Medi-Share Insurance: Pros and Cons of Christian Health Care Sharing Program

Published by Lookforzebras

Medi-Share is a health care sharing program and though it is commonly referred to as insurance, it is not. Many non-profit Christian Cost-Sharing Ministries enroll people struggling to pay for health care expenses but are not legally bound to cover their members’ claims.

Medi-Share is one such Christian Healthcare Sharing Ministries where members share medical expenses, support and honor biblical values.

Learn why Medi-Share is increasingly becoming relevant today and why it may be worth recommending for your patients with financial hardship.

Table of Contents

• What is Medi-Share?
• How Medi-Share Works?
• Medi-Share Coverage
• Pros and Cons of Medi-Share
• What is Christian Health Insurance?
• List of Christian Health Sharing Plans
• What is Health Care Sharing Ministry?

What is Medi-Share?

Medi-Share is a health cost-sharing program that enables its members to pay each other’s eligible medical expenses.

Medi-Share is run by a 501(c)(3) non-profit organization, Christian Care Ministry. It provides affordable access to quality healthcare where Christians help each other by sharing healthcare expenses. Members help other like-minded people by contributing monthly “shares.”

How Medi-Share Works?

Members who join Medi-Share deposit monthly payments known as “share amount” through a secure online portal. It works like a premium, ensuring eligibility for assistance should you need it.

The below listed are the basic principles of how healthcare sharing ministry works:

Annual Household Portion

Members can choose an Annual Household Portion (AHP) according to their family’s healthcare needs. The payment amount determines how much you will have to pay out-of-pocket toward medical bills before being eligible for sharing.

The AHP size you choose will determine your monthly share. For instance, if you choose an AHP of $12,000, the standard monthly share would be $118. If you meet certain health and fitness requirements, you may qualify for a health incentive of up to 20%. You may further save on your monthly share and end up paying about $95 to $100 per month.

The AHP amount can range from $500 to $10,000.

Provider Fee

Like co-pay, you will have to pay $35 for doctor visits and $135 for emergency room visits if not admitted to the hospital.

Preferred Provider Organization (PPO)

Medi-Share is partnered with one of the largest and strongest PPOs, Private Healthcare Systems (PHCS). Members are encouraged to seek care from the providers within the PHCS network. Members are free to choose an out-of-network doctor for treatment, but a penalty may be applied for using a non-network provider.

Doctor Visits

Any member needing medical care can hand over their Medi-Share Card and pay the provider fee. The provider will then bill Medi-Share. It will be processed and discounted, and the rest of the amount that the doctor bills will have to be paid by the member. Once the paid amount matches the AHP for the year, approval for sharing will be done for eligible medical bills.

Health Incentive

Families may get a discount of about 20% on their monthly share amount by qualifying for a health incentive. Members who lead a healthy lifestyle and keep their vital signs such as BMI, weight, and blood pressure under control may be entitled to discounts.

Medi-Share Coverage

Medical expenses that qualify for sharing include:

• Doctor Visits:  Free telehealth access via phone or video 24/7. The doctors diagnose and prescribe medications. You may qualify for discounts by choosing a doctor through PHCS.
• Emergency Room Visits and Hospitalizations:  A provider fee of $200 for an ER visit and $35 per hospital visit must be paid by members that do not count towards AHP.
• Prescriptions:  Sharing for FDA-approved prescription drugs per eligible condition is for up to six months.
• Maternity:  Pregnant members should have an AHP of $1,250 or higher and should have faithfully shared from the month of conception through delivery to qualify for maternity sharing.
• Well-Child Care:  Sharing for routine care is eligible until the child is six years old.
• Adoption Costs:  Up to two adoption events can be shared per household after meeting certain criteria.
• Senior Assist:  Seniors who turn 65 with Medicare Parts A and B can change to Senior Assist. Some of the benefits include copayments, deductibles, hospitalization, and out-of-country urgent care.
• Disability Expenses:  Medi-Share helps replace up to 80% of lost income for up to 12 months for Manna members. Speaking of Disability insurance, learn how much disability insurance you may need as a physician.
• Final Expenses:  Funeral expenses up to $5,000 are eligible for sharing.

