Health Share plans and bowhunting?
General Topic
Now that I'm single and relatively healthy, my doctor suggested I try one of the "Christian health share" plans instead of expensive Obamacare. For those who don't know how it works, as long as you abide by the lifestyle rules (no smoking, no alcohol "abuse", no major pre-existing conditions) they pretty much cover everything out of the shared pool up to $1M a year. The cost for me is very affordable - $200 a month and after $500 "deductible" they cover 100% of everything. For scrips, you're on your own but have a discount card. I don't need any scrips anyway except for an occasional sinus infection.
But then I get the packet and learn that they can refuse to cover injuries sustained as a result of "engaging in hazardous hobbies". They list as examples, "Rock climbing, spelunking, skydiving, or bungee jumping", but not limited to those. So it's their discretion as to what they will cover.
My concern is that if I stab myself in the thigh while quartering an elk, impale my calf with a sharp staub, shoot off a mountain bike and break a couple ribs, fall and break an ankle, get bitten by a bear, you know, everyday stuff that happens with the kind of hunting and adventuring I do alone for about 100 days a year, will somebody on the panel determine that I am engaging in a "hazardous activity" and refuse to cover it? Maybe even an anti-hunter? You have to submit a detailed description of how the injury occurred so I can't just say I accidentally stabbed myself with an elk tine while riding a mountain bike. Their customer service people are no help, of course.
So for those who have such a plan, any thoughts? Mine is Liberty Share.
Lou, define Alcohol abuse. I read a thread here the other day that some of us might not be qualified for such a plan. ;-)
You bring up some good questions. Id like to hear some of those answers as well as im creeping up on retirement.
"Shared Pool"
You mean like socialist countries have;)?
This world is full of cheaters, I prefer you buy what you need (with your own money) and I'll do likewise.
Lou
At your age getting out of bed may qualify as 'engaging in a hazardous hobby' :)
I wouldn't risk something like that to their discretion.
Hmm ... I hate to sign contracts that have "waffle words" that are in the other party's favor. Reminds me of when you purchase a gun and they ask if you abuse alcohol (or drugs) ... my thought is that some people think ... "Like right at this instant? Nope".
Tax laws, Insurance contracts, guarantees and warranties ... all have this language, it seems. If it matters, I'll testify that I never saw you ABUSE alcohol. (Stories are just stories, after all).
Do they limit your "network"? If not, I'm wondering how they control costs.
South Farm, I hear you, but all insurance plans are effectively "socialist" because everyone pays into the pool and the healthy people subsidize the sick. No one can afford to "self-insure" anymore without risking bankruptcy, so we need something "socialistic". Obamacare health insurance forces me to pay for what I don't need - like maternity care, abortion coverage, contraception coverage, mammograms, drug abuse treatment programs, etc.. with a high premium and high deductible and high co-pay, just in case something bad happens. All I need is something that will cover catastrophic events and everyday injuries, but Obamacare doesn't allow insurance companies to offer those plans anymore.
These are based on the "Christian sharing" principle, and this one is run by the Mennonites. Others I've talked to have had great luck with them covering stuff, but none of them engage in my kind of "hazardous hobbies". My doctor is on this one herself, and she recommended it to me based on my health.
No, they don't limit the "network" - instead they negotiate pricing with the doctors. I'm surprised to learn how many doctors around here are in the plans already (Liberty, Medishare, etc.) and like it because the reimbursement is comparable to O-Care, but they don't have to go through all the paperwork and coding nightmares, which you well know. Otherwise you submit the claim yourself on the online portal and they reimburse you.
BTW, if you read online reviews it seems the people who have problems are too stupid to know how to submit a claim online. Those who do understand how it works are really happy.
Hey buddy, again sorry to hear about your situation.
As far as the "Health Share" insurance. There are many of those type of plans and they are great for the "Healthy" with a less than adventurous lifestyle. Yes, they could deny paying for a knife in the thigh or a elk tine in the thigh. Those type of share plans are well known for the practice of "cherry picking" members. I'm not bashing them as they have a place and serve many well. I've had several clients choose to go that direction because they don't want to do the ACA thing. I don't knock them in what they do and they do work well for many small families. I personally know of 5 of these type of share plans. Here in Idaho where I have been a broker for over 11 years we are kind of lucky as we created our own state based exchange and don't participate in the federal obamacare exchange. I am glad we did that. I would be cautious with the "Exclusions" that your share plan "CAN" use. I guess all I am saying is read the fine print very closely in whatever plan you choose.
Hunting is not dangerous so fire away. I’m a year older than you and in 5 months I’ll be on Medicare so I’ll be getting a big raise by not paying health premiums any more. That silly Part b premium will be a cake walk compared with the $650 per month I pay now. You’ll be there before you know it so worst case is you could do this one for a year or two then decide. People like us retiring before 65 get whacked pretty good so this sounds like a viable option for you. Good luck!
I just got rid of Obama care and got the Christian health care also, saves 400 or so a month ! My Psoriasis medicine was 500 dollar for small tube under O care . Not even half that on The Christian health care !
