What is Medical Cost Sharing Health Insurance and is it a Good Alternative? Part I

Medical sharing insurance

A semi-truck and a double-decker bus have been colliding in my mind, over and over, the past few days. The semi truck represents the thrifty side of me. The double-decker bus represents the cautious side of me, specifically when it comes to matters of my family. Normally these two vehicles run side by side, because most of the time saving money means I am looking to secure a more stable future for my family. However, this time, when pondering my options for family health insurance, the vehicles are on a collision course.

My family situation

A baby girl is on the way (our first!) in June, and my wife (Alli) is ending her employment to stay home for the foreseeable future. Health insurance was a non-issue beforehand because both Alli and I were offered insurance with our jobs. It is definitely an issue now. Adding Allison and any children to my current employer-based, high deductible plan is 950 more dollars per month, out of pocket. I actually cringed when I typed that.

Alli and I sat down and crunched our future monthly budget numbers with this in mind. We squeezed the numbers into a monthly budget like my thighs into a pair of skinny jeans (try a pair on some time and you’ll understand the illustration…). We grudgingly set our numbers and are prepared for the crunch to happen next September when the insurance change will occur. We know that we can do it and we feel very secure if any medical cost comes up. This represents the cautious vehicle of the collision – the double-decker bus.

See what Charlie and his wife did to help them manage their money better.

An alternative? I’ll bite

Security is great, but…the $950 was stuck on me like that same pair of skinny jeans (good luck getting out of them). I began the process of looking at health insurance plans. One alternative that kept coming to my attention from friends and online sources was medical cost-sharing. It is not insurance, but medical cost-sharing is supposed to function in the same way. Most of these cost-sharing organizations are Christian-based, non-profit organizations that are gaining popularity now that premiums and deductibles seem to be increasing by leaps and bounds.

From what I have gathered, these organizations are able to keep plans affordable by minimizing overhead costs and being selective in who and what is covered. When I say affordable, one plan I am currently looking into would provide Alli and the little tyke access into a sharing plan for $250 per month, with an annual deductible of $2500.  

The term “sharing” is used because medical expenses are directly shared with others. To play out a scenario, I would pitch in my “share” each month (effectively a premium) and it would go directly to pay for someone else’s medical bill in Whoknowswhere, Alabama. When we would have a medical bill arise, we’d share this cost with the community plan and we would be the benefactors of others’ monthly share. Some cost sharing ministries like Samaritan Ministries actually have members write a personal check to another person! Others, like Medi-Share, have members sign up with a specific credit union so money can transfer from account to account and account to medical providers directly.

Beep…beep…mental scam alert meter…

After being scammed into thinking I won a car a few years ago, I am super suspicious of anything that seems like a good deal for me. And when the arena we’re talking about is family health, I don’t want risk anywhere near! Hence, this is the semi-truck of my illustration. It saves a lot of cash, but brings up a lot—I mean a lot—of questions. Here are a few that I had, with the answers I have, thus far.

  1. Does this pass for having insurance according to the mandate of the Affordable Care Act? It is lawful alternative.
  2. Do I have to negotiate my own medical bills? With some plans it is encouraged, with others it is not emphasized.
  3. Will my doctor know what this is? Anecdotal evidence is mixed. I’m still gathering evidence as to how this would work in my neck of the woods. Some plans boast of a network called the Private Healthcare System (PCHS) that gives members a variety of medical providers.
  4. Will the other people come through? There’s a lack of accountability by the law, but I have yet to find a story of somebody not pitching in their amount when they are supposed to. The organizations obviously know this is a concern so have safeguards in place.
  5. What are situations where I can be hung out to dry? I’m looking for testimonials detailing negative experiences, and they are admittedly hard to find.

Read more about Matthew’s journey with medical cost-sharing insurance:

Part 2: Comparing Medical Cost Sharing Plans and Which One I Chose

Part 3: Knowns and Unknowns in Medical Cost Sharing (Medi-Share Review)


As I dig deeper, what other questions should I be asking? What experiences do you have in medical cost-sharing? Do I have to wear skinny jeans?

Learn more about Medi-Share

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9 Comments

  1. We are also Samaritan Ministry members and have a very high regard for them. They are actually based out of our home town of Peoria IL but the company has been growing by thousands each year. There are two different levels of membership. The lower one covers publishable costs up to $250,000. If you are a “Save-to-Share” member costs over $250,000 can be covered. It is a Christian based organization and they do a wonderful job helping their members receive the best price for a procedure. The turn around time for costs being shared by other members is also very good. The hospitals and doctors in our area have a favorable opinion of the ministry since they know they will receive their payments in a timely manner.

  2. I have to admit that I don’t have any experience with medical cost sharing but I have heard some good things about it over the years. For the most part it seems like it really works. Although I don’t have any experience, so who really knows. I’ll be curious to hear what you end up doing.

  3. We are Samaritan Ministries Members and are completely happy with it! We’ve had several needs over the past few years, and all the “publishable” needs dollars have been reimbursed to us by other members. (We pay our medical bills upfront or work out a payment plan with the dr./hospital.) (Unpublishable needs would be things like dental/vision.)

    Also, Samaritan Members have access to the Karis Group — who go to bat for you and negotiate with the hospitals/dr. for lower bills. That by itself is valuable – hospitals don’t always listen to their patients.

  4. I’d ask about chronic illness, too. If one of you ends up with lupus or rheumatoid arthritis or something, do you get booted from the plan? Lifetime limits would be important here too. And look at total out of pocket on top of the premium.

    Does it pay x% of the cost, or do you have a max out of pocket annually? What about Rx coverage?

    Do you get typical rates like ones insurance companies negotiate, or do you pay the cash price? A 5 day hospital stay could easily be $50k before insurance discount, so with no annual max, that could be huge.

    I don’t know the answers, but those are some questions I’d ask. Medical costs can be staggeringly high.

    • Abby – Thanks for that message…the annual and lifetime limits have been things I’ve been looking into recently and I have been encouraged by what I read. Researching Rx coverage is next on my to-do list!

  5. Matthew, thanks for taking the time to write a blog and include Medi-Share! Although we aren’t completely opposed to skinny jeans, we suggest having some room to be comfortable is the best choice! :) We would be happy to explain how Medi-Share could work for your family and address your questions and concerns you may have. Let us know if you would like someone to give you a call! We also pray you find the healthcare that best fits your needs.

    • Matt, you have a few months to get answers to your valid questions…and others that will come up. E.g., is there an annual “cap” on the coverage. Or a lifetime “per illness” limit. Were I you (I’m 86 with prior insurance experience) I would go with the conventional (expensive) coverage unless you get satisfactory answers to your questions. Med costs are likely the major cause of bankruptcies for otherwise prudent people.

    • Thanks! I have had e-mail contact with Medi-Share already and I have been really encouraged and impressed so far. I will be on the phone sometime soon to talk details!


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