Healthcare Sharing Ministries vs. Health Insurance: Not the Same
People looking for affordable health care may have found health care sharing ministries.
These ministries exist to share healthcare costs. They do this among people with a shared religious or ethical belief system.
These are commonly cited as health insurance alternatives. That is not necessarily true.
The confusion comes from the U.S. Patient Protection and Affordable Care Act of 2010.
The law included an individual mandate. Everyone had to buy health insurance. People without it had to pay a penalty.
Thankfully, the law exempted people that used these ministries from the individual mandate.
Today, the individual mandate no longer exists. The ministries still do, though.
Here’s what you should know to start investigating whether they’re a good fit for you.
Health Care Sharing Ministries Are Not Health Insurance
You must realize one crucial distinction before digging into health care sharing ministries.
Health care sharing ministries are not insurance.
- They are not subject to insurance regulation.
- You do not have an enforceable contract.
- They are not required to share your medical expenses.
In a nightmare scenario, you could make your monthly payments and receive nothing.
Fundamentally, that’s not how these organizations work. It is possible, though.
How Healthcare Sharing Ministries Work
Each healthcare sharing ministry works uniquely.
These aren’t regulated companies. They all work based on how they feel best fits their membership.
Requirements may apply
To join a healthcare sharing ministry, you usually have to agree to abide by their guidelines.
Some require you to meet rigorous religious requirements. One common rule requires regular church attendance.
Other ministries are more loosely based on agreeing to their belief systems.
Not all accepted
Healthcare sharing ministries don’t have to accept everyone, though.
They can deny you based on pre-existing conditions. They can also tell you they won’t share the costs for those pre-existing conditions if you are approved.
Once you’re a member, you usually share a monthly payment to the ministry.
The ministry then shares the money with other members for eligible expenses.
Other ministries may have you send payments directly to the person you’re sharing with in a given month.
You have to do a lot more work with healthcare sharing ministries than health insurance to get reimbursed.
In some cases, you have to secure a cash discount. Then, you may have to pay upfront.
Ministries may require you to collect the necessary medical billing information to process your share request.
You often need medical billing codes and itemized bills. These can be cumbersome to obtain.
Without the required documentation, your share request may get denied.
Working with providers
Other times a provider may work directly with a health sharing ministry. In this case, the provider may submit the bill to the ministry.
The ministry then negotiates the price. Eventually, the ministry shares the costs with the provider.
Different plans offered
The plans ministries offer work in different ways.
Some are structured similarly to health insurance. You may have to pay a certain amount out of pocket before costs become shareable.
Other plans may require you to pay a set amount for each bill. For example, you may have to pay the first $500 of each medical bill.
Only after that threshold will sharing kick in.
These healthcare sharing ministries don’t have to cover all of the standard costs health insurance does.
Prescription drug coverage is often excluded. The same goes for mental health services and contraception.
Other services may be limited to a certain number of visits. One typical example is chiropractor visits.
Benefits of Healthcare Sharing
You can benefit from using a healthcare sharing ministry in a few ways.
- Ministries may be less expensive than traditional health insurance.
- Ministries allow you to help others by sharing medical costs.
- You can sign up any time of the year, not just during open enrollment.
- You may not be limited to a network of providers and might be able to choose who you want to see.
Drawbacks of Healthcare Sharing
Healthcare sharing ministries have plenty of drawbacks you have to consider.
- They aren’t health insurance and aren’t regulated so nothing is guaranteed.
- Ministries can pick and choose which costs are shareable and which ones aren’t.
- Many plans do not share prescription costs.
- It may take months to get reimbursed, which could be a cash flow issue if you pay upfront.
- You can get denied if you have a pre-existing condition.
- You must abide by their guidelines, which could include regular church attendance.
The Biggest Health Care Sharing Ministries
Here are three of the more prominent ministries and how they generally work.
Liberty Healthshare has some of the least strict membership requirements. In some ways, it works like insurance.
Members must agree to observe Christian standards.
- Regularly participating in worship or prayer
- Accepting their shared beliefs
- Maintaining a Christian lifestyle.
A Christian lifestyle includes refraining from:
- All tobacco use
- The abuse of alcohol and prescription drugs
- The use of certain legal or illegal drugs, such as marijuana
After joining, members pay a monthly share amount to the ministry each month. Then, the ministry shares those amounts to help pay other members’ medical expenses.
You can choose to visit a provider that works with Liberty Healthshare. If you do, the provider usually bills Liberty Healthshare directly.
You can also visit any other provider. You may have to pay cash upfront and submit the bill for reimbursement, though.
With this ministry, you have an annual unshared amount which works like a deductible.
You must pay expenses up until this amount before members start sharing in your medical costs.
Medi-share, also known as Christian Care Ministry, is another health-sharing ministry.
You must agree to live by biblical standards. You have to attend and actively support a fellowship of believers regularly to qualify for this program, too.
Medi-share does not allow people that have used tobacco or illegal drugs within the last 12 months to join the program.
You must also not have abused legal drugs or alcohol, either.
This ministry collects payments and shares them with eligible members for eligible expenses.
Depending on the plan you choose, your monthly share amount and share of the costs you must pay out of pocket vary.
Medi-share offers plans with different annual household portions. These work like deductibles.
They also have co-shares on some plans. These are like co-insurance.
Provider fees, which work like co-pays, also exist.
Using providers within the ministry’s PPO ensures you won’t get charged for high bills.
Visting providers outside of that network may have different results. You may end up responsible for certain costs depending on the type of visit and the amount billed.
Christian Healthshare Ministries
Christian Healthshare Ministries (CHM) requires members to live by biblical principles. You must also abstain from tobacco and illegal drug use.
The ministry requires regular attendance at worship if health permits.
They have a unique way of cost-sharing the above providers don’t use.
Their plans share costs above a specific dollar amount per medical incident.
The cost levels sharing starts at include:
The lower the amount, the higher the monthly cost of the plan.
These plans only share up to a total of $125,000 per eligible incident. Expensive treatment could exceed these limits.
You can add the brother’s keeper option to increase the $125,000 limit. The increase depends on the plan you choose and how many years you have been with CHM.
CHM states it takes 70-85 days from turning in all required documentation to reimbursement.
Can You Have Insurance and a Healthcare Sharing Ministry?
You can have both a healthcare sharing ministry and a traditional health insurance plan.
In general, the healthcare sharing ministry will make you go through your traditional insurance first.
Then, any outstanding balance owed may be shared. This is done according to the ministry’s guidelines.
Financially, having a healthcare sharing ministry and insurance usually doesn’t make sense.
Many people strongly believe in helping others through healthcare sharing ministries.
If this is you, the financial cost won’t likely be a significant factor in deciding whether to carry both or not.
How to Choose the Right Healthcare Sharing Ministry for Your Family
The first step is deciding if any sharing ministry is good for your family.
This is not insurance. You aren’t guaranteed to be repaid. You need to be comfortable accepting that fact.
If you are, you can base your decision on these ministries’ previous performance.
You’ll need to compare the share programs each healthcare sharing ministry offers.
- The monthly shares
- Which medical costs are shareable
- How much you’ll be expected to pay out of pocket
Consider the opinions of people currently using the healthcare sharing ministries. They have first-hand experience in how they work.
If you can find a match, read everything you can about the ministry. Read official documents including any sharing guidelines they may have.
Then, ask the ministry questions you have.
Once you’ve investigated your options, hopefully, a decision is clear for your family.