Christian cost-sharing plans (ministries) are often considered an affordable biblical faith-based alternative to conventional health insurance plans with rising costs. Typically, most applicants are accepted, and premiums are generally about the same, or lower, than coverage from a major insurer. There are no “Open Enrollments” and federal tax subsidies do not apply. This membership-based religious solution to high medical costs helps many applicants avoid Obamacare, and build customized policies that match their specific needs and budgets. Typically, group members practice the same religious faith. Some plans can also be used to supplement Medicare benefits.
Expense-sharing can be very effective in providing low-cost options for comprehensive and catastrophic benefits. Fund-sharing tis typically voluntary and there is no legal obligation to pay member medical bills. Adherence to Christian beliefs is a requirement for participation. Note: Consumers eligible for a traditional Open Enrollment should always consider Exchange options, especially since subsidies have substantially increased in the last 12 months, and many $0 premium plans are offered in all states. Faith-based plans also may not provide 100% coverage for preventative expenses.
A faith-based solution is often a viable option if corporate plans are not offered, and a subsidy is not available. However, the reputation and longevity of the company should always be reviewed before enrolling in a plan. A.M.Best ratings are typically not available. Although there may not be any network restrictions, verification is recommended.
Plans are considered a legally-acceptable option since there is no longer a mandate requiring the purchase of qualified coverage. But there is no guarantee to members that their claims will be paid. Also, financial liability of participating members is not assumed by the Ministry. You can choose your own physicians and hospitals, although discounts are provided for network usage.
Community prayer support is also provided on most faith-based medical-sharing healthcare plans. Typically, policyholders are not terminated after submitting unusually large medical claims. During epidemics (COVID-19), virtual and online support is offered with occasional waiving of virus-related testing and vaccinations.
More Than One Million Americans Are Enrolled
More than one million Americans are enrolled in these types of plans, and the number of covered persons is expected to increase each year. Currently, about 100 different registered policies are offered. The main reason is that conventional plan rates, despite the ACA legislation, remain very expensive for consumers that don’t qualify for large amounts of financial assistance in the form of instant tax credits. Also, prices have continued to rise much faster for Exchange plans than originally predicted. Without a federal subsidy, rates can easily exceed $1,500 per month for a family with children. Rates for healthy individuals and families also remain high.
Double-digit price increases are now quite common, and the number of network providers is reducing. Often, HMO options have replaced previously-available PPO plans, resulting in fewer available physicians and medical facilities. EPO options are available in most states. Consumers prefer to choose their own physician and specialist, which is available on most Senior Medicare Supplement plans. Medicare Advantage plans are offered in all states, and often feature low premiums, prescription drug benefits, and additional ancillary coverage (dental, hearing, and vision benefits). Once an MA plan is selected, underwriting approval may be required to change to a Medicare Supplement contract.
The availability of competing companies in most areas has decreased, with many areas featuring just one available carrier. Blue Cross, Aetna, Humana, and UnitedHealthcare have withdrawn from many markets. Naturally, cheaper alternatives are always considered. Previously, Mennonite Churches, Evangelicals, and other small groups offered faith-based options. But more Christian and non-Christian plans are becoming available, especially as medical costs continue to rise. State-regulation is not present in most states, although this is expected to change in the next 10 years. In several states, regulators have taken decisive action against Ministry plans, including cease and desist orders.
Exempt From Affordable Care Act Requirements
They are an ideal solution after Open Enrollment has ended. Plans also are not required to meet Affordable Care Act (Obamacare) mandates or participate in federal and State Exchanges. Our published guide explains how to enroll in the healthcare Marketplace and offers tips for consumers that do not participate in the ministries we are discussing in this article. Seniors that are eligible for Medicare should apply for Parts A and B benefits. During the initial enrollment phase, no medical questions are asked. Typically, applicants eligible for Medicare (or Medicaid) should not consider a Christian plan.
Definition Of Healthcare Sharing Ministry
Generally, it refers to an organization that is exempt from taxation under section 501 (a). Members also should share similar religious beliefs and accordingly share medical expenses of members without giving priority to location of residence or type of employment. Medical bills must be paid regardless of the condition or illness.