Expenses ineligible for sharing include:

• Dental, Vision, and Hearing:  Members are provided with savings cards for exclusive discounts though not eligible for sharing. Discounts of up to 60% on many dental procedures, 30% on eye exams, glasses, contact lenses, LASIK surgery, and 60% on hearing aids are offered.
• Routine and preventive care such as physical examination, lab studies, immunizations, vaccines, colonoscopies, and mammograms
• Fertility/infertility care
• Alternative care such as vitamins, acupuncture, and experimental treatments
• Counseling, including dietary, genetic, diabetic, lactation
• Behavioral or mental care
• Cosmetic procedures
• Non-prescription drugs
• Hearing aids

Medical expenses eligible for limited sharing under certain circumstances include:

• Ambulance or other medical transport services
• Cardiac rehabilitation (up to 36 sessions)
• Home care (limited to 60 calendar days)
• Non-hospital admissions
• Chiropractic treatment
• Durable Medical Equipment (DME)
• Genetic testing
• Outpatient speech therapy (up to 10 visits)
• Physical therapy (up to 20 visits)
• Prostheses
• Primary care evaluation
• Sleep apnea studies

Pros and Cons of Medi-Share

Medi-Share is sharing medical bills among Christian believers who largely share similar lifestyles. A member’s deposited monthly share goes into a fellow member’s sharing account to pay their medical expenses.

Pros

• Cost-effective – Members can choose specific monthly deposits based on the program options
• Cannot terminate membership due to evolving medical condition
• No annual or lifetime limits
• Coverage for qualified adoption and funeral expenses
• Membership is not affected by the employment status or state of residence
• An alternate choice to the Affordable Care Act Marketplace

Cons

• Medi-Share is not an insurance
• No legal protection for an unpaid claim, coverage denied, or bankruptcy
• Restrictions based on lifestyle and pre-existing conditions; may have to make additional monthly payments
• No Health Savings Account (HSA) Contributions or reimbursement plans
• Healthcare providers may not want to bill Medi-Share, ending up in a huge out-of-pocket bill
• Faith-based and must follow specific rules associated with membership

What is Christian Health Insurance?

There is nothing such as “Christian Health Insurance.” Christian Healthcare Sharing Ministries (CHSMs) share a common set of religious beliefs and share medical expenses among members.

Christian Healthcare Sharing Ministries are vastly different from conventional health insurance plans. CHSMs have become one of the most attractive alternatives for many American individuals and families.

Their healthcare programs offer a wide range of medical and pharmaceutical benefits and services and even critical illness and accident plans. Members may often have greater flexibility than the traditional health insurance, such as choice of doctors, access to enormous pharmacy benefits and services.

With the rising prices in healthcare and prescription medications, paying out-of-pocket can be difficult for most people with conventional insurance policies. Health share programs provide affordable options to help pay for medical services.

List of Christian Health Sharing Plans

Christian health sharing plans tend to be much more affordable than conventional health insurance plans. Members can save more through discounts when compared to the premiums charged by private health insurance plans.

Below is a list of Christian Healthcare Sharing Ministries that offer flexible healthcare programs:

• Medi-Share
• Samaritan Ministries
• Christian Healthcare Ministries
• Liberty Healthshare
• Sedera
• US Healthshare
• United Refuah HealthShare
• MCS Medical Cost Sharing
• Altrua HealthShare
• Freedom HealthShare
• Trinity HealthShare

If you are exploring an alternative healthcare solution such as healthcare sharing, read through the rules carefully to ensure compliance.

What is Health Care Sharing Ministry?

Health Care Sharing Ministries (HCSMs) are non-insurance organizations where participating members share common ethical or religious beliefs and share health care expenses among members. HCSMs are not regulated by the state insurance commissioners or the Affordable Care Act (ACA), and the coverage will vary from one ministry to another.

Membership is limited to like-minded people who share similar religious faith and agree to various rules, including avoiding tobacco, alcohol abuse, potentially hazardous behaviors, etc. Members have to meet certain requirements according to biblical principles and strive to maintain healthy lifestyles.

Members make monthly contributions into the pool of funds, which is used to help pay the medical expenses of other members. Every member’s contributions are recorded, and any member can check into the pool of funds collected to incur an eligible medical expense.

Though there are advantages and disadvantages in HCSMs, people join these groups due to the lower price rates. The groups can set limits on how much their members can pay, and many groups grandfathered in under the federal health care law through a religious exemption.

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