How Health Share Plans Compare to Real Health Insurance

With health insurance costs on the rise, consumers are looking for other affordable options. Popular alternatives are health share plans, but these could come with a cost.

With our advice, you can help your clients navigate these plans and make sure your clients aren’t being led astray.

What Is a Health Share Plan?

It’s important to know that health share plans (also known as health care sharing programs or health sharing ministries) are not the same as a typical health insurance plan.

These programs are normally faith-based and rely on their members to pay a portion of one another’s costs. When a member of the program is sick, they submit a request for their bills to be paid with money from an escrow account.

Many also require their members to embrace a Christian lifestyle and abstain from activities like drinking or smoking.

What Isn’t Covered Under Health Share Plans?

In many states, health share plans are exempt from health insurance laws. Without these regulations, a consumer with a pre-existing condition may be denied coverage.

Since these programs have a religious foundation, they also may not cover services they deem “unbiblical,” which could include things like fertility/infertility care. Ultimately, it’s up to the program to decide what health care requests will be approved.

Without the same regulations that apply to health insurance, a consumer with pre-existing condition may not get coverage from a health share.

Be aware, if your client has a condition that requires frequent doctor visits, a health share program likely won’t be the best choice for them.

Differences Between Health Insurance and Health Share Plans

Under a traditional health insurance plan, members pay a premium and are guaranteed compensation for outlined losses, illness, damage, or death. There is no guarantee of coverage with health share plans.

Each community decides their own process for money distribution after a member submits their claim. They may also limit the payout even if the plan would cover the service otherwise.

There is no guaranteed coverage with health share plans.

While health share plans aren’t like typical health insurance, they have similar details, which can be confusing.

For example, in a health share plan, members choose a deductible amount they’ll contribute as a household before receiving assistance from the community. Similar to a premium, a monthly share payment ensures your assistance eligibility.

Here are some health insurance terms and their health share plan equivalent:

• Deductible: Annual unshared amount
• Premium: Monthly share
• Explanation of Benefits: Explanation of Sharing
• Claim: Eligible event, illness, or incident

It’s important to help your clients understand that health share plans are not equivalent to health insurance and are not required to guarantee coverage of pre-existing conditions or provide benefits absent of meeting lifestyle standards.

We hope this breakdown helps you to educate your clients about the availability of options and the value of qualified health insurance.

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