Healthcare Sharing and Small Businesses: A Comprehensive Guide

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When you’re running a small business, you have to think about your options for healthcare. While the Affordable Care Act (ACA) healthcare plans are one of the most widely used options today with about 8.8 million covered Americans, it’s not your only option. You can also use healthcare sharing plans.

Reportedly, about 1 million Americans are members of healthcare sharing ministries. Subscribing members pool money together to pay for healthcare expenses and follow faith-based or ethically-based rules. You can choose a plan that fits your needs. Here’s how:

1. Consider Your Needs

Before you start researching the different healthcare sharing plan options that are available, it’s important to assess your needs. For example, you should consider if you have pre-existing conditions, such as treatment for AIDs or autism, that may not be covered by the healthcare sharing plan you are considering.

It’s also important to do the math and compare costs. For instance, if you don’t qualify for a subsidy under an ACA plan that may lower your monthly costs, healthcare sharing plans may be a better alternative to traditional health insurance.

2. Do Your Research

There are over 100 of known healthcare sharing plans, including those that are affiliated with nonprofit religious organizations and non-religious healthcare sharing plans. However, there are only five healthcare sharing plans that are exempt from the ACA tax penalty.

One of these healthcare sharing plans include Medi-Share, Liberty HealthShare, Samaritan Ministries, Altrua HealthShare and Christian Healthcare Ministries. The ACA tax penalty doesn’t apply to these healthcare sharing plans because they existed before 1999.

Not all healthcare sharing plans offer the same benefits. So, it’s important to do your research and review the benefits that each plan offers.

3. Know What a Healthcare Sharing Plan Does (and Doesn’t Do)

Healthcare Sharing Plans are not insurance plans. However, they work in a similar manner. For example, instead of having an annual family deductible, a healthcare sharing plan has an annual family portion.

This is the maximum portion of shared payments that you’re expected to pay for your family within the year of having the plan. After you pay this amount, the other eligible expenses are typically covered in full. You still get to go to your doctor, present your healthcare sharing plan card and pay the provider service fee. The provider service fee is similar to copay.

4. Evaluate the Pros and Cons

Each healthcare sharing plan has disadvantages and advantages you should consider. One of the major benefits of healthcare sharing plans is that they can be helpfully in reducing out-of-pocket expenses and often don’t have limitations on the doctors you use.

This is because these plans aren’t insurance and often do not have a network of doctors. Because members share the costs, you often don’t have to bear the burden of paying large expenses, such as hospital bills for brain tumor surgery. Members also typically negotiate prices with their doctors or healthcare providers and get as much as 50 percent off.

These providers and physicians are typically willing to reduce the cost of the service provided since payment is often received faster than health insurance payments or directly from the patient. Small and medium-sized businesses (SMBs) may even be able to reimburse members of the healthcare sharing plan via a health reimbursement arrangement (HRA).

However, there may be plan limitations, such as lifetime limits and annual plan coverage limits and limits to coverage for pre-existing conditions. For example, if you have a pre-existing condition and you have immediate needs, such as chemotherapy treatments for cervical cancer, then a healthcare sharing plan may not be your best option as many of them having a waiting period.

Also, it may not make financial sense to use this plan if you qualify for a tax credit off of your monthly premium with an ACA healthcare plan.

5. Consider Using a Broker

To narrow down your options and make comparing the benefits of each healthcare sharing plan easier for you, you can opt to use a broker. These brokers often have web or mobile applications that prospective members can use to filter and compare plan features and costs.

Healthcare sharing plan providers also can leverage the help of healthcare app developers to develop tools to help its members and prospective members compare features. App developers are also useful for helping to facilitate the activities of healthcare sharing plans. They can create apps that make finding the healthcare sharing plans easier enrolling members and making and deducting payments.

6. How to Qualify for Healthcare Sharing Plans

Consider if you have pre-existing conditions and whether or not the healthcare sharing plan will cover these conditions. To sign up for the service, members typically must sign a statement of faith.

The statement of faith typically acknowledges that the member is aware that he must abide by specified ethical or religious beliefs to receive coverage for the services.

You may also need to agree to live a healthy lifestyle, too. For example, some plans may require that its members abstain from alcohol, smoking or illegal drugs. If the members don’t do this, they risk not being covered for health conditions that may be a result of these actions, such as receiving treatment for an injury due to substance abuse.

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