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mary theresa
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| Posted: March 31 2008 at 3:44pm | IP Logged
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Or something similar?
And if so would you mind sharing your experiences/thoughts with me?
We are seriously considering this but it is a little scary to think of dropping conventional insurance for something that technically isn't.
Medi-Share
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Mary Theresa
mother to 3 little girls --March '06, Dec '07 and Jan '10
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Martha
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| Posted: March 31 2008 at 4:22pm | IP Logged
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Routine mammograms
My dh and i have been very curious about this program and the Good Samaritan one.
Two things leap out at me on this one:
#1 - it says that they are NOt an insurance company and cannot be certified as one for those required by law to have insurance.
My dh cannot legally refuse to accept his companies insurance unless he can prove he has insurance elsewhere - thus, we'd still have to purchase the company insurance (altho we might opt for the cheapest plan they offer) even if we did Medi-Share
#2 - It gives me pause for concern that they don't seem to cover routine preventive care. Preventive care such as these things they state very clearly are not eligible for share benefits:
"Routine pap smears
Routine screening tests and procedures without medical reasons (e.g., colonoscopy without specific symptoms)
Well patient care, for example, annual physicals, routine lab studies, mammography, pap smears and well-baby check up."
#3 - If I can afford to pay and wait to reimbursed, then do I need any plan at all? My understanding is that you go in without insurance (which can make it problematic to get regular care that isn't life-threatening) and ask them to bill you for it. When the bill arrives, you submit it for sharing. Frankly, I just don't see that working a LOT of the time?
So those are my concerns... 
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Martha
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Nina
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| Posted: March 31 2008 at 5:24pm | IP Logged
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I also looked into medi-share three yrs ago.They stated in their literature that they reserve the right NOT to pay for a procedure/treatment at their discretion.So you could get stuck with a lot of bills because THEY decided that they do not wish to pay.Before we had children I worked for a major health ins. co. in Chicago,so I am pretty familiar with this.I would stay away from this plan.If you are looking for a type of health ins,I strongly suggest a Health Savings Account.This is the type of plan that we have and it has saved us a great deal of money.We are very happy with it so far.As much as anyone can be with a health ins.  
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chicken lady
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| Posted: March 31 2008 at 5:29pm | IP Logged
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We have two friends who love these programs. They have used them for years and have never had a moments problem. Hope that helps!
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mary theresa
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| Posted: March 31 2008 at 8:29pm | IP Logged
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We like the idea of MediShare because we have philosophical objections to the tyranny of insurance companies.
We know they could screw us. But this particular group, Medi-Share, has never hung anyone out to dry as long as they've been around. They are required by law to emphasize that they are not an insurance company. They don't raise their rates on you if you become high-risk. Each kid you have doesn't make the "family" plan more $$.
Martha wrote:
My understanding is that you go in without insurance (which can make it problematic to get regular care that isn't life-threatening) and ask them to bill you for it. When the bill arrives, you submit it for sharing. Frankly, I just don't see that working a LOT of the time?
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Yeah, I don't like this part much.
You do have this insurance card thing that you present. If they won't accept you, you tell them to call the number while you wait. Our Medi-Share contact says they get this alot, but the providers are usually satisfied after talking to a Medishare person.
They do have a PPO-type thing and those providers on that list will just bill Medishare. Using those providers is 40% off.
The "plan" we are considering has a $250 per incident fee. For example, Pregnancy is an "incident," and well-babys, if they were covered, would be an incident. KWIM?
My family practice well-babys run $100-200 for the basic stuff. (I don't get any immunizations) So, I'd be paying the "incident" fee for them anyways. I plan to just space the well-babys out alot. for example, for my 3mos old I'll just do 6, 12, 18 mos.
As far as routine pap smears . . . I don't do them -- just wait till I'm pregnant.
I guess I hadn't thought about the mammograms seeing as I'm only 25. Good point, Martha.
I guess this seems a good fit for us because we are just not doctor-going people. we do alot of alternative care stuff, which Medishare says they like and will pay for if an MD recommends the care. (We know a MD who will do that for us if nec.) And M-S will pay for Chiropractic care related to pregnancy -- which is great, b/c our Anthem plan doesn't.
Sorry if this is boring or confusing. I'm thinking out loud . . . 
I'm appreciating your feedback everyone!
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Mary Theresa
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Martha
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| Posted: April 01 2008 at 8:43am | IP Logged
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I see what you mean about not being "doctor-going people", because we aren't either. I've got some kids who literally haven't been to a doctor in years. Let's face it, after the 3rd or 4th baby, I know how to treat the common cold and detect when it's nt a common cold just as well as any doctor.
BUT preventive care such as pelvics, routine blood work, or physicals for adults is not the same. My dh has type 1 diabetes for example. It's vital, literally, that he get those check ups because a slight problem noticed early can be a real life-saver.
