Health Insurance vs. Medical Sharing Plans
NOTE: FOR CURRENT FEES FOR THE VARIOUS HEALTHCARE PROGRAMS, CONSULT THEIR WEB SITES. I DO NOT TRY TO KEEP THIS REPORT UPDATED WITH THAT TYPE OF INFORMATION. ADDRESS ANY AND ALL QUESTIONS DIRECTLY TO THE SPECIFIC ORGANIZATION. WE DO NOT REPRESENT ANY OF THESE ORGANIZATIONS AND CAN PROVIDE NO FURTHER INFORMATION. WE MAKE NO GUARANTEE THAT THE INFORMATION LISTED IS UP-TO-DATE.
In 1999, I sent out a request for information from those who have had personal experience with medical sharing plans. We had had family health insurance through Blue Cross of Washington and Alaska for the six or so years prior to that. After moving to another state in 1999, we were informed that Blue Cross of Washington could no longer cover us and we would have to get another policy (each Blue Cross associate is a separate entity). We learned that a Blue Cross in the new state would cost more than we had paid in Washington for less coverage. As we investigated the options, we became impressed that there are good alternatives, at least for many Christian families, than standard health insurance.
I received a flood of invaluable responses to my request for help in 1999 and have continued to receive responses over the years since then. Since many have asked me to share my findings, I will do so in the following report. Please note that I realize that family situations vary greatly. If you are satisfied with traditional health insurance, that is fine. If you are satisfied with a certain medical sharing plan that I do not highly recommend in my little report, that is fine, too. I am not trying to sell anything, and I certainly don’t want to debate anything. I am merely sharing the information I have collected for those who might find it useful. I have updated the information as I have received it, but the reader must understand that the following facts can easily change without my knowledge.
STANDARD HEALTH INSURANCE COVERAGE
The main problem with standard health insurance coverage is that it is extremely expensive and even with high monthly premiums the family is left with many medical bills that are not covered. Our family health care policy in Washington cost roughly $450 per month (in the 1990s). Over a period of 10 years, a policy like that costs $54,000. That is a lot of money. In our family’s case, we ended up paying for most of our health costs ourselves in spite of paying the $450 per month, because most of our medical costs involved expenses at or below the annual deductible, uncovered prescriptions, etc. In practice, therefore, we were paying $5,400 per year for health insurance plus we paid for most of our own health care. Of course, if we had had expensive medical needs during that period, the picture would have changed dramatically. Our family’s situation is probably typical, though. Also, when paying for standard health insurance policies, the Christian is helping pay the large medical expenses incurred by the unhealthy lifestyles of unsaved people (drunkenness, drug abuse, gluttony, shootings, stabbings, beatings, child abuse, venereal disease, etc.).
In the replies I have received, there were four that suggested various twists on the standard health insurance coverage plan. Since someone might find these helpful, I will include those replies are as follows:
“I received your inquiry about health insurance. For years our family had LAM-Good Samaritan and we never used it because the deductibles were so high. My wife and four kids were always going to the clinic for check-ups, vaccinations, etc. Finally I had enough and asked our church to switch us to Aetna-US Healthcare. For about $100 a month more we now have no deductibles, only $2 co-pay, and this includes prescription and most dental. Now we can go to any neighborhood doctor (and dentist). We could not get dental with LAM). Personally I think we are much better off now.”
“I really don't know anything about [medical sharing plans], but as far as insurance goes... Here in NY when you're considered self employed (which I think you might consider yourself) you can join a local chamber of commerce and buy insurance thru them. We have a family of four and we pay just under $400 a month. I don't know if you can do that in OK or not, but if you can, you might want to check it out. Just a suggestion.”
“You may check into special programs with adjusted rates. In our area of Pennsylvania, Blue Cross charges lower rates for families with lower incomes. The program here is called 'Special Care.' I find it to be a good plan. It does not cover prescriptions (I am always sure to ask the doctor for samples) but it only costs us $145 per month for a family of four. Less then half of what your increase will be.”
“I am with Golden Rule. 1) Good prescription plan. 2) High deductible ($1500 then covers 100%). 3) Reasonable rates $3200 per year); for similar coverage with Christian Brotherhood, I would pay over $3600.”
