If your health insurance premiums are making you sick, you might want to explore another option that’s becoming increasingly popular: a health share program.
A health share program can be a way to get medical coverage that’s sufficient for your needs. With open enrollment starting soon, on Nov. 1, it’s worth your while to learn about this kind of health coverage before you renew your existing plan.
Here’s all you need to know about health share programs.
What is a health share program?
A health share program, also known as a health care sharing ministry, actually works a lot like a credit union. There’s no Big Cheese sitting on top of a wealthy corporation while trying to dream up new ways to squeeze money out of you. Instead, the program is run by a not-for-profit religious organization and is jointly owned by members who share expenses for their collective medical needs.
Most people opt to join a health share program because of the significant savings potential: A family of four can easily find a health share plan for just a few hundred dollars a month. Many others will choose this kind of health care because conventional health insurance covers medical procedures that are not in line with their religious beliefs.
Some popular health share programs include Liberty Healthshare, Medi-Share and Christian Healthcare Ministries.
How does a health share program work?
Health share programs are usually faith-based. As such, members must agree to uphold certain religious beliefs before joining the program. Once they’ve signed up, members are charged a monthly premium based upon their age and general health. They will then receive a membership card they can present to a medical practitioner in lieu of an insurance card. The practitioner will then bill the sharing program for the cost of the member’s visit.
How does a health share program differ from traditional health insurance?
While their goal is similar, there are several important differences between a health share program and traditional insurance. Most significantly, since sharing programs are not official health insurance providers, they are not subject to the same federal laws and regulations, as reflected in several of the differences listed below.
- Unshared amounts – Health share programs don’t have deductibles. Instead, every member has an annual unshared amount. Some programs will begin covering a member’s medical expenses after the member has shelled out as little as $1,000 toward these costs. Other programs, though, require members to pay $5,000 toward their medical expenses each year before the program kicks in.
- No network requirements – All health insurance providers have a list of doctors, medical professionals, clinics and hospitals that are covered under their insurance. But members of health share programs have the freedom to use any doctor in any health care facility they desire. If a doctor refuses to accept the membership card, the member can pay out of pocket and the health share program will reimburse them for the cost of the visit.
- Strict rules regarding pre-existing conditions – Unlike most plans offered by the ACA, many health share programs will not accept members who have pre-existing medical conditions. Some will accept members with pre-existing conditions, but will only begin covering the attached expenses after a year – and they will only partially cover them.
- Refusal to cover certain procedures – Health share programs reserve the right to deny coverage for procedures that are against their religious beliefs, like abortions. Many won’t cover the costs of birth control either.
- Lifetime caps on coverage – Sharing plans are usually accompanied by a lifetime cap on health coverage. These caps have a broad range and their exact amount depends on the member’s chosen plan. They can be as small as $250,000 or as large as $1,000,000.
- Incomplete coverage – Many health share programs don’t cover costs for an annual well visit. Lots of them will not pay for vision or dental needs either.
- No government protection – Since health share programs are not subject to government regulation, members lose out on the government’s protection if the program does not deliver as promised. This means every member is essentially taking a risk by signing up for the health share program.
- Lifestyle requirements – Lots of insurance providers will encourage and reward healthful lifestyles. But a health share plan will often require members who are even slightly overweight to consult with a nutritionist and start working out.
Health share programs can be a terrific way to free up some extra cash each month, but they are not for everyone. If you are in good health and you rarely see a doctor, a health share program might be right for you. Just be sure to read the fine print so you know exactly what you are signing up for before joining a program.
Your Turn: Are you a member of a health share program? Tell us what you love about it in the comments!