In NY, the only options in the individual and small group market are HMOs and EPOs with no out-of-network coverage. For most types of routine care, even the current narrow network options are fine. For more complicated injuries and illnesses, the difference in quality of care between the top tier, which is not covered by ACA plans in NY, and the mid and lower tier of care could be substantial. To be clear, I am talking about rare, but very expensive types of care, that most of us won’t need. Still, it made sense for me to consider where I would want to be treated if I had cancer or a serious injury and to try to obtain coverage for the possibility of needing it at a reasonable cost
In order to mitigate this risk I have coverage from Liberty HealthShare, which can be used as a supplement to a catastrophic or bronze plan. For a full year, this plan currently costs $3,713 for two people with a $1K deductible but will increase by $50 per month for a $1,750 deductible. If we had added this coverage for roughly $4K per year to our existing coverage, our deductible would have dropped from @ $15K per couple in-network and unlimited out-of-network to $1K.
Although they have reimbursed us for a very expensive specialist that doesn’t take any insurance in addition to other lower cost providers, I am not assuming that the full cost of every type of care will be covered. Still, some coverage for what care that would not have been covered at all is better than none.
Since health sharing ministries are considered qualifying coverage, purchasers avoided penalties for a lack of coverage. Since there are significant difference between this type of coverage and ACA plans, I would be hesitant to recommend them as a replacement for any existing coverage. On the other hand, they could be a great option for someone who otherwise would have gone without coverage or someone who understands the limitations and believes the savings and expanded coverage outweigh the restrictions.