At HSA for America, we are passionate advocates for healthcare freedom. We think Big Insurance has gotten too powerful, and some of their cost-cutting measures have been outright harmful to patients and doctors alike. One of the problems is healthcare narrow networks. Read more to learn how to solve this problem.
Narrow Networks in Healthcare
A big part of the problem is restrictions on the doctors patients are allowed to see within their plans thus narrow networks in healthcare.
While traditional health insurance approaches still have their place, we envision a future where individuals are empowered to make their own healthcare decisions.
Unfortunately, traditional managed care systems like HMOs and PPOs limit our options and bind us to their narrow network of providers.
But what if there was a way to break free from these constraints?
The Problems with Traditional Managed Care
Millions of Americans are stuck in Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).
These managed care plans cut costs by contracting with only a narrow network of doctors, clinics, and hospitals. They have pricing power, and can negotiate very cheap prices in exchange for a flow of patients who are enrolled in the plan.
These systems only permit visits to healthcare providers within their approved network, often sidelining quality for cost-effectiveness: Only the lowest bidders in each category are likely to get approved for the network.
That’s probably ok for people who never need care.
But if and when you do need to see a doctor… Well, you get what you pay for.
The Affordable Care Act and its Aftermath
The Affordable Care Act (ACA) promised to revolutionize healthcare, and cause our health insurance premiums to fall by thousands of dollars.
We all know how that worked out.
Meanwhile, managed care plans like HMOs and PPOs dominate the Affordable Care Act-qualified policies available on the health insurance Marketplace websites and healthcare.org.
Employers have also dropped old-fashioned indemnity plans, which allowed patients the freedom to choose their own doctors – in favor of cheaper managed care plans that don’t let patients choose.
This poses a significant challenge for those seeking specialized or high-quality medical care.
Narrow Networks Compromise Quality
These restricted narrow networks often comprise the lowest bidders rather than the most proficient and well-regarded medical professionals.
With managed care plans such as most Obamacare plans, you’re not necessarily getting the best care. You’re getting the most cost-effective care according to the insurance company’s metrics.
That may not be in your best interests.
Think Different to Escape Narrow Networks
Fortunately, there are better options out there.
Ones that put the medical decision making authority squarely where it belongs: Not with some faceless beancounter in a managed care organization’s accounting department, but with you!
You can declare independence from bloated, inflexible managed care plans like HMOs, EPOs, and PPOs.
There are two paths that can help you do this:
Health savings accounts (HSAs), and medical cost sharing, or health sharing plans.
Compare Pricing on the Best HSA Plans Available
Option 1: Health Savings Accounts (HSAs)
Health Savings Accounts are powerful tax-saving vehicles that let you set aside money pre-tax that you can use to pay tax free for future medical expenses.
To contribute, you must be enrolled in a qualified high-deductible health insurance plan. These plans have higher deductibles, but lower premiums than comparable traditional health insurance plans.
But if you have been contributing to an HSA, the higher deductibles won’t be much of a problem: Your HSA funds will be there to pick up the slack… tax-free.
One of the great things about HSAs is that you have complete control over the money. Not the insurance company.
No matter how narrow your insurance company’s care network is, you can still use your HSA dollars with any provider you choose.
Option 2. Health Sharing Plans
But HSAs are just one part of the equation. Another revolutionary model that champions healthcare freedom is medical cost sharing – or more commonly, health sharing.
How Health Sharing Works
Health sharing is a cooperative model where members share healthcare costs.
It’s not health insurance. Instead, health sharing organizations are non-profit associations of health-minded people who share common values, and who agree to help their fellow members pay unexpected medical bills.
Members pay a monthly share amount, similar to an insurance premium.
When you incur medical expenses, you can request assistance from this collective pool of funds.
The beauty of most health sharing plans is the freedom it provides. Unlike traditional insurance, you’re not limited to a network. You can select any doctor or healthcare provider you choose.
The Freedom to Choose
With most health sharing plans,, you can visit top-tier specialists or seek second opinions without worrying about out-of-network fees.
This freedom is essential for receiving optimal care, especially for complex medical conditions. You can go wherever you believe you’ll receive the best treatment.
This is a far cry from traditional insurance managed care models, where it can be very difficult or even impossible to get approved for coverage at top tier clinics and hospitals or with the best available specialists.
Health sharing plans are generally more cost-effective than traditional insurance, without sacrificing the quality of care.
The absence of middlemen like insurance companies keeps administrative costs low, allowing more of your money to go directly towards healthcare services.
While every individual and family is different, health sharing plans routinely save up to 50% compared to the unsubsidized cost of a traditional health insurance policy.
