Affordable Care Act mandates, growing deductibles, and skyrocketing insurance premiums have left many independent pastors scrambling for an answer to their family’s health care needs. Luckily, there is a more affordable alternative to health insurance: medical cost sharing plans.
Obamacare Open Enrollment is just around the corner, November 1 to December 15 for next year’s healthcare coverage. Thousands of people will be going to the exchanges and finding that premiums have gone up yet again, up 30% in some cases.
Even with government subsidies, many families are struggling with the rate at which premiums are increasing and the out-of-pocket costs. And no one knows if those government subsidies will even be around next year.
Many independent, non-denominational pastors don’t have healthcare coverage through their church or spouse’s job. If you’re one of them, I’m sure you feel as though you’re between a rock and a hard place. What can you do? You want to take care of your family, but the math just doesn’t add up in your budget.
I’m here today to tell you about a little-known but completely legitimate and more affordable alternative to health insurance, medical sharing plans.
What Is A Medical Sharing Plan?
Medical sharing plans are based on the early church’s idea of Christians taking care of one another (as seen in Acts 2 & 4). Members of a medical cost sharing ministry pay each other’s eligible medical bills instead of depending on an insurance company to pay them.
They are not insurance companies and are not subject to the same rules and regulations. As ministries, they qualify as 501(c)(3) tax-exempt organizations. They are groups of like-minded individuals who pool their resources to prepare for unforeseen medical expenses.
Each member pays a monthly share amount, just like you would pay a premium to an insurance company. When you have medical expenses, you will first have to pay an “unshared amount” or “annual personal responsibility,” which works the same as a deductible. After that, your expenses are shared among the group, who pay the costs with the money that has been accumulated.
Are They Legal?
These are not scams aimed at overly-trusting Christians. They are legitimate means for covering health care costs. The Affordable Care Act mandates that these ministries have annual audits conducted by an independent accounting firm with the results made public upon request.
They are even exempt from mandatory coverage under Obamacare. That means that even though they are not technically health insurance, they meet the coverage requirement and their members are not penalized for not having insurance.
Before Obamacare, there were about 200,000 members of health sharing plans. After its passage, the numbers have grown to about 530,000. One of the largest has been around since 1981 and says that its members have shared more than $2.5 billion in medical bills.
Advantages Of Medical Sharing Plans
One of the major advantages of medical sharing ministries is the cost. They are significantly cheaper than traditional insurance, with annual fees as low as $500. You can cover a family of 6 for $449 a month with an annual “deductible” of $1,500.
For someone that believes that life begins at conception, paying into a system that provides abortions and emergency contraception can go against your convictions. Obamacare requires that all private insurance covers emergency contraception, but medical sharing plans are exempt. Joining one of these programs is a way to ensure that your money is not being spent on something that goes against your Christian values.
Not Dependant On Employment
We all know at least one person stuck in a job they don’t like because they don’t want to lose their medical benefits. It’s like a less-appealing form of golden handcuffs. The great thing about medical sharing plans is that they have nothing to do with employment, so you can make your career decisions based on your career goals and not healthcare.
Health insurance companies don’t pray for you. They don’t send you personal notes of support when you’re going through a medical crisis. Because they are companies, not people. Medical sharing plans are groups of people who pray for each other, lift each other up, and provide spiritual and emotional support during difficult times.
Disadvantages Of Medical Sharing Plans
Of course, nothing in this world is perfect. There are disadvantages to medical cost sharing programs that you need to be aware of before signing up. Not all of these disadvantages apply to every ministry, though. It is important to have a thorough understanding of a specific plan’s policies before making a decision.
Pre-existing conditions are handled differently by each medical cost sharing ministry. Some do not cover them at all while others phase in coverage over differing periods of time. If you have a pre-existing condition, you need to make sure you know the organization’s rules before signing up.
Medical sharing plans are not subject to the same coverage rules as health insurance is. Therefore, each plan can decide what they will cover and what they won’t. Many ministries don’t cover things that don’t align with a Christian moral standard, such as an accident from drinking and driving. Also, they do not all cover mental health, preventive care, birth control, or dental and vision for children.
Some cost sharing ministries use a PPO network. That means you are restricted to using providers within the network, which may not be easily accessible in some areas. Not all cost sharing programs use networks, though.
If you don’t have affordable employer-provided health insurance, a medical cost sharing plan may be just what you were looking for. There is even federal legislation that has been proposed that would allow members to open health savings accounts.
Come back next week when we dig deeper into the details of some of the largest medical cost sharing programs.