Some of my favorite things: alternative healthcare insurance decisions, calling government numbers and wrangling the buggy healthcare.gov website.
Oh, and colds and flus and antibiotics.
If your open enrollment period for corporate insurance is leaving you less than thrilled because of higher co-pays and more out-of-pocket costs for healthcare every year, or if you’re self-employed, there’s no reason to be uninsured, underinsured or just plain ticked off.
When my husband worked a corporate job, we were actually very fortunate to “only” pay about $250/mo. for our company-provided health insurance. Compared to many in this era, he had great benefits. How we would compensate for the loss of health insurance was a huge factor in our decision-making process as we weighed the options for him to leave and join me to be an entrefamily.
With the support of other colleagues in the blog world and learning from their experiences, we felt very comfortable exploring the various Christian healthcare sharing ministries. There are three major options, all of which are permissible under the Affordable Care Act (aka Obamacare).
Health Insurance or an Alternative to Insurance?
Health cost sharing ministries are NOT insurance, but thankfully they all sought and were granted approval under the Act, which means that at tax time, you have no penalties and no real paperwork hassle either – one simple form or box to check on your taxes.
We would have had to pay over $1000/mo. through the government for incredibly basic health insurance with over a $10,000 deductible (’cause that’s super “affordable”). With Samaritan Ministries, we paid $405/mo. in 2015, which increased to $495/mo. halfway through 2016, but that’s still so much less than insurance that we can’t complain for a hot second.
Why Choose a Healthcare Sharing Plan?
I think a healthcare sharing plan is a perfect fit for Kitchen Stewardship, because it allows us to feel more able to choose our own care, whether we need the medical model for something big or prefer a more natural approach. It’s also clearly a huge budget saver, so we can finally put into practice the adage:
Pay for food now or medical bills later.
I thought I’d take a little break from the kitchen and explain how this all works, in case anyone is in a situation where it’s a good fit.
I’ll discuss a little about how healthcare sharing ministries differ from insurance, the differences between the 3 major options, the pros and cons we tossed around when looking into them, and some of the situations that lend themselves very well for participating in a sharing ministry.
If you find it helpful and end up signing up for Samaritan Ministries, please mention us as your referral: Kristopher Kimball, Michigan. We’ll get a credit on our share (and you can do the same by passing on the news to others). If you opt for another sharing ministry but are grateful for this post anyway, you can say “thanks” by starting with this Amazon affiliate link for any of your shopping there! As long as you buy something within 24 hours of clicking on it, I’ll get commission without changing your experience at all. Thanks a ton!
UPDATE: Medi-Share reached out to me after discovering this post and offered referral credit as well, and I’m happy to support their organization too. Here’s the referral link to check out Medi-Share, and please email [email protected] to request access to a spreadsheet comparing the big three and some more info on our experiences after two years with Samaritan.
What is a Healthcare Sharing Ministry?
In a nutshell, a Christian sharing ministry puts into practice the early Church’s habit in Acts of everyone pooling their resources and helping the whole community when in need.
Practically, it means that all members send in an amount of money, and from that pool for the month, any members with medical needs (that fit that ministry’s guidelines) get covered.
It is NOT insurance in the traditional sense at all (nor is it defined as insurance by anyone who counts for anything). There aren’t corporate offices, payment does not go to doctors or hospitals (it comes to you and you pay your bills), there’s no coding of appointments or procedures, far less red tape, and technically, no guarantees. If there’s not enough money in the pool that month, then a medical need might not get covered.
The three major options are:
- Samaritan Ministries
- Christian Healthcare Ministries
- Christian Medi-Share
- (and a fourth bonus of CMF CURO, a Catholic version of Samaritan)
For all of these ministries, you DO have to make a statement of your faith, committing to be a practicing Christian. For some, you need your pastor to sign a piece of paper stating that you’re involved in your community, etc. Things like out of wedlock pregnancies, alcohol and drug abuse and rehab, sterilization – they’re not covered because they go against Biblical teachings.
How do the Healthcare Sharing Ministries Compare?
Where You Send Money
The MAJOR difference with Samaritan vs. the other two is that it’s the only one where you send your check directly to the person in need.
