Health Insurance is a product you purchase. It’s a contract with an insurance company to assume your risk and pay your eligible medical expenses per the terms of the contract or the policy. Thus, health insurance is a guarantee or a promise to pay. On the other hand, with healthcare sharing, there is no guarantee or promise to pay. Healthcare sharing is a membership that you join. It’s a large network of individuals and families who voluntarily share a portion of their monthly income to pay each other’s medical bills. Neither the HCSO or the members have an obligation to pay your medical bills. Whereas a health insurance company does have an obligation to pay your medical bills. Despite not being legally obligated, HCSO members have a very strong and proud history of sharing (i.e., paying) the medical bills of other members. If properly designed, managed, and governed, a Healthcare Sharing Program can be an affordable and reliable option to health insurance. But, if not properly designed, managed, and governed, a HCSO should not be trusted, no matter how affordable it appears. So, those are the primary differences between health insurance and healthcare sharing.

Individuals, couples, families, and businesses can join healthshare programs. Some healthshare allow for members over age 65, others don’t. Each healthcare sharing program has its own requirements, offers different benefits, and its strictness varies dramatically. Some healthshares require members be of a specific denomination or attend services on a regular basis, others don’t. There are healthshares that require proof of church attendance in the form of a letter from a Pastor or Church Elder. Healthshares prohibit the use of illegal drugs and the abuse of alcohol, food, and tobacco.

Most people think it is too good to be true when they hear how much they can save by using healthshare instead of health insurance for the financing of their medical expenses. But the fact is, it’s absolutely true! You can save thousands of dollars as a member of a legitimate health share organization. That’s because health share organizations are not regulated by the Affordable Care Act (ACA). The ACA, enacted in 2013, requires health insurance companies to cover pre-existing conditions. Since healthshare is not regulated under the ACA, there is no such requirement of healthshare ministries. With that said, legitimate healthshare organizations will cover pre-existing conditions after a waiting period of one year typically.

A healthshare model refers to how the healthshare is structured when it comes to medical billing, medical providers, and costs for membership and out-of-pocket fees. The model employed by the healthshare organization has a direct impact on how you are able to use it and how much it is going to cost you. There are three sharing models, the network model, the cash-pay model, and the hybrid reference based repricing model. Ultimately, choosing the right model will impact the convenience, level of satisfaction, ease-of-use, and your costs.

The first thing you should be concerned about when evaluating a HCSO is the design of its Sharing Program(s). Is it designed, and does it operate, in a manner that clearly differentiates it from the practice of insurance? Is it designed to ensure that member funds will be properly used to share and pay eligible medical bills? Is it designed in a way that protects members from the mischief of “bad actors” and financial malfeasance? If a HCS Program isn’t designed and operated in a manner that clearly separates it from health insurance, then it is at risk of being destabilized and/or possibly shutdown by an aggressive state insurance regulator.

To be truly credible, a Sharing Organization needs to be managed for the benefit of its members, as opposed for the benefit of others. Like businesses, Healthcare Sharing Organizations (HCSOs) can choose to manage their operations by developing skills, expertise, and technology in-house or they can outsource a portion (or all) of their operations to gain access to those skills, expertise, and technology. Both are reasonable strategies for managing the operations of a Sharing Organization. Unfortunately, the rapid growth of Healthcare Sharing has attracted a few entrants who have levered the outsourcing model as a means to attain profit and benefits for themselves, while skating around IRS statutes that prohibit “inurement.” Beware of HCSOs who have outsourced portions of their operations to 3rd party vendors that are owned by one (or more) of the HCSO’s Executives, Board Directors and/or their family members.

In recent months we have seen the first bankruptcy of a HCSO in healthcare sharing’s 40-year history. In addition, there have been rumors and accusations of financial malfeasance at others. So, how can you know that your Healthcare sharing organization and its programs are credible and warrant your trust? You must educate yourself. It’s important you understand the different sharing models, how health share organizations are governed, if there are conflicts of interest between the board members and their employees, their track records, their faith requirements, their tools and resources, their timeliness on bill payment, their reserves, and so on.

