It’s hard to believe, but our family has been uninsured for almost three years now. In fact, three of our four children have never had health insurance — crazy, I know!
In 2017, I wrote a lot about health sharing basics and some cost breakdowns.
Today, I want to share an overview of our health sharing experience, as well as some other details about what we’re doing to keep our family healthy while keeping our budget in line. As parents of four and small business owners, both of these factors are very important to Joshua and me.
First, since it’s been a while, let’s review:
What is Health Sharing?
Health sharing — or in our case, Christian health sharing — is a health care alternative or supplement. It’s NOT health insurance. This means that as members of a health sharing group, we don’t have the benefit of guaranteed coverage for our health care expenses. However, we also get the benefit of not being locked into a corporate insurance plan.
As members of our health sharing group, we pay a monthly share. You can think of this as a “premium”, except that it never goes to the corporate office to be redistributed to hospitals and doctors’ offices. Instead, we send our share to fellow members directly to support them in their medical needs.
On the flip side, when our family has a medical need, which can be anything from an emergency room visit to a whole pregnancy and delivery, we submit our medical bills to the group. Then, our need is divvied up between members and they send us their monthly shares so that we can pay our bills.
Christians aren’t the only ones with health sharing groups. There are different groups throughout the nation, each with its own set of rules, fees, and standards.
For our Christian health sharing group (and for many others), the rules are pretty strict: we can’t engage in extramarital sex, do drugs, drink alcohol excessively, and so forth. If we end up with a medical need associated with one of these activities: such as causing a car accident and being charged with a DUI, we can’t submit any medical bills associated with the need, since we violated the covenant we signed when we joined.
For us, this isn’t a problem. We strive to maintain a high standard of moral living, whether we have a group keeping us accountable to it or not. But it’s nice to work with a pool of like minded individuals who are also abstaining from behaviors that often result in pricy medical needs. This keeps the costs low for everyone — and honestly, I like having the option to be part of a group that doesn’t support medical costs associated with things like abortions and drug use.
What are the Costs Associated with Using a Medical Sharing Group?
Christian health sharing can seem confusing or intimidating because it functions quite differently from traditional health insurance. Not only are the ways of sharing money a whole lot different, but the amounts that any one family might contribute can vary quite a bit, depending on their individual circumstances.
While there are a few different pricing models out there, I’m going to talk about the one that we use because, well, it’s the one I’m most familiar with. To my understanding, it’s the most common sharing model, but you may find that there are some differences from group to group.
Here’s what our family’s monthly breakdown looks like:
- Monthly share for family of 3 or more: $530 (This is what we send to other member families each month.)
- Save to Share option: $530/year (This is an optional expense that allows us to submit needs greater than the $250,000 max. sharable amount per need. How it works: we keep $530 in savings and are asked to contribute an amount above and beyond our initial monthly $530 share to various needs, which are rolled into our monthly bill. Over the course of a year, our additional Save to Share expenses will not exceed $530. Usually, it’s somewhere in the ballpark of an extra $20-$50 per month, but it’s POSSIBLE that we could be asked to contribute the entire $530 in one go: hence why we keep the entire amount in savings.)
Now, this is the amount that we pay monthly for our coverage. But, as we all know, there are other health care costs to bear when it comes to managing a family. We’ll look at this in a moment.
What Happens when You Submit a Need?
As mentioned above, each medical incident is called a “need”. I covered some hypothetical needs the last time I wrote this post because we hadn’t had our group membership long enough to have enough needs to work from. However, my analysis wasn’t terribly far off from the reality of submitting a need and paying medical bills.
Since we’ve become members of a Christian health sharing group, we’ve had a few large-ish medical needs including: two pregnancies, a minor surgery for a family member, and a couple of ER visits scattered amongst the children.
The process for navigating these needs is simple. When we are seen at a medical facility, we tell them that we’re self-pay patients and request for the bill to be sent after services are rendered. Usually this isn’t a problem.
If a provider wants an up-front payment, we request to pay a portion and for the rest to be billed. I’ve never been asked to spend more on the spot than what I can reasonably afford.
As the bills come in, we snap a picture of each one and upload it to our group’s site, under the appropriate need. We can add notes about the care, reason for visit, etc. We can also rate our providers, and that information gets added to the group database so that other members can know what they’re getting into when they browse providers through the group’s site.
Now, when we submit a need to our group, our family is responsible to cover a small portion before the amount is shared with other members. You might think of this as a deductible of sorts. With our group, that amount is $300 per need. This is a whole lot less than we would pay with traditional insurance co-pays and deductibles.
After accounting for the $300 amount from our pockets, the remainder of the combined amount of medical bills for the need go into review and are shared to members throughout the group. Then, we sit back and wait for the money to come. Next, we use those funds to pay our bills. It really is that simple.
