Prescription costs can be a key consideration when it comes to the choice between a HealthShare and traditional insurance. For those with prescription needs, it should be noted that most HealthShares currently do not offer prescription sharing. While this will likely change as the industry continues to grow and adapt to market demands, only Zion HealthShare and Solidarity currently offer this. Discount plans are more common among HealthShares, and some may provide limited assistance for prescriptions, though this varies.
Limited prescription assistance
Samaritan Ministries and Christian Healthcare Ministries (CHM) do not share the costs of maintenance medications and do not offer medication discounts. This aligns with their focus on unexpected healthcare costs rather than preventive care. Generally, these HealthShares will offer a program level that will share prescription costs related to a shareable medical incident. For example, Samaritan Basic and Classic will assist with these prescription costs, while CHM will only assist Gold members with these costs. Medical incident prescriptions typically will be shareable for a 120-day supply, sometimes longer for needs related to cancer, organ transplants, and immunotherapy.
Prescription discounts
Several HealthShares, including OneShare Health, Medi-Share, Liberty HealthShare, Sedera, and Altrua HealthShare offer discount programs for prescriptions. However, shoppers should understand that these discount programs are typically separate from HealthShare memberships and may possibly be joined independently. While some discount programs may provide better discounts to enrolled HealthShare members, there is currently no evidence to suggest that HealthShare members save more compared to non-members. Services like GoodRx offer similar benefits and can be accessed without joining a HealthShare.
GoodRx
Several HealthShares utilize GoodRx to provide discounts, which warrants consideration by prospective members. With the GoodRx app or website, users can compare prices of different prescriptions and find the most affordable options in their area. GoodRx occasionally offers coupons as well. While the prices provided by GoodRx may not always be as low as those obtained through traditional insurance plans, the program can still provide significant savings.
Common medications are often discounted through programs like GoodRx; however, these programsmay not be a suitable replacement for plans that specifically assist with expensive medications related to serious medical needs such as diabetes, heart conditions, or neurological conditions. In such cases, it may be safer for a member to supplement their primary plan with a discount program.
Sharing prescription costs
Currently, Solidarity HealthShare and Zion HealthShare are the only two HealthShares that offer prescription sharing. Members should carefully review the details of their plan and seek assistance from the organization if there is any uncertainty or confusion. The following is brief overview of their prescription sharing:
Solidarity HealthShare: Offers comprehensive sharing in prescription medications through their Solidarity ONE program. Prescriptions are fully shareable, even for conditions related to pre-existing conditions and maintenance.
Zion HealthShare: Provides generic, preventive prescriptions with a $5 or $15 member responsibility with OptumRx’s “Rx Share” discount program. According to their Member Guidelines, prescriptions related to an eligible medical need are shareable if:
- the Rx is billed by a provider
- prior approval is given by Zion HealthShare
- the prescription is related to the treatment of a shareable need.
OptumRx
Zion HealthShare uses OptumRx, a popular mail-order pharmacy used by traditional insurance companies. It offers discounts for 90-day refills, providing convenience value for members. However, there have been reports of occasional challenges with communication between healthcare providers and OptumRx. Although these issues were eventually resolved, navigating the appropriate channels for specific needs can sometimes be challenging with a company the size of OptumRx. Nonetheless, OptumRx offers competitive prices and is regarded as a reputable pharmacy.
Understanding the role of prescription costs in the context of health sharing is key to making an informed decision. While prescription sharing is currently limited among HealthShare organizations, prospective members should review specific plans and guidelines to determine the sharing level offered.
