Health Care Sharing Ministries Comparison Chart

Transcription

1 ALLIANCE OF HEALTH CARE SHARING MINISTRIES HealthCareSharing.org Health Care Sharing Ministries Comparison Chart FOREWARD The Alliance of Health Care Sharing Ministries is an advocacy organization founded in 2007 by Christian Care Medi-Share and Samaritan Ministries International. Health care sharing ministries (HCSM) are nonprofit, religious ministries whose members share the financial, emotional, and spiritual burden of medical expenses. Health care sharing is not insurance, however participation in a HCSM satisfies the Affordable Care Act s requirement that individuals purchase insurance. The Alliance seeks to return health care to a private, patient-centered model. While fundamental, nonprofit principles of bringing Christians together to bear one another s medical burdens are adhered to by all of the health care sharing ministries, the sharing model each ministry uses to serve their members varies. This chart is intended to help demonstrate the similarities and variations between the member-ministries of the Alliance.

2 Founded in 1993 Headquarters: Melbourne, Florida MyChristianCare.org Founded in 1994 Headquarters: Peoria, Illinois SamaritanMinistries.org LEADERSHIP Board of Directors Majority of the Board of Directors are elected by the membership. GOVERNING Member-Directed Guidelines (majority vote) The Board of Directors are responsible for Guideline changes, though they may take an advisory vote from the membership on certain issues. A member vote is required to increase the monthly share amounts. SHARING OPTIONS (Monthly share amounts are determined by Family Status & Age) $120 One-time New Member Fee $200 One-time New Member Fee Singles ($21 - $393) Singles ($140 - $180) Couples ($33 - $594) Couples ($280 - $360) Single parent (Not Available) Single parent ($200 - $250) Families ($109 - $760) Family ($355 - $405)

3 INITIAL RESPONSIBILITY PER INCIDENT (Applies to all sharing options) Members pay all of their medical bills up to their Annual Household Portion (AHP). Once the AHP has been reached, 100% of all eligible medical bills are published for sharing. Members pay a non-sharable Provider Fee of $35 per office visit. ($135 Emergency Room) $300 for each incident. No limit on how many needs may be submitted within a year. If more than 3 needs are submitted within 12 months, the initial unpublishable amount of $300 is published for any needs after the first 3 needs. MAXIMUM AMOUNT SHARED (Ministries are considered secondary to other sources of payment) No limits on sharing $250,000 Per Person, Per Incident. No Yearly/Lifetime Limit. Members can electively participate in Save to Share for needs over $250,000. HEALTH STATUS Applicants who have a history of serious medical conditions may not qualify for membership. Some applicants may be required to complete a personalized health coaching program to improve their health conditions. Membership will not be refused on the basis of present or previous health status. Most pre-existing needs are not shared in the basic program- see guidelines for details regarding pre-existing conditions

4 ENTRANCE CRITERIA Must present a written Christian testimony indicating a personal relationship with Christ, abstains from illegal drugs, tobacco use and sex outside of marriage, and must not abuse legal drugs or alcohol. A born-again Christian, who affirms our statement of faith, regularly attends church, abstains from or moderately uses alcohol/ drinks in careful moderation, abstains from illegal drugs, tobacco use and sex outside of marriage. A pastor must sign a statement confirming applicant s qualifications. GUIDELINES ON PRE-EXISTING CONDITIONS (Share amounts are determined by Family Status & Age) Conditions that are not cured prior to membership are not published for sharing, unless the member has faithfully shared for 12 months and the condition had gone for 36 months without treatment or symptoms. However, there are some exceptions to the time limits and limits on eligible amounts for sharing. Pre-existing conditions are not normally publishable unless the member goes 12 months without symptoms or treatment (7 years for cancer, 5 years for genetic defects and hereditary diseases). However, no needs will be published related to pre-existing heart conditions and diabetes. However, many preexisting needs are published as Special Prayer Needs through our monthly newsletter and members are encouraged to send a suggested free will offering to the members with these needs.

5 sharing process WHO SUBMITS THE MEDICAL BILLS TO THE MINISTRY? Service Provider Patient/Member WHO NEGOTIATES DISCOUNTS ON MEDICAL BILLS? Contracted discounts per terms of the PPO network Member & Third Party Negotiating Group SHARING METHOD All members participate in the Member Share Exchange, which is a patented process for transferring funds from one member's bank account to another member's bank account. All accounts are held and administered at America's Christian Credit Union. Direct Sharing (members send checks to one another) WHAT HAPPENS IF YOU HAVE TOO MANY NEEDS AND NOT ENOUGH SHARES? If all published needs (in a given month) cannot be met, the unpaid needs are simply carried forward to the next month. (NOTE: the average time to share (pay) needs is used as a trigger to raise or lower monthly share amounts.) If all needs cannot be met, a prorating method may be used to evenly distribute the burden. Members may contribute extra monies (over and above their monthly share) to a Prorata Fund to help make up the difference.

