Wednesday, December 17, 2014

ObamaCare: What's An American To Do? (Part 2 - Alternatives to ObamaCare)

Are you...
- looking for alternatives to ObamaCare?
- looking for affordable health care?
- looking for health care that does not cover abortion?
- ready for some good news?

You have affordable alternatives! You don't have to buy ObamaCare! You don't have to pay the government imposed penalty/tax for not having "insurance."

Ok, here we go...

By law, you must sign up for health care before the open enrollment deadline of February 15, 2015 (in order to be covered for 2015), or face paying a penalty/tax imposed by the IRS for failing to have minimum essential coverage.

However, under the Affordable Care Act, there are actually several ways a person can be considered legally exempt from having to comply with the insurance mandate.  Here's a page which lists several exemptions recognized by ObamaCare, but my focus will be on one in particular:
being a "member of a recognized health care sharing ministry."
It's easy to miss. The government site doesn't extend the courtesy of defining the concept for you, or identifying the names of any of these ministries. But you can find all that below.

What are health care sharing ministries?

They are "a health care cost sharing arrangement among persons of similar and sincerely held beliefs." These are tax exempt nonprofit 501(c)(3) organizations, and each one is a sort of "mutual aid society" which facilitates the voluntary payment of medical bills between members. The members must agree to sign a statement of shared beliefs, based on religious or ethical reasons, and agree to live a healthy lifestyle. The ministry must have been established before December 31, 1999, and must have received approval from the government as an ACA-exempt health care sharing ministry.

What are they not?

They are not insurance companies. They do not legally have to guarantee to pay all your bills. They don't have Dental and Vision and Prescription all rolled into one. But, they can actually be better than insurance.

Don't PANIC!

Before you automatically dismiss these options because you won't have "insurance," please continue reading. These ministries have been in existence for decades and have excellent track records of meeting members' needs. They have hundreds of thousands of members who have met over $1 billion in each others' medical needs. It's much more stable than it may sound on the surface, and chances are you already know several people who are members of these ministries - they just don't happen to go around talking about it.

I have personally spoken with several members from each of the biggest three ministries, and not one of them would go back to an insurance company. Every member refers to the ministries in glowing terms, and feels they are well taken care of as part of a family. There's a bit of a learning curve with this new system, but soon you'll figure it out, and then you'll be able to share the information with your friends. These ministries are truly remarkable, and more Christians need to know they exist. So, read on...

How many recognized* health care sharing ministries are there?

At least three. The ones with the highest memberships (in no particular order) are:

*Smaller groups may include Altrua Healthshare (which merged with Blessed Assurance Bulletin to try to qualify for ACA exemption), which has submitted their request and is waiting for confirmation. Likewise, Liberty Healthshare has submitted documentation for approval. I spoke with a Liberty representative who said they did receive confirmation from the government, yet that confirmation is not mentioned on their website. Please pursue these matters further if those ministries seem to be a better fit for your needs. Because the membership in health care sharing ministries has grown so massively in the past two years, many smaller ministries are working to gain recognition form the ACA, and are petitioning the government to change the arbitrary December 31, 1999 deadline so they can qualify.

Also, a note of distinction between the five ministries above... the first four are exempt on a religious basis, and require a statement of Christian faith. But Liberty Healthshare is exempt on an ethical basis, where members agree that they should be free to practice their faith (or practice none at all.) As a result, Liberty is open to Jews, Muslims, and same-sex couples, as "open and inviting to everyone as we can be."

Details about the Big Three...

Samaritan Ministries International (1994)
Samaritan Ministries matches Shares with Needs. Shares are similar to the concept of insurance premiums (a set amount members pay each month). Needs are the medical bills that members submit to the organization. It's a simple program, based on the number of family members. You can go to any doctor you choose, and tell them you are a self-pay patient with Samaritan Ministries, which automatically reduces the cost of your bill. The doctor bills you, and you submit the bills to Samaritan. Here are their Guidelines.

One major difference between Samaritan and other groups is that, instead of members sending their payments to the headquarters, for 11 months of the year they actually send checks to each other. Once you submit a bill to Samaritan, and they review it and confirm it as a publishable Need, then they instruct other members how to send their monthly Share to you. If your Need is in the thousands of dollars, then you would receive many checks from many members, often in greeting cards with handwritten notes saying they are praying for you. This process results in a very personal sense of the Body of Christ meeting the needs of each other. Prompt accountability is key, and if a member is delinquent in sending you their Share, then you can notify Samaritan and they are faithful to assign another member to mail a Share. Samaritan will remove delinquent members if the conflict is not resolved quickly.
Samaritan also has a separate division for Catholics, called CMF CURO.

Medi-Share (part of Christian Care Ministry) (1993)
With Medi-Share, you begin by choosing what size deductible you want for your family (what they call an Annual Household Portion) and choose a monthly payment from there. Medi-Share has their own list of participating in-network doctors which they want you to use. You get an ID card which you show to the participating doctor's office, the office submits the bills to Medi-Share, and Medi-Share pays the office.  Through an online portal, Medi-Share tells you about the specific needs of other members, and how your monthly payments met those needs. This builds a prayer community. Here are their Guidelines.

