The cost of healthcare in the US has continued to rise in recent years. Health insurance premiums are at unprecedented high levels and out-of-pocket medical expenses are just too much.
With this situation, it’s becoming harder for most US households to meet their healthcare budget.
But there are a few innovative ways that are helping address these high costs and one of them is the idea of health-share plans.
These plans will be the focus of this article. We give you all the information you need to fully take advantage of this innovative idea, and save on health care while you’re at it.
You Get Very Little Legal Protections
Being exempted from law can have its downsides too. While this makes it easier for people with a health share plan to have flexible health care spending, it offers very little legal protection.
In essence, if there are any disputes about the payment of claims and benefits, there’s very little legal redress you can go for.
This is an integral point on how Annual Open Enrollment Health Share Programs work.
They Aren’t Health Insurance
One thing we need to get out of the way is making a clear distinction between health share plans and health insurance.
In most cases, health share plans tend to be faith-based cooperatives. Members agree to cover a certain portion of each other’s medical expenses when needed.
At face value, this sounds and looks more like your traditional insurance premiums. Well, yes it’s insurance but there are a few legal and practical differences to note.
For example, states have laws that govern how premiums are collected and how benefits are distributed by insurance companies. Health share plans don’t have these restrictions.
Pre-Existing Conditions Aren’t Covered
Federal and state law mandates that preexisting conditions must be covered by insurance companies.
Since state and federal law don’t recognize health share plans as insurance, they aren’t bound by such requirements.
In that case, they can easily discriminate against people with existing conditions without any legal consequences.
The Cost Can Get High
Insurance companies have a lot of power and can yield it to negotiate with doctors. This eventually leads to a better deal for the client.
However, health share plan cooperatives are often smaller and may not have the kind of clout insurance companies have.
Negotiating prices with doctors then becomes very hard and eventually, you may end up paying relatively higher for healthcare than someone with a traditional insurance cover.
They Don’t Have to Cover Everything
Health share cooperatives will have their own specific rules on what the plans cover and what they don’t.
This is relatively different from comprehensive health insurance which tends to cover any medical procedure.
In most cases, these cooperatives will also consider the circumstances that lead to illness or injury before they decide to cover the medical bills.
As for traditional insurance, you’re entitled to a cover as long as you pay premiums.