Most healthcare sharing programs operate a bit like insurance, in that members are strongly incentivized to use network providers. Each program has guidelines addressing how bills are submitted and the process of reviewing, sharing in, and discounting them.
Many of the more popular programs are faith-based. They may also require certain lifestyle choices outlined in their membership guidelines.
Costs
In an era of rapidly rising health insurance costs, healthcare sharing programs (HSP) have been gaining popularity as an alternative. In fact, the four largest healthcare sharing organizations have seen their memberships increase to over one million people.
While these organizations vary in their guidelines, they all share the common objective of a group of like-minded people supporting one another financially in times of need. As a result, they generally operate more closely to traditional health insurance than other types of cost-sharing at the point of service (e.g., copayments, co-insurance, and deductibles).
However, there are also many important differences between HSPs and traditional insurance. For example, most HSPs do not offer coverage for pre-existing conditions or preventive services. In addition, they typically do not provide legal protections in the event of a dispute with the provider. As a result, these programs may not be the best fit for people who need comprehensive healthcare coverage.
Coverage
Healthcare sharing programs are cooperatives that share a portion of members’ medical bills. These organizations are not insurance, so they don’t have to abide by federal and state laws that govern health insurance. However, these programs do have strict requirements for membership. For example, some health-sharing ministries require that members live by specific faith beliefs and adhere to certain lifestyle guidelines.
In addition to being more affordable than traditional health insurance, healthcare sharing programs offer a variety of benefits. For example, they may offer lower deductibles and coinsurance costs. Many also have provider networks that are nationwide, making them ideal for people who travel a lot.
Health-sharing plans are becoming increasingly popular as a solution to high health care premiums. However, they may not be right for everyone. Some health-sharing programs have age restrictions and waiting periods, so it’s important to know your options before you sign up. Nevertheless, these programs are a great alternative to traditional health insurance, and can save you 30-60% on your healthcare expenses.
Taxes
After the Tax Cuts and Jobs Act of 2017 ended the individual mandate, many people have turned to medical sharing programs. These faith-based programs are similar to traditional insurance but offer a more flexible approach to healthcare costs. The most well-established healthcare sharing programs, such as Medi-Share, have a long track record and are very familiar with paying eligible medical bills.
They also offer a religious component that appeals to some people. However, membership in these programs is not universal – most require a statement of faith or adherence to moral codes.
These programs are largely exempt from the laws that normally govern health insurance, and their monthly contributions are much less than typical health insurance premiums. If you’re cost-sensitive or earn too much to qualify for an ACA subsidy, healthcare sharing may be the right choice for you. But before you join, make sure you understand exactly what these programs are and how they work.
Savings
As the cost of health care continues to climb and insurance premiums with it, some families are looking to healthcare sharing programs for a more affordable alternative. With average annual family insurance premiums reaching $18,764 and rising, these programs can offer much lower monthly costs and often times have much lower deductibles than traditional health insurance plans.
Healthcare sharing programs are also not bound by the same requirements that traditional insurance companies must follow. For example, most healthcare sharing programs don’t cover pre-existing conditions, and they don’t have the ability to negotiate negotiated discounts like insurance companies do.
However, as the major healthcare sharing programs all make abundantly clear in their disclaimers, membership in the program is voluntary. It’s important that clients are reminded of this when considering these programs and take the time to thoroughly read the guidelines before joining one. This will help them determine if these programs are the right fit for them.
