Health Care for the Pastor?

Updated: Sep 13


Most pastors maintain a very busy schedule and to keep up they need to stay in good health. Good health is a result of several factors. Diet and exercise are two of the major factors that we as individuals have control of. Good genes also play in our health but we can’t choose our parents.


It is also important that we credit the professionals in the healthcare industry with helping us to stay healthy. Today we can be easily treated for many diseases that were considered a death sentence at the beginning of the last century. Antibiotics, vaccines and advances in medical care have extended the life of millions and most treatments enjoy a high rate of success.


However, these advances have come with a price. The United States has the most expensive health care system in the world and we spend more on healthcare than any other nation. Our aging population and the explosion of chronic health conditions have fueled a lot of this cost. Health care is so expensive that even minor encounters with the system are more than most household budgets can absorb.


To help the average family pay these costs most of us have some type of healthcare insurance that is paid by our employer or Medicare. In 2010 Congress passed and the president signed the Affordable Care Act. The stated goals of this new law was to make healthcare more affordable to people between 100% and 400% of the federal poverty level, to expand the Medicaid program and to support innovative medical care designed to lower costs. Depending on your income level you may qualify for a subsidy from the federal government to help you pay for your health insurance. Otherwise you are on your own and in 2018 the average cost for an individual policy was $440 and the cost for a family was $1168.

Even though the number of insured has increased since the passage of the ACA 10% of the population is still uninsured. Is your pastor one of these? Of the individuals with no insurance 48% cite cost while 12% are unemployed, not offered healthcare through work or simply not eligible. Each church with a pastor under the age of 65 should have this conversation with their minister. Many of our ministers are bi-vocational and may be insured through work but this is something that the church needs to make it their business to know.


If your pastor is uninsured and develops a serious illness who is going to pay for his care? You might say that it is his responsibility and you would be partly right. However, coverage for a 60-year-old man, the average age of a minister in our denomination, with a Blue Cross gold plan is $1419 a month or $17,000 per year. Is your church paying your pastor enough to afford that kind of premium? If you are not then isn’t it fair to assume that the church has some responsibility for his medical costs?


Also, if the pastor has to pay the premium out of his own income then the cost is not tax-deductible. That means that if he is in a 20% tax bracket and has to pay a 15.3% FICA tax along with a North Carolina state income tax they have to earn $23,500 to pay the $17,000 premium.


There is some good news. Your minister may not need a top of the line program and he does not have to buy an individual plan for coverage. Blue Cross of North Carolina offers group insurance for organizations with as few as one employee. This allows the church to offer their pastor health insurance that is non-taxable. In some situations your pastor may qualify for a federally subsidized policy which may further reduce the cost. Information is available on the Internet at healthcare.gov Either way a church should make certain that their minister has adequate health insurance in case accident or illness strike.


Quality information is available in many cases through a local insurance agent. Blue Cross of North Carolina list their partners on their website and most of them are conveniently located. Is your minister covered?


There are other options available as well with one being the Health Saving Account (HSA). This account is a tax-advantaged account created for individuals who are covered under high deductible health plans (HDHPs) to save for medical expenses that HDHPs do not cover. Contributions are made into the account by the individual or the individual’s employer and are limited to a maximum amount each year. The contributions are made over time and can be used to pay for qualified medical expenses, which include most medical care such as dental, vision, and over-the-counter drugs.


One of the best sources for information can be found at optumbank.com which is a company that can help the pastor set up an account online at low or no cost and keep them in compliance of Federal regulations. If a church cannot provide all the health coverage needed by the pastor perhaps they can help establish a HSA. The point is there are options out there that will provide a meaningful level of coverage for the person leading your congregation. Illness is stressful enough on the patient and their family without the added burden of how the medical bills will be paid.


It is easy to write a check to pay the pastor each week but the church should assume an obligation that goes beyond that. Helping your pastor plan for financial contingencies does not always mean more money. Sometimes simple planning utilizing available strategies can make a lot of difference. Take care of your pastor so that he can take care of you.

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