Medical cost sharing organizations have helped families pay for millions of dollars’ worth of medical expenses. If you are considering taking part in a HealthShare community, you may wonder if your membership will suit your medical needs. HealthShares may not be for everyone, but they are a good option for many individuals, especially those who want to take an active role in their healthcare choices.
Is a HealthShare right for you? Ask yourself these questions before joining one to help you determine if medical cost sharing is the right fit for you and your family.
1. Am I ready to take responsibility for my healthcare?
HealthShares can save you money on medical expenses, but the process for having a medical need shared with the community is different than working with an insurance company. Because medical providers are accustomed to working with insurance entities, generally, all you have to do is provide them with your insurance information at the time of service, and the provider can work directly with the insurance.
Though HealthShares are growing in popularity, many medical providers are still unaccustomed to working with them. This means you have to take responsibility and request cash-pay discounts, get itemized bills, and work with both your healthcare provider and HealthShare to obtain all the documentation needed to determine sharing eligibility.
This might seem like a lot of work, but the savings are usually worth the effort! Most HealthShare organizations give their members the freedom to choose their providers without network limitations, and they may share in alternative practices that traditional insurance doesn’t cover. If you are willing to be responsible for your healthcare choices and take the extra steps required by HealthShare organizations, then medical cost sharing may be right for you.
2. Am I a savvy healthcare consumer?
Most HealthShares have certain sharing limitations designed to keep member contributions low for the entire community. Common limitations include sharing for emergency room visits, which are incredibly expensive, for needs that do not constitute an emergency. If you’re first response when you have a sore throat is a visit to the emergency room, health sharing might not be the best choice for you. However, if you make smart healthcare decisions, take advantage of telemedicine, and practice savvy healthcare consumption, then a HealthShare will likely share in many of your medical costs.
3. What are my healthcare needs?
Whether joining a HealthShare is right for you will depend on your individual healthcare needs. Most HealthShares are designed to help members with larger, unexpected medical expenses, though as they grow, many are beginning to offer more diverse preventive care options. You should consider some of the following factors as you determine your needs from healthcare providers:
- Do my usual healthcare needs align with the shareable medical expenses of my chosen ministry?
- Am I prone to accidents, or are most of my healthcare expenses related to preventive care?
- Do I have any pre-existing conditions that would be subject to sharing limitations or waiting periods?
- Am I planning to start a family?
Answering these questions for yourself can help you determine whether your needs align with what HealthShare organizations have to offer.
4. What is my budget?
Many families are turning to medical cost sharing because of the savings in their monthly payments. Before joining a HealthShare, you should look at your healthcare budget—including the following costs:
- What you are spending now on monthly premiums, office visits, medications, and deductibles and coinsurance costs.
- What you would spend for your HealthShare membership in each area.
- Your payment responsibilities for each if an unexpected injury or illness were to occur.
Going along with the question of budget, it is also important to consider whether you have the assets to pay healthcare costs upfront and wait for reimbursement from your HealthShare. Every HealthShare has a slightly different process for sharing in its members’ medical costs. As health sharing becomes more common, organizations are moving toward paying providers directly. However, this process is not yet universal and many still require the member to pay for their medical services and then get a reimbursement once their need is processed.
This can take anywhere from about a week from the time that all necessary documentation is provided to the HealthShare, to upwards of 180 days. Some HealthShares boast faster reimbursement times than others, so your choice of organization should take into account the time required to process member needs. HealthShares generally do not take responsibility for late payment fees or interest, so you will need the financial ability to pay for your medical needs while waiting for a reimbursement from your HealthShare. The money you save in monthly contributions may give you this ability, but any healthcare decision should include a detailed look at your finances and consider choosing a HealthShare that makes payments directly to your medical provider on your behalf.
5. Are the HealthShare’s values consistent with my lifestyle?
A HealthShare is not insurance. You’ll see this phrase somewhere on every HealthShare site, and it’s true. HealthShares see themselves as communities coming together to share one another’s burdens in the form of medical expenses. As such, each one has its own set of values and requirements for membership. Before making the decision to join a HealthShare, ask yourself if you agree with the beliefs set forth by your chosen organization.
Common values include a commitment to healthy living; ethical behavior; abstinence from drugs, tobacco, and/or alcohol; and, in the case of religion-specific ministries, living a lifestyle compliant with certain denominational beliefs, usually derived from the Christian Bible. If you want your healthcare choices to reflect your moral values, a HealthShare can provide the community you seek.
