What is Health Care Sharing?
Onviant Insurance Agency represents both traditional insurance products and non-insurance products. As Director of Business Development, I am asked all the time to explain what a Health Care Sharing Ministry (HCSM) is, the benefits as well as the disadvantages. Below is a short definition; if you would like to learn more, please feel free to reach out.
What is an HCSM?
HCSM’s are an alternative health care coverage option where like-minded people agree to share the medical expenses for members in their group. The monthly contributions are in lieu of the standard monthly premiums that insurance companies charge. HCSMs are non-insurance entities, and membership in one is not the same as having traditional medical insurance.
Although HCSMs are not health insurance and do not count as minimum essential coverage under the ACA, the law grants HCSM members an exemption from the ACA’s requirement that people maintain minimum essential coverage (provided they are an ACA Exempt HCSM, some are not Exempt). Note, that while the individual mandate was eliminated for 2019, several states have reinstated it on a state level. Most of these states have adopted the ACA rule for Health Shares.
What are the benefits of an HCSM?
The monthly amount that members contribute is typically much less than the full-price premiums for individual major medical coverage, so for people who don’t get ACA premium subsidies, HCSMs are generally less expensive in terms of a monthly expense.
A “Qualifying Life Event” is not required, and therefore enrollment/membership is available year-round. Also, some HCSM’s have next day effective dates.
Some states don’t allow “Short Term Medical Plans,” and of those who do, the restrictions on the length of time a plan can be in effect, and the number of times it can be renewed; can make an HCSM a great alternative. HCSM plans, in most cases, can be in effect for as long as a member chooses.
Many HCSM have extensive networks that act like a PPO so that you can choose your Doctor.
What are the disadvantages of an HCSM?
The coverage you get will vary from one HCSM to another, and they are not required to cover pre-existing conditions, cap out-of-pocket costs, or include essential health benefits. And they can still have annual and lifetime benefit caps.
HCSMs are not insurance and are not regulated by state insurance commissioners.
For questions regarding Health Share, please contact Rick Campbell at https://www.dhirubhai.net/in/rick-campbell-811a2b18/