One of the things I emphasize to people is that being an uninsured self-pay patient doesn’t mean having no coverage at all in the event of a major medical catastrophe, it can just mean not having conventional health insurance. There are a number of alternatives that can provide coverage that is often just as good, and almost always at a much lower cost.
One alternative to conventional health insurance is membership in a health care sharing ministry. These are voluntary nonprofit organizations of people who agree to share each other’s medical bills, similar to how insurance operates. There are four ministries that I’m aware of: Samaritan Ministries, Christian Healthcare Ministries, Christian Care Ministry, and Liberty HealthShare. Membership in Liberty HealthShare is open to anybody who agrees with their commitment to religious liberty, while the other three only accept members who are practicing Christians.
The cost of joining each ministry (technically I suppose Liberty HealthShare isn’t a ministry, but that’s the term I’ve been using for a decade now so I’ll stick with it) varies, but is often around half of what a roughly equivalent insurance policy might cost. Some charge more or less for membership according to age, and all of them have some sort of ‘personal responsibility’ amount similar to deductibles in conventional insurance.
Members in the ministries are able to submit their eligible medical bills to the ministry, and are reimbursed by other members, either directly or through the ministry’s central office. Eligible medical expenses are similar most insurers would cover, although there are some things that won’t be covered. Substance abuse or any injury that occurs during the commission of a crime, for example, won’t be covered.
Health care sharing ministries are attractive alternatives to conventional health insurance for a couple of reasons beyond just their affordability. Because they are voluntary organizations, they aren’t regulated as insurance companies. This means they aren’t required under Obamacare or state regulations to pay for services that some find highly objectionable, such as abortion or contraception.
In addition, even though members of ministries are technically considered to be uninsured, they are exempt from having to pay Obamacare’s tax for being uninsured.
I should also mention The Health Co-Op,* which isn’t a health care sharing ministry in and of itself, but is a separate entity for members of Samaritan Ministries that helps to provide some of the services that a conventional insurer might provide or fill in some of the gaps that can occur for ministry members. These include bill mediation, a telemedicine service, and a prescription drug discount program.
I’ve written about sharing ministries before, of course. I thought today I’d share some of the stories I’ve found of individuals who have been members to give readers a better sense of how they work in practice.
Jared White, founder of the Creation Based Health web site, published a testimony written by Dustin and Melissa Cheatham on their experience as members of Samaritan Ministries:*
…my family is a member of Samaritan Ministries International, and our monthly payment is $315 with a $300 deductible per medical need. This is a sharp contrast to insurance policies with similar coverage which would cost us a $600 monthly payment and a $10,000 deductible…
When an insurance company is not in the equation as the middle man between patient and provider, then doctors and patients are the only ones deciding what’s best for the patient’s health care—not an insurance underwriter, adjuster, or government bureaucrat…
Samaritan members have come through for us each time we had medical needs in our family. One medical need of my wife’s required an MRI and lumbar puncture procedure, as well as follow-up doctor visits. The bills totaled $9,566.00, but the medical providers gladly offered us discounts, simply because we asked kindly, eliminating $5,464.16 off our balance due. That left us a balance of only $4,101.84, which we were reimbursed in full via personal checks from other members through the Samaritan Ministries International’s very organized system for ensuring every medical need is covered… Additionally, our deductible (“Share”) was $0 for this medical need, because Samaritan reduces the Share when discounts are negotiated…
The second medical need my wife had was for ingrown toe nail surgery in two toes. This surgery would have cost us $675 if we had no health care coverage, but the final amount we’re out of pocket is $121, because like the previous medical need we asked for discounts from the doctor’s office and received reimbursement from members.
The only perceivable drawback to this health care alternative is that we had to pay a few bills with our credit card while we waited for reimbursement checks, but this wasn’t a problem for us because it allowed us to earn bonus points with our credit card issuer. Despite this, health care sharing has eliminated fears of expensive medical bills, and it’s proven an empowering experience for us as we feel we have much more control of the decisions and options we make regarding our health care.
My husband and I have been self-employed for years so insurance coverage was always a big concern for our family. We had insurance, but it was so expensive and such a drain on our finances…
In April of 2000 I suffered a terrible accident while on a ski trip with my family. One moment I was skiing, the next I was falling. As I fell, I heard a pop in my knee and knew it was bad. The staff at Christian Care was great. That was such a relief and it freed me to concentrate on healing.
That process turned out to be more complicated than expected. The fall tore my ACL and I had to undergo reconstructive knee surgery to repair the damage. Unfortunately, complications from the surgery hampered my recovery. I was in a lot pain and my leg wouldn’t function properly. I ended up having extensive physical therapy for over a year.
CCM was really wonderful throughout this entire ordeal. The doctors at CCM were especially helpful. They gave me exercises to do and never failed to encourage me or answer any questions. At this point I feel as if I’ve known them all my life. I even called Dr. Evans recently because I was experiencing knee pain again and he told me exactly what to do to relieve it.
