Health care sharing networks?

[SteveinMN]

One other point that probably bears making: if you switch plans in mid-year/before open enrollment, you may find that deductibles reset themselves. So if you were maybe $2-3,000 into a deductible with your old plan and you switch to another one, that $2-3,000 may not (likely won't) count toward your new plan.

My wife and I chose to go with COBRA when she retired in May because there would be no issue that we could keep our existing practitioners/insurance and either finish courses of treatment or at least have some time to find a new doctor or whatever. We know what our medical expenses/pay-ins have looked like over the past few years; for us, resetting deductibles pays us a month or two of COBRA and makes some lower-cost alternatives a wash financially.

[ApatheticNoMore]

you would lose me at unregulated, but maybe if I had no other options, or as a supplement to a high deductible cheapest ACA or equivalent plan.

[Tammy]

Do these plans qualify as having health insurance coverage under the law?

[iris lilies]

SteveinMN, many thanks for the Bogleheads links. Very helpful.

Iris Lilies, thanks for mentioning direct care physicians. That's another thing I'm looking into. And to clarify -- sorry if my OP was not clear -- it's not that I can't afford an ACA plan or COBRA. It's that I don't like the prices and so am seeking other options that might be a better value for me. I have read enough now about health care shares to see that they might be a good match for me. Not for everyone, of course.

Yppej, as far as I know, the sharing networks, which are nonprofits, are not rated for financial stability. I wish they were. Nor are they regulated. They are on their honor. This is why I am skeptical and why I started this thread, to ask who might have any personal experience with them.

I actually read a few MMM threads (not just skimmed), and the consensus is that most folks who are on these plans are quite happy with them. One person reported a long delay in getting reimbursed, but eventually the payment came through.

I'll have until September to accept or decline COBRA. If I don't do a health share, I'll likely get a Bronze ACA plan for the rest of this year. Then in January, if I have not found a new job with coverage, I will be eligible for an ACA subsidy, making it much cheaper. Since my layoff has come midyear, I have already earned too much to get any ACA breaks.

A major piece of your puzzle is how much in healthcare services you consume each year. Are you insuring for known costs or are you insuring against catastrophic things you can’t predict, possibly catastrophic? That’s a rhetorical question you don’t have to answer, it’s just what strikes me when I read your post.

[Oddball]

you would lose me at unregulated, but maybe if I had no other options, or as a supplement to a high deductible cheapest ACA or equivalent plan.

Unregulated bothers me too, but so does the fact that even an ACA plan can deny coverage per service with little recourse.

The work coverage I'm about to lose has a tiny $250 deductible and covers a lot of stuff. I've been paying peanuts for it -- $120 a month, and that includes dental and vision. To keep this plan for 18 more months through COBRA will cost nearly $800 a month -- more than a 550% jump. The cheapest ACA Bronze plan for me is over $500 a month with a $7,000 deductible. This is why I am shopping around.

[Oddball]

A major piece of your puzzle is how much in healthcare services you consume each year. Are you insuring for known costs or are you insuring against catastrophic things you can’t predict, possibly catastrophic? That’s a rhetorical question you don’t have to answer, it’s just what strikes me when I read your post.

So far I have been very low use, so I am looking to insure against catastrophic things I can't predict. I live a super clean lifestyle and have no issues with the health share networks' requirements since I live that way anyway.

[Oddball]

Do these plans qualify as having health insurance coverage under the law?

Some do, some don't. The religious ones do as long as they formed before 1998. The newer ones that are not religious do not qualify. For now, the ACA mandate is repealed (since the 2017 tax law), but of course it could return. At that point, I would have to look at ACA plans for sure, or pay the fine.

[Tradd]

I was permanently laid off in late March. Cobra was about $600/month. I called a friend who has always been self employed and asked what she did for insurance. Got the number of her independent agent. Ended up with a short term plan that can go for no more than 6 months. $5K deductible. Not regulated by ACA. Pretty similar to one of the old catastrophic plans before the ACA. I’m saving about $200/month.

I would look into this option until the end of the year.

[Oddball]

So I went for a bike ride this afternoon and got to thinking about Steve's post above re deductible resets.

If I switch to a high-deductible ACA plan for the last few months of the year and something big happens -- like if I get hit by a car while biking -- I'm out at least the $7,000 deductible.

If I bite the bullet and go with COBRA for six months, I could drop the vision portion, get the health portion only, trimming the total to $700 a month, and that would be $4,200.

If I subtract the $120 a month that I would have spent anyway, had I not been laid off, the difference is $3,480.

So for $3,480 in unexpected premiums, I could keep most of my coverage (all but the vision portion, which I exhausted in January) while insuring against a possible $7,000+ loss, not to mention the hassle of changing doctors, since the ACA plan would not include my current docs in its network.

Then in January, maybe sooner, I'd either have a new job with new coverage, or a very affordable ACA plan, since I'd have little income still and therefore qualify for a large subsidy. Or if I have zero to very low income, I would qualify for my state's relatively good expanded Medicaid.

Just thinking out loud here, but maybe COBRA isn't the wild rip-off I was grumbling about after all?

Tradd, sorry about your layoff. Hang in there.

[SteveinMN]

Just thinking out loud here, but maybe COBRA isn't the wild rip-off I was grumbling about after all?

That was kind of our conclusion -- and our COBRA is significantly more expensive than yours. It helps that DW's unused PTO was thrown into a reimbursement account we can use for insurance premiums, so it's sorta-free money. We'll go for an ACA plan (or whatever's out there; the healthcare situation in the U.S. is nuts) when we can do so without resetting deductibles and costing us some money that way. It's insurance. It's always a gamble.