Healthcare (health insurance and medical bill coverage) keeps getting more complicated, yes? No matter where we land politically, there’s something for us all to despise about this industry. Perhaps healthcare for you is unaffordable. Frustrating. Unavailable. Confusing. Long before RepubliCare – even before ObamaCare – the healthcare industry is not one most people think of with fondness. Many people are voicing their aggravation, feeling stuck between a rock and a hard place when it comes to comprehensively (but affordably) covering the health needs of themselves and their families.
A few years ago, we got notice that our private insurance plan would no longer be available and we needed to choose something else. We surveyed the options and could choose between A) paying a fortune for mediocre coverage OR B) still coughing up more than we pay for our monthly mortgage for terrible coverage. We looked into what it would cost for our family to hop on the group plan at my husband’s workplace. Again, unbelievably expensive for a sub-par healthcare policy. Does this sound familiar?
Not wanting to be pigeon-holed into either option, we went on the hunt for an alternative. Our search criteria was simple and modest: affordable, reasonable healthcare coverage. Does that sound like a pipe dream? It shouldn’t, but in today’s day and age, it actually kind of does. Until we stumbled upon something fantastic. Turns out there are these privately owned medical-cost sharing programs.
I looked into several and went with Christian Healthcare Ministries. Let me quickly explain the premise (everything I’m about to say is true of CHM; most other cost-sharing companies are structured similarly, but you’ll have to consult their websites for more information about their programs). With CHM, there are three tiers of membership. We picked the middle one. Our whole family of 5 pays a total of $255/month. We have a $1,000 deductible per health “event.” CHM will pay up to $125,000 per health event. You can buy additional coverage for healthcare reimbursement beyond the $125K for a low monthly fee. If/when we have a health problem for which we incur medical bills, we submit the bills to CHM and they reimburse us (minus our deductible, of course). We are responsible for routine wellness visits (CHM pays zero dollars toward preventative care).
This is a real thing, guys. However, we’re the type of family who really only visits the doctor for our annual exams, so when we found out we were pregnant last July, we started wringing our hands. We had not exactly been planning on being pregnant again – ever – so we were unwittingly going to put the whole system to the test.
Let me break down what it cost us to bring child 3 into the world. Our “silver” policy with CHM covered all hospital and labor/delivery costs. Not pre- or post- natal (the “gold plan” covers more, FYI). Here’s the thing: most healthcare providers deeply discount their services when you tell them you’re self-pay (See? NObody likes dealing with insurance). Our self-pay rate doctor bill was $2,500 ($1,750 of which was hospital-related, so it was reimbursable). Watch this: the hospital bill was $15,000. When I told them I was self-pay, the cost went down to $7,500. When I told them I would pay it all at one time, it got chopped down to $4,200. FOUR THOUSAND TWO HUNDRED TO HAVE A BABY. Now, remember, CHM reimburses all but my $1,000 deductible. Therefore, I paid the $750 of my doctor bill that was prenatal care related + my $1,000 deductible + other prenatal costs that weren’t rolled up in my doctor bill (ie: sonograms, glucose test, blood panels, etc). In all, we paid around $3,000 total.
In short, we paid less (by far) for child 3 with CHM than we paid with the other two (child 1=group insurance plan; child 2=private insurance plan). If you factor in the premium we’re paying per month for CHM ($255) vs our former insurance plans ($850), the difference in total funds invested is HUGE.
A few items to note:
For reference, an annual wellness exam (self-pay) ends up being about $100 per person in our family with our doctors.
Existing health conditions and health history do not disqualify someone from CHM’s cost-sharing program.
People using medical cost-sharing programs are exempt from paying the ObamaCare penalty.
You use whatever doctor, office, provider, hospital, specialist you want.
Per CHM’s website, once accepted/processed, it can take 3 to 4 months for bills to be reimbursed. However, after I submitted my hospital bill, it took less than two month to receive a reimbursement check in the mail.
If you’ve been searching for a satisfactory solution to healthcare woes, take a minute to look into a cost-sharing program. Maybe it’ll be the right fix for your family, too!
Here are some resources: