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One of the biggest concerns those self-employed, unemployed, or early retired have is how to pay for healthcare.
According to EHealth, the average non-subsidized healthcare plan for a family of four was $1437 per month in 2020. And that is just the cost of premiums!
An alternative health coverage choice that’s become popular in the last few decades is the health care sharing ministry.
What is a Health Care Sharing Ministry?
A health share ministry program is not insurance. There are no insurance agents or insurance companies involved.
Instead, it’s a membership-based non-profit program where members with common religious beliefs share the expense of each others’ medical costs.
Members pay monthly fees (“shares”), which are usually vastly more affordable than traditional health insurance premiums.
Members have deductibles, or amounts they are required to pay before sharing kicks in, and after that, the organization covers part or all of their healthcare costs up to certain defined limits.
Health care sharing ministries are, by definition, religious organizations.
Their members are exempt from the Affordable Care Act’s individual insurance mandate (required healthcare premiums) because of their members’ religious faith.
That means that these ministries are not required to accept consumers with pre-existing conditions or pay for expensive coverage claims.
There are seven primary healthcare sharing ministries.
Five of the seven require members to be Christians, one requires members to be Jewish, and all request members to agree to certain lifestyle behaviors that promote health and long life.
To join a sharing ministry program, you’re usually required to be an active member of a Christian (or Jewish) faith community, like a church, and you must agree to certain healthy behaviors.
The requirements to join a sharing ministry are too rigid for many people. However, those practicing a religious faith who are willing to agree to live a healthy life and abstain from illegal drugs and excess alcohol may find that a sharing ministry is a viable alternative.
How Sharing Ministries Work
Most sharing ministries have costs similar to premiums and deductibles.
The majority have sliding “deductible” scales used to determine your monthly “premiums” (which are called “monthly shares”).
The higher your deductible, the lower the cost of the monthly share that you pay.
Some organizations have “Healthy” plans so that if your blood pressure, waist circumference, and BMI meet certain levels, then you pay less each month.
The money that members put into the Sharing Ministry is the money used to fund members’ medical claims.
Some organizations pay practitioners directly, and others reimburse their program members for a paid claim.
Most ask members to negotiate cash discounts for services before they will pay. A portion of members’ monthly shares (usually 20%) is reserved for administrative costs.
Sharing ministries predominately operate on biblical or ethical principles, meaning they require their members to adhere to certain lifestyle behaviors that they believe will result in a healthier lifestyle and, therefore, lower medical care costs for members.
Health care sharing ministries are not legally obligated to pay for a member’s healthcare claim.
Even so, most ministries have successfully operated for decades and have a history of successfully covering even high healthcare costs associated with cancer, childbirth, and severe illness.
To join the majority of ministry programs, you must sign a pledge stating that:
- You have not abused illegal drugs or alcohol in the previous 12 months and will not do so in the future.
- You will not have sex outside of marriage
- You are an active member of a Christian (or Jewish) denomination, or you adhere to Christian (or Jewish) beliefs, depending on the organization.
Major Differences Between Health Care Sharing Ministry Plans
Below we list the seven primary health sharing ministries (in alphabetical order) and their plan highlights.
1. Altrua HealthShare
Altrua has been in business for 25 years. Altrua has an escrow account where they deposit member shares to then pay for other members’ bills.
To apply, you will need to pay a $100 application fee and $25 to the non-profit that is non-refundable.
Altrua has a user-friendly website that explains its four options for membership:
- Diamond (from $280 per month)
- Emerald (from $250 per month)
- Sapphire (from $140 per month)
- Ruby (from $105 per month)
The top options provide more coverage and a lower Member Responsibility Amount (MRA).
MRAs work like deductibles, and Altrua has two: the first you must satisfy before Altrua pays for any of your medical bills, and the second is a percentage of your bills that Altrua will pay after that.
Altrua will pay for all eligible healthcare coverage after you reach those two amounts each year. However, some situations are not covered, such as adoption and lab services.
The company does provide telemedicine, prescription discounts, and cancer sharing services.
To become a member, you must agree that you believe using tobacco, illegal drugs, or excessive alcohol is “harmful to the body and soul.” You must also agree to no sex outside the bond of marriage.
You also have to be under a certain weight to qualify for lower monthly member shares.
2. Christian Healthcare Ministries
In operations since 1981, Christian Healthcare Ministries is one of the oldest health sharing ministries. The organization is an A+ Accredited Charity on the Better Business Bureau.
Pricing is per person, with a maximum of three. So, if you are a family of five, you would only pay for your first three family members.
There are three membership levels:
- Gold ($172 per person per month)
- Silver ($118 per person per month)
- Bronze ($78 per person per month).
Christian Healthcare Ministries has a “Brother’s Keeper” program where, for an additional $75 per month, you can get coverage for medical expenses beyond the yearly $125,000 coverage total.
Be aware with CHM, you are in charge of paying your medical bills, and then they will reimburse you for payment.
To be a member, you must be an active member of a Christian denomination and avoid tobacco, illegal drugs, and excessive alcohol use, as well as sex outside of marriage.
3. Liberty HealthShares
Liberty currently has over 220,000 members and offers four coverage options:
- Liberty Complete – $399 single, $675 family
- Liberty Plus – $374 single, $624 family
- Liberty Share – $349 single, $599 family
- Liberty Select – $199 single, $399 family
After you pay your AUA, Annual Unshared Amount (similar to a deductible), which varies between plans, Liberty covers additional bills per incident in amounts from $125,000 up to $1,000,000, depending on the plan chosen.
