Last year, more than 12 percent of people under age 65 didn’t have health insurance to help cover the cost of medical treatment. If you were one of them and you’re ready to enroll in some type of insurance plan, you need to understand your options.
For many people who aren’t happy with traditional health insurance, health sharing plans are a great choice. They’re a simple way to pay for your medical expenses without having to work with a large corporation.
Before you enroll in a plan, you need to make sure you understand how they work. Here’s what you need to know so you can make the right health sharing plans choice for your needs.
1. They’re Issued by Private Organizations
When you apply for traditional health insurance, you apply through a large insurance company. These companies are able to provide you with affordable health insurance due to their size and connections in the industry. However, these companies function as proper businesses, not service organizations.
This means it’s often harder to get a hold of customer service representatives and processing claims can take time.
When you enroll in a health sharing plan, you’re working with a small, often religiously minded, organization. The organizations focus on doing what’s right for their members rather than increasing their bottom line every month.
2. You Pay for Your Healthcare Upfront
When you use health insurance, you pay a small co-pay about for every treatment you receive. The treatment provider then files a claim with your health insurance provider who then pays the set amount according to your insurance plan’s details. If there’s anything that the insurance provider doesn’t cover, you’ll have to pay the remainder out of pocket.
With health sharing plans, the treatment provider doesn’t file a claim with your health sharing company. Instead, you pay for your treatments upfront. Once you’re done, you submit your receipt or invoice to the health share provider.
They’ll review the treatment you received and send you a reimbursement payment for the amount they deem appropriate. For most treatments, the reimbursement should be enough to cover most or all of the treatment costs you incur. However, it’s up to the discretion of the health share company to determine how much money they’ll pay you.
Keep in mind that you’ll still have to cover at least some of your treatments out of pocket. Think of those costs as the same as a deductible found in traditional insurance plans.
3. The Financial Strength of the Company Matters
Since you’re not guaranteed repayment after getting treatment, it’s important to research the heath share provider in detail. Read up on reviews from current and previous enrollees and see what they have to say.
You’ll want to work with a provider that has an established history of paying their members.
If you think the health share organization isn’t financially sound, you’ll want to look for a different option. The last thing you want to do is seek treatment only to discover that the heath share organization can’t afford to reimburse you.
4. You’ll Want to Choose the Right Providers
Traditional health insurance companies have a list of doctors that are in-network providers. These doctors will cost you less out of pocket if you use them over doctors that are out of network.
According to teams of top health care sharing plans, you’re able to choose whichever practitioner you want to use wherever you are in the country. That doesn’t mean you shouldn’t do your research.
Make sure the practitioners you’re working with have valid licenses in your area. If they’re not or you can’t find information about the service provider, it’s best to look elsewhere.
5. Pre-Existing Conditions Aren’t Always Covered
Health insurance providers are now required to cover pre-existing health conditions. This means they can’t deny you coverage if you have a condition like diabetes, HIV, arthritis, or other chronic condition.
Health sharing plans aren’t considered insurance under the law. This means they’re not required to cover pre-existing conditions at all.
Some organizations may charge you a higher monthly rate if you have a pre-existing condition if they choose to accept your application for membership. Keep this in mind when considering health insurance vs health share plans for your medical needs.
6. They May Not Cover Everyone Who Applies
Health insurance companies are also legally required to cover anyone who can afford to pay the monthly premiums. They can’t discriminate against you for not following a certain faith or being in a non-traditional or unmarried relationship.
Health share organizations can pick and choose who they accept as members. If they don’t think your lifestyle is in line with their values, they can refuse to cover you. If you aren’t comfortable agreeing to their strict terms of behavior or providing a statement of faith, they can deny your application.
7. Health Sharing Plans Can Be a Cheaper Alternative
The biggest reason people look for health share plans is because the monthly payments are cheaper. If you’re looking for an affordable alternative, they can be a great choice. Just make sure you’re comfortable with the possibility of not getting paid back. You never know if the health share organization will recognize your claim.
However, if you’re looking for flexibility and the freedom to choose your doctor, they’re a great choice. UHSM Health Share facilitates member-to-member sharing of medical bills.
Are Health Care Sharing Plans Worth It?
Ultimately, choosing between health sharing plans and traditional health insurance is a matter of personal preference. If you identify with the health sharing organization’s values and believe in their mission, the plan may be a great fit.
However, if you’re worried about a pre-existing condition or aren’t religiously inclined, traditional health insurance is still going to be a better choice.
No matter what type of health coverage you choose to enroll in, it’s still best to avoid having to seek medical treatment in the first place. The best way to start is by improving your health and well-being with health insurance. Check out our latest healthcare posts for more tips and helpful advice to make getting and staying healthy easy on a frugal budget.