Medi-Share with a newborn

On May 24th, 2023, I was laid off from my full-time job, 2 months from my 30th birthday. I had never been laid off before and had to deal with the uncertainty surrounding unemployment for the first time. Although I have a mortgage and plenty of expenses, the biggest uncertainty post layoff was “what do I do about healthcare?” 

In this post, I want to walk you through my experience using health-sharing instead of traditional health insurance and what the experience/costs looked like with a newborn child. My wife went through her first pregnancy on our old health plan, then we switched over to Medi-Share the month after delivery. This will give you some perspective on the costs surrounding well-child visits and general newborn care through Medi-share.

Extending my Employer’s Health Insurance through Cobra

After I was laid off, I opted to extend my current high-deductible plan from my former employer. This meant paying for the entire premium, both the employee/employer side, 100% out of pocket. That was a whopping $1,630/month (later increasing to $1,864/month). This was a complete shock to me, but I felt I could sustain this briefly while looking for another job. 

Well, as you can imagine, life doesn’t always go as planned, and I ended up carrying that health insurance premium for far longer than expected. In fact, my plans shifted towards being self-employed rather than going back to the job market. This meant I needed a longer term plan for healthcare.

My wife got pregnant a few months after I was laid off. This made me even more stressed about losing health coverage. After looking at marketplace options, I decided to stick with extending our plan until after our child was born. 

Our son was born April 2024 and we made the switch to Medi-share the following month. The cost of premiums to maintain health insurance from my former employer through the pregnancy cost $15,606.

But some payments weren’t covered at all, much to our surprise.

We paid an additional $3,081 out of pocket. Total healthcare costs for 9 months of coverage, ended up being $18,170. If we had held on to this plan for the remainder of the 12 month period and paid 3 more premiums, we would have paid a minimum of $24,294 (not including out of pocket costs incurred for those 3 months).

But that’s not all - one of the providers we worked with through the hospital was not covered by our insurance at all. We had no clue and there was no way for us to know about this up front. Even worse, it was for very minimal tele-health. We were billed almost $900 for tele-health! This brings our additional out of pocket for the year closer to $4,000, but we chose to pay off this bill on a payment plan instead of paying for it upfront. 

So there you go - healthcare costs for a 9 month period with a pregnancy was about $20,000. Our 12 month total would have been over $25,000 if we continued to pay the premiums for 3 more months. 

Granted, this was healthcare through a pregnancy, which involved a C-section. My wife is expecting our second child in July of this year and we plan to do a c-section. I’m also personally dealing with health issues, so I’m racking up far more medical bills compared to the 2023-2024 period. We’re still using Medi-share. I’ll follow up after our new child is born to compare the cost of pregnancy this time around!

Switching to Medi-share with a newborn

We switched from the Cobra extended health insurance to Medi-share the month after Luke was born. Most, if not all medical visits were OBGYN related and well-child visits.

We initially had the AHP 3000 plan, which means that we would need to pay at least $3,000 out of pocket for the year. It’s similar to an out of pocket max for traditional health insurance. It’s similar to a low-deductible plan, so our monthly premium was higher ($843). After 

Program summary for 5/1/2024-9/30/2024

• Total billed: $706
• Discounts & Adjustments: $295
• My responsibility: $411.20
• Amount that went towards annual household portion (AHP): $193
• Total premiums paid over 4 months: $3,372

This covered 2 OBGYN visits for follow-up on a complicated delivery and 2 well-child visits. 

We soon realized that we weren’t on track to hit the AHP portion, so we should switch to a plan with a lower monthly premium. Nothing really changes other than the AHP amount and monthly premium paid. Luckily, there isn’t an enrollment period with medi-share - you can change plans at any time, but your AHP amount resets. This was worth it in our case since we only had $193 applied towards our AHP.

So we switched to the AHP 9000 plan, meaning we would need to pay at least $9,000 out of pocket for the year for expenses that were eligible for sharing. The monthly cost was $492.

Program summary for 10/1/2024-9/30/2025

Total billed: $860

Discounts & Adjustments: $390.75

My responsibility: $454.25

Amount that went towards AHP: $314.25

Total premiums paid over 5 months: $2,460

This covered 4 well-child visits. 

So for the 9 month period after switching from insurance to health sharing, $5,832 for the premiums and $865 for out of pocket costs (6 visits). $6,700 total for healthcare. 

Now, obviously this isn’t a one-to-one comparison since the traditional medical insurance covered pregnancy and a c-section. Also, medi-share covered an additional dependent since we switched to it after our son was born. It’s difficult to know what that pregnancy would have cost if we were on medi-share. However, I was assured by the medi-share staff that the maximum would be close to our monthly premium + AHP. Meaning, if we were on the 3000 AHP plan for that time period, we could have expected total medical costs for the same 9 month period to be around $7,587 for premiums + $3,000 in out of pocket costs minimum since the pregnancy would cause us to hit the AHP quickly. If true, this is quite incredible. 

However, even with medi-share, we have so much uncertainty around the cost of healthcare. It sounds almost too good to be true that the 9 month period would have cost around $11,000 instead of $20,000. With our second little one on the way (due in July), I guess we’ll find out!

Healthcare is a black box

Post layoff, I had no idea what to do about healthcare coverage. If I switch plans, will my wife get sub-par coverage while going through pregnancy? My nightmare was losing the ability to work with our preferred providers and getting lumped into a less than ideal system. 

Initially, when looking at marketplace plans, I saw what appeared to be a few great options. $600/month? Sign me up! Oh wait, there’s not out-of-pocket max. If something goes really wrong, we’ll probably go bankrupt….

I researched more online and saw that it was normal for healthcare premiums, when not purchased through an employer, to range between $1-$2k.

Cost comparison:

Urgent care