The article I posted from Nick Parker generated a lot of interest. A friend, Jill, wrote a response to the issue of Health Insurance before Medicare. Please read below. I think you’ll find it quite informative.
Good article on an important topic, Josh! I read and liked Nick’s article too. Some of the Healthshare information is different (not as good) than the one I know about firsthand so I thought I’d share in case anyone else is interested and thinking about this option!
I just signed up and was accepted for Solidarity Healthshare starting in January 2021. I had my employer’s insurance plan all this year, paying the full premium March-December, after retiring in February 2020 at 56. It was a very expensive year (about $7500), as all I got was a free wellness tele-visit and one $3/month prescription – well no, actually, I’ve been paying for that out of pocket for a couple years because it’s less expensive than WITH insurance (about $20 for 90 days using mail order service)! I did fully fund my HSA for 2020 in Jan/Feb with tax free W2 income and that saved me about $1700 in taxes along with tax-free growth going forward in my HSA – so in that light it wasn’t a bad choice.
Solidarity Healthshare has Catholic roots, though you don’t have to be Catholic to join, just Christian. They honor Catholic Christian morals and don’t pay for certain things, including birth control, sterilization procedures, or issues stemming from those items or surgeries, etc. and expect you to be aware of this and ok with that etc. Most of those things won’t affect anyone over 50 that’s a practicing Christian – just be sure and read them all and ask any questions and you are good. They have coverage options for single individuals, married couples, traditional families, etc. I did not have to tell them the church I attended or sign any kind of “oath” however if you aren’t a practicing Christian you should definitely disclose that and this probably isn’t the option for you anyway.
My co-worker for 30 years and friend who is a single Catholic female, 62 in January, has been in this plan for four years since she retired at age 57 in 2016. She says it works just like they say it does.
The monthly costs are extremely reasonable and for a single person (only prices I got) are:
Monthly – $249 (age 30-65 individual)
Max Annual Share – $750 (NOT per incident, per year!)
Coverage – up to $1,000,000 per incident
You also have the freedom to pick any provider – not in and out of networks or changes annually to who you can see, which is great! They have a card you present to the provider at the time of service and then they send the bill to Solidarity, just as they would send it to an insurance company. Solidarity then takes care of re-pricing/negotiating bills with providers etc., then tell them what to bill you for directly, if you have not yet met the annual $750, then they pay the rest direct to the provider on your behalf. If a provider won’t take the card, (and my friend says no one has ever not taken it, once she explains that they should send the bill to them just like insurance), you ask for a self-pay discount, pay the provider, then upload the bill to Solidarity and they will reimburse you.
Solidarity also has FREE video visits (doctors in every state) for minor incidents including prescriptions or advice of whether you should see your regular doctor or get an X-ray etc.
They cover annual well visits 100% including annual lab services etc. They cover mammograms, colonoscopies, etc. 100% just like ACA. They cover mental health, PT, chiropractor, etc., and even cover some home health visits and other things I don’t think all insurance companies cover. Read all the details as they lay everything out and are there to answer questions up front.
There is even a $10,000 death benefit for your family should you pass away while in the plan to help with last expenses, etc. And they will pay your final hospital or medical bills as if you were alive as insurance and Medicare do. While they don’t cover most dental or routine eye exam expenses, they do cover some dental surgeries involving infection that aren’t to save a tooth but medically necessary. Also most all needed eye procedures or surgery would be covered as medical. They have a myriad of discount cards and networks for dental, vision, prescriptions. They cover the first 90 days of any new prescription drug, and of course chemo treatments etc. but not maintenance drugs. I take one prescription that’s $3 a month so it’s not a big issue. For some with more medications, it might be. I’m not too worried about this even if I have to add some drugs in future as everything else is so affordable.
My friend’s one complaint was that as they’ve been growing, they’ve been changing computer systems, adding staff, etc. and some of their bill processing and reimbursements have gotten behind, which caused some providers to bill her directly. She had to make calls and intervene to get things moving along again but never felt like they weren’t going to take care of it. Overall, though, she feels like they are improving and it is a great alternative for a relatively healthy person who is looking at cost effective alternatives. Of course, she referred me!
I’m happy they took me! I frankly trust them and their compassion, ethics, and honesty much more than any insurance company ACA or government run plan. For me it was a perfect fit at a perfect price!! They limit their risks on the front end, i.e. don’t take on already very sick, high risk pool type people, but seem to not be overly strict or expect perfect health – nor try to trick you into a trap then decide not to pay when you need it most. As long as you are totally honest about your medical history on the application, then I believe they will pay when you need them even if they legally don’t have to. They even have Medicare supplement plans which my friend is considering in three years vs Medigap but hasn’t fully explored yet.
I like that you can pick your own providers without hassle and that you don’t need to artificially jimmy around with your AGI income and optimal tax strategy just to get a subsidy to bring an age based $800 or $1000/mo premium with an $8000 deductible down $300 and something a month. Also they raise premiums with age in the ACA, whereas Solidarity has a flat low premium for 30-65 year olds. When my friend started monthly amount was $199, and now 4 years later it’s $249….not bad at all!
If anyone is interested I would appreciate it if they could email me (Jill) at firstname.lastname@example.org for your first contact so I can be eligible for a referral reward if you end up joining, etc. All I need is an email with your name and an email address to refer you. Solidarity will email you info directly from there and offer to get any questions answered with a phone appointment to decide if you want to apply.
Even after you apply, you can decide you don’t want to join. A nurse calls after you apply to discuss your medical information and ask any additional information and approve you for membership and discuss any stipulations based on your information, etc. And you can ask whatever questions you have.
I had a wonderful easy experience with this process and am greatly looking forward to the extra $500 plus dollars per month and no $8000 possible additional annual health care spend hanging over my head (just $750 max!) and not having to worry if my income exceeds a certain dollar amount even by a penny to try to get a government/taxpayer subsidy for too expensive insurance that can dictate who you can see and what facilities you can use!