Healthcare Sharing Ministries Review and Comparison (updated 2018) and why we chose Samaritan Ministries after many hours of research!
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.
Especially if you like to use natural remedies and not visit the doctor for every little thing.
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 four major options, all of which are permissible under the Affordable Care Act (aka Obamacare).
Late 2017/2018 Update on Insurance for Self-Employed Business Owners
It’s getting a little crazy out there – major insurance companies are leaving the private market in droves, making it impossible or prohibitively expensive for solopreneurs to keep coverage. Many counties and some entire states are left with no “major” options in the Marketplace. (sources: 1, 2, 3) Affected states include MO, KS, AK, OH, WI, IN, MI, AZ, CO, WA, WY, NC, SC, TN, GA, MS, KY, OK – who will be next to join?
Choosing a smaller insurance company can be big trouble – if you’re in that situation, call your closest hospitals to make sure they accept the little guys. Some don’t at all!
Some do, but they’ll send your children to a nearby children’s hospital, which may not – meaning you’ll get a surprise bill. ;(
There is a better way.
Are Sharing Ministries 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 Affordable Care 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.
Plus we have truly enjoyed not having to delay care or jump through hoops to make sure all the “codes” are right for coverage.
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.
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, but keep reading because there’s a lot of good comparison info in the post.
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, but keep reading because there’s a lot of good comparison info in the post.
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 four major options are:
- Samaritan Ministries
- Christian Healthcare Ministries
- Christian Medi-Share
- Liberty HealthShare
- (and a bonus of CMF CURO, a Catholic version of Samaritan, and Solidarity, a Catholic arm of Liberty)
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 “big two” (CHM and Medi-Share) 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…
UPDATE Nov. 2017! Samaritan also added a “pay online” feature via Paypal, for all of us who love our tech! I really do appreciate this, because although I still like the connectedness of the Body of Christ…finding cards to send in the mail was starting to feel annoying…
Liberty wasn’t even on my radar (and Solidarity didn’t exist) when we started looking into this in late 2014. They are a little different as well, because you send the money online to other members’ “share boxes” but the doctor still sends bills directly to Liberty. With Samaritan, you receive and pay your own bills so the doc may save expenses vs. submitting claims through traditional insurance.
Structure and Review of Samaritan Ministries Healthcare Sharing
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 (or PayPal.me as of late 2017!)
- . 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.
- 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.
- Your out-of-pocket, to use a regular insurance term, would then be $300 multiplied by your number of disasters and illnesses plus whatever you might spend on preventative/well care. If you’re like many Kitchen Stewardship readers (want to join the tribe?), you don’t go to the doctor for every little thing, so this might be quite minimal.
If you do go with Samaritan, thank you for using our name (Kristopher & Kathryn 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.
Some Samaritan Ministries Stats
- Currently 68,000 households/over 229,000 individuals sharing (as of Sept. 2017).
- More than $25 million/mo. in medical needs are covered.
- Operating since 1995 in all 50 states.
- Any size family pays $495, couples $440, individuals $220. On the “Basic” plan, you can pay far less (and have more responsibility in case of an event). Check the spreadsheet comparison chart for details!
- Includes a “save to share” option for very large medical emergencies. (We do use this option!)
Alternative Healthcare Options for Your Family Doctor
We are very fortunate to have an “out-of-the-box” option here in the Grand Rapids, MI area – we’re members of Christian Healthcare Centers, a Direct Primary Care center, so all of our regular care, well and sick visits under $300, are covered through that membership, which was just over $2k for the whole year for our family of 6.
We’ve been so pleased with the level of care and genuine concern there and definitely appreciate the “whole person” approach, both because the doctors look at everything at once to try to determine root causes of symptoms and also because they’re willing to take less “modern medicine” approaches to healing. The pediatrician even prays with us at the end of each appointment and responds by email probably faster than she should for her own work-life balance!
