Christian medical-bill sharing a growing trend

John Kuiper, a financial planner from Kalamazoo Michigan, got some great advice in church several years ago. It wasn't how to save his soul, but rather how to save thousands of dollars each year on health insurance.

Kuiper is among the more than 100,000 Christians who belong to a biblically-based bill-sharing collective called Medi-Share. He and his wife pay $436.50 a month to belong to Medi-Share, one of the largest Christian programs in the country. Before Medi-Share came onto his radar, Kuiper's insurance had been paid by his employer, a large financial planning company. Kuiper wanted to strike out on his own, but the cost of buying his own insurance was prohibitive. Then four years ago he and his wife (both pictured) joined Medi-Share, making it possible for him to leave his job and start his own business.

Instead of buying traditional health insurance, a growing number of Christians are turning to these medical-bill sharing groups. Members not only agree to pay one another's medical bills, but they also promise to live within the Christian teachings. Among them: "Do not forget to do good and to share with others."
A Christian approach to health care

Based on those principles, members of the sharing collectives make the rules about what to cover and what not to cover. You can forget medical care for unwed pregnancies or any other problems that stem from having sex outside a traditional Christian marriage. They also won't cover birth control, abortions, or medical problems stemming from lifestyle choices that run contrary to Christian values. Members are not permitted to smoke or abuse drugs, including alcohol. Participation in activities with willful disregard for personal safety will get you booted from the plan. Some with chronic health problems may be accepted, but only if they agree to work with a "health" coach. Ditto for the obese -- you know, gluttony and all. And perhaps the biggest requirements are that you are a regular church-goer (as verified by your minister) and sign a statement of faith accepting Jesus Christ as your savior.

Since health care reform took center stage last year, interest in these faith-based programs has increased by more than 150%, according to Medi-Share, one of the best known Christian bill-sharing collectives. It's easy to see why: Premiums -- called monthly shares -- are significantly lower than traditional health insurance. Family rates start at $109 for a monthly share, or premium.

Tony Meggs, executive vice president of ministry development for the Christian Care Ministry disagrees with critics who say Christian bill-sharing collectives turn away people with greater needs, which would be well... rather un-Christian-like. Medi-Share excludes those with Type 2 diabetes, lupus and certain cancers including those that have metastasized. Sharing is also limited to six months of a medication and no maintenance medications are covered.

"Members decide what conditions are to be covered, not Medi-Share," he said, adding that what Medi-Share offers is an improvement over traditional insurance companies "that had to be ordered by the government to accept people with any sort of pre-existing condition." "We are working to expand who we can accept and every day we make changes to be able to include more," he said.

A Communal Approach to Health Care

The Medi-Share program has been around since 1993. The group "supports, funds and shares biblical lifestyles," which makes for a "healthier group of people to care for and equates to a lower cost for our members," says Meggs.

In lieu of premiums, Medi-Share members get monthly notices indicating the amount of their "share." According to the group's web site, "each month, Medi-Share matches up member's monthly share amounts with other member's eligible medical needs and facilitates the direct sharing of those costs between them. It's a modern-day version of what the church started back in the book of Acts."

Members can go online and see which other members they are helping (they are also urged to pray for those people and send them supportive messages to speed their recovery.) To set up an account, each member household establishes a bank account with a Christian Care Ministry-specified financial institution and signs a limited power of attorney agreement that gives CCM the ability to facilitate sharing on behalf of the member household.

Members with a medical need may go to any doctor of their choosing and show their Medi-Share card. The doctor submits the bill to Medi-Share, which negotiates the cost with the doctor and sends out those monthly notices. Doctors cost less if members stick to those listed in the PPO network, but they remain free to see whoever they want. Members also are responsible for a $35 co-pay for office visits and $135 co-pays for hospital stays.

Many procedures require pre-authorization and Medi-Share's web site is replete with reminders that this is not insurance and neither the group or its members are financially responsible for anyone's medical bills. If a member's claim is denied, he may take it to a member-staffed appeals board. But since these collectives aren't insurance companies, they aren't regulated by states. A complaint ends with the appeals board.

Count Kuiper among the satisfied. He has no complaints about his Medi-Share experience. He and his wife pay $436.50 a month and have twice needed to file claims. Both times, their bills were paid in full.

Medi-Share member Lisa Kerickhoff of Wellington Colorado says she appreciates that she was assigned just one point person to deal with at the company instead of always getting the run-around, and that person has "always been pleasant and treated me in a Christian manner. I appreciate the attention to the whole person, spiritual and physical."

Since Kerickhoff is a new member, she hasn't had the experience of processing a claim yet, but she pays just $140 a month for her coverage and gets a discount for being within the "healthy" body category, determined by physical measurements and blood glucose analysis, she said.

The biblical roots of bill-sharing

Medical bill-sharing groups came into being in the 1980s. According to Christianity Today , a pastor from Ohio named Bruce Hawthorn was involved in a tragic car accident in 1982 that killed his wife and daughter and left him with more than $50,000 in medical bills. He turned to his church for help and the church members' generosity more than met his needs. It also gave him the idea that Christians could share payments for each others' medical bills on a nationwide level. Soon, the Christian Brotherhood was born.

The Christian Brotherhood, now called the Christian Health Care Ministries, provides medical bill-sharing for the self-employed only. Another large program is run by the Samaritan Ministries. Samaritan's Assembly Care program has a policy that for every 20 households that sign up, one "commended worker" or missionary who has a pre-existing condition is allowed to join.

Even though these bill-sharing collectives are not considered health insurance, they were still granted a special exemption from the law President Obama signed last March that requires most Americans to buy government-regulated health insurance by 2014 if they don't get it at work.

"Health Care Sharing Ministries are the only organized health-care concept to receive a special exemption from the taxes, penalties and regulations that are a part of this new law, as these apply to insurance companies," according to Meggs.

But not everyone is on board. "These plans function just like health insurance, but they operate in a regulatory black hole," Mia Kofman, formerly an assistant research professor at Georgetown University's Health Policy Institute told the Washington Post. Kofman is now insurance superintendent for the state of Maine. "There is no accountability, no oversight, and the people who participate have no protection." Unlike insurance companies, which are required to have reserve funds to pay claims, church plans do not maintain reserves.

State authorities have been slow to take action, critics say, because of the plans' religious affiliations -- and the scarcity of subscriber complaints. And since it's not an insurance company, it isn't governed by your state's insurance laws. If you have a beef over a claim denied, where do you go? Perhaps appeal to a higher authority.
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