Health sharing ministries, commonly referred to as medishare plans, have grown in increasing popularity in recent years as traditional healthcare insurance plans have seen their costs rise dramatically. The Affordable Care Act (ACA, also referred to as ObamaCare) also led to an increase in medishare participation for a number of reasons. Regardless of political affiliation, the majority of people joining health sharing plans are typically just looking for a more affordable way to pay for health care, especially in the context of unexpected or catastrophic medical expenses. In this article, we’ll look at how these plans work, some of the most popular plans and also some personal medishare reviews. The goal of this article is to give you, the reader, a solid understanding of these options and help you decide if one of these plans is right for you and your family.
While a wide range of information is in this article, some individuals prefer the medishare reviews at the end of the article to get real world, anecdotal insight from existing members of these programs. Be sure to check them out.
- How do Medishare Programs Work?
- Are Health Sharing Plans Cheaper Than Health Insurance?
- Overview of Popular Programs
- Which Program is Right For You?
- Common Questions
- Member Reviews
How do Medishare Programs work?
The general premise behind these programs is that members agree to share medical expenses. Members agree to a certain amount to pay into the system each month (similar to an insurance premium) that helps other members pay for medical bills. Like regular insurance, the amount you pay is determined by some personal information such as age, whether it covers just you individuals vs. your family also, the degree of “coverage” you want, etc. Some plans will have you send checks each month directly to other members (they tell you who and how much), and others have you send the money into a central office that distributes the money.
The biggest key here is that this is not insurance. There is no contractual obligation to pay anything. There’s no recourse if you don’t get money for something. While this eliminates this kind of plan for a segment of the financially prudent public (understandably), it’s worth considering that many of these plans have been successfully operating for decades through a number of economic cycles, and generally, they work well. Medical bills, even large ones, are paid for. The programs would have already fallen apart years ago if they didn’t work well.
Are Health Sharing Plans Cheaper Than Health Insurance?
Typically, yes. If they weren’t, most people would opt for traditional insurance. For an example, I can say that personally, I was paying $1,500-$2,000 in monthly premium for an average health plan for my family (wife plus four kids). Under the Samaritan Ministries health sharing plan, I pay around $500 a month.
How is it cheaper? There are a few reasons why these plans are cheaper when compared to traditional health insurance:
- These plans have stricter controls over what is covered, and this often includes not covering preexisting conditions. Now, they cover a very wide range of health needs (personally, I’ve been reimbursed medical expenses that span these areas: vision therapy, eye surgery, lung tests, getting the flu, hernia surgery), and each plan typically has a large guide you can review that details what is covered and what is not covered. In general, cosmetic or purely elective procedures are not covered, and preexisting conditions are not covered. So, these plans tend to attract a more healthy demographic (essentially the group of people who get “screwed” the most by traditional health insurance).
- For some plans, wellness stuff isn’t covered. So, you’re coming out of pocket for straight forward checkups. This keeps the costs down systemwide.
- For some plans, there’s a level or threshold that isn’t covered until you hit it. For example, under my Samaritan plan, I pay cash for everything until I hit $300 for something. For many sick visits or wellness visits, it’s under $300, and it never hits the wider network. I eat those costs.
- They aren’t for-profit businesses. There is no profit incentive. Everything is designed around optimizing for paying for people’s medical bills. Some plans don’t even collect your money, but rather you send it directly to other members in need. This keeps overhead down and costs down.
- For some plans, there are additional levels of accountability that hedge against fraudulent activity. The more religious-centric plans will sometimes require a pastor to sign off on your general lifestyle and membership at a church. Or, a pastor sometimes will have to sign off on various expense reimbursement requests. While this might seem odd to some folks, this helps prevent fraud which keeps costs down for everyone.
- The incentives are aligned. Many plans incentivize you to negotiate better deals, and/or the company itself will help negotiate major expenses. From the individual members to the company itself, everyone is incentivized to reduce costs and negotiate lower fees. This is a very underrated element of these plans that frankly doesn’t exist in traditional health insurance. Very few people will actually “shop” a medical expense when they’re covered by health insurance. The way medishare plans are structured encourages this kind of cost consciousness.
