Have you wondered how a pregnancy is covered by Liberty HealthShare? My wife and I just went through the entire experience starting in late 2016 with the birth in August 2017, so in this post, I will explain how it works and how it went for us.
A pregnancy is covered if the following qualifications are met:
- Mother has been a Sharing Member prior to conception.
- Liberty HealthShare is notified by member directly upon learning of pregnancy – as early as possible.
(please read the Sharing Guidelines, as they are the authoritative source of information regarding Liberty’s policies)
Since earlier this year, Liberty enacted a new policy for covering non-emergency medical expenses:
First 60 Days of Participation. For sixty (60) days after Enrollment Date as a Sharing Member, medical expenses for any reason, other than accidents, acute illness or injury, are not eligible for sharing among members.
I originally thought this included pregnancy, but I called Liberty twice and got two different representatives and both confirmed that pregnancy is still covered within the first 60 days. They confirmed the policy is confusing, as the Sharing Guidelines give no indication there is an exception for pregnancy, but there is. Always feel free to double-check this and confirm for yourself!
My wife scheduled her first OB appointment soon after we discovered she was pregnant. I called Liberty to find out if we needed to do anything specific with them. The representative said nothing needed to be done and to go ahead and begin submitting the medical expenses to Liberty.
After that call, I read the Sharing Guidelines and found that the rep was wrong. It explicitly requires the member to “notify Liberty HealthShare directly upon learning of pregnancy” (see #2 above). The rep was either speaking from ignorance or trained incorrectly. Either way, I was frustrated that she spoke so matter-of-factly, yet was wrong.
The lesson I am learning so far is the same one I learned dealing with my former insurance company Coventry: double-check everything. I would call in and be told one thing, only to find out the rep didn’t know what they were talking about, then have to call over and over to get the right answer. I thought I might get less of that with Liberty, but they suffer from the same problem most companies do: some reps just aren’t great. You’re likely going to get that anywhere, though.
After the first visit, the office administrator with that Mercy clinic called us into her office and presented us with an “Obstetric Prepay” document. It estimated costs for all prenatal visits, delivery, and the 6-week post partum visit and included a discount because Liberty members are considered “self-pay.” She thought we were required to submit this document to Liberty, but from what I understand, it’s Medi-Share who requires that.
The obstetric prepay agreement allows the clinic to receive payment up front, the patient to not be out of pocket for the amount, and helps Liberty knows what costs will be due.
I immediately submitted the prepay document to Liberty, but it was denied with the reason, “Was not presented ahead of time for prior approval.” I called in to find out why. Evidently, the rep wasn’t familiar with prepay agreements and said to instead just submit each expense individually.
Over the next few months, I submitted each expense to Liberty. Note that recently, it has been taking them over 60 days to process expenses. This is unfortunate, especially for those with cash flow issues (as I detailed in my first post about healthcare sharing ministries), but expected with how much growth they have been experiencing.
Finally, late in the summer, I received notice that a medical bill had been processed. I logged into my ShareBox, and I saw that they went back and approved the prepay agreement! What?! After submitting every visit individually, and them applying those expenses to my AUA, now they approved the prepay agreement, which meant they were double covering our expenses!
I spent 30 minutes on the first call about this problem, and she finally said she would submit my account for auditing. I didn’t hear anything for two weeks, so I called back, and the second rep said there was literally no record of a call or request for auditing. Sigh. After another 30 minutes explaining everything, she actually submitted my account for auditing.
Finally, a man named Jordan emailed me, and I worked with him to smooth everything out. The processors did indeed double cover our OB expenses, and they had no idea. If I wouldn’t have notified them, I wouldn’t be surprised if no one noticed. That’s obviously terrible for their company. Seems to me like their processing department needs some serious improvement.
The actual birth experience was very easy and hassle-free. Our Mercy hospital didn’t say a single word about payment while we were there. As far as Liberty, I simply called the day after our daughter was born and within a minute or two, the rep added our daughter with just her name and date of birth. That was great to be so quick and easy.
About a week after the birth, I saw some charges appear in our online billing account. I called the Mercy Billing number and told them they could submit the charges directly to Liberty, just like with traditional insurance. I’ve previously had providers say they wouldn’t do this, but with Mercy, they said yes, and within a couple days, the charges disappeared from our account and went to the “Insurance Balance.” In around 75 days, I saw the medical expenses appear in my Liberty ShareBox as being “Shared.”
I did ask a rep if the check would go to me or the provider. They said if the bill was submitted by the member, the check would go to the member. If by the provider, the check would go to the provider. That’s great that I don’t have to mess with cashing the checks and transferring the money to the provider!
Since our birth was handled by a hospital, it is always possible we will encounter what they call a “balance bill.” Basically, this means the hospital won’t accept the adjusted payment that Liberty makes to them for your health expenses, and they come after you to get the “balance” of your account, minus Liberty’s payment. Do not work directly with the provider if they do this! Liberty works with a third-party company to provide legal and administrative resources to help you fight these balance bills. I haven’t encountered this problem yet, but I will certainly blog about it if I do! It’s now January 2018, and we still haven’t received a balance bill, so it would appear Mercy isn’t arguing with how Liberty paid them. That’s great!
I’m already used to companies having mediocre customer representatives in some cases, and I sadly experienced that a few times with Liberty during this process.
But with how much money we are saving every month, having an insanely lower deductible/out-of-pocket max, and not having to pay for medical costs that go against our beliefs, I am still very glad to be with Liberty.
I must say, it was wonderful being so hand-off with the bills after our AUA (annual unshared amount) was met! We use all Mercy providers who send bills directly to Liberty, and since we had met our AUA by the time of the birth, Liberty received the bills and sent the checks directly to the providers. We never received a bill or a check or anything. Liberty handled it all. Awesome!
My hope is that they continue to:
- Reduce time to process medical expenses and send reimbursement checks
- Better train their reps to reduce amount of disinformation or confusion for members
- Improve their website, so it’s easier to audit expenses, add documents to existing expenses, etc.
Learn More about Liberty HealthShare
I’ve been blogging about my experience with Liberty HealthShare, so feel free to read my posts!
- 2017 Liberty HealthShare Review – Part 1
- Is the Liberty HealthShare Referral Program Legit?
- 2017 Liberty HealthShare Review – Part 2
- How Liberty HealthShare Covers Pregnancy
- 2018 Liberty HealthShare Review
- Liberty HealthShare Increasing Share Amounts
If the information I’ve provided here has been helpful to you, and you feel Liberty HealthShare works for you and your family, please give me a shout, and I can provide you my member ID for when you sign up. Liberty offers a $100 gift card for referrals!
If you’ve got any questions or an experience of your own, let’s discuss in the comments below!