Step 1: Insurance and Its Alternative: The Quick and (not so) Dirty

Step 1 of 10 in our series– “Do-It-Yourself Health Care: 10 Steps You Probably Don’t Know About

Most would rather endure a tax audit than read about insurance, so I promise to keep this short. The following are ideas for protecting you against the really expensive health surprises while avoiding the Individual Mandate tax penalty. No matter what the current administration does, that remains in effect at least through 2018. Therefore, DO NOT WAIT for Washington to resolve this by the end of open enrollment. Move now.

First, the Quick: And I mean that literally! If you are self-employed or employed without employer-based health insurance, get a high-deductible Bronze Plan on your state healthcare exchange or at by Friday 12/15/17, the end of open enrollment for the Affordable Care Act (aka “Obamacare”). If you have employer-based coverage, it most often pays to select the highest deductible option available especially if you also have a Direct Primary Care (DPC) doctor to help you navigate some of the crazy (more on that below and in subsequent posts in this series). Though it all feels impossible, you do have more power and flexibility than you realize.

Then the (not so) Dirty: In fact, some would say downright “righteous.” Consider joining a health-sharing ministry. Keep reading even if you are estranged from your religion of origin, or currently have none. Even the staunchest non-believer can agree with the concept that “treating the body in a Godly manner” would mean actively maintaining your health, avoiding activities that injure health, and sharing that promise with a community of people all agreeing to do the same.

Health sharing ministries are not “insurance” in the classic sense but belonging to one does meet the individual coverage mandate, meaning no tax penalty. Yes, they are all affiliated with some religious denomination, though whether or not you must belong to that denomination (or any denomination) to be a member varies with the plan. You must be able to sign onto the set of shared beliefs governing the plan you choose. Then, do not lie about your health. You could lose the protection when you need it most if you do. There are some conditions they will not accept (remember this is not insurance). However, you also don’t have to have perfect health to be accepted. You just have to be willing to change towards healthier goals.

Many of these plans also reward you for using Direct Primary Care (DPC) doctors. As a whole, they know that DPC keeps you actively engaged in your health. Evidence shows that this engagement both increases your health and lowers the cost of keeping you healthy. Because of this careful stewardship of finances shared by millions of other members, the savings are substantial. For example, a midlife couple looking at conventional insurance premiums rising to $2000/month this year, with an additional $10,000 deductible, is likely to find their combined monthly bill dropping under $500/month with a health-sharing ministry. They may be responsible for the first $1000 before the “plan” kicks in and covers up to a million dollars. This is called the “unshared” amount rather than a deductible and is the amount the couple would pay before the other members “share” the burden.

These programs do not cover medications. As you might expect, they do not cover abortions or many birth control options. They all have specific exclusions plainly stated upfront — so read them. They support and encourage people to have preventive care but it is subject to the same restrictions as any other medical expense. Understand that most doctors don’t know what your costs will be for anything they order because those prices are set through contracts with the insurance companies. However, that doesn’t mean the information isn’t out there if you know where to look and who to ask. In our area, the cost of a screening colonoscopy ranges from $675 to over $4000! However, I may be one of fewer than 10 MD’s in this region that knows that. Making that knowledge more available to you is what the rest of this 9 part series will cover, so don’t change the channel.

However, today, and I mean TODAY, get something in place to keep one catastrophic health event from throwing you into bankruptcy. Then stay tuned and discover how to unplug from a system that is serving fewer and fewer of us each day.

Next: Step 2: When NOT to use insurance: “These are not the prices you’re looking for.”

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