Last year, I reviewed Medi-Share as a insurance professional. This year, I want to share my experience as a MediShare member.
As medical insurance premiums grew and physician networks shrank, I found myself in a similar situation as many of my clients: How can I afford it and keep my family covered? Medi-Share seemed like a good option: lower premiums, PPO network that included my wife’s OBGYN, and the pediatrician for our children, and a tacky website (it’s gotten better). ).
But how would it not work? We also anticipated some major modifications – my spouse was expecting and we were anticipating a child boy number 3 by the summer. Could this be possible for us?
A MEDI SHARE IS A POSSIBILITY, HOWEVER, THERE IS A LITTLE BITE LITTLE BITE OF A STUDY CURVE RELATED TO.
Once you’ve got the hang of it, I think most people and families will be satisfied. You can either fly right into our website to compare Medi-Share with other plans in your area, or continue reading to learn the details.
Before you sign up for Medi-Share, there are some things to consider
Medi-Share does not exclude people for pre-existing conditions (just like the main medical plan), but they won’t pay if you have any pre-existing conditions for the first 36 months. Essential!
My wife was not eligible for our family because she was already expecting when we signed up. We decided to leave her on our previous main medical plan (Aetna), and move me and my then 2-year-old boys over to Medi-Share. After the birth of my child, I would bring along my spouse and our new child.
The sign-up process was simple, but a bit different from the other insurance companies (remember that learning curve I mentioned?). Medi-Share does not enroll you automatically when you apply. You’ll need to fill out a couple of extra forms and sign a press launch about your religion, as well as provide some references from church. We never checked our references, but now customers have told us that they did.
You must also set up your share account with the bank. The process is relatively painless, but there are some small fees and paperwork involved. Medi-Share does not have an Open Enrollment, so you can join at any time. However, they recommend that you submit your initial application by the 20th of the month to ensure your plan starts on the 1st of the next month. It took about a week.
The PPO Physician Community is Legit
Medi-Share has a legitimate PPO physician network, which is one of the reasons we chose it personally and decided to feature it on our website. Many sharing ministries let you choose any doctor you want, but being “in network” with a PPO allows you to get discounted rates. This is much better than haggling over money (which can be higher and often worse).
Most likely, the front-office staff of your physician will not have heard about “the Medi-Share Community”, so don’t panic if they look at you funny if you ask. Medi-Share uses the “Multiplan PHCS Community”. If you ask them about it, they may nod.
We have added Medi-Share’s physician community to our physician search characteristic at in our insurance coverage information at TakeCommandHealth.com, so it will be straightforward so that you can see in case your physician’s are “in community” or not. Medi-Share will still pay for doctors who are “outside of network”, but they’ll only cover the agreed upon fee. It sounds fair to me.
Medi-Share manages payments in a different way
Medi-Share’s biggest difference was the way billing worked. The billing process was initially a bit confusing, but once you got the hang of it, it’s much easier than other main medical plans.
Medi-Share does not have deductibles, or a maximum-out of-pocket limit. Instead, it has an annual family portion (AHP), which is a combination of deductibles and capped-out-of pocket limits. You pay for all of your expenses before your AHP and then nothing afterward (for companies that are eligible, more on this in a moment).
Medi-Share does not charge co-pays on physician visits. Instead, there is a $35 “supplier fee”. This charge is paid every time you visit a doctor (whether it’s a specialist or if it’s primarily for major care). This charge does not count towards your AHP but is applied to your physician’s bill. As an insurance expert, I can explain the difference. Let’s say your doctor charges $100 for a 15-minute session. If your insurance plan requires a $35 copay you will only pay $35, and the rest of your insurance policy will pay. Medi-Share lets you pay $35 for the supplier and then get a bill later with the remainder $65 (which goes towards your AHP). It is not a huge deal, as most people will never discover out. However it’s something to point out.
This helpful diagram explains the Medi-Share billing system:
Here’s a quick example of how to follow the above steps. If you’re on the AHP2500 plan, and fall ill and have to spend the night in the hospital, for example:
- Does the invoice qualify for sharing?
- Does there exist a “in-community” low cost? If you go to a Medi-Share community hospital, you will get the negotiated fees. The negotiated price is $6,000, but the hospital stay costs $8,000. Medi-Share will send your hospital invoice to you. They’ll then apply the correct charges.
