My companies health insurance is outrageously expensive and I have to jump through so many hoops to get some discounts. Even with the discounts, it's still over $900/month for a family of 4. I've been look into some alternative options. Does anyone have experience with "Health Share Plans"? Pros vs cons? Red flags to be aware of? Recommendations?

TIA

They're paid with after tax dollars, so factor that in. Your company premium is going to be 12-37% cheaper due to that. And then you need to add a catastrophic plan on top of that (think long cancer battle).

I look at it every year when our premiums come out, and I always decide it's not worth the risk.

My sisters family uses it and has for 6-7 years, but they have really crappy insurance options through work. They have a child with a few chronic health issues, and my BIL hurts himself frequently playing sports like he's still 17. They float $10k-$20k on a credit card frequently waiting for reimbursement. They always get reimbursed, but it takes a few months.

I'm a 20 year Army retiree and consider my Tricare for Life one of the absolutely best benefits they give me.

My wife and I are on Medishare. Awesome for us. We are on the $12K deductible and pay $328/month. It has been good. If you have a suitable emergency fund, it can work great. We just budget about $2-3K a year for doctor visits and come out way ahead.

However, I have heard reimbursement can take time as said above. I have also heard from others that counseling/mental health/autism issues are not handled by these type plans so check into that if it is an issue. As suggested above, they are not tax deductible.

Wes '87

Aggiewes said:

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My wife and I are on Medishare. Awesome for us. We are on the $12K deductible and pay $328/month. It has been good. If you have a suitable emergency fund, it can work great. We just budget about $2-3K a year for doctor visits and come out way ahead.

However, I have heard reimbursement can take time as said above. I have also heard from others that counseling/mental health/autism issues are not handled by these type plans so check into that if it is an issue. As suggested above, they are not tax deductible.

Wes '87

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I'm on it with family of 4 with the same deductible and pay $580/month. So, yeah, with a high deductible, everything that's not catastrophic is out of pocket. But I'm self-employed, so it's a great option given the alternatives. After 5 years on it, I had a heart attack and stint put in, and they covered $100,000 of that, so it's basically real "not real" insurance so to speak. And they didn't screw me on premiums the following year. I'm sure my previous individual BCBS would have tripled my premiums or just not renewed after that.

BTW, are all Medishare plans through Christian Care that require you to sign a statement of faith and not cover unwed pregnancies and such?

We had one several years ago...Liberty Healthshare, I think. It worked fine for us. But it was always a pita to use at doctor's offices and to get reimbursed. It also took forever to get reimbursed sometimes. Ultimately not worth it for us and I was also unsure how it would have worked in a real catastrophic type situation.

Mas89 said:

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900 a month for a family of 4 is very cheap if it's quality insurance imo. I know age and location vary, but I bet your employer is paying a lot of it also.

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I'll preface by saying I know we have really good benefits. But this still seems really high to me.

Family of 4 in my plan for the High Deductible Plan w/ HSA is $200/month (Get $1,250 put into our HSA by employer).

If you wanted a PPO plan it's $510/month.

Our benefits page shows my employer pays about $2,200/month for each of those plans. Guess I've always taken those numbers as a grain of salt.

If we went through my wife's insurance it's $350 for the HDHP or $600 for the PPO. We split up, she is an individual on her plan and I have the kid(s) on my plan, as it comes out cheaper and we aren't "missing out" on Employer HSA Contributions.

Guess I knew our benefits were good but maybe not how good....

You also need to take into account that your employer healthcare has built in discounts with the providers through negotiated rates.

Even though we are on a HD plan with an HSA, what we pay out of pocket is less than what you pay if you did not have insurance.

I am not sure that the healthshare plans have negotiated rates.

Those are good figures. Wsj says $22k-$24k is the average cost to cover an employee.

I work for a large company with benefits generally considered "good". Health care is just extremely expensive. My W2 last year said $25k or so was the cost of mine. I pay ~$1100/m for 5 on a HD plan with no employer contribution to my HSA.

