As you consider Karis Health Choice, the following are common questions that have been asked over the years by those who have chosen our plans. You may also search for a given topic.
Karis Health Choice provides a different and better way forward for addressing one’s healthcare expenses. The Karis Group has been focused on making healthcare work since 1996, and offers alternatives and options to relying on traditional health insurance for paying medical bills. Group Plans are employee benefits plan designs and services designed specifically employees of U.S. churches, Christian schools and hospitals. Individual Plans offer bundled services that provide an affordable option that may be purchased easily from our website. Services are performed by The Karis Group, Samaritan Ministries International, and identified insurance providers, administrators, and agents, whenever applicable.
As an individual or household, you may enroll anytime into Karis Health Choice and our Individual Plan. Similarly, employer groups such as churches, Christian schools and hospitals may also choose at any time to begin offering their employees Karis Health Choice and a customized Plan Design under our Group Plans.
Karis Health Choice offers Group Plans to employers, specifically churches, Christian schools and hospitals. These employers, in turn, offer our Group Plans as part of their comprehensive and affordable employee benefits program that’s made available to their employees.
Karis Health Choice Individual Plans are offered directly to qualified individuals and households and may be purchased directly from our website. The benefits offered under our Group or Individual Plans are different yet both provide healthcare sharing via Samaritan Ministries and patient advocacy services, chaplaincy services and Christian counseling.
For healthcare sharing via Samaritan Ministries, there are no “preferred providers”, or required networks. You can simply choose the doctor or provider of your choice. Members of Samaritan Ministries aren’t restricted to seeing certain doctors or staying within a network. Thus, there are no “out of network” penalties. And this freedom to choose gives you the opportunity to choose the doctor, hospital, and pharmacy that works best for your family whenever you need medical care.
Other benefits offered through Karis Health Choice may use a network or participating providers. For example, the Preventative and Wellness Plans offered under our Group Plans uses a network and your provider must be part of this network. Under our Individual Plans, the Discounted Health Benefits uses participating providers to receive the discounted services.
As a Samaritan Ministries member, you will have access to online tools that can help with choosing a provider, pricing medical procedures, and even getting online medical advice. For example, the online tools will help you manage your membership, view your Shares, start your Needs, update your Checklist, access the Prayer Guide, and read the monthly Newsletter.
For Group Plans, certain benefits will be supported by online tools primarily to upload and manage your employee information, add a new hire or make other adjustments.
Each service provided under Karis Health Choice provides meaningful and relevant benefits to our members. For other non-insurance benefits, insurance benefits and Discounted Health Benefits that may be provided under your plan, members will receive an ID card and information on accessing benefits or filing a claim. You may also consult the Member Access tab for Karis Health Choice on the website to learn more.
Specific to healthcare sharing, members are self-pay patients and are billed directly by their provider. This means that when a member receives medical care, there is no “claim” that is processed or owed. There is simply a medical need. Samaritan members send proof of their medical expenses to the Samaritan Ministries office where they are evaluated according to the Guidelines. Then the qualified needs are shared among the members by being published, whereby each active member is asked to share in another member’s medical need. Sharing is voluntary and does not involve a legal obligation (claim) on the ministry or the other members.
The Karis Health Choice service model is based on health care sharing to fund one’s healthcare expenses. Health care sharing is simple – Christians praying for, supporting, and encouraging one another as they bear each other’s medical burdens. Samaritan Ministries uses a direct sharing model, meaning members send directly to other members who have medical needs.
Health care sharing is not a new concept, it has been around for decades. Samaritan Ministries is a growing Biblical community that has been helping Christians care for one another since 1994. Yet nearly everyone is used to thinking in terms of “major medical insurance” or more commonly, “health insurance”. Therefore, we will provide some context around what medical bill sharing is and how it works.
Members of Karis Health Choice and Samaritan Ministries generally “share” or fund expenses for medical needs that total more than $300. In general, a medical need is an illness or injury resulting in visits to medical doctors, hospitals, emergency rooms, testing facilities, surgery centers and the like. These needs are shared on a per-person, per-incident basis. When a member has a health care “Need”, they receive health care treatment from a provider of their choice, collects the bills and uploads them to Samaritan Ministries.
