To understand how a health-sharing ministry works, you first need to understand how the mainstream, traditional health insurance industry functions in the United States. Once you know how most people receive medical coverage, you’ll understand what makes these sharing ministries so unique. 

In a typical health insurance policy, many Americans share the risk of incurring medical costs by paying monthly premiums. These premiums go to a central “pot” that pays for medical care when policyholders need it. Fortunately, many people don’t need medical care on a regular basis – and they remain healthy despite paying their premiums every month. These healthy people end up paying for the medical bills of unhealthy people. But when healthy people get sick, they can expect the same assistance from that central pot of money. 

For the typical insurance company, the goal is to get as many people as possible together in something called a “risk pool.” With a greater number of people comes greater levels of predictability and (generally) lower premiums. 

However, it’s important to note that everyone’s premiums are almost never enough to totally cover medical bills. In fact, most ACA plans will only cover a portion of your medical bills – with even a Platinum plan requiring you to pay 10% of your fees. In addition, you may need to pay a deductible before your coverage kicks in. If you choose an ACA plan, you never have to pay a deductible for preventative care – but you might end up paying thousands of dollars in deductibles for other treatments. 

If that wasn’t enough, you also need to pay additional fees called copayments or “copays.” These are flat fees that you’ll need to pay whenever you see a doctor, visit the hospital, or engage in any other treatment. These copays can cost anywhere from a few dollars to a few hundred dollars. 

With all that said, you only have to pay a certain amount of money before your out-of-pocket maximum kicks in. This is when you spend so much money during a plan period that your insurer agrees to pay for everything else from that point onward. The ACA states that this amount cannot be more than $8,700 for an individual and $17,400 for a family. 

But if you’re forced to pay deductibles and copayments on top of your premiums, then where are your premiums going? First of all, it’s important to note that health insurance companies are not charities. They are for-profit organizations, so a significant portion of your premiums goes toward their bottom line. Part of your premiums also goes towards administrative costs needed to run the business. Another chunk goes towards taxes. This means that by the time everyone’s premiums reach the central pot, they are notably smaller. 

‍