GMR 59: Healthcare Sharing Programs
Episode 59
Healthcare cost has becoming a large part of our monthly spending. Every year the cost continues to rise, and the Affordable Care Act has made healthcare cost anything but affordable. Alternative healthcare sharing programs have been growing in popularity over the past few years and they may be the answer to lower healthcare cost you’ve been looking for.
SHOW NOTES
What Is A Healthcare Sharing Program or Ministry?
Faith-based programs (of varying degrees with options for different religious denominations) which facilitate voluntary sharing among members for eligible medical expenses.
Members send in monthly ‘shares’ (i.e., premiums) which are distributed to or on behalf of other members with medical expenses (i.e., benefits payments) in accordance with program guidelines.
Built upon the principle of people with similar beliefs and values coming together to share each other’s burdens (in this case healthcare costs), not unlike the risk-pooling nature of health insurance.
The appeal of healthcare sharing programs is that in practice, they are much less expensive than health insurance.
Families can become members in healthcare sharing programs for $300 to $500 per month, compared to the average unsubsidized cost of family traditional health insurance coverage at $1,564 per month, and it’s easy to see the savings appeal for those who lack generous employer coverage or do not qualify for government premium assistance.
Healthcare sharing programs typically have lower out-of-pocket expense limits than typical high-deductible health insurance plans as well.
Caution: healthcare sharing programs are not actually health insurance. In fact, part of the reason that they’re less expensive than traditional health insurance is that their coverage may be more limited (than Affordable Care Act mandates for essential health benefits).
Limitations of coverage are based not only on managing potential costs and claims, but also the faith-based nature of the programs.
While healthcare sharing programs do cover many typical medical expenses that health insurance covers, they typically do not cover many health-related costs deemed to be ‘unbiblical’ – which the programs define in their guidelines – and may exclude payments for:
Birth control.
Abortions.
Injuries related to alcohol or drugs.
And injuries from certain hazardous activities (i.e. failure to wear helmets or seat belts in some situations).
Participating members are exempt from the Affordable Care Act’s individual mandate to purchase health insurance, and from completing the IRS Form 8965 at tax time which attests to membership in a qualifying program (in lieu of traditional health insurance).
To become a member, healthcare sharing programs may require agreement with a statement of faith, and in some cases even have a process to verify regular church attendance, although each has a different policy.
How they work?
Basically, everyone pays in a certain monthly share amount, and for your own expenses, you are responsible for covering an “annual personal responsibility”, or “unshared amount” (like a deductible). Then, the rest of your medical expenses are shared among the group from what they have paid in – in many cases up to $1 million per incident!
Are There Restrictions?
Yes. Since they are faith-based ministries, they do have different guidelines (like smoking, or certain pre-existing health or lifestyle-related conditions). In which case they will decline membership.
Some take people with pre-existing health conditions others do not. For those who accept pre-existing conditions, these types of conditions may be handled in a few different ways. The condition may be phased in. If that's the case, members do not share costs for that condition during the first year. Then during years two and three of membership, members share up to a certain amount ($50,000) of eligible expenses to treat that condition. However, some pre-existing conditions might never be shareable. You can always just call an ask.
Are there programs for families?
Yes! They have programs for the entire family. Your family can participate in a very comprehensive option for under $500 a month, which is a maximum. There is a range of options less expensive than that depending on how much you want shared.
Differences between Sharing Programs and Health Insurance
Healthcare Insurance guarantees a certain level of payment depending on your level of coverage.
Healthcare Sharing Programs provide no guarantees of payment, although many do provide reimbursement for qualified expenses.
A few of the major health care sharing ministries are:
Christian Healthcare Ministries, this is the one I (Leo) use.
What is the difference between the health care sharing ministries?
All four of the above medical cost sharing ministries are very similar, but there are some differences among them. The largest differences are:
Their acceptance guidelines
If they process medical bills electronically or not
If they allow cost sharing of alternative or natural treatments.
Beyond that, we included a FAQ in our show notes which you would find extremely helpful. It has a very informative and clear answer for every question you would think of asking.
If you are looking for an affordable way to handle your medical expenses, a health sharing ministry could be just what you need.
RESOURCES
Christian Healthcare Ministries
Samaritan Ministries
Medi-Share
Liberty Healthshare