6 WAITING PERIOD AFTER JOINING BEFORE A BILL CAN BE SUBMITTED Maximum $50,000 during first month of membership. No waiting period as long as the need is not pre-existing. AVERAGE TIME BETWEEN WHEN BILLS ARE SUBMITTED AND TIME NEED IS SHARED It takes days to publish a need after the bill is received from the service provider. It takes days to publish a need after patient submits bills. DO YOU HAVE A NETWORK OF HEALTH PROVIDERS?. MultiPlan PPO No. Members can see any licensed medical doctor. WHAT ARE THE RULES ON ACCESSING TREATMENT? Sharing of any medical expense is subject to ministry guidelines some exclusions include infertility expenses, suicide, preventive care, abortion, mental illness, etc. Sharing of any medical expense is subject to ministry guidelines some exclusions include infertility expenses, suicide, preventive care, abortion, mental illness, etc.

7 WHAT ABOUT ALTERNATIVE TREATMENT? Only in accordance with ministry guidelines or with prior approval. Anything legally prescribed by a licensed medical doctor in accordance with ministry guidelines, or with prior approval. WHAT ABOUT PRESCRIPTIONS? Prescriptions associated with a medical event are eligible for sharing, but limited to 6 months. Members with ongoing needs are provided a discount card to reduce the costs of their maintenance prescriptions. All inpatient prescriptions published; prescribed medication published only for one 60 day period for outpatient prescription; no publication of prescriptions for maintenance of chronic or recurring conditions. Members are given a prescription discount card. WHAT ABOUT NEEDS THAT CANNOT BE SHARED LIKE PRE-EXISTING, VISION, AND DENTAL? Needs that do not meet the Guidelines may be eligible for publication as Extra Blessings that members may voluntarily contribute to above their monthly share. Needs that do not meet the Guidelines may be eligible for publication as Special Prayer Needs that members may voluntarily contribute to above their monthly share.

8 LARGEST NEED SHARED (AFTER DISCOUNTS) TO DATE (As of March 1, 2015) $896,828 $717,742 CURRENT NUMBER OF HOUSEHOLDS BEING SERVED (As of March 1, 2015) 47,883 45,231 CURRENT NUMBER OF PEOPLE BEING SERVED (As of March 1, 2015) 135, ,424 AVAILABLE IN HOW MANY U.S. STATES? 49 (Not available in Montana) All 50 States TOP THREE STATES WITH MOST PARTICIPANTS (As of March 1, 2015) Texas, California, Florida Texas, Indiana, California

9 AVAILABLE OUTSIDE THE U.S.? AVAILABLE TO NON-U.S. CITIZENS? AVAILABLE TO MEDICARE RECIPIENTS? miscellaneous NUMBER OF TIMES MINISTRY WEBSITE STATES THEY ARE NOT INSURNACE? 8 unique web pages All page footers 23 unique pages NUMBER OF TIMES MINISTRY APPLICATION STATES THEY ARE NOT INSURNACE? 3 5

10 HEALTH CARE SHARING AND TAXES? The State of Missouri allows individuals to deduct amounts contributed to other members in a health care sharing ministry from adjusted gross income for state income tax purposes. All extra donations to specific charitable funds, made directly to the 501 (c) (3) health care sharing ministry, are tax deductible. Consult a tax professional before making deductions on any other state or federal income tax form. HEALTH CARE SHARING AND THE AFFORDABLE CARE ACT? Beginning in 2014, each year U.S. citizens must satisfy the individual mandate to purchase health insurance or potentially face a tax penalty. While health care sharing IS NOT insurance, participation in a recognized health care sharing ministry satisfies the requirements of the individual mandate. Members of health care sharing ministries demonstrate their exemption (see 26 United States Code Section 5000A, (d), (2), (b)) by using IRS Form 8965 when filing their tax return. Organizations comprising the Alliance are recognized health care sharing ministries by the Department of Health & Human Services. JOIN A HEALTH CARE SHARING MINISTRY If you would like more information about Christian Care Medi-Share please call or find them online at MyChristianCare.org If you would like more information about Samaritan Ministries International please call or find them online at mysamaritanstory.org