CMH Ministries Health Insurance

brij2006 · January 2016

Just wanting another opinion on this.

DD is currently on my health insurance plan. My employer doesn't offer for it to be taken out of my check (don't even get me started), so I have to pay them for it after tax. It went up from $200/month to $265/month beginning in March. We did some quoting for her on her own plan and it doesn't make much sense to take her off since her doctor isn't covered by the cheaper options that have higher max OOP's.

So I'm looking into some other options for her.

Anyone have any thoughts on CMH Ministries healthcare? It's endorsed by Dave Ramsey, their reviews are amazing, our church uses it, and it seems like it would be a good fit for us. It's a risk sharing healthcare option. So you work with your provider as being a cash paying customer, then turn the bills into CMH for payment. The only downfall I'm afraid of is that the max is $125,000/year. You can purchase "Brothers Keeper" that gives you an extra $100,000/year in coverage. The $100,000/year doubles every year you have the policy, and maxes out at $1mil. The cost for Brothers Keeper is a $40/year membership fee, then $25/quarter.

We were thinking that we would go with the "Silver" plan for DD since the $1,000 OOP is comparable to my current plan. H is thinking we could go to the Bronze plan and be just fine as well, but the premium difference isn't too bad to me.

Is this a ridiculous thought to switch to? DD is very healthy and we vaccinate her. So her appointments will be the regular annual checkups plus any vaccinations she may need. We've brought her in 1 time for an illness, and that was an ear infection. The charge for that was $95 (had to pay my $50 specialty visit co-pay anyways) and $12 for the antibiotic.

I feel like this could be an area where we save a ton of money monthly, but I want to make sure I'm not overlooking anything.

Here's a breakdown of their plan comparisons:
Gold, $150/month

Silver, $85/month
Bronze, $45/month

Adding Brothers Keeper: $40/year plus $25/quarter

	Gold	Silver	Bronze
Personal responsibility	$500 per unit, per year (bills per incident must exceed $500; please see example above)	$1,000 per medical incident	$5,000 per medical incident
Sharing limit	$125,000 per illness	$125,000 per illness	$125,000 per illness
Sharing limit w/Brother’s Keeper	Unlimited per illness	An additional $100,000 per illness, per year; up to $1 million	An additional $100,000 per illness, per year; up to $1 million
Hospitalization (inpatient/outpatient)	Included	Included	Included
Surgery (Performed at a facility that meets accepted standards of care)	Included	Included	Included
Doctor’s office visits	Incident-related	Not included	Not included
Prescriptions	Incident-related	Not included	Not included
Physical therapy/home health care	Up to 45 visits per incident	Not included	Not included
Maternity	Up to $125,000 per pregnancy or unlimited w/Brother’s Keeper	Only hospital treatment (up to $125,000 per pregnancy) or up to $2,500 for midwife services per pregnancy	Only hospital treatment (up to $125,000 per pregnancy) is eligible for sharing
Alternative care	Not included	Not included	Not included

als1982 · January 2016

Does your current insurance have a maximum benefit? Honestly, when it comes to healthcare, $125,000 is nothing. Should she require a stay in a pediatric intensive care unit, you're likely looking at $10,000 a day, minimum. And considering your financial situation, you likely wouldn't qualify for Medicaid or financial assistance from the hospital unless you sell your land and drain your bank accounts. I personally wouldn't risk it.

hoffse · January 2016

That's an interesting option.

The only "gotcha" I see here is that they describe the brother's keeper add-on as an add-on for illness, rather than "incident." I would confirm that it would also kick in for injury, because it sounds like you would be most likely to use it in a catastrophic emergency (car accident, etc.). Assuming it qualifies, I would absolutely add that on. A bad injury can easily exceed that $125K limit, and an extra $140/year is really not very much.

I would also make sure to understand what they mean by "facilities that meet acceptable standards of care." Make sure her doctor and a nearby hospital would be in network.

I would do the gold plan+brother's keeper so you don't have a maximum benefit ceiling.

brij2006 · January 2016

als1982 said:

Does your current insurance have a maximum benefit? Honestly, when it comes to healthcare, $125,000 is nothing. Should she require a stay in a pediatric intensive care unit, you're likely looking at $10,000 a day, minimum. And considering your financial situation, you likely wouldn't qualify for Medicaid or financial assistance from the hospital unless you sell your land and drain your bank accounts. I personally wouldn't risk it.

*SITB****

Our current health plans do not have a maximum. That's the only part that scares me. If something drastic were to happen and she needed hospitalization for a long period of time, I know that $125,000 would be maxed quickly.

Other thoughts were to just go with the gold plan plus the brothers keeper. It's still cheaper than what we're going to be paying for her, and the deductible is much less too. Then there's no maximum.

