’s more a cautionary tale and what to look out for when joining a medi-share program
The web addresses are too long to say over the air on the podcast so we will list them in the show notes on the podcast page.
Why Medi-Share: https://ptmoney.com/medishare-review/
Why Not Medi-Share? https://www.wellsteps.com/blog/2018/01/06/medishare-insurance-medishare-review/
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