MediShare Christian Care: How It Works + Our Mind-blowing Story!

We’ve been with MediShare Christian Care since November 2017, so we’ve now experienced enough (like wellness checkups for kiddos, high-risk pregnancy care, ambulance transportation, hospital stays for a new baby, a home birth, and more) to share what it’s like to have this particular alternative to health insurance. Below are some key pieces of information that may not be obvious to someone new to or that might be helpful to someone learning about MediShare.

MediShare Christian Care Is Not Health Insurance, But It Functions Similarly

It all works very similar to normal health insurance, but MediShare Christian Care is super clear in all communication that they are NOT health insurance, but rather a medical expense sharing ministry. 

I often share that it’s very similar to tithing, where a church receives monetary gifts to be used towards church expenses and for helping the church family. Instead of monthly premiums going to insurance companies, the $368 we pay every month goes into a big account that pays for other members’ medical expenses. Then the ministry aspect is that it tracks my monthly premium to another person's medical bill, let's each of us know who is paying for whoever's medical expense, and then opens up a prayer stream. The ministry is like a church where monthly tithing goes towards medical expenses of anyone in the church, and part of that is prayer.

Verbiage Matters

Here’s how the language differs from typical health insurance and relates to a church ministry:

• MediShare members make a monthly contribution which is similar to a health insurance monthly premium. Monthly contributions go into a bank, where funds are then used to pay other members’ medical expenses that are eligible for sharing.

• Each family has an “Annual Household Portion” which you can think of as your Deductible. The higher the Annual Household Portion, the lower the Monthly Contribution, and visa versa–just like typical health insurance

What’s Covered / Not Covered?

A key difference is that not all medical expenses are covered, or rather “eligible for sharing,” like normal health insurance. MediShare Christian Care is a health insurance alternative for Christians, and to qualify, you have to sign an affirmation of faith and agree to a godly lifestyle.

That's where this insurance alternative really differs from normal insurance, as MediShare will not cover medical expenses caused by ungodly/unbiblical lifestyle/decisions. So a baby out of wedlock, illness caused by recreational drug use, accident from you drunk driving... none of that would be eligible for sharing.

Medical expenses caused by pre-existing conditions are not covered unless symptoms have not shown for 36 months. Pregnancy is considering a preexisting condition! Keep reading for more on family planning and pregnancy. 

Also, anything considered preventative care is not eligible for sharing, meaning you pay for it all. That includes pap smears, vaccines of any type (like flu shot) for you or your children. This includes any prenatal testing for disease or genetic disorders (which we decline anyway) or common shots they give to newborns. It’s also includes things like preventative mole removal… they’ll remove it and send it for testing. If it’s cancerous, then it’s considered medically necessary and covered. If it’s not cancerous, you pay out of pocket. Ha! 

Decline anything preventative and let your doctors, nurses, and front desk people know why. Be direct in telling them that you do not have health insurance (which is accurate) and it’ll all be out of pocket for you if you receive any preventative care. I accidentally allowed my provider to give me a flu shot last year and got stuck with a $300 bill for it. Such a bummer. I now know to decline anything that could be considered preventative and go to a county clinic to get them for free for our whole family. 

Family Planning & Pregnancies

There’s a $120k cap on coverage per pregnancy. Normal pregnancies total to about $13k. My second pregnancy was considered high risk since my first baby arrived 6 weeks early–and my high-risk pre- and post-natal care amounted to just under $80k. We likely would have gone over if our little guy needed the NICU (he was actually born in our car! More on that later). Fortunately all pre- and post-delivery care was covered since we conceived after our start date (Keep reading for more about pregnancy eligibility and our crazy story about timing). So, if you decide to sign up for Medishare, don’t get pregnant until after your official start date… you know, since we have so much control of that! ;) 

Comparing MediShare to Kaiser Healthy Insurance

Before signing up with MediShare, we were looking at continuing our Kaiser Health Insurance at nearly $1,000/month for the 3 of us (at the time), with a $7,500 yearly deductible. We needed to make a decision by the end of September for a November 1st start date, but we were hoping to become pregnant with our second baby soon. 