And although religious plans have been in existence (officially) for about 40 years, the concept is still considered anything but mainstream. You are required to live a “biblical lifestyle” to qualify for a policy. Policy provisions are also much different than mainstream contracts and usually your premiums are not tax-deductible. Rate increases occur, but they are usually less than conventional plans. Rarely, do customers see large 20%-30% increases. And depending on the number of catastrophic claims, rates can decrease. Of course, abortions and birth-control are not covered and “healthy lifestyle” agreements must be signed.
Submitted claims for alcohol abuse and drug abuse are rarely covered, along with several other similar and sometimes-costly situations. Also, as an ungoverned industry since this type of policy falls within the gray area of the law, many standards don’t have to be met, and there is rarely a legal contract to sign. But the low monthly cost and lack of enrollment periods keeps more persons applying each year.
The shareable expenses concept is now offered in all states. If federal subsidies decrease in the future, these types of plans may increase in popularity. However, 2024 premium tax credits substantially increased for most qualified applicants, so until the Open Enrollment period ends, a Marketplace plan should be strongly considered.
What Is A Christian Healthcare Ministry?
Actually, the concept is fairly simple, As an alternative to Obamacare, employer-sponsored and privately-purchased medical plans, members share other member costs of healthcare treatment by paying a monthly “premium.” The amount of the premium often determines how much coverage you receive and what your potential out-of-pocket cost is going to be. Companies that offer these programs are non-profit and administer the collection of dues and disbursement of funds to pay medical bills. Payments are typically sent via mail. Donations above the required payment are accepted but are not considered tax-deductible.
Although the coverage does not satisfy ACA (Affordable Care Act) Guidelines and mandates, you don’t have to worry about the annual non-compliance tax if the “health cost sharing ministries qualifications” are met. The IRS and HHS eliminated a 2.5% household income tax for non-compliance, so it is no longer illegal to be uninsured, or enroll in a plan that is not Obamacare-compliant. Non-compliant temporary plans remain very popular, although they are subject to medical underwriting, and lifetime medical payout limits. Office visits and prescriptions are often subject to the policy deductible.
The industry itself is not regulated on a state or federal level, so all consumers should understand all provisions of their contract. But since the typical Ministry is non-profit, a formal complaint can be submitted at the state-level. Also, audits are completed on a regular basis, and the results rarely show any improprieties. All submitted claims that have been approved, have been paid, and ample reserve funds seem to be available. As more consumers apply for coverage, additional reserves may be created. Pandemics (including COVID) can place an unexpected financial strain on these types of plans.
Thirty states have enacted legislation that provides exemptions from Department of Insurance regulations. However, the remaining 20 states typically do not apply state laws and regulations to Ministry plans. In those states, complaints are reviewed by the Attorney General, although significant action is rarely taken. Obligations to pay claims is also not enforced in most states. However, increased state regulatory actions may be practiced by several states.
Currently, Texas is considering legislation that would regulate religious-based health care sharing ministries. HB 573 is currently being debated and would require that health-sharing ministries obtain a certificate of registration to conduct business in the state. However, three years ago, the House postponed action, and it is presumed the bill will not be acted upon. The annual fee, if paid on time, would be approximately $100. Three years ago, a Texas judge ruled that the government can not force a Christian-owned company to pay for HIV preventative medication.
It is very important to research the company you are considering doing business with. Previously, Aliera and Trinity HealthShare were accused of violating federal and state requirements. Several of the accusations include marketing policies outside of approved service areas and neglecting to make their religious affiliations clear. A class-action lawsuit has been filed for alleged deceptive practices, and the company has been fined $1.1 million. Texas, Washington, and Colorado state insurance regulators alleged that unlicensed products had misled consumers to believe that they were purchasing insurance products.
How Are Pre-Existing Conditions Treated?
Marketplace Health Plans Cover Pre-Existing Conditions
Unlike Obamacare, it is possible that pre-existing conditions may not be initially covered. Each plan has different sets of criteria, and of course, your specific ailment will be carefully reviewed to determine if expenses will be paid. Usually, if you are being treated for an illness (as opposed to it being contained with maintenance drugs), it will not be covered. If it is a serious expensive illness, ACA Marketplace plans are far superior. Thus, current applicants with serious or chronic conditions, should take advantage of Marketplace options or Medicaid (if available).
There is also benefit enhancements that many Christian plans include. For an existing condition, the longer you are a member of the program, the higher the benefits become for current treatment. The assumption is that as your disease or condition gets treated, the overall cost will be lower each year. There are exceptions, of course.
