Healthcare sharing ministry accused of misleading customers comes under fire

Healthcare sharing ministry accused of misleading customers comes under fire

Health insurance can be so expensive, many are turning to another option: healthcare sharing ministries. It is not health insurance, but a kind of medical "crowdfunding."

According to multiple online sources, more than 1 million people have gone this route. Some customers and analysts say it's better than no insurance. Others disagree.

Action 9's Jason Stoogenke has reported on these ministries. Now, in an ongoing investigation, Stoogenke found multiple states are trying to ban one of them.

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It's called Aliera.

Washington state Insurance Commissioner Mike Kreidler is seeking a million-dollar fine against the company.  In his opinion, Aliera sold insurance without a license and misled consumers.

"We had a bucket-full of complaints that were coming in," Kreidler said. "There's no question about it.  They thought they were buying real insurance."

The Texas Department of Insurance is suing Aliera and wants to ban it from doing business in the state.  A judge there issued a temporary restraining order against Aliera, preventing it from accepting new customers there.

The Colorado Division of Insurance got a cease and desist order against Aliera.

New Hampshire's Attorney General ordered Aliera to stop doing business in the state. The New Hampshire Insurance Department got a cease and desist order against Aliera.

"It looks look like Aliera is administering claims or even acting like an insurance company, which is against our statutes," New Hampshire Insurance Department's lead lawyer, Heather Silverstein, told Stoogenke in a Skype interview.

Aliera is now on the FBI's radar, after the Georgia Attorney General's office passed along consumer complaints.

Some Aliera customers are suing the company, hoping it turns into class action.

But, so far, neither Carolina is taking action against Aliera.

North Carolina Attorney General Josh Stein told Stoogenke he's investigating complaints customers filed with his office, which he does with every case.

North Carolina Insurance Commissioner Mike Causey's office told Stoogenke, since Aliera isn't technically insurance, his office doesn't have authority over it.

The South Carolina Department of Consumer Affairs told Stoogenke it hasn't received any complaints involving Aliera, so there's nothing to investigate.

Aliera wouldn't go on camera, but emailed Stoogenke a statement saying they will defend against any false claims.

ALIERA STATEMENT: 

"Aliera will continue to vigorously defend against false claims made about the administrative, marketing and other support services we provide to health care sharing ministries (HCSMs), and we're confident the HCSMs we support will defend the right of their members to exercise their religious convictions in making health care choices.  We are actively working with regulators to address their concerns and are hopeful we'll resolve these matters soon.

HCSMs provide members with a flexible method for securing high-quality health care at an affordable price, something that is becoming more important than ever with the skyrocketing costs for traditional health insurance.  We remain committed to serving the ministries' health care sharing members across the country, working with regulators to provide the health care solutions these members need."  

Stoogenke went through three of Aliera's brochures.  You see a disclaimer on every page.  It says, "This is NOT insurance."

Kelly McFadden told Stoogenke her husband's self-employed and the Affordable Care Act was too expensive for them. So they signed up with Aliera.

"It's less money per month," McFadden said.

She told Stoogenke everything was fine until she took her children to the doctor for well visits.

"My son was billed, we were billed $70. My daughter, we were billed $570 for her visit," McFadden said.

She expected the appointments to cost about the same because they were very similar.

Then, she needed a mammogram. She said she knew -- as long as she went to an imaging center that was in-network, she'd only have to pay $55.

"I did everything by the book," McFadden said. "I called Aliera and I said, 'Ok, I’m getting ready to get a mammogram. I can look on the computer, on the website and see who’s in network, but I want you to tell me.' So the lady gave me the name of about three, and so I went to the one on Exit 31."

But, McFadden said, Aliera still had her paying nearly $230.

"I did everything, and they said, 'Well, because they’re not in network,'" McFadden said. "I talked to a representative right before I went to make sure that this imaging center was in-network and I switched imaging centers because I wanted to make sure. I was in tears. I called my husband. I'm like crying because it's so frustrating, just so wrong."

"I did everything, especially for my mammogram, to the 'T,'" McFadden said. "They're totally taking advantage and giving me every excuse to not to pay what they need to be paying."

McFadden was so upset with Aliera, she turned to Action 9. The group wouldn't discuss her case -- maybe for privacy reasons -- it didn't say, but, about 24 hours later, it agreed to cover everything in full.

Now, McFadden is going back to actual health insurance.

Here's how healthcare sharing ministries work: you pay a set amount every month, no matter what. The money goes to members who have medical bills they can't pay. These plans are not health insurance and typically cover far less than insurance.

For example, they don't cover a lot of preventive care or even prescriptions.  Plus, since they're faith-based, many don't cover abortions, substance abuse treatment, or cosmetic surgery.

If customers have a problem with Aliera -- or any healthcare sharing ministry -- they can file a complaint with the North Carolina Attorney General or the South Carolina Department of Consumer Affairs.

Also, tell Action 9.

The only other recourse may be to sue to company, which may or may not be worth it.