GOLDEN RULE is an insurance company but its policies are a little different than the standard plans. They have a Basic Plan that is described briefly in the previous paragraph. They also have an interesting plan called MSA for the self-employed, which combines high-deductible major medical insurance with a tax-free savings account. The subscriber uses the savings account to pay the deductible and coinsurance. Interest accumulates tax-deferred and, if used for medical care, is never taxed. [Golden Rule, 7440 Woodland Dr., Indianapolis, IN 46278-1719. 800-444-8990 (voice), 618-943-5063 (inquiries), www.goldenrule.com (web site)]
MEDICAL SHARING PROGRAMS
One serious alternative to standard health insurance is a medical sharing plan. In short, the participants in the plans assume responsibility for paying the medical expenses of the program members. This is done by averaging the cost of health care and dividing that into a monthly premium or pledge that each participant is required to make. Instead of pooling the money, the participants send their monthly pledge directly to another participant who has a current medical expense. One man said, “I would much rather write a check to an individual every month as opposed to an insurance conglomerate!” The participants pledge that they are church-going Christians and that they abstain from alcohol and tobacco. This helps keep the health costs lower than those of the general population.
Five medical sharing programs have been recommended to me, and I will share the basic overview of each program and some of the responses I have received about them.
It is important to note that several dozen people shared their personal testimonies with me about these programs, and all but two or three are generally satisfied and find the medical sharing programs equal or superior to standard health insurance policies.
There are a couple of downsides to any of these programs. First is the problem of dealing with healthcare providers without standard insurance. Let me hasten to say that most of the respondents who wrote to me about these plans said that this is not a serious problem. Many hospitals and doctors have experience with one or more of the medical sharing plans. Others can be taught about the program. On the plus side, it is not uncommon for hospitals and doctors to give discounts (as much as 50%) because they are being paid by cash rather than having to deal with an insurance company.
Following are some of the comments about how health care providers accept the policies:
“Good Samaritan was in place for our last two children and several other necessary procedures. While they pay in 60-90 [days], the hospitals had no problem accepting it. I can recommend it heartily!”
“We have not had any problems with our children that were born under their medical program [Christian Brotherhood]. What hospitals and others have to do is bill you and you pay off the bills as the money comes in. Never had a problem.”
“We explain that we do not have health insurance, but the doctors and hospital we have worked with have understood and have been cooperative and understanding. Both have given us up to a 30% discount off the total bill.”
“Most hospitals treat you as a 'self-pay' patient and require a substantial payment prior to treatment unless it is an emergency. Most doctors offices are unaffected by it and will put you on a monthly payment program. When the funds do come in from Brotherhood, you can then pay off all your bills and recoup the payment the hospital required.”
“It takes time to acquaint hospitals, etc., with the concept but they soon see the advantage. We recommend it totally.”
“The few people I know who use these plans have been completely pleased. (I have one couple in my church who used one of these plans. He recently died of cancer after a lengthy hospital stay. His wife reports that she has had little trouble with getting her bills paid.) However it is important to understand that sharing plans ARE NOT insurance therefore there is nothing for hospitals to accept. When you are admitted to a hospital you are considered non-insured / self-pay. This could limit the care that you receive. For instance; if you require a rather expensive procedure that is not considered life threatening a hospital could refuse to perform it based on your ability to pay. Also they may in case of life threatening cases require you to apply for public assistance / welfare.”
Another potential problem with at least some of the medical sharing plans is associated with MATERNITY NEEDS. Some of the plans are very restrictive about what they cover in this area. One man warned: “[Some of the sharing plans] offer little or no financial help for maternity. And if there are complications for mother or child in childbirth, or within the first six months of the child's life, watch out, you could be stuck with a bill of tens of thousands, if not hundreds of thousands of dollars, with no way to pay it. I know this from first-hand experience.”
Now we will look individually at five medical sharing programs that have been recommended to me.
CHRISTIAN HEALTHCARE MINISTRIES [P.O. Box 3948, Akron, OH 44314. 800-269-4030 (voice), 330-753-6886 (fax), email@example.com (e-mail), www.cbnews.org (web site)]
Though Christian Healthcare Ministries (formerly known as Christian Brotherhood) went through some rough water financially some years back, things have turned around.
