Shared Health Plans

A lower cost alternative to traditional health insurance!

Health care options are getting more and more expensive. Traditional insurance plans are still a good, and often the only, way to go for many people, especially those with pre-existing conditions.

The issue that many face are the rising costs year over year. For people that purchase health insurance on the healthcare marketplace (Obamacare), not through their employer, you have another option, Shared Health.

Shared Health Plans offer an alternative to traditional health care plans. These plans have a lower deductible and have lower prices than traditional plans.

Since it is not a traditional insurance plan they are allowed to exclude certain coverage. For example: they do not fully cover pre-existing conditions, some plans exclude smokers and you are also expected to lead a healthy lifestyle.

Are you ready?

If you and your family need coverage, now is the time to find out how these plans can help you!

More about Shared Health Plans

The health share world can be quite confusing if you are used to having traditional health insurance through a company such as Aetna, Anthem, Harvard Pilgrim, United Healthcare or Maine’s only insurance co-op, Community Health Options.

The great news is that the various Health Share Groups continue to grow, and depending upon your tolerance for submitting your own claims (called a “need request” in the health share world), monthly costs to join these programs are significantly less than traditional major medical insurance – especially if you are paying more than $400 each month in premiums.

If you are no longer working for a company that offers health insurance or if you have lost coverage you may be shocked at the cost for insurance when you begin shopping and comparing costs and plans on the healthcare marketplace online.

What options do you have?

It is really important that you do your own research. All the various health shared health plans offer varying levels of membership programs. Getting into the wrong program or joining at the wrong level could open your family to being without any access to “need reimbursement” for certain catastrophic claims.

My personal thoughts on the more popular Health Share Programs

Christian Health Ministries
Based upon their website information, they are the oldest health share ministry by about 14 years. They have three levels of membership (at the time of this post). Gold, Silver, and Bronze.

Important Note: I would not recommend joining CHM at any other level than Gold. The Gold Program is the only one that includes both inpatient (hospital) and outpatient (medical) reimbursement, as well as their only program that offers no maximum reimbursement limit.

Basically, the only real value of Silver and Bronze is that one meets the ACA requirement to avoid the penalty which will no longer exist starting in 2019. These programs, however, would leave you greatly compromised and at risk if you have inpatient (hospital) expenses.

CHM requires members to tell Providers they are self-pay and pay their own bill up front and wait for reimbursement. One member’s experience is that he had a $1,900 bill that he received an $800 ”cash pay” discount. He submitted all the forms to CHM, and it took 5 months to get his $1,100 reimbursement check. That is a long time to wait but considering the savings it may be worth it.

This is the one you have heard advertised on the radio a lot lately. They may be the largest health share program soon. They aggressively market all over the country. They started in the mid 1990s, and their reimbursement process is a bit more like traditional health care. They use a network (PHCS), and will pay the Providers directly on the members’ behalf.

It is nice to have the Providers paid directly, however Medishare does cost a little more than CHM. In general, to get a monthly cost fairly close to CHM, you would have to choose a plan with a $3,500 Deductible (member responsibility). But if you’re healthy this should not be a problem.

The good news is when you have a “need” (claim), it is much easier than with CHM, and size-wise, they are growing substantially. And in a world where the community is sharing in expenses, bigger is better.

Altrua has a much more “vague” statement of belief policy. Their application is one where most likely, Christians and non-Christians would feel comfortable saying “yes” to their statement of beliefs.

The biggest negative on the Altrua side is some of their exclusions are for “accident – related” injuries for which many people would take part in on a regular basis. As with all the health share programs, it really is important to read understand their guidelines and exclusions.

Each person is responsible to understand the risk on their own. Sometimes I think the health share programs use the fact the health share world is quite different from major medical to their advantage and while I believe they all want to help people, they could probably be a bit more careful in their descriptions of their programs.

Sedera is an employer program. It is a non-faith based option designed to help small employers offer an affordable alternative to major medical to their employees.

I like their approach, and working in the insurance industry for the past 8 years, I have encountered many small businesses who are looking for a way to offer their employees a reasonable alternative.

If you are an employer looking for a great solution for your employees, Sedera could fit the bill. You just need to couple it with a MEC program (minimum essential coverage) like Shared Health Alliance offers in order for your employees to meet the ACA requirement. [READ MORE]

Sedera offers $500 and $1,000 IUA amounts and they are very reasonably priced. Also, it can be an employer deductible expense, so a nice potential solution here.

I am not a fan of Liberty. They make a claim that they will pay the Provider directly, but many Providers will not accept a payment from them. What I have seen is that Providers typically make the member pay upfront and then have to file on their own anyway.

They are priced reasonably, and their statement of belief is a bit more vague as well, so many non-Christians are able to feel comfortable joining.

They have also been around since the mid 1990s. Their application process is a bit cumbersome, just like Medi-share. Members make their monthly amount to other members around the country. If you did have a big claim, you would get dozens, or hundreds of checks mailed to you from around the country in order to get your reimbursement. They are not really any cheaper than the others, and administratively, I would not want to send my checks to other members. The other health share programs act as “centralized” collection and distribution points.

In Conclusion

The Health Share world continues to grow. Remember, health share is not an “insurance contract” so you need to make sure you have read carefully the guidelines and exclusions of each program. The responsibility falls on you and you alone.

Each Health Share Program has its own website and multiple options to consider. While some of the information can be confusing to wade through, each one will always fall back to the fact they are not “insurance” and it is not a contract for payment, so make sure you under the pre-existing condition limitation clause of each one and the various levels they offer.