The “sharing” approach is focused on people sending people the needed funds to put towards the medical bills. The process involves:
Members send checks, prayers, and notes of encouragement directly to the member in need. Because we’re lifting each other up in prayer in addition to sharing monetary gifts, members can minister to the whole need, including the physical, spiritual, and financial aspects.
To facilitate the monthly process, Samaritan Ministries publishes a monthly newsletter that reports the total Shares and Needs and includes an individualized Share Notice for each member household. As a member, your Share Notice will list the household to which you will send your monthly Share, including their mailing address, the specific member with a Need, and suggestions on how to pray for a specific member with a Need. Typically, less than 10 percent of the members have a Need in a given month and are receiving Shares.
For Karis Health Choice and our Individual Plans, neither the healthcare sharing via Samaritan Ministries nor any other benefits found in the elements of Karis Health Choice are insurance or underwritten by any insurance company. As stated by Samaritan Ministries: “Insurance is usually thought of as a contract whereby one party agrees to be legally responsible for and accept another party’s risk of loss, in exchange for a payment called a premium. Health care sharing is an arrangement whereby Christians share, to assist one another with medical expenses through voluntary giving. We are not licensed or registered by any insurance board or department since we are not practicing the business of insurance.”
For Karis Health Choice and our Group Plans, healthcare sharing via Samaritan Ministries, our patient advocacy services and the hearing benefits discount program are not insurance nor underwritten by any insurance company. Group Plans do offer select insurance benefits that may be part of a client’s plan design and in these cases, the plans are underwritten or reinsured by an insurance company.
Starting in 2014, the law required individuals to purchase health insurance or pay a penalty. However, the law also contains a provision that members of health care sharing ministries are not subject to the insurance requirement, and they are exempt from the penalties. Therefore, the law does not hinder our members from participating in the ministry.
For Group Plans, should an employer provide one of our Preventative and Wellness Benefits Plans, the underlying coverage provided conforms to the Minimum Essential Coverage requirement under the law. Employees/members participating in these plans will receive the requisite annual IRS form to demonstrate their compliance with the law.
In general, yes maternity needs are shared and include bills for prenatal care, delivery, postnatal care, and miscarriage – maternity and these related bills are treated like any other medical expense.
Specifically, there are Guidelines for types of maternity needs that are publishable and the initial unpublished amount. Please be sure to consult the current the Guidelines for additional information. Expenses related to pregnancies and complications of birth of the mother and child where the pregnancy began before membership will be shared as a Special Prayer Need.
Yes, healthcare sharing is a decades old, proven method for paying for one’s medical expenses without the use of health insurance. Karis Health Choice members and the greater Samaritan Ministries community generously give to other members with a qualified medical need. The process and its members reliably provide for one another each month, enabling the Karis Health Choice member to count on and reliably pay their medical bills.
There is no limit on the number of needs one person may have shared. The maximum dollar amount that will be shared among the members for each medical need is $250,000. The need must meet the Guidelines before it can be shared. Samaritan Ministries members are also eligible to participate in another sharing ministry, Save to Share, where remaining needs over $250,000 are shared (for a modest additional cost).
In general, needs for illnesses or injuries resulting in visits to medical doctors, emergency rooms, testing facilities, or hospitals are shared on a per person, per incident basis. You will want to consult the Guidelines for complete details.
Needs resulting from conditions that existed prior to your membership are usually not shared. Routine checkups and preventative care are considered items that can be included in your budget and are not shared. There is limited sharing of maternity needs related to a conception prior to membership. Most dental, audiology and optical needs are not shared. If any of these needs that do not qualify for sharing should become a burden to your family, the Special Prayer Needs ministry may be able to provide assistance.
Under our Individual Plans, membership in Karis Health Choice provides discounts on some of the areas in which Samaritan Ministries Guidelines do not share with members. You can receive discounts on dental, prescriptions, optical and audiology services, as well as many others. Under our Group Plans, membership in Karis Health Choice may provide your employees with other non-insurance and insurance benefits to that effectively address areas that are not part of healthcare sharing.
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