Will Your HealthShare Share Prescriptions?

Prescription costs can be a large consideration when it comes to the choice between a HealthShare and traditional insurance. If you have a maintenance or preventive prescription, you might wonder if your HealthShare will help share in the costs of your medications. Right now, the answer is “probably not,” but you should know that HealthShare companies are changing quickly to keep up with their competitors. In the future, prescription sharing might be more common, but right now, only two companies do it (ZionHealth and Liberty HealthShare). Most HealthShares offer discount plans and do not share prescriptions, and a few give very limited help—if any.

To help you sort through this, we’ve reviewed the largest HealthShares. The image below is a quick way to compare HealthShare companies and prescriptions:

Limited prescription assistance

Samaritan, Christian Healthcare Ministries, and Sedera do not share maintenance prescription costs and also don’t give any medication discounts. These HealthShares focus more on unexpected healthcare costs than on preventive care, so that isn’t surprising. Generally, like most other ministries, 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

OneShare Health, Christian Care Ministries, Solidarity, and Altrua all have discount programs for prescriptions. This is where things start getting a little complicated. The main thing to know is that you can join most of these discount programs for free, and you don’t need to belong to the HealthShare to enroll. It’s possible that some discount programs give better discounts to enrolled HealthShare members, but so far there’s no evidence that HealthShare members save more than other people. Basically, don’t decide to join a HealthShare just because they offer prescription discounts. It’s a good service, but one that you can get on your own with services like GoodRx.

Good Rx

One of the largest discount programs is GoodRx. GoodRx is used by several ministries to provide discounts, so I want to talk about it here. I was part of GoodRx for about 8 months after losing employer insurance, and it is worth joining. The app and website let you compare prices for different prescriptions and find the cheapest options in your area; they also sometimes have coupons. GoodRx’s prices are not as cheap as you might pay with traditional insurance plans (for example, my $15 90-day supply of allergy pills went up to $35 using GoodRx). However, the program still helped. Without it, I would have paid about $60 for the same product.

Please Note: If you have any serious medical needs, I don’t recommend GoodRx as a replacement for plans that help pay for prescriptions. Common medications are often discounted, but there was one inhaler I never refilled because the cheapest price was $450. Medications related to diabetes, heart conditions, or neurological conditions will likely be expensive even with discounts. If you know that you need pricey meds, it’s safer to use a discount program to supplement your main plan. You can visit the GoodRx website to see how much your current prescriptions would be with discounts.

Sharing prescription costs

Right now, two ministries offer prescription sharing: Liberty HealthShare and ZionHealth. Keep in mind that both HealthShares have multiple plans to choose from, and prescription sharing might change from plan to plan. If you are a member of either HealthShare, read the fine print. Meds for pre-existing conditions might not be shareable, for example. Study your plan and ask your HealthShare for help if you’re confused. With that said, here’s a basic rundown of each company:

  • Liberty HealthShare: Limited sharing for $5 generic prescriptions; discount program for all others.
  • ZionHealth: Generic, preventive prescriptions are available for $5 or $15 with OptumRx’s “Rx Share” discount program. According to the 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 Health
    • the prescription is related to the treatment of a shareable need
    • and prescription costs accumulate to $500 monthly. Sharing for these prescriptions is limited to 12 months.

Of the two, ZionHealth is the better option. Liberty’s sharing program is extremely limited and not helpful for prescriptions related to major medical needs. $15 generic meds are much more common than $5 generics and cover a wider range of needs (like birth control, allergy, antidepressants, and antacids). Overall, you are likely to pay less for your prescriptions with Zion Health’s program. For more information, see https://zionhealth.org/.

Optum Rx

Zion Health uses OptumRx, which is a popular mail-order pharmacy used by traditional insurance companies. From personal experience, OptumRx gives discounts for 90-day refills. This was much more convenient for me and was the best part of the service. On the other hand, there were some snags with communication between my doctors and OptumRx. Everything was solved eventually, but be aware that there could be problems. OptumRx is a big company and it can be tricky to talk to the right person for your need, but it’s doable and none of the employees were ever rude. Just know that a large, reputable pharmacy with great prices may come at the cost of easy communication.

Hopefully this blog helped clear up some confusion about HealthShares and prescriptions. Knowing what meds you need and some rough costs will make it much easier to choose a HealthShare that’s right for you, so do your research! A great healthcare experience is worth a little extra work; after all, good health is priceless.

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