As health insurance costs rise, more consider shared health programs

It is the time of year when thoughts turn to the joys of giving, family, and unfortunately in recent years, rising health insurance costs.

Around Ohio, those who are self-employed or working at a small business are getting the news that their health insurance premiums will be getting another healthy increase for 2018. Ohioans purchasing health insurance through the Affordable Care Act will see average premium increases of 34% in 2018, according to the Ohio Department of Insurance. In addition, the insurance policies might not cover certain providers and may have higher co-pays. There will also be a shorter period to enroll in plans this year in some cases with a deadline of Dec. 15, compared to last year’s enrollment deadline of Jan. 31.

The growing health insurance frustration of many people in rural Ohio has them searching for other options, including Christian medical cost sharing programs. Michelle and Mitchell Stammen of Mercer County made the decision to switch after Michelle left a corporate job that gave their family of four very good insurance, and started working from home. Mitchell’s full-time occupation is operating the family’s grain and cattle farm.

“Switching to something that is not considered health insurance is a huge decision, but we decided to take a leap of faith,” said Michelle Stammen. “Being Christians, there were many reasons we wanted to ditch the government-mandated healthcare system and to instead join a health cost sharing ministry. The main reason for us was that we did not want to continue paying ever-increasing prices to insurance companies who made us cover things like abortions and birth control pills.

“After becoming self-employed in 2014-15, we transitioned from my employer’s health insurance to another insurance company who charged $850 per month with a $12,500 deductible for our family of four. We had received a notice towards the end of 2015 that the insurance company was going to raise the rate to $950 per month for the following year. It made us upset because we felt it was pointless to pay that much for ‘healthcare’ when we had no claims that year. We knew the high-deductible plan we opted into was for the purpose of covering a major medical problem, but on the other hand, we felt like we were just throwing all that money for our monthly premiums down the drain.”

After lamenting about their situation to a fellow farmer, that friend introduced the Stammens to the health cost sharing community his family was a part of called Samaritan Ministries. The other farming family told the Stammens that they did not have insurance, however, their medical bills were paid through Samaritan Ministries.

“This family of 12 was paying less than half of what we were going to be paying monthly to the insurance company in 2016,” Michelle said. “We are not a family who goes to the doctor very often because we do a lot of natural remedies and herbal treatments — which were not covered by insurance anyway — so at the end of 2015, we did some research and decided to cancel our health insurance.”

With the cancellation of their insurance, the Stammens decided to become part of Samaritan Ministries, one of several Christian health sharing options available nation-wide. Unlike insurance, the focus of Samaritan Ministries is on helping others with their needs.

“After talking to that other farming family and realizing how well it was working for them, we knew we had to look into it. We found out that there are many more Christian health sharing plans out there than we realized, and we were quickly overwhelmed. With the end of 2015 rapidly approaching, we knew we had to make our decision quickly. After reading though Samaritan’s Guidelines, it seemed like a good fit for us so we applied. Samaritan doesn’t cover dental or vision, but we were used to paying for that out of pocket anyways,” Stammen said. “The most fulfilling aspect of this ministry is knowing that your money is going directly to a family who needs help paying their medical bills. When you are a part of Samaritan Ministries, you are not sending your monthly check to an insurance company; rather, you send your check to someone with a real medical need, along with a note to let them know you are praying for them and thinking of them. The person in need has to provide a copy of their medical bill and Samaritan takes care of making sure the person’s need qualifies underneath the established guidelines.”

The ministry serves as a hub for meeting members’ needs with funding from other members. For the Stammens, medical bills under $300 are paid out of their pocket. Needs greater than $300 are covered by Samaritan members.

In a nutshell, Stammen said the sharing process is:

1. A medical need begins. When a member has a health care need, they receive heath care treatment from a provider of their choice, collect the bills, and send them to Samaritan Ministries.

2. Samaritan publishes the need. Samaritan Ministries verifies that the need meets the guidelines. Then, in the monthly newsletter mailing, Samaritan Ministries directs some members to send their shares to the member with the need.

3. Shares are received. The member with the need receives the shares to pay health care bills along with prayer and notes of encouragement.

