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Is it a Good Alternative to Health Insurance?

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Is it a Good Alternative to Health Insurance?

If you’ve ever heard of Medi-Share, you might be intrigued by its promises to cover your health care costs.

Curious? We looked into the details to find out how Medi-Share works — and whether it’s a good option. Here’s our honest, unbiased review of the program.

What Is Medi-Share?

Medi-Share is a health-care sharing ministry made up of members united by their faith.

This program and similar medical-sharing ministries rely on their members to take care of one another through financial contributions, as well as prayer.

The details work much like typical health insurance. Like having a deductible, members choose an amount they’ll contribute as a household before they can submit bills to the community for payment assistance.

A monthly share payment works like a premium, ensuring your eligibility for assistance, should you need it.

There’s no guarantee your medical expenses will be covered through Medi-Share, and there are plenty of exemptions to consider before you apply.

But if you’re particularly religious — and healthy — you may want to consider this alternative to traditional health insurance.

How Much Does Medi-Share Cost?

First, the up-front costs: It costs $50 to apply, and you’ll pay a $120 one-time member fee with your first monthly payment. You’ll pay another one-time fee of $2 to set up your “sharing account.”

As for your monthly payment options, Medi-Share’s system is sort of like choosing a health insurance deductible and monthly premium.

As an example, we calculated costs for a 30-year-old woman in Florida seeking membership for herself only. Share amounts change annually, based on the oldest member of the household.

If she chose a $12,000 annual household portion — the amount of medical bills the member must pay out of pocket before being eligible for sharing — her standard monthly share would be $118.

If she met certain health and fitness requirements, she could qualify for a Healthy Monthly Share, which would lower her cost to $115 per month.

As a Medi-Share member, when you need medical care and visit a Medi-Share provider, you pay $35 for doctor visits and hospitalizations, and $200 for emergency room visits. Telemedicine visits do not cost anything.

You submit the rest of your bills to Private Healthcare Systems (PHCS) for payment consideration.

Christian Care Ministry, which operates Medi-Share, is a 501(c)3, but your payments aren’t tax-deductible.

Do You Need to Be Religious to Use Medi-Share?

Just as Medi-Share embraces the idea of a community of members supporting one another, it also believes in having a membership that embraces Christian lifestyles.

“Medi-Share members and their dollars do not pay for abortions, drug addictions, or any other unbiblical lifestyles,” according to the website.

Medi-Share also assumes that if you’re willing to take care of your Christian community by sharing the burden of medical bills, you’ll do your best to take pretty good care of yourself.

Some health conditions, like heart disease, high cholesterol or diabetes, put applicants in the mandatory Health Partnership Program, which pairs you with a health coach and costs an extra $99 per month.

What if You Have an Ongoing Health Condition?

While Medi-Share might be an appealing option if you’re healthy, anyone who suffers from a chronic health issue is probably better off turning to an ACA health insurance program for coverage.

“The primary purpose of Medi-Share is to help share members’ burdens,” the program explains. “Burdens are those unexpected medical bills you are unable to plan for (ie. broken bones, cancer, etc). Low monthly share amounts enable you to budget for your family’s routine care, which can be planned.” 

Prescription drugs can be eligible for cost-sharing, but only for up to six months for the lifetime of the member.

Behavioral and mental health care are also ineligible for coverage. This includes psychiatric or psychological care, as well as “counseling or care for learning deficiencies or behavioral problems,” such as ADD or autism.

But here’s the big catch: Routine health screenings aren’t eligible for cost-sharing either.

Well-patient care like annual physicals, pap smears and well-child checkups aren’t included. Dental and vision care aren’t eligible, either.

For instance, if your doctor recommends getting a colonoscopy because you’ve reached a certain age, you can’t submit the test for Medi-Share payment. If you have symptoms warranting the same test, the program might grant payment.

So, Is Medi-Share Legit?

Here’s our conclusion: Medi-Share isn’t a scam.

It’s totally legal and there’s a strong membership base to support it and similar programs.

But it’s likely not the most affordable health care option for most people. The ideal candidate for Medi-Share is in excellent health and also has a robust savings account to pay out of pocket for routine medical care.

One risk: Medi-Share and other cost-sharing programs aren’t subject to regulation like typical ACA programs.

So while a typical health insurance benefits booklet might clearly explain what’s covered and guarantee coverage up to a certain amount or percentage, Medi-Share participants might not be able to figure out ahead of time which medical bills will be paid by the program.

While Medi-Share probably isn’t the best financial choice for most people, it does serve as an option for anyone who doesn’t have access to a job-sponsored health insurance plan or who finds individual ACA coverage options prohibitively expensive.

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