During pandemics, if a large percentage of members developed a chronic illness, it is possible that insufficient funds would be available to pay all medical expenses. Changes in healthcare legislation could also impact the number of Ministry customers. Bank failures could also possibly impact the financial strength of the carrier. When Covid was at its peak, although many expenses were paid, no Ministry plan was unable to pay covered expenses for financial reasons.
The Christianity Requirement
Typically, you must be Christian (also all family members) and tobacco use and illegal drug usage is strictly forbidden. Premarital sex is also not allowed. Alcohol consumption is a bit of a gray area, and of course, very hard to closely monitor. Regular attendance at churches or other specific types of worship are generally required. Children are also eligible, although they must be unmarried and listed as dependents on your federal tax return. Once they file their own return, they can request an individual application.
Simple belief in a God or “supreme being” may also be acceptable, depending on the plan. Often, a “Statement Of Faith” is required, which insists that all applicants adhere to specific Biblical standards. Believing in one single God and the deity of Jesus Christ are generally a requirement. Other faith-based conditions may also need to be followed, which may include personal living habits. Compliance with these habits is difficult to monitor and enforce.
Bills are directly submitted to the organization, and not to a health insurance company. Any discounts you receive or payments you make would be deducted from the amount due. Usually you must notify the cost-sharing billing department within 30-180 days of receiving treatment. There is no waiting period and you’re allowed to choose your own treatment, assuming they are licensed practitioners. Experimental drugs and unconventional treatment should be approved in advance. Naturally, non-generic medications are highly encouraged, if available, and approved by a physician or pharmacist.
What Providers Are Available?
You can choose your own doctor, specialist or hospital for treatment as long as they meet the Christian Cross Sharing plan guidelines. Since there are several levels of benefits available, coverage depends on the option you select. It is recommended that you inform the provider you are paying by cash or check, so the cost of treatment is less. Often, the discount will be as much as 30%. Selected carriers may utilize a national network (possibly PPO or EPO).
A direct-bill payment plan is also utilized, which may allow members to spread out payments over a 3-12 month period. Depending upon where you live, it is possible that certain local providers will offer special billing options that may involve a substantial reduction. Lab tests and x-rays (also MRIs) that are performed outside of a hospital, may reduce you out-of-pocket costs by up to 50%. Large PPO options may also be offered along with telehealth online access. Virtual pcp and specialist visits often provide copays under $50.
Often the “Healthcare Bluebook” is recommended (you can view it here). It is utilized by thousands of organizations and companies. This guide informs consumers about the cost of services in their area and what they should expect to pay. It acts as an unbiased resource that is especially helpful when unconventional coverage is being utilized. Separate sections are available for doctors, hospitals, labs, dental, hearing aids, cosmetic medicine and X-ray imaging. Ultrasounds, immunizations, drug testing, and many other procedures can be shopped among local providers. Healthcare price transparency often leads to employee satisfaction and employer benefit savings.
What Type Of Plans Are Available And How Much Do They Cost?
Often, there are several options available. The differences are cost, the benefits you receive, the amount of out-of-pocket expenses you are expected to pay, and whether maternity coverage will be included. Several levels of benefits can be typically purchased, with single and family plans offered. Group options through employers are generally not available. Since Senior Medicare benefits are widely available, over-65 coverage is not always offered through Christian Healthcare carriers.
For example, the most basic tier of benefits may cost between $40 and $70 monthly per person. Thus, a family of four would be expected to pay about $200 per month. For this premium, maternity is generally not fully (and sometimes not partially) covered. Although inpatient and hospital bills are covered, often any condition or illness that is not hospital-related will be limited. This differs greatly with Federal and State Exchange policies (other than catastrophic), where inpatient, outpatient, ER and Urgent Care benefits are required. The 2024 maximum out-of-pocket expenses for a single person (regardless of medical expenses) is $9,450 per year.
There also are “Gold” or “Platinum” tiers (not to be confused with Exchange Marketplace tiers) that feature more comprehensive benefits. Premiums are naturally higher and can range in the $70 to $150 per month per person. For larger families, of course, this will result in large premiums. However, free healthcare plans are actually possible through state Exchanges, depending on your income and state of residence. Since these plans are often Bronze-tier contracts, the deductible and maximum out-of-pocket expenses can be as high as $17,400 per family.