On June 11, 2007, a pastor wrote: “My wife and I have been members since '93, and found no problems whatsoever. For the two of us, with a $1K deductible, we pay a total of $135/mo. Since both of us also have Medicare, if and when we have to use their program for health care, our Medicare covers the deductible, therefore, there will always be a zero balance on our part. They also offer a comprehensive education into how to negotiate with hospitals regarding a payment schedule that can lower your expenses a great deal.”
On July 20, 2009, a lady wrote, “I am just writing to suggest that you update your posting regarding Christian Healthcare Ministries. Although they had some difficulties quite a few years ago, they have worked hard to overcome the issues and now serve Christians with integrity. My husband has incurred over $100,000 in medical bills due to a cancer diagnosis in 2007. Although some providers don't understand the concept and are a bit hesitant, several others welcomed the plan and allowed us to make minimal payments while we were waiting for our need to be shared with the other members. CHM has ended up paying a considerable amount more toward our bills than a traditional insurance company would have, so our out-of-pocket expenses over the last 2 years have been substantially less than they would have been. I highly recommend Christian Healthcare Ministries.”
On August 13, 2009, a pastor wrote, “I just wanted to say that my family uses Christian Health Care Ministries, formerly Christian Brotherhood. Yes, they had problems in the past but it is a great service now. We highly recommend them and so do my in laws who are missionaries in the Philippines.”
On November 28, 2010, Pastor John Horner, Liberty Baptist Church, Minier, Illinois, sent the following testimony:
“Christian Healthcare Ministries is great. We have been members since 1989. Last year, when I had two disks removed from my cervical spine, bone grafts done and three vertebrae fused with a titanium plate, the bills totaled about $80,000. CHM negotiated discounts with my providers and got most of my bills lowered by anywhere from 40 to 74%. Because I received discounts of more than my $500 deductible, CHM waved the deductible and paid all of my bills in full. Within seven months of my surgery, all of my providers were paid. CHM has three levels of participation, Gold, Silver and Bronze. The monthly cost and amount of deductible depends on the level you choose. My wife and I pay $300 per month for the Gold level and have a $500 deductible. This takes care of major medical problems, rather than simple doctor visits, prescriptions, etc. CHM will cover the cost for up to $125,000 per medical incident. CHM also offers a program called Brothers Keeper, that covers medical bills which exceed $125,000. Brothers Keeper will provide coverage up to $1,000,000 per medical incident. The charge for this additional coverage is about $25 every three months. With each of these programs, it takes approximately six months to receive payment from the time approved needs are submitted to CHM. The length of time in receiving payment is the only drawback that I have seen with CHM. Most providers will want a monthly payment, on the account, while waiting for full payment.”
[If you sign up for Christian Healthcare Ministries, we suggest that you mention Pastor Horner as your referring party. They will wave one month’s payment for him for each referral.]
SAMARITAN MINISTRIES [CHRISTIAN HEALTH CARE NEWSLETTER, P.O. Box 3618, Peoria IL 61612-3618. 309-689-0442 (voice), 888-268-4377 (toll free), http://www.samaritanministries.org (web site), firstname.lastname@example.org (e-mail)]
Under the Samaritan Ministries program (not to be confused with Good Samaritan, a sharing program that ceased to operate as such in 1999), the cost is $135 per month for single, $270 for married, and $320 for a family with three or more children. There is also a $150 per year fee that goes to the operation of Samaritan Ministries. The subscriber pays for the first three medical incidents per year under $300, and the program shares the cost of treatments over $300 (up to $100,000).
The subscriber receives a newsletter each month listing the needs of fellow subscribers. He also is given the name and address of the specific individual or family to whom he is to send his monthly share. The subscriber sends his gift and a note of encouragement. When the subscriber has a medical incident, he sends the bills to Samaritan Ministries for verification and publication.
Samaritan Ministries began publishing medical needs in 1994 after three years of research and planning. The Samaritan Ministries program was highly recommended to me by several people and no serious problems were mentioned. One pastor described it as "an extremely well managed program."
SAMARITAN MINISTRIES IS WHAT OUR FAMILY JOINED IN 1999, AND WE HAVE BEEN COMPLETELY SATISFIED. RECENTLY I USED IT FOR TWO SURGERIES PERTAINING TO GALL STONES. THEY ARE QUICK TO PUBLISH YOUR MEDICAL EXPENSES.
