Medical Cost-Sharing: A Viable and Attractive Alternative to Traditional Health Insurance
As of 2023, the average cost of an ACA-qualified silver-tier health insurance plan covering a family of four tops $22,000 per year, before accounting for subsidies. Whereas Medical Cost-sharing is a viable alternative to traditional health insurance that helps people save money every year.
The Medical Cost Sharing Alternative
For millions of families who don’t qualify for a subsidy, or only for a small one, that’s simply not sustainable.
What’s more, deductibles on traditional health insurance plans continue to relentlessly increase. The average deductible for an ACA-qualified health insurance policy as of 2021 was $6,921 for Bronze plans and $4,816 for Silver plans.
In other words, Americans have to spend thousands of dollars before the inflated premiums charged by traditional insurance companies begins to do them any good.
Millions of American families left behind by the Obamacare subsidy schemes are searching for reasonable, cost-saving alternatives.
That’s where medical cost-sharing programs – often called “Healthsharing” programs – can play an important role. Healthsharing offers an affordable and flexible alternative to traditional health insurance.
In this article, we’ll explore the advantages of medical healthsharing plans and cost sharing may be the right choice for you.
What is Medical Cost-sharing?
Medical Cost-sharing is a healthcare financing method that allows individuals to share medical expenses with a community of like-minded individuals.
Healthshare programs aren’t run by for-profit insurance corporations. Instead, healthshare organizations are non-profit, voluntary associations of people who share a common set of values and who agree to help share one another’s medical bills.
Healthsharing organizations are often organized around shared beliefs or religious affiliations. Members contribute a set amount of money each month. When a member incurs medical expenses over a certain amount, the health sharing community helps share the financial burden of those expenses.
Healthsharing vs. Health Insurance
Medical cost-sharing is not traditional health insurance and is not regulated in the same way. However, many Healthsharing programs are members of the Alliance of Health Care Sharing Ministries, a self-regulatory organization that promotes ethical and transparent practices.
Advantages of Medical Cost-Sharing
1. Cost Savings
The monthly contribution for health share plans is typically 30 to 40 percent lower than the unsubsidized cost of a comparable traditional health insurance policy. This translates to immediate savings of hundreds of dollars per month for a family of four, and thousands of dollars per year.
Where a Silver-level health insurance policy purchased over your state’s ACA exchange typically carries a premium of more than $1,200 per month for a family of four, many widely-available healthsharing plans are available for less than $600 or $700 for the entire family.
2. Personal Responsibility
Healthsharing encourages personal responsibility and stewardship of healthcare resources. When individuals are directly responsible for their own healthcare costs, they are more likely to make informed and cost-effective decisions about their health.
While health insurance companies are required by law to take all comers, healthsharing organizations generally restrict membership to people who agree to live relatively healthy lifestyles. Members must typically agree not to abuse alcohol or illegally abuse drugs, exercise regularly, and avoid risky or irresponsible lifestyles.
This contributes immensely to the cost savings available in the healthsharing model.
Additionally, members of healthsharing programs are often encouraged to take an active role in managing their own health and wellness. Many healthsharing programs offer health and wellness resources, including:
These resources help members make informed decisions about their health and encourage them to take proactive steps to maintain their health and prevent illness.
Healthsharing organizations typically have a healthier risk pool compared to traditional insurance plans. This further helps control costs across the entire membership.
3. Flexibility of Medical Cost-sharing Plans
Medical cost-sharing offers members greater flexibility in seeking and getting care compared to most traditional health insurance plans available via state Affordable Care Act exchanges.
For example, while HMO and PPO plans require plan members to restrict themselves to a narrow, limited care network for non-emergency care, healthsharing members are free to choose their own healthcare providers.
4. Medical Cost-sharing Sense of Community
Another advantage of medical cost-sharing is the sense of community and support that it provides. Members of healthsharing programs are often bound together by shared beliefs and values, creating a supportive network of individuals who provide emotional and practical assistance to one another in times of need.
For example, many medical cost-sharing programs have prayer or support groups, where members can share their experiences and offer support to one another. Some programs also have resources for members who are experiencing financial hardship, such as community funds that can be used to help cover medical expenses.
