A Guide to Health Cost Sharing

Health Cost Sharing

Each day, most individuals and families have to deal with the costs of insurance. Though some pay a substantial tax penalty, they are not eligible for a tax credit. Therefore, they face hefty monthly costs. Thus, medical cost sharing is the solution for such individuals. It helps them to save lots of money needed to cater for healthcare.

How Medical Cost Sharing Works

Those who need health care sharing ideas are assisted by certain organizations. Here, members share medical costs by paying a specific amount monthly. They pay in the form of a premium or annual unshared amount or a deductible. Each member’s medical expenses must be more than what each member is needed to contribute to qualifying for medical sharing expenses.

The unshared amount depends on the person. Couples pay at least $1000, families pay between $900 to $5000, and individuals pay about $300 to $500. However, the amount varies depending on the plan. The monthly cost is determined by an individual’s coverage and ranges between $64 to $627. If medical expenses exceed this amount, they are shared among the organization’s members.

Most health-sharing organizations follow a certain religion. Those joining mustn’t declare their faith. However, they must agree to live morally to maintain a healthy lifestyle. For instance, they shouldn’t use any drugs. Health care sharing is beneficial to certain people, including those who;

  • Can’t access insurance either through a government program or their employers
  • Miss the open enrollment and can’t get coverage
  • Earn low wages and can’t pay health insurance premiums
  • Have excellent overall health
  • Only need catastrophic coverage.
  • Aren’t eligible for a tax credit

The Difference Between Health Care Sharing and Health Insurance

Health care sharing has numerous benefits over insurance. Though health care sharing isn’t insurance, it’s termed as insurance under the Affordable Care Act. Its benefits include lower monthly costs compared to insurance premiums. The annual shared amount is also lower than the deductibles. Those who enjoy these benefits also don’t pay any tax penalties despite been uninsured.

Organizations offer their members a health sharing card which acts as coverage. They use these cards anytime they visit the hospital. Sometimes, the doctors refuse these cards, and members are forced to pay medical expenses from their own pockets. If this happens, health sharing plans refund these expenses. 

Despite having benefits, health care sharing has several limitations. It doesn’t cater for any pre-existing conditions such as diabetes, cancer, or those caused by a poor lifestyle, including drinking and smoking. Mostly, such individuals are denied membership. The organization helps them for less than one year. Again, it doesn’t help those who suffer from mental health issues.

How Health Care Sharing Plan Options Differ

The biggest difference between health-sharing organizations is varying guidelines when choosing their members. Again, sometimes they cover different treatments, and some bills are processed electronically while others aren’t. Popular health sharing organizations include Christian Healthcare Ministries, Liberty Healthshare, Samaritan Ministries, alieraCare, Sedera, Medi-Share, and Altrua Healthshare.

Health Care Sharing and Direct Primary Care

Direct primary care (DPC) goes together with health care sharing programs. Most individuals in direct primary care are offered a low payment in a single month. However, they only pay a retainer fee. Direct primary care is different from health care sharing. Members in DPC benefit from lab services at low costs, consult with specialists and get medications. 

DPC offers high-quality services to individuals. They can get access to doctors without having to wait in long queues. However, it could be expensive because it doesn’t cover catastrophic needs. Therefore, paying for such needs from an individual’s pocket could be expensive. This is where health care sharing comes in handy.

Health care sharing covers for catastrophic needs or wants. Therefore, DPC members who are in such needs are covered by having a health care sharing card. Some health care sharing organizations can give discounts to members with DPC membership. Therefore, DPC covers services not offered in health care sharing, and health care sharing does the same. Therefore, members joining these organizations should consider being members of both. This way, their health care needs become affordable, and this relieves stress. 

Though health care sharing has limitations, it has its benefits. Those willing to join the organization plan should live a moral lifestyle to avoid being denied membership. They should also join direct primary care membership to receive the benefits not offered by health care sharing. Thus, medical expenses are catered for, and these members live healthy lives.

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