Health sharing programs (also called medical cost-sharing programs) are growing in popularity as a substitute for traditional healthcare insurance. They are open to anyone and are not insurance companies, but rather membership-based groups that share in their members’ medical costs.
Members contribute a monthly amount and are able to access funds for eligible medical needs outlined in the program’s guidelines.
Why It’s a Good Option
A growing number of consumers are turning to healthcare sharing ministries as a cost-effective alternative to traditional health insurance. These faith-based cooperatives share medical expenses among members based on religious or ethical beliefs. Unlike actual insurance, they don’t have to adhere to strict rules and regulations for policyholder treatment or fund management.
Despite these similarities, there are a few key differences between these organizations and traditional insurance. For instance, healthcare sharing programs may not require members to see in-network doctors, and they usually have an annual “unshared amount” that is required for each member before the program begins sharing costs.
The most significant difference, though, is that these programs are not considered to be “insurance.” That means they’re not subject to the same laws and regulations that bind traditional insurers. That’s why it’s important to understand the nuances of each program before making a decision. Those who do choose this option can find many benefits.
Health Sharing coverage programs, also known as healthcare sharing ministries, are a risk-pooling alternative to traditional health insurance. Members pay monthly contributions that go into a shared savings account, similar to a premium in an insurance plan. When a member has a medical expense, they submit a claim to the program and funds are allocated from the shared savings account accordingly.
The cost of a health share membership can be significantly lower than an unsubsidized family health insurance premium. While the exact costs vary from program to program, families can usually join a healthcare sharing ministry for less than $300 per month.
Unlike traditional health insurance, however, most healthcare sharing ministries do not cover pre-existing conditions. While some do, they usually require a waiting period of 1 or 2 years before these expenses are eligible to be shared. This can make these plans unattractive for people with costly or chronic medical issues.
As the name suggests, these programs are faith-based and designed to bring people together through a shared pool of money. They have become very popular as a replacement for ACA-compliant insurance, especially for people who can’t afford the premiums on the exchanges.
Members pay a monthly amount that looks similar to a health insurance premium. When they need medical care, they submit their bill to the community bucket where other members will share in the cost. Treatments considered a violation of faith (such as abortions, gender reassignment and morning-after pills) are typically not covered.
More than a million Americans are currently enrolled in these healthcare sharing programs. Most states have safe-harbor laws that distinguish them from traditional health insurance companies and prevent them from being subject to stricter regulations. This allows them to keep their rates low and attract more enrollees.
With skyrocketing health insurance premiums weighing down your budget, you may be looking for other options. But how do you balance your desire for flexibility with your need to cover medical costs?
Healthcare sharing programs are cooperatives — often faith-based — where members share a portion of each other’s medical bills. While they sound a lot like traditional health insurance, these organizations are not subject to the same laws and regulations.
Choosing the right healthcare sharing program for you will take some research. Larger ones typically have a long track record and strong history of paying eligible medical expenses once you meet your equivalent of an annual deductible.
And as you compare plans, consider how community is a major part of the health-sharing experience. Some programs are limited to a specific geographic area, while others have nationwide or even worldwide coverage. You’ll also want to look at network restrictions and pre-existing condition coverage.