We've had Christian Healthcare Ministries for 5-6 years. $471/month. Family of 4. That's for their "Silver" level.
Essentially have a $7,500 deductible. Actually, $2,500 "per unit," and a family of 4 is 3 units.

We don't have any chronic conditions so we're basically covered if something substantial happens, up to $1MM, I think. We do have free teledoc visits, which we used for the first time this week. The "Gold" plan includes urgent care visits I believe.

We've only submitted one claim since we've had it. I think the reimbursement was around $5,000 for a bunch of visits and tests I had for some chest pain issues. EKG, cardiologist, lab test, endoscopy. It was probably a month or so before we were reimbursed. The key is to keep good records.

so your employer is paying half the benefit costs or is the $25K in addition to what you cover?

I believe the W2 figure is the total cost, employer + employee. In my example, that figure lines up to what WSJ says is average.

That's what I figured.

So they have the employee paying half the total costs? That seems high.

It's tiered by income/level. Some pay nearly nothing, some pay 50% more than me.

Your numbers and conclusion are correct imo. Self employed with PPO Hdhp bcbs and it goes up every year. Currently is 2,400 a month for 2 in our 50s and one 18 year old.
Quality health insurance has gotten stupid expensive and continues to increase yearly.

Ridiculous. One of the reasons I ended up getting a corporate gig.

Basically takes a low level FT job just to cover benefit loads.

We offer 3 options for our employees. Most of them seem to take the mid tier HMO option, which is probably suitable for most people - it has $0 co pays for generic drugs and $35 co pays for doctor visits. We use the highest deductible PPO for ourselves and will never hit the deductible unless something catastrophic happens or we have several ER trips, but MD Anderson is in network if someone gets cancer and there is also an out of network out of pocket maximum even if we need coverage from an out of network facility or provider. The super high deductible PPO still costs about double what the lower deductible with co-pays HMO plan costs.

Not that it really matters because the deductible is so high, but we would have to change most of our regular docs if we wanted to be in network with the HMO, and the only two in network hospitals for the HMO near us are HCA and St Luke's.

I think it is really unfortunate that there isn't a single PPO plan available on the individual market, and it seems the individual market HMO networks are even more limited than the small group HMO networks.

COBRA was a way better deal than individual or small group plans, but my eligibility for that ran out a while ago.

If we get a handful more people on payroll, I'm told a "level funded" plan might be a good idea based on our relatively young employees and claims experience. Will probably look into that for 2025.

LostInLA07 said:

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We offer 3 options for our employees. Most of them seem to take the mid tier HMO option, which is probably suitable for most people - it has $0 co pays for generic drugs and $35 co pays for doctor visits. We use the highest deductible PPO for ourselves and will never hit the deductible unless something catastrophic happens or we have several ER trips, but MD Anderson is in network if someone gets cancer and there is also an out of network out of pocket maximum even if we need coverage from an out of network facility or provider. The super high deductible PPO still costs about double what the lower deductible with co-pays HMO plan costs.

Not that it really matters because the deductible is so high, but we would have to change most of our regular docs if we wanted to be in network with the HMO, and the only two in network hospitals for the HMO near us are HCA and St Luke's.

I think it is really unfortunate that there isn't a single PPO plan available on the individual market, and it seems the individual market HMO networks are even more limited than the small group HMO networks.

COBRA was a way better deal than individual or small group plans, but my eligibility for that ran out a while ago.

If we get a handful more people on payroll, I'm told a "level funded" plan might be a good idea based on our relatively young employees and claims experience. Will probably look into that for 2025.

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I feel like it still makes sense to be in-network with HDHP as you'll get the benefit of negotiated rates for your doctor visits.

I'm sure it's possible to negotiate a "cash" amount that is similar to what the insurance company pays, but that's just a PITA (and somewhat fraudulent if you plan on turning into your insurance to count towards deductible).

Yes we are in network because we use the PPO option, so we get the negotiated rates. If we went with the HMO, it would be out of network so no coverage at all - we'd pay the cash rate and wouldn't be able to file for reimbursement.

Their published cash rate is about the same as the negotiated rate.

If anyone needs quotes this open enrollment I'm here to help. Selkins.insuranceagent@gmail.com