Healthcare Sharing Ministry Instead of Traditional Health Insurance?
For households that are buying their own health insurance, the monthly premiums for even the most basic coverage can be crippling. In many cases, a family’s health insurance premium may be their highest bill, surpassing even their rent or mortgage payment. Fortunately, there is a cost-effective alternative to traditional health insurance that allows families to enjoy coverage without having to significantly alter their monthly budget.
Although once considered a fringe option for those unable to or uninterested in purchasing traditional health insurance, Christian ministry programs have experienced a surge in popularity in recent years, adding millions of subscribers. These programs are based on the biblical mandate given in Galatians 6:2 to “bear one another’s burdens” by connecting Christian families and individuals with others who share their beliefs and values and allowing them to share medical expenses.
What Is a Health Care Sharing Ministry?
A health care sharing ministry is a faith-based organization that makes it possible for like-minded people of faith to share each other’s medical expenses. To be considered an HSM, the organization must fulfill five requirements:
- It must be a non-profit organization
- It had to have existed in December 31, 1999
- It must permit an independent CPA to perform an annual audit
- Its members must share common ethical or religious beliefs, regardless of which state they live or work in
- Its members must be allowed to stay in the program even if they develop a medical condition or are injured
How a Health Care Sharing Ministry Works
On the surface, health care sharing ministries work similarly to health insurance. You pay dues each month (similar to a premium) and you have a set amount that you’re required to pay out of pocket before receiving financial assistance (similar to an insurance deductible). In some cases, you’ll pay for medical expenses out of your own pocket and then get reimbursed by the ministry. Other times, your doctor will submit the bills directly to the ministry. Each member has maximum eligibility amounts, which limits how much they can receive for medical expenses. With some HSMs, the money is disbursed by the ministry as needed, and with others, members contribute directly to the fellow member who needs it.
Health Care Sharing Ministry vs. Traditional Health Insurance
Things to Consider Before Signing Up
Health care sharing ministries and health insurance have a couple things in common. Obviously, both provide you with a way to pay for medical expenses that would otherwise be entirely unaffordable. With both, you’ll generally pay an out-of-pocket amount before your coverage will begin (with a health care sharing ministry, this is often called a personal responsibility; your health insurer calls it a deductible). However, this is pretty much where the similarities end.
Traditional Health Insurance
Major Medical ACA (Obamacare) health insurance is required to provide coverage for 10 essential health benefits, including prescription drugs, maternity and newborn care, hospitalization, and substance use disorder services. Patients can’t be turned away due to pre-existing conditions or other factors like obesity or tobacco use. There are no lifetime limits or caps in coverage. When you have a health insurance policy, your insurer is contractually obligated to provide you with the insurance coverage that you’re paying for; if they refuse, you have recourse and can take your complaint to a state insurance regulator.
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Medicaid is a health insurance program administered by the state and federal government, to provide health coverage for those who meet income restrictions or have qualifying medical needs. Medicaid can also be used alongside other health insurance coverages such as private health insurance, Medicare, etc.
What is Tier Pricing With Prescription Medications?
Your health insurance company’s formulary is a list of all the different drugs that their plans cover. Within the formulary, there are drug tiers. These tiers determine the level of coverage your prescription drug plan offers for a specific type of medication.
Health Insurance with a Preexisting Condition
You may assume that since you have a preexisting condition, you’ll pay a higher premium than someone who is in perfect health. However, an insurer cannot reject you, refuse to pay for health benefits pertaining to your illness or injury, or charge you a higher premium because of your condition.
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Health Care Sharing Ministry
With a health care sharing ministry, things aren’t as cut and dry. Health Care Sharing Ministries are faith-based and some require that you share their religious beliefs, while others require that you share a similar set of “values”. Because they aren’t an insurance company, they aren’t required to cover those 10 essential benefits outlined in the ACA (affordable care act).
Unlike insurance companies, Christian ministries have very limited oversight. Most ministries are upfront with the fact that members are not guaranteed to receive any assistance with eligible medical bills, and that they reserve the right to distribute funds when and how they see fit. Subscribers trust that their medical needs will be met, but there have been plenty of instances in which eligible medical bills have not been covered. When this happens, there is little recourse.
