Emmaus family talks about their health care.
A Baptist missionary, Nat Williams has no trouble putting his future in God's hands.
But when it came to his family's medical care, enrolling in Samaritan Ministries' health care cost-sharing group instead of traditional insurance took a special leap of faith.
The plan came recommended by fellow missionaries who said it was effective overseas, where using health insurance can be dicey.
Before Williams and his wife, Anne, could leave Emmaus for Thailand, Anne got pregnant, putting their coverage to the test here at home. The plan ended up covering all but $300 of the Williamses' maternity and delivery bills, even after doctors at St. Luke's University Hospital had to perform a cesarean section to deliver their son, Paul, last year.
"I've been very pleasantly surprised with what Samaritan Ministries has covered," Williams said.
The nonprofit health care sharing ministry is one of a handful of faith-based cost-sharing programs operating nationwide. Their members pay a monthly membership "share" that is often less than a comparable health insurance premium.
The plans are not insurance and aren't subject to most state regulations but their popularity is rising because the Affordable Care Act specifically exempts their members from Obamacare's controversial individual mandate. That's the requirement that everyone obtain health insurance or pay a tax penalty that starts at $95 in 2014, and in 2016 will hit $695.
True health insurance plans start with capital reserves, guarantee certain coverage and charge members a monthly premium based on their actuarially evaluated claim risk.
Health care sharing ministries simply take healthy members' monthly share payments and redirect them to other members with health care expenses. Members often know whose expenses they are sharing, and are encouraged to pray for and encourage them.
Based on the principle that Christians should rely on each other rather than a faceless corporation, the three largest health-sharing ministries also require members to make a statement of Christian faith, promise to lead healthy lives, attend church, abstain from extramarital sex and avoid alcohol and drug abuse.
They don't cover medical procedures such as abortion or the morning-after pill, and exclude a variety of other maladies and treatments such as drug rehab. Get hurt while committing a crime or participating in a riot, and one ministry won't pay your medical bills, according to its enrollment literature.
Most members have to pay out-of-pocket for everyday services such as doctor's office visits, vaccinations and minor blood tests. Some include annual deductibles, which are referred to as the annual household portion or the personal responsibility.
Williams said his main reasons for signing on with Samaritan Ministries were practical, but that it was nice to know he was part of a like-minded community of Christians bearing each others' health care burdens. That's what really sets the plans apart.
"The whole model to be able to share expenses was very encouraging to us," he said. "That is a principle we can find in the Bible and a good decision of faith."
The plans promote themselves as a Christian alternative to health insurance, citing Bible verses like this one, found in Galatians: "Bear one another's burdens and so fulfill the law of Christ."
But insurance industry experts say that while health care cost-sharing ministries may work for some people, consumers need to know a few things before they enroll.
Coverage concerns
The plans bill themselves as a substitute for health insurance but they are rarely subject to oversight by state insurance regulators and aren't required to have financial reserves to cover catastrophic illnesses. They don't cover all medical procedures and can reject expenses related to preexisting conditions.
Most have a cap on reimbursement and are under no legal obligation to cover members' health care costs.
"People are trying to do whatever they can to lower the cost of health care, they are looking to a lot of avenues to do that," said Tom Croyle, president of the Lehigh Valley Business Coalition on Health Care. "What concerns me about these arrangements is there is really no guarantee of payments, they are really outside of regulation."
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