Exploring Health Share Programs as a Cost-Saving Alternative
Health insurance can be confusing and expensive. If you’re one of the many people who don’t qualify for a subsidy through the Affordable Care Act (ACA), you might be searching for cost-saving alternatives that still provide financial protection for you and your family in case of illness or accident. Health share programs, also known as medical cost sharing, offer a potential solution by helping you save on health insurance premiums while providing essential coverage.
How Health Share Programs Work
Health share programs are offered by organizations where members “share” medical costs. As part of a health share plan, you’ll pay a monthly share amount (similar to a premium) and an annual unshared amount (similar to a deductible). Your medical expenses must exceed this unshared amount before the plan begins sharing costs.
The unshared amount can range from $300 to $5,000, depending on the company and plan you choose. Monthly premiums vary based on factors like age, location, plan details, and family size, typically ranging from $150 to $700. Unlike traditional insurance, health share premiums are not based on income, so there are no tax implications or fluctuating premium amounts to worry about.
Health share programs can be a great fit for individuals who:
- Are generally in good health
- Are not eligible for an ACA tax credit
- Lack access to employer or government insurance
- Missed open enrollment for traditional health insurance
- Only need catastrophic coverage
- Cannot afford current health insurance premiums
Most health share organizations are faith-based, though you may not be required to declare a specific religious affiliation. However, members are typically asked to agree to a moral and healthy lifestyle, which may include restrictions on things like tobacco and alcohol use or participation in dangerous activities, depending on the principles of the organization.
Health Share vs. Health Insurance
It’s important to note that health care sharing is not insurance, but these plans are considered compliant under the Affordable Care Act (ACA), meaning you can avoid the tax penalty for going uninsured. There are several advantages to health care sharing over traditional insurance:
- Lower costs: Monthly costs for health sharing are often much lower than traditional insurance premiums. The annual unshared amount is also generally much lower than deductibles on low-premium or catastrophic insurance plans.
- Large networks: Many health share plans offer access to large, nationwide networks, making it easy to find in-network providers or continue seeing your current doctors.
- Reimbursement: If a doctor doesn’t accept your plan and you pay out of pocket, health share plans will typically reimburse your expenses.
However, there are important considerations to keep in mind:
- Health share plans are not regulated by the Department of Insurance, so they may have exclusions or limitations
- Pre-existing conditions may not be covered, or there may be waiting periods before they are eligible for coverage
- Some plans may exclude mental health services or addiction treatment
Is a Health Share Program Right for You?
Health share programs can be a viable alternative to traditional health insurance, especially if you’re looking for affordable coverage and are generally in good health. However, it’s important to understand the limitations and restrictions that may come with these plans. If you’re interested in exploring health share options or finding out if it’s a good fit for your family, contact United Benefits to speak with a specialist who can guide you through your choices.