# Liberty Health Sharing Update

It’s been a while since I’ve talked about health sharing–almost a year, in fact.  Last summer, I was still comparing the offerings, but can now offer some insight into my own experiences.  I’ve also been compiling the financial stats sent each month to Liberty HealthShare members.  This month includes a few tweaks to the reporting that make the internal operations much more transparent.

# Using the Membership Card

My first real experience using Liberty’s program was in going to see a provider for a physical. I presented the card, got the physical, and waited for bills to arrive.

Even before they did, I had a notice from Liberty explaining the bill–very much like an Explanation of Benefits that you’d get from a traditional insurer.  It listed all of the charges, with adjustments to get to the rate schedule the provider accepted when they submitted their bill.  What rate schedule is that?  It’s right on the card:

Group does not use a PPO network.  Reimbursement is determined in reference to Medicare allowable amounts (150% for physicians, 160% for inpatient, 170% for outpatient) or, in absence of applicable CMS fee schedule, in accordance with Sharing Guidelines.  Acceptance of Group sharing payment for Eligible Expenses constitutes waiver of Provider right to balance bill patient.

In other words, the rate schedule is a multiple (150%-170%) of Medicare rates.  The portion of the bill that exceeds those rates is waived just as it would be if you saw an in-network provider on a PPO plan–they won’t seek payment for the amount above the agreed-upon rate schedule.

When I examined the provider’s bill, charges totaled $863.15. The rate adjustments brought the total to$141.27, which was shared by Liberty.  The provider was paid on December 20th, for service billed October 13th–a little over two months.  Included as part of the sharing benefits for preventive care, I paid nothing for those services.

# Submitting Medical Expenses

In another instance last fall, I went through the process of getting a flu shot (for the first time in at least 25 years) and another 3-dose vaccine.  A relative had been the recipient of a stem cell treatment as part of a fight against cancer.  He’s just about to the point where he’ll be restarting all of his childhood vaccines–but over the holidays, that meant he had the immune response of an infant, but the disadvantage of being much older.   Those of us visiting over the holidays had to take special precautions for his health.

I stopped in at a small Kroger Pharmacy–the same Kroger you’re familiar with, but a store smaller than a typical CVS or Walgreen’s.  Think pharmacy counter, greeting cards, and not much else. The clerk wasn’t sure what to do with the Liberty card, given that it wasn’t in Kroger’s computer system.  They had the shots I needed though, so I went ahead and paid directly.

Receipt in hand, I logged in to Liberty’s online portal to explore the process of submitting a bill myself.  Turns out, it was as simple as entering the date of service, amount of the bill, and attaching a receipt image.  I included a short description of what I received, “flu shot”, and the bill was submitted.

Thirty days later, I had a notice of payment, and a check in the mail.  Easy enough.

# Financial Reporting

One of my reservations about health sharing in general revolves around understanding how effective they are at meeting the needs of their members.  Most have very little information about that online, other than how long they’ve been in operation.  Since they aren’t traditional insurance underwriters, their financial health isn’t subject to various state financial requirements and disclosures.

Of course, part of what makes it all such a good deal is that they’re not spending piles of your premium dollars doing administrative stuff for the government.  Through November of last year, the eligible medical expenses submitted were roughly in line with what was shared (i.e. paid).