Drugs Not Always Covered
Often, prescription coverage is only offered on the most expensive plans. Otherwise, you pay for all drugs that are prescribed. The risk is substantial if a serious chronic illness (or injury) requires using an expensive non-generic drug. If the condition is chronic, years of paying out of pocket for prescriptions could be financially debilitating. If generic prescription drug options are prescribed, out-of-pocket costs will substantially reduce. Also, occasionally, drug companies may offer their product at a reduced cost.
Some of the most common ailments and conditions that you should not expect to be covered include abortion (previously mentioned), expenses resulting from attempted suicide, illegal activity that results in injury, HIV or AIDS (there are many exceptions), or any illicit drug-related illness. Experimental surgeries and procedures are also not covered. Cosmetic procedures may also not be fully covered. These types of procedures are also not covered in foreign countries.
Benefits are upgraded from the “basic” policies and include a much richer maternity benefit. Most often, prenatal, delivery, hospitalization, delivery, and complications (including C-Sections) are covered. And instead of only $2,000-$5,000 of benefits, often the limit exceeds $100,000. An extra rider is often offered that will increase the cap above $125,000. However, often you slowly build up the extra coverage by “renewing” the rider each year.
Other coverage is also upgraded, including physical therapy, prescriptions, diagnostic testing, and treatment outside of a hospital. Although the term “deductible” is rarely used, the “responsibility” of each member is typically $500-$2,500 per year, instead of $5,000 or more. By paying a higher “premium,” lower responsibility options are offered.
Since the average PPO/HMO from a major insurance company costs about $350-$700 per month (catastrophic plans are much less), Christian Health plans are sometimes a “good buy.” In many situations, they are. However, when taking into consideration missed federal tax credits and specialized critical care and therapy that may be lacking, it’s important to understand the importance of thoroughly researching all available personal plans, especially during Open Enrollment periods.
Additional Benefits
Prayer Hotlines Are Typically Available 24 Hours Per Day
A monthly or quarterly publication offers free expert advice and information along with a “hotline” to live persons that can offer advice and recommendations. Prayer requests can be requested privately or through social media outlets such as Facebook or Google Plus. Prayer requests also, as you might expect, are obtained in a variety of ways, along with support from staff members and other plan participants. Networking through special groups help members communicate with each other, and discuss common issues.
A referral service is also fairly common to encourage new participation. As an inducement to refer more potential members, a credit is often given for the successful recommendation and subsequent enrollment of anyone that signs up. Typically, anywhere from 1-6 months of your own suggested premium can be waived. Thus, if you continuously refer new people, your cost could substantially reduce.
Dental and vision savings plans are frequently offered. They are not considered an insurance product, but rather a program that can offer potentially large discounts on preventative and major medical services. Networks tend to be quite large and the average monthly premium is approximately $15-$25. Comprehensive plans with shorter waiting periods are more costly.
What Companies Offer Christian Health Insurance?
There aren’t many organizations that provide this type of coverage. Although verifying reliability and reputation are difficult, we listed the five largest companies below:
Medi-Share – In business since 1993, Medi-Share exemplifies the “Christians helping Christians” concept. Located in Melbourne, Florida, this non-profit organization requires members to profess a “statement of faith” before joining. A $120 fee is also required before becoming a member, along with total abstention from alcohol and tobacco for one year before enrolling. Currently, more than 300,000 members are enrolled, and since their founding, more than $2 billion in medical bills have been discounted or paid.
Members can vote to change specific guidelines, if approved by more than 67% of the ballots. Also, a 24-hour telehealth service is provided. Abortions, or any complications, are not covered. Adoptions and related expenses may be partially reimbursed. A Board of Directors self-regulates the company, although members determine the type of care provided. Program guidelines can be changed with a successful vote.
Who Is Eligible?
Seniors can also purchase coverage, along with Christian employers and churches. The “Senior Assist” program helps persons that have reached age 65, and have enrolled in Medicare Parts A and B. Current policyholders can easily convert existing coverage to the Senior Assist program. Persons who live outside of the US may be required to complete a physical examination.
Adult children (ages 18-22) must also adhere to the same guidelines as their parents, to remain in good standing on their policy. A certification must be completed within 60 days of the 18th birthday, or future medical bills will not be paid. The certification procedure requires a commitment to a “healthy lifestyle,” and a verifiable Christian testimony (verify a personal relationship with Jesus Christ).
