Since Jan. 1, my family has been without traditional health insurance for the first time in our lives. Sounds scary, but it wasn’t a decision we took lightly, or one we made voluntarily.
Due to the passage of the Affordable Care Act (ACA), also known as Obamacare, the Anthem plan we had last year was canceled because it didn’t offer the standard benefits required by the new health care law. That meant we would need to purchase a new ACA-compliant plan in our state.
The problem? All the new plans available in our state and county cost at least twice what we had been paying. Even worse, all the cheaper plans had family deductibles as high as $13,000. Frustrated, I started looking around for other options. And that’s when I stumbled upon health care sharing ministries.
Health care sharing ministries are groups of like-minded people who band together to share medical expenses in a mutually beneficial way. There are four main sharing ministries offering these plans in the United States: , , , and .
According to the Alliance of Health Care Sharing Ministries, the groups provide a “health care cost sharing arrangement among persons of similar and sincerely held beliefs.” Further, “HCSMs are operated by not-for-profit religious organizations acting as a clearinghouse for those who have medical expenses and those who desire to share the burden of those medical expenses.”
Each ministry works in its own way, but in all cases, each member pays a monthly “share” that is distributed among members who are simultaneously experiencing a need. In addition to their monthly share, members must also meet an “unshared amount” of money each calendar year, similar to a deductible. And depending on the plan, members may also be responsible for paying for their own well-care visits out of pocket, as those expenses aren’t typically eligible for sharing.
How Are They Different?
In some ways, health care sharing ministries are just like traditional health insurance. But there are some notable differences, including the following:
- Unlike new health insurance plans offered in the post-ACA era, health care sharing ministries can and do discriminate against customers with pre-existing conditions and existing health issues such as obesity or smoking.
- Health care sharing ministries may choose not to cover medical procedures the group finds morally objectionable.
- Unlike ACA-compliant plans, these ministries are allowed to impose lifetime limits or caps on coverage. Those limits vary by plan, but typically fall somewhere in the range of $250,000 to $1 million per illness.
- Health care sharing ministries are not required to pay for free preventive care, though some ministries include free well visits in their plans.
Other differences exist as well. For example, traditional health insurance plans are available to anyone of any religious background with no conditions. Health care sharing ministries in the U.S. are mostly geared to like-minded Christians, with the exception being Liberty HealthShare since they claim to accept individuals from any religion (or no religion) as long as they agree to their “shared beliefs.”
Can These Ministries Save You Money?
This will depend upon your circumstances, the health insurance plans offered in your state, and your income.
The ACA offers subsidies that can make health insurance more affordable if you meet certain income guidelines. However, subsidies drop off if you make more than 400% of the federal poverty limit, which is around $95,400 for a family of four and $62,920 for a family of two. If you make less than 400% of the poverty limit, you should first check in with (or your state’s health insurance exchange) to see what, if any, subsidies might be available to your family. If you make more than 400% of the poverty limit, you’re mostly on your own, subject to whatever prices the market will bear.
In my county in Indiana, the cheapest plan on or off the exchange for 2015 is a $728-per-month CareSource Just4Me plan with a $13,200 deductible. That means that, if we met our deductible, we would spend a total of $21,936 per calendar year on health care before our insurance kicked in to assist. With this plan, we would also be on the hook for $40 for regular doctor visits, $80 for visits to a specialist, and a $500 deductible for emergency room visits, even after the $13,200 deductible was met.
Instead, we joined Liberty HealthShare. For $449 per month, we have a $1,500 annual unshared amount (deductible), one free well visit per person per year, and $1 million of coverage per illness or incident. Do the math and you’ll see that, instead of being on the hook for over $21,000, the most we can be responsible for is $6,888 in one calendar year, the cost of any preventive care.
Other ministries offer similar plans, although “unshared amounts” can be higher or lower and each plan features its own lifetime caps and included benefits. Although prices for these plans vary, plans start at around $200 per month, though the cost will depend heavily on the plan chosen and benefits offered.
More Reasons to Consider Health Care Sharing Ministry
Aside from any potential savings, another benefit that comes with joining a health care sharing ministry is the fact that it exempts you from paying the fine for not having an ACA-compliant health insurance plan. For 2014, the fine was $95 per person or 1% of your annual household income. But for 2015, the penalty surges to the higher of these two amounts: 2% of your annual household income or $325 per adult and $162.50 per child.
If you believe in sharing the medical costs and financial burden of others, health care sharing ministries allow you to do so in an environment of your choosing. Meanwhile, if you happen to find any parts of the ACA morally objectionable, health care sharing ministries offer an alternative that allows you to escape the financial penalty for not having health insurance while also providing coverage for your family.
Although we were initially worried about opting out of traditional health insurance in favor of a health care sharing ministry, our minds are now at ease. We’re still paying more than we were before, but our out-of-pocket limits are considerably less now and we can visit any doctor or hospital of our choosing.
All any family can do is look at their options, educate themselves, and choose what works best for their budget and overall health. No plan is perfect, but health care sharing ministries offer an alternative for families who can no longer find affordable options.
Have you considered a health care sharing ministry? What are your thoughts?