Hey all,
I've been lurking on this forum for quite a while and finally decided to post to share a health insurance alternative my DH and I just found (actually our new accountant told us about it). We are in our 40's and will be fulltiming while working. We just can't afford traditional health insurance. so we joined a health care cooperative. I'm not going to list the exact one because I don't want you to think I'm some random salesperson or something crashing your site with my first post. If you google "health care coop" or "Christian health insurance" several of these large national coops will pop up and you can gather info from there.
Basically it works like this and I'll use a scenario. We pay a certain set amount each month. About $170 for the two of us total. Three months from now I fall and break ankle (Oh no!). The total for the ER, xrays, cast etc is $9000. I tell the hospital, "I am a member of a national healthcare coop (show them the card), they will help with my medical bills, can you call them please". The hospital calls the coop, the coop negotiates the bill, the hospital charges me or puts me on a payment plan and I submit the bill to the coop. If I don't want to negotiate the bill I can just pay it and submit it. My deductible is $1000 per person. Any money that can be negotiated off of the original bill is applied toward my deductible. So if $500 can be negotiated off of my bill, then I only have to pay $500.
The downside, you usually have to pay upfront or work out a payment plan then get reimbursed. This is a high deductible kinda set up, so there are per illness caps. They don't cover pre-existing conditions, and you can't be a smoker. They are also all religious based and you have to attest to the fact that you are a practicing Christian. These are not HSA eligible since they are technically not health insurance, but a health cost sharing plan. No coverage for PCP visits. Do not cover mental health, drug abuse services, and a few other things.
The upside, cheaper than even my old pre ACA HDHP. Most have been around for more than 30+ years and have great reputations. They are exempted from the ACA rule, so if you participate in one of these coops you are exempted from buying regular health insurance. They don't dispute or deny claims. There is no preauthorization, go anywhere with these coops.
Also in my research I found out that there are 22 states that have health insurance cooperatives. They are nonprofit insurance companies that provide more traditional health insurance. If you google your state , for example, "Wisconsin health insurance cooperative" it will come up. These rates are significantly less than say ehealthinsurance. You may not have heard of them because apparently the federal government has banned them from doing any kind of advertising ( I thought this couldn't be true but apparently they receive limited federal funding and that's part of the clause in the funding.)
Sorry this was so long, let me know if you have any questions but if you google the above topics you will find plenty of info to digest. I'm just sooo stoked to not be paying nearly $1000/month for a HDHP I had to share!
. The one we joined actually does do this randomly with its members when you submit a claim. It's apparently a quick "Hey are they really church members" kinda thing. We have no worries there.
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