@hoffse There's no PPO's or anything. You choose the doctor or hospital, tell them you're a cash paying customer but have CMH as well, then they do the cash discounts and any assistance there may be offered, before billing. We would have to do the legwork of being the interim person with billing, but I feel comfortable with that.
The part where it talks about "facilities that meet acceptable standards of care" is mostly meaning that they do not cover care at places like Planned Parenthood. By my research, they also do not cover IUD's or the morning after pill. However, I currently work for a Christian based company and our current insurance does not cover any of that either.
And it better be a long time before DD needs any of those. ;-)

MommyLiberty5013 · January 2016

Food for thought: I have read that in some of the sharing types of HI, that are religiously-based and this sounds like it may be, that they have denied peoples' claims because the cause of the person's treatment was due to what the group would perceive as immoral.

For example, a teenager gets drunk and crashes his car into a tree. The teen, making a poor life choice (and to some also an immoral, unbiblical choice [drunkenness]) could avoided the problem by not consuming or over consuming. He needs medical treatment, but the claims are denied due to the group not wanting to pay out for someone's immoral choice.

I see it both ways. If you agree to pay into such a group then you are also buying into the collective's perspective on what should get paid and what wouldn't. That seems fair. But, on the flip side people make poor choices and there also needs to be some level of mercy and grace given.

I would just look into HOW they determine valid claims. Obviously for a child as young as your DD seems like, poor choices are not yet an issue in her life.

mgarza1231 · January 2016

We actually have used CHM for a few years. It works really well for our scenario, we are more natural-minded and tend to lean towards homeopathic remedies for our family. It is a Christian based company so keep that in mind. They will not cover you if you or anyone in your home smokes. We have the bronze tier and pay $135 for a family of 4 but it would not cost any extra to add on any future children we may have.

This is our scenario but I also have lots of friends who use it as well and have had to claim large claims and they have paid all of their claims. Feel free to shoot my any questions you may have.

hoffse · January 2016

MommyLiberty5013 said:

Food for thought: I have read that in some of the sharing types of HI, that are religiously-based and this sounds like it may be, that they have denied peoples' claims because the cause of the person's treatment was due to what the group would perceive as immoral.
For example, a teenager gets drunk and crashes his car into a tree. The teen, making a poor life choice (and to some also an immoral, unbiblical choice [drunkenness]) could avoided the problem by not consuming or over consuming. He needs medical treatment, but the claims are denied due to the group not wanting to pay out for someone's immoral choice.
I see it both ways. If you agree to pay into such a group then you are also buying into the collective's perspective on what should get paid and what wouldn't. That seems fair. But, on the flip side people make poor choices and there also needs to be some level of mercy and grace given.
I would just look into HOW they determine valid claims. Obviously for a child as young as your DD seems like, poor choices are not yet an issue in her life.

Yeah that's what concerns me. Frankly, I would want something that was a cut & dry contract. Reading between the lines, it sounds like they can deny coverage if they think the accident or illness was due to something they consider immoral. I know your DD is very young, but could they deny coverage for parental behaviors they disagree with (ie: kid gets injured while parents are throwing a party with alcohol present)? Hopefully I'm wrong about that and they have a list of things they won't cover at the outset so you at least know where the parameters are.

Regardless, if you go with this I think you need to do the gold plan with the brother's keeper thing so there isn't a ceiling on your coverage for her. Ceilings, caps, lifetime limits, etc. were some of the things that got heavily modified in Obamacare because they screwed a lot of people over who needed catastrophic care. Regardless of how you feel about Obamacare, it's worth avoiding a plan with a ceiling if you have that option.

Last point here is if you go with this, I would make sure to have a plan about what you guys would do if she in an accident and you have to float hundreds of thousands in medical bills while waiting for this group to pay you back. I know you all have assets, but if your health care providers wouldn't be billing this group directly, you're going to be responsible for the initial financial hit.

vlagrl29 · January 2016

Kids can rack up medical bills like crazy. DH and I rarely go to the doctor but DD has gotten sick way more than we have. I would keep it with an insurance company but that's just my comfort level.

brij2006 · February 2016

My biggest fear would be that H and I do drink. Not in excess, but we do that occasionally at home. Never with DD and especially not with a vehicle involved (my brother was killed from drunk driving, it's not funny to me). So I wouldn't want there to be any backlash if something were to happen and any alcohol had been involved and our claim is denied. That would be a very drastic situation if that were to arise at all. That's the only thing I can think of where they may deny a claim on her. It's not like she's going out drinking and doing drugs, and if we like having her on a plan like this then maybe we would re-visit it in her teen years

I need to call them anyways and make sure first that it's an option to put her on a single plan alone, or if they need a parent on the plan as well.

@mgarza1231 Have you had many claims with them at all? It may be a good option for our family as well, but I want to make sure I'm not missing something with it. We rarely go to the doctor besides the usual annual checkups.

CuriousKiddosMama · March 2016

Did you ever decide to go with this? I'm looking at this as an affordable option for us until dh gets benefits again. He has a couple good job leads so it may not be long, and without Obama care I would go without for myself, but I also don't want to pay the freaking penalty and we need it for sure for the kids. I'm mainly wondering about the monthly cost share (Bill) you get in the 15. And if I sign up I could use you as a referal and you get a free month. Let me know! Thanks!!

brij2006 · March 2016

@curiouskiddosmama We did not go with them, yet. My employer is supposed to be shopping around our group plan for a better rate. If it doesn't come back with a better option, then we'll dig further into moving DD to CMH.

