The Detail

Let us answer your questions

The Details

Within the different sections of this page. We will try to dig a little deeper to the questions most people have about Medical Cost Sharing.  We know, even though it has been around for decades, it is new to most people.  We will also give  some details about your membership benefits of belonging to True Life Alliance.

Informational Videos from Co-Founder Kevin Miller

The Cash Pay Mindset

the hassle factor

Is this fair?

What is IUA – Initial Unshared Amount?

What is medical cost sharing and is it for me?

The Medical Cost Sharing model has been in existence for over 30 years with a proven track record of meeting the needs of its members. We are simply bringing the concept mainstream, to the masses of health-minded people like you.

In contrast to traditional health insurance, it is not intended to pay for your routine health maintenance. You can easily pay for those expenses with the money you are saving every month.

NOTE: When you have a medical “Need”, our Medical Cost Sharing is facilitated by Sedera Health. Sedera serves employer groups and associations like True Life Alliance, they do not contract directly with the general public.

*Download the full Guidelines of our Medical Cost Sharing program with Sedera Health: Sedera Guidelines

Would this work for you?

Do any of these fit you? Do you..

  • Cook whole, natural foods more than you eat out?
  • Buy foods with attention to truly natural, organic, whole, and GMO free?
  • Realize fast food is not actually…food?
  • Rarely have a need for traditional doctors and pharmaceuticals?
  • Frequently exercise and make movement a priority?
  • Put a premium on quality sleep?
  • Have awareness of the effect of too much screen time?
  • Realize the state of your mind impacts your body and vice versa (the mind-body connection)?
  • Take personal responsibility for your health and wellness?

Then you have found your true home!

How exactly does this work?

Let me give you an example to help explain how it works.

Hopefully, a year passes ,and you are happy, healthy, and do not have to think one moment about any health problems. If you are a family, you would have shared about $6,700 for True Life Protect health coverage instead of spending $18,000 in insurance premiums. You saved $11,040 for the year, $920 per month!

But, accidents sometimes happen. So here is a story about a family, Seth and Lori, both in their 40s, and their two kids, Molly and Ryder.

Option 1. Traditional Health Insurance: $1,500 per month, $7,000 annual deductible

  • January – Molly takes a backwards fall while skiing and breaks her arm. Costs for an ER visit, X-ray, and casting are $4,815. They give their insurance card, and weeks later, receive a bill which they must pay in full due to their deductible. Out of pocket costs = $4,815.
  • March – Ryder catches a virus at school, and has a severe sore throat. A doctor visit reveals strep throat. Cost for the doctor visit and an antibiotic is $275. Deductible is not met. Out of pocket costs =  $275.
  • June – Lori has not had a checkup in a while and goes in for an annual wellness check that includes a doctor visit, labs, and mammogram at approximately $1,500. Deductible not met. Covered by insurance.
  • November – Seth is in dire pain. They go to the ER, and he has a ruptured appendix. $27,500 in total bills. Only $1,910 left in the deductible. Cost = $1,910

Year end – $18,000 in insurance premiums plus $7,000 in out-of-pocket medical bills.

ANNUAL COST = $25,000

Option 2. Medical Cost Sharing: $580 monthly share, $1,500 IUA

  • January – Molly’s broken arm cash pay price is only $1,290 which is under your IUA, so you pay. Out-of-pocket cost = $1,290.
  • March – Ryder’s virus cash pay price is $90. Out-of-pocket cost = $90.
  • June – Lori’s wellness visit cash pay price is $450. Out-of-pocket cost = $450.
  • November – Seth’s appendix cash pay price is $9,494. You pay the first $1,500 and the rest is eligible for sharing. Out-of-pocket cost = $1,500.

Year end – Seth and Lori spent $6,960 in monthly contributions plus $3,330 in out of pocket medical bills.

ANNUAL COST = $10,290. Approx. 60% savings.

That’s about a $1,200 per month raise that can start today.

