Are Christian health-sharing plans a viable option? - AmericaNowNews.com

Health

Are Christian health-sharing plans a viable option?

When people lose their job, they often lose their company health insurance. Others who are self-employed often find they can't afford a personal plan and are forced to drop it.

Now, a growing number of families and individuals around the country are finding an alternative to private health insurance through their faith, with a cost-sharing idea based on the Bible.

These organizations have spread hundreds of millions of dollars across their members.

Based on the Biblical admonition to share one another's burdens, tens of thousands of people say they now have faith their medical bills will be paid in full thanks to their participation in Medi-Share, one of the largest non-profit Christian Healthcare Sharing organizations in the country.

Jonathan and Stephanie Roberts are married and they have been members of Medi-Share for two years.

"It's 100 percent different; it's a radical shift from the insurance industry that I was acquainted with and most of us are acquainted with," said Jonathan Roberts.

The couple had private insurance, but they couldn't afford the $1,300 monthly premium. After joining Medi-Share, their family of eight now pays about $400 per month.

So, what's the catch?

Well, not a penny of what he now pays each month guarantees him coverage. Instead, it's shared among a Christian community to help cover each other's costs.

"It doesn't at all feel like a bill," Roberts said. "It's like sending someone some help."

All sharing systems operate a little differently, but here's how Medi-Share works: Every member pays a monthly "share" into a credit union. Medi-Share says most individuals pay about $170 and those with families pay about $280.

If a member has a medical need, they first have to pay the yearly portion in which they have selected which could range anywhere from $500 to $10,000 which is sort of like a deductible.

After that, the rest is shared among the members.

The doctor or hospital sends the bills directly to Medi-Share.

If the expense is eligible for sharing, Medi-Share dips into the members' share account. It takes out a 23 percent administrative fee and sends the billed amount to the doctor's office.

While it may sound like insurance, it's not because there is no state or federal regulation of healthcare sharing groups. Instead, there is a board of directors with member-voted guidelines and there is no contractual guarantee your bill will be paid.

Shannon Buckner with Blue Cross and Blue Shield of North Carolina says this makes him nervous.

"It makes me worry about, first and foremost, what's going to happen to these families?" Buckner asked. "Yes, maybe they found a way to pay less in premiums than you would pay through a traditional insurance plan, but at the end of the day, they're not getting what they thought they were paying into. That worries me."

Christian healthcare sharing plans can often significantly reduce medical expenses with monthly costs about 40 percent lower than the average insurance premium according to Medi-Share's CEO.

Members, however, should be ready to pay out of pocket for things like routine check-ups, dental care, preventative screenings like mammograms and any pre-existing, long-term conditions like heart disease or diabetes.

Like insurance, there's plenty of paperwork outlining exactly what is and is not eligible for coverage or sharing.

With Medi-Share, lifestyle choices which they believe are not condoned by the Bible disqualify a person from membership including sex outside of marriage, smoking, and excessive drinking or drugs.

Furthermore, procedures like abortion or cosmetic surgery do not qualify for sharing.

For many members, being part of a like-minded community has far more value than a private company's promise of payment.

Those we spoke to said every eligible expense has been fully met by fellow members.

"I don't trust people who run insurance companies to look out for my best welfare," said Sybil Loposser, a Medi-Share member since 2003. "I would rather take my chances with a group of Christians."

For others who may want coverage for life-long illnesses or preventative care, or who just want the piece of mind with a contractual guarantee, insurers say you may be better off with a private plan. 

Christian Healthcare Sharing group members say they often get raised eyebrows when they present their Medi-Share card at the doctor's office.

Like an insurance card, the office can call the number on the back and send the bills directly to Medi-Share. If the organization doesn't reimburse, however, the bill will then be sent directly to the patient.

Copyright 2012 America Now. All rights reserved.

