Navigating Health Coverage:

Choosing Between Health Insurance and Health Sharing

Understanding the best health coverage options for your patients is crucial, especially when it involves choosing between traditional health insurance and health sharing plans. Both have their unique benefits and limitations, and the right choice often depends on individual circumstances.

When Health Insurance is the Better Option

There are specific situations where traditional health insurance may be more beneficial for a patient:

• Marketplace Subsidies: If your patient qualifies for substantial subsidies through the Health Insurance Marketplace, traditional health insurance can offer more value. These subsidies can significantly lower the cost, making health insurance an affordable option.
• Pre-existing Conditions: Patients with serious pre-existing conditions should consider health insurance. Health sharing plans typically have a waiting period before they start sharing expenses related to pre-existing conditions. During this period, the patient would need to cover these costs out-of-pocket.

The Advantages of Health Sharing Plans

In cases where the above conditions do not apply, a health sharing plan can be a valuable alternative:

• Lower Costs: Health sharing plans are generally about half the cost of unsubsidized health insurance. This cost-efficiency can be a significant factor for patients without access to subsidies.
• Freedom of Choice: One of the most appealing aspects of health sharing plans is the absence of network restrictions. Your patients can choose any doctor or hospital, offering them greater flexibility and control over their healthcare decisions.

Health Sharing with DPC

Partnering with a Direct Primary Care (DPC) provider like you ensures that our members receive comprehensive primary care. In the event of more serious health issues that require hospitalization or surgery, a health sharing plan can protect them from high medical costs while allowing them the freedom to choose their healthcare providers.

Making the Right Choice

Every patient’s situation is unique, and it’s important to consider these factors when advising them on health coverage options. 

I’m here to help you guide your patients through these decisions. For more information or personalized advice, connect with a Personal Benefits Manager, who can assist in navigating these options.