Christian Healthcare Ministries (1981)
CHM has a system based on Units (one per family member) rather than one fee per family as a whole. Each Unit can choose an annual deductible (called Personal Responsibility) under a Bronze, Silver, or Gold system. That way, it is tailored to different family members with varying health needs. One family member may need a high level of coverage, while another may only need the minimum (catastrophic) coverage. You may choose your own doctor, the doctor bills you as a self-pay patient, and you submit your bills to CHM. CHM then reviews the bills and sends you a reimbursement, which you then use to pay your doctor. Their Guidelines are available upon request.
Golden Rule/UnitedHealthcare
I need to mention this insurance company for a moment because, during my investigation, several people have volunteered this name as having "opted out" of ObamaCare. Now, if you have read Page 1 of this series, you know that insurance companies are bound under the law to comply with the ACA, and cannot simply "opt out." UnitedHealthcare is the name of their group insurance division, and Golden Rule is their individual insurance division. UnitedHealthcare has "opted out" of participating in some state exchanges, and Golden Rule has "opted out" of participating in all federal and state exchanges, because both divisions have found it less financially viable to compete in the exchanges. Many other insurance companies have done the same. In these cases, you must contact them outside of an exchange in order to buy a policy, which makes you ineligible for a federal subsidy. So, if you do find these policies, they are still insurance and therefore must be ACA compliant, and, as such, are still ObamaCare.

What makes health care sharing ministries affordable?

The self-pay principle.

When you're a member of a big insurance company, chances are you don't look at the bills. Your in-network doctor recommends tests or treatments, and you never think twice about whether or not you could have gotten the same treatment for less money, because it's all "out of sight, out of mind" and "covered by insurance." And that's one reason insurance premiums are so high. But what happens when you take a moment to compare prices, just like you do every day at the grocery store? You make informed, cost-saving decisions. These ministries enlist your help in making wise choices, asking you to make price comparisons between providers and treatments, which reduces administrative costs for themselves, and reduces costs for yourself and for all members. Self-pay patients automatically receive discounts since the provider does not have to bother with interacting with an insurance company to recover payment. You still get the treatment you need, but you save money in the process. And these ministries can even contact your doctors to help negotiate prices down on your behalf.

Healthy lifestyles.
The use of tobacco and alcohol is generally not allowed (some exceptions apply). People with preexisting conditions can join, but coverage is handled on a sliding scale, depending on the condition and how long it's been since you've had symptoms/treatment for it. Check each plan to learn their particular conditions of service.

If a new member signs up through you, you can receive a free month of membership. Check each plan for details.

What are some major pros and cons of health care sharing ministries?

This site has a good list. It is in reference to Samaritan Ministries specifically, but many of the points apply to other ministries.

Now, down to the nitty-gritty on coverage under these ministries.

I've put together a handy-dandy comparison chart which compares some plans, costs, and options:

Health Care Sharing Ministries Comparison Chart

(The information on this chart is not exhaustive by any means, and may not be completely up-to-date after the time of its creation - Dec 2014 - but it should give you a good overview. Please visit each ministry's website and follow up on particular details yourself.)

Isn't it great to know you have alternatives?

They may not work the way you are used to; they may require some effort on your part to understand; they may be outside your comfort zone; they may take a little faith (but not blind faith), but you have alternatives. Going with the flow and picking a plan from your state exchange means picking ObamaCare.

If you're on the fence, how about trying it for one year, until next year's open enrollment?

What difference can it make if we sign up for one of these alternatives?

1) We take a stand. "As for me and my house, we will serve the Lord."
2) We save money. It's amazing how inexpensive these plans will work out to be for most families.
3) We support solid Christian alternatives which have been in business for over 15 years. The more Christians that enroll, the more the costs are spread out. Instead of fees going up, sometimes they actually go down. No kidding.
4) We make a difference for future generations. The more people that sign up, the louder our message is. And 30 years from now, we can look back and know we made a difference. We have to start somewhere.

Be a pioneer. Make the effort. Do the research.

Which one is right for you?

One important note.

Some of you may decide, after faithfully examining all alternatives, that these health care sharing ministries still will not work for your family, and your only health care option really is ObamaCare. If that's your case, then no one can fault you for that, nor should they judge you for it. The fault lies with Obama and the impossible position he put you in by inextricably tying ObamaCare to abortion. It's a crime that many people will find themselves faced with the decision of no health coverage for their family vs. having to buy insurance that violates their convictions. God sees and understands, and we pray He will give you peace in your decision.

Here are some additional websites I found particularly helpful when researching these ministries (in no particular order):

(It calls ministries "insurance," but mentions "short-term" and "alternative" insurance policies)
Alternatives to Obamacare: (Samaritan Ministries vs. Medi-Share vs. Christian Healthcare Ministries)

ObamaCare: What's An American To Do? (Part 1 - Introduction)
ObamaCare: What's An American To Do? (Part 2 - Alternatives to ObamaCare)
ObamaCare: What's An American To Do? (Part 3 - Abortion)
ObamaCare: What's An American To Do? (Part 4 - Prescription, Dental, and Vision)

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