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Open Enrollment 2021: Health Sharing Plans Compared To Health Insurance Marketplace

If you’re enrolling in a health insurance plan for 2021, marketplaces like healthcare.gov or HealthSherpa are ideal for people who don’t get their insurance through their employer and who have pre-existing conditions or higher health needs.

But what if you’re healthy? What if you don’t have high expenses related to chronic conditions? What if you still want health coverage without having to pay hundreds every month for a plan that has a $2,000, $3,000, or $4,000 deductible?

If you do not have pre-existing medical conditions, you should consider and compare Health sharing programs, otherwise known as Christian care plans. 

The Alternative To ACA Plans That Can Save You Up To 50% Per Month On Healthcare

What Are Health Sharing Plans?

Health Sharing programs are 501(c) 3 non-profit organizations that help their members share their money to pay for each other’s medical bills. These programs are not insurance programs in the traditional sense, but they do cover your medical expenses and can save you hundreds of dollars on premiums and deductibles compared to ACA plans. Read Nat’s story to see Medishare in action.

What You Get And How They Work

Cheaper “monthly premiums” – Health sharing plans don’t have monthly deductibles, instead they require monthly share payments that are based on your age, health and number of people in your household. The average single family household saves $128 per month with Medishare. A family of 3+ saves $590 per month on average.

Coverage for unexpected medical bills – A health sharing plan covers you for unplanned, costly medical expenses like a broken bone or getting diagnosed with a disease like cancer

A PPO Network – Most Health Sharing plans offer a Preferred Provider Organization (PPO) where members can choose in-network doctors to receive discounted medical care

Coverage for prescriptions – Prescriptions can be covered but are limited to six (6) months of treatment for each medical condition over the lifetime of the Member.

What’s Different Compared To An ACA Plan

Since health sharing programs are not health insurance, they aren’t mandated to cover the 10 essential benefits that all ACA plans are required to cover. Because of this, health sharing plans mostly focus on providing assistance for unexpected, larger medical expenses. These are the key differences between a health sharing plan and typical health insurance.

They require a commitment to certain Christian Tenets –  Because most health sharing organizations are Christian faith organizations, they do not cover health needs that fall outside the tenets of the religion. Things like alcohol abuse, illegal drug use and birth control related costs are not covered. 

They can exclude pre-existing conditions – If you have preexisting conditions, they can choose not to accept your member applications since they are not governed by the affordable care act.

Share in the financial health burdens of other members – Your monthly share payments go directly to helping other members pay for their medical bills.

Ask for your medical history – As a part of the application process, most health shares ask you to complete a medical history questionnaire before your application is approved.

They may limit medical coverage levels – health share plans usually do not offer unlimited medical coverage. They will cover you up until a point, usually $1 million, after which you have to start paying the medical bills.

Do You Have To Be Christian To Have Christian Care?

In order to qualify to become a member, you have to abide by the tenets of the health share. This usually includes making a statement of faith when you sign up. Beyond that, members are asked to agree to live by biblical standards and to support one another’s burdens. However, there aren’t explicit requirements that applicants have to belong to a church to become members.

When considering this type of plan always ask the following:

  1. What type of plan is it HMO (do not have out of network benefits), PPO ( has in and out of network benefits), and Health Saving Account Plans  (HSA) ( let you save for medical expenses on a tax deferred basis).
  2. Are my current providers covered?
  3. Are my current medications covered?
  4. Are any of my treatments or services excluded?
    1. To shortcut reading the whole summary plan description document, go to the exclusion section first.  Then you service is not specifically excluded read the entire document.

Comparing ACA Plans To A Health Share

So how do Health Share plans stack up to a comparable ACA plan? Below is an example of the comparison for someone who’s 29 years old and doesn’t have health issues.

ACA PlanHealth Share
Premium Cost$222$242
Deductible$8,550$3,000
What insurance pays
before deductible is met
$0$0
Visit to a
Primary Care Provider
$30$35
Visit to a
specialist
Deductible must be
met first
$35
TelemedicineNot coveredFree
PrescriptionsDeductible must be
met first, then 100%
6 months covered
after deductible has been met
ER VisitDeductible must be
met first, then 100%
$200 per visit
Inpatient Hospital
Visit
Deductible must be
met first, then 100%
Deductible must be
met first, then 100%
Mental HealthDeductible must be
met first, then 100%
6 months psychotherapy covered
PregnancyDeductible must be
met first, then 100%
Coverage limited to tenet guidelines
In Network
Coverage
Varies by plan990,000 nationwide providers
Out Of Network CoverageVaries by planPlan pays 70%, you pay 30%

Reviewed: Which Health Share Company Is Right For You

Trust is important when it comes to finding a health share organization that fits your needs. When the affordable care act was passed, so-called “health share” companies started to pop up as a way to skirt ACA requirements and offer sub-standard coverage. These newer organizations were also notorious for being slow to pay for benefits or even not paying at all.

The Top 3 Health Share Organizations

  1. Medi-share – Our #1 pick
  1. Christian Healthcare Ministries
  1. Samaritan Ministries 

Let us know what you think!

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