I am self-employed and I do not carry health insurance. In this blog post, I’ll share why.
When I was considering leaving my corporate career, I made a list of pros and cons. One of the biggest cons on my list was having to give up our family’s health insurance.
I grew up on a dairy farm and watched my mom work off the farm to help provide for our family. We were always told how good my mom’s insurance was and how important it was that our family had that safety net. It was ingrained in me as a child that this was a necessity.
We’ve been conditioned to think traditional health insurance is the only route to go when it comes to healthcare. I’m going to break down why that’s simply not true.
We had the option when I left my career to purchase health insurance from the provider my employer worked with. At the time we were quoted $1800/month to cover my husband, myself, and our newborn son. This was with a $3500 deductible per person per year and 80% coverage above and beyond our deductible.
I recently hopped on the old interwebs to get updated insurance quotes, as a case study for this blog post, to see what it would look like if we went a traditional health insurance route today. What a trip that was! It could be because we were out of the open enrollment period, but it was almost like fighting tooth and nail to get a quote of any kind.
I could go into deep detail about all the reasons why I felt uncomfortable with the conversation I had with the provider, but I’m not sure you’d be interested in reading all of it. A synopsis, I was asked a bunch of deep personal questions over the phone and was pressured by the operators to give specific start dates and more. I was also guilted by them and they used my two kids as leverage. The conversation felt very pushy. I was uncomfortable. It did not pass the vibe check.
Finally, after several minutes on the phone, I received one quote:
$840/month for our family of four. A $5,000 deductible per person, with a $15,000 family max. There were also a bunch of other complicated details about what is and isn’t covered.
So, if I don’t carry insurance, how am I handling my family’s healthcare?
Health Cost Sharing
My family and I are part of a health cost-sharing ministry called Christian Healthcare Ministries. (CHM for short) CHM isn’t insurance, instead, it’s a membership-based, nonprofit health cost solution through which hundreds of thousands of Christians voluntarily share to pay each other’s medical bills.
My biggest fear when switching from traditional employer-provided insurance to CHM was that it had to be too good to be true. The way our society has framed insurance can add a level of fear from exploring anything different.
Although CHM isn’t health insurance, in relation to traditional insurance, CHM has a Personal Responsibility that works somewhat like a deductible. CHM shares 100% of qualifying medical bills, unlike some insurance plans that may only cover 80% or less which is what I was originally quoted from the provider I worked with.
Ultimately, my husband and I felt comfortable with our decision because we had close family and friends who had been part of the ministry and were very happy with it. My brother and sister-in-law had maternity experience with CHM and knowing we were wanting to grow our family in the future, hearing about their experience made me comfortable with our decision.
We were expecting to have medical costs associated with maternity, so we went with the CHM Gold level program. We also consider our occupation of farming high-risk, so having the additional provisions through the CHM Gold program was important to us.
We also chose to participate in the CHM Plus program which is for catastrophic illness or injury. On the gold level program, there are no sharing limits when you have Brother’s Keeper.
For information on the silver and bronze programs, visit this link.
How Does it Work?
Program costs are based on the number of units you need sharing provisions for. Children are considered a single unit. So, if you have more than one child, they are considered one unit.
For our family, I am one unit, my husband is our second unit, and our 2 kids are our third unit. If you are a single parent, you would be considered one unit and your kids would be the second unit.
For 3 units on the CHM Gold program, along with the CHM Plus program our family pays $771/month. We have a $1000/unit personal responsibility. I pulled this screenshot from CHM’s guidelines because it does a really good job outlining what personal responsibility looks like.
What does the process look like when you have medical costs?
One thing I really love about CHM is there are no networks. You can go anywhere you want to get care and submit expenses for sharing as long as the care is within their guidelines. Whenever you go to a medical provider one of the first things they ask you for is insurance. With CHM, you are considered a self-pay patient.
You go into a provider, tell them you are self-pay, and then you are billed directly for medical expenses. When you get those bills, either in-person or over the phone, be sure to ask for itemized bills. It’s also important to ask the provider if they have discounts for self-pay, because 99% of the time, at least in our experience, they have had a discount. Sometimes it cuts the bill in half or more. This was a hard concept for me at first because I wasn’t used to being more hands-on with my medical bills.
With traditional insurance, it’s very hands-off especially if you are covered through an employer. You really don’t see the monthly costs because they come directly out of your paycheck. If you have a medical event, the provider submits bills directly to your insurance and you are billed by insurance if they are owed anything according to your plan.
With CHM, you are your own advocate when it comes to healthcare expenses. It is very hands-on and important to note it takes a lot more involvement on your part. Keeping a good record of itemized bills along with any discount you were given is very important for the sharing process. When you receive a bill, you submit it to CHM through their online portal. The submission process is very simple, but keeping organized bills was a challenge for me.
