Friday, January 16, 2015

About CHM...

I had a blog reader ask me about our decision to drop our insurance and join CHM (Christian Healthcare Ministries). I generally don't want to discuss products or services or anything like that on this blog... but after typing out the story of how/why we made that choice, I realized that there was some testimony in there. It's part of our story of what Living With Jesus looks like. And maybe some other readers out there would benefit by the information, like we would have if we'd have found out sooner.

So with that warning...

Insurance costs over the last couple of years were starting to rise with the company my husband was with before last year's job change. Almost all Americans know that story, so we probably weren't the only ones who were starting to wonder if it was worth it.
The kids and I have essentially never used our insurance (only using dental regularly) and my husband has had several surgeries and procedures over the years.  But we'd already seen that, in the last few years, every time something came along, like when they wanted to do colonoscopy and endoscopy, etc, the insurance paid almost nothing. So the more costs rose, the more we started wondering if it was worth it. (Even for the three births, insurance was only used on one of them. The other two, we paid out of pocket for mid-wife services that the insurance did not cover.)

So both at the end of 2012 and 2013, we thought about dropping our insurance. Each time we ultimately chickened out, reasoning that the insurance we had was still better than most places (because the company was SO large that they self-insured). Each time we opted to keep it, even though we rarely used it. The only thing we use regularly now is a chiropractor and we have always self-paid those visits. (Many chiropractors in our experience and where we live will charge self-pay patients $35/visit, while the insurance co-pay is $50... if the insurance even covers it. Another example of how useless health insurance has been for us.)

In August of last year, when my husband got his new job, we were told that the insurance with the new company was expensive, but we didn't think about it too much or worry about it... we were too confident that God had provided this opportunity and that it would work out somehow. (Which it did, just not in the way we were thinking.)  

The last week of August, though, my husband had his heart do something funny, he thought, so he went to the doctor while we did still had insurance. It wouldn't have mattered if we hadn't, as everything fell under our deductible, but they did a stress test and chest x-rays. The doctor said he had an extremely mild case of Bronchitis, gave him an antibiotic, and said his heart was fine. We eventually (In October) received $1600 in medical bills, and the insurance paid nothing because it was all under the deductible. 

Through September, we had no health insurance, and nothing happened. I should have been looking for other alternative options at that point, and I did look at the exchanges and public insurance, but all of those were more expensive. I did not find out about any other alternative. And everyone I talked to said their family rates were in line with ours.

In October, we were eligible for insurance under the new job. We found with a shock that the new company did not offer dental at all... we've NEVER been without dental, and that we have used a lot... lots of teeth with deep groves, so sealants needed, and cavities filled, etc. Not to mention 2/year cleanings and yearly x-rays.  So not only was the insurance about $150/month more than we were paying before, it did not include dental. And they said it was going up even more in 2015.

We still weren't sure what to do, so we reluctantly signed up for the insurance. He was getting paid less already, but we'd accepted that because it wasn't a lot less, and it was about 20 hours/week less. It was more per hour, and far less stress, and getting him out of the cold in the winter. All reasons why we were praising God for the new job... but the insurance was making the overall picture a lot more bleak than we anticipated.

A week into October, we got his first paycheck with the medical insurance taken out, and we realized that either we needed to drop insurance, or else I'd have to work longer hours and make more money, or he'd have to get a second job, or God would have to give us peace that He was going to work a miracle every paycheck.  We could not afford to pay for insurance that covered none of what we actually used (chiropractor and dental) and still somehow pay for what we did need out of pocket. We seriously began looking into dropping the insurance. The thing is, we knew that, come 2015, the government fine for not having insurance would be over $1000. Still, though, it seemed that paying that and cash for the few doctor's visits we usually had would be maybe $1500/year... while the insurance was going to cost us $6000/year AND his company another $6000/year. (2014 rates... 2015 is 15% more.)

