Faith-based healthcare is offered through 501(c)(3) nonprofit charities with a religiously-oriented purpose, and serves as an alternative to health insurance. These plans are often referred to as “health sharing ministries” or “healthcare sharing ministries.”
How Does Faith-Based Healthcare Work?
Unlike traditional health insurance, these plans do not “insure” people but rather “share” healthcare costs among a large pool of people. Members pay into the system and upon receiving a bill from their physician, other members of the plan will contribute to help pay the bill.
Functions Similarly to a Credit Union
The underlying philosophy is similar to that of credit unions. Faith-based health plans, like credit unions, are community-oriented and membership-driven nonprofits. So, let’s say Jake is a member of a faith-based health plan. Jake will contribute a monthly fee – a fee that would be much lower than a traditional insurance premium – and, if Jake gets sick, the rest of the members of his faith-based healthcare will contribute money towards his bill.
Does Faith-Based Healthcare Cover Essential Health Benefits?
Faith-based healthcare is not ACA-compliant and does not have to cover the essential health benefits mandated by the Affordable Care Act (ACA). These plans are exempt from the mandates of the ACA. For example, these plans do not have to accommodate the 10 essential benefits.
ACA does set certain requirements for faith-based health plans:
- Members must share a common set of specific ethical or religious beliefs;
- Plans cannot discriminate based on employment or residence;
- The plans must share medical expenses among members regardless of state residence;
- Members can’t lose their membership even if they develop a medical condition – although, members who don’t pay their share of costs can be disenrolled; and
- The plans must be subject to an annual audit, which must be available publically, on request.
These four plans met the ACA requirements:
- Christian Healthcare Ministries,
- Samaritan Ministries, and
- Liberty HealthShare.
Can You Use a Health Saving Accounts (HSAs) with Faith-Based Healthcare?
No. HSAs only work with high-deductible health plans (HDHPs), so members of faith-based health plans cannot utilize HSAs.
How Strict Is the Religious Requirement?
The religious requirement depends on which faith-based health plan you choose. These plans typically ask their members to sign a statement of faith, and some check for proof from your local church. Liberty HealthShare is a Christian healthcare group but members do not need to consider themselves part of a particular church or denomination.
Are There Premiums or Deductibles? How Much Do They Cost?
Faith-based health plans do carry monthly premiums and deductibles; however, under different names.
Monthly Sharing Amounts
Premiums are referred to as “monthly sharing amounts” and usually range from around $100 to $500, depending on your plan and size of family.
Deductibles and other out-of-pocket costs are called “sharing responsibilities” and can be as low as $500 to as much as $10,000, depending on your plan.
Also, in addition to monthly sharing amounts, most plans require a small enrollment fee. In most scenarios, these total costs remain far lower than traditional insurance costs.
What Does Faith-Based Healthcare Cover?
The specifics of what faith-based healthcare will or will not cover varies on your plan and on each given circumstance.
Here is a general breakdown of what plans will and will not cover:
Can You Be Denied Coverage?
Yes. Since faith-based health plans are not bounded by the Affordable Care Act, people can be denied coverage based on pre-existing conditions or for religious beliefs.
Will You Be Able to Keep Your Doctor?
Yes, healthcare sharing ministries do not have networks and allow you to see any doctor you choose.
What Are the Advantages of Faith-Based Health Plans?
There are several important advantages of using faith-based healthcare as an alternative to traditional health insurance.
- Affordability: These plans are usually more affordable than traditional health insurance, especially plans in the unstable Obamacare market. Additionally, donations which come in from other members are considered “gifts” which are tax-free.
- Belief-Driven Healthcare: If you are a person of faith, this plan allows you to contribute money to an organization whose beliefs you share without worrying about helping to fund care, such as abortions, gender reassignment or morning-after pills.
- Community: There is a sense of community within these faith-based plans that is absent with traditional health insurance companies. If you are diagnosed with a serious medical condition, you can expect your health-sharing ministry to care for you physically and emotionally, not just financially.
What Are the Risks?
There are important risks to be aware of when considering faith-based healthcare:
- Don’t Have to Cover Essential Health Benefits: Since these plans are not ACA-compliant they don’t have to cover essential health benefits such as preventative care or mental health care.
- Denied Coverage: You can be denied coverage for pre-existing conditions or for certain religious beliefs.
- Belief-Driven Healthcare: Your faith-based health plan may not contribute toward injuries related to an accident that was caused by immoral reasons, such as drinking alcohol or using illicit drugs.
- No Guaranteed Coverage: Since these plans “share” costs and don’t insure members, you are not guaranteed coverage. Technically, they can run out of funds, go bankrupt and fail to contribute towards your costs. This outcome, though, is unlikely.
- No Legal Protections: With faith-based health plans, there are no legal protections to ensure that your claims will be paid. Because you do not sign a contract, disputes are generally limited to an appeals process overseen by the ministry itself. Government agencies do not have any jurisdiction.
Are Faith-Based Plans Subject to Regulation?
It depends on the state. 30 states have instituted safe-harbor laws that differentiate between health-sharing ministries and health insurance companies. This prevents state regulators from enforcing strict laws against faith-based health plans. In the map below from The Commonwealth Fund, the states in light green have safe-harbor laws in place, while those in dark green have some other kind of regulatory exemption for healthcare sharing ministries.
(via The Commonwealth Fund)
How Many People Are Enrolled in Faith-Based Healthcare?
There are more than 1 million Americans enrolled in faith-based health plans according to The Commonwealth Fund.
When and How Can I Enroll in Faith-Based Healthcare?
You can enroll online with any of the major health sharing ministries listed above (Medi-Share, Christian Healthcare Ministries, Samaritan Ministries, and Liberty HealthShare.)
You can enroll at any time you want – there is no open enrollment period for faith-based health plans.