Health insurance can be frustrating, expensive, and difficult to navigate. That's why Scott was looking for something else.
"I was just looking for another affordable option to traditional health insurance," he explained. Scott felt like he found a good fit and signed up with a faith-based nonprofit called NetWell.
NetWell's website describes it as a non-profit health care sharing ministry, stating it cares for members like family with "care and compassion." Scott says the values aligned with his own.
Health care sharing ministries (HCSMs) typically work by offering memberships. Members pay a monthly fee to the non-profit, similarly to how consumers pay premiums charges to an insurance company. Then, when a member needs treatment, it is paid for by the HCSM.
In the beginning, Scott says it worked for him and his family.
"We really didn't have anything we needed to put in for quite some time," he explained.
However, in the summer of 2024, that changed.
"I was coming back from Africa on a mission trip and I had gotten really sick," Scott recalled, adding, "I was at an event working with high school students, and I passed out, and the ambulance had to come and take me away."
Scott was rushed to the emergency room. He says his wife gave the hospital their NetWell information to bill.
Scott says he believed everything would be covered, but a large chunk of that was not the case.
"I got declined because my hospital visit and my doctor was not pre-approved. So, how do you get pre-approved for an emergency?" questioned Scott.
Scott says he repeatedly reached out to NetWell, but described it as hitting a "brick wall".
The Let ABC15 Know team reached out to NetWell by phone and email asking why Scott was declined and how a consumer can realistically get an emergency room visit pre-approved.
We also asked NetWell for their "Employer Identification Number" or EIN to verify their non-profit status.
We have not received a response. The Let ABC15 Know team searched the name "NetWell" in the IRS database of non-profits and did not find a listing.
Meanwhile, Scott says he is putting off getting additional treatment.
"I'm scared to go get the treatment I need because of the bills that are incurred," he said.
The biggest takeaway for consumers is to know that HCSMs are not health insurance. That means they are exempt from regulations and the Arizona Department of Insurance and Financial Institutions cannot intervene on a consumer's behalf.
The Department tells us, in part:
"Consumers need to be aware HCSMs are not required to have reserves (to pay claims if financial problems arise), no guarantee fund (if insolvent), HCSMs are not required to pay a claim, DIFI cannot advocate on behalf of a consumer if the HCSM is in compliance with the statute, HCSMs may not cover pre-existing conditions."
If an HCSM registers as a 501(c) (3) charity, it is regulated by the IRS and State Attorneys General.
If you're struggling to pay for medical care or with medical debt check out a list of programs you may qualify for here or reach out to the Patient Advocate Foundation on their website.
