Dec
12/20
15

What is a Medical Sharing plan? Is it a good idea?

in Human Resources, Insurance

There are several “Health Care Sharing” options, but none of them provide “Credible Coverage”. Here’s how they work:

Each person or family is required to pay a monthly fee (this is NOT a premium). This monthly fee pays the health care costs of other families in the program. When you need health care, the money comes from this fund as well. In addition to their monthly fees, members are encouraged to give further money in order to help pay for the treatments of others. This is necessary because medical costs are high and the monthly fees are low.

None of these organizations will guarantee that your medical bills will be paid. This is very different from traditional insurance, and it can get very dangerous. Take this example.

Couple A needs emergency care. Upon arrival at the ER, they present their card, and the hospital discounts the bill per the prearranged discounts. The hospital sends the bill to the health share company, who then examines the bill to determine if they will share the expense. (This is a faith-based option, so several moral issues will preclude services being shared. If the health problem involves tobacco, alcohol, or a sexually transmitted disease, the bill is not likely to be covered.)

If the health share company accepts the bill and agrees to pay for the services, Couple A is required to pay the deductible. Then, the remainder of the bill is published for other members to contribute those extra dollars we talked about earlier. Obviously this will take some time!

So, after Couple A has received their emergency care, the hospital sends a bill for the remaining amount due. The sharing hasn’t been fully funded, so the couple must pay out-of-pocket and hope that their sharing community will pay for the rest of it. In the worst-case scenario, the bill may be sent to collections. The couple may be sued because they cannot afford to pay the bill while the health share company tries to gather funds.

Here’s the bottom line: health share companies can put you under undue financial risk. Traditional healthcare is available, and these insurance companies operate under laws and regulations to protect you and your family.

Comments

15 Responses to “What is a Medical Sharing plan? Is it a good idea?”
  1. Joel says:

    A health care sharing ministry (HCSM) provides a health care cost sharing arrangement among persons of similar and sincerely held beliefs. An HCSM is a not-for-profit religious organization acting as a clearinghouse for those who have medical expenses and those who desire to share the burden of those medical expenses. Because HCSMs are not insurance companies, HCSMs do not assume any risk or guarantee the payment of any medical bill. Rather, as an alternative to traditional health insurance, a need sharing ministry is founded on the Biblical mandate of believers to share each other’s needs.

    The largest of the three major HCSMs is Samaritan Ministries. Samaritan Ministries members have been sharing medical expenses for more than 17 years and the amount shared between the members each month is more than $4.5 million. Shares ($320 for a family, as of 1/10/12) are sent from one member to another and do not come to the ministry’s office. Samaritan members are responsible for the first $300 of each medical need that they submit for publication. In 2011, Samaritan Ministries reported a growth rate of 20 percent.

    It is important for any individual to investigate the guidelines of each individual health care sharing ministry and make educated decisions, but to address some of the broad claims made in the blog post, I would like to speak specifically about the largest HCSM, Samaritan Ministries, and how the post reflects on it:

    [From the post]“Each person or family is required to pay a monthly fee (this is NOT a premium). This monthly fee pays the health care costs of other families in the program. When you need health care, the money comes from this fund as well. In addition to their monthly fees, members are encouraged to give further money in order to help pay for the treatments of others. This is necessary because medical costs are high and the monthly fees are low. “

    The amount a Samaritan Ministries member agrees to send to another member each month is determined by household size. As of January 26, 2012, share amounts are $320 for a family, $270 for a couple, and $135 for a single. Shares are sent directly from one member to another and do not come to the ministry’s office. This is direct sharing of medical needs, members to members, and there is no “fund” involved. Members are responsible for the first $300 of a need. Needs that do not meet ministry guidelines may be eligible for publication as Special Prayer Needs that members may give to in addition to their regular monthly share as a free will offering. Members are fully aware that sometimes needs do not met the guidelines to be published and that money sent to Special Prayer Needs is charitable giving and is not “because medical costs are high and the monthly fees are low. “

    [From the post]”Couple A needs emergency care. Upon arrival at the ER, they present their card, and the hospital discounts the bill per the prearranged discounts. The hospital sends the bill to the health share company, who then examines the bill to determine if they will share the expense. (This is a faith-based option, so several moral issues will preclude services being shared. If the health problem involves tobacco, alcohol, or a sexually transmitted disease, the bill is not likely to be covered.)If the health share company accepts the bill and agrees to pay for the services, Couple A is required to pay the deductible. Then, the remainder of the bill is published for other members to contribute those extra dollars we talked about earlier. Obviously this will take some time!”

