We’ve got healthcare! “Health share”, actually

Published March 27, 2017   Posted in How to Think

As we wind down our working careers and slide naked into our next life of full-time travel in an RV, figuring out our healthcare options was the major remaining task on our plates. After months of research, we’ve decided on healthcare.

Without making you read a bunch of text before spilling the beans, here goes: We chose Liberty HealthShare.

Liberty Healthshare is not health “insurance”, but it is exempt from Obamacare (thus, no penalties!).

Quick health check: I almost never go to the doctor. I work out routinely and lead a healthy life. We eat mostly vegan at home. Occasional drinks. Last blood test returned perfectly normal. More or less, I don’t need much in the way of insurance. My wife suffers from migraines, but she is as active and healthy as I am.

Why Liberty HealthShare?

We hate health insurance. In fact, we hate insurance in general. The insurance industry is a huge money-maker for large corporations in the United States, and there’s a reason for that. Thankfully, we have USAA for our car insurance – which helps to ease the psychological burden of maintaining insurance, but with healthcare, we didn’t want to touch the whole “Marketplace” thing if we could avoid it…even with subsidies.

Healthcare is also more difficult for full-time RVers, like us. Most traditional health insurance companies won’t cover health costs once you leave your home state. While we do maintain a home address, we won’t actually be at that address the large majority of the time. We’re travelers, damnit.

Insurance just doesn’t work for us. But, a health share can. You incur a medical expense. You submit a claim. Done. It doesn’t matter where in the United States you are.

What is a health share? More or less, you’re sharing the medical costs among those who are generally healthy. Monthly dues are all pooled together and collectively fund the healthcare costs of those who are members of the health share. Health share services are about as straightforward as anything I’ve seen in the healthcare industry.

Liberty HealthShare happens to be a non-profit organization, which means revenue is not the predominant factor in health services for its members. However, they aren’t required to cover medical expenses, either. More on that below.

How much do we pay for this service?

We signed up for Liberty’s “Complete” service account, which covers 100% of eligible healthcare costs up to $1,000,000.

As a couple, we pay $299 / month for service on both of us. We also paid a $135 signup fee upon acceptance into the program. The plan requires a $1,000 Annual Unshared Amount, which is Liberty’s way of describing out-of-pocket expenses.

There is no such thing as “in-network” doctors with health shares. For our $299 / month, we can go to any doctor at any hospital – a requirement for those of us who travel.

The downside of health shares

While health sharing services can be quite a bit cheaper and more flexible than traditional insurance plans, they also aren’t governed by the same laws that insurance companies operate under. This means that health shares are under no legal obligation to cover your medical costs.

In addition, most require their members to abide by certain ethical rules – such as no smoking or excessive drinking, etc. And if you’re skydiving and hurt yourself, they probably won’t cover those types of expenses. If you are engaging in selective activity that increases your chances of huge healthcare costs, health shares may not cover you.

Including pre-existing conditions. My wife suffers from migraines, which is a pre-existing condition. Liberty HealthShare will not cover migraine-specific treatment for the first year. While not ideal, I can at least appreciate the fact that we know that up front.

Health shares aren’t required to accept you. If you are overweight or lead an unhealthy lifestyle, you may not be a candidate for membership. That’s just the way it is, and it helps to keep costs down for all members.

Check out their “Do I Qualify?” page for more on how Liberty runs their ethical rules and system of beliefs.

Even with these downsides, Liberty HealthShare was a clear winner for us. It enables us to maintain our mobile lifestyle and allows us to meet the federal government requirement for healthcare at a reasonable cost. It also lets us avoid the whole Obamacare thing and the uncertainty around what it might look like down the road. Liberty HealthShare is a simple solution for us.

And, we like simple.

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Comments

56 responses to “We’ve got healthcare! “Health share”, actually”

  1. Thanks for sharing!!! I haven’t researched a ton of options at this point since I am still a few years away from retirement. I was hoping that the Republicans would have been able to tweak Obamacare to make it more friendly but we see that failed miserably. So we’ll see what happens in the future.

    • Steve says:

      Yeah, we decided not to wait before taking the plunge with a Healthshare account. Neither my wife nor I trust the government to put together something that makes sense for us, so no need to wait. 🙂

  2. Slow Dad says:

    Naked RV adventures? Now there is a mental image that is going to haunt me.

  3. TheRetirementManifesto says:

    Steve, great timing, as I’m just now starting to investigate health care options for my FIRE in June 2018. Health Share is rapidly rising to the top of my list, and I’ve added your article link to the Google Doc I’ve started on my “Investigation”. I look forward to hearing how it works for you, let’s keep in touch.

  4. That’s a great option! Not sure if your research led you down the path of buying a “non-compliant policy”. If so, I’d be curious of your thoughts. A non-compliant policy would in effect be a catastrophic health care policy only. Given you folks are so healthy it may be suitable (although not sure how much the migraine care for your wife would result in out-of-pocket costs). Catastrophic policies are really cheap, but since they are non-compliant you would have to pay the fee (“tax”) for not having compliant health care. All said and done though, even with the tax, it is still a reasonable option that many folks do pursue.

