Answers to the Most Frequently asked Questions about
Healthshare Programs and Health Care Sharing Ministries (HCSMs)
How long have healthshares been around?
- Healthshares have been in existence for over 30 years. To qualify for the Afforadable Care Act (ACA) exemption, a healthshare has to have been around since at least 1999.
Are healthshares the same thing as health insurance?
- Healthshares are not health insurance. Healthshares are organizations that facilitate sharing of health care costs among individual members, who have common ethical or religious beliefs.
How do healthshares work?
- While healthshares are not health insurance, they do function in much the same way as health insurance plans prior to the Affordable Car Act (ACA).
Are they less expensive than Obamacare?
- Healthshares are typically 50% less expensive than ACA-compliant health insurance plans.
Are healthshares Obamacare compliant?
- Healthshare programs are specifically allowed in the ACA. Members of healthshare organizations are exempt from the requirement to carry health insurance and from the tax penalty resulting from not carrying health insurance. Healthshare programs are not subject to regulations that govern what health insurance plans must pay for.
Are healthshares HSA qualified?
- Currently, we offer an HSA-qualified program through Sedera. While other healthshare programs are not HSA compliant, the Health Savings Act of 2017 would make all healthshares HSA qualified if passed.
Do healthshare programs accept anybody?
- No. You must meet certain qualifications.
- To become a member of a healthshare, you must agree to certain beliefs, which vary by healthshare. Additionally, most require you qualify based on your health history and do not cover pre-existing conditions.
Are there waiting limits?
- Some healthshares do have waiting periods forcertain benefits like preventive and cancer treatment. Also, there are usually waiting periods before pre-existing conditions are eligible for sharing.
Are there coverage limits?
- Yes. Most healthshares do have coverage limits.
Do healthshare programs pay for preventive care?
- While benefits vary, preventive benefits are eligible in some healthshares.
How do healthshare programs pay for doctor visits?
- Most healthshares do have co–pays for doctor visits built into the plans. Once again, benefits vary.
How do healthshares pay for Rx?
- Healthshares do not traditionally cover prescription drugs, but most offer a discount program to help you save on costly medications.
Do healthshare programs pay for expenses for pre-existing conditions?
- Pre-existing conditions are not generally eligible for sharing under healthshare programs right away, but there is at least one healthshare program that will count most pre-existing conditions as eligible for sharing after 24 months.
Can smokers join healthshare programs?
- Healthshares do not generally allow smokers, but there are options for smokers who intend to quit.
What kind of provider network do healthshare programs use?
- All healthshare plans use PPO networks, or allow you to see the doctor of your choice, giving you the greatest access and flexibility when receiving care.
Are there religious requirements?
- Faith requirements vary by healthshares. Some are Christian-based, while others are non-religious.
Am I locked into any contracts?
- There are no contracts with healthshare programs and you have the right to terminate coverage at any time.
How am I billed?
- Most healthshares will require you to set up a direct draft or credit card for recurring monthly contribution deductions.
When can I enroll?
- Unlike ACA/Obamacare plans that require you to enroll in short annual enrollment periods, you can enroll in a healthshare at any time during the year.
Can you deduct healthshare contributions like you can individual health insurance?
- No, you cannot currently deduct healthshare contributions in the same way you can for health insurance premiums.
ACA-Exempt Healthshare Plans
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