Health insurance plans are a must in today’s world. We all need the peace of mind that comes with having a health plan in place. But they’re not always affordable, especially for families on a tight budget.
Have you heard about Medi-Share? This non-profit, Christian-based medical expense-sharing program may be the answer to your prayers. It’s an affordable alternative to traditional health insurance that operates similarly to the health plans you’re familiar with.
But there are some key differences, which may make it more suitable for you than other medical insurance policies and health plans. Discover how it works, what it costs, and who it’s right for, in this complete guide to Medi-Share.
What Is Medi-Share?
Medi-Share is a medical expense-sharing program. You don’t have to wait for an open enrollment period to join. Sign up at any time and you’ll have assistance in covering your medical expenses.
The network of Medi-Share members contributes to the fund. These funds can be used by any member for paying their medical bills, once a certain criterion called AHP is reached.
The amount that each member pays, and how much they can use, is governed by several rules. Let’s look at those, next.
How Does Medi-Share Work?
Medi-Share works by sharing the burden of medical expenses. The members pool their monies in what is essentially a credit union account.
But how do they know what to pay each month, and how much they are eligible to use? This can be affected by the following factors.
Members Pay Provider Fees
You’re probably familiar with the term co-pay. This is similar in that Medi-Share members will have certain medical expenses throughout the year that Medi-Share doesn’t cover.
Provider fees that aren’t covered include routine wellness appointments, dental and vision check-ups, annual physicals, and preventive health exams. However, you’ll be covered for some of these with Medi-Share Complete, the most comprehensive option.
An Annual Household Portion Applies
You’ll be able to choose your annual household portion ( AHP). This is similar to the concept of a deductible. But with Medi-Share’s AHP, there are no per-incident deductibles. And there’s also no individual deductible. Each household or family has only one AHP.
When you have a doctor’s visit, you’ll present your Medi-Share membership card. The medical provider will bill Medi-Share, and once the bill has been processed and any applicable discounts have been applied, you’ll pay the rest.
Once you have met your annual household portion for the year, you’ll be eligible for medical expense sharing. Ninety percent of medical bills are shared within 30 days. There are no annual caps or lifetime limits, although maternity care after AHP may be subject to certain exceptions.
Members Must Obtain Services In The Private Healthcare System
Medi-Share is partnered with Private Healthcare Systems, an organization of their preferred healthcare providers. As a Medi-Share member, you’ll be advised to choose a healthcare provider from their list.
Although you can choose to see a medical professional who isn’t a member of this professional body, you may risk a penalty for doing so.
But you don’t have to stress that you won’t be able to find a medical provider near you. The PHCS system has more than 900,000 providers, which makes finding a suitable provider easy and convenient.
Health Incentives Are Available
Would you take better care of your health if you knew it would reduce your monthly healthcare expenses? We’re certain you would – especially if those lifestyle changes helped you stay healthier for longer, too. The Medi-Share health incentive promises to do just that.
By meeting certain health criteria, particularly around weight and blood pressure, you can save up to 20% on your Medi-Share monthly share amount. That’s because people who keep their weight and blood pressure under control are less likely to develop lifestyle-based health conditions.
How Much Does Medi-Share Cost?
The cost of Medi-Share depends on various factors. These include your age, marital status, family size, the state you live in, and your annual household portion (AHP).
Certain pre-existing medical conditions will also require additional monthly contributions, for example, diabetes. If you’re uncertain about the effect your pre-existing health condition will have, you can discuss it with a Medi-Share representative.
There are some application fees and upfront fees that apply to all new members, though. You’ll have to pay $50 to apply and a $120 once-off membership fee, along with your first monthly installment. Your sharing account will be set up for an additional fee of $2.
But some factors are largely under your control. One of these is the AHP. You’ll be able to determine your specific household portion, which affects your sharing eligibility. You’ll be advised of these amounts after consideration of the factors mentioned earlier.
What Does Medi-Share Cover?
Access to Telehealth services is provided free of charge. You can access these services 24/7 and may be all you need for minor health complaints like the common cold, the seasonal flu, or minor allergic reactions. But for more serious medical issues, you’ll need to go to a doctor’s room or even a hospital.
So in addition to Telehealth services, Medi-Share’s cost-sharing covers a wide variety of more urgent medical situations.
Here’s a breakdown of what you’ll have to pay, and how this affects your annual household portion amount.
Doctor’s Room Consultations
If you choose to see a doctor from the approved PHCS list, you’ll pay a $35 provider fee. It doesn’t count toward your AHP amount.
You’ll also be eligible for in-network discounts at certain medical practitioners. These discounts also apply even when you have routine check-ups that aren’t covered by Medicare cost-sharing.