There is a new mindset that you will have to adopt.  That is the Cash Pay Mindset.  Here is what I mean by that:

Americans are used to the $1,500 per month health insurance premium and, for that, we just hand over our shiny insurance card whenever we have any medical cost, whether emergency or health maintenance. Then we get a bill for our portion (the high deductible), which we pay out of pocket.

With True Life Protect, you will be paying out of pocket for your routine health maintenance – this is being “cash pay.” In the event of an emergency, accident, or unexpected illness, you are a cash pay patient and responsible for the initial costs up to your selected IUA – $500-$5,000.

Our members take pride in and are confident with being cash pay, saving lots of money, and having far more control of their overall health care.

What about pre-existing conditions?

The community does not share pre-existing conditions, i.e. diagnosed conditions, observable symptoms or treatments occurring within the past 36 months. We know this generates a lot of questions. Ultimately, sharing works well for people who have fewer medical costs and just want secure health care ready in case of accidents, emergencies, and unexpected illnesses.

The average American family is paying $18,000 annually in health insurance premiums and often goes years without using it at all. These families could simply pay $6,720 annually (40-49 years old, $1,500 IUA) for the “just in case” big need, which is exactly what health coverage is intended for. Then they can pay the smaller, maintenance expenses for their health and wellness out of pocket.

can i trust medical cost sharing?

Health insurance is legally obligated to cover qualifying claims, while Medical Cost Sharing is not. But does that guarantee health insurance will, in fact, cover you?

AARP* reports the Department of Labor estimates one health insurance claim out of seven is initially denied. The LA Times* reports that the California Nurses Association estimated the state’s top insurers reject about 26% of all claims, and a separate study by the Government Accountability Office found the denied claims were only reversed in about half of all appeals, “for those with the stamina to work the system.”

“It’s a money making tactic.” Carmen Balber, executive director of the Santa Monica advocacy group, Consumer Watchdog, said of the high frequency of denials, “The companies know that when they deny claims, most people will just give up.”

The LA Times* went further to state, “Insurance companies are playing the odds, patient advocates say. They’re counting on people not having the stamina to challenge every denied claim, even when there is a valid medical reason for a drug or treatment being covered”.

The article quotes Chuck Idelson, a spokesman for the California Nurses Association, who said, “Insurers make money when you pay in through premiums and co-pays, and they lose money when they pay out. So they do everything possible to deny claims.”

“The system is designed to wear you down and to weed out the weak from the strong. An insurer has nothing to lose and everything to gain from putting barriers in your path. Something to keep in mind: Insurers are so unhappy about paying claims that the percentage of premiums received that they have to pay back to policyholders is known as the “medical loss ratio.”

Seriously. To them, covering your healthcare is considered a financial loss.

“The system is structured so that insurers make money,” said Idelson at the California Nurses Association. “What you need to remember is that you’re paying for care. You ought to be able to get it.”

Medical Cost Sharing is designed to share the member’s eligible medical expenses after their IUA is met; post bill negotiations, if any.

Further, Medical Cost Sharing is prevented from building up excess funds from members’ monthly contributions. We “share” the contributions received, only retaining 15% for the infrequent, very large Needs. In this way, we are more than motivated, we are required to make sure we do not overcharge you.

We make our money from admin fees, and referral fees from products and services. Since our goal is to reward your wellness efforts, we keep these costs to a minimum and base the model on low cost and high volume. This allows us to offer high value to as many members as possible, and in doing so, everyone benefits.

*Source https://www.aarp.org/health/medicare-insurance/info-09-2009/health_claim_game.1.html
http://www.latimes.com/business/lazarus/la-fi-lazarus-denied-insurance-claims-20170109-story.html
http://www.latimes.com/business/lazarus/la-fi-lazarus-winning-insurance-appeals-20170117-story.html

Get In Touch

True Life Protect

403 S Baldwin St., Suite B
Woodland Park, CO 80863

Phone: (877) 968-8772
Email: team@truelifealliance.com

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