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Health care cost-sharing program Medi-Share now in Montana

Health care cost-sharing program Medi-Share now in Montana

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A previously banned way to pay for health care costs is now available in Montana.

Matt Rosendale, commissioner of securities and insurance, announced on Monday that Medi-Share, a heath care cost-sharing program, can operate in Montana. Christian Care Ministry Inc., had been banned from operating in the state after a 2007 district court opinion found the company was selling insurance without registering in the state.

After a 2007 civil lawsuit filed by a pastor who said the program would not pay for expenses related to a heart condition, a Helena jury ordered Medi-Share to pay $850,000. The organization paid the medical bills after the pastor filed a civil lawsuit, according to then-insurance commissioner John Morrison.

At the time, a little more than a thousand Montanans were participating in Medi-Share, the Associated Press reported.

Health care sharing ministries, where members of a common religious faith pool their money to cover health care costs for their group, were a key issue for Rosendale in the election last November, when he defeated Jesse Laslovich, who was the top attorney in the commissioner's office.

Rosendale said the programs, which are not insurance and therefor not obligated to pay out for participants, could help save Montanans money, while Laslovich cited the past lawsuit and said it was difficult to ensure that people would get payments for health care expenses.

This year Medi-Share requested that Rosendale review the current version of its program to see if it met requirements to operate in Montana.

In a letter issued March 21, Rosendale found that Medi-Share had changed its program enough to no longer qualify as an insurance product subject to regulation under his office.

Under the current program, members deposit their monthly shares into their own accounts at a designated credit union. That means member funds are not held in a pooled account controlled by Medi-Share. 

Medi-Share does not pay claims from a pooled account. Instead, providers are paid from the members' funds held in their own account, with Medi-Share serving as the members' agent for payment processing.

Medi-Share can transfer funds among members' accounts to pay claims. Members are notified before transfers are made and are told who is receiving the money. Members may decline to share their funds and can withdraw their money from the credit union at anytime.

Under the new program, a panel made up of Medi-Share members will determine if expenses members submit are eligible to be paid.

Rosendale also wrote that Medi-Share had met its requirements after the 2007 lawsuit to set aside $1.5 million to cover future claims of program participants

In a press release announcing the change, Rosendale referenced radio ads that play on talk radio programs around the nation advertising the program. During the campaign last fall he often mentioned the ads and even included links to the audio of Medi-Share's new Montana ads in his press release Monday. The audio is posted on the commissioner's website.

“For far too long, we’ve been hearing the radio ads that say Medi-Share is not available in Montana. I’m excited to announce that as of this week, those ads have changed. Medi-Share is now available in Montana!” Rosendale said in the release.

Rosendale said Medi-Share has been operating in every state except Montana. He said the programs can be more affordable alternatives that expand access to Montanans.

Medi-Share programs, though not insurance, still comply with the Affordable Care Act’s individual mandate. The programs have grown in popularity over the last several years, going from about 200,000 participants in 2010 to more than 530,000 in 2016. Medi-Share is one of the largest sharing ministries in the country.

To qualify for coverage, potential members must meet several requirements including attesting "to a personal relationship with the Lord Jesus Christ."

According to the Medi-Share website, a church leader may be interviewed to verify their testimony.

Members must also agree to live by biblical standards and live by a healthy lifestyle, which includes not using tobacco or illegal drugs.

Members must also only "engage in sexual relations within a Biblical Christian Marriage," according to the Christian Care Ministry website. Maternity medical expenses for newborns conceived outside of marriage are ineligible for sharing, according to the website, with rape reported to a law enforcement authority the only exception.

Members and the program itself do not have a legal obligation to pay medical expenses. The ministry's website says members have shared more than $1 billion in medical expenses since 1993 and the program has a network of more than 700,000 health care providers, which has saved members another $587 million, according to the ministry. Medi-Share has more than 266,000 members.

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