I wonder if you’ve ever heard of direct primary care (DPC)? DPC is a form of healthcare that takes medicine back to its roots, and actually pairs very well with these health sharing ministries, high deductible plans, and even works well for people who have “great” insurance or are uninsured. I thought you might like to give some information about DPC to your readers. If you google “direct primary care” you’ll find links to lots of great articles, and there is a mapper (to find DPC practices around the country) at dpcfrontier.com/mapper or dpcare.org.
– Kirsten D. Lin, MD
Every visit is absolutely REFRESHING healthcare, and I feel so blessed to have the option. It really is a perfect fit with being a member of a healthcare sharing ministry.
If you don’t have a DPC practice near you (they’re getting more common but still rare), you can actually obtain “concierge model healthcare” 100% virtually. It sounds sci-fi, but it’s reality! I recommend SteadyMD, which is what I would use in a heartbeat if we didn’t have CHC nearby.
With concierge medicine, you choose a primary care doctor, and for a few hundred dollars a month (for a big family), you have video, phone, email and text access to your doctor for any reason. Docs can diagnose rashes, talk through symptoms, order labs and prescriptions if needed, and best of all they know your full medical history AND understand functional and alternative medicine. Wow!
Structure of Christian Healthcare Ministries – How it Works
Christian Healthcare Ministries (CHM) allows you to choose levels and sort of accept risk – you pay less per month for a higher payment per incident. CHM’s levels are
- 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 up to $500 per incident with unlimited coverage on anything above that amount; 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.
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.
My colleague Amanda has had a great experience with CHM and wrote about how much it has saved them over insurance, plus how it went being repaid for an incident.
Note: People have different experiences – A comment from a reader on our Facebook page alerted me to the fact that CHM doesn’t pay out until 120 days after the event. Her experience has been very poor, discovering that getting discounts wasn’t easy (she had to pay in full to receive it and could not do that) and that CHM didn’t help them negotiate discounts. She also mentioned that the terms and conditions keep changing and it’s been a lot to keep up with. 🙁
Structure of Medi-Share (also called Christian Care Ministries)
Medi-Share has levels as well (more than 3), but in essence has a similar structure to CHM as far as where you send the money.
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.
They do not cover preventative/wellness visits. If you go to someone “in network” (PHCS) you pay $35 right away but are still billed the rest later, but you may be able to negotiate a lower fee with the organization’s help.
The levels are as follows, for our family of 6 (should be similar for a 4-person family):
- pay out-of-pocket $1250 max per year (called the “Annual Household Portion”), $685monthly payment
- OOP $2,500 max per year, $552 monthly
- OOP $3,750 max per year, $439 monthly
- OOP $5,000 max per year, $370 monthly
- OOP $7,500 max per year, $303 monthly
- OOP $10,000 max per year, $222 monthly
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 list reflects the “healthy” rates, which apply to both adults in the household.
Believe me, those low monthlies under $250 were very tempting! But we worried about the out-of-pocket unknowns eating at us, so we went with a little more “known” security. We have since learned that any preventative/wellness checkups do not count toward the Annual Household Portion either.
We figured out the 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 insurancspreae terms – the most you have to pay in case of a medical need). With each option, the “monthly payments,” go down as you assume higher risk for the AHP.
See those figures plus a lot of $ info in a helpful spreadsheet that my team and I keep up to date!
A few Medi-Share Stats:
- Over 220K Christians sharing since 1993, over $1.6 billion shared total (as of 2016).
- Health incentive of up to 20% available for those who meet certain criteria.
- Option for sharing for those over 65 with Medicare Parts A & B.
If you end up with Medi-Share, I’d much appreciate it if you went through this link, which helps keep the content free at Kitchen Stewardship.
Structure of Liberty (& Solidarity) HealthShare
I’m confirming whether these two organizations definitely are part of the same parent company, but 95% of the words on their websites are exactly the same, so I’m going with “yes” for now.
Liberty and Solidarity both require doctors to send bills electronically to their system, then they are checked to see if they fit the guidelines, and members contribute directly to an individual’s “ShareBox” online, and the bills are paid to healthcare providers via the system.
It’s much more hands-off than Samaritan and could save a lot of time when you have a need, so as long as your doctor’s office doesn’t give you a hassle about submitting bills, it sounds very interesting and different from other systems. If you want to, you can know about the person your monthly payment is going to so you can still pray for them, reach out, etc., although it’s not a central focus like it is for Samaritan.
