MediShare 65+ Review: An Affordable Healthsharing Alternative to Medigap

In fact, Medicare by itself still leaves gaping holes in your coverage that can leave you facing thousands of dollars in out-of-pocket medical expenses.

As of 2023, Medicare Part A (hospital insurance) carries a deductible of $1,600 per benefit period. That means you could face multiple deductibles for hospital bills within the same year. 

Medicare Part B, which covers physicians’ charges, lab fees, and durable medical equipment, only covers 80% of those charges, after you meet a $226 deductible.

Without some additional protection in place besides Original Medicare itself, that still leaves you exposed to 20% of surgeon’s fees, specialists’ fees, MRIs and other imagery costs, lab fees, durable medical equipment costs, and other expenses – with no cap.

That means that even with Medicare, you could face thousands and thousands of dollars in out-of-pocket medical costs. That’s enough to derail almost anyone’s retirement security.

That’s why millions of Americans choose to supplement their Medicare with a Medigap policy.

The problem:  Medigap policies are becoming increasingly unaffordable, especially in high cost-of-living areas or areas with few medical providers.

Fortunately, Americans have a viable, more affordable Medigap alternative: Medi-Share 65+ – a healthsharing plan designed to compete with the best and most popular Medigap plans currently on the market: Plans G and N.

In most cases, MediShare 65+ compares favorably with these private Medigap insurance plans – at a more affordable price.

To understand Medi-Share 65+, it’s important to understand what healthsharing is, and how it differs from traditional insurance approaches like Medigap.

MediShare 65+ vs. Medigap Health Insurance

Unlike Medigap policies, which are private health insurance plans, Medi-Share 65+ is not an insurance product at all. 

Instead, Medi-Share is a non-profit, faith-based association of more than 400,000 Americans who all have a shared value system, have committed to living healthy and responsible lifestyles, and to the importance of sharing each other’s medical expenses.

Medi-Share 65+ is the MediShare plan designed specifically for Medicare beneficiaries. 

Yes, both MediShare 65+ and Medigap insurance policies are designed to help Medicare beneficiaries pay for the significant potential out-of-pocket costs under Medicare Parts A and B.

But Medigap plans are highly regulated, and by law are standardized. Medigap plans are required to have identical benefits in 47 out of the 50 states, and must include multiple types of coverage that drive up premiums without providing much benefit for healthy and responsible plan members.

For example, Medigap plans must cover treatment for illegal drug overdoses, motorcycle accidents, psychiatric care, and drunk driving injuries but  healthshare plans like Medi-Share 65+ do not. This helps healthsharing plans offer much lower monthly costs compared to bloated Medigap and other traditional insurance policies.  

How Does MediShare 65+ Work?

Every month, you’ll pay your monthly contribution to the Medi-Share 65+ plan. Medi-Share then directs your contributed amounts to help other plan members in need, with eligible medical expenses.

If you need medical care that’s normally covered under Medicare Parts A or B, you will be responsible for the first $500 in out-of-pocket costs, which are your Medicare Part A and B deductibles, co-insurance, and copays. 

This $500 amount is called your annual household portion, or AHP, and functions similarly to a deductible in the health insurance world.

Once you have paid the first $500 in out-of-pocket costs, your Medi-Share 65+ benefits kick in. The Plan will then share all your additional deductibles, co-pays, and co-insurance charges required by Medicare Parts A and B.

The rest of your out-of-pocket medical expenses for the year are 100% shareable. You will pay nothing more out of pocket for the remainder of your plan year. 

With MediShare 65+, your AHP is calculated per household, not per individual. So if you are a married couple, and you need care and spend $500 in Medicare-approved charges, you will have satisfied the annual household portion for both you and your spouse.

If your spouse then needs care during the same plan year, his or her costs will be 100% shareable. You will pay nothing more out of pocket until your plan year is over. Then your AHP resets to $500.

Note: Medi-Share only pays for eligible medical expenses approved under Original Medicare but not paid by the government directly. It does not pay for prescription drugs.

Can You Use MediShare if You’re Over 65?