    • Steve says:

      I can definitely see that being an option, though it was never something that we had considered. My wife isn’t as much of a risk taker as I am, so she wanted something more encompassing than a non-compliant policy.

    • Physician on FIRE says:

      That’s an option I hadn’t considered, TGS. All we’re really going to want or need is catastrophic coverage. Seems crazy to have insurance and pay the fine, but it could work out in our favor to do so. Odd.

      Thanks for the tip!

      Best,
      -PoF

      • Definitely worth consideration. I’m retiring a little further down the road than you folks (PoF and Steve) so we’ll see what options I’ll have. But the one factor I’d weigh heavily is coverage for the kiddos. Catastrophic only may not be the best for the wild and free.

  5. Matt @ Optimize Your Life says:

    That’s really interesting. I was not familiar with health shares. I’m surprised that this type of coverage is acceptable under ACA rules, since they don’t have to cover you in certain situations. Interesting find.

  6. Apathy Ends says:

    Interesting, I had heard about these plans before but never dug into how they work. Sounds like a good solution for you two – another example of it paying to be healthy!

  7. I’ve never heard of a health share, but it sounds like a good fit for your current age. I’d probably look for a non compliant catastrophic plan were I in the market and mobile. Great post as I had wondered how being so mobile you’d manage insurance.

  8. hoosierfi says:

    I had never heard of a health share either until this article. It seems pretty cool and as you stated, living a healthy lifestyle, it seems like a good choice for you. I am going to dig into this more as it is very interesting. I am glad to see that they reward participants for living healthy.

  9. Joe says:

    That’s very affordable, but I don’t like no covering pre-existing condition in the first year. I’ll need to do a bit more research. We have some health concerns so maybe it’s better to stick with the traditional healthcare.
    Sounds like a great plan for you because you’re very healthy.

    • Steve says:

      We don’t like that part either, but, that’s the breaks. It was one of the only affordable options for our chosen lifestyle, so we’re okay with that limitation. After the first year, we’re good to go until we decide to switch to another company.

  10. Thanks for this super efficient summary. I recently learned about plans like this and you’re the first person I “know” who actually has one! Very cool. We know we’re going to need to look into health insurance coverage if I decide to pull the plug on my corp when we hit FI. It’s definitely a daunting task – which is why we’ve ignored it. For now. 🙂

    • Steve says:

      It definitely can be daunting! A subsidized plan through the marketplace might be a better solution if you’re stationary. For us, though – it just wasn’t an option that we could seriously consider.

  11. I have a coworker who signed up for a health share (I didn’t know what to call it at the time) for Catholics. I was vaguely familiar with this process, but it’s interesting to see the inner mechanisms of it.

  12. A number of readers have suggested health shares to us, so I will be interested to see what your experience is. The government has so removed the free market from buying health insurance, that I think many alternatives like this will pop up. I hope entrepreneurs are asking themselves (what is the Uber of health insurance)? One question … how do you cover the risk of health care that exceeds the $1M ceiling? Have you done any research on how common that might be?

    • Steve says:

      Not really. We definitely understand that something like that can happen. If we have a situation where healthcare will exceed $1m, then we have HUGE problems on our hands anyway, and probably nothing that we could have avoided. Things happen, it’s a risk.

      • My thoughts exactly on the “big problems on our hands anyway” in such a scenario. I really like what you have to say about this health share idea, and I’ll be excited to see how it all plays out over the next 5-7 years before I will probably be needing such a thing myself!

        • Steve says:

          I definitely plan on writing about our experiences, especially if/when we need medical services. I won’t be sugar coating anything. 🙂

    • Physician on FIRE says:

      There is an option for a health sharing plan with no spending cap via CHM http://www.chministries.org/catastrophicbills.aspx

      I had dismissed the sharing plans until I came across this. I’ll research more as we get closer to requiring a plan of our own.

      Best,
      -PoF

  13. less4success says:

    Not being required to cover your medical expenses, having a cap on payouts, and not being regulated as tightly are enough to scare me away from health shares. In the majority of cases, I suspect it turns out ok, but I’m wary of putting a decade’s worth of savings at risk. Not that I have an alternative proposal 🙂

    • Steve says:

      To my understanding, all insurance options have a cap on payouts, and no insurance plan that I’ve ever had covered everything. We definitely did our due diligence before we bought into Liberty, though. If they had a history of denying people reimbursements, we never would have signed up. 🙂

      • less4success says:

        Obviously it could be changed/repealed, but the ACA might disallow capping payouts: https://www.hhs.gov/healthcare/about-the-aca/benefit-limits/index.html

      • The ACA definitely got rid of the cap (also called lifetime maximum). I hope you’ll be OK with the $1 million per incident. My husbands medical bills likely exceeded that amount the year he almost died of sepsis at 37. As it was, insurance paid out over a quarter million – AFTER all the discounts they get. Not sure if these kinds of policies get you discounts from doctors/hospitals, or if you get charged the regular out of pocket price. If you’re charged the regular price you can burn through a million in the blink of an eye. But, as you say, it’s a risk based bet.

