Health sharing ministries are growing in popularity after the ACA, and they offer a unique alternative to traditional healthcare insurance. However, they don’t come with the same consumer protections as Marketplace plans.
HCSMs are open to members who share religious or ethical beliefs and don’t meet the ACA definition of health insurance. Some states have even blocked HCSMs as unauthorized insurers.
Cost-effectiveness
Health sharing ministries are groups whose members pay monthly fees, similar to premiums, which are used to cover medical expenses for other members. They aren’t insurance companies, however, and they don’t provide actual health insurance in any form. Members may also be responsible for paying the first $500 of any bill and are required to see in-network doctors. Some services are excluded, such as mental treatment and maintenance prescriptions.
HCSMs have become more popular since the Affordable Care Act, known as Obamacare, because they offer an alternative to costly healthcare coverage. They’re also exempt from the law’s requirement to carry minimum essential coverage, so they can avoid the penalty for not having a traditional healthcare plan.
But despite their popularity, HCSMs have many drawbacks. For example, they’re not insured and don’t have a guaranty association to protect consumers in case the ministry goes bankrupt. They’re also not subject to state insurance regulations. In addition, they typically have strict membership rules that include attesting to a religious faith and abstaining from tobacco, alcohol, and illegal drugs.
Sense of community
The sense of community is one of the biggest draws for many members of healthcare-sharing ministries. They often encourage each other through personal notes and prayer, and they take to heart the biblical message that Christians should “carry each other’s burdens.”
These ministries are not considered insurance under the Affordable Care Act, and they don’t have the same consumer protections as ACA plans. They may have a cap on monthly sharing amounts, or they might only cover certain types of medical bills. For example, most of them don’t pay for birth control or OB-GYN services, and they may not cover substance abuse treatment.
In addition, the IRS rules for recognizing health-sharing ministries are strict. They must be tax-exempt 501(c)(3) organizations and have been in existence since 1999. They also can’t discriminate between members based on state of residence or place of employment. Moreover, they can’t be reimbursed through a qualified small employer HRA. These limitations can make it difficult for some employees to use health sharing ministries as a group-health plan option.
No protection for pre-existing conditions
Health sharing ministries are faith-based nonprofits that allow their members to share medical expenses. Each one works slightly differently, but most require a monthly contribution similar to a premium and have rules that discourage harmful practices, such as alcohol and drug abuse. They also may not cover certain procedures if they violate religious or moral beliefs.
Unlike health insurance, healthcare sharing ministries are not subject to state or federal insurance laws. As a result, they don’t have the same consumer protections as marketplace plans and don’t offer coverage for pre-existing conditions. In addition, they often don’t reimburse members through HRAs.
Despite their limitations, healthcare-sharing ministries are a good option for families who cannot afford traditional insurance or don’t qualify for subsidies in the ACA Marketplace. In addition, they have a sense of community that can encourage people to help each other. They also help to reduce the burden on the system by encouraging healthy lifestyles and by fostering relationships between members.
Strict membership rules
Health sharing ministries are an alternative to traditional health insurance. These groups allow members to pool their money in order to pay each other’s medical expenses. They are based on religious and ethical beliefs, typically Christianity. They are not regulated by the Affordable Care Act and may not offer all of the consumer protections that are found in Marketplace plans.
They are marketed as an affordable alternative to healthcare, often with ads on right-wing media and at Conservative Political Action Conferences. Despite their claims to be an affordable option, some have strict membership rules. For example, they may require members to attend church regularly and attest to a statement of faith.
Some of these ministries also limit the amount they share per month and exclude certain types of procedures. In addition, they do not cover pre-existing conditions and require a waiting period before allowing new members to join. Despite these limitations, these ministries have a growing following in the United States.