Use of alcohol and tobacco products is not allowed. Biblical standards must also be met. A severe disability can result in an approved exception. PHCS is the PPO network that is utilized to provide quality care at discounted prices. A provider search tool is provided to access doctors and hospitals throughout the US.
Family members can include spouse, adopted children, biological children, children in guardianship, or in complete legal custody. Note: Children that reach 18 may also apply for individual coverage. The initial application fee will be waived. The adult member must notify the Christian Share Ministry (CCM) if an adult child no longer meets membership guidelines. Applicants may be designated as “Health Partners” if they are considered a higher risk for specific diseases. A special program is set up to improve the lifestyle.
Board Of Directors
The Board of Directors makes all key decisions regarding major operations, although members are heavily involved in making and shaping rules. They can vote on what type of care is given and who receives it, along with recommending specific guideline changes. The America’s Christina Credit Union (ACCU) creates an account with every family to handle disbursement of funds.
An online “PrayerStream” can be utilized at any time along with a Chaplain for specific needs. Counseling and education are also readily available. Additional nursing, nutrition and physical therapy professionals also assist members on a regular basis. Two adoptions per household, are also allowed. The maximum coverage for maternity is $125,000. A “Health Incentive” can potentially reduce the monthly share amount. Members
Cost Of Coverage
Monthly rates illustrated below are based upon a “healthy monthly share,” which costs slightly less than the “standard monthly share” premium. The “AHP” is the annual household portion required to pay throughout the year. The term is similar to the deductible on a conventional health insurance plan.
Age 20
$117 – $3,000 AHP
$103 – $3,000 AHP With 30% Co-Share
$92 – $6,000 AHP
$82 – $6,000 AHP With 30% Co-Share
$77 – $9,000 AHP
$70 – $9,000 AHP With 30% Co-Share
$60 – $12,000 AHP
Age 30
$167 – $3,000 AHP
$146 – $3,000 AHP With 30% Co-Share
$128 – $6,000 AHP
$114 – $6,000 AHP With 30% Co-Share
$106 – $9,000 AHP
$93 – $9,000 AHP With 30% Co-Share
$79 – $12,000 AHP
Age 40
$173 – $3,000 AHP
$151 – $3,000 AHP With 30% Co-Share
$133 – $6,000 AHP
$117 – $6,000 AHP With 30% Co-Share
$109 – $9,000 AHP
$97 – $9,000 AHP With 30% Co-Share
$81 – $12,000 AHP
Age 50
$198 – $3,000 AHP
$172 – $3,000 AHP With 30% Co-Share
$152 – $6,000 AHP
$133 – $6,000 AHP With 30% Co-Share
$123 – $9,000 AHP
$109 – $9,000 AHP With 30% Co-Share
$91 – $12,000 AHP
Age 60
$249 – $3,000 AHP
$216 – $3,000 AHP With 30% Co-Share
$205 – $6,000 AHP
$179 – $6,000 AHP With 30% Co-Share
$166 – $9,000 AHP
$145 – $9,000 AHP With 30% Co-Share
$123 – $12,000 AHP
And yes…prices can increase if the number of submitted claims rises faster than expected. However, there is also a potential 20% savings reduction if you meet specific criteria. Your BMI and weight will be evaluated along with results from an HbA1c home test. Exceptions can be made for athletes with higher body masses. Eligibility is still determined on various factors.
Also available through Medi-Share is a disability coverage referred to as “Manna.” Partial replacement of income from illness or injury is available for 12 months. Up to 80% of lost income can be replaced. Different levels are offered, although the $22 per month option is the least expensive. It will provide up to $2,200 of monthly income replacement for a year. Cosmetic surgery, mental illness, acts of war and fibromyalgia are several of the conditions not covered.
Note: The Kentucky State Legislature banned Medi-Share in 2012 from operating in the state. However, the ban was rescinded in 2013.
Samaritan Ministries – Fairly new, Samaritan was created in 1994 in Illinois by Ted Pittenger. Today, more than 220,000 persons contribute more than $25 million per month, which makes it one of the larger Christian healthcare organizations. Each month, members send “shares” to other members that are “in need.” Members must agree to terms of a “statement of faith,” with an accountability form required each year. Increases in required “shared” monthly amounts must be approved by members.