Timely submission of bills is also important. You need to submit bills within 6 months of the date of service. I had an issue with my D&C where they didn’t bill me for some of the care until 9 months after the date of service. CHM was very understanding and worked with me to get the bills shared although they were out of their specified date range.
You can either pay medical bills upfront and wait for a check to come in for shared bills from CHM, or, you can submit bills to CHM and wait to pay the bills once you get a check from CHM. Any bills over $1,000 should not be paid upfront so that CHM’s Member Advocate department has a chance to negotiate them for you. A lot of providers also have financing options where you can pay very small amounts of the bill while you wait for sharing provisions from CHM come in. The timeline for how long it takes from the time bills are submitted to the time they are shared for can change. CHM takes needs for cost-sharing in the order they come in and currently the timeline is 70-85 days. You can visit this link for up-to-date average sharing times.
My Personal Experience with Health Cost Sharing
As I mentioned before, I was nervous when making the switch from traditional health insurance to health cost-sharing. It is so different than what I was used to. I was expecting my first medical needs through CHM to be related to maternity. They were, but unfortunately, it didn’t end how I had hoped.
In the summer of 2020, I found out I was pregnant. We were so incredibly excited to welcome our second child to our family and give our son a brother or sister. Unfortunately, at our first ultrasound, the baby wasn’t measuring as big as it should’ve been, and they couldn’t find a heartbeat. I was in total shock after having a very uneventful and “normal” pregnancy with our first. We went in for another scan a few weeks later, and found a heartbeat, but the baby wasn’t growing as quickly as it should have been, and the heartbeat wasn’t as strong as they like to see. A couple of weeks after that I started to miscarry.
I bled off and on for 16 days before returning to my doctor for an evaluation. They did an ultrasound, and found no signs of life, but determined my body wasn’t doing what it was supposed to release the baby’s remains on its own. They recommended a D&C.
Because I wasn’t totally familiar with all of CHM’s guidelines, I hesitated on whether a procedure like that would be eligible for sharing. I called CHM from the exam room, and talked with an extremely nice representative who assured me a surgery like this would qualify for sharing, and then she prayed with me on the phone before I hung up.
Less than 2 hours later I was in surgery. I woke up overwhelmed with emotion with my husband by my side. We were devastated with the loss and that my body didn’t do what it was supposed to, but to this day I am thankful for the CHM representative who talked me through it and made sure I was taken care of.
We have had other incidents CHM has shared for including my husband breaking his leg in a farming accident and the birth of our rainbow baby. CHM has been there when we needed them. In total we have submitted $39,328 of medical bills to CHM, and they have shared $36,247 of that.
I have shared about our experience with CHM for several years now. I often get the same questions.
What medical expenses are eligible for sharing?
- CHM outlines in their guidelines specific examples of expenses that are eligible for sharing. They also list those incidents that aren’t eligible for sharing, including alcohol or smoking-related incidents, chiropractic care, functional medicine or naturopathic doctors, fertility treatments, birth control, dental & vision, and other such procedures.
What happens when you submit a bill for sharing?
- CHM has an online portal for submitting eligible medical bills
- Make sure you’ve submitted itemized and discounted medical bills in order for the process to go smoothly.
- You can check the status of the submitted bills directly from the online portal.
How do you manage expenses for those costs that aren’t eligible?
- There are several options. Through our dentist, we were able to get a very affordable plan that helps to reduce costs. I believe we pay $100/year as a family. and we get discounts on cleanings and fillings, etc. That plan paid for itself with our first visit. Ask individual providers if they have a service like this or if they offer discounts for self-pay patients.
- As you’re considering your expenses remember, several employers don’t offer vision and dental without it being an add-on coverage option. It would cost additional money for these things anyway.
- CHM also recommends dental and vision savings plans through the Careington LiveWell Plan for saving on dental, vision, chiropractic and more.
Is plan pricing based on income?
- No, pricing is based of the number of units you need provisions for. I shared more on this above but think it’s also important to note, there are no restrictions for membership based on age, weight, geographic location, or health history.
What is the most you have ever paid per month?
- Regularly, we pay our family’s contribution of $771/mo to the ministry which is for the CHM Gold Program + CHM Plus program.
- We have paid some medical bills up front before we received a check for sharing from CHM but it’s not necessary to do that. You can wait to pay bills until after CHM gives you a check, but providers must be paid within 30 days of receiving sharing dollars from CHM.
- If medical bills are due before you receive funds from CHM, most providers have options to pay little by little until you receive your funds to pay the full amount.
What about Pre-Existing conditions?
- I think a common misconception is that health cost sharing isn’t available for people with pre-existing conditions. However, CHM does have available provisions for people who have pre-existing conditions.
- There are a lot of details to outline on this specific topic and they do a great job of addressing common questions in regards to pre-existing conditions on this page.
