“I don’t like my job, but I can’t leave because I’m the one with the insurance and the benefits. My entire family depends on it.”
I’ve been there. This is how I thought.
It truly breaks my heart that some folks out there don’t like their job, or wish they were doing something else, but they choose not to take the leap PRIMARILY for insurance/benefit purposes. We’ve been brainwashed into thinking there aren’t any other options.
I’m here to tell you there ARE options, you just need to explore them and seek out others’ experiences to bring you confidence. Maybe what I share isn’t the right option for you, but I’m hoping it’ll open your eyes to do your own research to see what’s out there.
When I was pregnant with Hank, I was working and the company I was at provided insurance. I was happy with the coverage at the time and chose a plan that would be optimum (so they said) in my childbearing years. All of my maternity checkups were covered 100%, along with pediatric visits… but for the actual birth itself, we had to meet our deductible of $3500 and then pay 20% of anything over and above that, insurance covered the rest.
That doesn’t sound so bad right?
Well, when all was said and done we paid nearly $10,000 out of pocket to have our son for a fairly uneventful birth. I mean, besides the actual human coming out of me, that part was pretty eventful.
Here’s how it broke down:
- $3500- my deductible
- $3500- my son’s deductible
- Plus 20% of anything over and above= Almost $10K out of pocket.
We were dumbfounded. First of all, we didn’t know enough to know both me and our new child had our own deductibles. My husband and I were both fairly healthy individuals and doctor visits prior to having kids were few and far between. We were anticipating paying about $4-$5K for the whole deal, so when we had to pay $10K that definitely threw a wrench in our plans.
Josh’s brother and his wife had a baby just 3 months prior to us having Hank. They were on the Christian Healthcare Program we’re on today. They birthed their baby in a hospital with the same type of experience we had, and paid a total of $500 out of pocket for the entire experience. This is what opened my eyes to the world of healthcare costs and the opportunities out there.
What is CHM and how does it work?
Christian Healthcare Ministries is a faith-based healthcare cost-sharing organization. It’s not insurance but it is a certified exemption to the national healthcare law.
You pay a monthly membership fee depending on what level of support you’re looking for. They have great programs available for growing families. CHM Programs and levels
You pay for any healthcare “occurrence” that is under $500. For example, you aren’t feeling well and go in for a checkup- find out it’s a sinus infection and get meds. The total is $350 for the doctor’s visit plus the prescription. You would pay for that cost out of pocket. I also pay for any pediatric visits we have. Another example is expenses to have a baby falls under one occurrence– so literally pay $500 out of pocket and CHM covers the rest. Anything maternity, birth, and until your baby is 3 months old falls under that occurrence.
When you go to the doctor for anything, you always say you’re a cash pay patient and I ALWAYS ALWAYS ask for cash discounts. Usually, they will have at least a 30% discount for cash patients, but a lot of times it’s more. Asking for a discount was hard for me at first… this probably has something to do with my “midwest nice” roots, trying to avoid any type of awkward conversation.
I know there are a couple of ways you can go about paying bigger bills, and CHM is really great to work with, but we paid healthcare bills upfront and then got refunded by CHM. So we negotiated cash rates from anyone who billed us (the hospital, anesthesia, etc) and cut a check for each one. Then, we submitted the bills to CHM and they cut us a check back.
That’s the biggest difference between CHM and traditional insurance. You are your own advocate. With traditional insurance, healthcare is extremely hands-off. If you’re employed, money comes out of your check every month and you don’t really realize it because it’s money you never see. If you pay for insurance out-of-pocket you realize it a little more, but when it comes to paying actual health bills, you only deal with your insurance and not the individual companies billing you. It’s still very hands-off.
The insurance agency deals with everything, they pay the bills and then send you the balance for whatever your deductible is. You pay it. You have no say.
Since becoming my own healthcare advocate, my eyes have been completely opened to healthcare here in the US and how so many have chosen not to understand its nuances.
I sat down to figure healthcare bills for Harper and had a very eye-opening realization. If we had no insurance whatsoever and just paid cash for every service we had involving her birth, we would have paid nearly the same out of pocket as we did for Hank. I know that’s not the same for everyone, but it was for us and realizing that is definitely a big part of what has caused me to be more vocal on this topic.
What about prescriptions?
We haven’t had to have any regularly occurring prescriptions, however, this would be a question to ask CHM directly if you do have a need to cover something continuously.
The prescriptions we’ve needed that are associated with an occurrence under $500 have been very reasonable at cash discount rates or using a service like Good Rx to get a discount. I found Phil is my Pharmacist on Tik Tok and he gives great information but this video is one that really struck me. Again, medical services and medications are not always cheaper with insurance and it’s something too many people don’t know.
Dental & Vision
Again, it depends on what kind of dental and vision needs you have but we pay for these services out of pocket. Our dentist had a program we could sign up for that was very affordable. I think it was $100/ year and it gives us discounts on cleanings and any fillings we may have. It paid for itself in our first visit.
Vision-wise, I found an optometrist I like and they also gave discounts for cash patients.
Do you have to sign up at a certain time of the year?
No. There is no specific enrollment date range for CHM. And what’s even better? Talking to them on the phone is refreshing. Their support team is great and super easy to talk to. I had to call them at the hospital when I was determining if I could get a D&C for the baby we lost through miscarriage. I wasn’t sure if it was covered. They assured me it was and prayed with me before we got off the phone.
Monthly Contribution Based on Family Size
It depends on what level of coverage you choose to go with. We chose to go with the gold level for our family. We have two adults and two children in our family. Each adult is considered one unit and any number of children is considered one unit. For example, we pay for 3 units. We also have brother’s keeper and our total monthly contribution right now is $675/month. Broken down it’s $615/month for the gold program and $60/month for brother’s keeper which covers catastrophic occurrences.
If you were a single parent with four children, you would only have 2 units. If you were a 2 parent with 7 children family, you would have 3 units. Their programs for families are great.
You can read more about programs here: https://chministries.org/programs-costs/
Pros and Cons of CHM (specific to our situation)
- We pay overall less money out of our pockets for healthcare each year
- The people who work at CHM are really wonderful and helpful
- You don’t need to worry about a provider being “in-network.” You can get healthcare wherever you choose.
- You have an increased awareness of your medical expenses and can make your own decisions on where to do business.
- It’s more legwork for you as a patient. You are your own advocate and you need to be much more involved.
- You need to have funds available to pay medical expenses in a timely manner.
- If you want to be paid back timely, you need to submit your bills in a timely manner as well.
Pros and Cons of Traditional Insurance
- It’s very hands-off. You only pay your insurance company and don’t have to deal with several different places billing you for medical expenses.
- In my opinion, you have very little awareness of your medical expenses and what you’re actually being charged for.
- You have fewer options and often have to choose someone “in-network” or pay more for medical expenses.
- In our experience, our overall expenses for healthcare were much higher carrying traditional insurance.
401K at my job- what did you do when you left as far as retirement?
When I left my job, we took everything that was in my 401K and hired a financial advisor to manage our investments. Each month we have funds that go into a retirement account and our advisor has been helpful in educating us. There are several options out there for financial planning outside of what you get for benefits from a career.