We became pregnant with our first child the first month of “trying,” but at this point 2 cycles had passed without a positive test. My expectations of conceiving quickly were starting to fade and I was getting a little stressed with the pending insurance decision, but clearly God had a greater plan for us. 

If we were pregnant by the time we needed to make a decision, we’d go with Kaiser so that all medical expenses related to my pregnancy would be covered, whereas they wouldn’t be a “eligible for sharing” with MediShare (remember, pregnancy is considered a pre-existing condition). If we weren’t pregnant by that time, which is what ended up happening, we’d go with MediShare and hope we’d become pregnant soon after our start date. 

GET THIS… Our effective date was November 1, 2017. We applied for Christian Care MediShare in early/mid October, with an expected start date of November 1st (it takes about 20 days to process everything). A few weeks later, we got a positive pregnancy test! We were thrilled, but I was also a little freaked out about the timing of it all and whether the pregnancy-related medical expenses would be “eligible for sharing” or not. 

According to MediShare’s review of my earliest ultrasound measurements to determine eligibility, we conceived Banyon (baby #2) between Nov 2-Nov 5! Ahhhh!!!! So if it was just two days sooner, none of the medical expenses from my pregnancy or delivery (about $80k) would have been covered/“eligible for sharing.” God certainly knew what he was doing by not allowing us to become pregnant in those first two months of trying to conceive!

Instead of $1,000/month and $7,500 deductible Kaiser option, we paid $368/month with a $3,750 OOP max for all 4 of us. Also, additional children does not increase share amounts (aka premiums). Member share amounts are based on these status options: single adult, married adults, then 1 adult + any # of kids, then 2 adults + any number of kids (which is what we have).

Notice how in 2018 and 2020, when we welcomed baby #2 and #3, we met our Annual Household Portion (aka yearly deductible), but we had less than $500 in medical expenses in 2019. We expect 2019 to be the norm for us now that we’re done having children… praying we all stay healthy!

UPDATE: Like everything else in life, costs and pricing has gown up since we joined in 2017. Below are the current pricing options based on a 32 year old adult with 3+ members in their household, living in CA. We’re currently on the 4250 Program, which is our annual out of pocket/deductible. The monthly share amount/premium is $576, but with the Health Incentive discount, we pay $496/month. For a family of 5, that is still significantly more affordable than what we’d pay for a PPO with Kaiser or the like.

Health Incentive

Christian Care MediShare also offers a discount for being healthy. It’s called the “Health Incentive,” where a household may qualify for up to a 20% reduction of their monthly share amount if all adult members meet specified health criteria, including blood pressure, BMI and weight/waist measurement. Adult children age 18-22 are not required to qualify for the household to receive their incentive.

The health incentive does not automatically renew every year. Within 90 days prior to your effective date, you (and your spouse if applicable) may submit new results. We’ve learned to set a calendar reminder, as last year we forgot and lost our 20% discount for two months.

Finding a Provider

When it comes to finding a doctor, MediShare is considered a PPO, so you can go anywhere, but “in-network” is still the best value. The tricky part is most medical offices have no idea what MediShare is or how to go about processing. The solution is to not refer to it as “Christian Care MediShare,” but instead let them know you have a PHCS (Private Health Care System). Then they start to ‘get it.’ Thankfully all of our local hospitals and doctors are considered in network. 

Medical bills are submitted by the provider/doctor directly to ChristianCare MediShare, then MediShare negotiates pricing. If you’ve met your Annual Household Portion (aka Deductible), then MediShare will begin paying your medical expenses and it is your responsibility to may medical bills from your provider up until you meet your AHP–as well as medical expenses considered ineligible for sharing.

We’re Very Happy With MediShare!

Overall we’re incredibly happy with MediShare, especially being self employed. Employer group plans may still be a better option for lots of people (money-wise) if that’s an option. Also, MediShare is best for people who are generally healthy since pre-existing conditions wouldn’t be eligible for sharing. You’ll need to do your own research to determine exactly how any conditions you might have would be classified.

Oh, and they’re the sweetest people who pray with you every time you call… and I’m a ball of tears at the end of every prayer.

One last thing, they have a referral program once you sign up, so if sharing our experience with Christian Care MediShare helped you decide, you can click this link and we get a $100 gift card if you join. :) http://bit.ly/2tLIhCn