As a member of Liberty, you send your monthly share to a “Share Box,” which is then dispersed to other members with reimbursable costs. Liberty will pay large bills directly to your provider.
To be a member, you must observe Christian standards, accept shared beliefs, and maintain a Christian lifestyle, including abstaining from drugs, excessive alcohol, and tobacco and exercising regularly.
Founded in 1993, Medi-Share currently serves over 400,000 members and has shared over $4 billion in medical expenses between members. As part of their membership program, Medi-Share works to secure discounts and facilitate direct payment to health care providers.
They offer four “annual household portions” (deductibles) for singles and families, ranging from $3,000 to $12,000. Monthly share amounts are based on your household size, age, marital status, state, and the Annual Household Portion.
To join, you must pay a $50 application fee and a one-time $120 member fee. No one is denied membership, if you are a Christian and can adhere to the lifestyle agreement, but there are conditions for sharing in pre-existing conditions according to their member-voted guidelines.
Members have access to a network of board-certified telehealth doctors who can prescribe routine medicines and help with minor health issues, as well as access to professional virtual mental health counselors. Additionally, through the Medi-Share app, members can pray for one another’s specific needs.
Medi-Share also offers a Christian Disability Sharing program called Manna, where monthly member contributions help other members replace lost income due to a disabling event.
5. Samaritan Ministries
Samaritan Ministries has approximately 250,000 total members and has been in operation since 1994.
Payments are sent directly to other members, except for one month per year, when you send your payment to its administrative offices to cover admin costs. Samaritan has an administrative fee of $200 to apply or reapply to the ministry.
Samaritan’s prices are based on the size of your family–one person, two-person, three-to-seven person, eight-or-more person, and widowed or divorced with children.
Monthly shares range from $100 to $600 depending on your family size, age, and health. Most plans cover bills up to $250,000, but there is a Save to Share plan, where you contribute $400 or less annually and receive coverage for larger expenses.
Samaritan does not cover your bills directly since members send reimbursement directly to each other, so be prepared to pay bills out of pocket first.
There are strict requirements to join. Each adult seeking membership must affirm to Samaritan’s Statement of Faith and Membership Agreement – which includes annually assuring you will attend a Biblical, Christian church regularly, abstaining from getting drunk, using illegal drugs or tobacco, having sex outside of marriage, or suing a fellow Christian.
6. Sharity Ministries (formerly Trinity Healthshare)
In business since 1997 and under the umbrella of AlieraCare (a for-profit company) is Sharity Ministries.
There offer three coverage types – prices vary on age:
- Basic – from $125 to $240 for a single person, $355 to $700 for a family of up to seven
- Catastrophic – from $210 to $465 for a single, $570 to $1290 for a family
- Complete – from $315 to $715 for a single, $715 to $1915 for a family
Coverage of hospital visits and operations varies based on your plan. Sharity makes payments directly to the provider. It also has the most flexible statement of belief for members.
While you do need to believe in God and pledge you will avoid unhealthy behaviors, you are not required to declare yourself a Christian. However, multiple complaints have been lodged against former company Trinity in various states for refusing to pay for healthcare for its members.
The Better Business Bureau has an alert on the business for a pattern of complaints (Aliera, its parent company, had an A+ rating that was revoked and is now a B+). If you pick this company, make sure to do your homework first.
7. United Refuah HealthShare
In 2017, United Refuah HealthShare, a Jewish health sharing ministry, was launched to serve members who live in accordance with Torah values.
Monthly ministry fees are straightforward:
- Single person – $199
- Couple – $349
- Family – $499 for a family of up to six (after that, it is $50 per additional member)
The annual pre-share amount (what you must pay before sharing kicks in) is $500 for a single, $1000 for a couple, or $1500 for a family.
After that, Refuah pays up to 80% of eligible bills with a $1 million per incident limit. Your fees are paid into a ShareFund, and, apart from fees held back for administrative costs (20% of fees), they are fully shared with members in need.
Refuah will share pregnancy costs, provided the mother is married at the time of conception, and the pregnancy is ten months after joining. They also impose a $125 administrative fee to join and $75 per year thereafter.
To become a member of Refuah, you need to be a member of the Jewish faith and agree to abstain from tobacco, follow biblical teachings on alcohol use, abstain from illegal drugs, and exercise regularly.
The Cons of Health Sharing Ministries
While health care sharing ministries are drastically more affordable than standard healthcare plans, some health-sharing ministries have gotten into trouble for aggressive marketing techniques and overselling their services to consumers.
The New York Times reports that in January of 2020, Washington State fined Trinity Healthshare and banned it from doing business in the state because it was operating as a de facto insurer when it is not.
There is no government oversight for the organizations since health share ministries are not insurance, and they are not legally bound to pay members’ medical bills.
That uncertainty is too much for many people. Still, some are willing to take the risk.
Is a Health Share Ministry Right for You?
Those with pre-existing conditions, a family history of medical conditions, or poor health habits are likely better off obtaining traditional medical insurance.
If you’re thinking about using a health share ministry, be sure to do your homework before joining, and make sure you have some money saved up for medical emergencies, just in case.