CASPER
New member
The brain tumor came back. An ugly mass growing in plain view threatened Karen Niles' remaining eye. She needed more surgery.
This time, however, her medical plan wouldn't pay.
It sounds like one of those insurance "horror stories" that President Barack Obama hammered home during the fierce debate to pass his health care overhaul. Except Niles' plan ended up as the beneficiary of a rare exemption to the new law — a waiver highlighted in the plan's promotional materials.
The plan didn't come from an insurer, but from a religious "health care sharing ministry." Consumer advocates call them a gamble.
These plans successfully lobbied Democratic lawmakers to free their members from the requirement that everyone in the country have health insurance.
"Christians are exempt from insurance mandates," Niles' old plan, Medi-Share, says on its website. Sharing ministries are "the only organized health care concept to receive a special exemption from the taxes, penalties and regulations" that the law imposes on insurers, the site says.
Medi-Share members affirm a statement of Christian beliefs and pledge to follow a code that includes no tobacco or illegal drugs, no sex outside of marriage, and no abuse of alcohol or legal medications. Every month, they pay a fixed "share" to cover the medical expenses of members in need. The cost usually is less than private insurance, but it's not tax deductible. Members use a network of medical providers.
If that seems close to regular health insurance, it's not, says Michael McRaith, the top insurance regulator in Illinois. "We have seen individuals who buy into a sharing program believing they are paying for a promise, and in fact that is not what they are receiving," McRaith said.
"There is no promise or certainty this sharing program will pay for health care expenses," he said.
Florida-based Medi-Share says it's faithfully helped members pay medical bills for more than 17 years, based on a Bible verse: "Carry each other's burdens, and in this way you will fulfill the law of Christ."
"It accomplishes some of the same purposes of health insurance," said Medi-Share's president, Robert Baldwin. "There are also a lot of contrasts ... first and foremost, the biblical basis: Members pray for one another and are prone to encouraging one another."
This time, however, her medical plan wouldn't pay.
It sounds like one of those insurance "horror stories" that President Barack Obama hammered home during the fierce debate to pass his health care overhaul. Except Niles' plan ended up as the beneficiary of a rare exemption to the new law — a waiver highlighted in the plan's promotional materials.
The plan didn't come from an insurer, but from a religious "health care sharing ministry." Consumer advocates call them a gamble.
These plans successfully lobbied Democratic lawmakers to free their members from the requirement that everyone in the country have health insurance.
"Christians are exempt from insurance mandates," Niles' old plan, Medi-Share, says on its website. Sharing ministries are "the only organized health care concept to receive a special exemption from the taxes, penalties and regulations" that the law imposes on insurers, the site says.
Medi-Share members affirm a statement of Christian beliefs and pledge to follow a code that includes no tobacco or illegal drugs, no sex outside of marriage, and no abuse of alcohol or legal medications. Every month, they pay a fixed "share" to cover the medical expenses of members in need. The cost usually is less than private insurance, but it's not tax deductible. Members use a network of medical providers.
If that seems close to regular health insurance, it's not, says Michael McRaith, the top insurance regulator in Illinois. "We have seen individuals who buy into a sharing program believing they are paying for a promise, and in fact that is not what they are receiving," McRaith said.
"There is no promise or certainty this sharing program will pay for health care expenses," he said.
Florida-based Medi-Share says it's faithfully helped members pay medical bills for more than 17 years, based on a Bible verse: "Carry each other's burdens, and in this way you will fulfill the law of Christ."
"It accomplishes some of the same purposes of health insurance," said Medi-Share's president, Robert Baldwin. "There are also a lot of contrasts ... first and foremost, the biblical basis: Members pray for one another and are prone to encouraging one another."
