Pros and Cons Of Health Sharing Programs

Health is one of the basic rights of an individual. However, health insurance costs seem to be on the rise over the years, making health maintenance a challenge. Aside from premiums that an insured has to pay each month, there are still maximum payments that must be satisfied before the full coverage kicks in.

As most people can no longer afford health insurance, many find alternatives to resolve this problem. One of the popular alternatives is health sharing programs. If you’re considering this alternative, you must learn first what these are as well as their pros and cons to help you decide on the right healthcare program for you. 

What Are Health Sharing Programs 

Healthcare sharing programs or ministries are organizations where participants with similar ethical or religious views share healthcare costs. They’re religious or non-profit charitable organizations that coordinate and manage services to assist healthcare costs. 

Alternatives to primary medical insurance include health share schemes. According to their members, these plans are more competitive, offer more options, and are more personal than corporate plans. While health care sharing is not insurance, the policies they offer count as insurance under the Affordable Care Act. 

You might want to check online resources on the way Annual Open Enrollment Health Share Programs work to understand them further. 

Why Choose Health Sharing Programs? 

Below are the advantages of being a member of a health-sharing program:

  1. Lower Costs 

Premiums may vary, depending on the type of plan you choose. Most say that monthly premiums in a health sharing plan are lower than traditional health insurance. The annual “unshared amount,” which is the deductible for conventional methods, is also cheaper in a health sharing program. 

  1. You Can Enroll Anytime 

Traditional insurance has what is called open enrollment. It’s the time of the year when people need to enroll or re-enroll to a conventional health plan. If you missed it, you’d have to wait until the next open enrollment to get one. However, not having health insurance for a certain period might face some tax penalties. 

Health sharing programs, on the other hand, don’t have scheduled open enrollment. You can enroll to whatever policy you want any time of the year. 

  1. Freedom To Choose Your Own Healthcare Provider 

Although it seems that many individuals have mixed perceptions on Christian health sharing programs, some like it as it allows the freedom to choose one’s healthcare providers, and provider participation doesn’t matter. Traditional plans have a specific network of doctors assigned to such type of plan that might limit you in choosing your doctor. 

  1. No Lifetime Maximum Limits 

Some traditional plans specifically have a lifetime maximum limit. When a beneficiary’s medical expenses reached the dollar limit, the insurance no longer pays any of their medical expenses regardless if it’s medically necessary or not. Health share plans don’t impose this limitation.  

  1. Transparency 

You can see where your money is going with some health share plans. You’ll know, for example, whether your monthly contribution helped someone heal from an illness or welcome a new family member. You may also be required to give your monthly contributions directly to individuals rather than to the ministry to allocate the funds. Health sharing programs can be audited annually by an independent accounting company to identify their financial stability. 

What To Avoid In Health Sharing Programs

Below are the disadvantages of a health-sharing program: 

  1. No Coverage For Pre-Existing Conditions 

Pre-existing conditions like autoimmune disease are often not covered by health share policies. It means that if you want to get the most out of a contract, you must sign up for it ahead of time. Other pre-existing illnesses, such as cancer and heart disease, require a certain period in “cured” status before they can be shared, such as five years for cancer and heart disease and a year for most others. 

  1. Some Medically Necessary Services Aren’t Covered 

Because health share programs are faith-based, it doesn’t typically cover rehabilitation and substance abuse related services and services for extramarital children. Some health share plan also excludes mental health services. 

  1. Health Share Programs Aren’t Regulated 

Health share programs aren’t considered health insurance. That’s why your state’s Department of Insurance doesn’t regulate them. It means no law can protect its members from unpaid claims. If the health share program faces bankruptcy as they’re not insured, they don’t need to follow specific guidelines regulated by the government. 

Should You Or Should You Not Enroll To A Health Sharing Program?   

Like any other health program or insurance, health share programs have their advantages and disadvantages. Whether it’s a good option or not will depend on your needs and preference. If you need more affordable healthcare, and you don’t have a problem with the cons of having a health share plan mentioned above, then a health sharing program might be a good option for you.