Many of my clients have seen large premium and deductible increases in the last few years. Have you? Obviously, ACA (Obamacare) has put pressure on premiums due to the fact carriers can no longer say no to new clients. Guaranteed issue plans and new mandated coverage requirements called essential health benefits (maternity, drug rehab, free birth control, etc) are probably the biggest factors. In addition, add to the mix more insurance companies only offer HMO type plans and fewer offer PPO plans are available. Bottom line, consumers are faced with less and less choices when it comes to doctors and hospitals. Christian Sharing programs address both of these huge issues and offer a great solution to many families.
How long have Christian Sharing programs been around.
Some would point to Acts in the bible. As far as the United States these programs been operating in the form of a ministry for over 30 years. These ministries that share the medical burdens of their members and provide a solution to the high cost of medical care in lieu of health insurance These programs are actually a viable legal option under the ACA (Obamacare) law. The program I joined currently has over 54,000 members so it is large enough to take advantage of the law of large numbers and basically spread the financial risk among a very large ministry. Again, if you are a member of a Christian Sharing program you do not have to pay a fine for not having “health insurance.” This is often called the individual mandate. The fine for not having health insurance is currently 2.5% of your gross income. For people who are opting out of buying health insurance these ministries would prove to be a much better decision.
IMPORTANT: Since Christian sharing programs are not insurance you cannot use terms like copay, contract, deductible, claim, insurance, out of pocket max, guaranteed coverage, etc.. The ACA law states you can select a Christian Sharing ministry as an legal option in the law itself. Here is a Copy of actual law. These ministries are guided by published member guidelines and are funded by set monthly contributions by all members based upon their family size and which plan they select when they join the ministry. The plan I joined has shared over $1,000,000,000 (one billion) in health care needs over 30 years.
Who can join a Christian Sharing ministry?
I only know of three Christian Sharing ministries that fit under the definition given in the ACA law. The ministry I joined has the following guidelines for their members who can qualify to join the ministry:
- be Christians living by biblical principles
- abstain from the use of tobacco and the illegal use of drugs (1 Corinthians 6:19-20)
follow biblical teaching on the use of alcohol
attend group worship regularly if health permits (Hebrews 10:25)
Christian Sharing programs might NOT be a solution for some families.
Lets start with the negative. If you are currently on an expensive Rx or have a major ongoing illness hen it might not be a solution for you right now. The reason being is Pre-existing medical conditions are limited to protect the viability of the entire ministry. It is only fair. It was the single biggest factor keeping individual (non group health) premiums lower than group health rates all those years before ACA. Now if you join the ministry and then get sick or have an accident after you are a member then you are fine as long as there was no sign, symptom, or treatment that any normal person would have noticed. The Christian Sharing program I joined actually still will let me share some PreX conditions but limits the shares to $15,000 the first year, $25,000 the second year, then $50,000 the third year. After that it is unlimited. Pretty fair if you think about it and really makes since. The example I give as to why ACA has driven up the cost of health insurance is in the form of a question. How expensive would Allstate be if you could call Allstate when your house is on fire?
Rx can be very expensive problem as well and the ministry does not provide sharing for maintenance meds. The ministry I joined does provide for Rx within 90 days of event or illness just not maintenance. Most people have no clue what the real cost of their meds are. We see the $50 copay at the pharmacy when we pick up the med and assume that is the cost. Not the case. ADHD meds and many others can run $800 a month. You can do some research and find the actual cost minus PBM discounts (like a PPO is to Dr. visit) with tools like www.goodrx.com Find out the real cost of your Rx.
Christian Sharing programs might be a great solution for most families.
The idea family for Christian Sharing should be a pretty healthy one. “Healthy” meaning the family does not need a lot of ongoing expensive Rx or medical that they know about (like a pending knee surgery). The Christian Sharing program that I recommend is pretty easy to understand. Let me explain…If I have a Dr visit or medical event is under $500 then it is my problem and I hopefully get a discount and get some generic meds and be on my way. Hopefully my monthly premium savings more than pays for those rare events that happen a few times a year. Now if I go to the doctor, hospital, or have some other medical event that is over $500 then I can share the need with the entire ministry (called a share) and as long my need meets the member guidelines I will be made whole minus my “personal responsibility” of $500. The good news is if I able to negotiate a $500 discount with the medical provider then that counts as my personal responsibility and I can share my entire bill. This is quite a change for folks who I have sold insurance plans with $5000 deductibles and then also pay coinsurance after the large deductible in many cases with out of pocket maxes sometimes of $10,000. Pretty cool concept.
What doctors and hospitals can I go to?
A great benefit of the sharing program I use does not restrict you to a network of doctors and hospitals. I can go anywhere I want for medical care. This is very important in todays market of HMOs and very narrow PPO plans with most insurance plans. In addition, if the medical event is under $500 then I do not even have to explain the sharing program to the provider because it really does not matter. I get a discount and be on my way.
The program I use does address Pharmacy. Pharmacy cost can be shared in the case where the event is over $500 just like any other medical cost. The shares do not include ongoing maintenance cost so it is important that I use generics and other savings programs in those cases. Typically if the cost is incurred within 90 days of the onset of the medical event it is included in the share. If I had cancer and had expensive meds to treat it then that would be included in the share.
Is Christian Sharing right for your family?
Finally, I would consult with a licensed insurance counselor to evaluate ALL your options. Who knows. You could employ this strategy for one family member to avoid the family rate of an expensive group plan premium or put the entire family on the program. Sharing programs are not for everyone; however, they are a breathe of fresh air to the rising cost of expense of planing for medical needs. You might not entertain this strategy for this year but it is nice to know about all your options.
To view all the details including cost of these plans visit www.sickofinsurance.com
I will be happy to take you from start to finish and assist your family with VIP support with any Christian Sharing program. Joining my VIP membership program & scheduling some time to talk today.