How health share plans work

Health Share Plans Made Simple

Health share plans have become increasingly popular in recent years. Health share plans are alternatives to health insurance that offer lower premiums and more control over your policy. At Veritas Insurance, we offer medical cost-sharing programs through Medi-Share and Sedera, two well-known health share companies Here is an overview of how health share plans work.

Health Share: The Original Health Insurance

Health share plans are really what health insurance was intended to be back in the day. The members of a health share community voluntarily pool their money to help cover the medical bills of people in the network. If someone has a medical bill, the health share company sends them a share of the pooled money to help make the payment.

What Makes Health Share So Affordable?

One of the primary reasons people opt for health share plans is that they are typically much more economical than traditional health insurance. That is because health share plans are able to do underwriting.

The Affordable Care Act became law in 2010, insurance providers were no longer permitted to do medical underwriting for individual health insurance. Medical underwriting is where an insurance company examines your medical history before putting you on a plan. That allows them to assess your level of risk, which is the basis for how much your premium costs.

However, health share plans are allowed to do medical underwriting. That means if you have a medical history or certain pre-existing conditions, you may not be able to get onto a plan. But it allows them to keep their rates significantly lower for healthy individuals. We have seen individuals be able to cut their premiums by about 60% by switching to a health share plan.

Can You Use Your Doctor With Health Share?

One of the biggest questions a lot of folks have is whether they can stay with their current doctor if they switch to a health sharing program. The answer is, it depends.

For some programs, like Sedera, there is no doctor network. You can work with any doctor. Sedera will then negotiate rates with the medical provider. The downside of this system is that it takes longer to get the payment to the hospital. Usually this isn’t an issue unless it’s a surgery center where they want their money up-front.

If you join other programs, like Medi-Share, you will be part of a network where you receive network discounts. That makes things logistically easier, but your options may be more limited if your current medical provider is not within that network.

Other Considerations

Health share plans can be a great option for you if you are looking for an economical alternative to health insurance. Sometimes the coverage options can be different, which you can learn about here. It’s important to know how health share plans work before making a decision.

If you would like to speak with an agent about health share vs. health insurance, call our Johnson City office at (423) 292-4142. We are an independent insurance agency, which means we help you find the insurance or health share provider best suited to your needs.

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