ATLANTA - Nearly a million Americans have found a unique way of paying their medical bills.
Instead of signing up for health insurance, they've joined a faith-based health care cost-sharing ministry.
The ministry is not health insurance, and there is no contract or guarantee of coverage.
Members send each other checks to help cover medical costs, and they pray for one another and write notes of encouragement.
Five years ago, Atlanta blogger, mother of three and cancer survivor, Cortney Campbell quit her job as an Atlanta elementary school teacher to become a stay-at-home mother.
"I said, 'We have another kid. On a teacher's salary,'" Campbell remembers. "It didn't make sense to keep working and pay for daycare expenses. So I stopped working."
But quitting meant giving up her family's health insurance.
Then, a friend told Campbell about Samaritan Ministries International, a faith based cost-sharing ministry.
"It felt like a blessing," she says. "Like, here you go. Here is the solution for you. You don't have to work just because you need insurance."
Campbell still pays $495 a month for her family of 5.
But instead giving their money to an insurance company, she mails her payment to another SMI member.
"You get a notice that says, "John Smith is being treated for lung cancer. Please send them a check for the amount specified and a note of encouragement."
So, Campbell sends her monthly "share" to that member along with a note or a card, telling him she's praying for him.
In return, when the Campbells have a medical bill over $300 for an illness or injury, they call in a "need" request to Samaritan Ministries.
"And the first time I did this, it was so interesting," Campbell remembers. "They ask you, 'Can I pray for you?' And, I'm like, 'Sure! I'd love that!'"
When Courtney got pregnant with their third daughter, 3 years ago, they chose to have a home birth, which she says typically costs about $4,500 and is not covered by traditional health insurance.
"With Samaritan, they share 100% of your expenses for home birth," Campbell says.
Anthony Hopp, Vice President of External Relations for SMI, says members are drawn to cost-sharing because it's a way to live out their Christian faith in a practical way, by helping each other.
"But it's also the freedom to direct one's health care, to choose one's own provider, to choose one's own treatment," Hopp says.
But, there are strings attached.
For one, SMI members have to be practicing Christians.
"They also agree to attend church 3 out of 4 Sundays," says Hopp. "And, they have their pastors sign off that this is part of their fellowship."
Members also agree not to drink to excess, or take illegal drugs.
"In order to keep expenses down, you have to adhere to a kind of clean living," says Cortney Campbell.
And Hopp says SMI members never share anything related to abortion.
"That's one thing that attracts members to this approach," Hopp says. "We're never sending our money to something that conflicts with our values."
Campbell usually pays for covered expenses up front and they contacts Samaritan Ministries to request reimbursement from another member.
Because SMI doesn't cover preventive care, the Campbells have a savings fund set up to cover those costs.
Campbell looks forward to sending off her monthly "share" to another member.
"It's my favorite bill," she smiles.
As she wraps up her interview, Cortney Campbell checks her mail.
There's a card from another Samaritan member, with a check inside, and a handwritten note, telling Campbell the sender is praying for her family.
It's payback, you could say, for paying it forward.