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Digging deeper into costs of health insurance alternatives

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MADISON (WKOW) -- A Madison family says a health insurance alternative they joined to save money ended up costing them thousands.

Dustin Maher joined Liberty HealthShare a few years ago. The reasonable cost appealed to him.

"As a small business owner, we have to pay like $1,500, 1,700 a month for insurance," Dustin told 27 News. "This was only $500 a month. So some might say, if it sounds too good to be true it probably is, but I like the idea that you kind of signed off on living a healthy lifestyle."

At the beginning of 2019, Dustin's wife Tessa and their toddler son Bo joined his membership.

Members of health care sharing ministries pay a monthly rate and get reimbursements for certain bills from the health share's members.

"You pay your monthly fee to be a part of it. And then once you hit your deductible, there's certain things that are all outlined in their guidelines, certain things they cover and certain things they don't," Tessa said.

Soon after joining, the Mahers learned they'd be adding on to their family. They say the health share told them their pregnancy related visits and bills would be shareable, but as they approached their due date, they were facing nearly $10,000 in pre-approved bills for the pregnancy that were still pending.

"It's been just a frustrating process. And especially now, when we started doubting whether we were gonna see money back from all this maternity care, from the delivery," Tessa said.

She says she's spent countless hours on the phone trying to get answers on when they'll see reimbursements, only hearing that they should keep waiting. Knowing a hospital delivery would cost another $10-15,000, the couple started to panic.

"I was crying," Tessa said. "And I was up for nights, I couldn't sleep. I was looking at going to Mexico or Canada to give birth."

The Mahers are not alone. In the past three years, The Better Business Bureau has taken more than 500 complaints against Liberty HealthShare.

Many of those who've filed complaints have similar stories: big bills for surgeries and other procedures that haven't been shared, despite prior approval from the health share.

"Either the consumer is out the money and hasn't been reimbursed, or they've ending up going to collections," said Tiffany Schultz, with the Better Business Bureau in Wisconsin.

At least 10 customers have filed complaints with the BBB against Liberty HealthShare in Wisconsin, showing a pattern of non-reimbursements, according to Schultz, some still waiting after six months or more than a year.

"Every company has a different reimbursement time frame. And with a health insurance plan, that's under federal regulation, so they are completely different. [Health shares are] not regulated by the federal government," Schultz said.

Other health shares, like Georgia-based Trinity Healthshare, have come under fire. A few states are taking legal action claiming that organization has misled customers, including Texas, Colorado, Washington and New Hampshire.

Health care sharing ministries are not considered insurance, but the members pay a monthly rate, typically lower than regular insurance, which experts say has been a big draw since the price of insurance has skyrocketed in recent years.

"These are attractive products that are out there. But you need to do your research at the same time," Schultz told 27 News.

Schultz says in some cases, these health shares could be right for you, but it's always best to understand how it works, talk with an insurance broker and read all the fine print before signing on to a new plan or membership.

Liberty HealthShare tells 27 News it has addressed the issues in the BBB complaints, saying new software in February caused delays in expense sharing. The ministry has made changes since BBB started working with the organization.

"Liberty HealthShare hired a new CEO, doubled the number of staff processing medical expense share requests, engaged with outside vendors, disengaged with a problematic software vendor, hired a new IT leader, and initiated greater efforts to educate members as to what medical services are eligible for sharing," the ministry said in a statement to 27 News.

"More recently, Liberty HealthShare has also created an advisory council to assist in improving operations including a former FDA co-commissioner, a long-standing member of Liberty HealthShare, and the ministry’s founder and former CEO," the statement reads, in part.

The ministry says it has 287, 000 members now, many who've turned to organizations like Liberty to support its mission of sharing costs. Liberty HealthShare has grown in two years, sharing more than $365 million in expenses in 2019, up from $168 million in 2017.

Leaders say they make it clear their company is not insurance. The ministry is not allowed to make any promises on a time frame for reimbursement.

The Mahers say their pile of unpaid bills sent them back to regular insurance before the birth of their new daughter Maple in December, despite how much it'll cost them every month.

"We're very healthy people here and are paying more than our house payment going towards being healthy, but it is what it is and I hope other people don't get caught up and lose a lot of money in the process," Dustin said.

The Mahers did get a reimbursement check for a wellness visit, unrelated to the maternity care about five months after they submitted the expense.

Liberty Healthshare tells 27 News they are still reviewing the Mahers' pregnancy related bills and plan to share eligible costs that came before they canceled their membership.

"The bigger picture, hopefully, is that Liberty HealthShare steps forward and reimburses all the members that are waiting, waiting to receive that money that they've been promised," Tessa told 27 News.

Jennifer Kliese

Weekend Anchor and Reporter, 27 News

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