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Is a Health Share Considered Health Insurance?
A Health Share is NOT the same as traditional Health Insurance. While they operate similarly in many ways, there are some key differences between the two.
How does a Health Share work?
As a member of a Health Share, you would pay, or contribute, a set amount of money each month to your Health Share community.
Additionally, the member would first need to pay a set amount, which is the member’s responsibility before the Health Share community pays any medical bills. This is similar to a deductible that you’d have with a Health Insurance plan.
Once the member has paid their responsibility, the Health Share would “share” in all eligible medical expenses.
What are the different HealthShare Terms?
While every HealthShare company has their own name for some of these things, here’s some ways to help you understand.
| Health Insurance | HealthShare | Notes |
|---|---|---|
| Deductible | Member Responsibility Amount (MRA), Initial Unshareable Amount (IUA), etc. Every HealthShare has their own terms for this. | This is the amount the member would need to pay BEFORE the Health Share will “share” in any medical expenses. Typically, the larger the member’s responsibility amount is before the Health Share “shares” in anything, the lower the monthly contribution amount. |
| Monthly Premium | Monthly Contribution | This is the amount the member will contribute each month to go toward’s the community’s medical needs. |
| Claim | Need or Eligible Medical Event | Members will typically submit a “Need” to request “Sharing”. The Health Share will review it (make sure it’s an eligible medical need for sharing), and start the process. |
| Explanation of Benefits (EoB) | Explanation of Sharing (EoS) | Each Health Share has a Membership Guidelines that goes into detail on what is and isn’t an eligible “Need” for “Sharing”. |
| Covered/coverage | Share or “Sharing” | The Health Share will “share” in a member’s medical “need” after they have paid the “Initial Unshareable Amount”. |
Main Differences Between Health Insurance and Health Share Plans
Here are some of the ways a Health Share is different than Health Insurance:
- A Health Share is a nonprofit organization.
- A Health Share has open enrollment all year long.
- Health Share Plans are not required to share in Minimum Essential Coverage benefits, like Health Insurance plans. Depending on which state you live in, you may need to have MEC Insurance in addition to your Health Share membership.
- Health Share plans are typically designed for larger unexpected medical needs and is also a big reason why Health Share plans are much more affordable.
- Health Share organizations decide what medical expenses are shared with the community, and how the medical bills are paid.
- Each Health Share chooses who can join their community, based on similar beliefs or ideologies.
- With a Health Share, there are usually restrictions or waiting periods for pre-existing conditions.
- Health Share plans typically do not have network restrictions.
- Most people save up to 30-60% on their healthcare costs when they join a Health Share.
CASE STUDY: A Year of Medical Expenses for a Family of Four
Let’s say someone in your family has an accident that results in a hospitalization and some follow-up chiropractic visits. This is a price comparison on what someone could pay if they are Uninsured, pay for traditional Health Insurance or if they were a Health Share member. I will use Zion HealthShare in this example.
As you can see in this scenario, the Health Share membership saves the person $14,010.00 in just one year – compared to traditional Health Insurance.
While the Uninsured person saved money compared to traditional Health Insurance, they are more at risk if bigger medical costs come their way. That’s why I have chosen to join a Health Share rather than just be Uninsured. I save money year over year and have peace of mind knowing that I have a community to support me if or when large and unexpected medical bills come my way.
| Uninsured | Traditional Insurance | Zion HealthShare | |
|---|---|---|---|
| Monthly Premiums/Contributions | $0 | $15,600/year ($1,300/month) | $6,840/year ($570/month) |
| 4 Preventative Visits ($125/each) | $500.00 | $0 | $0 |
| 4 Sick Visits ($200/each) | $800.00 | $200 ($50/each for co-pays) | $800.00 or $0 if you chose Telemedicine (which is included in your membership) |
| $13,000 Hospitalization for accident | $13,000.00 | $6,250.00 (deductible and coinsurance) | $1,000.00 IUA |
| 15 Chiropractic Visits as a result of hospitalized accident ($75/each) | $1,125.00 | $600.00 ($40 co-pays) | $0 |
| TOTAL COSTS FOR THE YEAR: | $15,425.00 | $22,650.00 | $8,640.00 |
Benefits of Joining a Health Share
- Save Money. This is the number one reason why most people choose to join a Health Share over Health Insurance.
- Community. Members choose a community that fits their personal beliefs or lifestyle choices.
- Less or no Network Restrictions. Health Share members typically enjoy more freedom to choose which Doctors or healthcare providers they want to see. For preventative services, most Health Shares seem to have a network that they work with.
- Nationwide or Worldwide sharing. HealthShares usually have sharing available to people all throughout the United States and even abroad. Health Shares are a great option for those who love to travel.
Looking for Affordable Healthcare?
Check out my article on the Best Health Share plans to find affordable healthcare for you and your family.
Health shares are not insurance and do not offer insurance coverage. Membership in a health share does not guarantee the payment or reimbursement of medical expenses. Each organization operates under its own membership guidelines, which determine what expenses may be eligible for sharing. This publication is for informational purposes only and is not provided by an insurance company. For state-specific notices and full program details, please visit the respective health share’s official website.
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