IF ANYONE READING THIS ARTICLE SIGNS UP FOR SAMARITAN MINISTRIES, IT WOULD BE VERY HELPFUL IF YOU WOULD TELL THEM THAT YOU WERE REFERRED BY BROTHER CLOUD. THEY WILL GIVE US A DISCOUNT ON OUR MONTHLY PAYMENT FOR EACH REFERRAL.
CHRISTIAN CARE MEDI-SHARE [P. O. Box 1779, Melbourne, FL 32902. 800-374-2562 (voice), 407-726-8016 (fax), email@example.com (e-mail), http://medi-share.org (web site)]
This program was highly recommended to me by some of the respondents, and most had experience with other medical sharing plans before changing to Christian Care Medi-Share. I have received three unfavorable comments about this program, though. One respondent, a missions secretary in a large church, said Christian Care Medi-Share is “beneficial and professional” and they “communicate thoroughly.”
The following comment was made by the pastor of a church with a larger staff who used Christian Brotherhood for eight years before changing to Christian Care Medi-Share: “With Christian Care the coverage is much better than with Brotherhood. Also the costs are less; that is why we went with them. However, we have found them to have a red tape trail that leaves you hanging to get payment from them. In the meantime your hospital and doctors are left hanging. This will bring threats from the doctors or hospitals. In short, we have found it much better to pay a little, $5 or so, on each bill each month until Christian Care gets around to doing something or telling you something. You will also have to fight with them to get coverage. They are not as willing to help in problems. However they are very good at negotiating with doctors and hospitals to get the bill reduced, once they decide they have to pay” (Pastor Doug Hammett, firstname.lastname@example.org).
Another man wrote on June 18, 2007: “We have been with Christian Care Medi-Share for 7 years. I came across your publication looking for an alternative to CCMS. In the 7 years we have been with them we have never received any aid from them at all. We have paid thousands of dollars worth of medical bills on our own. The only thing that kept us from immediately canceling our membership was the fact that at least we were helping someone else, presumably. A couple of years ago my wife developed a loss of hearing condition which required an MRI to rule out a possible tumor. Fortunately there was none. Three years ago our son suffered a broken collar bone. Friends of ours with a family of 7 children in the past year had a major medical problem which cost them 10’s of thousands. It took them a very long time to before they received help.”
A man wrote the following on July 26, 2007: “We had a real problem with CHRISTIAN CARE MEDI-SHARE, they should take name Christian out of their name. After being told my wife's procedure would be included for sharing, They paid about $2500.00 of a $16,000 bill. Since that time I have been told by others that they had similar problem with them. I was also told by the Florida DA that there were other complaints with them also. We canceled with Christian Care Medi-Share and have been with SAMARITAN MINISTRIES for about 5 years and have used it about 3 times without incident.”
BLESSED ASSURANCE BULLETIN [P.O. Box 5392, Lubbock, TX 79408. 800-328-4068]
This program was not recommended to me personally by anyone, but I received information from them directly. Blessed Assurance Bulletin has been in existence since 1994 and is similar to the plans already discussed. The monthly subscription varies slightly, because it reflects the actual cost of the subscribers’ medical bills each month. Subscribers send in copies of their bills to Blessed Assurance Bulletin; the bills are totaled and divided among the subscribers. The current cost is between $80 and $95 per subscriber. A family of two pays two subscriptions per month. A family of three or more pays three subscriptions. Thus for a family of three or more, the cost is between $240 and $285 per month. Blessed Assurance does not raise the monthly share more than $5 from one month to the next. Blessed Assurance publishes up to $100,000 per incident for each subscriber, and the subscriber pays the first $500 per calendar year. Pre-existing conditions related to heart, asthma, cancer, and diabetes are limited to a maximum of $10,000 per year. Blessed Assurance does not publish bills for congenital or birth defects.
THE BEST ALTERNATIVE MIGHT BE A COMBINATION OF TRADITIONAL/ SHARING/ SAVING
Samaritan Ministries recommends a combination approach to health care coverage: Combine the medical sharing plan with a high deductible major medical policy as a backup for any catastrophic medical needs. That is a good approach.
