Health insurance for USians who don't have employer plans... How are you dealing?

I almost titled this post  "American Health Insurance Horror Story"...

I'd really like to devote my energy to work within any intentional community I'd live in. I might be able to make that work except for one big BUT: no group health insurance.

Going uninsured, for me, is not an option: my medical costs are generally low, but that could change on a dime.

How are folks who don't have employer sponsored health insurance managing? Information about monthly cost, if you are comfortable sharing that, would be really helpful (and whether you're insuring one or more people). Also, which state you're in: I'm in Massachusetts, for example, and health insurance is really expensive here compared to other states.

I use a plan that is colloquially known as Obamacare.  If your income is above the poverty line and below 4x the poverty line there are subsidies to make it more affordable.  Prices vary by county/state and they vary significantly by income so you have to check it out to see what you'd pay.  I have to go through healthcare.gov (as do many other people) but I think for Mass you can check it out at mahealthconnector.org.

Health insurance is not the same thing as health care. I know many people who do not buy heath insurance, and who will not go to a licensed doctor. They maintain their health via alternate lifestyles.

Health care is different for each person (and US Health Care is different from that in every other country!... :-/ ) and I try to avoid the current US health care system as much as possible.  When I retired, I had the option of keeping the plan that I had under the employer, but I would have had to pay the full premiums which were prohibitively expensive.  But until I actually reach the age where I can collect my pension and social security, I'm doing some part-time contract work, engineered to produce the same amount of income that I will be getting when the pension/social security kicks in.  The idea is to guage, over the next few years, just how 'liveable' that income will be.  The irony is that this engineered salary puts me at poverty level where I qualify for (essentially) Medicaid. Admittedly we live in a high-tax state, I was still a bit shocked to discovery that I did not need to pay premiums....and no doubt the plan will be a reduced one on account of that....but still could use my same doctor (if desired) and still got a reduction on the few prescription medications that I take.  I thought to myself "Finally!!!.. A single-payer system!... :-)   If I end up making more salary, which is indeed an option, then I get bumped up into the more 'standard' Affordable Care Act paradigm---and pay the "annually-arbitrary" premiums to match the 'plan de jour'.  Which has me thinking I'm going to keep my eye on things like tax brackets and income level as it applies to these various programs and see how things pencil out.  So again, each person is different, but depending on the state in which you live, there may be some options to check out depending on income class.

It's the reason I still do software consulting.

I was on an Obamacare plan until this year, paying about $500/mo for a terrible plan. Now I'm on my partner's health insurance and pay about $550 in incurred taxes for a good plan.

The situation is not great.

My husband and I opted for a health share ministry instead of the Affordable Health Care act insurance.  That's a non-profit that all members pay into, and then the proceeds are used to pay people's covered "needs".  We're self employed, so this was a motivation to find an alternative in the first place.  But I also like that health share ministries don't invest the money in things that I might not agree with, like regular insurance companies do.

At the time, I was working with an insurance agent to find coverage for us in Oregon.  What we could afford was ridiculous - we would have had a multi-thousand dollar deductible, no coverage in other countries or states...it was a complete waste.  I discovered the health care ministry concept online, and found the one that made the most sense and showed the plan to my insurance agent.  He was astonished, and had never heard of it.  He looked everything over, and said that "If that's for real, then it's a way better plan for you."    Quite honest of him.  I've sent him many clients since then!  

We went with the health share ministry, and yes, they are very real.  They are one of only a couple exceptions allowed to the mandatory insurance requirement, being Amish or Mennonite are others, and weren't an option.  :-)

We chose the oldest one, Christian Healthcare Ministries, because it had the best program for pre-existing conditions, as well as price plans we felt were reasonable, and they don't require one profess an evangelical Christian faith statement.  (Some of the health sharing ministries require one to sign a statement that says things like "The Bible is the literal word of God"... which I cannot do.  I have a different understanding of the term "literal" than would allow that sort of statement. So those weren't an option for us, but the one we chose did work for us.)

We are on their top tier program which is $150 per month per person. That plan pays 100% of covered expenses. Covered expenses are slightly different with each plan, but they are usually easier to decipher than with insurance companies.  Much simpler in my experience.  We also get the "Brother's Keeper" plan which is a yearly cost, and ups your coverage limits significantly.

Last year, we used it for the first time.  My husband cut his hand badly enough to need stitches and we went to the only nearby option, a local hospital.  To our shock, the bill for a few stitches was $1300!  Sheesh.  The whole bill was covered by our health share, it was so simple and amazing.  The way it works is you submit your bills online with a very minor amount of paperwork (a page explaining the need for care, what happened, etc), and then they send you a check directly.  Then you pay the doctor.  

It worked beautifully, much easier than insurance.  This was a relief, since we'd had it a couple years already, and never had to use it and thus didn't know what to expect.

There are several health share nonprofits to chose from.  Christian Healthcare Ministries is the oldest, and one of the largest, but there are several others of different sizes.  Liberty Health Share is the only one (last I checked) that covers naturopathic care.  It's more expensive, though.  