Additional Information:  

  • Jonathan and Stephanie Roberts have six children: Ford (14), Juliana (11), Walker (8), Hannah (5), Elsie (4), and Phoebe (9 months). Their youngest child, Phoebe, was born by Cesarean section at a cost of $30,000 paid by Medi-Share. The Roberts pay a fee of $35 every time they walk into a doctor's office or hospital. They say they would never go back to private insurance. Jonathan Roberts says he does not want his money paying for procedures he does not believe in. Their deductible went from $5,000 to $2,500 with Medi-Share. They want to have more children and were thrilled to hear there was no waiting period or extra charge for having more kids.
  • Sybil Loposser's private plan was $500 per month with a $5,000 deductible. Her family has racked up about $35,000 in debt, mostly medical bills and out-of-pocket costs. With Medi-Share, she still pays $500 per month, but has a $250 deductible. She says her Medi-Share costs have risen, but nothing compared to the rate increase with private care.
  • Shannon Buckner is a retention manager for Blue Cross and Blue Shield of North Carolina. He recommends if you can't afford insurance coverage, call your provider and see if you can raise your deductible or switch plans. Sometimes, people are paying for more coverage than they actually need. He also has concerns regarding "catastrophic care" where people encounter massive bills after a major medical event. Without adequate coverage, it can bankrupt you. He says insurance gives you peace of mind in the worst-case scenario. He says with insurance, you don't pay what you use, you pay into a system that spreads the risk over tens of thousands of people. He says he's nervous about the lack of regulation for sharing groups. The benefit to regulation is that insurers must keep a set amount of money on hand in case they get hit with a wave of claims. They can not refuse pay for covered claims. He says the 23 percent administrative fee for Medi-Share seems high. At BCBSNC, 85 percent of every dollar goes towards claims. Because insurers can spread the risk over hundreds of thousands of people, companies are able to negotiate down costs with providers who get more business from their membership. Consumers end up paying less than the "street value" of services. He has concern that sharing systems may not be sustainable because of the small number of people sharing the risk. He believes that most people benefit from preventative care and screening, and worries that without coverage of those services, people will avoid critical tests and potentially end up with major illnesses that could have been caught earlier.

The following details are about the Medi-Share program.

  • Since Medi-Share started 18 years ago, over $600 million has been shared and discounted. It is a not-for-profit ministry.
  • Medi-Share dollars does not subsidize what it considers "unbiblical choices" like abortion, drug or alcohol abuse.
  • Medi-Share is not insurance. Insurance is contractual guarantee to pay your medical bills.
    Medi-Share is faithfully sharing medical bills on a non-guaranteed basis.
  • Medi-Share cites the following passages from the Bible (Hebrews 13:16) and (Galatians 6:2).
  • Medi-Share participants can benefit by significantly cutting their annual medical expenses.
  • Every household has an individual account with America's Christian Credit Union. Each month, Medi-Share matches up monthly share amounts with other member's eligible bills and transfers funds between accounts.
  • Share amounts can change at any time. The average increase is 3 percent.
  • To qualify for participation in Medi-Share, you must have a verifiable testimony of faith, regular church attendance, and share the conviction of Galatians 6:2.
  • You must not have sex outside of a traditional marriage and not use tobacco or illegal drugs. You must be a US citizen.
  • Your Annual Household Portion is the amount of medical bills the household is responsible for paying before being eligible for sharing (similar to a deductible), ranging $500 to $10,000.
  • You may qualify for a monthly share reduction of 20 percent for meeting certain health criteria (BMI, blood sugar, weight/waist).
  • Preferred Provider Organizations (PPO) have agreed to discount their fees to Medi-Share members.Non-PPOs require usual and customary (U&C) charge.
  • Pre-Existing Conditions:

Eligible for sharing up to $100,000 per Member per calendar year if: Member has been sharing for 12 consecutive months, medical records state condition has gone 36 months without symptoms, treatment, medication

Eligible for $500,000 per calendar year if Member has shared for 60 consecutive months and no symptoms for 60 months

Treatment of high blood pressure is not eligible

Permanent, lifelong diagnosis is not eligible

Cancer is eligible for $500,000 per year sharing IF they are cancer-free for 84 months from conclusion of symptoms/treatment

  • Conditions not eligible:

