Medi-Share Review: The Affordable Alternative to Expensive Health Insurance

Joining the Christian medical expense sharing community, Medi-Share, for around $250/month has been a fantastic financial move for my family. Prior to joining this healthcare expense-sharing community, I was paying $1,100 per month for a health insurance plan with Humana!

PT Money FamilyMedi-Share is not insurance (nor is it charity as you’ll see). But it’s a great alternative for some, and it does count as coverage in regards to the Obamacare mandate (which officially ends as of the 2019 plan year). Even without the mandate, however, this alternative will continue to be a great option for my family and could be for you, too.

Read on to learn more about how Medi-Share works, what are its advantages and disadvantages, as well as my personal experience so you can know what to expect should you decide to join yourself.

What is Medi-Share?

Medi-Share is a non-profit, medical expense sharing program for Christians. Members share in each other’s health expenses.

Essentially, each month, we all place our monthly share (like a premium) into one big pot (technically a credit union account), and those with expenses use that money to pay their bills. It’s not insurance. But for some, it is the ideal replacement for health insurance. Here’s how Medi-Share:

Medi-Share is a healthcare sharing program where Christians share financial resources to pay each other’s medical expenses. Since 1993, over $875 million has been shared and discounted among Medi-Share members. It’s a proven biblical model of healthcare–Christians helping Christians.

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How Medi-Share Works

Annual Household Portion

Members choose an annual household portion (AHP), which is similar to an annual deductible. The size of your portion determines how much you will have to pay out-of-pocket for covered medical expenses before the health share kicks in. You get to choose how much you can afford for both the AHP and the monthly share. The size of the AHP you choose will determine your monthly share. For my family of five, we chose a $10,000 AHP, which is high, but it means a lower monthly share (which we pay $235 per month). In the case of an emergency, we could handle having to pay $10,000 out of pocket, and we enjoy the savings that the lower monthly share affords. If your family would struggle with such a high AHP, you could choose a lower AHP but then will pay more in monthly portions.

Provider fee

As with traditional insurance, you will still pay a provider fee (like a co-pay) of $35 for doctor visits and $135 for emergency room care. Routine well patient care–such as annual physicals–and dental and vision care are not covered by Medi-Share, so you need to be prepared for those expenses throughout the year.

Preferred provider organization (PPO)

Medi-Share is partnered with the preferred provider organization PHCS, and members are encouraged to seek care from providers within the PHCS network–but you are free to choose treatment with an out-of-network doctor. However, if you do so, a penalty may be applied for going out of network.

Doctor visits

When you need medical care, you will hand over your Medi-Share card and pay your provider fee, and the provider will bill Medi-Share. The medical bill will be processed and discounted, and then your doctor will bill you for the amount you owe. Once the amount you pay meets your AHP for the year, your eligible medical bills will be approved for sharing.

Health incentive

Families may take up to 20% off their monthly share amount by qualifying for the health incentive. To qualify, all adult Medi-Share members in the household must meet certain health criteria, including blood pressure and BMI and weight/waist measurement. It was this health incentive which has helped spur me to lose some weight over the past couple of years–and it put money back in my pocket in addition to improving my health!

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Advantages of Medi-Share

medishare-how-it-worksLet’s explore some of the positives of this sharing program.

Escape the Market Altogether

Before Obamacare came along, I used to pay $300 a month for a $10,000 deductible health insurance policy. I am self-employed and make a solid income. However, once that law was passed, my monthly premiums shot up to $1,100 a month! I fundamentally disagree with Obamacare for its partisan implementation, selective enforcement, collusion with insurance companies and wasteful roll-out. With the future of American health insurance still being unclear, you may feel uncomfortable with a system that is being tinkered with in real time and Medi-Share allows you to leave all that behind. I cannot express the joy of being able to check out of the system and not having to face a penalty or high premiums for the rest of my life.

You can join Anytime

That’s right. You can apply for Medi-Share and join it anytime during the year. With Obamacare, you are forced to join within their open enrollment period, which runs from November 1 to December 15, unless you have a change in status (move, have a baby, etc). You may be looking at this review during open enrollment but understand that you can jump on Medishare anytime during the year. And you don’t need one the special exemptions to make the move.

It’s Significantly Cheaper

Compared to unsubsidized health insurance under Obamacare, Medi-Share is a huge money saver. My own family’s switch has shown very significant savings. (See below for details) Medi-Share is affordable compared to health insurance because they are still allowed to discriminate.

Disadvantages of Medi-Share

However, there are some disadvantages to Medi-Share too:

Cannot Participate in Health Savings Account (HSA)

Since Medi-Share is not insurance, you can’t qualify for an HSA. HSA’s as you know, require you to have a high-deductible health insurance plan. This is a major bummer for me. I was really enjoying the annual tax deduction from contributions to our HSA. Medi-Share is working with Congress on a bill that might allow HSAs to be used with sharing programs. I’m contacting my Representative to ask him to support this. Don’t worry if you already have funds in an HSA. You can still use them for qualifying medical expenses. We plan to use ours for expenses that aren’t covered by our particular Medi-Share plan.

