Like life insurance, health insurance is one of those things you really don’t want to do without.
Even if you’re a pretty healthy person, paying for routine doctor visits and check-ups can get expensive. And if you get sick or hurt, medical bills can quickly pile up if you have to go to the hospital or see a specialist.
But if you have health insurance, you probably know that it’s not cheap. The average annual premium for family coverage under an employer’s plan was $19,616 for 2018. Single coverage premiums averaged $6,896.
Not everyone qualifies to purchase health insurance on the exchange, or for a tax subsidy to diminish the cost. Health insurance can be a huge budget drain if you’re buying it on your own and paying for it out-of-pocket.
A couple of years ago, I signed up for family coverage for myself and my two kids through a large, nationwide insurer that offers plans in my region. My premiums came to just over $1,000 a month and the plan had an almost $7,000 in-network deductible. As a self-employed freelancer, I didn’t (and still don’t) have the advantage of a group plan through an employer, so this was my “just-in-case” policy.
The only problem was we hardly ever used it. When it was time to renew the policy, I faced an even higher cost – a routine premium increase added more than $100 per month to my bill. I said no thanks and started looking for other options.
That’s when I learned about health care sharing programs. If you want to save money on health care, here’s what you need to know about this insurance alternative.
What is health care sharing?
The easiest way to understand health care sharing is in terms of what it’s not. Health care sharing programs aren’t health insurance. They’re not offered by insurance companies or employers.
Instead, health care sharing is a group approach to managing health care costs. The members of a health care sharing program each pay a monthly share amount. Individual shares are pooled together and when a member submits an eligible medical bill, it’s paid by the program using those pooled funds.
Unlike health insurance, you don’t have to stay in a certain network; you can see any doctor you want. And instead of an annual deductible, you’re only responsible for paying an unshared amount of medical expenses each year.
The unshared amount, the amounts that can be shared, and the expenses that qualify for sharing vary from one program to another. For example, I use Liberty HealthShare and pay $449 a month as my “share” for family coverage. My annual unshared amount is $2,250, which is about a third of what I would have paid as the deductible on my old health insurance plan. And I can share eligible expenses for up to $1 million per incident.
Other health care sharing programs include:
- Christian Healthcare Ministries
- Samaritan Ministries
- Aliera Healthcare (which administers the Trinity HealthShare program)
- Altrua HealthShare
Phil Taylor, founder of PTMoney uses a health care sharing program and says it has made a huge difference for him and his family from a cost perspective.
“I’m so thankful that health care sharing exists,” he says. “It allows me to share my family’s health care expenses with others who share my values and I end up saving a tremendous amount over traditional health insurance options.”
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Health care sharing pros and cons
Saving money on health care is a big deal. I’m saving almost $8,000 per year by using health care sharing instead of health insurance. But it’s important to look at the big picture if you’re considering it yourself.
On the pro side, health care sharing programs generally offer:
- Predictable monthly payments and annual share amounts
- Freedom to visit any doctors
- Potentially lower out of pocket costs compared to traditional health insurance
- Coverage for some pre-existing health conditions
- Higher lifetime coverage limits for medical care
- Discounts on health care if you’re in good health
- The opportunity to share health care expenses with people who also share your faith
Many, though not all, health care sharing ministries have a religious affiliation. Medi-Share, for example, is a Christian health care sharing program while Aliera Healthcare doesn’t have any specific religious requirements. As part of your enrollment in a health care sharing program, you may have to sign a statement of beliefs or principals.
That might not be an issue for some people, but it could be for others so it’s something to be aware of.
One thing I don’t love about health care sharing is that I miss out on a few tax benefits:
- Members are not eligible to open or contribute to a Health Savings Account (HSA). These accounts offer a tax-advantaged way to save for future health care expenses. To open or contribute to an HSA you must have a high deductible health insurance plan.
- Since members don’t pay a traditional premium, they are not eligible to claim the tax deduction for health insurance premiums that’s allowed when you’re self-employed.
- Members are not eligible for any kind of Affordable Care Act subsidy.
It’s also important to keep in mind that health care sharing programs may not cover every medical or related expense. Prescriptions, for example, might not be included in your plan so if you regularly take prescription medications, they may be an out-of-pocket expense, depending on the plan. Additionally, while some health care sharing programs accept people with pre-existing conditions, it could be harder to get covered through one of these programs if you have a serious health issue.
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Look at both sides before you decide
“Health sharing isn’t for everyone,” Taylor says. Not all pre-existing conditions and medical expenses will be covered, which can be frustrating for some people.”
As you compare health care sharing plans to one another and to traditional health insurance, remember to consider:
- The monthly and annual cost
- What’s covered (and what’s not)
- Where you can use your coverage
- The process for sharing medical expenses
- What requirements you’ll need to meet to qualify
Bottom line, do your due diligence thoroughly before making a move from health insurance to health care sharing. And remember that you can always go back to the marketplace for coverage if you need to.
Rebecca Lake is a freelance writer specializing in personal finance and small business. She lives on the North Carolina coast with her two children. Opinions are her own.
Haven Life Insurance Agency offers this as educational information only. Haven Life does not endorse or offer the programs, products, services and/or strategies discussed here.