Overview Of The Most Popular Health Share Programs
These are some of the most popular medishare companies that are sharing medical needs of their members. Included are some reviews that hopefully will help you with choosing the right program.
For years, Samaritan only had one option, but now they offer a second plan. The two plans are Classic and Basic. Here’s the outline of each:
- Eligible expenses are covered 100% up to $250,000 per need, not including the first $300. However, if you show a negotiated discount (almost always possible for anything of decent size when you’re paying cash), you’ll get the first $300 covered as well.
- You pay anywhere from $150 to $500 per month depending on your age and number of dependents.
- Eligible expenses are covered 90% up to $236,500 per need, not including the first $1500. Note that maternity has a much lower limit for Samaritan Basic.
- You pay anywhere from $100 to $400 per month depending on your age and number of dependents.
Samaritan’s Save to Share Program:
- Samaritan addresses catastrophic needs that exceed the $236,500-$250,000 limit by providing an additional “Save to Share” Program. If you participate in this program, you’re eligible to be reimbursed for the catastrophic events that exceed the limits of the normal plans.
- Participation in this plan costs $100-$400 per year depending your size family.
Other important information about Samaritan Ministries:
- If you use Samaritan, you pay your medical expenses directly, then submit the need with copies of the bills to the Samaritan office (through the web interface typically).
- Members send payments directly to other members, rather through a central office, each month.
- There are faith-based membership requirements. You can examine their membership guidelines to see these in detail.
- Samaritan Ministries was started in 1994 and reportedly has over 200,000 members.
- Samaritan Ministries has restrictions on preexisting conditions.
You can learn more about Samaritan Ministries at their website. Keep reading to view the medishare reviews pertaining to this program and other programs at the end of the article.
Medi-Share is another program that has been around for a few decades. It has a slightly more complex pricing/membership structure compared to the other plans. The membership options are mostly dictated by the size of your family and the age of the oldest participant. Then, the membership varies based on the “Annual Household Portion” (or AHP as they call it). The AHP refers to how much money you pay out of pocket before you’re reimbursed for expenses (similar to a deductible in insurance). Lastly, Medi-Share will then even break out the costs separately for those who are deemed “healthy” according to a few health standards.
The Health Incentive which can reduce your cost is based on meeting criteria concerning blood pressure, abdominal circumference, BMI and more.
Let’s look at some examples so you can see how it works.
A single, 22-year old member
- If opting for a $1,000 AHP, the monthly payment is $198. The “healthy” monthly payment is $178.
- If opting for a $5,550 AHP, the monthly payment is $105. The “healthy” monthly payment is $97.
- If opting for a $10,500 AHP, the monthly payment is $57. The “healthy” monthly payment is $51.
A married, 28-year old member (with spouse covered)
- Option not given for a $1,000 AHP level.
- If opting for a $1,750 AHP, the monthly payment is $451. The “healthy” monthly payment is $394.
- If opting for a $5,500 AHP, the monthly payment is $224. The “healthy” monthly payment is $200.
- If opting for a $10,500 AHP, the monthly payment is $112. The “healthy” monthly payment is $99.
A married, 40-year old member with two kids (entire family covered)
- Option not given for a $1,000 AHP level.
- If opting for a $1,750 AHP, the monthly payment is $909. The “healthy” monthly payment is $753.
- If opting for a $5,500 AHP, the monthly payment is $485. The “healthy” monthly payment is $485.
- If opting for a $10,500 AHP, the monthly payment is $286. The “healthy” monthly payment is $237.
A married, 55-year old member (with spouse covered)
- Option not given for a $1,000 AHP level.
- If opting for a $1,750 AHP, the monthly payment is $846. The “healthy” monthly payment is $732.
- If opting for a $5,500 AHP, the monthly payment is $528. The “healthy” monthly payment is $448.