"Shared Pool" You mean like socialist countries have;)? Voluntary participation is NOT a socialist proposition. A collection is not necessarily collectivist, politically or economically
This world is full of cheaters, I prefer you buy what you need (with your own money) and I'll do likewise. Only, that is completely unavailable in the insurance market. Be it health, life, auto, GL, worker's comp., etc., insurance companies evaluate premiums demographically. The only way to truly score yourself is to abstain completely from coverage.
-Sorry, Lou. I don't want to derail. Just wanted to drop a note of what I consider clarification.
As for the concept, it is sound. We have our worker's compensation insurance through a group self-insured company of contractors. It is selective and we can disqualify ourselves from eligibility (in numerous ways)...but we tend to get an annual fat premium reimbursement for good loss history. I see these Christian plans as structured the same way.
Lou - I was on a plan like that for over a year. Good plan at a big savings over Obamacare and if you ask them questions up front, they will answer them. I always got great customer service. The plan I went with paid out a percentage of your claim based on total claims for the month, so there was some risk...but I'd do it again in a minute.
--Mitch
I think you are fine with hunting. Every Mennonite I know likes to hunt, and eat wildgame. Very practical outlook on life from that perspective. Plus the chance of ever getting seriously injured while hunting is statistically very small, probably less than very common "safe" activities of Hiking, backpacking, camping.
"Hunting is not dangerous"... "the chance of ever getting seriously injured while hunting is statistically very small"...
You guys need to follow me around in the woods. Between broadhead cuts, knife cuts, sliding down talus slopes, ramming a staub through my calf, knocking myself out and cracking ribs from a mountain bike wreck in the dark, puncturing an eardrum when I turned my head into a stick, falling 14 feet when taking out a treestand, being swept downstream through rapids, dodging a falling tree, being chased by a moose, crashing and getting thrown off an ATV, falling through ice, - and these are just the little things that immediately come to mind - I think my odds are a bit higher than the average guy who hunts back by Uncle Buford's bean field...
Thanks for the input. I'll do some more discovery about the vagaries of the plan, but I've already been accepted.
I don't like grey areas either Lou but I suspect you will have no issues. Sounds like you have a good setup with this plan.
Lou, you're self-incriminating!
Well, I just got the answer. Any injuries sustained during bowhunting would not be covered under the plan. They consider bowhunting to be a hazardous activity. So I have to cancel the plan and look for the lowest cost Obamacare plan offered on the state exchange.
Voluntary insurance is pure capitalism. They raise the rates as needed for the pool that has purchased through that provider. Any other subsidy, pooling, or requirement is indeed something else.
Surely there is more thorough language on coverage? I think any good lawyer could help if you injure yourself doing what many would consider a normal activity. I'd consider trying something like that if I was on my own and not employer-covered.
Franzen, they have a lengthy list of "hazardous hobbies". I had to call to have mine vetted. Bowhunting is on the list, as is riding an ATV. Mountain biking injuries are covered if you wear a helmet and gloves. I didn't bother to ask about fishing and running rivers on my Class IV pontoon boat since bowhunting and ATV riding just knocked me out of the coverage pool.
Glad I called before the December 15th cutoff for Obama.
I'm surprised anyone buys it then. I imagine a good chunk of the people who did aren't aware that they won't be covered for some of these things. Could be wrong.
Lou,
Haven’t been on in awhile, very sorry to hear about your wife.
I have some experience with Christian Medi-share. My wife had this as her insurance before we got married five years ago. Her parents have it as well.
For the most part it is ok. But there is some fine print that can cost you. My wife was diagnosed with Chrohns disease during this time and had lots of testing. Since some of these were “genetic screenings” we got stuck with a couple g’s out of pocket as the genetic screening didn’t align with their values. I fought it for months, no win.
The medication card got us 50$ off the 790$ per month prescription she needed.
Now, if you stay healthy and don’t have anything arise, it’s great. But if God forbid something did, you may be on the short end of the stick.
Julius
You forgot giardiasis...
I like the Ann Coulter health care plan but that's just too simple.
If the wording is grey why not be grey if there is a claim. cuts with knives happen in the kitchen as well as the back country and you can break an ankle as easy stepping off a step stool or getting out of your truck as crossing a fence.
I called again and spoke to someone up the ladder. Sure enough, "hunting" is considered a dangerous activity. They have a long list of stuff they won't cover. As Julius describes, you learn about it after the fact when you try to submit a claim, since the details aren't published. This sharing program is for people who are very healthy and spend a lot of time doing sedentary activities like gardening, walking the dog, going to the movies, going to church, and watching sporting events, etc..
Now that I'm going back on Obamacare I can drink more, and may start smoking cigarettes just for the hell of it. Obama doesn't give discounts for being healthy....
Don't forget to stop in at the doctor's office for every little sniffle Jaq. We'll foot the bill!
Jaq.......your standard answers should be "I got injured while gardening"....."while hiking"....."while grocery shopping"......"while cooking dinner". That should just about cover it.
