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Learn About Health Insurance Options

I got my new insurance premium and Ouch!!  It has officially surpassed my mortgage payment.

This is what made me seriously look into my health care options.
In hopes that nobody has to live in a tent to be able to pay for health insurance, I'm sharing what I learned.

Health Insurance Options

Remember, it's still the law to have health insurance!

  • Option one- Medicaid, Medicare or other state / government insurance policies. These usually go hand in hand with SSI, SSDI, and SS programs.
    Examples of people who might qualify for these programs include: Persons with disabilities; seniors; expecting women; children in low income families and their parents.
  • Option two- Marketplace insurance plan.
    If you are self employed, you might think this is your only viable option.  (Not true, see option four!!)
    They are saying that 80 percent of enrollees will be able to purchase a plan for $75 or less per month. If you qualify for a tax credit, this could be an affordable option.  How much will you pay?  Check the Marketplace cost estimator.  It wasn't easy at all to find the cost estimator.  Here it is, to save you lots of time  -​
    Also, if your deductable is high, look into getting a Health Savings Account (HSA).  I wish I had know about this sooner.
    HSA contributions are pre-tax/tax-deductible. The money grows tax-free, and the money can come out tax free if used on eligible medical expenses.  The catch- You have to have a high deductable on your insurance to qualify. Since I've been paying 95 percent of my healthcare expenses out of pocket, this is something that really makes sense.
  • Option three- Group Health Insurance through your employer.
    With most job-based health insurance plans, your employer pays part of your monthly premium. If you enroll in a Marketplace plan instead, the employer won’t contribute to your premiums. Keep this in mind if you compare your job-based insurance to Marketplace plans. If you have an offer of job-based coverage and enroll in a Marketplace plan instead, you probably won’t qualify for a premium tax credit and other savings — even if your income would qualify you otherwise. You’d have to pay full price for a Marketplace plan — even if you don’t enroll in the insurance your employer offers. The only way you’ll qualify for savings on a Marketplace plan is if your employer’s insurance offer doesn’t meet minimum standards for affordability and coverage. Most job-based plans meet these standards.
  • Option four - Healthcare sharing ministry
    If you are self paying for insurance and don't qualify for tax credits, this could be the cheapest option. For my family, I could be covered for $241 per month. Compare this to
    my only other real option, a marketplace insurance policy, which for my family would be $697 per month with an extremly high deductable. HOWEVER, Healthcare sharing ministries are not technically insurance.
    Basically it is a group of like-minded individuals that agree to come together and help each other pay their medical expenses. Medi-Share is a Healthcare sharing program by Christian Care Ministry.
    Basically members of the group pay a "Share" which goes directly towards paying somebody's medical bill. Members of health care sharing ministries are exempt from the individual responsibility requirements of the Patient Protection and Affordable Care Act. There are three Healthcare Sharing Ministries that qualify - Christian Care Ministry, Samaritan, and Liberty.Although it's not technically insurance, it's protects you from the penalty.
    Most ministries are oriented toward practicing Christians, with restrictions like abstaining from extramarital sex, excessive drinking, and use of tobacco or illegal drugs.
  • Option five- Pay penalty / individual shared responsibility payment. This option leaves you with zero healthcare coverage and is very risky.  Being without insurance is a fast track bankrupsy gamble. For tax year 2017, the penalty for not having insurance is 2.5% of your total household adjusted gross income, or $695 per adult and $347.50 per child, up to a maximum of $2,085. For tax year 2018 and beyond, the penalty amounts have not been announced, but are expected to increase.
  • Option six- health coverage exemption -
    Again, very risky. You are rolling the dice by not having any health insurance.
    However, if you qualify at least you won't have to pay the individual shared responsibility payment.

No matter what you decide, this should not be a decision you make lightly.  I'm not an expert on insurance, so please do some research yourself.  I hope this can at least be a starting point for you to compare your options.  



Review on MediShare By One of Our Readers-

HI Aaron,

Thanks for your great description of options for personal health insurance.

As far as I know everything you said is correct, but I have some important additional information on Medi-Share since my wife and I enrolled in it this year instead of the using the marketplace policies. Due to our income being too high for a subsidy, but not high enough to afford a marketplace policy, we were priced out of the marketplace policies with their high deductibles and astronomical premiums (we’re in our 60’s). So we enrolled in Medi-Share.

Everything you said about Medi-Share is correct, but folks should be aware that it does not cover pre-existing conditions! While this wasn’t a problem for us, it would be a problem for those who have expensive to treat conditions that need ongoing treatment. Also, Medi-Share does not include prescription drug coverage. They give you a discount card, but it’s not very helpful. We have found Good RX to be much more helpful in getting big discounts for generic drugs that are no longer covered by a patent. But for proprietary drugs even Good Rx won’t get you much of a discount, if any. Sometimes the manufacturer offers a discount coupon on their website for these drugs. Consider, however, that if you’re saving hundreds per month in insurance premiums you can afford to buy more medications without a discount.

So if you don’t have an expensive pre-existing condition and you don’t need expensive medications then Medi-Share will save you a huge amount over the marketplace policies. Our premiums were cut by more than 50%, from $1800 per month down to $800.

Medi-Share has a $1250 per person or $2500 per household deductible (whichever is less), so you’ll be paying out of pocket until you reach that limit. They also have a very extensive network of doctors and hospitals. So you generally get a good in-network discount when you see a doctor. Our medical costs were very high this year, over $100,000 in medical bills when my wife was hospitalized twice, and Medi-Share paid everything above the $2500 household deductible. You do have to sign a statement that you are a Christian and that you live by Christian values (no adultery, illegal drugs, etc.). They won’t cover medical costs resulting from immoral behaviors, like extra-marital sex or drug abuse. So keep that in mind. But if you fit their profile it’s an incredible value as an alternative to the government regulated marketplace policies.

Thanks again for your valuable information!

Larry Smith