Martin Estacio was shelling out $800 per month for a health plan that didn’t fit his two-state lifestyle.
The retired San Bernardino firefighter lives between Oklahoma and California. But his health insurance policy, purchased in Oklahoma, didn’t cover non-emergency care outside the state.
So Estacio dropped his plan this month and took a leap of faith. He joined Christian Healthcare Ministries (CHM), an alternative to health insurance that offers a religious approach to covering medical bills.
Health-care ministries such as CHM are essentially cost-sharing programs. Members’ monthly fees are applied directly to other members’ medical bills. Members also pray for each other and often send notes of support and encouragement.
“What led me to look into it was financial,” says Estacio, 58. “When I started to realize it’s based on biblical principles where you help your brother out, that’s what really clinched me.”
A health-care sharing ministry is primarily a “community of faith,” says Michael Gardner, spokesman for Christian Care Ministry, which operates the Medi-Share program. Medi-Share has roughly 300,000 members as of June, he says.
Christian health-care ministries are not insurance. Members must attend church regularly and agree to abstain from certain behaviors such as “sexual immorality” and drug abuse. Preventive care, routine prescriptions and mental health-care may not be reimbursed.
Estacio pays $150 per month for his membership, plus quarterly payments of about $30 that offer him a higher level of reimbursement.
He’s responsible for the first $500 on each medical incident before the ministry’s sharing kicks in, but only for allowed services. CHM’s list of non-covered services includes “psychological treatment,” medical supplies and equipment, immunizations, and maintenance prescriptions.
Membership in health-care sharing ministries has ballooned since passage of the Affordable Care Act, in part because the health law provides an exemption for members. Members of a qualified health-care sharing ministry don’t have to pay the tax penalty for not having insurance.
About 1 million Americans participate nationwide, according to the Alliance of Health Care Sharing Ministries. Texas has the most members; California is second.
The three largest ministries are CHM, Medi-Share and Samaritan Ministries International.
“It’s our Christian practice of how we bear one another’s burdens,” says James Lansberry, executive vice president of Samaritan Ministries, which has about 227,000 members nationwide.
Samaritan members, who share about $23 million a month, mail their monthly fees directly to other members facing medical bills, Lansberry says.
Each ministry works differently, but you can generally expect to pay a monthly membership fee. You may be responsible for all of your own routine and preventive medical costs in addition to paying a set amount before reimbursements kick in. There’s no contract with health-care sharing ministries, which means there’s no guarantee that your bills will be covered.
“However, most of them have always paid their members when they have medical bills,” Weldon says.
Most health-care sharing ministries don’t cover preventive care such as mammograms, colonoscopies and birth control, and some don’t cover mental health care, addiction treatment and other services, says Janet Coffman, associate professor of health policy at University of California-San Francisco.
Health-care sharing ministries aren’t required to cover pre-existing conditions, so members may have to wait one to three years — or longer — to be reimbursed.
Health care sharing ministries are not regulated by government agencies that oversee commercial health insurance.
If you don’t agree with how much you’re being reimbursed — or whether you’re being reimbursed at all — your only recourse will likely be an internal appeals process.
Estacio hasn’t had to request reimbursement from his health-care ministry yet, and he has money set aside for health-care expenses that wouldn’t be eligible for reimbursement.
“I’m confident,” he says. “I have faith in it.”
Leap of faith: How do health care ministries cover patients’ costs? | Faith & Values