I’ve heard it touted for years that ACA insurance is so great because people can get free annual checkups now. Agreed, that’s a nice perk and it may help motivate some people visit a doctor, but it comes with a tradeoff and they’re certainly not “free”. The tradeoff for most is that their premiums are skyrocketing and their deductibles are monstrous. I’m trying to figure out why that “free” checkup is such a big draw when it ends up costing us so much in the long run.
Let’s say your annual checkup costs $200, which would honestly be pretty high, but I want to be fair. If you are a family of 4, that is $800/year if every member got a checkup.
Sounds like a high number, so ok, we should probably get insurance that will save us $800/year in checkup costs.
The insurance comes with a premium of $950/month. Wow, wasn’t expecting that. Well, maybe the deductible isn’t too bad because junior might break his leg and have an ER visit. Oh, it’s $5500? The family deductible is $11,000? Are you serious? So when exactly was the insurance company planning to pay for anything? Oh that’s right, they’re paying for my $800 in family checkups.
So we’re going to pay $11,400 a year in premiums to avoid paying $800. With that huge $5500 deductible it’s going to cost us another $5500 if our family has any kind of emergency, illness or injury, so NOBODY get sick or hurt. Seriously. Nobody. Let’s all walk on eggshells because we’re terrified someone will fall down or catch a disease. It’s no longer an inconvenience to get hurt, it’s a life changing financial nightmare to visit an emergency room and the premiums are breaking us. $11,400 + $5500 is $16,900 a year to avoid $800. I’m starting to think there’s a BIG PROBLEM with this insurance system. I ask again, why are we falling for the free checkups?
WHAT ELSE CAN WE DO?
1. One option is to have nothing. Pay that $800 for 4 annual checkups and have absolutely no safety net for anything else. Honestly, not a real option in my opinion. Why walk around with no safety net? Sure you’re saving the money, but you’re still walking on eggshells terrified of the next fall or sickness. Doesn’t seem like a good way to live. And now the government makes you pay a big fine of $325/pp for 2015 or 2% of your income. So add another $975/year (family max) to your costs at minimum, or lots more if your income is higher (2% of income). OUCH.
2. What about the healthcare sharing ministries? They’re not a new concept, they’ve been around for 30 years. Wow, that’s a long time. Do they work? Research and experience says yes. There are thousands of glowing reviews of how these ministries are helping. Great. Will they really help me and my family? What do they offer? Let’s look.
Samaritan Ministries is the biggest ministry and the one we joined.
- No tax penalty to pay for the months I’m a member: CHECK. Awesome, there’s $975-$4000+ I won’t pay in fines.
- Monthly cost? Samaritan’s family rate (3+ ppl) is $495 even if we have more kids. Wow, that saves me $455/month which is $5460 I won’t pay to insurance.
- Deductible? Samaritan doesn’t call it that, is our personal responsibility amount and it’s only $300 for those trips to the ER or any other incident/illness we have. $300? Seriously? So I don’t have to live in fear of financial ruin if my kid breaks a leg? Wow, what a relief! Wait a minute, you also tell me that if the hospital gives me a discount you will reduce my $300 amount? So you’re telling me that my kid could break his leg, and Samaritan members could actually share in all of those costs if I get $300 in discounts and I would pay pretty much nothing? Holy cow. I mean wow, that’s just amazing. Insurance would have made me pay that $5500 deductible first. $0-300 vs $5500…and members pray for me when I have a need? Pretty sure insurance doesn’t offer that.
- Free checkups? Nope, Samaritan doesn’t offer that. So I would need to pay for those 4 $200 checkups on my own. $800 out of my pocket.
Samaritan total: $5940/year in monthly shares (think premium). $800 for those 4 checkups. $300 if junior breaks his leg (with no discount). That adds up to $7040 per year. Wait, what was insurance going to be? $16,900? YIKES, that’s a difference of $9,860 per year!!! That means my free checkups with insurance fine print are costing me almost $10,000 more than paying for checkups on my own and having Samaritan backing for other things.
I’m starting to think insurance is just a big bait and switch.
Wait. There’s more than just the ER visits. What if I have a heart attack? Or get cancer? Those are huge bills, would Samaritan be there for me? Yes, Samaritan’s largest need to date was $1.5 million, and it was fully shared. The Samaritan member was part of Save to Share, the extra program available to pay for just that type of very expensive need. And there’s no need size limit for Save to Share and no lifetime limits. Looks to me like Samaritan members are prepared to be there for us for the smaller broken-leg type needs and the major expensive needs, too.
I think members of healthcare sharing ministries have it figured out. And I’m so glad we joined one! 🙂
INSURANCE – $16,900/yr for premiums and an ER visit and I live in fear of actually meeting the deductible I can’t afford. But I get my free checkups!
SAMARITAN MEMBERSHIP – $7040/yr for monthly shares and an ER visit (includes those checkups I paid myself) but I don’t live in fear of medical bankruptcy and my bank account can breathe. Plus Samaritan offers help through Special Prayer Needs. They actively look for ways to help their members. And the prayers… those wonderful prayers.
NO INSURANCE, NO MEMBERSHIP – $800 checkups + $975 minimum fine (or more), and I live in fear of any illness or injury because we’re on the hook for the whole thing and it will likely bankrupt us.