So my husband and I opted to cover any "alternative" health care we might choose out of pocket, and instead go with a cheaper plan that covers all major things, like emergencies, surgeries, etc.  

For people with lots of kids, some of these health shares have a point where they don't charge you for more kids, so that's a huge advantage.  Some health shares have certain lifestyle requirements, too like no smoking or abusing alcohol.

Here are some of the ones out there:

Christian Healthcare Ministries  The oldest one, a big one, had the best acceptance of pre-existing conditions when we originally looked, allows home church.

Liberty Health Share The only one that covered naturopathic care, last I checked.

Medi-Share Another big one, but with a very concise Christianity agreement required.

Samaritan Ministries A smaller one, but worth looking at.

Kim Goodwin wrote:
At the time, I was working with an insurance agent to find coverage for us in Oregon.  What we could afford was ridiculous - we would have had a multi-thousand dollar deductible, no coverage in other countries or states...it was a complete waste.  I discovered the health care ministry concept online, and found the one that made the most sense and showed the plan to my insurance agent.  He was astonished, and had never heard of it.  He looked everything over, and said that "If that's for real, then it's a way better plan for you."    Quite honest of him.  I've sent him many clients since then!  

Wow, wow, wow. I'd never heard of these ministries either. Thank you for sharing that, Kim. I would give you an apple if I weren't so new here!

I'm not Christian, but geez, you could probably set a ministry up for any faith or creed.

Amy Brown wrote:

Kim Goodwin wrote:
At the time, I was working with an insurance agent to find coverage for us in Oregon.  What we could afford was ridiculous - we would have had a multi-thousand dollar deductible, no coverage in other countries or states...it was a complete waste.  I discovered the health care ministry concept online, and found the one that made the most sense and showed the plan to my insurance agent.  He was astonished, and had never heard of it.  He looked everything over, and said that "If that's for real, then it's a way better plan for you."    Quite honest of him.  I've sent him many clients since then!  

Wow, wow, wow. I'd never heard of these ministries either. Thank you for sharing that, Kim. I would give you an apple if I weren't so new here!

I'm not Christian, but geez, you could probably set a ministry up for any faith or creed.

Echoing this statement here. Thank you so much Kim, I'd never heard of them either.

At this point in time I'm on medicaid, but I'm in the process of expanding my operations and improving the profitability of my farm. I've actually been a little concerned about the day my need to reinvest into the farm dwindled enough that my profit took me out of that range and forced me into buying a health plan.

These suit my interests far more than standard health insurance.

So Amy, yes, people could set them for for any creed... but new ones won't be able to exempt from the tax penalty.  Some work around that by basically "sharing" the cost of the tax penalty.   This restriction our government and insurance companies way of discouraging new ones from forming, since they are the only real competition for insurance.  Here's a Wikipedia article about Health Share non-profits, and a quote:

Wikipedia Health Care Sharing Ministries

...[to be exempt form the tax penalty] ministries must meet the following qualifications:

   Must be a 501(c)(3) organization
   Members must share common ethical or religious beliefs
   Must not discriminate membership based on state of residence or employment
   Members cannot lose membership due to development of a medical condition
   Must have existed and been in practice continually since December 31, 1999 (a grandfather clause)
   Must be subject to an annual audit by an independent CPA which must be publicly available upon request[18]

Four ministries that meet these qualifications are: Christian Healthcare Ministries, Liberty HealthShare, Medi-Share, and Samaritan Ministries.[citation needed] MCS Medical Cost Sharing, founded after 1999, does not meet the qualifications, but offers to pay the tax penalties incurred by members.[19] Altrua HealthShare has also been recognized as an qualifying health care sharing ministry, due to its merger with Blessed Assurance Bulletin.[20][21] Anabaptist Healthshare, founded in 2015,[22] claims to be recognized as a health care sharing ministry by the U.S. Department of Health & Human Services.[23]

It takes so much organization and a big core starter group of members that churches have been the only ones successful at it, as far as I know.  But any group could do this, with the right organizational skills and member foundation.

Thinking I would share them, I found some articles online about health sharing ministries - but there was too much misinformation mixed with correct information.  One article implied that all members of health share ministries can't use contraception, have to make an "Evangelical statement", can't drink alcohol!  Not true.  That's a total generalization, and I didn't even find any that had a contraception restriction when I was investigating them.  That wouldn't be to anyone's benefit.  :-)  

The different organizations all have different ethical guidelines and are upfront about them.  So if you are interested, please don't be discouraged by articles, rather look into the individual health shares directly.  Also, you can call all of these places and ask questions to a real human being.  It's so pleasant!

Kyrt, glad you found this useful, too!  We've been much happier with this program,  and I don't see us switching to insurance for any reason in the future.  A few of my self employed friends also signed up for the same one as us, and they got just the bare bones coverage, just emergency coverage for peace of mind and to not have to pay the mandate penalty. Lots of ways to go about it.