Healthcare Sharing Ministries

Greetings folks,

Thanks for your interest in medical need sharing. As a staffer at one of the three health care sharing ministries operating internationally, I thought I'd try to bring a little clarity to your discussion.

A health care sharing ministry is a group of people of common faith who share one another's medical burdens without using insurance. Members commit to sending a share each month that will go to another member who has a medical need.

Health care sharing ministries serve more than 160,000 people around the world, with participating households in all fifty states. Currently, twenty-two states recognize the ministerial nature of these health care sharing ministries and acknowledge that they are not practicing the business of insurance. Participants of health care sharing ministries share more than $165 million per year for one another's health care costs

The organization I work for has not had charges of fraud levied against it, nor has any court that has looked at our structure declared us to be practicing insurance in any way. Our members do sign a broad, basic, historical statement of Christian faith, agree to either abstain from alcohol or only drink in moderation, abstain from tobacco use except for a rare celebratory cigar or pipe, and abide by the guidelines that are constructed and maintained by our member elected board. Our members send their monthly shares directly to another member (not the ministry itself.) If there is ever a dispute over a matter between our ministry's leadership, our members can request a 13 member panel of randomly selected member-peers to arbitrate the matter – and whatever that panel decides is binding upon the ministry. I have never heard of an insurance company that does that. In addition to this, our monthly share amounts are determined by the members themselves through a majority vote – when there are more needs than there are shares for three months in a row, our board submits a ballot to the membership with a proposed share increase. In the meantime needs are equally prorated (sometimes no more than 10-15% but as much as 20%) and the ministry makes members aware of the difference so that they can electively give enough to make up the difference. To date, all of the eligible medical bills that have been submitted have been shared using this model - And that is with members having shared the complete costs for cancers, strokes, and organ transplants up to and above 500K on multiple occasions.

Health care sharing ministries are 501 (C) (3) organization that simply facilitate member's sharing with and ministering to one another. The organization that I work for has 23,000 plus participating households that have been happily well-served since 1994.

Regards,

J
 
sim... this concept somewhat scares me so can you clear up a few things..... health insurance is nothing more than a "line of credit" provided to consumers to protect them when they get into "hot-water"... lets paint a scenario:

say im covered and my kid needs a heart transplant.. during the transplant something goes wrong and my kid goes on life support.... the medical bills are at the 1 million dollar range..... what happens?
 
sim... this concept somewhat scares me so can you clear up a few things..... health insurance is nothing more than a "line of credit" provided to consumers to protect them when they get into "hot-water"... lets paint a scenario:

say im covered and my kid needs a heart transplant.. during the transplant something goes wrong and my kid goes on life support.... the medical bills are at the 1 million dollar range..... what happens?

If a member were to experience a scenario like you've outlined, and they were also part of our optional program for sharing needs which exceed $250,000, we have already shared individual needs over $1 million in the past. No one who has both levels has yet exceeded the amount available.
 
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It is a ministry for those who wish to share in the medical needs of other members that exceed the $250,000 publishable amount. Members are asked to set aside the designated amount for their household size. They do not send the amount set aside to our office.
When a participant has a need that exceeds the $250,000 maximum publishable amount of a regular need, the other participants are asked to share from their set aside funds for the amount over $250,000.
 
How do you account for pre-existing conditions, double insurance and fraud?

Do you have a waiting period for pre-existing conditions, or an underwriting process that excludes certain expensive conditions that are already pre-existing or already in process (like current hospitalization)?

Do you coordinate benefits with other insurance, or can a person be double insured? For instance, if a person has a $50,000 hospital bill, submits it to his own insurance, which pays most of the bill (let's say $45,000 of it), how to you keep the person from submitting the same $50,000 bill to you, gaming the system and making a whole lot of money off double coverage?

Same issue, if the person is double covered, how do you account for fraud committed against the actual insurance company that paid $45,000 of the bill when the person was actually "double covered" and should have coordinated benefits between the coverages?

How do you handle outright fraud where the person bills (or "publishes") a fraudulent bill for thousands of dollars? Doctors and pharmacists are in the news right now for fraudulent charges to Medicare.

How do you account for guaranteed assurance? If a person joins your group, has a large claim, then the group folds or has a drastic drop in membership, what about the assurance you have made to the person to help fund their medical bills? For instance, with Obamacare, many of your members may find that their premium is subsidized for traditional insurance to the extent that they pay far less premium than the membership fee they are paying to you. If/when you have a drastic drop in that income, what assurances do you have to your members for ongoing claims? Insurance companies have reserves and reinsurance. What do you have?

Please understand that I am not bashing your organization nor your will to help. As an insurance agent for over 30 years (and a Christian), I have seen many people hurt by programs that do not have good standards. It is our job to protect consumers from those plans, and to steer them toward plans that offer valid protection at an affordable price.
 
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I think our VP has addressed at least some of your questions on this previous discussion on your forum:

hmm - ok, I"m not allowed to post url's, more on that, later.

I do appreciate your concern for seeing the needs of our members and the public at large be met. That is most certainly our aim.

Some of the other concerns I will try to deal with as time allows, I'll aim to return to your questions later.
 
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