Some people love that – the connectedness to the body of Christ, the personal prayers and notes. Some people just want to automate the process and be more private about it (since if YOU are the one in need, your medical issue is published publicly).
Legally, there’s a small chance that the other two major sharing programs could come under fire someday because of the system, because they collect and redistribute funds and may look more like “insurance” than “sharing.” So far, they’ve had no problem though. Samaritan feels that they have an extra layer of protection with the government because no money goes through their hands/offices.
I actually thought I’d really dislike that part because I adore automation, especially when it comes to boring things like paying bills. I’ve been surprised.
Most months, I really do appreciate knowing where our money is going, and we’ve definitely paid a little extra in a separate envelope for “special prayer needs,” medical bills from members that aren’t publishable, either because they’re not within the guidelines (like dental or eye) or because the condition existed before the person became a member.
So I guess I’m saying don’t let that part scare you, and even if you have a pre-existing condition or pregnancy, I’d encourage you to call the Samaritan offices and talk to them. It sure sounds like MANY members end up with even un-publishable needs mostly covered by the community of Christians that makes up Samaritan. It’s amazing…
Structure of Samaritan
In general, here’s how Samaritan Ministries works:
- Any medical need under $300 is not publishable – that means you pay for it yourself.
- Any approved need over $300 is “published” and people are assigned to send checks to you. You pay your own bills starting with $300 of your own money and then using what you’ve been sent (which is equal to the rest of your bill). Note that there are things that aren’t part of the plan, like dental care, motorcycle accidents, and preventative care like physical, well-child checkups, colonoscopies and mammograms, as well as the handful of “non-Christian” issues I mentioned above. See below for how pre-existing conditions are handled.
- Multiple appointments for the same medical issue/incident all count as “one.” So if you have an $180 bill for a doctor visit for a sprained wrist plus a $250 X-ray plus two follow-up appointments to make sure you healed okay at $180 each, you will only pay the first $300 of all of them added up (if I’m understanding it all correctly).
- Your $300 is reduced if you can get your bills reduced, so many people talk to payment offices, get their bill reduced and end up paying $0 for an incident.
- If you have 3 published incidents in a year, everything publishable after that is covered in full for the whole family.
If you do go with Samaritan, thank you for using our name (Kristopher Kimball, Michigan) as your referral!
For a family of 6 with our fairly good health history, we pay $495/mo. at Samaritan for regular membership plus about $15-20 extra for Save to Share for added maximum coverage.
Structure of Christian Healthcare Ministries
- Bronze – pay $5,000 per incident with limited coverage ($125,000); fees would be $135/mo. for our family
- Silver – pay $1,000 per incident with limited coverage; fees $255/mo. for us
- Gold – pay $500 per incident with unlimited coverage; fees would have been $450/mo. for us
You can put different family members at different levels. So for example, if you were trying to conceive, you might put mom on Gold because you know she’ll have a big cost that year.
Structure of Christian Medi-Share
Medi-Share has more than 3 levels but in essence has a similar structure to CHM. For both, you send your checks to a central office and the organization divides the money and sends checks to those in need. It’s less of a hassle for the members, certainly, but may come under fire from the government later.
Medi-Share is also the only ministry we looked into that has a “network” where in and out of network docs would cost differently and be covered vs. not.
Fees are set for office visits and emergency room visits (very reminiscent of traditional insurance), and you can pay using a credit union debit card that gets automatically loaded when you have a medical need.
A few of the levels are as follows, for our family of 6:
- pay out-of-pocket $1250 max per year, $497 monthly payment
- OOP $5,000 max per year, $276 monthly
- OOP $10,000 max per year, $146 monthly
Believe me, those low monthlies under $200 were very tempting! But we worried about the out-of-pocket unknowns eating at us, so we went with a little more “known” security.
Here are some numbers on Medi-Share that show the “Annual Household Portion” you can choose at various levels (similar to what you’re familiar with as a “deductible” in insurance terms – the most you have to pay in case of a medical need). With each option, you would definitely pay the middle column, the “monthly payments,” which go down as you assume higher risk.
The third column is the total you’d pay if you had to use your whole deductible because of a major medical need or “disaster.” Notice that total out-of-pocket increases as your risk increases.