Additionally, many exclusions apply. In many cases, subscribers are required to provide a statement of faith or a letter from their pastor to demonstrate that their values and beliefs are in line with that of the organization. These organizations can turn people away if they have any pre-existing illnesses or conditions, are overweight, are pregnant, smoke, drink alcohol, or have any other factors that aren’t in line with the organization’s beliefs. Some will reserve the right to not pay for medical procedures that they deem morally objectionable or for maternity care for an unmarried woman. While lifetime limits and caps are generally high, they do exist. Finally, they’re not bound by a contract to provide you with financial assistance for medical care. How they dispense money is left entirely to their discretion, and if for whatever reason they should decline covering a medical expense, you will be financially responsible for it.
An important question to ask is how quickly do large medical bills get paid with Health Care Sharing Ministries?
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Supplementing Your Health Insurance with Unity Healthshare
Open to all faiths.
Now that the individual health care mandate has been lifted, Nevadan’s will have more flexibility in 2020 when it comes to choosing a non-ACA-compliant healthcare plan. While these plans may be more affordable in the short-term, they often have some serious gaps in coverage that can leave patients with hefty medical bills.
Here’s where Unity Healthshare comes in. This program makes it possible for people to give and receive help for medical costs. Unity Healthshare members pay monthly dues. Once a medical service is received by a member, the doctor submits the bill to Unity, where it would be reviewed and then payment is sent to the provider. Members are required to pay a “Member Shared Responsibility” amount (similar to an insurance deductible) before Unity pays for medical expenses like hospitalization. There are some plans, however, that cover doctor’s visits, x-rays, labs, urgent care, etc., before the member shared responsibility comes into play.
Unity Healthshare is unique in that it is open to members of all faiths. Members’ lifestyles must align with the program’s statement of beliefs, and they are expected to have a healthy lifestyle.
While Unity Healthshare isn’t health insurance, it is designed to relieve financial strains that an unexpected medical emergency can have, pay for hospitalization, manage a chronic health condition, or cover acute illnesses and sicknesses. Your insurance agent can help you evaluate your needs and decide whether this program is a good fit for you. Unity Healthshare has many programs to choose from and may fill the needs you are concerned about.
Let Nevada Insurance Enrollment Guide You
Health care sharing ministries can be a legitimate way to help cover the cost of medical care, and generally cost much less. It is, however, very important to understand what it does and does not cover. They can be a good option for healthier individuals who would otherwise be without coverage.
Before signing up, it’s important to conduct thorough research to ensure that you understand the benefits and limitations of the plan you choose. Your Nevada Insurance Enrollment health insurance agent can provide you with more information and help you decide whether a health care sharing ministry will fit your needs.
Top 5 Most Popular
By page visits (this month)
#1) Health Insurance Subsidy Chart
#2) Health Insurance
#3) Health Insurance WITH a Subsidy
#4) Insurance Blog Posts
#5) Request a Quote
Recent Posts
Medicaid Basics To Know
Medicaid is a health insurance program administered by the state and federal government, to provide health coverage for those who meet income restrictions or have qualifying medical needs. Medicaid can also be used alongside other health insurance coverages such as private health insurance, Medicare, etc.
What is Tier Pricing With Prescription Medications?
Your health insurance company’s formulary is a list of all the different drugs that their plans cover. Within the formulary, there are drug tiers. These tiers determine the level of coverage your prescription drug plan offers for a specific type of medication.
Health Insurance with a Preexisting Condition
You may assume that since you have a preexisting condition, you’ll pay a higher premium than someone who is in perfect health. However, an insurer cannot reject you, refuse to pay for health benefits pertaining to your illness or injury, or charge you a higher premium because of your condition.
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Whether you have recently been injured or you are experiencing chronic pain or limited mobility, going to a physical therapist can greatly improve your quality of life. For many people, concerns about how much regular sessions cost is a big roadblock to getting much needed care. Fortunately, if you have an ACA-compliant health insurance plan, rehabilitative services like physical therapy are listed among the essential health benefits.