미국 주류 크리스천들에게는 오바마케어에서 인정받은 의료협동조합으로서는 현재 3개의 단체가 가장 활발하게 진행되어오고 있는데 이들은 크리스천 헬스케어 미니스트리를 최초로 해서 메디쉐어( Medi-share)와 사마리탄 인터네셔널(Samaritan International)이 있습니다. (최근에는 규모가 작았던 3개의 추가적인 단체가 오바마케어의 벌금면제를 받는다는 이유로 그 세를 넓히고 있음)

 

메디쉐어 (Medi-share)는 1993년부터 시작해서 미국 거주 시민과 영주권자만 가입이 가능합니다. PPO 네트워크를 사용하며 가족 수, 나이에 따라 비용이 달라 상조 프로그램 중 가장 보험에 가까운 형태를 띠고 있습니다. 회원에게 의료비가 발생할 시, 이 소식이 타 회원들에게 공지되고 회원들이 매달 정해진 금액을 납부하는 신용조합 계좌에서 의료비가 갹출(醵出) 형태로 지불됩니다. 가입비가 별도로 있습니다.

 

사마리탄 인터네셔널 (Samaritan Ministries)은 어떤 회원에게 의료비가 발생하면 각 회원들이 매달 납부하는 금액을 이 회원에게 전달되는 형식으로 상조가 이루어 집니다. 1994년 시작된 이곳은 세 단체중에서 제일 보수적인 성향을 띄고있어 매년 목회자로부터 신앙추천서와 본인의 신앙간증서를 제출해야 합니다.

 

크리스천 헬스케어는 세 단체중에서도 가장 한인들의 취향에 제일 적합하다고 생각됩니다. 월 비용면에서도 그렇고 운영하는 방법에서도 제일 합리적이라 하겠습니다. 표로 위 세 단체의 장단점을 비교한 표를 퍼왔습니다.

 

MEDICAL SHARING MINISTRIES (MSM) – COMPARISON CHART          (Rev. August 2013 with Rev. April 1, 2010)

(http://www.cchfreedom.org/pr/MEDICAL_SHARING_MINISTRIES-COMPARISON_CHART.pdf)

 

MINISTRY

Christian Care Ministry

(Medi-Share)

Christian Healthcare

Ministries

Samaritan Ministries

Start  Year

1993

1981

1994

FEES/PRICES

Average Monthly Price - Single

$273/mo

$45 - $150/mo

$120/mo

Average Monthly Price – Family of Four

$391/mo

$135 - $450/mo

$285/mo

Administrative Fee

Included in Monthly Share Amount, along with $2.65 per month for maintaining the individual bank account

None

Included in Membership fee

Membership Fee

$120

None

$200

Basis of Pricing

Age, unit, and initial member responsibility

Based on units and levels (Bronze, Silver, Gold)

Family status

Units

Single, Couple (2 persons), and Family (3+ persons)

Single (one unit), couple ( 2 units), family (3 units)

Single, Couple, Single Parent, Family

Price Levels

Varies by age at each category:

Single ($21 - $393)

Couple ($33 - $594)

Family ($109 - $760)

 

Bronze ($45) per unit,

Silver ($85 per unit)

Gold ($150 per unit)

Singles ($125 - $165)

Couples ( $235 - $315)

Single parent ( $180 - $230)

 Family ( $320 - $370)

Share of each medical episode before ministry pays (Individual)

$250 in MS250

$1,000 in MS1000

 $10,000 in MS10000

$500 for Gold

 $1,000 for Silver

$5,000 for Bronze

$300 for each incident for up to three incidents per calendar year

Share of each medical episode before ministry begins paying (Family)

$250 in MS250

$1,000 in MS1000

$10,000 in MS10000

$500 for Gold

$1,000 for Silver

$5,000 for Bronze

$300 for each incident.

Cap on Sharing

$1 million per individual per year; $5 million lifetime maximum

$125,000 per medical incident

Gold: Unlimited with Brother’s Keeper

$100,000 per person, per incident

EXCLUSIONS

Pre-Existing Conditions Policy

Conditions that are not cured prior to membership are not shared while a member, unless the member has faithfully shared for 12 months and the condition had gone for 36 months without treatment or symptoms. However, there are exceptions to the time limits and limits on eligible amounts for sharing

Costs for bills received to treat preexisting conditions can be shared on “Prayer Page” of monthly newsletter. Other members may voluntarily contribute above regular monthly gift to ministry.

“Pre-existing conditions are not normally publishable unless the member goes 12 months without symptoms of treatment. However, many pre-existing needs are published as Special Prayer Needs through our monthly newsletter and members are encouraged to send a suggested free will offering to the members with these needs.” However, no needs will be published related to pre-existing heart conditions, cancer, and diabetes.

Underwriting

“Applicants who have a history of serious medical conditions(s), who are significantly overweight or who are at significant risk for major disease may not qualify for Medi-Share membership…Failure to disclose medical or lifestyle information that might disqualify the applicant may result in future termination of membership and needs not being shared.”

None. Members not dropped or prices increased for sickness or age.

“As long as you meet the requirements in this section, membership will not be refused on the basis of present health status. However…we have chosen to publish for sharing certain types of needs and to not publish others.”

Entrance Criteria

Must have verifiable Christian testimony indicating personal relationship with Christ, attend and actively support a fellowship of believers, not engage in pre-marital or extramarital sex, and cannot use tobacco or illegal drugs. Must not abuse legal drugs or alcohol.

