What is Medi-Share Insurance?
Technically, Medi-Share is not insurance. It is a non-profit program for Christians to share their medical expenses that might be able to replace insurance for some families.
How Does Medi-Share Work
Every month, the monthly share of each individual is combined. This is similar to a credit union account. This provides the members with health expenses the funds to cover their bills. Although this program is not insurance, it is an excellent replacement. Many Christians have become members of the program in order to share their financial resources. The program was established in 1993. Since then, in excess of $875 million has been discounted and shared by the members.
The Rules of Medi-Share
It is important to understand the rules of the program prior to applying. Everyone must agree to specific terms to be approved. The program ensures the costs remain as low as possible by screening the applicants prior to granting approval for the sharing platform. Each individual is required to sign a document stating they are of the Christian faith. The additional requirements are as follows.
• Each individual must not have sexual relations other than the traditional Biblical marriage of one woman and one man.
• Each individual must not have used any type of illegal drugs or tobacco within the past twelve months.
• Each individual must agree not to use any tobacco or type of illegal drugs in the future.
The individual must state if any of the above rules are broken by any family member, they will immediately notify CCM. The individual must also understand the family member may no longer qualify for participation in the program. Their membership in the program will be terminated. This means their medical bills will become ineligible for sharing.
Once the individual or family have become members, they make a payment each month into the shared pool. Each individual is responsible for paying a specific amount of their medical expenses per year, similar to a deductible, called the annual household portion. When a member becomes ill, the money from the pool is used to pay their medical expenses over that amount.
What is Medi-Share AHP?
It is important to understand the annual household portion (AHP). Each member must choose their AHP. This is a lot like a yearly deductible. The amount chosen determines how much money the individual will have to pay up front for their medical bills prior to the health share becoming active. Each individual makes the decision for their monthly share and AHP based on their financial situation. The higher the AHP, the lower the amount due for the monthly payment. A lower monthly share will be easier for the family to pay each month. If the family is unable to afford a higher AHP, they have the option of paying a larger portion each month. This is an important decision and must be considered carefully.
The Associated Fees
There are a few fees associated with the program. There is a $120 fee for approval. The individual only has to pay this fee once. This fee is charged once the individual applies for the program and has been approved. The fee is added to the first monthly payment. There is a $2 fee for membership, also added to the first monthly payment.
If the individual signs up for automated payments to the ACH, there is no additional monthly payment. If the individual declines, there is a monthly payment of $3. There is still a fee the individual must pay for the provider. This aspect is similar to the co-pay of traditional insurance. The fee for a visit to the doctor is $35. The fee to visit the emergency room is $135. It is important to note routine care such as a yearly physical is covered. Neither vision or dental care are covered by the program. Each individual will need to cover these expenses as they occur.
How Does Medi-Share Work Regarding Preferred Providers?
There is a partnership between Medi-Share and the (PHCS) preferred provider organization. All of the members are encouraged to use providers in the PHCS network for their medical care. Each individual has the right to choose a doctor not in the network for any medical treatment. In this instance, there may be a penalty for seeking care outside of the network. When an individual requires medical assistance, they present their card and pay their provider fee. The provider then bills the program. Once the program has processed and discounted the bill, the amount due will be billed to the individual by the physician. Once the individual has reached their annual AHP, the rest of their medical bills eligible for sharing for the remainder of the year will be approved.
The Health Incentive
Twenty percent of the amount due for the local share may be removed for families who qualify for the health incentive. The household members have to meet specific health criteria including BMI, weight, and blood pressure. This incentive has not only provided a good reason for numerous individuals to lose weight, but they have also improved their overall health and saved money at the same time.
Other Benefits of the Program
Members of the program also receive two extra benefits. The first is the individual access to their telephone physicians. This is extremely important if the individual or a member of the family should become ill or require medical attention. The second benefit is the potential alleviation of the costs of both vision and dental care. There are dentists willing to provide discounts and accept the cards. Unfortunately, this is not true of every dentist.
A lot of individuals are concerned with the future of health insurance in the United States. There is no way to be certain of what is going to happen at this point in time. This program alleviates the concerns and provides peace of mind. There is no longer a reason to pay extremely high premiums for health insurance. It is also important to note there are no restrictions as to when a family can join the program. Membership is open throughout the entire year. Anyone who has ever applied for Obamacare knows the open period for enrollment is from November 1st until December 15th. The exceptions are few such as having a baby or moving. No special exemptions or circumstances are required to become a member.
Cons of Medi-Share
Pre-existing conditions are taken into account. Some of them will require higher monthly payments and some aren’t going to be covered.
Health Savings Accounts (HSA) aren’t eligible to be used with the program, my favorite healthcare/retirement account.
There are faith-based rules that don’t allow tobacco, illegal drugs, extramarital sex, and require members to attend church regularly.
There are a lot of pros and cons to Medi-Share and other health sharing ministries. In general, they are a good way to save money, especially if you are in good health. If you have pre-existing conditions, aren’t in great health, or aren’t a Christian it’s probably not for you. Make sure to research it thoroughly and comply with all of their rules if you decide it’s for you.