Samaritan Christian Ministries Pays Most Hospital Bills
A central data system matches the members who will be sending money with those persons that will be receiving it. Usually, only about 1 in 10 persons needs medical treatment in a specific month. Of course, the seriousness of the ailment and cost of medical expenses can greatly vary. About $9 million each month is available to pay bills. Occasionally, members will send other members that are being treated, more than the required share. Those extra funds are considered “gifts” and do not have to be returned.
While most conditions are covered, pre-existing conditions prior to joining generally will not be paid for. Once the condition is no longer treated for 12 months, it may be covered. A statement from a physician may be required to pay for future expenses. A five-year waiting period is sometimes required for the following conditions: cancer, heart disease, genetic disorders, and hereditary diseases. Diabetes, high blood pressure, and high cholesterol readings are treated differently. For example, Type 1 and Type 2 diabetes have different underwriting criteria. A 120-day supply for prescriptions is offered. However, chronic condition medications are not shareable beyond the 120-day limit.
Routine checkups, preventive exams and annual physicals, although covered in full on conventional Marketplace plans, are not fully covered through Samaritan Ministries. However, similar to Marketplace policies, there is no maximum limit to the amount of benefits paid over a lifetime. Members may choose any physician. Bills are collected and subsequently submitted for payment. Also, dental procedures are typically not shared. This includes routine and preventative checkups, cleanings, root canals, crowns, dentures, implants, extraction or removal of teeth, and fillings. Other items not covered include routine vision expenses, vaccinations, and wellness visits (Basic Plan).
The “Basic” plan begins to share after the first $1,500 of expenses. The sharing is 90%, and the maternity limit is $5,000. The maximum shareable amount per need is $236,500. The “Classic” plan begins to share after the first $300 of expenses. The sharing is 100%, and the maternity limit is $250,000. The maximum shareable amount per need is also $250,000.
Monthly Cost For Share Amounts
Samaritan Classic
$177 – 1 person Ages 18-29
$263 – 1 person Ages 30-60 and over
$177 – 2 person Ages 18-29
$511 – 2 persons all ages
$596 – 3-7 persons all ages
$682 – 8+ persons all ages
Samaritan Basic Under Age 30
$99 – 1 person
$209 – 2 persons
$263 – 3+ persons
Samaritan Basic Ages 30-44
$209 – 1 person
$251 – 2 persons
$314 – 3+ persons
Samaritan Basic Ages 45-59
$147 – 1 person
$293 – 2 persons
$369 – 3+ persons
Samaritan Basic Ages 60 And Over
$168 – 1 person
$337 – 2 persons
$412 – 3+ persons
If an applicant is 25 or older, a $40-$50 per person youth discount may apply. Members can increase premiums through a majority vote. Typically, increases occur every few years, and are less than 10%. Maternity benefits are limited if you become pregnant before joining.
“Save To Share” is a special program designed to pay for needs of members that have more than $250,000 of medical expenses. An extra annual payment of $133 (per person) is required and a $15 administration fee is added to the cost. When a special need arises, other “Save To Share” participants withdraw some of their extra deposited funds to help other needy persons. The $133 charge is capped at three persons per household. Unused funds can be held for future needs.
A “referral credit” is provided to members that refer others that eventually become members themselves. There is no limit to the number of credits you can receive. So conceivably, a family could cover their membership fees by continuously referring other members to the organization. NOTE: Health Co-Op is an additional option for Biblical-based coverage. They are a comprehensive service provided by the Karis Group and are part of Samaritan Ministries.
Christian Healthcare Ministries (CHM) – Created in 1981, CHM was the first sharing ministry in the US. Since that time, they have paid more than $2.5 billion in medical expenses for its members, and are classified as a 501 (c) (3) organization. Their Board of Directors consists of an impressive array of bank presidents and hospital CEOs. Currently, there are more than 100,000 active members, and the main directive of the company is still based on Galatians 6:2 and Acts 2 and 4. Their faith-based voluntary cost-sharing plans are offered in all states, and many countries throughout the world.
The budget and financial statements are reviewed each year by the Board of Directors and an outside public accounting firm is responsible for the annual certified audit. In our research of CHM, we have noticed that fraud prevention and detection is heavily emphasized. Also, all medical expense payments are personally reviewed by the Chief Operating Officer or President. The current Chairman of the Board is James Detwiler, and annual revenues are more than $200 million. The four “core” values practiced by the company are service, respect, gratitude, and excellence.
