With the reduced carrier selections, increasing and sometimes unattainable premiums, and increased deductibles and coinsurance, people are aggressively looking for alternatives to traditional health insurance. Some are turning to nonprofit, religious-based plans, known as Christian healthcare plans, due to their significant reduction in premium costs and their exclusion from ACA penalties and requirements.
These plans have seen tremendous growth over the past three years, paying close to two-thirds of a billion dollars in medical expenses and covering over 600,000 members in 2016. Their explosive growth is eliciting greater interest and greater scrutiny.
Both are warranted. Who are they? What do they offer? What don’t they offer? What are their costs? Are they legitimate? Are they regulated? Let’s take a closer look at Christian healthcare plans to see if they might be right for your needs.
What is Christian Healthcare?
Christian health plans are healthcare-sharing ministries oriented toward practicing Christians. They are aligned with biblical teachings that believers have a responsibility to assist each other’s needs. They have been in existence for over twenty years and are growing rapidly due to their philosophy and low initial costs for healthcare solutions.
They are not insurance companies. They are excluded from ACA mandates like pre-existing coverage exclusion, underwriting, and unlimited payments, due to their religious conviction. Members literally share in certain expenses covering one another’s costs. Interestingly, this is the basic definition of insurance to aggregate expenses.
What Are the Requirements?
The major membership qualifications require: Christian testimony (live by biblical standards, bear one another’s burdens, and regularly attend a fellowship of believers); healthy lifestyle (no smoking or illegal drugs); application review (underwriting—you can be denied for pre-existing conditions); and health partners (be willing to participate with health coaches to work toward a healthier lifestyle).
Interestingly again, this shared commitment to health produces solid aspects of the program that work in improving the members’ lives and keeping health costs in control, thereby leading to better quality of life for the individual.
How Does Payment Work? What’s Covered?
Some Christian health plans have PPO network providers, and some don’t. All encourage you to negotiate fees with providers and have provider counselors to assist with negotiations if providers refuse. By paying cash, the members are generally successfully receiving significant discounts off of the published provider charges.
The programs have annual contributions that grant you “sharing” amounts per qualified illness. Each illness will require a deductible from you before the illness is submitted for sharing. Non-qualified or preexisting condition bills can be submitted as financial prayer requests that may or may not be met by the membership. Each individual is assessed on the annual contribution level and then will also receive financial prayer requests from others throughout the year. Entry-level plans usually don’t cover prescription drugs.
When considering these plans, or any other plan for that matter, do not just read the covered procedures. Find the exclusion section, generally in the appendix of their coverage guide, and scrutinize those features. Make sure your health profile, which includes your family health history, does not include those features. Common exclusions with these plans are pre-existing illnesses, prescription medicine, chiropractic treatments, diagnostic services, birth control, and illegal drug-related services.
Who Are the Biggest Players?
The healthcare-sharing ministry landscape is dominated by five major players with the largest memberships and highest revenue spread across the country and across Christian denominations. Samaritan Ministries (Illinois), Christian Healthcare Ministries (Ohio), and Medishare (Florida) are the three large evangelical operations.
Dozens of similar ministries exist across the country, mostly smaller and more localized. Ohio’s Liberty HealthShare is Mennonite, a denomination traditionally committed to pacifism and dialogue. Solidarity HealthShare, founded in 2015, is Catholic, and partnered with another Mennonite aid group in Ohio to be grandfathered into the ACA exemption for sharing ministries, which required that they exist before 1999. There is also a Jewish-based health plan found at unitedrefuahhs.org.
Who Should I Talk to?
If you’re interested in one of these plans, analyze the plan designs, rules, and regulations. Seek out current participants who have had large claims. Find out what worked for them and what didn’t, and go from there.