Faith-based healthcare isn't exactly insurance - these plans allow a large pool of people to “share” healthcare costs.
How Does Faith-Based Healthcare Work?
A. 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.
What is an annual Household Portion? (AHP)
A. The AHP is the dollar amount a Member Household must pay toward their Eligible Medical Bills during a 12- month period before their needs will be approved for sharing. The AHP-12- month period begins with the effective date.
What Is The Health Incentive?
A household may qualify for up to a 20% off their monthly share amount with the health incentive. All adult Members must meet ceretain health criteria. To qualify, Members must verify their blood pressure, BMI and weight/weight measurement within 90 days of each other.
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Functions Similarly to a Credit Union: The underlying philosophy is similar to that of Credit Unions Faith-based healthcare, like credit unions, are community-oriented and membership-driven non-profits. 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 do not have to cover the essential health benefits mandated by the Affordable Care Act (ACA). These plans are grandfathered into the ACA. This means that enrollees are exempt from the individual mandate penalty usually associated with non-ACA plans.
ACA does set certain requirements for faith-based health plans:
- Members must share a common set of beliefs;
- 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 audited, with audits publicly available.
- Can Health Saving Accounts (HSAs) Be Used in Conjunction 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 Many Plans Are Out There?
There are four major healthcare sharing ministries that qualify for exemption from the Obamacare penalty:
- Christian Healthcare Ministries;
- Samaritan Ministries; and
- Liberty Healthshare.
Altrua Healthshare, Anabaptist Healthshare and Solidarity Healthshare also qualify for the exemption from the Obamacare penalty.
There are more than 100 other faith-based health plans that do not qualify for the exemption, most of which are organized by small local churches.
How Strict Is the Religious Requirement?
The religious requirement depends on which faith-based health plans you choose to go with. Faith-based health plans typically ask their members to sign a statement of faith, and some check for proof from your local church.
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.
Sharing Responsibilities: 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:
SHARED AND UNSHARED “What’s covered and not covered under Faith-Based Plans
|Acute Injuries and Illnesses||Unnecessary Hospital Visits|
|Physical Therapy||Cosmetic Surgery|
|Maternity Costs||Fertility Treatment|
|Travel by ambulance||Transportation to Medical Appointments|
|Hospitalizations (ER Stay and Stabilization)||Weight Loss Treatment|
|Dental and Vision Care
related to an injury
|Routine Dental and Vision Care|
|Doctor ordered test related to an illness||Psychological and Psychiatric Care|
|Medical needs resulting from an accident||Medical needs that arise during high-risk|
|These are the most commonly shared and unshared expenses in health sharing ministries or faith-based health plans. However, each plan makes different choices about coverage.
Refer to Outline of Coverage offered by each Company.
Can I 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 I Be Able to Keep My 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.
- Keep Your Doctor: You can keep your doctor as there are no separate in-network and out-of-network costs.
- No Obamacare Penalty:You are exempt from paying the individual mandate penalty imposed by the Affordable Care Act.
- Belief-Driven Healthcare: If you are a person of faith then 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 benefitssuch 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 towards injuries related to an accident that was caused by immoral reasons such as drinking alcohol or using illicit drugs.
- Running Out of Funds: 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.
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 Alliance of Health Care Sharing Ministries, 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.
How Many People Are Enrolled in Faith-Based Healthcare?
There are more than 1 million Americans enrolled in faith-based health plans
When and How Can I Enroll in Faith-Based Healthcare?
You can enroll online with any of the major health sharing ministries listed above. You can enroll at any time you want – there is no open enrollment period for faith-based health plans.
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