Healthcare IV

Well, as you remember from my last healthcare post, I checked out potential healthcare costs at the places we were thinking of moving to, once we hit our FIRE goal. We were lucky in that the healthcare was available, at roughly the same price we would pay if we stayed where we were. So much for Geoarbitrage in terms of healthcare!

I wanted to start exploring some other options for folks beyond the standard healthcare options.  As some of you may know, in the US there is an exemption to some of the requirements of the ACA medical act (Obamacare) due to religious exemption. “Members of recognized health care sharing ministries are exempt from the mandate to purchase health insurance by 2014 or face financial penalties. Enrollment with a recognized health care sharing ministry REMOVES your requirement under the healthcare mandate to purchase health insurance.” This enables the Health share organizations to provide an alternative to traditional medical insurance.

The general concept is that the individuals signing up form a “pool of funds” with their contributions, and share them with each other to cover medical expenses. You pay in money up front and monthly, and then the program compensates your doctor, pharmacy, etc. When asked by the doctor, you explain that you will “self-pay” but that you belong to a group that will compensate them with directly. You even get a medical card, etc. For existing conditions, they typically are not covered the first year, are partially covered in year 2, and fully covered in year 3+. When I checked for the two of us, our costs were coming in between $350 – $500/month.

 Part of the issue you may have with this form of health sharing system is the ethics that you are expected to adhere to in order to stay in the system. Some of the strictures could include:

  • Abstain from tobacco use in any form.
  • Follow biblical teachings on the use or abuse of alcohol.
  • Avoid abuse of prescription drugs, which means consuming prescription medications in a manner not intended by the prescriber that would likely result in bodily harm or dependency.
  • Abstain from the use of illegal drugs. Illegal drugs include, but are not limited to, any hallucinogenic substance, barbiturates, amphetamines, cocaine, heroin, marijuana, illegal intravenous drugs, or narcotics.
  • Exercise regularly and eat healthy foods that do not harm the body.
  • Some individuals who qualify for our medical cost sharing program but have certain pre-existing health conditions that can be improved through lifestyle changes will be enrolled in HealthTrac℠. This required program is in place for Sharing Members to improve their health while reducing the risk of developing or exacerbating serious diseases.
  • If a condition is accepted as pre-existing, that member will be accepted with that limitation (see question about Pre-Existing Conditions).
  • All decisions for membership approval are made in consultation with the prospective member and with the most complete information available.

A key point is the one below – membership must be approved by the program administrators – you don’t just get to enroll automatically.  In order to qualify for the exemption from ACA, the programs have to have ‘(II) members of which share a common set of ethical or religious beliefs and share medical expenses among members in accordance with those beliefs and without regard to the State in which a member resides or is employed. Thus, it is similar to belonging to a specific sect of a church in order to qualify. If you do not meet up with that program’s guidelines, they will not cover you – because to do so will put their program in jeopardy. Denial of pre-existing conditions seems to be another issue with this format. This may rub you the wrong way if you don’t follow that particular denomination, but you may be able to seek out one for your personally religious calling.  

These healthcare ministries are still very new, and the legal ramifications are still being worked out on them. They may be a compelling option in the future, but make sure you go in with your eyes wide open. I intend to keep this as one of my options as we get closer to FIRE.

Additional articles on the subject:

If this interests you, here are some Specific programs to investigate:

Anyone have further information, or things you want me to look into for Healthcare?

 

Mr. 39 Months

 

4 thoughts on “Healthcare IV”

  1. The part I don’t get about medical cost sharing groups is that medical care costs what it costs. In fact the major companies like Blue Cross Blue Shield are vastly more capable of shaving costs paid out to doctors and hospitals to the bone than the relatively tiny and inexperienced medical sharing groups. Yet the medical sharing groups have much lower rates. That leads me to fear they are really going to collapse under their own weight. The major insurers are not getting rich with their high premium rates. Mine are over $13k for me and my wife with another $13k in deductibles. I simply can’t take the chance of bankrupting my nest egg to save five or ten thousand a year in insurance costs when the math says that the sharing groups are unlikely to remain solvent in the long run. I was on a hospital board and believe me nobody is getting rich right now in the hospital and medical or insurance system. I just don’t think the sharing model is sustainable until their rates are equivalent to commercial insurance providers.

    1. Excellent comment, and very informative. I’d be interested in hearing more about some of your observations with the healthcare system, hospital board info, etc. It would be very informative.

      I agree that, since these are new, the long-term implications of their work still need to be ironed out. I think a lot of folks are concerned about their long-term viability. Still, for many folks who have religious concerns about paying for insurance with company benefits that directly conflict with their ideals, its another way. I like the old comment about the US having “50 different laboratories” to try and figure stuff out. As a libertarian, I’d prefer to have the government out of health insurance as much as possible. We will see.

      Thanks again, and feel free to share more info!

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