In 2015, the government made it mandatory for everyone to have health care insurance or pay a fine to the IRS. For those who don’t have access to (or can’t afford) employer-sponsored health care, the Affordable Care Act (also known as “ObamaCare”) was supposed to offer affordable health care plans without restrictions on pre-existing conditions.
Note the optimum words: “affordable health care plans.” Unfortunately, as many people are finding out, these plans may be anything but affordable. And if you’re considered as earning too much, yet originally qualified for a subsidized plan, you may find yourself owing thousands of dollars to repay that subsidy.
Enter: health care co-ops or health care sharing ministries. These co-ops (largely religiously-affiliated) aren’t insurance providers, but instead pool money among people who agree to follow certain values (namely, living a healthy lifestyle and, in some cases, participating in healthy programs with a health coach) and share the burden of providing health care to a large group of diverse people.
Sound intriguing? It gets better. In some cases, health care ministries can be a lot cheaper than ACA options – $200 or less if you’re young and single. However, there are some drawbacks to health care co-ops/ministries.
How Health Care Ministries Work
Most information out there about health care cooperatives is from religiously-affiliated (namely, Christian) ministries. They seem to be the most reputable and well-funded, which is why many health care co-ops are also known as ministries.
Basically, health care ministries work as follows:
- Every member contributes a certain amount monthly (this amount can depend on your age and status, although some ministries just have one set amount per person)
- Members submit their claims to the ministry
- The ministry approves or denies the claim
- Claim is paid either to the member, who then pays the doctor or reimburses him/herself, or is directly paid to the health care provider
If you don’t want (or don’t qualify for) health care ministries, you can still shop for private health insurance as well.
Benefits of Health Care Co-Ops/Ministries
One of the biggest benefits to joining a health care co-op or ministry is affordability. Depending on your age, marital status, dependents, and where you live, your ACA health care plan could vary wildly.
For example, last year when I was single (and one year younger), I investigated what it would cost for me to get a health care plan similar to the one I have through my employer. This meant an extremely good plan, with a low deductible, and affordable. I found a plan for roughly $250 a month with a deductible of $1,500. This price also included dental.
This year? Now I’m married, although my husband would stay on his employer’s plan, and one year older. The lowest deductible I qualified for was $3,250, meaning I would have to pay over $3,000 before insurance paid anything, and for that privilege I would pay $240 a month. This did not include dental.
I don’t know about you, but paying $149 a month with a deductible (or “annual unshared amount”) through Liberty Health Share looks a lot more appealing ($249 if enrolled as a couple, with an AUA of $1,000). However, this does not include dental either.
Really the biggest benefit to these ministries is the affordability. You may also like the community-feel to these ministries, and that they focus heavily on being healthy first. There is a religious component to this sentiment, as most of the ministries are rooted in Christianity. With some of these ministries, you don’t have to be Christian, although there are certain things you absolutely can’t do (smoke, use illegal drugs, etc.)
Drawbacks to Health Care Co-Ops/Ministries
Clearly one of the biggest drawbacks is the solvency of these ministries. Since they’re not insurance providers, it’s difficult to track ministries solvency and viability. After all, if you’re sending in $249 a month for you and your spouse, you probably don’t want the ministry to go bankrupt in 2 years and take all your money with it. While not all ministries pool their funds, some do, and this is a concern.
Another drawback is the Christian aspect. Not everyone is Christian or wants to follow that lifestyle, and in that case ministries might not be an option at all for them. Some ministries require you go to church (although how they track that is unclear), and many will not cover things they don’t agree with (birth control, smoking cessation, drug rehab, etc.)
Finally, some ministries won’t cover pre-existing conditions, or will make you wait for a period of time before your condition is covered. That’s obviously pretty big if you’ve got a pre-existing condition and need medical care immediately.
Are Health Care Ministries Right For You?
There are a lot of considerations when thinking of joining a health care co-op, ministry, or applying for private insurance. However, one thing is certain: health care costs are going up and, as my example shows, quality may be going down as well.
While health care ministries aren’t for everyone, they’re certainly another health care avenue to investigate if you’re looking for affordable health care. While not the solution for all, they may be an option for you.
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Have you heard of health care co-ops or ministries before, and do you think you would (or could) use them?