Health cost sharing programs are not insurance plans. There are significant differences between the two. Health sharing entities are non-profit, charitable organizations that are designed to help members pay for medical expenses by utilizing funds from other members.
WHAT MAKES US DIFFERENT?
Many of the differences in health insurance and health share programs involve the members’ rights to choose what type of medical expenses will be covered and who will be eligible for membership. Health insurance plans must comply with the Affordable Care Act. This means that insurance plans must accept all sorts of people with all sorts of medical issues. This can drive up the total cost of insurance plans and put comprehensive plans out of financial reach for many Americans.
Health share programs, on the other hand, are not bound by ACA requirements and therefore can be more selective in their approval of members, which can ultimately result in cost savings for the entire membership.
Here are some of the differences between insurance and faith-based health sharing programs:
HEALTH SHARE PROGRAM
Eligibility for membership is dependent only upon the standards outlined by the health sharing organization. The organization is free to limit membership to those in good health, thus saving money for the entire membership.
Members are expected to share a common ethic standard or philosophy and adhere to lifestyles that reflect those ethics.
No guarantees are made regarding payment of specific medical bills. Eligibility for sharing is based on the program and its guidelines.
Non-Profit
The healthcare sharing organization facilitates sharing of member share requests to pay for eligible medical expenses.
An Explanation of Share (EOS) is provided when Share Requests are processed.
HEALTH INSURANCE
Members with pre-existing conditions must be accepted in order to comply with ACA policies
Members with pre-existing conditions must be accepted in order to comply with ACA policies
Insurance providers guarantee what is and isn’t covered, the amount paid, and the portion customers pay based on their policy
Mostly for-profit
Claims are processed according to signed contract provisions
Explanation of Benefits (EOB) must be provided when claims are processed.
Benefits of Health Share Programs
There are several benefits that come with being a part of a healthcare sharing ministry:
What Types of People Choose Health Share Programs?
These may include people who meet the following criteria:
Are in good overall health
To keep costs down for the entire membership, most health sharing programs limit eligibility to people without complicated pre-existing medical conditions. For those with chronic health issues and pre-existing conditions, there may be better options elsewhere.
Engage in a healthy lifestyle
Avoiding tobacco use and excessive alcohol consumption. Again, being in good health is a prerequisite for joining a health care sharing program, and those who engage in dangerous activities may not be eligible for enrollment.
looking for more options
May be looking for a more affordable option than traditional health insurance can provide. Health insurance plans are expensive, so being a part of a health care sharing program may help save quite a bit of money every month – some will save 60% or more when compared to traditional insurance options.
Are of pre-retirement age
Are (between 55 and 64 years of age) and transitioning out of full-time work before becoming eligible for Medicare. People who are looking to retire will not be able to take advantage of their employer’s health care benefits, but a health care sharing program may step in to fill the gap between employer coverage and Medicare.
Operate small businesses
Operate small businesses or non-profit organizations with staff who require health care coverage. Businesses with a small number of employees may require OR desire to offer a health care program to their employees and their families.
Individuals who are self-employed
Individuals who are self-employed, freelancers, consultants or contractors. Those who are not employees may not have access to employee-backed insurance programs nor be able to afford typical health insurance programs, and medical care sharing programs may be a viable alternative.
Hard to be eligible for subsidies
Earn too much money to be eligible for subsidies with conventional ACA plans. Those who earn well over the federal poverty level (FPL) and don’t qualify for subsidies may find our programs more affordable.
Employer Health Insurance
Families of a individual receiving employer benefits. Many people seek and receive the coverage of an employer health insurance plan; however, the cost to insure a spouse and/or dependents can be completely unaffordable. Healthcare sharing programs can be an ideal solution for those dynamics.
People who want complete freedom
Healthcare sharing programs can be used nationwide. Finally Americans can choose their own path for work and location and take the healthcare with them.
