People new to health sharing usually have questions, often revolving around costs and benefits. This is usually because prospective HealthShare members are preparing to transition away from traditional insurance. But in some cases, those interested in joining a HealthShare community may also wish to keep their medical insurance. But, can medical insurance be combined with a HealthShare membership?
If financially viable, combining both health insurance and a HealthShare membership could be more effective than using either alone. It is important to remember that medical cost sharing is not insurance, and any medical bills would only be considered eligible for sharing after health insurance has processed them. This system has both advantages and challenges.
Advantages
One significant upside is the potential to pay considerably less money for large medical bills. This, however, is contingent on several factors. For instance, if the remaining amount owed meets the HealthShare’s annual or per-incident minimum after insurance processes the bill, and if that bill is considered eligible for sharing (i.e., it’s not related to a pre-existing condition and doesn’t result from violating a member guideline), the HealthShare will likely help pay for the remaining balance.
Challenges
The first major challenge is the numerous variable factors involved. The process would depend on the HealthShare and the membership type within that HealthShare. Not all large bills will be shareable, and it would be unrealistic to expect them to be. Some major HealthShares welcome members over 65, provided they pair their membership with Medicare, indicating that many companies are used to dealing with members who also have some form of insurance.
Another key challenge is the time limits many HealthShares impose for submitting needs for approval. Given that insurance processing doesn’t always proceed quickly, it’s important for members to document their case promptly to avoid exceeding the time limit. Submission of electronic forms, receipts, itemized bills, etc., often must occur within 30 days or less. Although a two-week wait could increase the likelihood of having all necessary materials ready for submission to the HealthShare and improve the chances of insurance processing the claim in time, it demands a delicate balance. Therefore, members interested in combining HealthShare membership and health insurance need to be proactive and organized.
Considerations for combining
Whether it’s best to combine health insurance with HealthShare membership depends on several factors. If a member lacks organizational skills, works with a slow-moving health insurance company, or doesn’t have the time and patience to keep up with paperwork, then combining the two might not be a good idea. Similarly, if a member doesn’t need much in terms of preventive or maintenance care, it might not be worth the extra money.
However, if affordability, efficient management of medical records and needs requests, and a significant benefit from extra care is likely, then combining HealthShare membership with health insurance could be a viable option. It may provide more financial security during emergencies and support from a community of like-minded people. Thorough research is recommended before deciding whether to combine HealthShare membership with health insurance to strike the right balance between healthcare and financial security.
It’s worth noting that some HealthShares offer affordable, catastrophic-only plans. If a full membership is overwhelming, combining both kinds by choosing the least expensive membership type could be a useful alternative.
