What is Medical Cost Sharing?

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What is Medical Cost Sharing?

Medical Cost Sharing is a proven and effective non-insurance solution for managing large, unexpected medical expenses. A Medical Cost Share is a non-profit organization that is built on a community of like-minded people who rely on each other to pay for large and unexpected medical bills.

Medical Cost Sharing is also known as a Health Share or a Healthcare Sharing Ministry (HCSM).

People can choose a Christian, Faith based, or Secular program that best fits their values and their healthcare needs.

Wait, I thought Cost Sharing was just a Health Insurance Term?

Cost Sharing in Health Insurance is not the same as Medical Cost Sharing.

According to Healthcare.gov, Cost Sharing is “the share of costs covered by your insurance that you pay out of your own pocket. This term generally includes deductibles, coinsurance, and copayments, or similar charges, but it doesn’t include premiums, balance billing amounts for non-network providers, or the cost of non-covered services. Cost sharing in Medicaid and CHIP also includes premiums.”

Medical Cost Sharing is an affordable and effective alternative to Health Insurance.

Is a “Health Share” and a “Healthcare Sharing Ministry” the same thing?

There seems to be a million different names for Health Share organizations. Whether you call it a Health Share, Healthcare Sharing, Healthcare Sharing Ministry (HCSM), Health Share Ministries, or Medical Cost Sharing company, they all pretty much mean the same thing: They are a non-profit organization of like-minded individuals that agree to share in one another’s medical burdens. 

(PS – I keep seeing people ask about “Christian Health Insurance”. They are talking about Health Share plans, even though it is not Health Insurance)

The key difference is that some Health Share organizations are a “ministry”, which means that there is going to be a religious requirement in order to join. The faith-based Health Share ministries usually have a religious aspect to their sharing, such as not sharing in maternity costs for an unwed mother.

There are two Health Share organizations (Sedera and Zion HealthShare) that have no religious affiliations or requirements to join them. Both Health Shares welcome people of all faiths and have chosen to create a community of members who all agree to be proactive about their health. 

What is Christian Medical Cost Sharing?

A lot of people will refer to a health cost sharing ministry (such as Christian Healthcare Ministries) as a type of “Christian Insurance” or “Christian Medical Cost Sharing”.

Christian Medical Cost Sharing is just a Medical Cost Sharing organization that is Christian faith-based, which means they have religious requirements to join them and to be eligible for sharing health care costs with the community.

As always, Medical Cost Sharing is not the same as an Insurance company and they do not offer any type of health insurance plan.

What is Secular Medical Cost Sharing?

There are no religious requirements to join a secular Medical Cost Sharing organization.

Is Medical Cost Sharing the same as a Health Insurance Plan?

Medical Cost Sharing is not Health Insurance.

Medical Cost Sharing is:

• A non-profit organization.
• Designed for large and unexpected medical needs.
• Not required to share in Minimum Essential Coverage benefits. Keep in mind that many Medical Cost Sharing plans do share in some preventative healthcare, such as annual wellness visits.
• Each organization decides on which medical expenses are shared with the community, and how the medical bills are paid. 
• Each organization chooses who can join their community, based on similar beliefs or ideologies. 
• There are usually restrictions or waiting periods for pre-existing conditions.

What about the Affordable Care Act?

Since 2019, you are not required to obtain Minimum Essential Coverage under the Affordable Care Act (ACA) and you will not be penalized for failing to purchase traditional health insurance. 

For most Americans, you can simply join a Medical Cost Sharing plan and use that as an alternative to traditional Health Insurance. 

However, there are a few states that have an individual mandate: California, District of Columbia, Massachusetts, New Jersey, Rhode Island, and Vermont. 

If you live in one of the states mentioned above, you will still need to meet the minimal Health Insurance requirement.

How Does Medical Cost Sharing Work?

Medical Cost Sharing is peer-to-peer sharing of medical costs though a membership-based community.

As a member of a Medical Cost Share, you would pay, or contribute, a set amount of money each month to your Medical Cost Share community. 

When the member has a larger and unexpected medical need, the member would first need to pay a set amount, which is the member’s responsibility before the Medical Cost 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 Medical Cost Share would “share” in all eligible medical expenses.

What are the Benefits of Medical Cost Sharing?

Save Money: One of the biggest benefits to joining a Medical Cost Share is the amount of money you save. In fact, most people save up to 30-60% on their healthcare costs when they join a Medical Cost Share, compared to a health insurance plan.

No Network Restrictions: Another benefit of joining a Medical Cost Share is that you typically do not have any network restrictions to worry about. You get to go to the right doctor or healthcare facility that works best for you.

No Contracts: You can join year-round and can cancel at anytime.

What are the Requirements to Join a Medical Cost Sharing Plan?

There are two types of Medical Cost Sharing plans: Faith based and secular.

Faith-based medical cost sharing organizations will require members to adhere to their specific faith-based principles.

You can join one of the many Christian health plans or a Jewish health plan, which will have their own unique and specific requirements to join them.

Secular medical cost sharing organizations will not have specific faith-based requirements to join their plan.

How much does Medical Cost Sharing Cost?

Monthly costs will vary, depending on which Medical Cost Sharing organization you choose to join.

Each organization will have different sharing that is available to you as well as their own sharing caps and limitations with members.

Factors that effect Monthly Costs:

• Which plan you join (some organizations have multiple plans to choose from).
• Age of the oldest person in the household or on the plan.
• How many people are on the plan (single, couple, family).

Each month, members will send their monthly payments (called “contributions” or “gifts”) to their medical cost sharing organization.

This money will be used to share in eligible medical costs with other members in their medical cost sharing community.

The monthly costs can range anywhere from $90 to $1,713.

Additional Costs to Consider

• Depending on which plan you join, you can have a one-time enrollment fee and/or yearly renewal fees.
• When members have a large and unexpected medical need, they will first pay out of pocket (to their healthcare provider) a pre-determined amount before the medical cost sharing organization will pay any eligible medical bills.
  • This can be called an “Initial Unshareable Amount” or a “Member Responsibility Amount”. It’s called different things at different Medical Cost Sharing organizations.
  • This is similar to an insurance deductible, but works a little different. Again, each organization will use it a little differently.

What about Preventative Sharing?

Medical Cost Sharing is mainly for the large and unexpected medical expenses that we all hope to never have to deal with.

This means that the smaller medical bills are usually the responsibility of the members.

Most (not all) Medical Cost Sharing organizations will have some preventative sharing available to members. This can include services like annual wellness visits, colonoscopies, or mammograms.

It’s important that you understand what is and isn’t included in the program you choose to join. You can find that information in their “member guidelines”.

What about Pre Existing Conditions?

For most Medical Cost Sharing organizations, there is a one year waiting period before anything related to pre-existing conditions is even considered shareable.

During the waiting period, this means that any medical expenses related to any pre existing conditions will not be considered an eligible medical expense for sharing.

After the waiting period, there are usually sharing limitations on pre-existing conditions.

What about Maternity Benefits?

Most Medical Cost Sharing organizations will have maternity benefits available to you.

If you choose to join a faith based plan, there will be requirements (such as proof that you are married) in order to receive those maternity benefits.

Which Medical Cost Sharing Plan Should I Join?

I’ve done countless hours of research, including reading through the fine print of the many Medical Cost Sharing plans, member guidelines, and reviews.

I suggest reading my article on the Best Health Share Plans (as a friendly reminder, Medical Cost Sharing = Health Sharing).

I have narrowed the list down to the top three, based on what is shareable and how quickly they pay eligible medical bills for you. I also go into more specific detail on what’s included and why I recommend them.