Although changes to health insurance guidelines have helped many more Americans get insured than before the ACA, the cost of health insurance is still high. When shopping for lower health care premiums, some people look at Health Care Sharing Ministries (HCSM) or medical sharing as one of the options to lower costs. It is important to understand that medical sharing networks are not insurance plans. Instead, they are registered non-profit or charitable organizations.
There are over 1 million health care sharing participants, with 100 registered Health Care Sharing Ministries across the country. Medical sharing is a way for people with similar beliefs, values, and lifestyle choices to share their medical bills. Here's what you need to know about medical sharing to decide if this idea may (or may not) work well for you
- Medical sharing is a way for people with similar beliefs and values to share their medical bills.
- Sometimes referred to as a medical sharing society or a medical cost-sharing organization, medical sharing networks are not insurance companies.
- These plans are not health insurance, and they do not guarantee payments based on a contract like an insurance policy.
- Medical sharing plans collect funds from members; when a member has medical expenses, they can ask for the help of the sharing plan to pay the bills.
What is Medical Sharing and How Does It Work?
Sometimes referred to as a medical sharing society or a medical cost-sharing organization, medical sharing networks are not insurance companies. The concept of operation is similar to a health insurance company.
To understand how a medical sharing plan works, you first need to understand how a typical health insurance plan works: The health insurance plan will have a large number of people insured, if the health insurance provider is ACA compliant, then people in the plan may have pre-existing conditions since this is not excluded by ACA plans. All these different people with varied pre-existing conditions and various lifestyle choices will all be on the same health care plan and so they all "share" medical costs.
Medical sharing plans are not insurance, and they do not guarantee payments based on a contract like an insurance policy. They do not have any requirements that force them to accept members with pre-existing conditions. They are non-profit, charitable organizations that collect funds from members. When a member has medical expenses, they can ask for the help of the sharing plan to pay the bills.
This system is different than insurance, which is guided by a specified contract that clearly outlines what is or is not covered, how much is paid and what portion each policyholder needs to pay.
Do Medical Sharing Plans Have Deductibles?
Medical sharing plans may not use the same terminology that you hear about in insurance, such as deductibles and premiums, because it is not insurance. For example, in insurance, the deductible is your share of the premium. In the medical sharing ministry, you may hear about this as a "share amount" or "family share amount."
What are the Advantages of Medical Sharing?
Because of the way the cost-sharing is organized, Medical Sharing Plans provide a few advantages, like the opportunity to negotiate lower costs of health services by allowing participants to pay cash. Paying cash has several advantages when it comes to medical bills. One of them is that when you pay cash upfront, you may be able to get a discount.
Medical sharing also provides another advantage to participants: It doesn't limit people to specific health provider networks because there is no "network." If you are a member of a health care sharing ministry, you can choose to get your medical services wherever you want.
Because of the members' ability to choose where they get their medical services, they may not be limited to their state, or even country like people are with many health insurance plans. Each ministry will be able to determine its criteria for payment.
If you are interested in learning more, look into direct primary care alternatives.
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