Medical Insurance for Christian Home Business Owners Part Two

If you’re a Christian home business owner, you’d like to think you have options for your medical cost needs.

And the truth is that you do.

If you haven’t read Part One of this series, check it out HERE.

If you assume that not having any medical cost assistance is not an option for your family, then it leaves you three options:

1. self insurance;
2. traditional insurance; or
3. a Christian health sharing ministry.

Self-insurance is really only for those with significant financial liquidity.  That leaves out most Christian families.

Traditional insurance is an option if you can find a plan that you can afford, which actually provides real coverage, and does not violate your Christian beliefs.  Sadly, those policies have been nonexistent these last few years.  Whether that will change over time remains to be seen.

For most Christian home business owners, that leaves the option of a Christian health sharing ministry.

If you don’t know what those are, generally speaking they are groups of people who come together professing the same religious beliefs who agree to share each other’s medical costs.

Christian health sharing ministries are not new.  They’ve been on the market for a long time and have been operating almost in the background.  The devastation wrought on Christians by Obamacare simply helped bring them to the fore.

In order to understand your options and how a Christian health sharing ministry plays into those options, let’s follow three case studies.

CASE STUDY #1:

SUMMARY:

This is a large family:  father, mother, and nine living children.  For many years the father worked a traditional job that came with medical insurance.  Unfortunately, the cost to cover their entire family (which then did not even include all of the children they have now) was prohibitive.  So they elected to cover just the father and mother.  The coverage was expensive with a big deductible and not very generous coverage.  And they always struggled finding alternative programs to help with medical costs for their children.  This all came to a head when the father decided to leave his traditional job and build his own business.

Pros and Cons of a Christian Health Sharing Ministry for Case Study #1:

PROS:

1. This family was able to join a Christian health sharing ministry and cover the entire family for less than they were paying for the father and mother on his old traditional insurance policy at work.  They currently pay less than $600 per month.  They pay the same price as a family of five.
2. The mother’s pregnancies have all been fully covered, including expensive testing and monitoring for problem pregnancies.
3. They are no longer dependent upon state or federal aid programs for help with the medical costs associated with their children’s medical expenses.
4. They are not aiding or abetting the evil behavior of others which would violate their consciences as Christians.
5. Each month their premium is sent directly to another Christian along with a note of encouragement. The premium goes toward that Christian’s medical expenses as submitted to the health sharing ministry.
6. They’re able to choose the doctors they see, receive whatever services the doctor says they need, and negotiate pricing for the services directly with the doctor or test provider.

CONS:

1. The health sharing ministry does not have a dental program and staunchly maintains that “dental” work is not part and parcel of health care.
2. The health sharing ministry they use does not have a benefit processing service component, so they are responsible for all price negotiation.
3. There is a $300 per person, per incident deductible.
4. Preventative care like well baby and well woman checks are not covered unless a problem is found during the exam or test.
5. Vaccinations are not covered.
6. The health sharing ministry penalizes you when it comes time to file a claim if you are not able to negotiate discounts with a provider even if that provider has an across the board policy against any negotiation of pricing.
7. Every year you have to submit paperwork to maintain your membership including a certification from your pastor that you still comply with all the required guidelines for membership.
8. You must submit proof with each claim that you still comply with the guidelines for membership. This is a very onerous and unnecessary requirement because it requires your pastor’s signature every time you file a claim.  They are never willing to take your word for your compliance notwithstanding the annual certification requirement.

CASE STUDY #2:

SUMMARY:

This is an average family:  father, mother, and three living children.  The father landed a position with a municipality that came with a living wage and benefits.  Unfortunately, the medical insurance was (1) expensive; and (2) violated their beliefs as Christians because of the things it forced them to subsidize.  They needed medical cost assistance, however, because the mother was suffering from a serious and mysterious illness that left her virtually disabled.  Lots of medical tests and treatments were causing financial strain.

Pros and Cons of a Christian Health Sharing Ministry for Case Study #2:

The pros and cons for Case Study #2 are very similar to those of Case Study #1 with the following exception:

Ultimately, the overwhelming issue for this family was that Christian health sharing ministries are not required to provide coverage of preexisting conditions.  Each plan has its own guidelines around what constitutes a preexisting condition and how they’re treated.  You are required to disclose all current and past medical issues just as you would be required to do with traditional insurance prior to Obamacare.