- If opting for a $10,500 AHP, the monthly payment is $357. The “healthy” monthly payment is $298.
Other important information about Medi-Share:
- The company has been operating since 1993 and has over 250,000 members.
- Members pay their monthly share amount directly to Medi-Share.
- When obtaining medical services, members pay the office co-pay and give their Medi-Share card to the provider who bills Medi-Share. The Medi-Share team will then send the bill back to the member if the AHP is not met. If the AHP is already met, the need will be eligible for sharing amongst other members and Medi-Share will pay the provider out of various member accounts.
- Medi-Share has restrictions on preexisting conditions.
- Medi-Share has faith-based membership requirements.
- Medi-Share has a senior-based membership option to be paired with existing Medicare plans.
You can learn more about Medi-Share at their website. Keep reading to view the medishare reviews pertaining to this program and other programs at the end of the article.
Liberty Health Share
Liberty has three tiers of membership with a more simple structure as compared to Medi-Share. But with slightly more options as compared to Samaritan Ministries. The membership options are as follows:
- Up to 70% of eligible medical bills are shared up to $125,000 per incident, after the “Annual Unshared Amount” is hit.
- Annual Unshared Amount is $1,000 for individuals, $1,750 for a couple and $2,250 for a family.
- Single members under 30 pay $199 per month. Single members over 30 pay $249 per month.
- Couple members under 30 pay $299 per month. Couple members over 30 pay $349 per month.
- Families under 30 pay $429 per month. Families over 30 pay $479 per month.
- 100% of eligible medical bills are shared up to $125,000 per incident, after the “Annual Unshared Amount” is hit.
- Annual Unshared Amount is $1,000 for individuals, $1,750 for a couple and $2,250 for a family.
- Single members under 30 pay $224 per month. Single members over 30 pay $274 per month.
- Couple members under 30 pay $324 per month. Couple members over 30 pay $374 per month.
- Families under 30 pay $454 per month. Families over 30 pay $504 per month.
- 100% of eligible medical bills are shared up to $1,000,000 per incident, after the “Annual Unshared Amount” is hit.
- Annual Unshared Amount is $1,000 for individuals, $1,750 for a couple and $2,250 for a family.
- Single members under 30 pay $249 per month. Single members over 30 pay $299 per month.
- Couple members under 30 pay $349 per month. Couple members over 30 pay $399 per month.
- Families under 30 pay $479 per month. Families over 30 pay $529 per month.
Other important information about Liberty Health Share:
- Liberty has been operating since 1995 and has over 125,000 members.
- Liberty encourages wellness by offering members some reimbursement for wellness visits (not something offered by Samaritan or Medi-Share).
- Liberty also works with members who have issues such as diabetes, high cholestoral or are smoker by putting them in a HealthTrac coaching program (comes with an additional fee).
- Liberty is similar to Medi-Share in how they handle medical bills. Members do not send payments directly to other members as Samaritan members do.
- Liberty has more restrictions on medical providers, where Samaritan and Medi-Share basically let you goto any provider.
- Liberty has looser faith guidelines pertaining to membership as compared to Samaritan and Medi-Share.
You can learn more about Liberty Health Share at their website. Keep reading to view the medishare reviews pertaining to this program and other programs at the end of the article.
Which Medishare Program Is Best For You?
Be sure to analyze the above program overviews for the top 3 health sharing providers, then also review the membership and sharing guidelines that each company has available on their websites. To help you narrow down your options, here are some things to consider:
- Of the three programs listed above, Samaritan has the lowest threshold you have to hit before expenses are shared. Samaritan’s first $300 is not covered. However, based on personal experience, if you negotiate a discount and show this to Samaritan, they waive this restriction and even the first $300 is covered. Note that wellness visits aren’t covered and aren’t “contributing” towards some type of deductible being hit. The $300 is per incident.
- Of the three programs listed above, Samaritan is the only program with the extra catastrophic “coverage” add-on available. Samaritan’s Save to Share program lifts any cap on expense reimbursement.