The first thing you should be concerned about when evaluating the reliability of a HCSO and its Programs is the “receipt of funds.” Does it take receipt of funds into a centralized account, or does it utilize Member-owned Accounts, thus having visibility of the funds but not full control? Taking receipt of funds vs. not taking receipt of funds is critical to a HCSO’s ability to delineate itself from the practice of insurance and is evidence of a HCSO’s willingness to engineer consumer protections into its sharing process. Consumers should consider prioritizing those HCSOs who direct funds into Member-owned Accounts. By design, these HCSOs have better protected their Members from the potential future governance and management issues by limiting their access to, and control of, funds. By utilizing Member-owned Accounts, the HCSO not only engineers a certain level of consumer protection in the sharing process but also enables a greater level of visibility into the “use of funds.” The use of Member-owned Accounts requires collaboration with a Financial Institution, e.g.,America’s Christian Credit Union , that serves as a fiduciary of sharing funds.

The first thing you should be concerned about when evaluating the reliability of a HCSO and its Programs is the “receipt of funds.” Does it take receipt of funds into a centralized account, or does it utilize Member-owned Accounts, thus having visibility of the funds but not full control? Taking receipt of funds vs. not taking receipt of funds is critical to a HCSO’s ability to delineate itself from the practice of insurance and is evidence of a HCSO’s willingness to engineer consumer protections into its sharing process. Consumers should consider prioritizing those HCSOs who direct funds into Member-owned Accounts.

Peer-to-Peer (P2P) Sharing is another protocol that protects Consumers and makes Healthcare Sharing a more fiscally sound and reliable model. HCSOs that practice P2P Sharing will process and share eligible medical bills by moving funds directly from member-to-member. P2P Sharing deploys advanced algorithms (managed by the Third-Party Financial Institution or its Agent) to electronically match, allocate, and publish every eligible medical bill, and then to share that bill by transferring funds from the available balance of Contributor Account(s) to the account of the Bill Owner. Funds are then transferred electronically from the Bill Owner’s Account to a Provider Account(s) as payment to the Provider. P2P Sharing is a fast and seamless electronic process that is enabled by permissions set by the Member and requires no additional effort by the Members. P2P Sharing assures that Members are in control of their dollars that are used for sharing. In contrast, HCSOs that use centralized and/or escrow accounts take receipt and control of ALL funds, even those used for sharing; they cannot distinguish which members own each dollar in the escrow account.HCSOs that deploy a P2P Sharing process advantage their Members, and the HCSO itself, in numerous ways.

The most reliable of HCSOs will engineer sharing protocols and practices into their HCSO Program that enables them to build and sustain medical reserves but do so in a way that is proper and compliant with state regulations. Building and sustaining medical reserves is necessary to ensure the prompt payment of medical bills in both the health insurance industry, as well as the Healthcare Sharing Industry.However, some states have forbidden HCSOs from holding medical reserves in a centralized account. As previously discussed, this would be the practice of “pooling,” which is a specific attribute of insurance. But also, as previously discussed, HCSOs that deploy P2P Sharing operate through Member-owned Accounts which enables a HCSO to build and sustain medical reserves without violating state statutes.

Healthcare Sharing is right for you if you understand how it works and if you are relatively healthy. The key to success with healthcare sharing is your understanding of healthcare sharing and how it works in comparison to health insurance. There are approximately one hundred and nine healthshare organizations in America, with nine major ones. But, all healthshares are not created equally, so we exist to educate you on everything you need to know in order to make an informed decision for you and your family. There are questions you need to ask before joining any healthshare organization.

It depends on the policies of each individual healthcare sharing organization (HCSO). Some HCSOs require that you pay all medical expenses upfront (out-of-pocket) then wait for reimbursement. For many Americans, this is simply not practical. Other HCSOs allow for provider billing or cash-pay. We’re here to help you understand the differences so that you can make the decision best suited to your needs and objectives.