So, every month, the Stammens send their check (that is around $500 for their family of five) to a fellow member in need as directed by the ministry. In part, the ministry is successful because members are strongly encouraged to seek cash discounts from medical providers for services. Similar discounts are fairly typical for health care providers when working with large insurance companies.

“Samaritan members are encouraged to be vigilant in asking for cash discounts and negotiating prices of services. If a patient pays on the day of service, medical providers are often willing to give discounts. Our family doctor gives us a self-pay discount. If your family doctor does not give any discounts and you decide to switch to a health share ministry, you may want to find a doctor who does,” Stammen said. “They may just take off 20% of the bill just for paying upfront in cash.”

It was not long into their membership when the Stammens found themselves in need.

“Soon after being accepting into Samaritan in December 2015, we found out we were expecting. There was a lot to consider with a pregnancy. I called many hospitals within a 60-mile radius inquiring what the charges would be for prenatal care and baby delivery. I got a lot of run-around and phone transfers, because many hospitals only deal with negotiating prices with insurance companies and didn’t usually deal with a patient wanting to pay cash. It was a little confusing and took some patience and a couple hours of time, but I felt that if other Samaritan members were going to be paying for my medical bills, doing the homework was worth it to get the best price for everyone. I found that the preferable hospital, which was closest to me, only offered a 3% cash discount, while a facility 50 miles away offered a 55% cash discount. To me, the thousands of dollars I would be saving from choosing the facility further away was worth the extra drive time and gas,” Stammen said. “For maternity needs, there were many OB appointments leading up to the delivery. The way Samaritan handles maternity needs is that a new ‘need’ is started with information like the baby’s anticipated due date. I made payments to the provider out of our checking account. I documented every bill no matter how small and added it to the main maternity need. There were times that I submitted eight bills at once. When you have an ongoing need like this, you have the option of paying for some of it upfront instead of sending all of them to Samaritan first and waiting for the reimbursement checks to come in. During this time, you also still need to make your regular monthly share payments. As your personal bills add up, Samaritan keeps track of them and they take care of telling other members how much money to send you. Within a month or two, you start receiving checks from other people. You may get a $250 check from a single and then a $400 check from a family. Even if you get bills months after the baby is born, you keep submitting them onto that main maternity need until all the bills are finished. Our total maternity bill was $18,184 minus $7,640 for being self-pay, so we ended up paying $10,544, and Samaritan reimbursed us for all of it.”

Looking back, the Stammens have been very pleased with their decision.

“Not only have we saved thousands of dollars — $11,400 for insurance per year versus around $6,200 for the Samaritan Classic family price, which includes the Save-to-Share option for bills over $250,000 — we feel more fulfilled on a spiritual level by being able to help like-minded Christians share their medical bill burdens,” she said. “The community of believers comes together as one body to assist members in need.”

Mitchell Stammen farms full time and health insurance was extremely costly for his family. Photo provided by Michelle Stammen.

Mitchell Stammen farms full time and health insurance was extremely costly for his family. Photo provided by Michelle Stammen.

Another benefit of being part of these programs is that members are not penalized for not having insurance. Members need to complete IRS created Form 8965, which indicates what portion of the year they were a member of a health care sharing ministry. Health care sharing also satisfies the mandates of the federal Affordable Care Act.

Participation in the ministry does come with requirements of a Christian faith and lifestyle.

“Within the guidelines, they specifically mention that members agree to limit consumption of alcohol to moderate amounts and never drink to drunkenness, or cause another brother or sister in Christ to stumble,” Stammen said. “Members must be professing Christians who attend a Christian church regularly. They must agree to abstain from sinful practices such as drug abuse and sexual immorality. If you are in an accident because of drunkenness, you are unable to submit the bill. They must be accountable to a pastor or other Christian church leader for the needs they submit. To me, these are important morals to live by anyways, and we have no problem abiding by them.”

There are numerous options available that can offer different advantages based on the specifics of different families and situations. A very helpful resource (though some of the numbers are outdated) comparing some of the options can be found here: http://www.cchfreedom.org/pr/MEDICAL_SHARING_MINISTRIES-COMPARISON_CHART.pdf.

For many, health insurance may still the best option, but a growing number of people are looking into cost sharing health programs. There are many details to carefully consider, but for many families like the Stammens, health sharing has been a great fit.

 

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