Zion Healthshare

[Knightclimber]

Anyone have real world experience with Zion Healthshare? My wife and I will be retiring early and going full time next year at the age of 55. So we will need Health insurance that can be used anywhere. Zion seems like the best choice but have read so many horror stories about Healthshares. Anyone use them or have recommendations for other places to research?

 

[UTTransplant]

Have you checked the ACA website? If your income is taking a significant drop, you may qualify for a heavy discount. Check different states to see where you can get nationwide coverage for a reasonable cost. Then you can make that state your domicile.

 

[Knightclimber]

I have, but the ACA programs are only good here in Minnesota. Which would not be great while traveling the rest of the country. I know emergencies are covered everywhere but any care beyond emergency room visit becomes burdensome.

 

[Knightclimber]

Should have mentioned that we will retain ownership of our house in Minnesota which will cause issues with establishing domicile in another state. Read of full time couples from MInnesota being sued by the state since they maintained ties.

 

[Skookum]

It's not illegal to have multiple residences across the country. It is illegal to lie to evade taxes by misrepresenting residency or income properties, or lying about the details of your residence to get a better insurance rate.

Healthshares are a very sharp, double-edged sword. If I were to ever sign up for a plan, I would want to know exactly what is, and is not, covered. And by whom, how much, and when. Sometimes they do not cover things you would expect of normal health insurance, and it's up to YOU to know that in advance.

 

[zulu]

. . . the ACA programs are only good here in Minnesota. Which would not be great while traveling the rest of the country.

I was able to use MNSure and found a couple of Blue Cross/Blue Shield MN health plans which should have nationwide networks.

Should have mentioned that we will retain ownership of our house in Minnesota which will cause issues with establishing domicile in another state. Read of full time couples from MInnesota being sued by the state since they maintained ties.

ACA plan qualification is determined by where you actually reside, which is not necessarily your domicile.

 

[Knightclimber]

Thank you. The MNSure plans I found would not actually cover much at all outside of Minnesota. They would at most cover 50% for anything. And from my research if you move about and switch from ACA plans between states it resets your deductibles each time you switch. So, I am hoping to find a solution that allows us to not have to change plans often or have huge out of pocket medical expenses should something happen.

 

[IBTripping]

Health Share is NOT insurance. Whether or not you get reimbursed for medical services is totally up to the company and there is no appeal nor state or federal government regulation. Check out this article: A Christian Health Nonprofit Saddled Thousands With Debt as It Built a Family Empire Including a Pot Farm, a Bank and an Airline

 

[zulu]

Thank you. The MNSure plans I found would not actually cover much at all outside of Minnesota. They would at most cover 50% for anything. And from my research if you move about and switch from ACA plans between states it resets your deductibles each time you switch. So, I am hoping to find a solution that allows us to not have to change plans often or have huge out of pocket medical expenses should something happen.

Consider establishing residence in one of the other states with nationwide plans: AK, AL, AR, CA, FL, ND, or WY.

However, if I were you, I'd be looking at FL not only because of the nationwide ACA plans but also because there are no state taxes and the Escapees mail service is available there.

BTW, the ACA does not require you to change plans each time you move. See this FAQ from the Department of Health & Human Services.

 

[Gary RV_Wizard]

ACA plans are often offered through statewide exchanges and only have in-state plans. You need a national plan if you travel, and you may need to contact the insurers direct to find them. Aetna, United Healthcare, Humana, Cigna, and BCBS all have them, but they aren't always sold in every state. However, you may be able to claim residency somewhere other than MN if you are a fulltime RVers. Owning property in MN doesn't disqualify that, even though you may owe MN taxes and such. Those are different things.

The key thing about Healthshare is that it is not insurance, there is no defined benefit, and essentially no regulation or oversight (it's a volunteer non-profit club). It's basically a pool that you contribute to and hope there will be funds remaining there when & if you need them. There may also be requirements in addition to a contribution, e.g. volunteer work or religious participation. Make sure you fully understand the details of both your participation and the coverage & benefits. Not just anecdotes about how wonderful it was for somebody..

 

[Tulecreeper]

Pretending for a moment that you are just going to retire in your mid-50's but just staying put in MN and not going on the road full time, what were you planning on using for health care in that regard? I'm assuming that neither you nor your wife have health coverage from the jobs you are retiring from.

 

[Tom]

One perspective ...

Several years ago we bought a lot in Star Valley, WY and have since looked at a number of regular S&B homes as potential full time homes. My observation, apart from winter snow, was that we wouldn't have access to the same medical resources we have here in the greater San Francisco Bay area. Star Valley has a nice, but small hospital with several satellite clinics.