I guess I would have them put in writing whether or not hunting is a "hazardous hobby". If they aren't willing to do that, I'd move on.
kota-man, they would do that. After my second conversation where she put me on hold to reference the hobbies that were concerning, she came back on and confirmed that bowhunting and ATV riding were on the list. She explained that they have to consider dangerous hobbies in the context of "what is best for all of the members". It seemed curious that mountain biking is ok with a helmet - how many broken bones, neck injuries, torn tendons and cuts are incurred from that compared to bowhunting?
I've canceled and moved on.
"I stabbed myself in the thigh with an elk antler tine while walking my dog...."
Heck Lou, you didn't even mention your little incident in Arizona!
I wonder if they cover any malady that might be incurred while procuring a resident guide for Wyoming at the local watering hole? :)
Hey Lou
Lets get drunk and stoned at Paul's on Friday night :) Nothing bad could come of that could it?
Lou, I have been a Liberty Healthshare member (along with my 3 boys) for a year now, and have referred 5 or 6 friends who have joined as well. I think it's great, no BS about reimbursements (after the "unshared amount", think deductible). My girlfriend joined as well, and she also became a provider for them, and says they're awesome to deal with. Happy to answer any questions you have.
I even get a $100 gift card for each person I refer who joins, so if anyone is interested shoot me a PM with your (real) name, state, email and phone number.
I would think sitting on the couch eating Cheetos is a bigger concern for this group than bow hunting. My bet is plenty of their members have that lifestyle.
Ace, I heard that from others too. But Liberty folks were very clear that any injuries sustained while bowhunting or riding an ATV ( scouting and cowboying) would not be covered. Other than an auto accident, those are probably the two activities where I would most likely sustain an injury that requires treatment. So they spooked me off.
Glad it's working for you, and hopefully you won't find out the hard way that something big isn't covered.
That's too bad about Christian Health, I was interested in pursuing that. If it makes you feel better our Obama care is now costing us ($18K Keiser or $22K Anthem) per year. This is for a family of four, all healthy with the largest deductible they offer. I just can't wrap my head around this, if anyone knows any better options I'm all ears. I may have to rethink my contracting career and find something with insurance.
Kota-man, that's good...join a Christian cooperative insurance plan and then LIE about how you got hurt. LMAO!!!
Matt, you might try some of the others, like Medishare. I know someone on that who said it works well, but he's not an outdoorsman.
Similar to the famed "golden horseshoe" that has made its rounds providing luck to Bowsite's extreme mountain hunters, I'm going to make a batch of golden gardening shovels so we can all carry them in our packs. When we get hurt, we'll be able to truthfully claim that were engaged in one of our favorite hobbies: gardening . You just have to make sure you stop every once in a while and actually dig LOL.
Oh boy, sounds like my dream of retiring at 62 is looking slimmer all the time. Lou, thanks for starting this thread and following through on it. Everyone's input sure sheds some light on health insurance and what they consider a hazards they wont cover.
Lou, You carry a spot or Delorme InReach on your hunts don't you? All those injuries and you keep on keepin on. Your one tough SOB!
I do carry a SPOT everywhere, since I spend so much time adventuring alone in interesting places. Always hope I'm conscious whenever the Bad Fairy strikes. Haven't checked into the other health sharing plans to figure out what they exclude.
Personally, with only another 1.5 years before Medicare eligible, I plan to get the lowest-priced O-Care plan available in my state that my primary doc accepts. Then I'll continue to play the O-Care taxable income game by living mostly on non-taxable (minimal - cap gains only) accounts again for the next year, so the premiums will be reduced to close to what the Liberty monthly share costs would be. But then I don't have to worry that some anti-hunting couch potato actuary will deny my claims if something catastrophic happens.
Sometimes being "poor" has its advantages.. :) I didn't make the rules, I only figured out how to play by them.
Sorry, Kota, my reply was actually in response to Tobywon above yours. Fingers move faster than the eyes sometimes. Sorry again.
The only way to know for sure is to ask, specifically, as you did. I specifically asked my life insurance company about things like getting mauled by a bear, crashing in a bush flight, etc. Lou, there are other cooperatives that will cost you less that will cover you while hunting, just shop around.
Or you could do what everyone else does and just BS the govt enough till they give you disability and Medicare. Might as well get your lap dog registered as a service dog while you're there and ask for a handicap placard for your car. If you can't beat em...
"You guys need to follow me around in the woods. Between broadhead cuts, knife cuts, sliding down talus slopes, ramming a staub through my calf, knocking myself out and cracking ribs from a mountain bike wreck in the dark, puncturing an eardrum when I turned my head into a stick, falling 14 feet when taking out a treestand, being swept downstream through rapids, dodging a falling tree, being chased by a moose, crashing and getting thrown off an ATV, falling through ice, - and these are just the little things that immediately come to mind"
Geez Lou, if we ever meet, don't take it personally if I stay about 20 feet away at all times...
I heard a commercial for Medishare and it was a member who was a guide in Alaska giving a testimonial.
