Three Options for Medical Insurance

Shopping for medical insurance can be worse than getting dental work done, (Even if the work is completely covered by your dental care insurance provider!)  The number of options is overwhelming.  The jargon and acronyms look like secret code and the cost structures feel like some kind of pyramid scheme!  You might decide to either just give up or jump into an option that might not be best for you and your family.

Let’s look at three options that might work well:

Marketplace (Healthcare.gov)

The plans are government approved from large insurers like Blue Cross or United Health Care.  You purchase plans directly from the Government. Almost everyone receives subsidies to make it more affordable. These are paid by the government based on things like family size and income.

The Marketplace is a good option for:

Ministers needing coverage for family

Significant portion of family’s income is housing allowance. (Non taxable income)

Chronic/Pre-existing conditions

Not a good option for

Ministers needing coverage for just themselves (less subsidies available)

Most of family’s income is reported on W2 (More taxable income means less of a cost reduction.)

It is very important to note that churches cannot reimburse the cost of these plans tax-free.  Churches can add to your taxable income if they want to help cover these costs.

Plans and costs are based on the county you live in.  I for example live in a county plagued by high medical malpractice costs, driving up my insurance costs.  My co-workers live in a neighboring rural county and have access to much cheaper insurance pricing.

More companies are getting into the marketplace with a large variety of plans, offering many options and competitive pricing.  *Make sure that your doctors are included in the network for your plan.*

It can be difficult to work your way through all the options available on the Marketplace.  Consider enlisting a broker to walk you through the enrollment process.   They can help you select the most cost-effective option for your family.

This link will help you find local help: https://localhelp.healthcare.gov/

Open enrollment beings on November 1st.

Healthcare Sharing Ministry

A healthcare sharing ministry may sound like insurance, but it is not.  You make monthly payments into a pool and share medical expenses with other members.

Some examples are: Christian Healthcare Ministries, MediShare, Samaritan Ministries.

Cost for plans cannot be paid tax-free by church.  Churches can add to taxable income if they want to help cover these costs.

Healthcare Sharing Ministries have some Unique features:

Sometimes have unique/confusing deductible policies.

Often have exclusions on coverage for pre-existing conditions.

Sometimes have a life-time max benefit.

Health Sharing Ministries-Sometimes you are required to negotiate directly with providers on price.  You pay cash while trying to get the best price you can.  Eventually the Healthcare Sharing Ministry reimburses you.

These are a good option for:

Ministers looking for most affordable options. (Often half of traditional insurance.)

Ministers who are very health and do not have pre-existing conditions

Ministers who are willing to carry the administrative load of working with providers.  (You do the paperwork, not the doctors office.)

Not a good option for:

Ministers with chronic or pre-existing conditions.

Those who go to the doctor often.

BEST OPTION

Spouse’s employer’s insurance or some other traditional insurance plan is the best option if available.

These can be reimbursed tax-free by the church using an Individual Coverage Health Reimbursement Arrangement (ICHRA).  This is easy to set up.  There are several websites to walk you through the process or you can give us a call

Here is how it works:

The pastor pays his monthly health insurance premium and then submits receipts/proof of cost of premiums to the church.

The church reimburses the amount that they have elected to cover.  NOT AS PAYROLL BUT AS A TAX FREE REIMBURSEMENT.

This is a good option for:

Ministers who have a non-marketplace option for insurance.

Bi-vocational ministers who could go on a work or spouse’s plan.

Don’t let the fear of not finding an affordable option or the overwhelming amount of jargon and options keep you from finding an insurance option that might work great for you and your family.  Get out there an look for options. This is almost always something available that will provide coverage for you and your family.