Truly, she is a mistress of many names, which is why so many people in this country are not even aware of exactly what she is. Health sharing plans (also known as medical sharing plans, health cost sharing programs, or HCSMs) have been helping Americans reduce their monthly health care spending for years, and today exist as a great alternative to Obamacare, especially for those of us who are making too much to qualify for the deductible.
And yet, it seems like every day we are meeting folks that still don’t know what they are, how they work, or whether they might be a good option for them. In the following guide I am going to answer these questions and more in an effort to more fully educate our friends and clients about both the possibilities and pitfalls associated with health care sharing.
I am also going to go over the primary difference between health sharing plans and health insurance.
Q: What is a Health Sharing Plan?
To put it as simply as possible, Health Sharing Plans are programs offered by membership-controlled organizations with the goal of sharing the costs of healthcare among its members. Because these organizations are always either ethically or religiously affiliated, membership in the sharing programs is more highly restricted.
On the other hand, health care sharing ministries are not subject to the same rules and regulations as plans offered under the Affordable Care Act. For this reason, they’re usually about half the monthly cost of an ACA plan, which is certainly their biggest selling point.
Q: Is Healthshare and Health Insurance the Same Thing?
No, Health Care Sharing Plans are NOT the same as health insurance. For this reason, the coverage options under sharing plans can be drastically different from a more traditional insurance plan, and generally speaking, far more restrictive.
However, enrolling in a health sharing plan does allow you to bypass the ACA insurance mandate. This is the primary reason why we recommend health sharing to most people who cannot qualify for an ACA subsidy.
The PROS & CONS of Medical Sharing Plans
PRO: Health Sharing is about HALF the monthly cost of an ACA plan.
Because Health Sharing Plans tend to attract more health conscious members, and because offer a more “stripped down” form of coverage, they are significantly less expensive than most unsubsidized insurance plans on the market.
CON: Health Sharing is more restrictive than health insurance
Not only are many pre-existing conditions not covered by medical sharing plans, but even certain conditions that arise during your first few years of coverage might also not be covered. Depending on the plan you choose, preventative care is sometimes not covered, and mental health is often not covered under sharing programs.
PRO: Health Sharing Plans both Encourage & Reward a Healthy Lifestyle
The various restrictions associated with health sharing plans make them particularly well-suited for people who are generally healthy. As plan members start to realize how much they are saving on monthly health care costs, their incentive to lead a clean and healthy lifestyle goes exponentially up.
CON: Health Sharing Plans are not subject to the same legal protections as insurance
Because of the faith-based nature of cost sharing organizations, certain federal protections that you would expect under a traditional insurance plan are not present in a sharing plan. For example, there is no legal mechanism to guarantee that your claims under a sharing program will be paid.
PRO: Unlike Insurance, Health Share Plans have No Enrollment Period
You can sign up for a health sharing plan anytime of the year, unlike insurance plans that restrict enrollment to specific, narrow windows.
The Most Popular Healthshare Plans in 2020
While there are dozens of different sharing organizations to choose from, a few specific plans have stood out from the pack in terms of both price and coverage options.
OneShare Health is a well-known plan with a growing doctor network, and MPowering Benefits gives members the freedom to ditch the network system altogether and go with whatever provider they like, as long as it’s for qualified care.
Get Help with Health Sharing
The truth is, the cost sharing plan for you is going to depend on both your current health and the specific things that you need covered. Navigating the plan details is something best done with the help of someone who knows what they’re talking about, and fortune has it that we have just the experts for the job.
Call us today if you are interested in learning more about whether switching to healthcare is the right decision for you, or which plans you might qualify for.
Hi! I’m Misty Berryman, and I’m one of your Personal Benefits Managers. I like working with HSA for America because we’re creating solutions to healthcare problems. Our focus on money-saving alternatives like HSA plans and health sharing programs, and the variety of health share programs we offer, are what set us apart.