You might have heard of health insurance and health share plans. Did you know those two are very different and provide different kinds of medical expense help? Not only that, there are different rules and regulations on both. Most people know about health insurance because insurance itself is prevalent. However, not many know well about health share plans. So let’s discuss some of the interesting facts about health share plans here.
What is a Health Share Plan?
A health share plan is when you join a group – organization as a member, give a fixed monthly donation, and then whenever you incur any medical expenses, the organization covers them for you. These organizations have membership eligibility criteria such as particular lifestyle or beliefs and so on.
It is Not Health Insurance
You might think that a health share plan might be similar to health insurance, but that is not the case. Health share plans are very different from health insurance. Health insurance is provided by private employers or educational institutes, but the health share plan is provided by an organization that is simply a group of members themselves, members who mutually agreed to help each other out in good faith and nothing more. Unlike health insurance, health share plans don’t have heavy premiums.
Organizations are Non-Profit
Whichever organization is providing a healthcare sharing plans program is not a company that incurs and enjoys profit. Such organizations are nonprofit and have no incurring profits; they are not founded to make money but to help the community.
You Need To Meet the Eligibility Criteria
Since these organizations that provide health care sharing plans are private and community-based, they require you to meet specific criteria. Most of these criteria surround the way of life, avoiding the use of substances, etc. Many of these organizations are faith-based and follow Christian values, and expect the same from the members. Members essentially create groups of like-minded people who want to help each other in case of need.
Different Legal Applications
Health insurance-providing companies are entirely different kinds of structures from the nonprofit organizations that provide health share plans; hence the laws or the rules and regulations in place are also very different. Some of such legal regulations are:
- Organizations have to be non-profit
- Members should not be face discrimination based on employment
- Memberships cannot be discontinued due to new medical conditions
- There has to be an annual audit carried out
- The audit should be accessible publicly
An organization can decide its own rules
Unlike health insurance providers, the organizations that provide health share plans do not need to follow specific processes and rules fixed by the state insurance department. The organizations and the members can decide their own set of rules and the process. For example, there is a particular process to claim health insurance, and you need to explain the claim. Whereas for health share plans, the organization may not require an explanation from you, and the organization itself can decide the claim process.
Anyone Can avail of Health Share Plans
Whether you are an individual or a business, a young adult or an elderly person or a family, health share plans can be available. Various organizations offer multiple types of health share plans for everyone. You can choose one that you or your family or your business needs.
Flexibility
When you avail of health insurance, you have the restrictions of which health care provider you choose. For example, your employer’s health insurance is valid only for particular hospitals or doctors. If you want to consult someone, not in their network, you cannot, or you will have to pay out of your pocket. At the same time, if you have a health share plan, the organizations allow you to consult and get treatment from the health care provider of your choice since there is no network of profits and interconnected contracts. This can be a considerable benefit of health share plans because choosing the health care provider is essential, and having the health care provider of your choice can be very comforting in times of health struggles. Another flexibility is the process of payments. In nonprofit organizations, the members are often allowed to pay the incurred medical expenses directly to each other. For example, if you are a member and need your bill paid, you can get the payment directly from another member and not have to go through the organization.
In these times of costly premiums and even costlier medical expenses, health share plans are something that can help you tremendously. Choosing the right health share plan for yourself can help you maintain your finances well, and you can avoid the possible huge dent in finances caused by expensive unforeseen medical bills. When choosing the health share plan, you should understand it entirely in-depth and not miss out on anything to avoid future issues.
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