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Here’s a story from someone who knows the all too awful reason why you need medical coverage. For anonymity reasons, we are just going to use Jethro’s first name. 

At 35 years old, Jethro was in tip-top condition and never felt better. He was working out, was active in sports, and ate a clean, healthy diet. By any measure, Jethro was the picture of good health. 

Jethro is a modest man of modest means. He worked as a manager at a local warehouse. A small-town man leading a happy small-town life.  Unfortunately, Jethro was laid off during the COVID shutdown, he didn’t think twice about the medical coverage. 

 

Jethro’s Big Mistake – Going Without Medical Coverage

His employer did the right thing and allowed him to stay on the company’s medical coverage, under the COBRA rules. Jethro has no idea just how much his employer was contributing to his medical coverage. Under COBRA, Jethro became liable for the whole amount, every month.

When he saw the real monthly premium (without his employer’s contribution), Jethro was shocked to the core. As a young man, newly married, and about to start a family – he decided to forgo the costs of medical coverage. After all, his next job was bound to offer medical coverage and babies are expensive.  So he dropped the COBRA medical coverage like a hot rock. 

He was saving big money and feeling pretty smart for making the decision to go without health insurance medical coverage. As a present, for having saved so much money, Jethro decided to buy himself a new mountain bike.

 

What Going Without Medical Coverage Meant for Jethro

While most people were still in quarantine, the mountain bike trails were virtually deserted. Straddling his new 2-wheeled pride and joy, Jethro was flying down the old familiar wooded trail, like it was his first time. He was thinking the high-performance bike was worth every penny of the health insurance savings he had used to buy it. 

After all, he deserved his new toy – he had outsmarted the system, no medical coverage, no costs. There was another rider that day who thought he was alone on the trails too. Neither one had time to break. The high-speed impact mangled both bikes, and both riders left the scene in an ambulance.

Jethro’s Wallet Felt the Burn of No Medical Coverage 

Even though the injuries were not life-threatening, the bills started rolling in. Jethro was horrified at the astronomical costs of his ambulance ride, emergency room visit, and treatment.

He was beating himself up inside for not having medical coverage.

Jethro had actually heard about medical cost sharing from Scoop Health before he canceled his COBRA. Even though it was 50% less than the employer’s medical coverage, he did nothing about it. He opted out of any protection because he believed he was healthy enough. He thought he didn’t need medical cost protection – he was wrong. Jethro was now personally responsible for over $50,000 in medical bills, while unemployed and having no way to pay.

Without medical coverage, he was liable for an ambulance ride, an ER visit, a CT scan, MRI, and the hospital. Not to mention,  an orthopedic surgeon and anesthesiologist. This was just the beginning of his nightmare. His new bike was a total loss, and he still needed extensive follow-up care and physical therapy to recover from his injuries.

The real cost of going without any medical coverage is that he had to choose between the care he needed and his financial future. There was no more spare cash to pay the bills. His credit cards were maxed out, unemployment was coming to an end and his parents and family were all tapped out. The doctor’s office was requiring cash payment up-front to continue his treatment. 

What a mess! And he felt it was all his fault because he didn’t have medical coverage. 

But Jethro Couldn’t and Still Can’t Afford Traditional Health Insurance 

Health insurance premiums are unaffordable for anyone – totally out of reach for a modest man like Jethro. 

Let’s imagine what Jethro’s scenario would have been like if he had had medical coverage through traditional health insurance. 

  • Firstly, Jethro would have been contributing a massive premium every month – well over half of his unemployment check. 
  • Secondly, before the insurance would have paid a single penny towards his medical expenses Jethro would have had to pay a deductible. A deductible is a portion that the medical insurance expects you to pay out-of-pocket prior to covering any costs. This amount can be to the tune of $10 000 or even more.
  • After this huge sum of money, Jethro would still need to pay a copayment (30% of treatment costs) and additional levies.
  • If his doctor wanted to prescribe Jethro a treatment that wasn’t on the medical insurances’ formulary. He would have to pay 100% of the costs. 
  • On top of all of this, if the ambulance had taken Jethro to an out-of-network hospital – he would have been liable for a hefty penalty. 

So, when looking at the big picture, Jethro wouldn’t be much better off with this so-called ‘medical coverage’.

 

Medical Cost Sharing With Scoop Health 

Jethro had to decide between his once prized health and his utility bill. At Scoop Health, we don’t believe any American should be in this position. Choosing between a doctor and feeding your family is not what our founding fathers imagined for our great nation. 

At Scoop Health, our model for providing quality affordable health care is based on the medical cost sharing model used in Christian communities for over thirty years. We have modernized this concept and formed a cost sharing community that serves the modern American – and there are no faith-based requirements. 

How It Works

  • Each Community member pays a monthly share amount. We base this amount on what each member can afford. We also consider lifestyle factors like age and smoking. 
  • When a health need arises, the member goes to the chosen health provider and registers as a cash patient. For the first three medical needs, the member has to pay a small IUA (initial unshareable amount) the community then pays the rest. After three needs – five for families – the IUA falls away and the member doesn’t have to pay anything. 

Unlike medical insurance, Scoop Health does not have a defined formulary or network. This gives our members the freedom to seek the best care for their individual needs. 

Each of our members has their own personal member advisor. We also have experience in negotiating the price of large medical bills  – helping our members get the best bang for their buck. 

What Medical Cost Sharing Could Have Meant For Jethro

Jethro would have only had to pay a monthly share amount of $500. It turns out, he could afford to take care of himself- just not overpriced insurance medical coverage. All of his treatment would have been seen as one medical need, the costs of which would be shared with a community. No profit-driven big corporations. No crippling debt. He would have gotten quality, affordable health care when it really counted.

Medical cost sharing is open for enrollment year-round. It could have solved this problem for Jethro – for half the monthly cost of traditional medical coverage. Find out how much you can save with Scoop Health.

 

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