Bible Emphasis
Just like other sharing organizations, members must be Christian and adhere to the teachings of the bible. Alcohol and tobacco use are not allowed and there are no restrictions based on your BMI (Body Mass Index), age or where you reside. Pre-existing conditions will be covered only if you are receiving “maintenance” treatment as opposed to treatment for the illness or disease itself. However, once the initial treatment has been completed or resolved, and only maintenance medications or treatment is provided, existing conditions can be covered. Applicants must also be currently following biblical teaching and regularly attending group worship.
However, there is still a three-year initial period after enrollment that limits the payment of expenses. There is a cap of $15,000 during the first year and a cumulative limit of $50,000 for the first three years. After the first 36 months, no limits or restrictions apply. Maternity is treated similar to other ministries. A 300-day waiting period (after joining) is required before sharing is approved. Also, pre-existing conditions that are considered “active” at the time of enrollment, are not eligible for coverage. However, maintenance medications for current conditions are acceptable.
The Monthly Cost
$150 – Gold Membership
$85 – Silver Membership
$45 – Bronze Membership
The Gold, Silver and Bronze plans have no relevance to the Affordable Care Act Metal plans, which are recognized by the same name. All three plans have a $125,000 per illness cap. Of course, this is substantially less than the unlimited lifetime maximums for Marketplace plans. It is also less than many “short-term” policies that include $250,000 (or more) of coverage for a single illness. Required monthly premiums (financial gift amounts) are not tax-deductible. However, amounts above the requirement are considered tax-deductible.
Maternity benefits of up to $125,000 are covered in the Silver and Gold programs. However, expenses resulting from a pregnancy before a member joins CHM are not covered. Also, the due date of delivery must be more than 300 days after your original enrollment date. Both programs include hospital delivery, midwife, and hospital complications benefits. However, the Gold program covers prenatal, postnatal (up to six weeks), and enhances complications and midwife benefits.
Deductible Options
“Personal Responsibility,” which is synonymous with a “deductible,” is $500, $1,000 and $5,000 on these three plans. The Gold plan also provides up to 45 physical therapy visits while the other options exclude this benefit. Physician office visits and prescription drug benefits are only included in the “Gold” option. However, all three plans include a CHMRX discount card, which can lower out-of-pocket costs, when presented to a participating pharmacy.
Catastrophic injuries and illnesses (more than $125,000) can also be covered by “Brother’s Keeper,” an optional rider that provides extra catastrophic benefits. Gold members are provided unlimited reimbursement coverage. Silver and Bronze members are credited with $100,000 of coverage the first year. However, an additional $100,000 is added each year, up to a maximum of $1 million. The only cost for the “Brother’s Keeper” rider is an annual $40 fee. Generally, bills are paid within 30-120 days.
Seniors are eligible for coverage if they have signed up for Medicare Parts A and B. The CHM benefits can act as a supplement, and are always considered secondary coverage. After initial bills are submitted to Medicare, the “Medicare Summary Notice” should be submitted to CHM. Unpaid bills for covered benefits are eligible, and the Gold plan is the most popular option used by members, since inpatient and outpatient surgery and incidents are included.
Solidarity Healthshare Offers Several Affordable Plans
Solidarity Healthshare, which began offering coverage in 2015, follows the teachings of the Catholic Church. It is the sharing ministry portion of Melita Christian Fellowship Hospital Aid Plan, which has been providing benefits for more than 40 years. Members must adhere to and practice Catholic values and beliefs. Monthly “shares” are deposited into a “ShareBox” that is utilized to pay your current medical bills of other member’s bills. Physicians and other facilities send bills directly to Solidarity for reimbursement. Solidarity is an active member of the National Coalition of Healthcare Sharing Ministries (NCHCSM).
To qualify for enrollment, members must promote natural family planning without using contraceptives, attend weekly Mass, frequently pray alone or with others, respect life from contraception to death, regularly exercise, regularly receive the Sacraments, and not abuse tobacco or alcohol. Generally, members respect life from conception to natural death, and regularly consult and confide with Priests. “HealthTrac” is available for prospective members with pre-existing conditions that can be treated or improved by participating in specific lifestyle improvements or changes. A personal coach is provided.
