Healthcare Coverage… another Option

Published on July 25, 2014 By Lauren
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    Do you know about this affordable alternative to health insurance? It's completely legit and could be a great solution for you!

    Love it or hate it, the Affordable Care Act has created a conundrum for some families and individuals.  While many will be eligible for subsidies from the government to help pay for premiums, there is a sizable cohort who earn too much income to get much assistance, yet aren’t wealthy by any stretch of the imagination. And if they do obtain coverage through either an employer or the marketplace, both the share of premium required of the employee and out-of-pocket costs (like deductibles and copays) have increased dramatically over the past 15 years. And boy… now in 2016, premiums and deductibles have gotten REALLY expensive in many states.

    Many believe that they are stuck with the following choices:

    • Buy expensive insurance, or
    • Go uninsured – risky and results in penalties

    But what if I told you that expensive insurance or paying the penalty were not your only options?

    There is another option available that isn’t widely advertised by the insurance companies or the government.  What if I told you that this option is totally legit, and has actually been around for a couple decades?

    Healthcare sharing ministries like Christian Healthcare Ministries and Samaritan Ministries offer a faith-based alternative to insurance. That’s right – they aren’t technically insurance products.  Instead, groups of individuals band together and share costs.  Everyone makes a relatively low monthly sharing contribution, and all of your costs above a certain dollar amount for those in need of medical care are shared among the members.

    Healthcare Options

    I only learned about these programs when I had begun to consider leaving my current job to become self-employed with Lauren.  Naturally, one of the biggest sources of apprehension in leaving my job was the loss of health insurance.  It was a seriously scary thought. But one of Lauren’s blogging friends Rachel mentioned that their family has participated in Samaritans Ministries for years and was very pleased. I was intrigued.

    But I was skeptical – if this wasn’t an insurance plan, then how would this satisfy the individual mandate?  Wouldn’t I still have to pay the penalty for not purchasing health insurance?  At this time, I worked as a health care actuary, and am well versed in the mechanics of the ACA having read the law, all regulations, and presented to numerous clients about the law’s impact on them and their employees.  So I was VERY surprised to learn that being a member of a religious sharing ministry is a valid exemption from the individual mandate penalties.

    And how does the “plan” work?  If we look at Christian Health Ministries as an example, there are several tiers that you can participate in.  But in contrast to typical health insurance plans, there are no copays or coinsurance, but there is sort of a “deductible”.  Each tier in the sharing program has an out-of-pocket cost for each incident or illness (varies by tier) and then 100% of the remainder of costs is shared among them members – and nothing else is required from the participant.  For the Silver tier, this out-of-pocket cost per incident is $1,000… which means that the participant would be on the hook for most doctor visits. But at a total monthly cost of $85.00, it can be a great deal if you are relatively healthy.

    I recently had to use this when I had a health scare a few months ago… and yup, they covered just like they said they would. Not only that, they were SUPER helpful. I called them numerous times to make sure I was submitting my bills correctly, and an actual person answered the phone every single time and immediately helped me. VERY impressive.

    When's the last time you got that service from an insurance company? Or the government?

    As for our kids (who go to the doctor more frequently) – we have purchased a more traditional health insurance plan.

    Keep in mind that religious sharing ministries are faith-based, and may have certain requirements on lifestyle (like smoking) and might not cover everything that a typical insurance plan would.  So if your belief system doesn’t line up with theirs, then it probably isn't the right fit.

    For many, including my family, it has truly been a great solution.

    Do you know about this affordable alternative to health insurance? It's completely legit and could be a great solution for you!

    COMMENTS

  • I looked into one of those insurance companies several years ago, and they told me to lose some weight and then get back to them at a later time. Very disappointed.

  • My husband had Good Samaritan before we got married. But the thing with us is that I have type 1 diabetes – insulin pump that cost $10,000 – and our son has ulcerative colitis. We are very expensive and I can’t imagine paying out of pocket and waiting for the money to come in. My husband pays $400 a month for insurance and our co-pays are very reasonable. I’ve had several insulin pumps and haven’t paid a dime. BUT all that to say, if you are relatively healthy, I think it’s a great way to go. Would be perfect for my hubby and daughters who just have usual routine things – rarely go to the doctor.

  • Hi. I am wondering what happens with prescriptions? Does the insurance pay for it either before or after the deductible is met?

    • Hi Elizabeth – some sharing plans cover prescriptions, and some don’t. They have different levels of coverage… so if you have expensive medications, it might be worth it to call and ask. They are terrific to deal with over the phone.

  • I am amazed when you say $85 a month with $1000 deductible. I am with HCM and pay $280 a month with a $10,000 deductible. I realize I may be older, 57, but that is a huge difference. Have been thinking of checking into regular insurance again.

  • Are you not concerned about one of your family developing a serious, chronic illness. Would it not be too late to purchase a more conventional insurance? I am Canadian, but I thought that Americans could be refused for pre-existing conditions. I have two chronic, serious illnesses, lupus and Type 1 diabetes and frequent one of my doctors every month or so, but it costs me nothing, although prescriptions need to be covered by private insurance which many have through their employers. If I lived in the U.S. I would be bankrupt and possibly homeless.

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