Star Valley Hospital has a big cadre of doctors of different specialities, but they rotate in from Salt Lake City, ST. George, UH, and other driveable cities.

 

[Trivet]

Should have mentioned that we will retain ownership of our house in Minnesota which will cause issues with establishing domicile in another state. Read of full time couples from MInnesota being sued by the state since they maintained ties.

The one I know of is Sanchez v. Commissioner of Revenue, in which the Sanchezes were found to not have shed themselves of their Minnesota domicile.
caselaw.findlaw.com/mn-supreme-court/1385455.html

Thank you. The MNSure plans I found would not actually cover much at all outside of Minnesota. They would at most cover 50% for anything.

Are you getting the 50% figure from plans' out-of-network coverage? If so, how have you determined what a given plan's network is, and whether it is limited to Minnesota?

Check out this article: A Christian Health Nonprofit Saddled Thousands With Debt as It Built a Family Empire Including a Pot Farm, a Bank and an Airline

Holy cow! When I went to the article it never occurred to me it would be Liberty Healthshare -- I'd venture that Liberty is most-recommended healthshare on RV forums. I was assuming the article would be about some marginal player in the field.

Interestingly, there's a company that specializes in insurance for RVers, including health insurance for fulltimers. It used to be run by a guy who had a pretty good reputation for helping people. His website and analysis were indispensable when fulltimers with an Escapees address in Texas were suddenly left without an option for health insurance with a national network when Blue Cross suddenly quit offering any PPO plans in Texas starting in 2016. People were really scrambling.

I'm not particularly impressed with the business/website these days (it's my understanding that it's been bought out), but even back when it was the one-man show by someone who was pretty good about offering information to people, he was recommending (and maybe selling--his website said you could call him to ask questions about it) a healthshare ministry called Aliera. (In 2018, he expressed displeasure with what he called a "liberty-based" healthshare ministry because he had it for three years and in the third year he was having a "horrible time" getting claims paid, which coincides with Liberty's meltdown that the ProPublica article describes.)

Anyway, the Aliera healthshare ministry he was recommending? It went bankrupt, leaving a lot of people with unpaid claims. Here's an article about it:
www.propublica.org/article/liberty-healthshare-healthcare-sharing-ministries-obamacare

It starts with: "Aliera, a now-defunct health care cost-sharing, or 'health share,' company founded by a man who served time in prison for fraud and perjury, has itself been found guilty of fraud in a federal class action suit."

Here's the website describing and recommending Aliera (an archived version from 2018):
web.archive.org/web/20181128235820/http://www.rverinsurance.com/health-insurance-guide

So we have the frequently recommended Liberty Healthshare having, uh, issues. And Aliera, recommended by someone who specialized in fulltimer health insurance, going bankrupt. So to the OP: maybe Zion is great. And maybe it's great only until it's not great, like Liberty and Aliera. You just never know.

Insurance companies are nothing to crow about, but at least they have regulations they have to abide by, including the amount of their premiums they're required to pay out in claims. Remember, healthshares never have to pay anything--everything they do is voluntary.

They say they have "shared 100% of eligible medical expenses for their members." But note the "eligible." Very clever, because claims aren't eligible unless they say they are. So of course they share 100% of those--if they don't want to share an expense, all they have to do is deem it non-eligible, and they keep their 100% track record. With no outside recourse by the member.

Pretending for a moment that you are just going to retire in your mid-50's but just staying put in MN and not going on the road full time, what were you planning on using for health care in that regard? I'm assuming that neither you nor your wife have health coverage from the jobs you are retiring from.

If the OP were staying put in Minnesota, he'd be getting his health care in Minnesota, and he wouldn't need to be seeking a plan that has a network that extends outside his local area. That's what makes the solutions for "most people" often not apply to people who travel fulltime.

The truth is that in some locations, there simply aren't any ACA plans that provide the nationwide network coverage most fulltimers desire. There are alternatives, such as healthshare ministries or short-term medical plans or indemnity plans, but the marketing on all of them is problematic, resulting all too often in people buying products they don't understand.

 

[Gary RV_Wizard]

The one I know of is Sanchez v. Commissioner of Revenue, in which the Sanchezes were found to not have shed themselves of their Minnesota domicile.
caselaw.findlaw.com/mn-supreme-court/1385455.html

Domicile and taxing authority are separate things. States enact their own tax laws and they rarely say anything about domicile, mostly because domcile is a more a concept than a definitive rule. Instead the state tax laws define who is subject to those taxes. Merely having domicile in some other state does not exempt one from paying taxes elsewhere if they also have connections in that state.