Between the surgery and the extensive therapy, I think the total cost of my accident was around $25,000. Medi-Share participants shared that cost and we are so grateful, but what really touched my heart was the spiritual support I received. The caring staff at Medi-Share called many times and no matter whom it was, he or she always ended our conversation with prayer. The prayers were so spirit-filled and I could tell the staff really lived what they were praying. What a blessing Christian Care Medi-Share has been!
Another story I found was that of Austin Davis, an auto mechanic who also blogs at The Honest Mechanic. He joined Christian Healthcare Ministries, and as you read you’ll definitely see the sort of challenges that self-pay patients often run into:
…My family (wife and two small daughters) are very healthy people. We do not take any prescription medications, we eat very healthy and stay active and we stay out of the doctor’s office because of our healthy lifestyle. I have had health insurance with Aetna for about 10 years now, and have been paying $780 a month for a $10,000 deductible health insurance policy. Meaning, I would need to pay $10,000 before any insurance coverage would kick in.
Two months ago Aetna raised our premiums to $1081 a month for the same policy… I called at least 5 other health insurance providers and got quotes from them. Each of their quotes were pretty similar, $800-$1000 a month give or take…
I called and emailed the people at Christian Health Care Ministries… and loved what I learned about them…
Your coverage starts immediately and there are no tests or exams to go through. I was able to start coverage for my family with a 10 minute very friendly and polite phone call. Not only am I saving a ton of money AND getting a much lower deductible but I feel good about helping others with my monthly contribution…
I was deathly ill last month with a very serious infection in my right arm. I broke down and went into a local emergency room with a major hospital, although it was a strip center building not a large hospital. My 1 hour visit with 1 shot and 2 prescriptions (no exams, no blood work…nothing really) landed me a $1,900 bill in the mail a few days later from Memorial Hermann hospital system, and a few more days later a bill from the doctor for $752.00!
…I called CHM and they said that the hospital I went to offers a 61% discount to insurance companies and to call and ask for the discount to be applied to me…
After contacting Hermann Memorial Hospital system 4 separate times with NO response from them, I submitted a complaint to the BBB which got a response within 48 hours. I then followed up with a phone call to the head of the billing department and pleaded my case….severe overcharging without my consent and basically no real “emergency services” provided to warrant the charges.
He stood his ground and said “I stand by the doctor’s billing” but I stood my ground and remained calm but was very firm about my assumption this was fraudulent and not justified.
He told me the hospital is transparent and open about their charges, and I told him I was going to go to the hospital right then and there with my i-phone and take a video of the front desk and post that video on youtube…and call him a liar.
They DO NOT post any charges or even a reference to any charges that WILL occur once you walk in the exam room. I got him red handed.
I told him I would pay the pharmacy portion of the invoice ($245) and that was all, take it or leave it and I will post that video and name names!
He offered me 50% bill reduction, which I refused and told him he had 1 minute to accept my offer or I was hanging up. I told him I knew they offered 61% to insurance companies and his deal was no deal. He said “you are not an insurance company”. I stood firm on my offer….and he finally accepted.
I contacted the doctor directly and he applied the 61% discount to his $752 invoice without much argument.
So, I can only thank CHM for giving me the inside info about the insurance discount and the BBB for helping me get my point across. Stand your ground people against the doctors and healthcare companies and do not be intimated by their ruthless practices.
Original invoices amount $2600, settled amount $688
The Healthcare Co-Op also shares a number of stories about how their services helped members. One story that jumped out at me in light of my recent posts on the challenges of finding a doctor that will treat self-pay patients fairly that of Cindy:
Cindy, a Health Co-Op member for only a few weeks, remembered we encouraged her to contact us before any doctor visit to see if The Health Co-Op can help her handle these visits in a more cost effective way.
Just a few short hours before the visit with her two children, Cindy called our office to inform us they will need allergy shots. By the time she arrived at the doctor’s office, her personal Health Co-Op advisor reduced the quoted cost from $419 to $120.
The Health Co-Op can achieve such savings by helping the office staff understand Cindy will be paying cash and by ensuring the routine lab work for her children is performed through our lab program. This family saved half of the annual cost of their member benefits on this first office visit!
Results: Savings of $299 on first office visit.
As I’ve said before, health care sharing ministries aren’t for everyone, and as the story of Austin Davis demonstrates there are still challenges to being a self-pay patient as a member of a ministry (although the ministries often are there to help meet those challenges). I encourage anyone looking for more affordable alternatives to health insurance to seriously consider one of the four ministries described here (or if you know of others, please let me know! I only recently found out about Liberty HealthShare, before that I’d thought there were only three).
* CORRECTION 1/3/2014: The original blog post misidentified the family describing their experience as Samaritan Ministries members, this has been corrected.