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Navigating HCSMs

By: Ernie Neve

As we continuously seek the best health care solutions for our clients, I want to introduce you to an alternative that may align with your financial goals and personal values: health care sharing ministries (HCSMs).

 

HCSMs are not your typical health insurance. They are non-profit organizations that enable members with shared religious or ethical beliefs to collectively share medical expenses. This approach is rooted in principles of community and charity, and it operates outside the conventional health insurance framework.

 

Financial benefits. Often, HCSMs offer lower monthly costs compared to traditional health insurance premiums. While contributions to HCSMs aren’t tax-deductible, for many, the significant savings in monthly expenses outweigh the tax benefits.

 

Membership requirements. HCSMs may base membership on adherence to lifestyle choices and ethical beliefs, including restrictions on tobacco and illegal drug use and, in some cases, regular church attendance.

 

Contribution structure. Unlike standard health insurance, HCSMs have contributions instead of premiums. Contributions are generally more affordable and pooled to share members’ medical expenses.

 

Coverage limitations. It’s important to note that HCSMs are not required to cover certain services mandated under the Affordable Care Act, such as preventive care or birth control.

 

Regulatory status. Federal regulations under the Affordable Care Act, ERISA, or HIPAA do not apply to HCSMs. Similarly, state insurance regulations do not apply to HCSMs. The lack of regulations means there’s no federal or state guarantee of coverage.

 

Despite the differences from traditional insurance, many find HCSMs a worthwhile option, especially considering the lower monthly expenses and the flexibility in service selection and doctor choice.

 

If you want to discuss HCSMs, please call me on my direct line at 610-278-8400.