    Samaritan Ministries members are self-pay patients and are billed that way by providers. Members are instructed to tell their provider that they do not have insurance. There are no pre-arranged discounts, but quite often members negotiate discounts as self-pay patients. In the self-pay situation, the bill(s) are sent directly to the patient and not to the office, because Samaritan Ministries is not an insurance company. When a member has a health care need, he receives health care treatment from a provider of his choice, collects the bills, and sends them to Samaritan Ministries. Samaritan Ministries verifies that the need meets the guidelines. Then, in the monthly newsletter mailing, Samaritan Ministries directs some members to send their shares to the member with the need. The member with the need receives the shares from his fellow members to pay his health care bills. The ministry guidelines state which medical needs are publishable are and which are not. Members sign off on their initial application upon joining and on an annual basis that they have read and understand the guidelines. Many members choose to join Samaritan Ministries because they do not want their health care dollars to pay insurance premiums that in turn pay for medical procedures they are morally opposed to, such as abortions, abortifacients like the morning-after pill, sexually transmitted diseases, and sex changes. As stated above, when a member has a need there is direct sharing of medical needs, member to member, and no extra dollars are required unless the member sends money to a member who has a Special Prayer Need. The publishing turnaround time is normally 30-60 days from receipt of the bills and required information.

    [From the post] ”Here’s the bottom line: health share companies can put you under undue financial risk. Traditional healthcare is available, and these insurance companies operate under laws and regulations to protect you and your family.”

    Samaritan Ministries members have been sharing medical expenses for over 17 years and the amount shared between the members each month is more than 4.5 million dollars. Samaritan Ministries is a 501(c)(3) nonprofit organization that falls under the oversight of each state’s attorney general. Samaritan also makes its annual financial audits available. Sixteen states have passed safe harbor laws which have defined HCSMs, like Samaritan, as legitimate, not-for-profit ministries that are not subject to the state’s insurance codes. HCSMs were similarly recognized in the new federal health care law.

    Here’s the actual bottom line: There is no argument that traditional insurance is available. And traditional insurance companies are for-profit entities and, when possible and applicable, deny claims, which keeps profits high. So there is also a financial risk for those who choose traditional insurance, which is the individual’s right to choose. Samaritan Ministries believes Jesus Christ is the Ultimate Provider for all of life’s needs. Individuals and families have the primary responsibility for their own health and decisions related to seeking health care. When they have burdens that are greater than they can bear, we firmly believe that the body of Christ, at the local church level first, and then in a broad corporate sense, should bear one another’s burdens to fulfill the law of Christ (Galatians 6:2). Our monthly newsletter seeks to teach these principles as an integral part of our Christian worldview, not only to our members, but also to all the Body of Christ, to whom we minister by example and exhortation.
    Roughly 70 percent of new members come from word of mouth, so before making a decision about joining a health care sharing ministry such as Samaritan Ministries, the wisest course of action is to speak to someone at the ministry directly and to those who use health care sharing to meet their medical needs.

  2. Greg says:

    GREAT REPLY POST…excellent

  3. Steve says:

    I agree, great post in reply to the original. I’m researching this right now and much of what is said in the original post is misleading at best. I’ve not come across any of the companies (there are three in the United States) that charge the monthy fee AND another fee to cover the medical expenses of another. The monthy fee IS the sharing.
    Do the reasearch yourself and don’t depend on this article.

  4. Roger Bower says:

    Odd to hear the original poster mention that there is a chance the bills will not be paid. I’ve had a BCBS plan under COBRA for three months and I’ve had much trouble getting them to pay for a covered illness, whereas Samaritan just asked for an itemized bill and a statement from my doctor and payment is coming in already. Your medical provider is quick to tell you that you personally are responsible for your medical bills, not your insurance company, even when that provider negotiates with that insurance company. So the original post’s comment is misleading. The insurance company is not liable for your expenses unless you can prove it meets their conditions for payment.