 

[UTTransplant]

You might also look at the Escapees RV organization, especially their sub-group Escapers which is primarily nom-retired folks who work on the road. They have the same insurance issues. FMCA, another RV organization, announced a new health insurance partner not too long ago, but I paid no attention since it didn’t apply to me. Might be worth a look there too.

 

[Tulecreeper]

If the OP were staying put in Minnesota, he'd be getting his health care in Minnesota, and he wouldn't need to be seeking a plan that has a network that extends outside his local area. That's what makes the solutions for "most people" often not apply to people who travel fulltime.

The truth is that in some locations, there simply aren't any ACA plans that provide the nationwide network coverage most fulltimers desire. There are alternatives, such as healthshare ministries or short-term medical plans or indemnity plans, but the marketing on all of them is problematic, resulting all too often in people buying products they don't understand.

I asked because if the OP had medical coverage if they stayed in MN, they might ask that insurance company if it has a plan for full-time RV'ers. Here are a couple links for more information:

https://www.fulltimefamilies.com/insurance-for-full-time-rvers/

Health Insurance for Full Time RVers: Ultimate 2023 Guide

Many full time RVers work as self-employed entrepreneurs or work short-term jobs without benefits. Without employer benefits, finding affordable health insurance for full time RVers can be one of the most difficult aspects of the

www.travelswithted.com

 

[Trivet]

Domicile and taxing authority are separate things. States enact their own tax laws and they rarely say anything about domicile, mostly because domcile is a more a concept than a definitive rule. Instead the state tax laws define who is subject to those taxes. Merely having domicile in some other state does not exempt one from paying taxes elsewhere if they also have connections in that state.

I'm not sure if you read the decision, but it's all about domicile, Minnesota's rules about domicile, and being subject to taxes based on domicile under Minnesota law. It holds that under Minnesota law, the Sanchezes didn't prove they had established a domicile in South Dakota despite going through the same steps many other people have done, and leaving Minnesota and not coming back. It's a cautionary tale for Minnesotans.

 

[Trivet]

FMCA, another RV organization, announced a new health insurance partner not too long ago, but I paid no attention since it didn’t apply to me.

In the past, FMCA's health insurance partner was selling indemnity plans, not health insurance. Indemnity plans were invented to cover gaps in health insurance, like deductibles, or to provide supplemental income if a person is sick and can't work. They are not health insurance as people generally understand it, and the marketing of them typically doesn't spell that out clearly.

As I said above, there are some places where there simply aren't any ACA plans offered that have a nationwide network that fulltimers can use for routine care. Until you get into the trenches, it can be hard to believe, but it's true. And health insurance agents aren't in the business of telling people they don't have what the person is looking for; they sell what they have, which in a lot of cases is indemnity plans or short-term policies, neither of which are ACA health insurance plans. The problem is that it can be hard for people to understand the difference, especially when the person explaining the difference is going to lose a sale if the customer is interested only in major medical health insurance.

Here's a good article about indemnity plans, what they are and aren't, and the issues with the marketing of them:
www.brookings.edu/blog/usc-brookings-schaeffer-on-health-policy/2020/08/04/fixed-indemnity-health-coverage-is-a-problematic-form-of-junk-insurance/

 

[zulu]

You might also look at the Escapees RV organization . . .

For your under-65 healthcare needs, Escapees is useful only if you're domiciling in SD, FL, or TX, but outside of that not so much.

For example, I've been on them to find out which states have nationwide ACA health plans. All they say is "it is getting increasingly difficult to find one that will cover you outside of the state where you purchase it".

So I did a lot of the grunt work myself and found that AK, AL, AR, CA, FL, MN (not all counties), ND, WA (4 of 35 counties) and WY have Blue Cross/Blue Shield nationwide health plans.

 

[Tulecreeper]

I'm not sure if you read the decision, but it's all about domicile, Minnesota's rules about domicile, and being subject to taxes based on domicile under Minnesota law. It holds that under Minnesota law, the Sanchezes didn't prove they had established a domicile in South Dakota despite going through the same steps many other people have done, and leaving Minnesota and not coming back. It's a cautionary tale for Minnesotans.

You, I, and only a couple other people seem to understand this and that most states follow the same rules. A lot of folks are confusing the term 'residence' with 'residency', and that 'residency' is another term for 'domicile'. Your residence is where your feet are planted now. Your residency/domicile is where you legally do business with government agencies.

You can have several different/separate residences (where you may pay state or local taxes on all of them), but you can maintian only one residency/domicile.