While many medical cost-sharing organizations are explicitly faith-based in nature, not all of them are. Some are entirely non-denominational and even secular. While you must still adhere to a statement of shared values, you can find an established, quality healthsharing plan regardless of your religion.
Misconceptions About Medical Cost-Sharing
Despite the many advantages of medical cost-sharing, there are some misconceptions that may prevent individuals from considering this option. Here are some common misconceptions and the facts that dispel them:
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1. Healthshare Plans Are Not Regulated
While medical cost-sharing is not regulated in the same way as traditional health insurance, many programs are members of the Alliance of Health Care Sharing Ministries, which promotes ethical and transparent practices. Members of medical cost-sharing programs are also subject to federal regulations that protect consumers from fraudulent or deceptive practices.
2. Medical Cost-Sharing is Not Reliable
Medical cost-sharing programs are designed to be reliable and effective. Members contribute a predetermined amount of money each month, which is used to pay for eligible medical expenses. When a member incurs medical expenses, the community shares the financial burden of those expenses. In most cases, members receive prompt payment for their medical expenses, and the programs have high levels of member satisfaction.
In addition, medical cost-sharing programs often have strict eligibility requirements to ensure that members are committed to the program and have a vested interest in its success. Members may be required to agree to a statement of beliefs or values and may be subject to medical underwriting to ensure that they are healthy enough to participate in the program.
Is Medical Cost-Sharing Right for You?
Medical cost-sharing may be a viable and attractive alternative to traditional health insurance for many individuals. However, it is important to carefully consider the advantages and disadvantages of healthsharing before making a decision.
If you are considering medical cost-sharing, here are some factors to consider:
1. Your Health and Medical Needs
Healthsharing may be a good option if you are generally healthy and do not require frequent medical care. However, healthsharing programs typically impose a waiting period before costs related to treating pre-existing conditions become fully shareable.
If you have a pre-existing or chronic condition or require ongoing medical treatment, traditional health insurance may be a better choice.
2. Your Budget
Medical cost-sharing may be a more affordable option than traditional health insurance, particularly for healthy individuals, and those who don’t qualify for a significant subsidy under the Affordable Care Act for a traditional health insurance plan.
Healthsharing plans don’t qualify for ACA subsidies. They offer an excellent value for people who have to pay full-price for health insurance policies, or who only receive a small subsidy under the Affordable Care Act.
If you are from a lower-income group or otherwise qualify for a significant Obamacare subsidy, traditional health insurance may be a better choice.
In any case, it’s important to carefully consider the costs and benefits of each option and choose the one that best fits your budget and circumstances.
3. Your Values and Beliefs
Medical cost-sharing programs are often organized around shared beliefs or religious affiliations. If you are interested in healthsharing, it is important to find a program that aligns with your values and beliefs.
Best Medical Cost-sharing Plans
While health sharing plans are proven money savers across the board compared to the unsubsidized cost of a traditional major medical insurance policy without a subsidy, medical cost sharing programs vary widely in plan design, benefits, exclusions and limitations, value-add services, and costs.
We’ve narrowed them down to the very best healthshare options on the market today:
You can easily enroll in any of these plans online in just minutes.
Want help?
If you need assistance, or just want someone to walk you through your options, and help you compare plan features and costs, we’re eager to help!
Just click here, and schedule a FREE consultation!
Conclusion on Medicare Cost-sharing
Medical cost-sharing is a viable and attractive alternative to traditional health insurance. It offers cost savings, personal responsibility, flexibility, and a sense of community.
If you are considering medical cost-sharing, it is important to carefully consider the advantages and disadvantages of this option and choose the one that best fits your needs and budget.
Here are some additional articles on healthsharing programs: Best Healthshare Plans Comparison Guide 2023 | Direct Primary Care: How to Use a DPC and Still Protect Yourself from Major Medical Expenses
Here are some additional pages related to this article: Healthshare Plans | Healthshare FAQs
Lou Spatafore works for HSA for America. As a PBM, his focus is to help people find money-saving alternatives like HSA plans and health sharing programs. Read my full Bio.