Uninsured in Alabama — and what we did about it

Hi, we’re an uninsured American family. Ok, we do have homeowner’s insurance and car insurance and life insurance, so we’re not totally living on the edge. But no, we do not have traditional health insurance.

Our Story

Health insurance has always confused me. What exactly am I paying for? For us, 2013 was a fairly uneventful year, medically. By October of that year we were deciding which health insurance plan to use for 2014. I crunched some numbers and realized we actually would have come out cheaper that year had we not had insurance at all, but had just paid out-of-pocket for the few needs we had. I called our insurance company and asked for a refund.

The girl on the phone was confused. I explained that we ended up paying more due to having insurance than if we hadn’t had it at all, so would they refund me the difference? Obviously, the answer was no, but what concerned me more was that she didn’t understand why I was asking for a refund. I explained we paid our monthly premiums, which, in part, pays the insurance company to negotiate our bills for us. However, they had apparently done a poor job as we would have come out cheaper NOT paying them at all and just paying the healthcare providers up front. She still wasn’t tracking.

By the end of October, my husband sustained a foot injury which required a lot of attention and then in November we found out I was expecting our second baby. So by the end of 2013, we broke even. However, I was still concerned with how much we were paying between premiums, deductibles, and co-pays. It didn’t seem like we were getting a deal.

In the summer of 2014, our second baby boy was born and we were thrilled. Unfortunately, at just three weeks old he was admitted to Children’s of Alabama for an 18-day stay to treat an infection. It was all very scary and stressful. Thankfully, he came through it all fine. However, between his birth and his additional hospital stay, we were left with thousands of dollars of medical bills. Again, how was insurance benefiting us? My pediatrician assured me we would’ve been crippled with the dollar amount if we hadn’t been insured.

I requested a line item bill from the hospital so I could see for myself. I was stunned at the markup. A standard pack of diapers was $36. A bag of saline and a needle for his PICC line was over $10. Every single, even seemingly-small, item used or requested in a healthcare facility is tracked and billed. But here’s the thing, your insurance company certainly isn’t paying full price for those diapers or that bag of saline. That’s why the hospital is placing such an exorbitant charge on it in the first place. They know the insurance company will negotiate it down. But are they negotiating it down to a truly fair price? Are their negotiations worth what you’re paying them every year?

Thankfully, we finished out 2014 with no more major medical issues and went into 2015, which was also uneventful medically. By the end of 2015, when we were once again deciding which health insurance plan to use, I came across a Facebook post in my homeschool curriculum group, of all places. A mother was asking for advice on health shares. It was a fascinating conversation. What in the world was a health share? I looked it up and was amazed at what I found. It seemed too good to be true.

Here was an alternative to traditional health insurance, that didn’t leave people vulnerable to crippling debt that can come without having coverage of any kind. It was a way to truly be in control, not only of our medical bills, but also our overall health.

The Switch

My husband and I talked it over. He was leery at first. After all, all we had ever known was traditional insurance. This seemed like a big risk, especially with two young children to consider. We watched some moving testimonial videos of people who had made the switch. Almost every single person talked about how nervous they had been leaving the norm. We sought wise counsel on the matter. We talked with those who did not participate with a health share but who could consider what we were looking at and give us guidance objectively. In the end, we made the plunge. We did not sign up for health insurance for 2016.

I was anxious. Had we made a huge mistake? I kept reminding myself, if it didn’t work out, we could always re-enroll in traditional health insurance in the fall. It was basically an experiment for just one year. I was also excited. Our health share certainly didn’t have a “network”. We could see whichever healthcare provider we wanted. Our health share also encouraged lots of natural healthcare alternatives.

Now, I’ll quickly break down how our health share works. Anything under $300, we pay for. Well visits, sick visits, minor injuries, chiropractic care, etc. Anything that costs more than $300, we submit to our health share and the cost is covered by the members. Let’s say we have an ER visit and all bills total $1,000. We would pay the initial $300 then the remaining $700 would be covered by our health share members. Again, this is a very basic breakdown of how it works.

