With the Affordable Care Act still in effect, every American needs to have some health coverage to avoid the fine come tax season.
Health insurance just isn’t the right call for some Americans, particularly those who don’t qualify for subsidized care or employers’ plans but can’t afford policies on their own.
One alternative to health coverage is a health sharing plan.
Health sharing plans aren’t health insurance, but they do exempt you from the ACA mandate.
Again, these health sharing plans aren’t a hack – they aren’t cheap insurance or even an alternative to health insurance. You won’t have a policy for health care providers to bill, a list of covered procedures, or even a network of doctors to visit for the price of a co-pay.
Instead, you’ll pay in money every month to what is called a health sharing ministry and use it only when you need to visit the doctor but can’t afford the overhead.
What Are Health Sharing Plans And Ministries?
The organizations offering health sharing plans are often called health sharing ministries.
In many cases, these ministries are faith-based health care sharing ministries. Many are based on the Christian faith, but they can also loosely pool together groups that share ethical or other religious beliefs.
Indeed, many of the Christian organizations base their work on scripture. For example, Paul says in Galatians 6:2 to “Bear one another’s burdens, and thus fulfill the laws of Christ.”
In other words, sharing the cost of healthcare is a Christian’s duty.
Unlike insurance companies, health sharing ministries do not employ actuaries to price policies. They also do not:
- Make guarantees
- Accept risk
- Purchase reinsurance policies for members
In 30 states, ministries are legislatively distinct from health insurance organizations. However, you’ll also need to see whether the ministry you’re interested in exempts you from the mandate. An exemption requires the organization to:
- Be a 501(c)(3) charity organization
- Not discriminate based on employment or state of residence
- Maintain coverage even in the event of a medical condition
- Must have existed since December 31, 1999
- Submit to an annual audit
- Base membership on shared religious or ethical beliefs
Four ministries meet these qualifications: Samaritan Ministries, Liberty HealthShare, Christian Healthcare Ministries, and Medi-Share.
Other ministries like MCS Medical Cost Sharing don’t meet the ACA qualifications and thus don’t exempt members from the mandate penalty. However, some new ministries will offer to pay the fee for you.
How Does It Work?
Each ministry runs the fund in a different way, but every ministry shares a common basic operation.
You and all the other members pay a set amount to the fund every month. The amount set should cover your own expenses with the goal of covering your “annual personal responsibility.”
Annual personal responsibility is similar to an insurance deductible. You’re responsible for the first x amount of payments for your health care, but once you’ve met your deductible, you can then avail of the benefits of the plan.
Say your annual personal responsibility amount is $5,000. After two years, you break your leg. You pay the first $5,000 in bills – x-rays, ambulance, emergency room bills.
After you’ve met your responsibility, you’ll tap into the group fund and use money paid in by other members. There will a limit, but you could be covered for up to $1 million per incident depending on your plan.
Can I Join?
Yes, you can join.
But just like health insurance, there are some limitations. In fact, these restrictions are even more reaching because many are faith-based and most are Christian.
Smokers may have a difficult time finding coverage. Lifestyle-related conditions may also disqualify you.
Some ministries take on members with pre-existing conditions. However, whereas a health insurance policy cannot charge higher rates for pre-existing conditions, health ministries can offer different benefits. For example, someone with a pre-existing condition may not share costs for caring for that condition during the first few years of their membership.
In some cases, a pre-existing condition will never be shared. The decision is made by the ministry.
What About My Family?
Health sharing plans sound like a plan designed for healthy individuals for whom the ACA has not resulted in significant cost savings. But they aren’t limited to individuals: families can join.
Ministries offer plans that cover a variety of options.
However, you should keep in mind that children tend to visit the doctor more frequently than healthy adults. Even if they aren’t sick, they need check-ups, immunizations, and have more accidents. It’s worth considering whether your children aren’t better suited to a health insurance plan while you and your partner use a ministry.
The 4 Different Health Sharing Ministries
Now that you know what health sharing ministries are, it’s time to learn how the available programs differ from each other. Here’s what you need to know about the four recognized ministries:
Liberty Health Share
- Three different sharing levels
- Available in 50 states
- Contributions range from $100 to $450 monthly
- Out-of-pocket costs range from $500 to $1,500 annually
- Liberty distributes money
- Non-evangelical faiths are allowed to participate
- No preferred care networks
The bottom line: Liberty Health share offers a flexible plan open to Christians of all denominations in 50 states.
- Six sharing levels
- Sharing levels between $64 and $627 monthly
- Out-of-pocket costs range between $1,250 and $10,000 annually
- Limited care networks
- Only Evangelical Christians accepted
- Not available in every state
The bottom line: With many options available, Medi-Share offers several potential plans for Evangelical Christians in a handful of states, if you’re willing to sacrifice freedom in care networks.
- Monthly payments between $180 and $405
- Available in all 50 states
- Shared responsibility of $300 per person or $900 per family
- Only Evangelical Christians accepted
- Don’t negotiate with providers
- Contributions are made to other members directly – not Samaritan Ministries
The bottom line: Limited to Evangelicals, Samaritan Ministries makes paying for health care more complicated than other ministries. You’ll be cutting checks directly to other members, Jane Smith or John Doe, rather than letting Samaritan do the work for you.
Christian Healthcare Ministries
- Three sharing levels
- Monthly costs between $90 to $450
- Annual out-of-pocket between $500 and $5,000
- Non-evangelical faiths are allowed
- Operate in all 50 states
- Don’t negotiate with providers or pay providers
The bottom line: Entrance to the program is more flexible, but you’ll be left negotiating with health care providers. Plus, you’re responsible for forwarding the checks to them.
Health Sharing Plans Are ACA Approved
If health insurance just doesn’t make sense, then you don’t need to buy it. By buying into an approved health sharing plan instead, you can save money and only pay for the care you need when you need it.
Have you tried out a health care sharing ministry? Share your tips and stories in the comments below.