The rising costs of health care and the challenge of finding health care coverage is a dubious reality that nearly all Americans are face today. The growing need for affordable health care has increased the interest in the concept of Health Sharing or Medical Cost Sharing. Despite the fact that health sharing organizations have been around since the early 80s, many Americans have still never heard of them before.
A Health Share Organization is a group of people with common ethical or religious beliefs who join together to share in each other’s medical expenses. The members of the group commit to paying a monthly amount toward each other’s medical expenses. When a member has a medical loss that is sharable, then other members pay toward that medical cost.
Health Sharing is NOT insurance. Unlike ACA plans, Health Share plans have more flexibility in some areas because they are not regulated by State or Federal rules and are not required to provide coverage that is at the same level with other health plans.
A Medical Cost Sharing organization must meet the following criteria:
- They must be formed as a Non-Profit 501(c)(3) organization.
- Members must have a common ethical or religious belief.
- The organization cannot discriminate membership on the basis of employment.
- They must have been in practice since December 31, 1999.
- They cannot cancel membership due to development of a medical condition while a member.
- The organization is required to perform an annual audit by an independent Certified Public Accountant. The audit is required to be publicly available upon request.
Who can join a Health Share or Medical Cost Share?
There are a few requirements to join. Unlike insurance plans, there is no medical underwriting, but there are requirements for membership, such as:
- You can enroll either individually or as a family. At least one adult (18+) must be enrolling.
- Members must observe the group’s religious or ethical standards. Most of these ministries require a life style that is consistent with Christian values. There is one exception.
- You will be expected to maintain a healthy lifestyle by abstaining from smoking, illegal drug use, eating healthy and exercising.
Types of Health Share or Medical Cost Share Plans
There are four basic types of health shares:
- Catastrophic Health Shares: Which are very barebones plan they’ll be a great help if you suffer from an unexpected catastrophic loss, but won’t help with more typical or minor medical issues or even preventive medicine. This can be a smart buy if you don’t go to the doctor often or you are able to make other arrangements for minor or preventive services.
- Standard Health Shares: Also sometimes called an “Everyday Plan,” these will have coverage for catastrophic loss and also coverage for preventive medicine. Some plans also have a limited number of doctor’s visits, or urgent care visits to handle minor health issues that may come up throughout the year.
- Comprehensive Health Shares: These types of health shares are for individuals and families who are looking for a way to reduce their monthly spending on health coverage, but would still like coverage similar to that of a traditional health plan. They have coverage from the doctors office to the operating room, but do tend to cost a bit more. A saavy shopper can still save money using these plans over traditional insurance, however.
- Ancillary Shares: These are health shares that help cover dental and vision expenses.
Is a Health Share Right for me?
Having some type of access to healthcare is critical, especially for families. Health Shares make a lot of sense for a lot of people, but there are some who are better off sticking with traditional Health Insurance plans.
If you’d like some help determining if a Health Share is right for you and your family, you can try my free online guide – a series of questions that will help you determine if a plan is right for you, or you can try shopping around and see if any of the plans meets your needs and compare the cost to you monthly health insurance rate. If you’d like to talk to a human being, you can call me at (916) 505-8950