Shopping for Healthcare
One of the biggest shifts for us from insured mentality to uninsured mentality is the idea of shopping around for our healthcare. Unless we’re dealing with an imminent health issue that requires an ER visit, we have the luxury of using whatever providers we want. And yes, this includes holistic healthcare professionals, chiropractors, and other alternative practitioners that traditional insurance companies rarely, if ever, deal with.
For our family, this opens a lot of doors. Our last two babies were born at non-hospital private birth centers that were WAY less expensive than using an OB-GYN/hospital birth route.
And a recent health need we had was quoted to us for around $20,000 at multiple area hospitals, but we found an independent provider with a lot of experience and positive reviews who would do it for ONE-TENTH of that cost. We ended up getting the entire procedure — including pre- and post-procedure visits — for $1,900 total.
It takes some careful research, some awkward phone calls (medical facilities are not used to people calling and asking the price of things), and yes, even a little prayer to land on creative solutions for our healthcare needs. In our case, finding the cheapest care isn’t the first priority, even if we are committed to generous stewardship for the benefit of others in our health sharing group. Ultimately, we want the best care — and if it happens to be cheaper than the run-of-the-mill hospital option, then so be it.
One last thing I want to touch on here is healthcare discounts. I went to great lengths to explain this in my past posts, so I’m not going to dwell on it here. However, I do want to mention that health care discounts are first applied to our family’s portion of any medical need.
Meaning: if we have a $7,000 birth center bill for a pregnancy and delivery, but receive a $500 discount for paying before week 28 of the pregnancy, $300 of that discount goes to covering the entirety our $300 responsibility and the remaining $200 is applied to the shared amount for other members to cover. Bottom line? The birth center birth costs us $0 when everything is said and done.
Pretty cool, huh?!
Direct Primary Care
Okay, now we’re going to set aside our talk of health care sharing, even though there’s a TON more I could say (and will in future posts), and move to another portion of our family’s health care plan: direct primary care.
Direct primary care is a sort of healthcare subscription: you pay your direct primary care group a set fee every month and in return you get unlimited office visits, prescriptions (if you need them), and some other benefits, depending on the specific office that you work with.
I’ve been aware of the direct primary care option since we initially went uninsured a few years ago. It’s a good alternative for families using a health sharing option, since health sharing groups don’t often cover primary care expenses like well-visits, immunizations, and preventative testing.
When we lived in Maryland, we didn’t have a direct primary care office anywhere within reasonable driving distance, especially for stuff like sick visits, when you just want to get in and out and back to your comfy bed. We had a primary care physician who we loved and who charged us fair prices, so it wasn’t really a big deal.
When we moved to Georgia, one of the first things that I did was research our direct primary care options and this type of care is definitely a bigger thing here than it was back home. We found a group near us, with Christian values (huge perk, but not a deal maker), and joined the week after we moved — you never know when someone is going to get sick!
So far, I like the security of having a direct care physician who I can text or call anytime. We can have as many office visits as we need without paying extra fees, which is appealing. I don’t have to feel like an idiot paying $100 out-of-pocket for a visit that’s “just a virus”. (Ugh! The bane of toddler moms’ collective existence, am I right?)
We pay a flat rate monthly, so we always know what we owe, regardless of how many well-visits or sick visits we might need. Before, we might spend $500 one month with multiple birthdays (hi, well checks) or cold/flu trips and $0 next month because we didn’t need anything. While we never felt like we were bleeding out for our basic healthcare expenses, it wasn’t ever easy to budget what we’d need ahead of time.
Now, we spend $240 a month, regardless of how many visits we schedule. Our direct care physician also has a dispensary for common pharmaceuticals and herbal remedies, so we can get most of the basic prescriptions we need in house and with a discount. We can also take someone in for a stitch up when roughhousing goes wrong or get a blood draw done in the office as part of a normal physical. For us and our fairly healthy family, this is a very good fit.
As you might have guessed, there are direct primary care groups that run the gamut. Some have a large team of physicians. Others have state-of-the-art facilities with imaging equipment and specialist visits. Obviously, depending on your location and family’s needs, you could spend quite a bit on direct primary care fees — but avoid urgent care or emergency room visits altogether. The amount that our family pays for direct primary care is on the lower end of the spectrum, but meets our needs for this point in time.
All That and a Bag of Chips
Alright, that was a pretty quick overview of our family’s approach to alternative healthcare! I receive a LOT of questions about being uninsured and how Christian health sharing work, so I wanted to jot down my thoughts, as well as provide some needed updates to my posts from a couple of years ago.
I would like to create some future posts featuring specific situations to help you get a better feel for how health sharing might (or might not) work for your family. Being uninsured is something I’m pretty passionate about and is something that’s actually a lot easier to navigate than it seems from the outside. If you have any questions, please feel free to ask!