n his capacity as Commissioner of Insurance, Lt. Gov. Osbert E. Potter advises the public to learn fully about a Health Care Sharing Ministry (HCSM) before joining it.
A Health Care Sharing Ministry is an alternative to traditional health insurance; it is not health insurance.
“If your intent is to buy health insurance, to have a policy, pay premiums, present a card to a health care provider with the expectation that a licensed and regulated health insurance company will pay your medical costs, be advised that you will not receive this from membership in an HCSM. If you have read the terms and conditions of an HCSM and find them acceptable, then you will become a member with knowledge of how an HCSM operates.” said Lt. Gov. Potter.
In the U.S. Virgin Islands
- Health Care Sharing Ministry (HCSM) coverage is not insurance coverage. It is not associated with a Preferred Provider Organization (PPO).
- A Health Care Sharing Ministry is not licensed or regulated by the Office of the Lieutenant Governor, Division of Banking, Insurance & Financial Regulation (Division).
- HCSM is not bound by Title 22, Virgin Islands Code (commonly knowns as the Virgin Islands Insurance Code) or federal regulations.
- Therefore, if an HCSM does not pay a member’s medical expenses or if the HCSM becomes insolvent, the member cannot file a complaint with the division for assistance in recovering any monetary losses.
Facts About an HCSM
- In an HCSM, which in many instances is a non-profit organization, monthly deposit requirements for members are determined. These monthly deposits are pooled together to pay for medical costs incurred by members.
- Members “share” the payment of each other’s medical expenses, subject to terms and conditions set by the HCSM, instead of paying for traditional health insurance.
- Generally, members pay their own low-cost medical expenses but typically contact the HCSM for the “sharing” of payment for large medical bills. There usually is an annual limit of total payments for medical expenses for each member.
- There is no guarantee that an HCSM will cover every medical procedure or provide minimum essential coverage.
- There is no guarantee that an HCSM will pay a participant’s medical bill in part or in full.
For more information, contact the Division of Banking, Insurance & Financial Regulation at 773-6459 on St. Croix or 774-7166 on St. Thomas.