WHAT ABOUT MAJOR MEDICAL INSURANCE?
You are not required to have insurance coverage to be a member but our affordable fees make our high level of service ideal for individuals with low cost, high-deductible insurance plans (with or without accompanying health savings accounts) and those who traditionally pay out-of-pocket for their primary care.
Our approach returns control of your care to you and your provider. Even if your employment status or insurance coverage changes, you can remain a member as long as you maintain your membership. Our patient-centered care is ideal for individuals who want better access, exceptional service and more attention from their primary care provider.
So, save your insurance for the expensive ER and hospital as it is designed, and retain your very own doctor, nurse practitioner, physician assistant and focused medical team to help you manage and navigate all of your primary healthcare needs.
WHAT ARE HEALTH-SHARING PLANS?
Medical Cost Sharing Plans are not health insurance….for most they are better. They are an affordable way to plan for unforeseen major medical expenses. It saves thousands of dollars! Plus, these heath care sharing plans are exempt from the requirements of the ACA mandate to purchase health insurance. That means you do not have to pay a penalty!
Medical Cost Sharing Plans are NOT a cheap insurance program. They are completely different.
A few of the major health care sharing ministries are linked here:
5. Sedera Health (small employer-sponsored plans)
HEALTH COVERAGE SHARING PLANS EXPLAINED
Medical cost sharing are a group of like-minded individuals that agree to come together and help each other pay their medical expenses. They don't have to play by the same rules as health insurance. There are no network requirements, you can go to whatever specialist or hospital you like. Once you enroll, you get a membership card, and when the specialist or hospital asks for your insurance, you can just give them your card. For many of the above programs, it will be processed in the same way.
On the rare occasion that the specialist or hospital will not accept your membership, these health sharing programs do pay in cash. That means you can request to be reimbursed by the sharing members if you choose to pay out of pocket.
Basically, everyone pays in a specified monthly share amount, for most families it will be less than $600 per month, and you are responsible for covering an “annual personal responsibility” (like a deductible). Then, the rest of your medical expenses are shared among the group from what they have paid in – in many cases up to $1 million per incident!
They have different guidelines (like smoking, or certain pre-existing health or lifestyle-related conditions). In which case they will decline membership or those conditions simply are not covered.
However many pre-existing conditions can be handled with an up-charge of the monthly shared amounts. Then during years two and three of membership, there will be increasing coverage of eligible expenses to treat that condition if improvement is exhibited. However, some pre-existing conditions might never be shareable. You can always just ask for specific clarification.
This chart by Liberty Healthshares is the best way to compare four of the non-employer based plans and what is included with each. This FAQ by Liberty Heathshares is helpful. It has a very informative and clear answer for every question.
If you are looking for an affordable way to handle your major medical expenses and have personalized healthcare, a health sharing plan combined with SouthernCARE direct can make a lot more sense than overpriced health insurance.