Religion-based groups offer alternative to health insurance

Mary Lou Jay

Thousands of evangelical Christians in the United States are attempting to beat the high cost of health insurance through a unique system called health care sharing ministries.

What are health care sharing ministries?

Health care sharing ministries are based on the biblical principle that Christians need to share their burdens. Members pay a pre-determined monthly share (similar to a premium) to a program, which is pooled with others' contributions and used to help pay for the medical bills of other members.

There are several major health care sharing ministries in the United States. Christian Care Ministry's Medi-Share, says its participants have shared more than $550 million over its 17 years of operation. Samaritan Ministries claims that more than 15,000 households from all 50 states and several foreign countries share more than $3.5 million for its members' needs each month.

Members must meet certain criteria to join: they must be practicing Christians and promise to maintain a healthy weight and lifestyle. That means no smoking, illegal drug use, extramarital sex or excessive alcohol intake.

Will ministries still be allowed under health care reform?

In 2014, most Americans will be required to get health insurance. Health care sharing ministry coverage is technically not health insurance; however, such ministries are among the exemptions granted by the reform law. Those who can demonstrate that they're part of a ministry won't have to buy health insurance.

According to the health care reform law, health care sharing ministries that are eligible for exemptions must have members that share a common set of beliefs and must keep members even after they develop medical conditions. Also, ministries must have been continuously in existence since 1999 to qualify.

The advantages -- and pitfalls -- of health care sharing ministries

One of the big attractions of health care sharing ministries is their low cost. Individuals' and families' monthly share payments are significantly lower than health insurance premiums. For example, the monthly share for a two-parent family who's part of Samaritan Ministries is $320.

But ministry members are taking a risk. Unlike health insurance, health care sharing ministries do not guarantee a certain level of coverage. The program is based on members' trust that other members will help take care of them.

Although health care sharing ministries do not consider themselves insurance plans, they share some features of traditional health insurance. People with serious medical conditions are usually not eligible to join a ministry, and pre-existing conditions often are not covered for a period of time, according to Medi-Share.

The fact that these ministries often fall into a gray area has gotten them in trouble recently. In March 2011, the Kentucky Supreme Court issued a permanent injunction against Medi-Share, preventing it from doing business in the state because it was operating as an unauthorized health insurer. Meanwhile, in April 2011, Washington state's insurance commissioner ordered Samaritan Ministries to stop doing business in the state for the same reason.