Three programs are available:
Solidarity Whole – Members share all medical expenses up to $1 million. Included is SavNet, which can lower costs on dental, medical, vision, hearing, and chiropractic expenses. The maximum unshared obligation per year is $500 per person, $1,000 per couple, and $1,500 per family. Single monthly rates are $149 (Under age 30), $199 (Ages 30-65) and $224 (Over age 65). Couple monthly rates are $249 (Under age 30), $299 (Ages 30-65) and $349 (Over age 65). Family monthly rates are $399 (Under age 30), $449 (Ages 30-65) and $499 (Over age 65).
Solidarity Extend – Members share all medical expenses up to $125,000. Included is SavNet, which can lower costs on dental, medical, vision, hearing, and chiropractic expenses. The maximum unshared obligation per year is $500 per person, $1,000 per couple, and $1,500 per family. Single monthly rates are $131 (Under age 30), $181 (Ages 30-65) and $206 (Over age 65). Couple monthly rates are $227 (Under age 30), $277 (Ages 30-65) and $327 (Over age 65). Family monthly rates are $374 (Under age 30), $424 (Ages 30-65) and $474 (Over age 65).
Solidarity First – Members share all medical expenses up to 70% of $1 million. The maximum unshared obligation per year is $500 per person, $1,000 per couple, and $1,500 per family. Single monthly rates are $107 (Under age 30), $157 (Ages 30-65) and $182 (Over age 65). Couple monthly rates are $198 (Under age 30), $248 (Ages 30-65) and $298 (Over age 65). Family monthly rates are $345 (Under age 30), $395 (Ages 30-65) and $445 (Over age 65).
Liberty HealthShare, based in Canton, Ohio, is the sharing portion of Gospel Light Mennonite Church Medical Aid Plan, which has been helping the needy since 1995. Members must adhere to a “statement of beliefs,” and a “Share Box” is also used. A “Godly lifestyle” must also be observed. They are a 501(c)3 organization with the same maximum share obligations as Solidarity Healthcare. There are three available programs (Liberty Complete, Liberty Plus, and Liberty Share) that have identical rates to the three Solidarity HealthShare Plans (Whole, Extend, and First).
You may terminate membership at any time, although the $125 annual fee is not refunded after 30 days. Once you are an Inactive” member, you may continue to contribute funds, and any medical expenses will be shared among other “inactive members.” To become a member, several “lifestyle requirements” include no use of tobacco, regular exercise and healthy diet, no illegal drug use or misuse of prescription drugs, and observe biblical guidelines regarding use of alcohol. You may also use your coverage as a supplement to other plans you currently own.
Liberty Complete – The most popular option has a cap of $1 million per incident. Pharmacy and medical discounts are available, along with hearing, dental, vision, and chiropractic cost reductions. The “Annual Unshared Amount” (AUA) is $500 per person, $1,000 per couple, and $1,500 per family. Rates match Solidarity Whole premiums above.
Liberty Plus – The cap is $125,000 per incident. Pharmacy and medical discounts are available, along with hearing, dental, vision, and chiropractic cost reductions. The “Annual Unshared Amount” (AUA) is $500 per person, $1,000 per couple, and $1,500 per family. Rates match Solidarity Extend premiums above.
Liberty Share– The least expensive option. 70% of eligible expenses are shared up to $125,000 per incident. Most expenses are met on a per person and per incident basis. The “Annual Unshared Amount” (AUA) is $500 per person, $1,000 per couple, and $1,500 per family. Rates match Solidarity First premiums above.
Pre-existing conditions (symptom, treatment or medication received within 36 months of initial application) are not covered during the first 12 months. $50,000 of sharing benefits are provided in the second and third years. Beginning the fourth year, there are no limitations.
“HealthTrac” is available to applicants that are treated for specific pre-existing conditions, but who also may be helped by lifestyle improvements. A “shared set of beliefs is required of all applicants. A coach monitors changes and progress, and recommends changes that may improve overall health. Common conditions that are often treated, include diabetes, heart disease, cancer, obesity, high cholesterol, and hypertension. Inspirational and motivational assistance is provided. The cost of the program is $80 per month. However, once goals are reached, the fee is eliminated.
To summarize our findings, Christian health insurance plans don’t provide the comprehensive coverage, financial backing or extensive national networks that many large health insurers offer. Depending on your income, you may also actually pay more for these types of plans. However, in some instances, they are worth considering, and may provide the benefits you need at a price lower than Marketplace policies in your area.