HomeFinderCody said:
I could have used better language. When people ask, I usually just say "don't do stupid or immoral stuff and you're okay". I'm good with it. If I decide to make a bad decision and I get hurt as a result, that should be on me.
The Medi-Share monthly cost is just over $400 for my family. It's a high deductible plan. I also priced BCBS and some other options....all of them were well over $1000 per month for high deductible plans.
It's certainly not for everyone. But for my family it was a pretty clear best option.
I helped one of my pastors look into Medi-Share. I administer a fairly large self-insured program at my employer, so I have some perspective I can bring.
Medi-Share is essentially an unregulated self-insured medical program. They do not meet the definition of affordable care provided in ACA, but ACA provides an exemption for members of healthcare sharing ministries, which gives an exemption to the excise tax for failing to have coverage. Along that same line, subsidies that are available to help purchase coverage under ACA are not available to be used for premiums in Medi-Share.
As Medi-Share is completely unregulated and exempt from ACA, they have absolutely no obligation to pay claims - just their own procedures that can change from time to time. They can make arbitrary decisions subject to their own policies, and the only appeal that can be made is a single appeal to other members of the program. If your case isn't compelling enough, or if you just get a bad draw on the "jury," you are SOL. For perspective, the appeals process is one of the more protected components in traditional insurance. In an insured medical program, you can first appeal to the carrier, then to the state's Independent Review Organization. In a self-insured program from an employer, then you may have an additional layer where you can appeal to the administrator at your employer.
How does Medi-Share offer benefits for a lower cost? They exclude coverage for many expensive pre-existing conditions. They can make arbitrary decisions on paying expensive claims, or paying for expensive drugs that may help someone have a successful transplant, or may be the most effective cancer treatment. They avoid the costs associated with running a regulated program, including annual reporting and independent audits. They claim to be members of the huge PHPS network, but many have reported that some providers that take PHPS won't take Medi-Share.
As more people seek them out in the wake of Obamacare, they have the risk of adverse selection in their member pool and negative claims experience, which means the less healthy people flock to them and costs for everyone go up. In a worst case scenario, they run out of money and have nothing more than their promise to pay claims. No department of insurance is there to oversea them and make sure they do pay claims, and they don't have the backing of a company with profits or stop-loss coverage to pay claims.
The legislation excluding them from ACA only applies to companies that had been in existence since 1999 - so that means they pretty much have a monopoly on the market, with no competition to do things better.
Lastly, while Medi-Share looks like a high deductible health plan, it does not make members eligible to participate in a health savings account. There was a movement with H.R. 1752 that tried to change that last year, but it never got out of committee.
Personally, I do hope that programs like this put pressure on the insurance industry to fix itself. But, as long as I have an alternative available through my employer, I'm not taking the gamble on medical coverage with my family. I have coverage so a catastrophic event doesn't bankrupt me. As long as Medi-Share is unregulated with no competition and no recourse for not doing what's right, I don't see that Medi-Share fully mitigates that risk.