Is it worth it for people with chronic illnesses and higher medical expenses?
- When folks are considering health-cost sharing I always encourage putting pencil to paper. Oftentimes, we aren’t used to seeing our medical bills itemized out, so if you are considering the move to health cost sharing, I would start with asking providers for your itemized bills so you can see what you and your insurance provider are paying for.
- You could also start exploring with your medical providers to see if they give discounts for self-pay patients or if you are eligible for financial assistance. State and federal governments allocate money for individuals who’s income falls below a certain level, and it would be worth looking into potential eligibility for it.
Is CHM a good option for growing families?
- YES! It’s a great option for many reasons.
- Your monthly gift is based on units and children are considered one unit. No matter how many children you have you will be paying for the same number of units
- They have a great maternity program. CHM shares for many costs associated with maternity and you can even view a list of all their eligible expenses within their free Maternity Guide. CHM shares for many costs associated with maternity and you can view a list of all their eligible expenses within their free Maternity Guide. If you call CHM’s Maternity Support Team and let them know about your pregnancy within the first 16 weeks, you could have $500 taken off your Personal Responsibility in addition to being connected to quality providers, spiritual support, Christian community, and more.
- The CHM Plus program offers unlimited cost support and removes the $125,000 cap on incidents. The only exception to this is congenital conditions which you can learn more about in their Guidelines.
- A couple of things to note: You must be a member of CHM at the Gold Level for 300 days prior to the expected due date to participate in the maternity program. You must also be married at the time of conception.
- You can learn more info on their maternity program, including what’s eligible for sharing in their Guidelines.
- These amounts are set in place for the whole year and are subject to changes each year.
- We have seen increases in both our personal responsibility and monthly gifts, however, CHM is still the most reasonable option for our family.
How often can monthly gifts and personal responsibility amounts fluctuate?
What about well-child exams and childhood vaccinations?
- Depending on the provider, most pediatricians have discounts on well-child exams and sick visits if you are self-pay.
- We found a provider that doesn’t even take insurance and only accepts self-pay patients. They are very affordable, and I believe places like this are becoming more common and accessible.
- CHM also offers a telehealth program called HealthiestYou that is free with any of the plans and can help reduce costs associated with visits for minor illnesses. (ex: cold & flu, allergies, skin irritation, respiratory illness, pinkeye, and more)
- If you are choosing to vaccinate your children, there are free vaccinations available from the Vaccines For Children program. It’s a federal program but each state handles it differently. You can google program specifics for your state.
How does the cost compare to when you had insurance through an employer?
CHM isn’t insurance and doesn’t operate in the same way, so this comparison isn’t exactly apples-to-apples. Everyone has to make the choices that are best for them, however, below is a quick snapshot of what our experience has looked like so you can explore if this is an option that might work for you!
My personal experience:
- Employer Insurance
- We paid (need to see if I can find this info) per month on my employer’s health insurance program
- It had a $3500 deductible per person and covered 80% over and above the deductible
- We paid close to $10,000 out of pocket to have our son while we were on this insurance
- We pay $771/month as a family of four
- When we had our daughter we paid our personal responsibility, which was $500 at the time. CHM shared for the rest.
- If we had a baby today, our personal responsibility would be $1000, but that is still SO much better than the $10,000 we would’ve paid through traditional insurance.
What about seniors on Medicare?
- If someone is 65+, is on Medicare, and has A + B, they will be eligible to sign up for CHM SeniorShare™, which comes out to $115/month. Medicare kicks in first and whatever it does not cover can be submitted to CHM for sharing. Medical bills must still be eligible for sharing based on CHM’s Guidelines.
What about employers wanting to provide benefits for their employees through CHM?
- There is a CHM groups department which creates custom plans to fit the needs of business owners. Contact the groups department for more information: firstname.lastname@example.org You can also visit this link for more information.
To Sum It Up
Not only is our family saving money by being part of CHM, but we are also able to support medical needs that are within our beliefs. It brings me a sense of peace to know I’m not contributing to medical procedures that don’t align with what I truly believe.
At this point, if I were to return to a career that had benefits, I would continue to use CHM for our healthcare because I trust and believe in the ministry.
My eyes have really been opened to healthcare and becoming an advocate for myself. I ask my medical providers a lot more questions and make sure I have the information I need before any procedures or tests are done.
There is a learning curve when it comes to switching to health cost-sharing vs. traditional insurance. It took some getting used to and some definite organization on my part. It is worth the extra legwork, no doubt.
If you are interested in making a switch, I highly recommend putting pencil to paper for your yearly medical costs. If you have specific questions about your own medical needs, CHM staff members are kind and super helpful.
CHM is not for everyone, but it has been a blessing to our family. I hope this helps and to get more information on CHM here!