AN EVEN BETTER TWIST ON THIS COMBINATION APPROACH IS TO ADD A SAVINGS PLAN TO COVER DEDUCTIBLES, DENTAL, ETC. This plan was described to me by a pastor as follows:
“I recently took a church near Pittsburgh, Pennsylvania. In preparing for the move I talked to several Pastors about the insurance coverage they had. Through this, I was able to set up a program that I feel is the best value for my family and the church. I use a combination of Samaritan Ministries International and Mutual of Omaha [note: Mutual of Omaha no longer provides this policy] to provide major medical care. Here is a breakdown:
“The church gives me $100 a week for a total of $400 a month. I place this money in a church account called Pastor's Medical.
“Samaritan Ministries (not to be confused with Good Samaritan) gets $120 a month for their program (which covers me up to $100,000.). Mutual of Omaha gets $35 a month for a 100K deductible major medical policy (100k to 1 Million coverage).* The balance ($245) stays and builds in the account to be used for things that are not covered in the above policies.
“Covered incidents that are more than $300 are sent directly to Samaritan Ministries. They pay the bill. Office visits, medications, dental, eye care, etc. are paid as they are required out of the account portion.
“If the Lord blesses us with good health, and the medical account builds up, I can take a portion and move it into an IRA or something else tax deferred if I wish. It's our money to use as we see fit. Note that dental is hardly never covered by Blue Cross Blue Shield, but this covers it. No co-pays to worry about either.
“This combination plan is absolutely terrific and recommended to me by three pastors who are also using this method.”
* The Mutual of Omaha deductible major medical is no longer available.
POSSIBILITIES FOR HEALTH COVERAGE FOR THOSE WITH PRE-EXISTING CONDITIONS OR WHO ARE OTHERWISE UNINSURABLE THROUGH THE PREVIOUS PLANS
DISCOUNT MEDICAL CARDS
I received the following information from Bob Sharpe:
“I'm a Baptist preacher. I also have an insurance license, and I've sold health insurance part time for eight years. There is another option concerning health insurance. I don't recommend it for people who have other options, but it is good for people who are uninsurable. That is a discount medical plan. Most people don't know this, but the discounts the insurance companies get from health care providers can be as much as 90%. ... The legitimate discount cards work with companies that negotiate rates that are somewhat similar to rates the insurance companies get at the hospitals. Although we have seen discounts up to 90% at hospitals, they usually fall in the 70% range. Since the discount card industry started a few years ago, a lot of people jumped into it with promises they could not fulfill. Most of the cards do not work well for doctor visits, but for hospital stays they can be a lifesaver for the uninsurable. I market a card that works well in hospitals. It makes a lot of sense for those who are uninsurable and can't get health insurance at any cost, and it is available in most States. You can see more information at www.EconomyHealthCare.com.”
AARP MEDICAL ADVANTAGE PLAN
Pastor Terry Coomer wrote:
“One of the real problems is preexisting conditions. The Med Share programs you have listed disqualify or severally restrict people with pre existing conditions. Many Pastors and their families between the age of 50-64 are in this high risk category because of health issues. One plan that will cover them is through AARP. It is called the AARP Medical Advantage Insurance Plan. There are three different plans, Gold, Silver, Bronze. Each costs a little less with a little less coverage. The rates are reasonable. There is a $2000 per year prescription plan. AARP Health Care Options, P.O. Box 64906, St. Paul, MN 55164-9840, 1-866218-8607, www.aarp.com. This is an alternative for those who are deemed uninsurable by other means and the Med Shares.”
CONCLUDING NOTE: FOR CURRENT FEES FOR THE VARIOUS HEALTHCARE PROGRAMS, CONSULT THEIR WEB SITES. I DO NOT TRY TO KEEP THIS REPORT UPDATED WITH THAT TYPE OF INFORMATION. ADDRESS ANY AND ALL QUESTIONS DIRECTLY TO THE SPECIFIC ORGANIZATION. WE DO NOT REPRESENT ANY OF THESE ORGANIZATIONS AND CAN PROVIDE NO FURTHER INFORMATION. WE MAKE NO GUARANTEE THAT THE INFORMATION LISTED IS UP-TO-DATE.
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