Though some standards are starting to emerge among the leading HealthShare companies, many still have wildly different approaches to helping members meet their medication needs.
Prescription sharing with HealthShare companies
Despite a lack of uniformity in how HealthShare organizations approach prescriptions, they do have some common elements: Almost all HealthShares generally share in costs for medications related to eligible medical incidents or injuries. This prescription eligibility may not extend to all membership tiers within a company, or it may come with some significant constraints. But for the most part, the leading HealthShare companies have something in place to address this need.
Every HealthShare is different
Where policies vary is when it comes to other medications not necessarily related to a specific eligible incident, or instead related to a pre-existing condition, or a medication that doesn’t have an end in sight. This is called a maintenance medication, and they are usually not eligible for sharing, or are only shared within predefined constraints.
Christian Healthcare Ministries offers this type of prescription sharing, offering incident-related prescription sharing on its Gold-level membership, and no maintenance medication sharing on any membership level. CHM has, however, partnered with several online pharmacy networks to help members find the best medication prices.
Supplemental prescription programs and partnerships
Alternatively, some of the leading HealthShare organizations offer supplemental programs for prescription assistance. These programs may include some limited sharing as described above, but also include flat rate discounts for certain generic prescriptions and other medications.
Zion HealthShare offers its Rx Share program, a cooperative partnership with OptumRx which provides sharing eligibility to prescriptions related to eligible medical needs, as well as flat-rate $5 price points on low-cost generic prescriptions, $15 price points on other generic prescriptions, and general discounts on all others.
Solidarity HealthShare has partnered with Drexi Pharmacy to offer comprehensive prescription sharing through their Solidarity ONE program. Unlike others, prescriptions under Solidarity ONE are fully shareable, even for pre-existing conditions and ongoing maintenance medications.
These are just a few examples of prescription sharing by leading HealthShare companies. As the industry expands, the larger leading HealthShare organizations are still establishing what will likely become industry standards someday. As prospective members shop for a HealthShare plan, they should do their own research and make sure the HealthShare program they are looking at can offer the prescription sharing they need.