Note that these costs are all based on the date-of-birth of the person applying, so born in 1979 in our case and 3+ in the family. There are significant savings for passing their test of “healthy” based on waist measurement, BMI and blood pressure. This chart reflects the “healthy” rates, which apply to both adults in the household.
Catastrophes are What Insurance is For
Another difference is maximum payout.
With the basic Samaritan plan, you only get $250K coverage per incident, max. We added the Save-to-Share option via Samaritan (which isn’t much more money, only about $15-20/month) and will get up to $1 million if something absolutely catastrophic happens.
Christian Healthcare Ministries has unlimited coverage at the gold level (more expensive per month) and Christian Medi-Share has 100% unlimited all the time.
Coverage – What Counts?
All 3 Christian health cost sharing ministries have slight differences in what they cover, but none of them were major factors in our decision. It’s worth reading the FAQs or terms and conditions at each though to watch for that.
If you have any chronic or current conditions, you’ll want to research those in depth. All 3 ministries do not cover currently active chronic diseases, but some (Samaritan included) will cover something like my husband’s Crohn’s Disease if it’s been inactive for at least 3 years without any treatment (it has, thanks be to God).
EDIT: a reader shared a bit more about how CHM works with pre-existing conditions:
They pay for pre-existing conditions on a sliding scale – $15000 the first year, $25000 the second year (15,000 from the first year plus an extra 10,000) and $50,000 the third (15000 first year, 10000 the second, and 25,000 the third) . After the third year, the condition is no longer considered pre-existing. We filed a claim for my husband’s recent medical issues and they paid all the bills without question and gave us credit off of our deductible for the discounts I arranged.
I looked up a little more and if a condition is treated only with “maintenance” then anything that pops up will be covered via CHM.
Bottom line on pre-existing conditions: You’re really going to want to read alllllll the Guidelines for each ministry you’re interested in and perhaps call the office to make sure you fully understand your exact situation!
Here are a few specifics that may catch your eyes as they caught ours:
- Natural/alternative treatments are covered with approval at Samaritan (some are, some aren’t); no alternative treatments are covered with CHM.
- Maternity is fully covered at Samaritan and CHM (Gold only) as long as the pregnancy was completely within membership dates. Medi-Share is similar at the $1250 level and up. It looks like all three will cover midwives under certain conditions (which may make participating in a sharing ministry less expensive than traditional insurance if yours won’t cover the kind of birth you want!)
- If you want a natural birth, by the way, this is the class you need, 100% online. Don’t you love it!?
- Prescriptions related to an eligible condition are published for 6 months with Medi-Share.
- Well-child care through age 5 is eligible at Medi-Share. In general regular well checkups/physicals are probably less expensive via Medi-Share because they have a set rate. We were not able to get a discount at our family doc, so every visit is $160-180 with Samaritan.
- Motorcycle accidents are not fully covered via some of the options; if you drive a motorcycle, read carefully!!!
Our Many Healthcare Financial Discussions
Last December/January, this issue certainly took up a lot of our couple time. It goes far smoother with a glass of wine and a good meal after the kids are in bed…really.
It’s a little scary going out on your own with healthcare, and here are some of the factors we tossed around:
- Catastrophic coverage was important to us. We wouldn’t be wiped out by a few $200 doctor visits or even a few thousand for a broken bone, but cancer and its hundreds of thousands would bankrupt us. We felt the lower maximums were far too risky and went with Samaritan’s add-on Save to Share to raise the max to a million dollars.
- Having just been through paying OOP for a home birth, the acceptance of midwives was a relief all around (although we don’t know what God has in store for us, we feel our hearts and minivan are full…but you never know…)
- I was extremely hesitant about Samaritan’s system of sending checks different places each month. I prefer to automate everything I can. I have a colleague who did NOT choose Samaritan because of that portion; she also didn’t like that medical needs are published so publicly. I got over my reservations and I really don’t mind it now. It’s only one check a month, and I do appreciate knowing what we’re paying for and praying for our recipient.
- If a need is unpublishable but you still need help, Samaritan sends out your address in their newsletter and recommends that people give $20 or so to help you out. It’s very personal, and from what I understand, many of those needs are fulfilled through the unrequired generosity of the other members. I’ve personally sent checks to the “additional needs” about four times in 18 months, for situations like a little boy who had been diagnosed with Crohn’s Disease, a family in my own community, and a few months where our payment was under $20 because of referrals so I couldn’t help but feel generous. You can even send an extra payment right to Samaritan and have it be tax deductible and anonymous for an additional need.