Most Healthcare Sharing Organizations (HCSOs) have discount programs for generic prescriptions, and in some cases brand-names.

Healthcare Sharing Organizations either have networks of doctors that you must choose from or allow you to choose any doctor or medical facility, it just depends on the HCSO.

Most Healthcare Sharing Organizations (HCSOs) allow for pre-existing conditions, however, may limit sharing for the first one-year to three-years of membership. In addition, some HCSO’s designate certain medical conditions as “Waivered”, meaning that they will never share into expenses related to the “Waivered” medical condition.

If you are serious about healthcare sharing it’s important that you ask the right questions to ensure that you understand the differences between each of the healthshare programs. Compare the costs versus the benefits and the tools and resources offered by each healthshare. Also, look into the reputation of the healthcare sharing organization.

There is no federal penalty for not having health insurance since 2019, however, certain states and jurisdictions have enacted their own health insurance mandates. The federal tax penalty for not being enrolled in health insurance was eliminated in 2019 because of changes made by the Trump Administration. Some states have requirements that residents carry health insurance, but most, if not all, have exemptions for residents who are members of healthcare sharing organizations.

Health Share Organizations require that members agree to a Statement of Faith which is a collection of statements that members must agree to in order to join a faith-based health share program. Many health share organizations restrict their membership to people who are also members of the Christian Faith, which is why most Statements of Faith are based on the Bible.

The average Monthly Share for a family of four is typically around $500/month. Whereas Health Insurance will cost approximately$1,212/month for a non-subsidized ACA Silver Plan. That’s a 59% savings over insurance or $700 per month that can be spent on other needs.

Since the enactment of the Affordable Care Act (ACA) in 2013, health insurance premiums have skyrocketed 137% and deductibles 87%. As a result, many Americans can no longer afford quality healthcare. For those who can afford the increased expense, why should they? Intelligent Americans understand that the extra savings generated through health sharing can be used for other purposes, such as educational funding, buying a second home, retirement planning, charitable donations, or anything else they may deem important.

If you are relatively healthy then healthshare is likely a better option for you than health insurance because it can save you thousands of dollars when compared to health insurance. However, understanding how these savings are generated is key to understanding the difference between Healthcare Sharing and Health Insurance. More importantly, it’s central to understanding if Healthcare Sharing is appropriate for you and your family.

Health insurance is mostly regulated by statutes outlined in the Affordable Care Act (ACA) and a State’s Department of Insurance (DOI). Healthshare Ministries are unregulated, but members of legitimate healthshare companies have a proven track record of paying eligible medical expenses. Each healthshare has written guidelines explaining eligible expenses. Most importantly, legitimate healthshare companies are structured and governed to act in the best interests of their members. It’s important that you educate yourself before joining any healthshare organization.

Health share organizations may impose limitations on the amount of sharing based on lifetime caps, annual caps, or event-based caps. It is also important to remember that most HCSOs do not share (i.e., pay) all the pre-existing conditions that are paid by insurance companies. It’s important that you understand the guidelines of any health share you are considering.

Few of us have ever had reason or need to understand the importance of Corporate Governance or the role of a Board of Directors. However, in the case of not-for-profit organizations such as healthcare sharing organizations, Governance is critically important considering the hundreds of millions of dollars that move through some healthcare sharing organizations annually. Governance of a for-profit insurance company is primarily focused on the interest and protection of its owners (shareholders). In contrast, the governance of a Healthcare Sharing Organization (HCSO) should be primarily focused on the organization’s exempt purpose as approved by the IRS and the best interests and protection of its members. The actual duties of the Board of Directors will vary from HCSO to HCSO, but generally they establish the mission and purpose of the organization, they hire and manage the CEO, and provide oversight to the management of the organization. In the case of a HCSO, the Board has a responsibility to provide financial oversight that ensures the fiscal soundness of the HCSO’s programs and ensures that member funds are used appropriately. To ensure the fiscal soundness of a HCSO Program and to protect the use of member funds, the Board should be transparent in their commitment to sound disciplines.