I came across this link telling about Christian ministries forming their own insurance cooperatives.

From what their website says, the thrust of their mission is this:

  • Avoid enrollment in the Affordable Care Act
  • Not pay into a system which funds abortions, despite any abortive coverage coming from states rather than federally
  • Incentivize a “Biblical” lifestyle which includes abstaining from non marital sex, tobacco, illegal drugs, and excessive alcohol use

The nation’s largest of these groups, Medi-Share, admits outright that it “is not insurance or an insurance policy nor is it offered through an insurance company.”  Essentially, these are cooperatives of insurers who help pay for each other’s medical bills.

At first, this may seem like a good idea.  It seems like a logical step toward reigning in abhorrent medical costs.  This, however, is not the case.

These programs:

  • Are not legally obligated to pay for your medical costs
  • Do not cover preventative care
  • Do not have an out of pocket maximum
  • Do not take into account sudden increases in costs

If you are considering purchasing one of these plans, we implore you to reconsider.

If you were to get cancer and had a bronze plan with the Affordable Care Act, with a maximum out of pocket expense limit of $6,350, that’s as much as you would have to pay for the year for all the chemotherapy treatments, radiation treatments, miscellaneous medications, hospital stays, transportation to treatments, rehabilitative care, surgery, and anything else associated with it.  Considering that many chemotherapy treatments cost $10,000 per month, this is an extraordinarily necessary option.

$6,350 is all you would be on the hook for in your time of need.  You could even likely work out a payment plan with your care providers to pay it back.  On top of that, your insurance company would be legally bound to pay the remainder of what you needed.

On top of knowing the highest amount you would be paying for your care, your insurance company gives you a schedule, a brochure of what percentage or amount they’ll pay for any given procedure.  This means you’ll actually be able to plan your course of action and what you’ll end up having to pay.

On the other hand, if you were to get cancer and were “insured” by Medi-Share, you might have 20% of your costs covered or you might have 60%.  You might have nothing covered, or you might have it all covered.

They are under no obligation to pay for anything you submit, despite having paid a monthly premium on par with what the bronze plan under the ACA costs.  They have no schedule of payments or transparency in how they operate.

Let’s look at another scenario: a broken ankle resulting in an ER visit with x-rays, cast, and rehabilitation.  With the bronze plan under the ACA, you go straight to the ER.  With Medi-Share, you have to make sure your medical provider accepts your program before going.

Bronze plan:

  • $1,500 hospital visit with a $135 copay = $135 out of pocket
  • $300 x-rays with a $15 copay = $15 out of pocket
  • $400 cast with a $25 copay = $25 out of pocket
  • $3,000 for 5 rehabilitation treatments with a $25 copay for each treatment = $125 out of pocket
  • Total of $300 out of pocket

Medi-Share with the $1,250 “deductible” option (note: “sharing” is when a bill is outside of the policyholder’s deductible and submitted to other members to pay):

  • $1,500 hospital visit: $1,250 out of pocket, $250 submitted for sharing
  • $300 x-rays: $300 submitted for sharing
  • $400 cast: $400 submitted for sharing
  • $3,000 for 5 rehabilitation treatments: $3,000 submitted for sharing
  • Total of $1,250 out of pocket with a potential for $3,950 coming back to you.

Health is a gamble.  We never plan on that car accident, heart attack, stroke, or cancer diagnosis.  We don’t plan on things turning bad quickly, but for far too many of us, they do.  While living a cleaner lifestyle may decrease many risk factors, most diagnoses of dread diseases come from unknown origins.

Aside from the daily gamble of sickness and injury, we have to make sure that we are able to get checked up regularly.  Plans like Medi-Share require you to pay for your entire doctor’s visit, lab work, and medications.  Preventative care like that is covered with no out of pocket costs under every single ACA eligible insurance plan.

All we want you to do at the Eddie Arriola Insurance Agency is know exactly what you’re getting and to help you plan, as best as you and we can, for both the good and the bad.

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