No Tax Deductions

Health insurance premiums are tax-deductible. Medi-Share contributions are not. That said, medical expenses are still deductible, subject to a threshold based on a percentage of your adjusted gross income. Have a business with a few employees? You may be able to deduct the cost of reimbursing them for their Medi-Share monthly share. I did this myself by setting up a QSEHRA. Read more about that here.

Medical Providers May not Want to Bill Medi-Share

There have been a few anecdotal cases of doctors and hospitals refusing to bill Medi-Share and instead asking the patient to pay out-of-pocket. In some cases, this may stem from the fact that the PHCS network that Medi-Share uses is not the universal PHCS provider network. It’s incumbent on Medi-Share Members to call PHCS directly to confirm that the provider you want to see is covered under the Medi-Share PHCS system.

That said, the anecdotes of providers being unwilling to bill Medi-Share have still had happy endings. In particular, this mother’s cancer treatment was prepaid by Medi-Share at self-pay rates after the provider initially refused to accept the plan. The health share ministry made sure to come through for her. However, receiving a huge out-of-pocket bill from a provider can come as a shock to a family who has already paid their full portion. Since you want to be focused on getting well rather than on finances, this bears keeping in mind.

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Other Considerations

It’s important to understand how Medi-Share works. It’s not a charity or a way for Christians to help the needy. My tithe to the Church or individual giving through certain charities is how I take care of that. Medi-Share is simply sharing among believers. So to have the right to share, you have to be a believer and living an active Christian lifestyle.

1. No coverage for medical expenses related to unbiblical (i.e. not Christ-like) activities
Get injured in an accident where you were driving drunk? No coverage. Get an STD from an extra-marital affair? No coverage. When you join Medi-Share, you agree to live your life according to biblical principles.

2. You must have a Christian faith and be attending Church regularly
To participate in the program you’ll need to sign a form professing your faith and share your Church information.

3. Restrictions for maternity expenses
Expecting? Don’t expect to just jump on Medi-Share six months in and get full coverage. You can have children on the plan, but to get full coverage you will have to be participating in the plan before you get pregnant. Otherwise, coverage has limitations.

4. Restrictions for pre-existing conditions
Common sense dictates that to make Medi-Share work, you can’t just have people jumping on the program after they discover a major medical need. If you do have a major medical issue (or have one in remission) you might be allowed to join Medi-Share with limitations.

medishare-membership-growth

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How Much is Medi-Share?

I’m in my early 40s with a wife and three kids. As a family we pay $235 a month and have a $10,000 Annual Household Portion (i.e. deductible). For a lower deductible, like $2,500, then your monthly payment would be $506. Here’s a chart based on my age and number of people on the plan:

MediShare Costs

We used to pay $1,100 a month with Humana. So in just the first seven months of being with Medi-Share, we had already saved $4,388! Here’s how that breaks down:

  • With Obamacare we would have paid a minimum of $7,700 ($1,100 x 7 months) in premiums.
  • With Medi-Share we’ve paid $1,960 ($280 x 7 months) in premiums.
  • Copays are roughly the same under both plans.
  • With Medi-Share we’ve paid roughly $70 each for five sick visits for the kids, and $475 each for the two well visits (six months and nine months) for our son. This totaled up to roughly $1,352.83. The well visits were a shock, but still not as shocking as an Obamacare premium.

Here’s a screenshot of our deductible (annual household portion) usage as of our first year with Medi-Share:

Medishare Annual Household Portion

Pay Less With Medi-Share

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So Is Medi-Share for You?

There’s a lot on the line when it comes to your family’s medical needs. Take plenty of time to evaluate all of the pros and cons of the program and don’t forget to consider your long-term plans. Are you having more children? Will you get married soon? Are you about to retire and qualify for Medicare? All these things and more make a difference.

Medi-Share makes sense for my family because:

  • We are self-employed Christians and don’t mind being obligated to the coverage restrictions related to lifestyle.
  • Our income will likely exclude us from being subsidized in the Obamacare health insurance marketplace. Medi-Share gives us considerable monetary savings.
  • We don’t have pre-existing conditions and we don’t plan on having any more children (i.e. we don’t have maternity care needs).

How to Join Medi-Share

It takes a while to go through the application process so leave yourself plenty of time. Here are the major steps:

  1. Click the link below which will take you to an application.
  2. Apply.
  3. Complete the medical forms and testimony of faith.
  4. Complete the power of attorney for the share account (set up with a credit union).
  5. Make your first share payment.
  6. Click Here to Apply to Medi-Share

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Are you a Medi-Share member? Please share your experiences in the comments!