What is Medi-Share?
Medi-Share (the brand name for Christian Care Ministries) is a medical cost-sharing organization based on the Christian faith. The association does not offer health insurance. However, members are exempt from the individual mandate to have health insurance.
This exemption had financial value as it allowed Medi-Share members to avoid penalties. However, there are no longer any financial penalties associated with a lack of health insurance. As of this writing, Medi-Share has more than 400,000 members who have shared more than $ 2.6 billion in medical bills.
How do members share the cost of health care?
Although Medi-Share is not health insurance, it works in the same way as health insurance. Members still have to make a monthly payment that Medi-Share calls a “share” rather than a premium.
The amount of the portion depends on age, marital status, and the number of people joining (such as children, spouses, etc.). For a 26-year-old single, a monthly portion ranges from $ 107 to $ 280. The site has a pricing calculator.
If you incur medical expenses such as a fracture, having a baby, or required surgery, you are responsible for provider fees ($ 35 for standard doctor visits and $ 200 for emergency room visits). The invoice is then sent to Medi-Share (Christian Care Ministries) for negotiation and discounts.
As a member, you are responsible for paying the bill up to your Annual Household Share (AHP). The AHP ranges from $ 3,000 to $ 12,000 and varies based on your monthly payments. All bills above your AHP are shared by the network.
Is Medi-Share Affordable?
If you get health insurance as part of your job or qualify for health insurance premium credits through Healthcare.gov, it’s unlikely you’ll save a lot of money with Medi-Share. When you add in the costs of primary care and the costs of the monthly premiums and the annual household portion, it’s hard to see it upfront.
However, if you have a higher income and are self-employed, Medi-Share could help you save hundreds of dollars per month. This is especially true if you are in good health and rarely need medical attention. Additionally, once their AHP is reached, Medi-Share members share 100% of the costs associated with their care (assuming their expenses meet the eligibility criteria).
Will Medi-Share cover my claim?
Medi-Share does not operate a compliant model. Since this is not insurance, medical bills should be considered eligible for sharing. Most medical expenses are considered eligible.
However, Medi-Share has a long list of terms that are not eligible for sharing. Some of the more notable exceptions include:
- Maternity coverage for a child born out of wedlock (except in the case of rape).
- Abortion
- Medical care for self-harm
- Medical treatment for drug use or abuse
- ETS support (except innocent streaming exceptions)
- Mental or behavioral health care (most health insurances also limit coverage related to this)
- Prescription drugs are limited (only 6 months of shared use for new diseases)
- Prosthesis (in most cases)
Pre-existing conditions are also eligible for coverage only after a member has shared them regularly for at least 36 months. Even so, you will have a participation limit of $ 100,000. After sharing for at least 60 months, your coverage limit for pre-existing conditions increases to $ 500,000.
Most of the time, Medi-Share will meet the needs of its members. However, if you are someone who might want any of the above services, it may not make sense to try to commit to Medi-Share.
How does primary care work with Medi-Share?
Unlike normal insurance, primary care coverage is generally not covered by Medi-Share. However, there are exceptions such as well-child visits up to the age of six and one annual medical exam per member.
Since members have to pay for most preventive services out of pocket, Medi-Share recommends that members seek medical care within their PPO network (which includes more than 900,000 providers nationwide) to find the best deal possible. . Medi-Share also offers free telehealth to its members.
My experience with Medi-share
I used Medi-Share for a short time when I made too much money to qualify for the Medicare premium tax credit and I didn’t. I also did not have access to an employer-sponsored health insurance program. She was young, healthy, and had just given birth. As a result, I didn’t feel like I needed intense medical care for the next year or so.
During the year I paid for dental treatment, a telehealth visit (which was not covered at the time), and an inexpensive prescription ($ 9 per month). I got a healthy living discount and didn’t need to see a doctor. My husband, who had pre-existing conditions, and my children were covered by his student health insurance.
Overall, I enjoyed being a Medi-Share member. I appreciated the opportunity to share encouraging notes with some of the prominent members. However, she couldn’t wait to get back to a normal health insurance plan. It was difficult for me to find a primary care physician who would accept me as a patient. That may have changed since the Medi-Share provider network seems much larger today than it did four years ago.
Is it worth it?
I believe Medi-Share offers a unique structure for sharing medical costs. Christians who have a specific belief against having standard health insurance should turn to Medi-Share or one of the other health care sharing ministries (there are currently 9 with widespread open registration options).
Aside from those with specific religious beliefs, Medi-Share could be a good option for individuals or families who cannot find cheap health insurance that meets their needs. For example, the self-employed can realize significant savings by excluding themselves from Medicare and joining shared health ministries. Nomadic self-employed workers who cannot easily qualify for state-specific insurance may find that Medi-Share (or health care exchange in general) makes more sense for their lifestyle.
Because Medi-Share has strict faith guidelines, I recommend that potential members carefully review the member’s faith and lifestyle guidelines. If you do not agree with all the member requirements, you may consider a nondenominational health care exchange program like Knew Health or another independent health insurance provider like Sidecar Health.