Health Care Alternatives

Health care sharing plans are gaining popularity as a viable alternative to traditional health insurance. A health care sharing plan is typically a faith-based organization, which facilitates voluntary sharing among members for eligible medical expenses. 

Members send in monthly “shares” (which is similar to a premium) and that share covers the medical expenses of other members. In other words, I make a payment and that payment is distributed to you for health care costs you incurred, according to the program guidelines.

The premise is that people with similar beliefs and values are coming together to share each other’s burdens. It is the same message we find in Galatians 6:2, “Bear one another’s burdens, and so you will fulfill the law of Christ.”

A major appeal of these plans is that they are much less expensive than regular health insurance.  Families can become members in health care sharing plans for $300 to $500 per month, compared to an average cost of $1,500 per month for traditional health insurance. 

The cost is usually calculated on one or two adults, plus children. However, children are considered one unit, so it’s the same cost whether you have one child or ten. In addition, health care sharing plans usually have lower out-of-pocket expense limits than typical high-deductible health insurance. 

It’s easy to see the savings appeal for people who do not have job related health care or those who do not qualify for government assistance. 

One caveat to keep in mind is that healthcare sharing plans are not actually health insurance and their limitations of coverage are based not only on managing potential costs and claims, but also the faith-based nature of the programs in the first place. The requirements to join vary by program and may require you to sign a statement of faith, verify regular church attendance and have your church membership validated by a church leader.

Health care sharing plans typically do not cover many health-related costs deemed to be unbiblical. People who use tobacco, drugs, or alcohol may be excluded. Recreational marijuana use (even in legalized states) would not be consistent with program guidelines. 

People who participate in hazardous activities need to be cautious. Each program defines “hazardous” differently. It may be riding motorcycles, or hobbies that require you to wear a helmet such as three-wheel ATVs, off-road vehicles, rock/cliff climbing, spelunking, skydiving, deep sea diving or bungee jumping. Any medical expenses related to these activities can result in otherwise eligible expenses being rejected for sharing.

Some of the sharing plans will negotiate lower costs with the doctors and other plans require you to do the negotiating. Are you comfortable negotiating lower costs with your doctor? Most medical providers are so happy to not deal with insurance companies and their claims process that large discounts are often available for cash-pay customers who are willing to ask.

There are several health care sharing plans which include a savings card for dental, vision, and prescriptions. And others don’t have that option. If those services are important to you, ask before buying.

Some plans require you to send your monthly payment directly to another member instead of to a clearing house. This may appeal to you as it gives you the chance to tell someone you are praying for them or maybe you like connecting with people in different areas. Other people prefer to send payments to a clearing house to avoid the personal connection. Which is right for you?

Pre-existing conditions are defined differently in each program. In general, there is some time limit applied, and sharing around subsequent events related to a pre-existing condition are either not shared, or shared at a lower level. If you have any pre-existing conditions, be sure to understand exactly what is and is not covered. 

Each sharing program has their own prescription drug policy, but generally prescriptions are only shared related to a specific medical need, and only for a short duration.  

This means that someone who developed a condition like Type I Diabetes after becoming a member would only have insulin considered a shareable expense for a very short duration. Maintenance prescriptions are usually not eligible for sharing at all.

There are some key features of health insurance which health care sharing plans lack. Insurance is a legally binding contract between an insurer and the insured. But everything in the health care sharing plan is voluntary and not binding. Health care sharing plans do not guarantee compensation for specified loss, damage, illness, or death in return for payment of a premium.

In a time of rapidly increasing health insurance costs, people are turning to this alternative option more frequently. All of the major healthcare sharing groups have seen dramatic increases in membership over the last few years, with total membership now over one million people between the four major programs. 

You can find information on the web arguing how good or bad each of these programs are. In general, the website of each program is very clear about what is and is not covered—and what they do and don’t cover isn’t always the same as traditional health insurance. 

On one hand, there is considerable risk in joining these programs, as your health and even your life may be at stake. However, there are many people for whom these health care sharing options are working very well. Their needs are covered, and they are saving hundreds of dollars (or more) every month. 

It’s a decision each individual needs to make based on their own situation, the price, moral appeal, and acceptance of the various coverage gaps and risks. And even being aware of the gaps, doesn’t mean it’s easy to know the risks. 

The major health care sharing plans are listed below. Most of them have an online calculator to determine your costs. There are “contact us” forms on their websites where you can request further information. And most of these sites have an online chat option. 

If you are considering a health care sharing program, we highly encourage you to do extensive homework. 

When making a decision such as this, which has such a potentially significant impact on your life and wellbeing, we also encourage you to pray for wisdom!

Our guest on the Compass Catholic Podcast this week has been a member of a health care sharing plan for the last 5 years. Join us as he discusses his experience.