And so January 2016, our uninsured journey began. The year was mostly uneventful, until the very end. I had my first miscarriage after Christmas and ended up in the hospital. I came home December 31, 2016.

When I received my hospital bill for my 14-hour hospital visit it was around $47,000. They had automatically given me a “discount” so the final bill was $25,000. This “discounted” amount still seemed exorbitant for 14 hours, especially since it did not include the ultrasound, anesthesiologist’s fee, nor my doctor’s fee. I called the hospital and ended up being able to negotiate it down to $5,000. When it was all said and done, the whole ordeal was around $7,000. We submitted our bills to our health share and began receiving the money to pay for it.

But along with the money, we received cards, notes, and letters from these members. Some empathizing with the deep pain we were walking through, almost all praying for us. It was truly touching and humbling. I have saved almost every single note, card, and letter we received. Strangers praying for us and writing out Scripture, sharing stories.

We have since had lots of expensive medical needs. We’ve even had to seek help from a fertility specialist. Being part of a health share has been a comfort.

Yes, it is expensive at times since we come out-of-pocket up front. There have been times when we’ve had to decide which non-urgent medical need takes priority.

However, one way we have been able to off-set upfront costs is to take advantage of using a flex card. We’re able to put pre-tax dollars in this account via my husband’s employer, and we use that for random sick visits or planned check ups. We estimate how much we’ll need for the coming year and go from there. Participating with a health share has given us more peace of mind than any insurance company ever has. We know exactly what we’re paying for, and typically we know exactly how much we’ll have to pay. We don’t wait around to see if or what the insurance company decides to cover.

I will admit one frustration of being self-pay is the shocking lack of knowledge most doctor’s offices have in regards to charges. Whenever I have called a doctor’s office ahead of time to ask how much a visit or procedure will be, they do not know. They either have to call their central billing office, ask their office manager, or give me a vague “range”. I’ve said before that if I’m going to a salon to get my haircut, I would never set up an appointment without knowing if it was going to cost me $50 or $500. Why would I walk in blindly to a healthcare facility to receive a service? Yet this is what often happens — especially with insurance. One of the major downfalls of the majority of our society being insured is that they do not realize how much healthcare costs. People have no idea if they’re getting a good deal or not. And mostly, they’re not.

Systemic Healthcare Issues

I do not propose to offer a solution to our country’s healthcare crisis. I have learned over these past few years that the problem is not just with insurance companies and their executives. Certainly, they are part of the problem. But other parts of the problem are with healthcare facilities, “boards” who run these facilities, and doctors who have no business sense or do not know how much their services cost or if their rates are comparable. Medical supply companies and pharmaceutical companies are another part of the problem. What they charge a pharmacy to purchase their medications is outrageous. I’m certainly not anti-profit. However, a drug I’m currently on would cost me $2200/month if I purchased it from a big-box pharmacy. But I’m able to purchase it for $267/month from a local pharmacy. At first I was very upset that the big-box pharmacy would place such a high markup on that drug. But I learned from an employee that the pharmaceutical company sells it to the big-box pharmacy for a much higher price than they sell it to local pharmacies, because they know the bigger companies will pay. The greed is astounding.

If you were going to purchase diapers and Walmart charged $10/pack and Target charged $50/pack, where would you go? Also, companies keep their prices competitive for obvious reasons. Why don’t pharmacies or other healthcare services? I would guess it’s because they don’t have to because most people don’t know they’re being ripped off.

As I said, I’m not proposing a solution as the problem is complicated. What I am proposing is an alternative. If your family is paying too much in monthly premiums and not getting enough coverage, consider a health share. There are several out there. I realize this is not a solution for every family, but it is a viable solution for a lot of people, and sadly, a lot of people have no idea they exist. I’m always happy to share what I know and to share our personal experiences. Feel free to reach out to me to ask questions if this is something your family is considering.

There’s no perfect way to tackle healthcare, but I do believe some ways are better than others and for our family, a health share has been the better way.

(Courtesy Birmingham Moms Blog)

Laura Wilder lives in Leeds, homeschools her two sons (a daughter is on the way), and is a contributing writer for Birmingham Moms Blog.