In the middle of October, I found out about Christian cost-sharing ministries whose members are exempt from the ACA mandate. I realized pretty quickly that the lowest and cheapest plan was essentially the same as the government would fine us for not having insurance... and we wouldn't be fined.  So I instantly knew that if we decided to drop insurance, we'd at least do that one.  Why pay the government $1000/year in a fine, when the some money can go toward other fellow Christians' health care costs and at the same time give us the option to ask for help if something huge and expensive arose?

The more I looked into it, the more we really, really liked it.  Every time we thought about $12,000/year going to an insurance company (half from our pocket) even if we didn't have any claims... and then us needing to pay for another $3,000 up front if anything happened... and more for coinsurance on top of that... the more we hated the idea.  We could not understand where $12,000/year was going, other than to be swallowed up by the system. On the other hand, the money paid into a cost-sharing system was definitely going somewhere good, even if we never had a need ourselves.

By the third week in October, we knew we were going to drop the insurance and switch... I just didn't know which one: Samaritan or CHM. I decided against Medi-Share for a number of reasons and I hadn't found out that there's a fourth option. (These four are the ONLY four whose members are exempt from the ACA mandate.)

I was leaning toward CHM because of the flexibility in different levels, but I wasn't positive yet. October 23rd, I almost signed us up, and I should have. It was probably God prompting me... thank goodness I know He is faithful even when we mess up! Because I put it off and said that I wanted to talk the differences between the programs over with my husband one more time... we'd do that in 3 days... on Saturday. 

But the next day, 10/24, he wound up in the ER with A-fib... heart going nuts.  

As we were driving to the hospital that night, I almost grabbed my laptop to sign us up for CHM from the ER room, because we'd be covered as of that day. But my conscience wouldn't let me. It didn't seem right to do that immediately just because we knew we already needed it. Sort of bending the rules. I'd have been fine if I'd done it earlier that day when I had no idea what was about to happen, but I hadn't.  Instead I grabbed our unused new insurance card from the stack of mail on the counter.  

And over the next three hours, as I sat with him in the ER and watched them hook things up to his heart, I was mostly thinking about him and thanking God for taking care of us. But in the back of my mind, I knew that I should have gotten us signed up for CHM.  I knew, knew, knew that this was going to cost us a LOT, and we'd have been much better off with CHM. 

He was transferred to the nearby town's hospital overnight because our hospital didn't have any ICU beds available and they had to keep him under constant watch until his heart reset and that drug left his system.  His heart did rest at 1am, and they released him and he came home that afternoon -- after going through another stress test and a million other tests.

Less than 24 hours in the hospital, and the doctors and hospitals billed the insurance over $12,000.

The insurance forced discounts of something like $3,000 and they actually paid only about $1,500.  Our portion was $7,500.  Avita did give me some additional discounts to knock it down to $5,600, but the insurance didn't help with that.

So an insurance company that is charging $12,000/year to insure our family paid out only $1,500 when we actually had something happen. And they wanted 15% more for 2015 premiums!

We could not do it. We refused to do it, even if we could afford it. 

On the other hand, if I HAD signed us up for EITHER of the two cost-sharing plans that I'd been going back and forth between, we would have wound up being out less than $1,000.00... possibly less than $500. 

So instead of being grateful we still had insurance when this happened, I was struggling to trust God and not kick myself for not having already switched it over. 

We needed no other confirmation that we needed to switch. 

And the fact that it happened ruled out Samaritan anyway, because they do not ever cover pre-existing heart conditions.  The doctors have said that this might never happen again to his heart... or it might, and if it does there's a heart procedure they can do to fix it. With CHM, those costs, should it happen again, will be "shareable."

Through November, my husband felt fine and went through checkups. The cardiologist wanted to monitor his heart for a month to see if his heart has any other bad rhythms on a regular basis, but the insurance wouldn't cover it. They'd rather just wait and see if we have another $12,000 incident and risk a stroke than pay out $450 to see if something preventative can be done. Insurance once again looking out for us! (Can you hear my sarcasm?)

Insurance proponents say that cost-sharing isn't reliable, because they are not legally required to cover your costs like insurance is. My husband and I laugh. Our insurance is legally allowed to deny any claim they want... and make us jump through hoops to get approval.  They are legally allowed to charge $12,000/year for a plan that only helped with $1,500 out of $12,000.  