Hospital & Emergency Visits
As with doctor visits, you’ll pay a $35 provider fee per hospital visit that doesn’t count toward your AHP. A $200 provider fee applies to emergency visits. This, too, doesn’t count toward your annual household portion.
FDA-Approved Prescription Medicines
Medical visits usually entail the prescription of medications, and these can sometimes be very expensive. Fortunately, Medi-Share members are entitled to up to 6 months of FDA-approved prescription drugs per medical visit.
Non-prescription over-the-counter medicines and alternative or folk remedies aren’t covered, though.
Ante-Natal & Child Care
Expanding the size of your family? Medi-Share can help, but there are some pretty strict guidelines.
To be eligible for cost-sharing, your AHP must be $3,000 or higher. You must have shared throughout your pregnancy and the limit for sharing is $125,000 for any single pregnancy event. Adoptions may also be covered, subject to certain criteria.
Until each child turns 6 years old, the costs of their routine wellness care may be shared. Thereafter, they will be subject to the same terms as any adult. And for adults, routine wellness care isn’t covered by Medi-Share expenses sharing.
Lost Income Due To Disability
Disability can be debilitating in more ways than one, especially if you are the primary breadwinner in your household. This is where Medi-Sahere can be of greater benefit.
Medi-Share’s Manna Program is suitable for you if you become disabled and have to take time off work. Through this program, Medi-Share will replace up to 80% of your lost income for up to a year.
Funeral Expenses
It’s impossible to know when you’ll be faced with funeral costs, as death is an unpredictable but inevitable experience in every household.
Funerals can be a very costly experience, too, adding financial stresses to the already heavy impact of grief. But with Medi-Share, up to $5,000 of funeral expenses are eligible for sharing
What Does it Not Cover?
Medi-Share Christian group insurance can be a lifesaver for many households battling with medical bills. But it doesn’t cover all procedures and products associated with health.
The following are the broad categories that are not covered by Medi-Share health insurance programs.
- The costs of birth control methods, infertility testing, and sterilization procedures.
- While you may find relief in them for certain health conditions, alternative treatments like reflexology, reiki, and acupuncture, are not covered by Medi-Share health insurance.
- Non-prescription medications, vitamin and mineral supplements, and health foods.
- Although you may receive discounts for hearing aids, vision care, and dental checkups, they are not covered by Medi-Share cost sharing.
- Elective medical procedures and cosmetic surgery.
- Mental health care, counseling, behavioral therapies, or occupational health sessions.
- Preventative procedures like colonoscopies, prostate exams, and mammograms.
- Costs associated with vaccinations and immunizations.
Medi-Share Pros & Cons
Like any other health plan, Medi-Share has its pros and cons.
Pros
Because there are various options available to you regarding your monthly dollar-amount contribution, it can be very cost-effective.
Your employment status will not affect your membership eligibility. And this makes Medi-Share Christian Healthcare insurance a good alternative to other health plans like Obamacare.
Cons
Because Medi-Share is not technically considered health insurance, you may find yourself with little to no legal resources in the event of coverage issues or the termination of the program. Medi-Share is therefore also not compatible with QSEHRA reimbursement plans.
Medi-Share is a faith-based health insurance alternative. Like any Christian insurance system, there may be certain rules you’ll have to abide by to qualify for coverage.
Medi-Share Frequently Asked Questions
How is Medi-Share not the same as health insurance?
Medi-Share may act similarly to health insurance, but it is not the same thing. It doesn’t cover many procedures and wellness activities that regular health insurance covers. And because it is a religious ministry-run healthcare option, it will be subject to certain rules that other health insurance is not.
Do you have to be religious to use Medi-Share?
Medi-Share is a Christian-based medical cost-sharing system. All members will be expected to meet the norms of Christian living to qualify for cost-sharing. This includes abstaining from sex outside of the confines of traditional Christian marriage. It also includes the avoidance of alcohol, tobacco, and narcotics for at least 12 months before joining.
Is Medi-Share more cost-effective than other health plans?
Yes, Medi-Care is very cost-effective for many people who have families and are struggling to find affordable health insurance. But as Medi-Share is not insurance in the strict sense, your contributions can’t be tax deductible. They don’t qualify as insurance expenses or charitable donations, by law.
Conclusion
Medi-Share is not medical insurance, although it shares certain similarities. This health insurance alternative may be the solution for those struggling to find affordable health insurance plans.
But it’s not the only option for families on a budget. Here at Enhance Health, we help you find the right health plan for your needs and your finances.
You’ll discover health plans with low and even no monthly premiums, depending on your employment status and income. Call us today to learn more.