But in the case of this family then, the existence and ongoing nature of the mother’s medical issues prior to joining a Christian health sharing ministry meant that she would not be able to obtain medical cost assistance for her current disabling illness through the health sharing ministry’s regular claim process.  She would be able to obtain coverage for things that occur separate and apart from the current illness and which develop after the family joins.  Also the family could becomes members, disclose her condition, and hope that she did not have any symptoms or treatment over a long enough period of time that they might be able to obtain medical cost treatment for her down the road if the condition reoccurs.

Separate and apart from having claims covered through regular claims processing, some Christian health sharing ministries also have foundations and/or other programs within the health sharing ministry where claims that are not eligible for coverage under normal guidelines can still receive financial assistance.  This is a major difference between Christian health sharing ministries and traditional insurance.  So this also made Christian health sharing ministries attractive to this family to help with the mother’s extraordinary medical expenses.

This family’s need to cover the mother’s current and ongoing medical expenses meant that a Christian health sharing ministry was their only affordable and ethical option to provide any medical cost assistance for the father and children.  Depending on which plan they choose, they could cover their entire family for just under $500 a month.

CASE STUDY #3:

SUMMARY:

This is a multi-generational family:  elderly mother, adult daughter, and one feline boy.  The adult daughter is a successful home business owner who lost her excellent medical insurance because of Obamacare and could not replace it with available products without (1) an exorbitant price tag, super high deductibles that rendered the coverage useless, and high copays; and (2) violation of her beliefs as a Christian because all of the plans available subsidized evil behavior.

Pros and Cons of a Christian Health Sharing Ministry for Case Study #3:

PROS:

1. Although the plan the adult daughter uses is similar to the one in Case Study #1, a big pro is that the adult daughter’s plan includes a benefit processing service component. So the adult daughter’s doctor’s office sends charges for her visits to a benefits processing service just as if it were a traditional insurance claim.  The benefit processing service sends a Explanation of Benefits to the adult daughter detailing the actual value of the service she received.  The daughter then communicates that amount to her doctor and asks the doctor to accept that amount as payment in full.  The adult daughter has had very good luck with her regular doctors accepting the amounts outlined in the Explanation of Benefits and has even been able to negotiate lower amounts.
2. You get to use the doctors that you choose and determine what care you receive without an insurance company in the middle of that decision making.
3. You never aid and abet anyone else in evil practices.
4. You are dealing directly with other Christians as you send and receive premiums for medical expenses incurred by them or you.
5. There is a drug card that you present to your pharmacy similar to a traditional insurance drug card so that you save significantly on prescriptions.
6. This plan comes with a whole host of online support tools to assist you in taking control of your health.
7. The cost for full coverage in the program is just under $400 a month.

CONS:

1. As a single person, the adult daughter’s premium is disproportionate when compared to the fact that the family of eleven in Case Study #1 can cover everyone for less than $600 a month.
2. The health sharing ministry struggles to approve coverage of medical costs associated with rare genetic conditions. They tend to substitute their guidelines and prior coverage practices as authorities over the more knowledgeable authority of a medical expert caring for you.
3. The health sharing ministry punishes you when it comes time to file a claim for reimbursement if you have not been able to negotiate reductions in costs with your providers. This is true even if the providers have a flat policy that they do not negotiate.  In truth, the only providers I’ve come across with this policy are those dealing with oral (i.e. dental) issues.
4. There is no option for regular coverage of things considered dental. These are relegated to alternative cost sharing means within other parts of the plan, so you don’t know what you’ll actually receive in terms of assistance.
5. Every year you have to submit paperwork to maintain your membership including a certification from your pastor that you still comply with all the required guidelines for membership.
6. You must submit proof with each claim that you still comply with the guidelines for membership. This is a very onerous and unnecessary requirement because it requires your pastor’s signature every time you file a claim.  They are never willing to take your word for your compliance notwithstanding the annual certification requirement.

Although this blog post is meant to give you some insight and guidance, it is not meant to be a one-stop view of everything you need to know to pick a health sharing ministry or decide if it’s right for you.

Each person considering a Christian health sharing ministry should review the options in detail as there are several companies out there.

The Christian health sharing ministry I use has two arms to choose from.  You can review them HERE and HERE.  Tell them I sent you!

If you’ve gotten value out of this post, please share it and comment on it below.

God bless.

Lynne

 

P.S.  PLEASE NOTE:  Throughout this article, I will use traditional insurance terms familiar to everyone for ease of discussion.  The Christian health sharing ministries would object to the terminology because they don’t want people thinking of their programs as, or in comparison to, traditional insurance.  Should you decide to join the Christian health sharing ministry I use, please let me know.