There is absolutely no security in having health insurance anymore. Not in our mind. We've got to trust God to provide if something happens, regardless of whether or not we've got insurance. 

The choice for us was only what we're going to do with the money from our paychecks: give it to an insurance company or give a much smaller portion of it toward someone else's medical bills and start our own medical savings account with the rest. 

So at the end of October, we signed us all up for the cheapest bronze plan with CHM, and we dropped the kids and I from the health insurance.  At the end of November, my husband's cardiologist said nothing more was needed as long as he felt fine, so we dropped him from the insurance as well and bumped his CHM coverage level up to Gold. 

We're paying/giving $240/month plus $75/quarter for our membership with CHM.

My credit union (USAA) did start offering dental insurance, and I bought basic coverage that will pay for cleanings and X-rays and give us discounts on fillings for $67/month.  

I also had to add the medical coverage to our auto policy which added $22/month.

Altogether, that's $354/month... and should my husband have another A-fib episode, we'll probably have to pay almost nothing, when all's said and done, because all of the expenses will be eligible for sharing with CHM. If the kids and I have something happen, and it totals less than $5,000, then we'd be out more because that's the threshold for the Bronze plan... but I don't even know if it's possible to have anything happen and have the bills total less than $5,000.  It probably is for something like a broken bone or something, and follow up visits aren't covered under the bronze plan. I don't really know... no point in trying to figure out the details on something that so far God has protected us from. I'd like to eventually move us up to one of the higher plans if we can afford it, but for now, Bronze covers us if something huge happens, and we can afford that.

And $354 is SOOO much more affordable than $700/month (2015 rates for our half) for coverage that didn't very little in October and doesn't include dental or chiropractor. We can afford to set some aside in our own medical savings account now.

And all of that money (other than the $22/month for medical on the auto policy) is now going either for medical costs that we will actually USE, or it's going toward other people's medical costs, rather than just going into an insurance company's coffers.  We feel so much better about this! Even if we go 10 years without every needing help with our bills, all that money will go directly to help those who ARE needing help, instead of disappearing into an insurance company's accounts.

For 34 years, CHM has allowed their members to help each other out with their bills. I searched the web for complaints and found virtually none.  Read their monthly newsletters on the website. That's what clinched it for me... I'm joining a community that trust God with me. We're all trusting God that He will provide for all of our medical needs together. I love reading their newsletters. I love reading the little listings on the prayer page and seeing how even those with pre-existing, non-eligible costs (incurred after they became members), are being covered through the generosity of other members. You can see people's amounts go down if you follow from month to month.

Finally, on top of all that, two weeks ago God led me to a doctor who is setting up a cash-only family practice in our nearby city. I talked with her over the phone, and she's just as fed up with insurance companies as I am. She knows people who are on cost-sharing plans, and she believes that she can offer doctor visits to cash pay patients at around $80/adult and $50/child... HALF what Avita doctors charge cash-paying patients. (Avita owns almost everyone and everything medical in this area. They charge $210 base rate for a 15-minute checkup, and they give cash-pay patients only a 30% discount, even though they have essentially zero paperwork and billing to do for cash-pay patients.)  

This doctor is also a naturally-minded doctor as well, which I like. She told me that she will have no problem working with doctors and hospitals in the area if need be; she has built relationships with many over the last 10 years. But if something can be handled naturally, then that's her preference. 

So God provided a doctor as well. He is so good!

So that long story is the journey of how we came to drop our insurance and sign up for CHM. That is also a bit more testimony of how God leads and provides, even when you mess up... as I know He will.  And THAT is why I wanted to share this story. CHM does offer a free month if you refer someone else, but since you all don't know my full name, you'll have to specifically ask if you sign up and want me to get the free month. That's not why I'm sharing this.

The ending of the story will be when/how God provides the $5,600 that is currently on a credit card. I've got until February 17th to either transfer it to a low rate card or pay it off somehow... God knows and I don't!

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