- Of the three programs listed above, Liberty is the only program that offer reimbursement for wellness visits and services.
- If you’re young and healthy with no dependents and are looking for lowest cost possible while getting catastrophic coverage, Medi-Share probably is most cost effective.
- Of the three programs listed above, Medi-Share is the only program that offers discounts for the especially healthy members.
- Of the three programs listed above, Liberty seems to have the loosest restrictions regarding faith-based membership guidelines as well as the loosest restrictions (though they still have some) on preexisting conditions.
Aren’t my services going to cost more now that I’m not getting insurance-negotiated reduced rates?
Based on my personal experience, I’ve found this to be the exact opposite of reality. For my routine stuff like annual physicals or sick visits, I called my existing doctor (and my kids’ existing doctor) and got price quotes on all the routine stuff that we use from time to time. I found that essentially every visit that we’ve done was under $100 each when paying cash. Additionally, I have a daily thyroid prescription I take so I was curious what that would cost. It was about $15 per month.
Now, over time, we’ve incurred some larger items. My son had eye surgery. Every step of the way, the provider had a price, then a significantly discounted cash price. For instance, the surgeon fee was about $2,000 (50% off the standard rate). The medical facility was about $1,000. The anesthesiologist quoted $1,200 (60% off the standard rate). My wife’s hernia surgery all-in was about $8,000 when you added up the physician, facility and anesthesia bills. Several were discounted by paying cash.
I had a chest x-ray done to just check out a few things. I figured it’d be a few hundred bucks. It was $40 because I paid cash. I had an EKG done at a hospital. For cash payers, it was $200.
This is just my experience. Do your own due diligence. Call around to your providers and ask about routine pricing for cash payers or medishare program payers.
What happens if there just isn’t enough money from members to cover the members’ shared expenses?
Since there is no contractual obligation, this is a very good question. Before signing up for a program and foregoing traditional insurance, you should ensure you understand how this scenario is handled by whatever program you’re considering.
At Samaritan Ministries for example, there is a prorated system in place if the needs exceed the available funds. From their guidelines: “For example, if $1,000,000 in total needs are to be shared in a given month, but only $900,000 in shares are available, we will take the percentage of shares as compared to needs—900,000/1,000,000 = 90%—and apply that percentage to each need. Thus, we will share 90% of the normal shareable amount of each need presented for that particular month. If you have a need for which $1,000 would normally be shared, $900 would actually be shared that month.”
The unshared portions of needs will carryover one month at Samaritan and potentially be shared that month. They typically don’t carry it over more than one month. If you negotiated discounts on your bills, that discount will be applied toward the prorated amount, so you can essentially still have the full bill paid for in this scenario. Typically, programs like Samaritan, should this event occur in consecutive time periods, they’ll consider raising the “premium” or the monthly payment of the members to bring a better level of equilibrium.
When researching a program, ask them how often this has occurred in the last five years.
What happens if there is more money from members than is needed to cover the needs of members?
Again, speaking from my experience with Samaritan, the monthly payment will actually be reduced in the scenario where less money is needed.
Does membership in a health sharing ministry program equate to health coverage as defined by the ACA law?
Yes, health sharing ministry programs are a defined exception to the ACA law meaning you will not be fined/taxed as a result of not having sufficient health insurance/coverage.
Are health sharing ministry payments (“premiums”) deductible?
This is a gray area. I’ve seen CPAs say it’s completely acceptable to deduct this “premium” amount from self employment or business income. Not everyone agrees on this. Talk to your accountant.
Medishare Reviews: What Members Are Saying
My personal review of Samaritan Ministries:
In addition to some of the comments made in the above sections of this article, I’d say that overall, I’m exceedingly pleased with Samaritan Ministries. Being overly conservative, I was very skeptical of joining this type of program. It made me nervous to not have true insurance. After researching for over a year, I pulled the trigger, and it’s been a great option for us.