You can always call and chat with them. They were very helpful when I called.

It would definitely be a better option for you guys than Cobra or going without. Even if you only end up using it short term.

formerlyGDaisy09 · March 2016

have you checked if anything else is available on the ACA open market? I don't like the caps and the fact that coverage could be denied for moral/religious reasons. I thought that the ACA outlawed caps on coverage; but maybe that was just lifetime caps.

$125,000 is nothing in healthcare. a dear friend of mine's little girl (2 1/2 year old) was just diagnosed with acute leukemia, initial treatment is a 1 month stay in the hospital and an intense course of chemotherapy...followed by a 2 1/2 year treatment plan; under this plan that would be considered one illness (as would any screenings down the line) and the $125,000 would probably barely cover that first month. We had a play date with her 2 1/2 year old over Christmas, 2-3 months ago, and she was 100% healthy.

short+sassy · March 2016

mgarza1231 said:

We actually have used CHM for a few years. It works really well for our scenario, we are more natural-minded and tend to lean towards homeopathic remedies for our family. It is a Christian based company so keep that in mind. They will not cover you if you or anyone in your home smokes. We have the bronze tier and pay $135 for a family of 4 but it would not cost any extra to add on any future children we may have.

This is our scenario but I also have lots of friends who use it as well and have had to claim large claims and they have paid all of their claims. Feel free to shoot my any questions you may have.

I didn't realize smoking is considered a sin (sarcasm).

I'm not saying these plans may not be a great idea for some people, but it sounds like they leave themselves huge, gaping holes of gray areas that they can wiggle themselves out of paying claims. Which I find very UN-Christian-like.

brij2006 · March 2016

short+sassy said:

mgarza1231 said:

We actually have used CHM for a few years. It works really well for our scenario, we are more natural-minded and tend to lean towards homeopathic remedies for our family. It is a Christian based company so keep that in mind. They will not cover you if you or anyone in your home smokes. We have the bronze tier and pay $135 for a family of 4 but it would not cost any extra to add on any future children we may have.

This is our scenario but I also have lots of friends who use it as well and have had to claim large claims and they have paid all of their claims. Feel free to shoot my any questions you may have.

I didn't realize smoking is considered a sin (sarcasm).
I'm not saying these plans may not be a great idea for some people, but it sounds like they leave themselves huge, gaping holes of gray areas that they can wiggle themselves out of paying claims. Which I find very UN-Christian-like.

I think this is more so they can keep the risks involved in this pool as lower risk. Not because smoking is a sin, it's just a huge liability and costs healthcare companies tons of money every year.

It's a pool of low risk individuals who share similar lifestyles. That's how the cost stays low for everyone.

CuriousKiddosMama · March 2016

We would also be purchasing the brothers keeper plan which would cover anything major up to an unlimited amount if we get the gold plan. And it's still much cheaper than what I'm finding else where. Vaccines and getting the cost of those figured out is the only thing I have left to do. Our little one will have a lot of them this year! So I guess Brij2006 if you do decide to do this for your daughter, let me know so maybe we can get a free month

brij2006 · March 2016

@curiouskiddosmama I will definitely let you know.

Another option is to look into Samaritan Ministries. Same concept but they have a higher max.

Liberty Health Share is another company set up this way as well, but I haven't heard as much about them.

short+sassy · March 2016

brij2006 said:

short+sassy said:

mgarza1231 said:

We actually have used CHM for a few years. It works really well for our scenario, we are more natural-minded and tend to lean towards homeopathic remedies for our family. It is a Christian based company so keep that in mind. They will not cover you if you or anyone in your home smokes. We have the bronze tier and pay $135 for a family of 4 but it would not cost any extra to add on any future children we may have.

This is our scenario but I also have lots of friends who use it as well and have had to claim large claims and they have paid all of their claims. Feel free to shoot my any questions you may have.

I didn't realize smoking is considered a sin (sarcasm).
I'm not saying these plans may not be a great idea for some people, but it sounds like they leave themselves huge, gaping holes of gray areas that they can wiggle themselves out of paying claims. Which I find very UN-Christian-like.

I think this is more so they can keep the risks involved in this pool as lower risk. Not because smoking is a sin, it's just a huge liability and costs healthcare companies tons of money every year.
It's a pool of low risk individuals who share similar lifestyles. That's how the cost stays low for everyone.

Thanks, that at least makes more sense.

Years ago, I interviewed for a job that would not hire smokers...they would test for it, just like for a drug test (and they did drug tests also)...and their reason for this unusual policy was they received some kind of super sweet deal from their health insurance if they didn't hire smokers.

jordanpricecheck · March 2016

So true. My mom was in the hospital for a week and a half: total cost? Over $300k....

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