Health Share Programs
With healthcare costs continuing to skyrocket and insurance premiums increasing along with them, Americans are seeking a more cost-effective and flexible alternative to get access to necessary healthcare. Health share programs are an increasingly attractive alternative to traditional insurance for many individuals and families.
What Is Health Sharing?
Health sharing ministries are organizations made up of individuals and families who voluntarily share the cost of each other’s health care. Members of health sharing organizations share common beliefs and agree to help each other by sharing in the cost associated with eligible medical expenses.

A health share program may be a good fit for your family.

How Does Health Sharing Work?

When members incur expenses for an eligible medical need, their benefits are applied, which essentially means that they are requesting that the health sharing ministry facilitate cost sharing by the membership. These health sharing organizations coordinate voluntary monthly financial contributions from their members in an effort to support the medical needs of all sharing members. Through this participation, members are helping others who share a common belief system.

Healthcare share programs have existed along with conventional health insurance plans for years, though they have increased in popularity since the Affordable Care Act (ACA) was passed back in 2010.

Health sharing ministries offer a means for people to get the medical attention they need, while sharing their health care expenses with other households.

 

Those who wish to be a part of a health sharing organization must meet certain criteria to be eligible for membership. For instance, in faith-based health share programs, members commit to maintaining a healthy lifestyle and understand that they will be a part of a community of like-minded people of faith.

 

Accepted members will choose a health sharing program and contribute a set monthly amount that is used to help other members who have medical needs. Members are then able to access funds in return if they incur medical costs that fall under the category of Eligible Medical Needs.

 

Just as people have several options when choosing a traditional health insurance policy, there are a number of different types and levels of health share programs from which to choose. Though health share programs are not insurance plans, they do offer a variety of flexible options with varying benefits to meet the needs of members.

What Is Faith-Based Health Sharing?

A Christian health sharing program may be a good choice for people with similar beliefs.

Unlike traditional health insurance, faith-based health sharing is designed to help families of faith to share the cost of medical care with others of like faith. Faith-based health share programs offer programs that are exempt from the rules of the ACA. These programs are not insurance policies, but they provide a way for people of faith to share the expense of medical care with others who share their beliefs.

 

“The generous will themselves be blessed, for they share their food with the poor.” (Proverbs 22:9)

Health Sharing Vs. Health Insurance

Health care sharing programs are not insurance plans. There are significant differences between the two. Health sharing entities are non-profit, charitable organizations that are designed to help members pay for medical expenses by utilizing funds contributed by other members.

 

Many of the differences in health insurance and health share programs involve the members’ rights to choose what type of medical expenses will be covered and who will be eligible for membership. Health insurance plans must comply with the Affordable Care Act. This means that insurance plans must accept all sorts of people with all sorts of medical issues. This can drive up the total cost of insurance plans and put comprehensive plans out of financial reach for many Americans.

 

Health share programs, on the other hand, are not bound by ACA requirements and therefore can be more selective in their approval of members, which can ultimately result in cost savings for the entire membership.

 

Here are some of the differences between insurance and faith-based health sharing programs:

Health Insurance

Faith-Based Health Sharing

Members with pre-existing conditions must be accepted to comply with ACA policies.

Eligibility for membership is dependent only upon the standards outlined by the health sharing ministry.

Members with all lifestyle choices must be accepted to comply with ACA policies.

Members are expected to share common faith beliefs and adhere to lifestyles that reflect those beliefs.

Members with all lifestyle choices must be accepted to comply with ACA policies.

No guarantees are made regarding payment of specific medical bills. Eligibility for sharing is based on the benefits and guidelines outlined in the specific sharing ministry and program.

For-profit

Non-profit

Claims are processed according to signed contract provisions.

Members make requests by way of established provider billing processes to the sharing program to facilitate and pay the cost of eligible medical expenses.

Explanation of Benefits (EOB) must be provided when claims are processed.

An Explanation of Share (EOS) is provided when Share Requests are processed.

Who Uses Health Sharing Plans?

Health care sharing ministries are not necessarily for everyone, but there are specific demographics that are better suited for participating in health share plans. These may include people who meet the following criteria:

Are in good overall health. To keep costs down for the entire membership, most health sharing programs limit eligibility to people without complicated pre-existing medical conditions. For those with chronic health issues and pre-existing conditions, there may be better options elsewhere.

Engage in a healthy lifestyle, avoiding smoking, tobacco use and excessive alcohol consumption. Again, being in good health is a prerequisite for joining a health care sharing program, and those who engage in dangerous activities may not be eligible for enrollment.

Are of a particular faith or belief system that is shared among other group members. Christians or those who share the same faith or religion as a particular health care group and want to be a part of something meaningful with other like-minded people may find a health care sharing program ideal.

Maybe looking for a more affordable option than traditional health insurance can provide. Health insurance plans are expensive, so being a part of a health care sharing program may help save quite a bit of money every month – with contributions as much as half the price or more when compared to traditional insurance options.

Want to help others while helping themselves. The Bible says, “And do not forget to do good and to share with others, for with such sacrifices God is pleased.” (Hebrews 13:16) For those of faith, the idea of helping others can be a strong determinant in choosing a health share program.

Are of pre-retirement age (between 55 and 64 years of age) and transitioning out of full-time work before becoming eligible for Medicare. People who are looking to retire will not be able to take advantage of their employer’s health care benefits, but a health care sharing plan may step in to fill the gap between employer coverage and Medicare.

Operate small businesses or non-profit organizations with staff who require health care coverage. Businesses with a small number of employees may require a health care program to offer, and a health sharing program may be an affordable option.

Are citizens that may be self-employed, freelancers, contractors, or running family-owned businesses. Those who are not employees may not have access to employee-backed insurance programs nor be able to afford typical health insurance programs, and medical care sharing programs may be a viable alternative.

