Understanding Your Healthshare Plan

We believe that one of the best financial decisions many people can make is to opt out of the crazy, bloated, overpriced traditional health insurance world and choose healthsharing instead.

The better you understand your healthshare program, the better you can take advantage of your membership. 

While we offer a large number of programs from several healthsharing organizations, they all work differently. So this month I’m going to review some general areas that you may want to be familiar with, for the particular healthshare program you currently have.  

Getting Oriented To Your Healthshare Plan

In most cases, the best source of information is your healthsharing ministry organization itself.

Start with the written documents your plan sends you in the mail, and your plan’s website.

Here are some of the resources and documents you should look at as you get acquainted with your ministry and their plans:

• Their statement of faith or values
• Their mission statement

These documents can help you understand the kinds of people who run the organization, as well as the people with whom you are sharing medical expenses.

If you have any moral or ethical concerns with any elements of health care, you will find them addressed here, as well as in your plan’s benefits and exclusions. 

What You Should Know

Make sure you understand what medical expenses your program shares, and how much of the expense would be your financial responsibility.

You should have a good understanding of each of the following:

• Your plan’s specific benefits – and exclusions
• What routine or preventive care is included in your plan
• Any waiting periods for pre-existing conditions, surgeries, or maternity benefits
• Benefits for chiropractic care or other forms of alternative medicine
• How your member responsibility amount works, and what expenses count towards meeting it

As you get acquainted with your new healthshare plan, here are some of the other key questions you should resolve.

Administration and Procedures

Every health sharing ministry organization also has some administrative procedures you should be familiar with. Make sure you understand the following: 

• How to make your monthly sharing contribution
• How to submit bills for sharing
• What medical services, if any, require pre-approval before sharing
• How to maximize the benefits of your plan’s medical bill negotiation services
• How to submit appeals or requests for review

Is there a provider network? 

Most healthshare plans let you use their  benefits with any medical provider. They don’t have a preferred network of providers. But a few do, so make sure you understand how your plan works.

Onboarding Programs and Seminars

Some healthshares offer an orientation meeting, to make sure you know how to use all of your benefits. Definitely attend this, if invited. It might be a big Zoom meeting, or a pre-recorded webinar.

These will definitely answer many of your questions. Obviously, you also can call the plan’s customer service number to clear up any issues not completely clarified by the introductory call or Webinar. 

Many plans have some good introductory videos on YouTube as well – along with some other great educational resources. So search for your plan’s name there.

How to maximize your cash-payer discounts

Some plans ask you to present to providers as a cash-pay client. You may be able to get substantial discounts as a cash payer. This will reduce your out-of-pocket expenses in those years where all you need is routine care and you don’t have any major medical events!

Some organizations have you present a membership card, instead of presenting as a cash payer. Make sure you receive your card. Also, make sure you know what to do if your provider’s office staff isn’t familiar with healthsharing and tells you they don’t take your plan. 

How to maximize the benefits of price negotiation services

Healthsharing organizations are great at negotiating the cash price of common medical procedures. But to get the most benefit from that service, it helps to have your healthshare plan contact your care provider beforehand. 

Find out what kinds of services you should tell your healthshare plan ahead of time, so they can negotiate the best price for you. Or recommend a reasonably priced provider. 

Understand benefits for routine, primary, and preventative care

Some healthshares share for routine doctor visits, while others share for only more catastrophic medical bills.

How are ER visits treated?  

Most limit your costs in an ER to a small amount, but others do not. Know what ER bills are shareable, and how much you would be responsible for.

In addition to your specific plan’s website, we’ve also got some great resources for general information about healthsharing, tips, and information on other important money-saving ideas like direct primary care plans right on our Website!

And as always, if you have any questions about healthsharing, direct primary care, health insurance, or transitioning to Medicare, we’re here to help.

Just drop your Personal Benefits Manager a line, or make an appointment! 

Click here to schedule an appointment, or call 800-913-0172 to get started.    

To your health and wealth,

Wiley P. Long, III
President - HSA for America

The HSA for America Maximize Your HSA Newsletter is published monthly and emailed to subscribers at no charge. Subscribe now to stay on top of the critical information you need to know about health insurance, healthshare plans and managing your finances to achieve financial security.