Skip to main content
You have permission to edit this article.
Edit
Health Insurance Guys: Health care sharing ministry plan costs compared
Health Insurance Guys

Health Insurance Guys: Health care sharing ministry plan costs compared

  • Updated
{{featured_button_text}}
Tom Schrette and Alan Cash

Tom Schrette and Alan Cash

Dear Tom and Alan:

I read your recent columns on health plans that are cheaper than many of the ones available out there. Can you give me some specific examples?

Gavin

Tom: OK, Gavin, just keep in mind that we’re comparing apples and oranges because the requirements of the Affordable Care Act (ACA, Obamacare) are detailed and every plan on Covered California complies.

The plans you are asking about are Health Care Sharing Ministries (HCSMs). We looked up one that’s available in California to get some benefits and rates. Our quote was for a married couple in Napa, both age 40, with two children, 20 and 18.

One Share came up with three different types of plans: Catastrophic, Classic and Complete. The least expensive for the family of four was $350 per month with a $125 application fee.

This particular plan has a $5,000 deductible and a maximum payout of $300,000. The cheapest of the Classic plans is the “basic” at $613 per month. Finally, the least expensive of the Complete plans is $842 per month.

Al: We ran the same family of four scenario on the Covered California website. We’re assuming they make too much money to qualify for a subsidy (to make it easier on us).

Here goes: the least expensive plan available for them would be the Kaiser Bronze HDHP HMO at $1,311.62 per month.

The acronym HDHP stands for High Deductible Health Plan which also stands for Health Savings Account (HSA) eligible. So the $13,800 family deductible means pretty much nothing is covered until or unless somebody racks up that much in medical/prescription costs.

Being eligible for an HSA also means Gavin can invest up to $7,100 this year for a separate account to cover some of the many out of pocket expenses.

The next level up is the Kaiser Silver 70 HMO at $1,709.78 per month. A Silver plan typically means a $4,000 individual deductible and an $8,000 family deductible.

Both the Bronze and the Silver are HMOs (Health Maintenance Organizations) which means a primary care physician and a limited network of providers.

Not surprisingly, the first PPO (Preferred Provider Organization) is more expensive than either of the HMOs. The Blue Shield Bronze 60 PPO is $1,893.56 per month. The family deductible on this one is $12,600 per calendar year.

Tom: We should point out that the deductible on the Silver HMO and on the Bronze PPO don’t tell the whole story.

For example, if you have a $500 deductible on your car, you would expect the insurance company to pick up the balance in case of a claim. Not so with non-HSA health plans.

Once you meet the deductible, you are still subject to copays and coinsurance up to the Maximum Out of Pocket (MOOP). In the case of the Bronze PPO, the individual deductible is $6,300, but the MOOP is $7,800.

If two or more of the family reach the deductible of $12,600, they would continue to pay until reaching the MOOP of $15,600. Ouch.

Complete coronavirus coverage from the Napa Valley Register, St. Helena Star, and The Weekly Calistogan

This webpage contains all Napa County coronavirus coverage as featured in the Napa Valley Register, St. Helena Star and The Weekly Calistogan. This page will be updated several times a day as news comes in. Please bookmark this page to stay on top of local developments.

Submit questions to schrette@gmail.com or alancash@gmail.com.

The business news you need

* I understand and agree that registration on or use of this site constitutes agreement to its user agreement and privacy policy.

Related to this story