As far as costs, you can really choose your risk level for catastrophes, from only 70% of up to $125,000 in bills all the way to $1 million, but no further. The monthly costs range about $50 between the lowest and highest levels.
A reader contacted me after he read this post to let me know about a company called Altrua. They are small, but he says they are one of the 6 healthcare sharing ministries that existed before 2000 and are CMS Recognized.
Apparently, they’ve added some additional benefits recently, including preventive care, $30 PCP VIsits, $75 Specialist Visits, and there are no per incident limits. Also, there is no statement of faith required, just a statement of standards.
More info about the options Altrua offers here.
Catastrophes are What Insurance is For
Another difference is maximum payout.
With the classic Samaritan plan, you only get $250K coverage per incident, max ($236,500 for Basic). We added the Save-to-Share option via Samaritan (which isn’t much more money, only about $15-20/month) and will get covered if something absolutely catastrophic happens.
Save to Share guidelines have changed since we started – the cap used to be $1 million, but now basically if your need is more than half of what is held in the “savings,” you can only be reimbursed for half during that year. It’s probably best if you just read the example in the guidelines!
Christian Healthcare Ministries has unlimited coverage at the gold level (more expensive per month) and Christian Medi-Share has 100% unlimited all the time. Liberty and Solidarity cover up to $1 million at their highest level of membership.
See the breakdown of all the numbers in one place in our up-to-date comparison spreadsheet!
Help for Chronic Conditions
What’s really fascinating about these ministries is that they truly DO care for the health of their members!
Samaritan’s newsletter is one of the only print items I continue to read, and they’re constantly adding more resources for members to stay healthy, get healthy, find alternative treatments, lower their costs, etc. One of the new features is their Health Resources app, including:
- Healthcare Bluebook: Search specific treatments in your area and get quality and price comparisons.
- Medibid: Receive bids from doctors for treatments you are seeking.
- Email a medical professional or call a nurse (free), or call a doctor who can write a prescription ($25).
- Discounts on prescriptions and labs.
There is such a cost savings with these resources!! Member stories and letters are being published constantly with great success using these tools.
I’m also impressed by “HealthTrac,” an optional feature at both Liberty and Solidarity. For an extra $80/month, someone with struggles such as diabetes, hypertension, cancer, heart disease, high cholesterol and obesity gets a health coach and develops a personal plan, goals, has regular communication and progress tracking.
Coverage – What Counts in the Various Options for Healthcare Sharing?
All 4 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).
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 or Medi-Share.
- 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!)
- 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 was $160-180 with Samaritan through our previous family doctor, but now we use the Direct Primary Care model (see above) and it’s just lovely. SteadyMD is another amazing option for anywhere in the country, fully virtual!
- Motorcycle accidents are not fully covered via some of the options; if you drive a motorcycle, read carefully!!!
Our Many Healthcare Financial Discussions (Why We Chose Samaritan)
When we became at-home entrepreneurs in January 2015, 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. UPDATE: As of late 2017, Samaritan has set up PayPal.me as an option! Woo hoo!
- 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.
- All of the big 4 have been around over 20 years. Samaritan, Medi-Share and Liberty are all children of the 1990s but CHM has been around since 1981!
- Samaritan seems to be the most airtight as far as following the rules set forth by Obamacare – because the other three collect and redistribute money, there’s a chance they could be called into question as an “insurance company.” I’m curious where Liberty/Solidarity falls in this since money is in specific members’ “Share Boxes.”
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.
- Liberty wasn’t on our radar and Solidarity didn’t exist. We’ve since had friends choose Liberty and have an absolutely horrible experience, so my mouth is sour about them.
To run all the numbers and try to figure out what each option would REALLY cost, my left-brained husband put together a comparison spreadsheet, which we’re happy to share with you (and my team has updated and improved often!).
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 – although this is beginning to change with some of Samaritan’s new features
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! My team and I also keep a spreadsheet comparing all the fees and expenses with each ministry very up to date.