YES! That’s the whole point of the Medi-Share 65+ alternative.

You can opt out of over-priced insurance policies, larded up with extra benefits that most healthy and responsible individuals don’t want or need, even when you’re over 65 and on Medicare.  

What Does Medigap Plan G Cost?

Medigap Plan G provides the most comprehensive coverage out of all the Medicare supplement insurance plans available to new enrollees: It covers all out-of-pocket deductibles, co-pays, and co-insurance charges under Medicare Parts A and B with the exception of your Part B deductible, which is $226 per year as of 2023. 

As the most comprehensive plan, Medigap Plan G also has the highest monthly cost of all the Medigap plans, with an average monthly premium of $145.

Medigap Plan G costs are even higher for older individuals, and in areas where the cost of living is high. There are some areas where Medigap Plan G premiums run as high as $400 or more.

Medigap plans, including Plan G, may increase premiums every year based on your age. So a Medicare supplement plan you thought was a bargain at age 65 may become more and more expensive over time. 

What Does Medi-Share 65+ Cost?

Medi-Share 65+ pricing is extremely straightforward.

For members aged 65 through 74, the monthly cost is just $99 per month. 

Pricing is guaranteed level (no price increases) through age 74 as long as you continue to be a sharing member in good standing.

For members aged 75 and up, the monthly cost is just $150 per month.

Pricing is uniform nationwide.

Medi-Share 65+ costs less per month than a Medigap Plan G in nearly every case. But the advantage is particularly apparent in high-cost-of-living areas. Medigap premiums are higher in these areas. Medi-Share 65+ contributions remain the same, regardless of your location. 

Does Medi-Share 65+ Cover Prescription Drugs? 

Neither Medi-Share 65+ nor Medigap plans cover prescription drug costs. Most people choose to add a standalone Medicare Part D policy, in addition to their Medigap or Medi-Share 65+ plan, to protect themselves against the risk of high prescription drug costs. 

Is Healthsharing a Good Alternative? 

In general, this plan could be a good alternative if this saves you money compared to your current plan, or if you want to change from Medicare Advantage plan back to something that allows you to see any doctor.

Currently Medi-share is not putting any waiting periods on pre-existing conditions, though that may change in a few months.

Medi-Share 65+ is one of the oldest and most-established healthsharing ministry organizations around, with over a 40-year track record, over 400,000 members, and more than $4 billion in healthcare costs shared since inception. 

Can I Choose My Own Doctor With Medi-Share 65+?

Both Medigap and Medi-Share 65+ allow you to use your benefits at any provider you choose. You don’t have to restrict yourself to seeking non-emergency care from authorized in-network providers.

Both Medigap and Medi-Share 65+ differ from Medicare Advantage (Medicare Part C) plans in this regard. Medicare Advantage plans rely on contracting with specific providers willing to offer discounted rates. These networks are often regional. But you can use your Medigap and Medi-Share 65+ benefits with any willing provider you choose in the United States.

You have the freedom to choose your own doctor!

Medi-Share 65+ also shares a limited amount for care outside of the United States, as well. See plan guidelines for details.

What are the Exclusions for Medi-Share 65+?

As a Christian healthcare sharing ministry, Medi-Share 65+ has some exclusions – costs that are not shareable.

Generally, Medi-Share will not approve share requests for medical needs arising from:

• suicides and suicide attempts
• deliberate acts of self-harm
• elective abortion
• injuries incurred as an intoxicated driver or as a passenger of an intoxicated driver
• alcohol abuse or illegal drug abuse
• rehab or detox facility costs arising from alcohol or illegal drug use
• injuries incurred in the commission of a crime
• psychiatric treatment

See plan guidelines for a full list of exclusions. 

Want to Learn More? 

You can find out more about Medi-Share 65+ by clicking here. 

You can also talk to your Personal Benefits Consultant who sent you this email, any time. The easiest way is to pick a time on their calendar, or send them a text or email. 

Here’s to your health and wealth,

Wiley P. Long, III
President – MediGap Advisors