One interesting event was when my son needed vision therapy. Under our previous traditional insurance plans, this would actually not have been covered. But Samaritan covered it in its entirety. It was $3600 in total. I paid upfront to get a 15% discount, and this eliminated the $300 unshareable amount, so the total vision therapy charges were completely covered!
One item that isn’t discussed often in this category is that you might need to have some cash handy to cover bills and then wait a few months before reimbursement. Obviously, in a catastrophic scenario, if you owe tens of thousands or more, you can setup a payment plan with the hospital which will help you on the timing of collecting reimbursements from the program (which can take a few months at times).
The other specific piece of advice I have is get good at record keeping and in asking for cash pay discounts. You’ll need itemized statements and complete receipts to expedite reimbursements.
Samaritan Ministries review by Cortney at AntiCancerMom.com:
In most cases in 5 years, we have NOT had to pay our $300 due to self-pay discounts we asked for. This was confusing at first for me, so I’ve included examples of what I’m talking about in my need experiences below. Many doctors offer discounts for self-pay because it saves them money not having to go through the insurance company and they get their money more quickly.
To help with this, my husband and I have a small savings account to “self pay” up front with enough money to “float” our medical expenses until shares begin to come in within 6 weeks. I strongly recommend doing this if you can as it will save you and the ministry money.
Here’s a rundown of our various “Needs” and how life has kept us and Samaritan busy over the past 5 years
Headaches from TMJ/ Teeth Grinding:
Total cost: ~$600
We only paid ~$40 after we asked for a ~$260 discount from our family dentist for self-pay and documented it when we submitted our need paperwork with Samaritan (simply an itemized bill showing the discount.)
Although routine dental care costs are not shared, medical conditions whose root cause requires the care of a dentist IS covered.
A new mouth guard and learning new stretches helped me immensely with this problem.
Total cost: $4,126
Samaritan covered 100%, we paid $0 because members pay no personal responsibility for home birth since it helps reduce costs for the ministry. Hospital births have a $300 responsibility total which is still significantly reduced from insurance!
Samaritan Ministries review by Jill Savage:
We’ve been so pleased with our decision to leave behind health insurance, replacing it with a health sharing plan. If you’re struggling with affording health insurance and are looking for a different way to handle your healthcare needs, we highly recommend Samaritan Ministries.
More than 250,000 Samaritan Ministries members share over $26 million per month in medical needs directly, one household to another, without using health insurance. It’s a healthy, stable, Christ-honoring ministry that has figured out how to harness the power of community!
If you’re thinking about making a change and have any questions, please ask! We’d love to help you determine if this could be a good option for your family.
Medi-Share review from ESIMoney.com:
Medi-Share lets you get out of the health insurance market. By enrolling in the Medi-Share program, you meet the requirements of the mandate for individual health insurance. There is no penalty to pay due to Obamacare or opting out of having health insurance. Or, if your income level excludes you from receiving subsidized Obamacare health insurance on the marketplace exchanges, Medi-Share may be a good choice for you and your family.
The biggest advantage of Medi-Share may be the cost savings that you and your family receive versus traditional healthcare insurance. Healthcare expense cost sharing through Medi-Share is typically a much cheaper alternative to the health insurance exchanges and high-deductible health insurance plans, if you can find those plans at all.
Medi-Share is accountable. The program’s members vote on the guidelines that govern what the program covers and how it runs. The program is based on biblical principles. It’s not about charity. There are other ways to give if that’s your aim. Instead, it is simply about sharing amongst believers. Additionally, there is a sense of community, which often includes prayer for the sick and medical expenses at a time you probably need it the most.
There are a few disadvantages of the Medi-Share program that you need to be aware of before you sign up.
Medi-Share is not a health insurance company, and you aren’t currently able to participate in a Health Savings Account (HSA) through the program. HSAs require you to have a high-deductible health insurance plan to join, which is not a part of the program. Likewise, there is no annual tax deduction for contributing to an HSA since Medi-Share doesn’t count as one.
