A Health Share Plan (HSP) is a method of “sharing” medical expenses across a group of people. Typically these are founded from religious groups, or groups of people that share similar ethical/moral beliefs. The criteria for joining a HSP can be vary from plan to plan.
An HSP (Health Share Plan) is not considered “insurance” in the traditional sense. Instead, health share plans are cooperatives in which members agree to cover a portion of one another’s medical bills. In other words, the organization’s members “share” medical costs. Members pay a monthly “share,” and the health sharing organization coordinates the financial contributions to support the medical needs of all sharing members. The goal of a HSP is to greatly reduce the monthly cost of medical coverage. However, there are some major things to consider before joining a HSP and whether or not it’s right for you.
“One main downside of a health share plan is its lack of coverage for pre-existing conditions. While state and federal laws mandate that insurance companies accept consumers with pre-existing conditions, a health share plan is not subject to these same requirements. This means that a consumer with a pre-existing condition, such as diabetes, high blood pressure, heart failure, or cancer, may not get coverage for this condition through an HSP.
Still, there are exceptions, and some HSPs might accept certain pre-existing health conditions. Some HSPs might phase the condition in, meaning that members would not share costs for that condition during the first year. Then, during subsequent years of membership, members might share a certain amount of eligible expenses that treat the condition. In other words, a member may need to pay into the plan for a certain number of years before getting coverage.
…The HSP decides which health conditions are deemed shareable and which are not, depending on how those conditions align with their beliefs. Eligibility is usually outlined in the individual member guidelines, and it’s important to be aware of the details when deciding on an appropriate program.” (gusto.com/blog)
Traditional health insurance plans have a major advantage when it comes to negotiated discounts, these place limitations on the cost that providers charge. Negotiating rates for service can greatly reduce the end cost to the consumer. Due to HSPs having significantly fewer members, they have far less bargaining power to reduce medical costs amongst providers.
“Health sharing plan members do not have the legal protections that they do under traditional health insurance. Most importantly, this means that HSPs are not under a contractual obligation to pay members’ medical bills.” (gusto.com/blog)
So if you’re wondering if a Health Sharing plan is right for you, talk to your broker and we can help you compare plans with traditional insurance and see what best fits your lifestyle.
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