Alternatives to ACA available
As health care costs continue to rise, some Illinois residents have opted to join faith-based sharing plans.
The plans, offered by groups such as Christian Care Ministry and Peoria-based Samaritan Ministries International, among others, have garnered increased interest in recent years.
The groups help pay each other’s medical expenses without the use of health insurance.
“You can think of it almost as crowd funding for health care where a group of people, in this instance, a pretty large group of people – about 80,000 households or families – they come together to share medical expenses,” said Anthony Hopp, Samaritan Ministries vice president for external relations. “But they not only share the financial part, they are praying for one another. They are sending cards and notes of encouragement. They are supporting each other. There is a ton of community as a result of members being connected directly with one another.”
More than 250,000 Samaritan Ministries members directly share more than $27 million per month in medical needs, Hopp said. The average monthly payment, Hopp told RFD Radio Network®, is around $400, depending on household size and type of membership.
Medi-Share, offered through Christian Care Ministry, has more than 400,000 members, according to its website. Members agree with a Statement of Faith, in addition to agreeing not to use tobacco or illegal drugs, not abuse legal drugs and not have sex outside of a traditional Christian marriage. Well visits, routine care and preventive care expenses aren’t shared.
The groups are subject to charity laws not insurance laws, he said. Members will carry an insurance-like card that will explain to health care providers they are cash-paying members who should be billed directly.
Once the member gets the bills, they turn them into the Samaritan office and they direct enough people to send their monthly share to cover the expense, he said. Members can also participate in “Save to Share” programs for those “really exorbitant medical needs,” Hopp said.”
Lisa Carlson, vice president of Lockton Companies, noted these arrangements may offer lower costs, but they aren’t subject to the requirements of the Affordable Care Act. As a result, she said, participants may be excluded based on health factors and there may be limits or exclusions on coverage of pre-existing conditions.
Carlson said nearly all options available to Illinois farmers are subject to ACA requirements except for faith-based medical sharing options, short-term medical plans and indemnity plans that pay fixed dollar reimbursements for specific medical services.
Short-term medical plans provide much more limited benefits, but are now available for up to 12 months of coverage with renewal options, she said. Previously, insurance carriers could only issue such coverage for a very short time with limited or no renewal options. New regulations have extended the time a carrier may issue short-term policies to individuals. However, short-term medical plans generally exclude pre-existing conditions, provide limited benefits and most likely use personal medical information for underwriting, Carlson said.
Indemnity plans offer a fixed-dollar amount for specific types of medical treatment. For example, Carlson said an in-hospital indemnity plan may pay $200 a day for each day someone is hospitalized, for up to 10 days. These plans generally provide a very small dollar amount in relation to the actual cost and may not cover treatment received for pre-existing conditions – but they can help reduce costs in a limited manner, she said.
While cost is always a major factor in deciding on health coverage, Carlson said Illinois farmers should take into consideration not only the cost, but the current health status of themselves and their family members as well as the level of medical coverage they need.
“If the farmer or family member has pre-existing conditions or expect high-cost medical treatment will be needed in the future, an ACA-compliant policy may be best, albeit costlier up front. In the long run, having coverage for expensive medical services may save money,” she said. “In contrast, a young or healthy Illinois farmer may find options like faith-based medical sharing arrangements or short-term medical plans to be less costly and provide appropriate protection against unforeseen catastrophic medical costs.”