Also, you cannot deduct your monthly share costs from your taxes. Your Medi-Share contributions are not tax-deductible. But, you can still deduct medical expenses if you itemize if you reach the proportion of your adjusted gross income.
Liberty HealthShare review by Chonce at mydebtepiphany.com:
As you can probably already assume, I decided to opt out of the ACA and enroll in Liberty HealthShare this year. A few months back, a reader asked me to provide a review about this particular healthcare option so I’d thought it was I’d give my honest opinion about the program in this review.
While the monthly fee or ‘premium’ is low and manageable for me, I love the flexibility of the coverage. I can’t name off every little medical expense in this post, but when I signed up I received a detailed list of the services and incidents that were covered under Liberty Health Share and it’s very similar to a private insurance company if not better. Members receive a free wellness check up. Hospital stays, medical tests and x-rays are all covered.
As I member, I can also choose which doctor or facility I want to go to. With an HMO or PPO I’d be subjected to finding a doctor within that specific network. Now I have the option to choose a quality care provider as long as the practice accepts my health share card. I was happy to receive a discount card for prescriptions and I’m sure you know this frugal woman loves a discount.
It seems like I signed up at the right time because before this year, it was a requirement that you maintain a membership for at least 60 days before you could utilize your sharing benefits (this meant no wellness checkups or any medical expenses for that manner would be covered during the first 60 days). Now that they got rid of that stipulation in 2015, I was able to utilize my sharing benefits as soon as I signed up.
I also like how the annual unshared amount or ‘deductible’ is so low. I signed up thinking All I have to do is cover my medical expenses up to $500 then they will cover the rest no matter what is is, as long as it doesn’t exceed $125,000. I’m aware that some serious medical expenses do exceed $125,000 so the best option would be to go with Liberty Complete just to be safe. If I continue my membership, I will certainly consider upgrading next year but I just wanted to try it out for now.
Despite my AUA being so low, I still haven’t had the time to save up $500 as needed (sad I know, but these bills….). Recently, I had to go to the doctor and was required to take a few more tests. I also ended up in the emergency room last week due to really bad back pains that I just wanted to get checked out early on. I realized that I needed to hurry up with my AUA if I wanted to avoid medical bills.
Then I made a big decision. I had about $1,000 sitting around from my tax refund that I desperately wanted to throw on my student loan balance this month. I chose to only put $500 on my loans and put the other $500 in a savings account to use for my AUA. That way, I wouldn’t have to worry so much about how much the extra tests and a follow up appointment might cost me if I hadn’t payed my AUA. I knew I made the right decision because my health and wellbeing will always be more of a priority than my debt payments and financial goals. At the end of the day, money is just money and what you truly need in order to enjoy your life and your loved ones is your health.
Medi-Share review from Debt Free Dr:
Escape the current health insurance market. If you’re like me – self-employed and making a solid income – the implementation of Obamacare more than likely caused a major toll on you financially. For me, it took away my low-cost, high-deductible health insurance plan for my family.
I used to pay $480 a month for a $12,000 HSA deductible policy. Obamacare took that away and replaced it with a $1596.00 a month plan.
Medi-Share allows you to finally have a legitimate alternative. Words cannot express the gratitude I have of being able to leave the system and not having to face a penalty or high premiums for the rest of my life.
The biggest advantage of Medi-Share may be the cost savings that you and your family receive versus traditional healthcare insurance. Each family contributes a monthly specific dollar amount they choose based on program options.
Medi-Share is accountable. The program is based on biblical principles. It’s not about charity. There are other ways to give if that’s your aim. Instead, it is simply about sharing amongst believers. Additionally, there is a sense of community, which often includes prayer for the sick and medical expenses at a time you probably need it the most.
Affordable Care Act (ACA) exempt. Medi-Share members are exempt from the individual mandate clause of the Affordable Care Act, which means that members are not subject to the penalty associated with not carrying insurance.
No Termination. Medi-Share membership cannot be terminated for developing a medical condition.
No annual or lifetime limits. Medi-Share will never impose any annual or lifetime limits as long as you are a member.