  5. Ron Lively says:

    I have been a member of two Health Care Sharing Ministries (HCSM) since 1996 and would not go back to traditional insurance even it was offered free of cost. We have filed three surgeries and each time, we pay only the initial cost of $300. Presently, we are more than satisfied with Samaritan Ministries. I encourage anyone to go to http://www.bridgerewards.com/place/samaritan-ministries/ to learn more about how the people of faith are helping each other. Presently 25,000 families are paying nearly $7M of real heath care costs monthly. Who you going to trust? Personally, I choose to trust a network of faith based people who gladly help cover the bills of others so they can submit their costs for sharing when necessary. I like that these plans are non-profits. I like the personal support of other like-minded people. I like the fact that I am not paying for the higher costs of those who choose a lifestyle that increases their costs and that goes against my personal moral and ethical beliefs. More now than ever, these plans that are exempt from the ObamaCare laws are ever more attractive. I do whatever I can to provide this valuable and effective resource. With a bit extra per year, we essentially have unlimited care from any doctor or provider I choose. There are so few restrictions in these plans. You can trust Samaritan Ministries. Ron

  6. Mike E V says:

    My 85 year old, Canadian citizen mother-in-law has legally immigrated to the US and lives with us in California. Her Canadian health coverage will not cover any expenses here. As she is not a US citizen, only a legal resident, she doesn’t qualify for the ACA or any State programs. She is actually quite healthy but there will come a time when she will need financial assistance for medical services. I have requested a packet and anxiously await its arrival in the mail. No insurance company will offer us coverage and she will not be eligible for Medicare until age 88. This almost sounds too good to be true as her age has always been the weak link in getting coverage.

  7. Jim W says:

    I am getting ready to retire so, obviously I have to consider how I will cover my health care needs. Samaritan Ministries sounds like a very viable option.

  8. Alan L says:

    My family has had traditional insurance for years. We don’t drink, don’t smoke, and do everything we can to stay healthy. Now that ObamaCare is mandated we found our insurance premium has tripled. Far beyond what we can afford!! And we still have to pay 30% of the bills. We are being penalized for everyone else’s bad lifestyles.

    Unless we the people force “big brother” to stop government mandated socialistic controls over our health insurance, this hidden “tax” will only get worse.

    I can see a lot of people telling the government to get lost and joining HCSM type services instead. Samaritan Ministries and others like them need to prepare for an ever increasing demand during 2014 and beyond. Better yet lets get rid of all of our unrighteous leaders the next time we vote.

  9. Jim says:

    I’m curious if Samaritan Ministries will even be allowed to function anymore. Seeing as how the government is mandating credible coverage, and Samaritan Ministries is NOT credible coverage, is the government going to force me to have an insurance policy on top of what Samaritan Ministries offers?

  10. Dave P. says:

    Jim and others:

    These health sharing ministry programs are **specifically exempted from Obamacare**. So they will continue to function and members will **not** be required to enroll in Obamacare.

    Personally, I used Samaritan Ministries for seven years till I became eligible for Medicare. My wife is currently a Samaritan member. The Samaitan plan works well.
    There are a couple of others, Medishare is the only name I remember offhand, but check them out online.

  11. Boxx says:

    There’s another sharing ministry out there that uses a very large PPO. It’s called Medi-Share by Christian Care Ministry… http://mychristiancare.org/ Their monthly share is a little higher than the others and there’s a reasonable “household portion” amount that is similar to a deductible (it’s 100% coverage after that). For me it is much better and more affordable than the Obamacare insurance options. Oh and I won’t have to pay for abortions, birth control, etc for others!

  12. Corlene Becker says:

    How much or what percent does your company take off the paid amount to cover your operating costs? Do you do any barganing with providers for reduced charges for your members?

  13. William Miller says:

    So far my coverage through employer us still being taken care of, but I’ve been looking into the cost sharing programs also. The one I’ve been investigating is chministries.org mainly because I’m in Ohio and their headquarters are there also. But if you lose your care or are forced to obamacare against your will and beliefs, check into the faith based cost sharing programs.

  14. Maggie Simpson says:

    We applied for MediShare a number of years ago and were denied membership because of the tiniest of health problems in spite of being nonsmokers and of healthy weight with healthy lifestyles.

  15. Sally Jones says:

    I’m in California, I am being treated for cancer, will medi-share accept me?