QUESTION

What are health care sharing ministries? What are the risks and benefits of signing up for one?

Individuals with no coverage | Coverage Outside the Marketplace |
ANSWER

It is important to understand that a health care sharing ministry is not health insurance and will not provide the kind of financial protection you can obtain through a health plan on the health insurance Marketplace. Membership in a ministry does not guarantee that you will be reimbursed for your medical bills. Typically, health sharing ministries operate by having all of their members pay a monthly “share” or fee. Those fees are then used to pay other members’ medical bills, if they qualify and if the reason for needing care was not due to behavior deemed unacceptable for members.

Health care sharing ministries do not have to comply with the consumer protections outlined in the Affordable Care Act, and many states have exempted them from the state’s insurance laws. Consumers are at greater financial risk in these programs than they would be in traditional insurance. In particular, if there’s a dispute between you and the heath care sharing ministry about covered benefits, or if you’re having trouble getting your medical bills paid, you have no right to appeal to an independent reviewer to overturn the health care sharing ministry’s denial, a right you would have with individual health insurance. (26 U.S.C. § 5000A, 45 C.F.R. § 147.136.)

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