ACA-Exempt Altrua Healthshare Plans

A Low-Cost and Legal Way to
Opt Out of Obamacare

Members of Healthshare plans are exempt from the requirements of the Affordable Care Act, including the requirement to purchase a government-approved health insurance plan.

Plans are available with membership responsibility amounts (out of pocket maximums) ranging from $500 to $4000, per person per year. The Lifetime Maximum limit is $1,000,000.


This Not a Health Insurance Policy

Make no mistake – HCSMs like Altrua aren’t big insurance companies. Because of this, they don’t fall under the regulatory guidelines of state insurance regulations. Altrua and groups like it have no backing from the insurance behemoths like Aetna and Blue Cross/Blue Shield. So how do they do it?

Members agree to pay a monthly contribution – which equates to a monthly premium that you’d pay with a traditional plan – and that money goes into escrow. When plan members have qualified medical needs, plan funds are shared to meet those needs.

How Do My Medical Bills Get Paid?

With HCSMs, things work differently than what you might be used to if, like most of us, you’ve had a “traditional” insurance policy. Here’s a graphic that should help you understand the process that occurs if you have a medical need.

Special Requirements and Conditions

Medical Underwriting

No Smoking

Lifetime Coverage Limit

When the ACA was implemented insurance companies could no longer exclude people from coverage because of pre-existing medical conditions. Because HCSMs are not subject to these  rules, you must be in good health to be accepted as a member. This doesn’t necessarily mean that you will be declined if you have a health problem, but your membership may contain what’s called a “member limitation” for a period of time, or even for the duration of your membership. This simply means that your expenses related to that condition won’t be reimbursed by the plan.

Altrua does not accept smokers.

Altrua also has height and weight guidelines.

Another condition of Altrua’s plans is that each member has a lifetime limitation of $1,000,000 in cost sharing. Should your medical expenses exceed this amount, your plan would terminate, however you’d be able to immediately enroll in an ACA plan, since losing your coverage qualifies you for a special enrollment period. Altrua will not share medical costs associated with cancer treatment during the first year of plan membership, so you also should strongly consider purchasing affordable cancer coverage to ensure that you and your family are adequately protected.

You Must Agree to Altrua’s Standards

When you sign up for membership with Altrua, you state that you agree to their Statement of Standards.

Considerably More Affordable Than ACA Plans!

How do they do it? First of all, the pool of individual members tends to be generally healthier, since each person must qualify for inclusion in the plan based on their health. Second, HCSM plan members are considered “self-pay” patients by providers, and as such they typically get charged at a lower price for services than patients with insurance.

As a member you can visit providers who are part of the PHCS network. Medical costs incurred from providers who are not part of the network are shared at a lower percentage.

Sharing amounts do not vary based on geographic location like traditional insurance policies. The following simple-to-use chart shows you what you might pay as a sharing amount per month, if you apply for membership.

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Healthcare at Affordable Prices for Everyone

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Disclaimer: All information on this website is relayed to the best of the Company's ability, but does not guarantee accuracy. Information may be out of date. The content provided on this site is intended for informational purposes only and does not guarantee price or coverage. This site is not intended as, and does not constitute, accounting, legal, tax, and/or other professional advice. Determination of actual price is subject to Carriers.