Must declare themselves to be Christians living by biblical standards & no tobacco is allowed

A born-again Christian who regularly attends church, abstains from alcohol or drinks in extreme moderation, abstains from illegal drugs, tobacco use and sex outside of heterosexual marriage. A pastor must sign a statement confirming applicant’s qualifications

ACCESS

Network

Yes. Penalties for using non-PPO providers

None

None

Access to Treatment

Members have voted to not share expenses for a list of specific services and conditions listed in their Guidelines.

Non AMA treatment for conditions, chiropractic, cosmetic surgery excepting as a result of accidents or for surgical reconstruction

Guidelines list “Miscellaneous Items Not Shared” including infertility expenses, suicide, preventive care, abortion, mental illness, etc.

Access to alternative treatment?

Only if pre-approved in accordance with Medi-Share guidelines.

AMA approved treatment

Only with prior written approval from MSM, “though almost all needs from which the member is able to demonstrate a comparable or lower cost to standard treatments are published.”

Available to Medicare recipients?

Sharing limited to $50,000 per year and based on difference between Medicare’s allowable charges and the actual payments made by Medicare. Medicare enrollment required.

Yes, but must be enrolled in Medicare parts A and B.

Yes

Prescriptions

“ScriptSave” prescription discount card

Partners with companies that offer discounts on prescriptions. A free prescription card is available for interested members.

All inpatient prescriptions published; prescribed medication published only for 60 days from first prescription; no publication of prescriptions for maintenance of chronic or recurring conditions.

SHARING

Largest Need Shared

$661,421 (cancer)

$1.6 million

$1,292,769.26 (as of Dec 31st 2008)

Total Payments Shared to date (12/31/08)

$345,000,000

>$500,000,000

$169,012,243.88

Total Bills Submitted to date

Approx. $90,000,000

>$1,000,000,000

$412,600,584.02 (as of Dec 31, 2008).

SERVED

Total # of Households Served

12,291

35,000

13,068

Total # of Individuals Served

>38,000

80,000

41,768

Current # of Individuals Served

35,700

Approx. 25,000

42,821

STATE STATS

Serving in how many States

49 (not Montana)

50

50

States where insurance department is making operations difficult

Illinois, Oklahoma

None

None

State with most subscribers/members

Texas

Ohio and Texas alternate

Indiana

State with least subscribers/members

Rhode Island

Rhode Island and Hawaii

D.C., Guam, Virgin Islands, Puerto Rico, Hawaii

PAYMENT PROCESS

Waiting period after joining before a bill can be submitted

30 days, except for accidental injuries

45 days, except for emergencies

90 days

Average wait before payment begins after a bill is submitted

CCM does not pay members’ bills; it facilitates matching a member’s bill with other member(s) who give their monthly share. From the date a need is approved for sharing, it takes 60-90 days for the bill to be paid by other members. Approval process itself takes approx. 30 days

“In general, eligible medical needs are shared by CHM members in the order they are received at the [CHM] office”

It takes 30-60 days to publish need after patient submits bills to MSM

Bill submitted to MSM by whom?

Doctor/Hospital

Patient

Patient

Payment method

Members pay MSM via an individual account with America’s Christian Credit Union

Member gifts are placed into a Member Escrow Account. DE & MD members send payment elsewhere

Directly to member in need, as directed by the Christian Health Care Newsletter

OTHER INFO

Share Payment Tax Deductible as Donation, or Medical or Insurance Expense?

No, except in Missouri where the amount is deductible from state income taxes.

Monthly gift amount is not tax deductible, however, all “extra giving” above the minimum monthly gift qualifies as a charitable contribution.

No, except in Missouri where the amount is deductible from state income taxes. However, all ‘extra donations’ (such as Special Prayer Needs…) made through the office as a 501©3 ministry are tax deductible.”

Extra Sharing Gifts from members

Monthly publication lists members with need ineligible for sharing. Extra Blessing Gifts can be sent directly to members on the list, or sent to the ministry where they are distributed monthly on prorated basis

Members regularly send the ministry extra gifts, ranging from $5 to $10,000.

Needs that do not meet the Guidelines may be eligible for publication as Special Prayer Needs that members may give to.

Balancing Needs with Available Sharing Dollars

“If approved needs exceed the shares submitted by members in a particular month, then the time to share needs may grow slightly. This has happened one month out of the last 12, so the time to share has been dropping. Ultimately, if the length of time to share a need grows, then the monthly share amounts are increased.”

“We pay all eligible needs submitted for sharing. A larger amount of bills presented can cause the stream to go slower but we are committed to sharing all eligible needs.”

“If all needs cannot be met, we use a prorating method to evenly distribute the burden.”

Negotiated Discounts by MSM or member?

Member and MSM

Member; Use of MSM Reductions Department

Member, and “The Karis Group” a third party bill negotiation ministry

Other programs

Guided Care Department, a wellness program (Restore) and a disability sharing program (Manna)

Brother’s Keeper Ministry to meet catastrophic needs beyond $125,000, up to $1 million (if contribute approx. $100 extra per year for nine years) Prayer Page for help with pre-existing conditions

“Save to Share” for needs above $100,000; Samaritan MV (motor vehicles) and a sponsorship program for those unable to pay full share and annual fee.

Leadership

Board of Directors

Board of Trustees

Board of Directors

Rules

Members vote on Medi-Share Guidelines.

Members in the early years made the rules. Now that the rules are set, Trustees approve adjustments based on policy and mission.

“The board of directors...is responsible for guideline changes, though they may and have taken an advisory vote from the membership on certain issues. Also, a member vote is required for monthly share changes and guideline changes that would significantly affect the monthly share.”

Location

Florida

Ohio

Illinois

Website

www.medi-share.org

www.chministries.org

www.samaritanministries.org

Phone

800-772-5623

800-791-6225

888-268-4377

 

 

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