In the two prior articles in this series, we discussed On and Off Exchange policies as well as Group options for employment. There has been a lot of talk about Health Share Organizations since the rates for coverage are so low. The first thing you need to know, however, is that a HealthShare Organization is NOT an insurance company. If you enroll in a HealthShare plan, you are not buying insurance. HealthsShare plans are not regulated by the federal government, nor do they have any guarantees or backing by the federal government. Rather than acquiring traditional insurance, you are subscribing to a plan where health costs are shared among a group of people.
Health Share plans are based on the original idea of insurance, creating a large pool of people who pay into a fund, from which a smaller number of claims are paid out. However, they differ in that rather than making those payments to a company who manages and invests those funds, enrollees send payments directly to the individuals who have claims. The HealthShare organization, which is usually a non-profit, only organizes and manages the sharing of medical expenses between members. Here are a few more things to know. Most HealthShare organizations:
Require a religious affiliation.
Involve some underwriting and DO NOT cover pre-existing conditions.
Have significantly lower monthly payments than actual insurance.
Do not have doctor networks, and the participant may see any doctor they want.
Are considered valid coverage under the Individual Shared Responsibility Provision, exempting families from the annual tax penalty
With the rising costs of health insurance and recent premium increases across the board, families are looking for financially viable options. HealthShare organizations are a good option for families with very few health problems (past or present) and who live healthy lifestyles. However, this option may be weighed against government claims that premium increases will not affect lower income families who qualify for subsidies. In theory, the subsidies will cover the premium increases, making healthcare as affordable as it was last year. Only time will tell as people begin applying for coverage and subsidies starting Nov. 1.