        • Steve says:

          I believe we are considered cash paying folks, so it’s probably just the regular price. A risk for sure, but definitely one that we’re willing to take at this point in our lives.

  14. In the Netherlands, I pay my share of the country’s healthcare costs for 1200 euros per year. That’s roughly $1400 per year. My boyfriend does the same. So you could say that for roughly $240/month we’re both covered for whatever is headed our way, minus an annual 380 euro co-pay if we actually need healthcare beyond seeing a general practitioner.

    Some things aren’t covered, by the way, such as unlimited physical therapy. You could pay more if you want that option included as well.

    I’m glad you two have at least some coverage if you would for example happen to slip and break a leg, or get into a car accident or something like that. Health problems can happen to young people with a healthy lifestyle, too.

  15. Health Shares sounded great until I got to the part about no treatment for your wife’s migraines for a year.

    As a migraine sufferer, I *know* how much that sucks. My sympathies for your wife.

    The part about ‘no legal obligation to cover your medical costs’ sounds concerning. What if you get some rare form of cancer — will they deny your medical claims? You mentioned skydiving, but it’s not clear what conditions might result in non-payment.

    • Steve says:

      As travelers, the Healthshare was the most affordable option…so while my wife didn’t like the pre-existing condition part either, she’ll load up on as many meds as she can before she quits and will make it through her first year the best we can. Our access to Mexico also helps us purchase extremely low cost medications – and this is something that we plan to take advantage of.

      They don’t specifically list out the things they won’t pay (like skydiving accidents, for example). What gave us the go-ahead for the Healthshare was simply talking to people who have and use Liberty.

      We aren’t all that concerned at this point.

  16. What a fantastic alternative to typical health insurance! I work in healthcare and know all too well that insurance companies are overly complicated, full of annoying contracts & networks, and exist in large part to make money. While this may not be the best “coverage” out there, it’s certainly worthwhile for us healthy folks that take care of ourselves 🙂 (& possibly an incentive for others to maybe quit smoking and drinking so much? One can hope at least!)

    • Steve says:

      Thanks Amber! Yup, always nice to have options. And I really don’t like the fact that insurance in general, but especially health insurance, is so damn complicated.

  17. It sounds like a good plan for you guys – thanks for sharing your costs and the specifics! It was something we were looking at until recently too, but health care is now going to be our biggest barrier to early retirement. Though we lead very healthy lifestyle – eat healthy, exercise, etc., we recently discovered I have a genetic disorder – one that will require “lifelong surveillance” and surgeries. That’s definitely pre-existing, but I’m glad we discovered it prior to FI so we can prepare.

    • Steve says:

      Boo! But yeah, much better to find out earlier rather than later so you can better prepare. I can’t imagine how that would feel if you found out a few months *AFTER* retirement.

  18. We’ve been with Liberty for over a year and have been pleased so far! Sounds like you made the best decision.

  19. Mrs. BITA says:

    Interesting stuff Steve. I had a vague idea that some churches had something like this, but no idea that it was offered in a non-religious context as well. The ‘no legal obligation to cover your your medical costs’ sounds scary, though I can see how being young and healthy, and having done some research on their reputation for payouts, that that may seem like an acceptable risk. I would be more worried about the $1,000,000 limit (ACA compliant plans are not allowed to have these limits, I thought. See https://www.healthcare.gov/health-care-law-protections/lifetime-and-yearly-limits/). I recently had a pretty minor surgery and the bills for that came to about $160k. Insurance negotiated most of that away, but the numbers were scary. Is that a lifetime limit or an annual limit?

    • Steve says:

      Hey Mrs. BITA – We definitely would NOT recommend a Healthshare account for anyone who isn’t relatively young and healthy. As your medical risks increase with age, then the need for something more “regulated” is probably the safer bet. And that $1,000,000 stipulation is *per incident*…not yearly, and definitely not over the course of a life time. 🙂

  20. This sounds like it is working well for you Steve. I’ve been following Michelle and Holly Johnson over at Club Thrifty too. We are set for employer (retiree) health care for the next six years. A lot can change by then, but it will be interesting to see how these plans work out for all of you.

  21. Secret Retirees says:

    Hi Steve – did you look into Medi Share as an option to Liberty?

  22. Thanks for sharing! My biggest question on early retirement is health care. I read all sorts of FIRE bloggers talking about how low their expenses are, and I just wonder what will happen if one of them gets cancer or has a major car wreck or something like that.

    • Steve says:

      A lot of this is about risk management. Some of us are prepared to take on more risks than others. Back before the mandate, I went several years with no health insurance at all, which saved me a BUNCH of money (that I ultimately wasted, but that’s another story). We are wise to assess our risks, but we don’t live our lives based on the “what ifs”. Anything can happen, we understand that.

      • SDD says:

        With regard to the migraines, has massage or needling been tried? I have a friend who suffered from migraines and they disappeared after she retired early!

        • Steve says:

          She’s had massages before, but they didn’t seem to make any impact. We both have a feeling that early retirement will have a positive effect on her migraines, though! That and getting out of Tucson. She’s apparently allergic to something here.

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