May 13 min read

Is a Health Share plan right for you? Exploring the basics and benefits.

Updated: Jul 31

The health insurance industry is a very popular political topic and is therefore always changing! You may have already heard of the term "Health Share". But most people aren't too sure about the differences between these options and some alternatives. So let's dive right in!

What is a "Health Share"?

Most Health Share plans are offered through faith based, non profit organizations. The first Health Care Sharing Ministries date back to Biblical times when early Christians pooled expenses to help their fellow brothers and sisters in need. These casual arrangements turned into more defined charitable organizations in the 1980s and 1990s. These options gained in popularity even more so amongst modern individuals and family's in the mid 2010's.

One important thing to keep in mind is that these plans are not, in fact, "insurance." Insurance offered through something like the Affordable Care Act offers guaranteed coverage, even for pre-existing conditions, for a monthly premium. Health Shares, on the other hand, provide a co-operative approach by pooling everyone's monthly contribution amount to help fellow members who share the same religious and ethical beliefs, which is considered a voluntary act.

How do I know if a Health Share is right for me?

A big reason why Health Shares saw a surge in enrollments during the mid 2010s was due to the enforcement of the Affordable Care Act. Lots of consumers did not like feeling boxed in and forced to choose health coverage regulated by the federal government. Not to mention the income based monthly premiums, which most could either not justify paying or simply could not afford. ACA plans also have specific times of the year, known as "enrollment periods" which allow enrollment in a chosen plan. Health Shares, on the other hand, are available 365 days a year - no enrollment period needed!

Health Shares do accept those with pre-existing conditions! Instead of denying coverage altogether, they have exclusions, limitations, and waiting periods in regards to treatment and care for such conditions. Eligibility on Health Shares are generally determined by agreement on the "Statement of Beliefs" and not engaging in unhealthy lifestyle choices like using tobacco or drugs. Of course that can vary slightly from company to company. If you would like to stay away from the Affordable Care Act and are open to alternative options, a Health Share might be the right fit for you!

So, what kind of benefits can I expect from these "Health Shares"?

Great question! While most Health Shares tend to offer similar benefits, it can certainly vary from company to company. What's important to understand is that since these plans are not insurance, they can not use the regular insurance lingo. You're likely used to seeing things like a deductible or copay. While these plans use terminology such as ISA (Individual Sharing Amount), MRA (Member Responsibility Amount) and visit fee. Most include free telemedicine benefits, preventive care allowances, and prescription discounts as well. There can also be varying levels of coverage - from catastrophic only (which is focused on things like hospitalization, surgery, etc) to robust, well rounded options that include multiple fixed visit fees for PCP/specialist visits, maternity care, and even adoption assistance! Health Shares also offer nationwide coverage through large PPO networks. Overall, these plans can be very comparable to traditional options you may be accustomed to.

If something happens, how do my medical bills get paid?

That's another great question! As mentioned earlier in this post, your monthly contribution is placed into a large pool, similar to an escrow account. Generally anything with a fixed visit fee amount is straightforward - you pay that visit fee at your time of service and the Health Share is billed the remainder. For more severe instances like hospitalization or surgery, it works a bit different. You will first have your chosen ISA (Individual Sharing Amount) that you are responsible for. Don't worry - you don't have to pay this before or during your hospital admission. After your responsibility is met, as long as the service is a "covered medical need", the Health Share will pull from that pool of member's contributions to pay the remaining balance up to your maximum amount per occurrence or overall policy coverage amount.

Okay, I'm interested! What are the next steps?

Lets connect! I can help you navigate multiple options, explain coverage more in depth, and assist with the enrollment process. If you'd like to proceed on your own, that's fine too! You can give me a call or text at 443-233-0572, email at shelly@familybenefitscenter.com, or browse through the links below.