Discover Health Sharing Plans (HSP)
Navigating Health Care Alternatives:
Health Sharing Plans and Direct Primary Care
Insurance costs are increasing and have become a growing source of stress for individuals and families. Many are not aware there is another alternative—and it’s called health care sharing plans. Health sharing plans (HSP), also known as medical cost sharing, can save you and your family a lot of money on healthcare. We review the basics of these plans and explore how they differ from traditional insurance coverage.
Health Sharing Plans (HSP): How It Works
Members in an HSP “share” medical costs. As part of an HSP, you are responsible for paying an initial unshareable amount (IUA) each month (like a premium). There is also an “annual unshared amount” (like a deductible) that your medical expenses must exceed before the plan shares your expenses.
Health care sharing can be great for people who:
- Are generally in good health
- Are not eligible for a tax credit based on income
- Lack access to insurance through an employer or government program
- Only want/need catastrophic coverage
- Can’t afford current health insurance premiums
HSP vs Health Insurance
The Pros:
- HCP counts as insurance under the Affordable Care Act (ACA), even though they are not insurance. This allows for affordable healthcare benefits while avoiding the tax penalty for going uninsured.
- HSP are provided at a much lower monthly cost.
- The annual “unshared amount” is much, much lower than deductibles for insurance plans.
- You have any choice of provider. There are no network requirements. If you pay out-of-pocket, health sharing plans reimburse your expense.
The Cons:
- Health care sharing plans are not required to cover pre-existing conditions at the time of enrollment such as cancer, diabetes, or smoking. Those who have them may be declined membership or won’t have the conditions fully covered for a year or more.
- Health care sharing also doesn’t typically cover the essential health benefits like wellness exams or mental health counseling.
HSP and Direct Primary Care work well together
The DPC will meet vast majority of a person’s primary health care needs and any urgent care needs for a low monthly fee without copays or deductibles. DPC will ensure access to high quality low cost laboratories, medications , and consultations with specialists. You receive higher quality care with better access to your physician without waiting.