Also, with my itty babies, I don't hesitate to haul them into the dr if I'm the slightest bit concerned. Those little ones can go from 100% healthy to a sniffle to needing oxygen in less than 24 hours.
Their literature specificly says they only cover AMA recommended treatment and you have to request a an exception to get otherwise, including for homopathic remedies, so I'd double check that before committing if it's something you would do a lot of.
If you already have a dr and/or ob, I'd call them and ask them about these plans. What is their experience with it? Would they keep you as a patient? Esp your obgyn. I love mine and it would be VERY hard on me to have to change. I went thru 5 kids before I was blessed with her and don't want to go back!
I guess it just depends on how much ready cash youhave at hand at any given time. To *me* if I had $250 to drop in the bucket at any time, I wouldn't be worried about insurance to begin with, kwim?
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Martha
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mary theresa
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| Posted: April 01 2008 at 11:57am | IP Logged
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Thanks Martha! I am putting together a list of questions to call our guy and ask before we make our final decision, so talking this out helps!
And I will call my ob on your advice! Thanks! Though I'm not SUPER attached to staying with them. . .
Martha wrote:
Their literature specificly says they only cover AMA recommended treatment and you have to request a an exception to get otherwise, including for homopathic remedies, so I'd double check that before committing if it's something you would do a lot of.
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We did talk to them about this. They PREFER alternative care, but have to say the AMA thing because of ppl possibly abusing the "priviledge". Does that make sense?
Also, "medically indicated" doctor visits are covered. I understand from out contact that that means sick-baby visits, diabetes check ups, etc. I will double check that too, though.
We don't have $250 lying around either.
But see, if we go from paying 650-700 bucks a month to paying $365 a month and we set aside half of the savings each month for the "incident" fund that will help.
We just can't swing the regular insurance monthly paym. and rates keep going up.
(There is some kind of tax exempt insurance fund thing that you can do if you are a small business owner, which my husband is.)
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Mary Theresa
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Martha
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| Posted: April 01 2008 at 1:56pm | IP Logged
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hmmm...
okay to a certain degree I see what you are saying, but and it's a big BUT...
the bottom line is the only thing you can count on is what is in writing.
if they are telling you different or a modified version of what they have put in writing, then I'd ask for more detailed information be provided IN WRITING
otherwise you are gambling that the particuliar rep you spoke to actually knows what they are talking about and the company will stand by it - which won't be much comfort when you are jumping through hoops trying to get an expense covered.
sorry if I come across as cynical...
insurance has been a rough round through the wringer for us far too many times...
Also it's not just about whether you want to which from your dr. it's about whether you would want to switch to one of theirs. Will they give you a list of their preferred providers in your area?
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LisaR
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| Posted: April 01 2008 at 2:35pm | IP Logged
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We looked into Medi Share and also Samaritan. Samaritan is located in my city. When I called about each of them, about two years ago, they said the first step would be to take an inventory type quiz about our health, etc. With both I asked them to give me examples of the questions and they said: do you or your dh smoke? or does anyone living in the home? my answer was no. the next question was "do you or your dh drink any kind of alcohol, or do you allow anyone in the home to?" well, um, on sundays I'll occasionally have a glass of wine, dh drinks a beer or two once or twice a month at most...
the reply I got was that they have a 100% tetotaler policy and that we would not be a "good fit". The Samaritan people even before hanging up gave me a scripture quote to "meditate on".
So, that ended that quest. I suppose some people lie?? on the inventory, but I knew I would not be able to do that. It kind of irked me, to tell you the truth...
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Nina
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| Posted: April 01 2008 at 5:48pm | IP Logged
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Lisa,that was another reason why we will not get these type of companies.It's always up to some Protestant standard as to if they will pay for anything.Also with medi-share,we were asked to provide a statement from our pastor that we were in "good standing in the church".My whole family are good catholics and the priest would have no problem with writing the letter,it was just the principle that offended me.How judgemental are these people?I don't think that anyone likes the conventional ins. companies,but I could not put up with medi-share.As to alternative med,a lot of the standard ins cover this in their policies,you just have to check.
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LisaR
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| Posted: April 01 2008 at 7:19pm | IP Logged
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Nina wrote:
| Also with medi-share,we were asked to provide a statement from our pastor that we were in "good standing in the church".. |
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Ah yes!! that was the other thing. The Samaritan Ministries guy wanted to know what Church I belonged to, and that my Pastor would have to send a letter. I said "Holy Family" and he thought I was speaking of a Holy Family Ministry Home Church that is in the area. There was a huge silence when I corrected him and told him, no, the Catholic Holy Family.... 
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Lisa
dh Tim '92
Joseph 17
Paul 14
Thomas 11
Dominic 8
Maria Gianna 5
Isaac Vincent 9/21/10! and...
many little saints in heaven!
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4Real Forums : Tea and Conversation
Topic: Do any of you use Medi-Share?
