Medi-Share Review: Legitimate Health Plan With Limited Coverage
If you’ve ever heard of Medi-Share, you might be intrigued by its promises to cover your health care costs.
Curious? We looked into the details to find out how Medi-Share works — and whether it’s a good option. Here’s our review of the program.
What Is Medi-Share?
Medi-Share is a health-care sharing ministry, administered by Christian Care Ministry and made up of members united by their faith.
This program and similar medical-sharing ministries rely on their members to take care of one another through financial contributions, as well as prayer.
The details work much like typical health insurance. Like having a deductible, members choose an amount they’ll contribute as a household (their Annual Household Portion, or AHP) before they can submit bills to the community for payment assistance.
A monthly share payment works like a premium, ensuring your eligibility for assistance, should you need it.
There’s no guarantee your medical expenses will be covered through Medi-Share, and there are plenty of exemptions to consider before you apply.
But if you can follow their rules and you are healthy — many preventative screenings are not covered nor are mental health services — you may want to consider this alternative to traditional health insurance.
How Much Does Medi-Share Cost?
First, the upfront costs: It costs $50 to apply, and you’ll pay a $120 one-time member fee with your first monthly payment. You’ll pay another one-time fee of $2 to set up your “sharing account.”
As for your monthly payment options, Medi-Share’s system is sort of like choosing a health insurance deductible and monthly premium.
As an example, we calculated costs for a 30-year-old woman in Florida seeking membership for herself only. Share amounts change annually, based on the oldest member of the household.
If she chooses a $12,000 Annual Household Portion — the amount of medical bills the member must pay out of pocket before being eligible for sharing — her standard monthly share would be $120. (For her first year, she is eligible for a 30% discount, resulting in an $84 monthly share amount. The current discount promotion is good through June 30, 2022; Medi-Share may offer additional discounts in the future.)
If she meets certain health and fitness requirements, she could qualify for a Healthy Monthly Share, which would lower her cost 5% to $80 per month at her discounted rate.
For most, a $12,000 deductible (Annual Household Portion) will be too high. The example woman from Florida also receives offers for a $9,000 AHP ($114 discounted monthly share, $162 without discount), $6,000 AHP ($139 discounted monthly share, $198 without discount) and $3,000 ($181 discounted monthly share, $259 without discount).
Note: If you apply as a family, you will have a single Annual Household Portion to meet, unlike some typical insurance plans, which have per-person deductibles.
How Does Medi-Share Work?
As a Medi-Share member, you will contribute a monthly share that operates like a premium. Other members who have met their AHP and need help with medical bills can use those shares from other members to cover expenses.
When you need medical care and visit a Medi-Share provider, you pay $35 for doctor visits and hospitalizations and $200 for emergency room visits.
Present your member ID card to your provider at time of treatment. Your provider then submits the rest of your bill to Christian Care Ministry “for discounting, to determine if they are eligible and whether they should be applied to your AHP.”
After your family has met your AHP, you can submit eligible medical bills for sharing.
Christian Care Ministry, which operates Medi-Share, is a 501(c)3, but your payments aren’t tax-deductible.
Note: Once you turn 65 and are eligible for Medicare, you can drop out of Medi-Share or switch to the Medi-Share 65+ program ($500 Annual Household Portion).
Do You Need to Be Religious to Use Medi-Share?
Just as Medi-Share embraces the idea of a community of members supporting one another, it also believes in having a membership that embraces their view of Christian lifestyles.
“Medi-Share members and their dollars do not pay for abortions, drug addictions, or any other unbiblical lifestyles,” according to the website FAQs.
Some health conditions, like heart disease, high cholesterol or diabetes, put applicants in the mandatory Health Partnership Program, which pairs you with a health coach and costs an extra $99 per month.
What Does Medi-Share Cover?
Eligible medical expenses (subject to Christian Care Ministry’s discretion) apply toward your AHP.
Plans include an annual physical. Telemedicine visits do not cost anything.
Prescription drugs can be eligible for cost-sharing, but only for up to six months for the lifetime of the member.
Maternity and even adoption expenses are eligible for cost-sharing. Testing and treatment for coronavirus are eligible for the program as well.
Behavioral and mental health care are ineligible for coverage. This includes psychiatric or psychological care, as well as “counseling or care for learning deficiencies or behavioral problems,” such as ADD or autism.
But here’s the big catch: Routine health screenings aren’t eligible for cost-sharing either.
For instance, if your doctor recommends getting a colonoscopy because you’ve reached a certain age, you can’t submit the test for Medi-Share payment. If you have symptoms warranting the same test, the program might grant payment.
Dental and vision care aren’t eligible either, but Medi-Share does advertise dental and vision discounts.
What if You Have an Ongoing Health Condition?
While Medi-Share might be an appealing option if you’re healthy, anyone who suffers from a chronic health issue is probably better off turning to an Affordable Care Act health insurance program for coverage.
“The primary purpose of Medi-Share is to help share members’ burdens,” the program explains. “Burdens are those unexpected medical bills you are unable to plan for (ie. broken bones, cancer, etc). Low monthly share amounts enable you to budget for your family’s routine care, which can be planned.”
So, Is Medi-Share Legit?
Here’s our conclusion: Medi-Share is legitimate, and there’s a strong membership base to support it and similar programs.
But it’s likely not the most affordable health care option for most people. The ideal candidate for Medi-Share is in excellent health and also has a robust savings account to pay out of pocket for routine medical care.
One risk: Medi-Share and other cost-sharing programs aren’t subject to regulation like typical ACA programs.
So while a typical health insurance benefits booklet might clearly explain what’s covered and guarantee coverage up to a certain amount or percentage, Medi-Share participants might not be able to figure out ahead of time which medical bills will be paid by the program.
While Medi-Share probably isn’t the best financial choice for most people, it does serve as an option for anyone who doesn’t have access to a job-sponsored health insurance plan or who finds individual ACA coverage options prohibitively expensive.
