Understanding the Concept of Health Sharing Coverage

Health share plans, also known as medical cost sharing ministries, are an affordable alternative to traditional insurance. They are not considered insurance and are exempt from the Affordable Care Act rules and regulations.

Members pay monthly shares into a pool, which helps cover eligible medical expenses. Each ministry has its own guidelines for what can be shared.

What is a Health Sharing Plan?

A health sharing plan, or health care sharing ministry, is a nonprofit organization in which members agree to share costs for medical bills. These organizations vary widely in terms of their membership requirements. Many are faith-based and ask their members to live moral and healthy lifestyles.

A lot like insurance, those who participate in health sharing programs pay monthly contributions into a fund that can be used to cover expenses. Typically, these plans also have an annual personal responsibility or unshared amount that must be paid out-of-pocket before the sharing portion kicks in.

Unlike traditional insurance, however, health sharing plans are not required to share in the cost of certain services. Some of these include birth control, maternity care and substance abuse treatment. Additionally, these plans often do not cover pre-existing conditions. Instead, they may decline membership in individuals with pre-existing conditions or require them to wait a set period of time before coverage begins.

What are the Benefits of a Health Sharing Plan?

With health insurance premiums rising and many Americans struggling to afford coverage, health sharing programs have gained popularity as a cost-effective alternative. While they’re not considered health insurance policies, a quality healthcare sharing program can save members half or more of what they pay for an unsubsidized plan.

Benefits include lower monthly costs than traditional health insurance and no deductibles. Additionally, the majority of medical sharing programs contract with established provider networks and negotiate fair and reasonable rates for services such as doctor office visits and prescriptions.

Another key benefit is that they are exempt from ACA regulations on pre-existing conditions, allowing members to share in the cost of their care while not paying an unaffordable premium. However, these plans are not required to share the costs of preventive care and may exclude lifestyle-related issues like smoking. Most health-sharing ministries also have rules regarding what they consider to be shareable expenses, based on their religious beliefs.

What are the Requirements to Be a Member of a Health Sharing Plan?

As an alternative to traditional health insurance, health sharing plans (also known as medical cost-sharing programs or faith-based health share ministries) allow members to contribute monthly funds into a pool that can cover a member’s medical expenses. This can include everything from prescriptions to maternity costs. When a member has a medical need, they can submit the bill to the plan committee who will decide how much of it should be covered by other members’ contributions.

Many health-sharing programs are rooted in specific religious beliefs that determine which medical expenses are considered shareable. This can also impact which pre-existing conditions are covered. While insurance companies must follow the ACA’s mandates, health-sharing ministries do not and can refuse to share medical expenses that are linked to activities they find immoral.

Additionally, most health-share ministries require membership applicants to commit to certain standards of behavior. These requirements are often religious, but can also include a commitment to live a healthy lifestyle and avoid smoking, illegal activities and alcohol use.

What is the Difference Between Health Insurance and Health Sharing Plans?

A health sharing plan may sound a lot like insurance, but there are significant differences. Health-sharing plans are often faith-based, and they share medical expenses among members in accordance with their program guidelines. They also typically have a monthly “share” amount, similar to premiums, and most require members to pay an initial unshareable amount, comparable to a deductible.

However, unlike insurance companies, they are not subject to state laws that require them to treat consumers fairly or pay claims in a timely manner. In addition, health-sharing plans do not cover pre-existing conditions.

Despite these limitations, health-sharing programs are gaining popularity, especially for individuals who want to combine their health care coverage with a way of serving others as part of their religious beliefs. With rising health care costs, it’s no surprise that more and more people are looking for alternatives to traditional insurance.