When I was a partner in my medical practice, our company provided a group medical insurance plan for all the doctors, staff, and their families. When I retired from my practice at the end of 2013 my family used COBRA for a while before attaining our own insurance as a family.
In 2016 my family’s insurance premiums were $1,408 a month, or $16,896 a year with a $6,450 deductible. In the fall of 2016, our insurance company informed us they would no longer offer individual policies in our state, and our policy would end on December 31st. We began a search to replace our lapsing insurance. That is when we discovered the Christian Health Sharing alternative to traditional health insurance.
There were very few choices available for us to get traditional insurance as an individual in our state, and all of them were at a significantly higher price than we were currently paying. The best policy we found cost over $20,000 a year for traditional coverage with a $7,000+ deductible. The Health Sharing option was going to cost $275 a month or $3,300 a year with a $5,000 deductible per incident. We decided to save $16,700+ a year and began our Health Sharing Ministry program. This is what we discovered.
We have not had any major medical problems since we switched to the health sharing program at the end of 2016. So far we have saved in excess of $78,000 in premiums.
For those of you who are not familiar with the health share ministries, they are a Christian organization. Participants must be Christians who attend church services regularly, abstain from tobacco and illegal drugs, and follow Biblical guidelines in the use of alcohol. They do not cover self-inflicted health care problems such as obesity, substance abuse or motorcycle accidents without a helmet. They also do not cover the little things as they expect you to take care of those. If you have an incident that will cost more than the deductible, you are responsible for negotiating a cash price from any provider you choose and submit the bills for payment.
I have yet to hear from someone using this program who has been unhappy with it, although I’m sure they exist. When I mention that this is the option I chose, I am usually met with a list of all the reasons that my choice was a dumb idea. Often this is from someone who does not qualify to participate, making me wonder if they are just mad because they can’t partake. Following are some of the reasons they list, and my take on the issues.
1: They don’t cover preventative medicine, such as mammograms and colonoscopies: With the $16,700 I am saving in premiums each year, I can cover a mammogram every year and a colonoscopy every 10 years pretty easily.
2: They don’t cover birth control, obesity, vaccinations, mental health or addiction: Again, if these are needed, they are easily covered by the massively lower premium.
3: They don’t abide by insurance laws: This is because they are not an insurance company. Consequently, we get to choose our doctor, don’t need to preauthorize anything, and don’t get reams of insurance paperwork every time we have a health care issue. That saves both the Health Sharing Ministry and us a lot of time and money.
4: They deny coverage if they think you are “immoral” or they find out you are not a Christian: Before you are accepted into the program you must fill out a questionnaire just like you would when seeking coverage from an insurance company. If they (or an insurance company) find out you lied on the intake questionnaire, you will not be covered. Same goes for your disability and life insurance policies. If you tell them you don’t scuba dive, and they find out you are a scuba instructor, there will be consequences. Don’t lie when applying for coverage.
5: There is no guarantee your bills will get paid: The same is true for insurance companies who daily deny coverage and make it a fight to get procedures preauthorized. I remember one insurance company that denied coverage for a patient of mine who needed a carotid endarterectomy. The kid on the phone told me he wouldn’t authorize the surgery because my group has done more than the national average of carotids for our patient population. He didn’t even care that the patient met the published criteria for a carotid surgery. He eventually authorized the surgery, but it took a great deal of effort on my part.
6: Bills may go unpaid: This isn’t different than insurance companies. There are many cases in the news where someone goes in for emergency services and is denied proper coverage because the doctor was not a participating provider. But if we keep all the receipts, turn in all the required paperwork, and the incident cost more than the deductible, our bills should be paid if the medical expenses are included in our coverage.
7: They are ruthless in denying claims: From my experience, I don’t know if this is true or not, but I do know it is true for insurance companies.
8: Preexisting conditions are not covered: Until recently this was an industry standard and still should be. It prevents people from waiting until they get sick to buy health insurance. You have to have the insurance before you get sick.
9: They have a maximum coverage of $250,000: The amount of coverage depends on what plan we choose. With the company I’m using, Christian Healthcare Ministries, our coverage maximum varies depending on what level of coverage we pay for. They have an unlimited amount of coverage option, or we can choose a less expensive plan with a coverage limit. The plan we chose had a first year maximum of $125,000 per diagnosis and increases by $100,000 every year until it reaches $1,000,000. To have unlimited coverage with a $500 deductible would have cost us an additional $3,780 a year in premiums.
10: It doesn’t allow for contributions to a health savings account (HSA): This is true. Instead of depositing $7,200 into an HSA account pre-tax, I will deposit $16,700+ into a regular account, post-tax. Seems like a good trade to me.
My opinion, after researching the options my family qualified for, was that the health sharing ministry was more than $16,000 a year cheaper with similar coverage for the big things (high deductible), but slightly less coverage for the little things, which can easily be paid for with the premium savings. It was also way easier to use.
When we had traditional health insurance we got a great deal of paperwork telling us what the insurance company did and didn’t cover, in addition to the bill for what wasn’t covered, every time we saw a doctor or got a test. Now we see a doctor, tell them we would like a cash discount since we have health sharing coverage (the doctor is happy to give a discount to get paid immediately without the hassle of dealing with an insurance company), pay the bill that day with a check or credit card, and that is the end of it. There is no paperwork to send in or receive for the little stuff. I like this much better. Paying for a few $160 doctor visits a year is much better than paying for the extra $16,700+ in insurance premiums. The big stuff will be covered with either option after paying the high deductible.
If you have used a health sharing ministry I would love to learn what your experience has been. I’m tired of only hearing from the people who have never used it but are certain it is a bad idea as they continue to pay high premiums and ask for permission (preauthorization) to meet their health care needs.
If you can get a good traditional insurance policy paid for by your employer, take advantage of the free option. But if you must buy your own insurance and can meet the inclusion criteria, I think a health share ministry is the best way to go.