- Samaritan and Medi-Share have both been around over 20 years. I used to think Samaritan was the oldest, but Medi-Share may be by a year.
- Samaritan seems to be the most airtight as far as following the rules set forth by Obamacare – because the other two collect and redistribute money, there’s a chance they could be called into question as an “insurance company.”
Final Decision Making
- We heard from colleagues with very good experiences with all 3 major options.
- Although we are Catholic, we didn’t go with CMF CURO because other than the convenience of a card with which to pay bills, we couldn’t determine any real value over Samaritan, which is the engine running CURO anyway. It’s nearly 20% more expensive than Samaritan.
- Medi-Share was out because we read that “permanent, lifelong diagnosis/conditions are ineligible for sharing.” We understood that to apply to my husband’s Crohn’s Disease. Samaritan doesn’t publish pre-existing conditions for sharing UNLESS it has basically been “in remission.” My husband’s Crohn’s was okay because he hasn’t needed real treatment for it in 10 years and hasn’t seen a doctor for anything at all related for at least 5 years.
- Because we wanted catastrophic coverage, we would have had to go with the gold level at CHM, and the monthly payment would have been about $45 higher than Samaritan, and the minimum expense per incident was also a few hundred dollars higher. I decided we’d try it and I could deal with writing one check by hand per month.
So far we’ve been happy with the ministry as far as their obvious heart for caring for the community and just the fact that we can break from the system and be autonomous and not have to pay crazy amounts for health insurance. It definitely makes you think about whether you really need to see a doctor for such-and-such when you know that $170 office visit will be completely out of pocket!
We have not had any needs published yet, praise be to God. We personally know others who have published needs and they have only good things to say about the process, so I feel confident that we’ll be taken care of. Any inconvenience from having to record each check received will likely be compensated 100-fold by the joy in receiving notes and cards from others in the Body of Christ that I don’t even know.
Are You on This List? [Good Fits for a Healthcare Sharing Ministry]
I don’t think this option is for everyone, especially if you have great insurance through work, but it’s perfect for these situations and many more:
- Any Christian who is self-employed, hands down
- A family paying more than $400 out of pocket for their insurance through work should take a hard look at these options and run some numbers
- Generally healthy people who greatly dislike the “system” they’re in, especially if that system forces them to go to certain doctors. Healthcare Sharing Ministries give you the option to be far more autonomous!
- Families who want the option of having midwives or home births covered
- Anyone fed up with insurance red tape
- An employee whose company offers a kickback if they don’t take the insurance plan, especially one who wants more autonomy in healthcare providers – run the numbers to see if it would work out for you!
- A Christian whose insurance covers procedures they find morally reprehensible and who hate the thought of contributing to that
- People on Medicare who want to be able to make their own choices about care (and who have savings to potentially spend a little more on healthcare) – again, run your own numbers. Note that Medi-Share has an option for those over 65 that pairs with Medicare A & B!
But Sharing Ministries are NOT for…
- Those with active, chronic, expensive illnesses
- Those who feel the need to go to the doctor for every little thing
- Those who can’t budget money to set aside
- Anyone with great insurance who is happy with their current doctor
- People on multiple, ongoing prescription drugs who wouldn’t be able to pay for them out-of-pocket
I truly hope this departure from the kitchen was helpful for many of you! If nothing else, even if you are happy with your insurance and don’t need this info, it’s interesting (and encouraging) to me to know that there are options out there beyond insurance, which drove me nuts.
If you have any questions for me that aren’t answered in the post, I’ll certainly try my best to answer them in the comments. Feel free to leave your own experiences with a healthcare sharing ministry if you like! We have a spreadsheet comparing all the fees and expenses with each ministry; if you’d like a copy to work from, dash me an email at katie at kitchenstewardship.com.
Disclosure: This post is not sponsored and is 100% our opinions and research based on what we needed in late 2014. We did update the numbers to reflect current prices and will continue to do so as much as possible. We will receive a credit on our Samaritan account for any referrals and a referral payment for Medi-Share – neither change your price at all.