Healthshare FAQ: Answers to the Most Frequently asked Questions about
Health Sharing Plans and Health Care Sharing Ministries (HCSMs)
Healthshare FAQ Questions & Answers
How long have healthshares been around?
- Healthshares have been in existence for over 30 years. To qualify for the Affordable Care Act (ACA) exemption, a healthshare has to have been around since at least 1999.
Are healthshares the same thing as health insurance?
- Healthshares are not health insurance. Healthshares are organizations that facilitate sharing of health care costs among individual members, who have common ethical or religious beliefs.
How do healthshares work?
- While healthshares are not health insurance, they do function in much the same way as health insurance plans prior to the Affordable Care Act (ACA). Healthshares facilitate sharing of medical expenses among members, but they are not insurance.
Are they less expensive than Obamacare?
- It is common for healthshare memberships to cost less than half what ACA-compliant health insurance plans cost.
Are healthshares Obamacare compliant?
- Healthshare programs are specifically allowed in the ACA. Members of healthshare organizations are exempt from the requirement to carry health insurance and from the tax penalty resulting from not carrying health insurance. Healthshare programs are not subject to regulations that govern what health insurance plans must pay for.
Are healthshares HSA qualified?
- HSAs, or health savings accounts, can only be opened and contributed to if you have an HSA-qualified health insurance plan. Currently, we offer an HSA-qualified MEC (minimum essential coverage) health insurance plan that is designed to be paired with a health sharing program. For more information, see our MPB page.
Do healthshare programs accept anybody?
- To become a member of a healthshare, you must agree to certain principles or beliefs, which vary by healthshare. Additionally, most require you qualify based on your health history and may have a waiting period before they will share for pre-existing conditions.
Are there waiting periods before expenses will be shared?
- Some healthshares do have waiting periods for certain benefits like preventive and cancer treatment. Also, there are usually waiting periods before pre-existing conditions are eligible for sharing.
Are there sharing limits?
- Most health sharing programs have per incident or lifetime limits, though some come with unlimited lifetime sharing.
Do health care sharing programs pay for preventive care?
- While sharing varies, preventive expenses are eligible for sharing in some health care sharing programs.
How do healthshare programs pay for doctor visits?
- Most healthshares do have co-pays for doctor visits built into the plans. Once again, benefits vary.
How do health care sharing programs share for Rx?
- Most health sharing programs will not share in the cost of prescription drugs, but some will cover not maintenance medication for a limited amount of time. Most also offer a discount program to help you save on costly medications.
Do healthshare programs pay for expenses for pre-existing conditions?
- Pre-existing conditions are not generally eligible for sharing under healthshare programs right away, but with most healthshares those expenses will as eligible for sharing after 12 to 24 months, sometimes with some restrictions.
Can smokers join healthshare programs?
- Many health sharing programs will not accept smokers. Others will accept the smoker, but may not cover share expenses for smoking-related medical issues. One popular program that will accept smokers is Covenant HealthShare. Feel free to speak with us for guidance on the best options for your situation.
What kind of provider network do health care sharing programs use?
- Most health care sharing programs use Provider networks, or allow you to see the doctor of your choice, giving you the greatest access and flexibility when receiving care.
Are there religious requirements?
Am I locked into any contracts?
- There are no contracts with health care sharing programs and you have the right to terminate your membership at any time.
How am I billed?
- Most healthshares will require you to set up a direct draft or credit card for recurring monthly contribution deductions.
When can I enroll?
- Unlike ACA/Obamacare plans that require you to enroll in short annual enrollment periods, you can enroll in a healthshare at any time during the year.
Can you deduct healthshare contributions like you can individual health insurance?
- No, you cannot currently deduct healthshare contributions in the same way you can for health insurance premiums.
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