Earn too much money to be eligible for subsidies with conventional ACA plans. Those who earn well over the federal poverty level (FPL) and don’t qualify for subsidies may find health share programs more affordable.

Families of an individual receiving employer benefits. Many people seek and receive the coverage of an employer health insurance plan; however, many employers do not offset the cost to insure a spouse and/or dependents – making coverage extremely expensive. Many find that health sharing programs are more affordable and offer great benefits, providing an ideal solution for the entire family.

Remote workers and people who want complete freedom. Healthcare sharing programs may only be sold in almost 50 states; however, they can be used nationwide through many sharing program’s provider networks. Americans can choose their own path for work and location and take the healthcare with them.

1 million +
Approximate number of Americans in health sharing programs

50% +
Amount members can save in health care sharing programs

18,4%
Increase in Health care spending per person from 2014 to 2018

95% +
Share of doctors and hospitals to which health care sharing members have access across the nation:

Why Use Health Sharing?

There are several benefits that come with being a part of a healthcare sharing ministry:

Low monthly costs:

Monthly contributions are voluntary and are based on the specific program chosen by the member to fit his or her health needs and budget.

Much more affordable than traditional health insurance:

Many health share program members see savings up to 50 percent when compared to health insurance.

Negotiated rates for medical and pharmacy services:

Quality healthcare sharing programs contract with established provider networks and negotiate fair, reasonable and affordable rates for typical services like a doctor’s office visit or a 30-day supply of generic formulary medication.

Programs tailored to specific needs:

Health sharing programs offer a wide range of programs with benefits to accommodate your budget and medical needs — some with only medical services and benefits and some with more comprehensive programs that include prescription benefits.

Exclusivity:

Rather than being required to pool resources in an insurance pool that cannot select members based on health or lifestyle choice, health sharing programs give members the freedom and ability to choose to share costs with other like-minded families.

Freedom to choose:

With health share programs, there are no limits on the type of doctor or specialist that members can see; however, they must be part of the health sharing program’s contracted provider network

Opportunity to help and support fellow believers:

As a member of a faith-based healthcare sharing program, you can be assured that your monthly contribution will be used in the service of people of faith.

“Give, and it will be given to you. A good measure, pressed down, shaken together and running over, will be poured into your lap. For with the measure you use, it will be measured to you.” (Luke 6:38)

What Kinds of Medical Expenses Will Health Share Programs Pay?

UHSM offers a variety of programswith benefits to suit various needs of individuals and families. Here is a quick overview of some of UHSM’s most popular programs.

Service

Gold

Vital

Fundamental

Annual Member Care Share

$5,000

$10,000

$10,000

Annual Member Care Share Maximum

$7,500

$12,500

$10,000

Annual Wellness and Preventive Care

$0 Consult Fee
(100% eligible for sharing; AMCS does not apply)
Available from day 1 of membership.

$0 Consult Fee
(100% eligible for sharing; AMCS does not apply)
Available from day 1 of membership.

$0 Consult Fee
(60-day wait from the effective date of membership; $500 share maximum per year)

Telemedicine

$0 Consult Fee
(Unlimited visits; 100% sharing eligible; AMCS does not apply)
Available from day 1 of membership.

$0 Consult Fee
(Unlimited visits; 100% sharing eligible; AMCS does not apply)
Available from day 1 of membership.

$0 Consult Fee
(Unlimited visits; 100% sharing eligible; AMCS does not apply)
Available from day 1 of membership.

Primary Care Physician Office Visit

$35 Consult Fee
(4-visit share maximum PCP & Specialist combined)

$20 Consult Fee
(5-visit share maximum PCP & Specialist combined)

Not available

Specialist Office Visits

$60 Consult Fee
(4-visit share maximum PCP & Specialist combined)

$40 Consult Fee
(5-visit share maximum PCP & Specialist combined)

Not available

Urgent Care

$60 Visit Fee

$40 Visit Fee

$100 Visit Fee
(2 visit limit per year)

Pregnancy/Maternity Care- Physician Visits

$60 Consult Fee

Not available

Not available

Pregnancy/Maternity Care-Delivery

100% after AMCS
($5,000 share maximum available for pregnancies in the first two years of membership)

Not available

Not available

Emergency Room Visits

100% after AMCS

100% after AMCS

100% after AMCS

Ambulance Services

100% after AMCS
($500 share maximum per ride)

100% after AMCS
($500 share maximum per ride)

100% after AMCS
($500 share maximum per ride)

Outpatient Facility Service:
Ambulatory Surgery
Outpatient Dept. of a Hospital: Surgery

100% after AMCS

100% after AMCS

100% after AMCS

Inpatient Facility Services

100% after AMCS

100% after AMCS

100% after AMCS

Diagnostic X-Ray, Imaging, Pathology and Laboratory Services

100% after AMCS

100% after AMCS

100% after AMCS

Physical, Occupation and Speech Therapy

100% after AMCS

100% after AMCS

Not available

Durable Medical Equipment

100% after AMCS
($2,500 share maximum per calendar year)

100% after AMCS
($2,500 share maximum per calendar year)

Not available

Pharmacy Services and Benefits

Available for additional Annual Member Care Share of $250
(see specific program brochure for details)

Not available

Not available

There is no annual or lifetime maximum on medical services and benefits, so members can rest assured that an unexpected catastrophic health event will not bankrupt their family finances. When healthcare is fair, awesome is easy. Are you ready to exercise your freedom to choose your own healthcare options and access affordable healthcare with a program designed for people of faith? UHSM can help. Read more about what UHSM offers and contact us today to discuss your unique healthcare needs.