Abortion, alcohol/drug related injuries, STDs (except via rape or sex within marriage or innocent transfusion), attempted suicide, maternity expenses outside of wedlock except from rape

Behavioral/mental health care (counseling, special education, etc)

               Cosmetic procedures

               Dental services

               Fertility/infertility care (birth control, vasectomy, etc)

               Birth defects

               Crutches, wheelchairs, hospital beds

               Hearing aids

               OTC drugs

               VA care

               Weight control

               Routine/preventive care (physicals, vaccinations, lab studies, screening mammograms, screening colonoscopy, genetic testing)

  • Extra Blessings. If there is a cost not covered in the Guidelines, Medi-Share members are able to ask for an "Extra Blessing" for coverage. Fellow members can chose to give an extra amount towards that care. Members say that most often, those extra blessings are paid in full.

The following information is from Tony Meggs, President and CEO of Christian Care Ministry (Medi-Share is the program, 1993).

  • Medi-Share is a healthcare sharing ministry of like minded individuals who share medical bills once a month, as part of the Christian Care Ministry.
  • Medi-Share is self-regulated by a Board of Directors. The Board of Directors is responsible for the policy decisions of the ministry.
  • Membership criteria:

Sign and agree to statement of faith

No abuse of drugs, alcohol, no sex before marriage

Pre-existing conditions: lupus, diabetes 2, stage 4 cancer, congestive heart failure, any long-term incurable condition

Testimony of faith, pastor signs off

Submit it online

Once a month, based on household size you pay your "share amount" and you deposit it into a third party credit union.

Christian Care Ministry has limited power of attorney to move and write checks to doctor out of that credit union account.

The money never comes to Christian Care ministry, however the organization takes out a 23% administrative fee in each share amount.

Members can pull from their own account to pay their medical bills.

Medi-Share is part of a PPO network with half million participating providers but you can still go outside the network.

Although there is no guarantee of payment, since 1993, Medi-Share has shared over 600 million dollars in share needs.

Membership lifts when unemployment is up because people lose insurance.

Current members: 47,000 members across the US (not Montana)

30-40% less expensive than average insurance premium

 The following information is from a TIME Magazine article entitled "Keep the Faith: Christian Health-Sharing Plans."

  • Organized Christian health-sharing arrangements, which first cropped up in the early 1980s, have become an alternative to traditional health insurance for an estimated 100,000 Americans.
  • Regulators can at least require insurance companies to abide by state laws. By contrast, health-sharing ministries provide no guarantee that they will cover medical costs and no recourse to members who get stuck with astronomical medical bills.

 The following information is from Samaritan Ministries.

  • Members agree to abide by a statement of faith, and ask their pastors for accountability when turning in needs and on annual continuation forms.
  • Members use checklists to make sure shares are sent each month.
  • The ministry is committed to direct sharing, from household to household. Share money is not pooled, managed, or invested. It is sent directly from one member to another.
  • Any increase in the share amount must be approved by a vote of the membership.
  • Samaritan Ministries has an annual independent audit.
  • Each member commits to sending a set "Share" amount each month. These "Shares" are sent directly through the mail from one household to another, to the members with "Needs".         
  • Samaritan Ministries uses a database that randomly matches Shares to Needs, so that the Sharing is coordinated and Shares go to the appropriate members with Needs.
  • A monthly newsletter reports total Shares and Needs, instructions for specific prayers and an address to send a Share to that person.
  • Typically, less than 10% of members have a Need in a given month and are receiving Shares.
  • When a member has a Need, they receive care, collect the bills and send them to Samaritan Ministries. Samaritan verifies that Need meets the Guidelines. In the newsletter, Samaritan then directs some members to send their Shares to the member in Need.
  • With 18,000 member households participating there is about $4 million available each month.
  • A medical need involving less than $300 is not shared among the members. When the need goes over $300, the amount from $300 to $250,000 is shared.
  • Each member pays an annual $175 membership fee, plus a monthly share to another member. A single member shares $135, a couple shares $270, a single parent family with children shares $200 and a two-parent family shares $320.

 

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