- Have you reached your AHP yet? If this is your first invoice, then you haven’t. If you’re on AHP 2500, then you pay $2,500 and the remainder $3,500 will be revealed to share. Since you’ve met your AHP, any other eligible payments that you or anyone in your family has made this year are covered.
In abstract, your $8,000 hospital invoice prices you $2,500 out-of-pocket. Not dangerous! It is much easier to calculate your copays, deductibles, and coinsurance on a regular medical plan.
The prevention of disease is not at all lined
In July, my wife and I welcomed our third child. I explained that I had left my wife on our old Aetna policy while she was pregnant, as we hadn’t enrolled into Medi-Share before the pregnancy and so it could have been excluded above from protection (would have failed question #1). This was a transfer. To save money, I moved my spouse and the new child to Medi-Share (the Aetna rates were outrageous). This was a transfer of medium quality. I will clarify.
In the Medi-Share guidelines, I read that preventive care is “eligible” for sharing for children and newborns up to 5 years old. It was a good thing because our child was due to get his immunizations and new child checkups. These are all things that can be considered preventive, and covered for free with a serious health plan.
Medi-Share is different. I received a bill for nearly $1,000 for my child’s immunizations. Even though preventive care is “eligible to be shared” for teens as young as five years old, that doesn’t mean it won’t cost me anything. The immunizations were eligible for sharing, but I hadn’t reached my family’s AHP yet (step 3).
On reflection, it was smart but a bit abrupt. As a side note, I sent the invoice to Take Command Wellbeing’s new negotiation service. They called the pediatricians office and worked with Medi-Share in order to reduce a few hundred dollars off my invoice. Not dangerous! Since then, I have also discovered that immunizations are available at a very low price in the county hospital.
I was initially kicking myself because I didn’t leave my son on the old Aetna program for another month or two, where his new child checks and immunizations were $0. Medi-Share sets their premium rates for individuals, couples, and then families of three or more. I didn’t think it was possible to save money by putting my spouse, child and one child on Aenta. The short version is that I still came out ahead with the lower Medi-Share premiums, but was a bit surprised by the immunization bill.
Add-ons and Customer Support
Medi-Share customer service has been great. They will usually pray for you too if you call. The account managers are very knowledgeable and will support you and your family. Although we haven’t crossed our AHP to share our payments, we often get postcards from other families who have. The reason is not disclosed (that would be a violation of privacy), but it’s still pretty cool.
Medi-Share has recently added a few primary ancillary products, including telemedicine through MDLive and dental discount programs with Carrington. They are automatically included in your monthly share amount. Telemedicine is an excellent choice as you can get your primary prescriptions by calling and paying $0.
I’m glad that I chose the Premier membership plan from Take Command along with Medi-Share. Although our telemedicine provider Teladoc, and MDLive may be a bit redundant, Take Command’s dental community was much larger and included our dentist while the Carrington community did not. The money I saved on my first invoice paid for the bill negotiation service.
Full disclosure: We made a small profit if you joined Take Command’s Premier Membership Plan, but I found it worth it as a Medi Share member.
Final steps and other actions
Medi-Share is something we will continue to use in the coming year and highly recommend! It’s true that there is a learning curve, and I was grateful to have our invoice negotiation service available. Although the immunization bill was unexpected, I’m not surprised anymore now that I understand Medi-Share billing process. Medi-Share is still a better option than a major medical plan when you take into account the monthly savings.
I think it’s worth a closer look if Medi-Share fits with your religious and moral values. If you’re eligible for tax credits or have an expensive pre-existing condition, it is worth weighing your options before signing up.
What is the best thing to do? See how Medi-Share compares to different main medical plans in your space by going by means of our self-guided interview at TakeCommandHealth.com. We are the only website that allows you to compare Medi-Share with other main medical plans available in your area. Our free website allows you to quickly search for doctors and prescriptions, and simulate your situation to see if Medi Share is right for you and your family.
And naturally, when you have any questions, be at liberty to ask within the feedback beneath or e mail me at assist@takecommandhealth.com and I might be comfortable to reply your questions!
