Health Care Sharing Lawsuit

[somarco]

From a $325,000 bill for a 10-year-old brain tumor to big unpaid bills for everything from heart surgeries to emergency room visits, we’ve been investigating problems with health coverage through Atlanta-based Aliera for more than two years.

“I called, and the response was, ‘Well, we can’t pay unless we have money.’ I said, ‘Excuse me?’ She said, ‘We are not an insurance company, we don’t have a pool of money to pay from,’” Rhodes said.

Judge says class-action lawsuit against Atlanta-based health share ministry can go forward

 

[scagnt83]

Read the contract. Its there. But we all know the abuses going on with these. What most of the contracts do not spell out is how the accounting for claims is conducted. They can legally say "we have money for claims up to $xxxx amount but nothing higher... or just say no more claims at all this calendar year....

Covid. Just a guess. Its always been a ticking time bomb imo.

 

[somarco]

Read the contract. Its there. But we all know the abuses going on with these. What most of the contracts do not spell out is how the accounting for claims is conducted. They can legally say "we have money for claims up to $xxxx amount but nothing higher... or just say no more claims at all this calendar year....

Covid. Just a guess. Its always been a ticking time bomb imo.

Yup! It's not insurance. Never was. Just looked like it. That's why so many providers, including hospitals won't accept these plans. You want treatment? Pay up front and then file with your plan. Good luck with that.



The CCP flu get's the blame for a lot of things, and I would not doubt if it was responsible for a big upsurge in claims . . . but maybe not as much as you suspect.

MOST of the flu related claims have been in folks 75 and older. Certainly plenty of folks 65+ on Medicare.

Until recently flu cases for folks under 65 were rare, but newer mutant variations are creating their own set of issues.

I have a few clients that left the sharing plans when they turned 65 and went on Medicare. I haven't really delved into the rules about continuing on a sharing plan once you turn 65 but my guess is there are very few Medicare eligible folks that didn't make the transition.

A sharing plan is not creditable coverage so if you delay enrolling in Medicare because you prefer a sharing plan you will incur a late penalty and the other associated problems.

So my wag says the sharing plans running out of $$$ has little to do with the flu.