If you need an alternative to traditional health insurance, a healthcare sharing program may be right for you. These programs offer a variety of benefits, including discounts for prescriptions and dental care.
Most of these programs are Christian-based, but many do not require a religious affiliation. Regardless of faith, most share plans do not cover expenses related to drug abuse or abortion.
Embracing Diversity Beyond Religious Beliefs
Health care sharing ministries (HCSMs) are groups whose members share religious or ethical beliefs and contribute monthly amounts that help pay for other members’ medical costs. Although these programs may resemble insurance, they don’t meet the requirements for federally compliant individual market health plans.
Some people find fulfillment in joining a community that shares similar values. These lifestyle-based groups often have rules and guidelines that require members to follow certain moral and spiritual principles, such as practicing good hygiene and abstaining from illegal drugs. They also typically pray for one another and send encouraging messages.
However, these programs don’t cover preexisting conditions or offer maternity coverage. This leaves them vulnerable to competition from short-term and association health plans, which have more robust benefits. This could lead to higher premiums for HCSM members who need health insurance coverage. As a result, many HCSMs have strict membership eligibility requirements and require members to sign a statement of faith.
Eligibility Requirements
Health care sharing ministries (HCSM) are membership groups whose members follow common religious or ethical beliefs and contribute monthly payments to cover the medical expenses of other members. They aren’t insurance companies and don’t guarantee payment of medical bills, but they’re gaining popularity as an alternative to ACA-regulated health coverage.
HCSMs typically require that members adhere to a specific set of rules and values, such as abstaining from tobacco or illegal drugs and attending church services regularly. In addition, they may exclude certain types of medical bills from their shared pools, such as those for abortions or euthanasia.
Because HCSMs aren’t considered health insurance, they can’t be reimbursed through a qualified small employer HRA (QSEHRA). However, they can be used with a health stipend plan. A health stipend is similar to an HRA, but it’s not a formal group healthcare benefit and doesn’t require receipts. Employees submit their eligible expenses to their employer, who then reimburses them up to their monthly allowance amount.
Benefits
Healthcare sharing programs have gained traction as an alternative to health insurance. Generally, they are open to people who share certain religious or ethical beliefs and operate through monthly contributions that are shared among members. In many cases, a health-sharing ministry will cover medical bills after an initial member responsibility amount is paid, similar to an insurance deductible.
These groups are not regulated by the same federal or state authorities as insurance companies, so they do not have the same legal protections for their members. For this reason, it is important to read the terms of each program carefully before deciding to join.
Some healthcare-sharing ministries require that potential members adhere to specific religious or faith-based guidelines, such as abstaining from immoral activities and practicing a healthy lifestyle. This can exclude people who do not share the same values as the organization, and may feel exclusionary to some. However, others can find a great sense of community in these programs and enjoy the benefits of being part of an active, supportive network.
Costs
Health sharing plans have been growing in popularity, largely because they offer members an affordable alternative to traditional health insurance. They also combine the ability to save money with a way to serve as part of their faith. However, the benefits aren’t without drawbacks. For one, state insurance regulations don’t apply to healthcare sharing ministries (HCSMs).
These groups are not insurance companies and don’t follow the same rules as insurers. They’re typically open to people who share religious or ethical beliefs and may have strict membership guidelines. In addition, they may not cover medical costs linked to actions the group finds immoral.
Those who join healthcare sharing programs typically make monthly contributions to a pool of resources that can be used to pay for eligible medical expenses. These monthly contributions are usually lower than typical insurance premiums and can be shared up to 100% of the cost of a qualified medical expense. Generally, a healthcare sharing program will not cover costs related to drug abuse, abortion, or maternity expenses out of wedlock.