Take the Next Step to Escape Narrow Networks: Contact a Personal Benefits Manager
If you’re tired of being stuck with mediocre providers, or if you yearn for the freedom to choose your own doctors, it’s time to take action.
Whether you opt for an HSA/HDHP health sharing plan, you’re not just purchasing a financial product; you’re investing in your healthcare freedom.
Contact a Personal Benefits Manager today to learn more about these empowering alternatives. Declare your independence from restrictive networks and step into a future where you are in control of your healthcare choices.
Are you ready to take control of your healthcare? Declare your independence today!
Here are some additional articles on healthsharing programs: Getting Disenrolled from Medicaid? Here’s What To Do | Unraveling Healthcare Sharing Ministries: Faith-Based and Secular HealthShare Options
Compare Pricing on the Best Healthshare Plans Available
Healthcare Narrow Networks FAQs
What is a Health Savings Account (HSA)?
A Health Savings Account (HSA) is a tax-advantaged account that allows you to set aside money for medical expenses, including the option to choose your healthcare providers. It empowers you to take charge of your healthcare choices, free from the constraints of network limitations.
How does an HSA help me choose my own doctor?
An HSA offers the flexibility to use your pre-tax funds to pay for healthcare services from any provider, be it within or outside a traditional insurance network. This flexibility enables you to choose doctors based on quality and compatibility rather than network restrictions.
What is Health Sharing?
Health Sharing is a cooperative financial model where members share the cost of healthcare expenses. Unlike traditional insurance plans, health sharing plans often don’t restrict you to a network, allowing you to choose your own healthcare providers.
Can I visit any doctor with a health sharing plan?
In most health sharing plans, you have the freedom to visit any doctor or healthcare provider of your choice. You’re not bound by a limited network, giving you the autonomy to seek care where you see fit.
How do HSAs and health sharing plans differ from traditional insurance?
Traditional insurance plans often restrict you to a network of approved providers. Both HSAs and health sharing plans break this mold, offering you the freedom to choose any healthcare provider, without worrying about “out-of-network” fees.
Are there financial benefits to choosing HSAs or health sharing plans?
Yes, both options often come with financial benefits. HSAs offer tax advantages, and health sharing plans are generally less expensive than traditional insurance. The money saved can then be used to seek quality healthcare.
How do health sharing plans handle pre-existing conditions?
Health sharing plans may have specific guidelines for pre-existing conditions, such as waiting periods or limited coverage. It’s crucial to consult your plan’s terms to understand how pre-existing conditions are treated.
Are there waiting periods for surgeries in health sharing plans?
Waiting periods for surgeries can vary between health sharing plans. Some might require a waiting period for elective surgeries but cover emergency procedures immediately. Make sure to consult the guidelines of your chosen plan.
How do I choose the best health sharing plan for my needs?
When selecting a health sharing plan, consider factors like monthly share amounts, individual versus family coverage, waiting periods for pre-existing conditions, and whether the plan aligns with your healthcare values. Consult a Personal Benefits Manager for expert advice tailored to your needs.
Can I combine an HSA and a health sharing plan?
While HSAs are generally tied to High Deductible Health Plans (HDHPs), some people use their HSA funds in conjunction with a health sharing plan for maximum flexibility.
Can I contribute to an HSA if I’m part of a health sharing plan?
You can only contribute to an HSA if you are enrolled in a qualified High Deductible Health Plan (HDHP). Health sharing plans are not considered HDHPs by IRS standards.
Do health sharing plans offer any tax benefits like HSAs?
No, health sharing contributions are not pre-tax. However, they are often more affordable than traditional insurance premiums, even without the tax benefits, making them a cost-effective option for many. Especially those who don’t qualify for a big subsidy under the Affordable Care Act.
Is there an age limit for participating in HSAs or health sharing plans?
There’s no age limit for participating in health sharing plans. However, you cannot contribute to an HSA once you enroll in Medicare, typically at age 65.
You can, however, enroll in a healthsharing plan specifically designed for Medicare patients – the Medi-Share 65+ health sharing plan.
Are there any quality checks for healthcare providers in health sharing plans?
Since health sharing plans usually do not limit you to a specific network, they also do not perform quality checks on healthcare providers. It’s up to you to research and choose high-quality healthcare services.
Are health sharing plans and HSAs compliant with the Affordable Care Act (ACA)?
HSAs are compliant with the ACA. Health sharing plans are not insurance and are not required to comply with the ACA, but they may serve as an exemption from the mandate to have health insurance.
For more information on health sharing plans and HSAs, consult a Personal Benefits Manager to make an informed decision tailored to your healthcare needs.