By Jolene Bryant, Health & Welfare Services Advisor, and Kathy Binkley, RHU, ChHC, Health & Welfare Services Advisor at The Wilson Agency
With the advent of healthcare reform, the ability to find affordable healthcare options has been a lingering concern for many Alaskans. This is especially true for those that cannot receive coverage through an employer and/or those whose financial situation makes them ineligible to receive Medicaid or at the very least a reasonable subsidy on the Exchange. For those of you who’ve done the research, religious healthcare co-ops, also known as healthcare sharing ministries, have likely come up as an alternative option to traditional health insurance that meets the requirements of the new regulations under healthcare reform. Simply put: if you are part of a co-op, you may qualify for an exemption. Before you go running full speed ahead into a healthcare co-op, here’s what you need to know to determine whether a religious healthcare co-op is the right option for you.
In general, the concept of these religious healthcare co-ops is easy. A group of individuals who share the same religious beliefs join together to share the healthcare costs of its members. Members will decide which healthcare claims to cover and then all members will pitch in to help cover the costs of the claim. Since the costs are split between a large group of people, the individual responsibility remains relatively low. This number is typically lower than the cost of paying insurance premiums out of pocket. This is a major benefit of participating in a healthcare co-op. For individuals with strong religious convictions, a healthcare co-op has benefits that span way beyond financial. Members often receive community and spiritual support from other members and they do not need to worry about their money going towards procedures (such as birth control) that go against their religious beliefs.
On the flip-side, the coverage that healthcare co-ops provide is not as comprehensive as that of traditional insurance. For example, the co-ops in Alaska do not cover preventive benefits and pre-existing conditions. As a comparison, traditional insurance is required to cover all preventive benefits and cannot deny a claim based on pre-existing conditions. Also, since the ministries choose which claims to cover, there is always a chance that your claim will not get paid at all.
That being said, if you are a relatively healthy individual/family with no pre-existing conditions who is willing to abide by a code of conduct consistent with biblical values, then a religious healthcare co-op could very well be the right option for you. Keep in mind that these groups often have strict religious requirements for membership. Some require a letter from a pastor or church leader confirming that you are a member in good standing.
If you’re a good candidate for a religious healthcare co-op then you have two options for our State: Samaritan Ministries International and Christian Health Ministries. If a co-op isn’t the right option for you and you want healthcare coverage that will exempt you from paying the penalties, then you can sign up for a group health plan if available through your employer, sign up for coverage through the Marketplace, where you can receive a subsidy if available, or sign up outside the marketplace. Whether you sign up inside or outside the marketplace, it would be a good idea to contact a qualified advisor to assist you in this decision. Keep in mind, the cheapest option may not always be the best. Working with an advisor will help you determine what plan fits the needs of you and your family.
If you want to talk to a qualified insurance advisor, who can help you make an informed decision on your coverage options, contact The Wilson Agency at 907-277-1616 or email@example.com.