More and more, both employees and their employers are unhappy with the group health insurance plans available to them. This dissatisfaction has both groups looking for alternatives to employer health insurance, though for slightly different reasons:
- If you are a business owner or decision maker, you might be frustrated with the rising cost of insurance plans. And despite being more expensive, the plans aren’t offering better care; in fact, in most cases, the level of care is less than what your employees want.
- If you’re an employee, you’re also questioning the value of your employer’s plan because even though your costs keep increasing, the level of care and access to medical professionals is decreasing.
We understand the pain for employers and employees — it’s why Ark Family Health has chosen to work outside the insurance system. The existing health insurance/healthcare model is flawed, but the good news is that there are alternatives.
What Are the Alternatives to Employer Health Insurance?
Health Sharing Plans (HSPs) are one of our favorite alternatives to employer health insurance. HSPs provide “per event” coverage for larger medical issues — those that go beyond the scope of your primary care doctor. These plans aren’t meant to cover day-to-day healthcare, but, like a high deductible health insurance plan, are meant to provide catastrophic medical coverage.
Health Sharing Plan Providers
A few of the major players in Health Sharing Plans* include:
- Sedera Medical Cost Sharing: https://sedera.com/
- Samaritan Ministries: http://samaritanministries.org/
- Christian Healthcare Ministries: https://www.chministries.org/
- MediShare: https://mychristiancare.org/medi-share/
*Ark Family Health doesn’t receive any financial incentive for sharing this information other than a built-in network/referral base. AFH is listed on a preferred provider list with Samaritan and Christian Health Ministries, but no monetary exchange takes place.
How Health Sharing Plans Work
It is important to note that Health Sharing Plans are not insurance. They are plans provided by non-profit organizations whose members “share” medical costs. Each organization has its own unique plans, but in general:
- To join the member pool, participants pay a low monthly amount (like a premium) that is shared to those that have a need.
- Members are also responsible for an annual “unshared amount” (ranging from $500 to $3000) to cover their personal medical expenses (like a deductible).
- If that need exceeds the unshared amount, you submit that amount to the health sharing plan for reimbursement and it is shared among the members.
Who’s a Good Fit?
Health care sharing can be great for people who:
- Are generally in good health.
- Lack access to insurance through an employer or government program.
- Can’t afford current health insurance premiums.
- Only want/need catastrophic coverage.
- Own businesses of all sizes who want to offer comprehensive medical care without impacting the bottom line.
Health Sharing Plan FAQs
Are Health Sharing Plans an Alternative to Employer Health Insurance?
HSPs are great for small business owners who want to offer employee incentives but feel like they aren’t getting a good value from the traditional insurance plans. Pairing a Health Sharing Plan with direct primary care (DPC) membership (more about this later) provides comprehensive coverage at a lower cost and higher value.
We have found that this alternative to employer health insurance, paired with our innovative healthcare, benefits the employers and employees equally. At Ark Family Health, we enjoy working with our local Phoenix businesses to provide the best, most affordable health care possible.
Learn more about Direct Primary Care for businesses.
Are Pregnancies Covered in Health Sharing Plans?
Lots of families (mine included) are growing and have questions about pregnancy. Each respective Health Sharing Plan has a maternity portion, but uniformly, they will NOT cover it if you sign up AFTER you become pregnant. This is what happened in my family situation, though Cash Pay Babies are more affordable than you might think.
The Perfect Match: Health Sharing Plans and Direct Primary Care
Though Health Sharing Plans can be one of the alternatives to employer health insurance, Direct Primary Care by itself is not. However, DPC is an excellent complement to a sharing plan.
Just like a high deductible health insurance plan, Health Sharing Plans are meant to cover big health issues and don’t provide much coverage or cost savings for everyday care. That’s where we, direct primary care doctors, come in — to fill the gap (those unshared costs) before your Health Sharing Plan kicks in.
We take care of your everyday medical needs for a small monthly membership fee and your Health Sharing Plan covers larger medical expenses and specialty care.
How Does Direct Primary Care Work?
Direct Primary Care is a unique healthcare business model that allows doctors to work directly with their patients without an insurance company in the middle. In exchange for a monthly or annual fee, patients have access to a variety of healthcare services that cover most primary and urgent care needs. A few of the benefits of the direct primary care model include:
- 24/7 accessibility to your medical team
- Extended visit times
- Same day or next day appointments for urgent needs
- Wholesale prescriptions, labs and imaging (reduced out of pocket costs)
- Telehealth visits
- Transparent costs
- Even house calls on special occasions
How a Health Sharing Plan and Direct Primary Care Saved Me Money
We shared the story of a young couple who saved more than $900 a month on their healthcare costs by using a Health Sharing Plan and Direct Primary Care. The plan they devised to fit the medical needs of their growing family takes into account the way they use healthcare.
Combining plans to ensure you are covered for doctor visits, allergy appointments, and dental care is something that should work for most individuals, families, and employers, especially business owners struggling to find alternatives to employer health insurance.
How Can Ark Family Health Help You?
At Ark Family Health, our priority is our patients. Ensuring you are healthy means you can live your best life. We provide personalized medical care that is a more affordable, convenient, and accessible option than just having traditional healthcare.
As primary care doctors, we think some sort of health coverage (traditional insurance or sharing plan) is necessary. Though we are confident we can handle 80% of your health care needs, we can’t cover all of them.
We can’t fix your broken hip; your heart attack or stroke (although we do our best to prevent them); your cancer; or your car accident injury. These catastrophic events are exactly why health insurance is necessary — to “insure” against risk. Primary care needs are not risk, they are routine.
We have found that Health Sharing Plans also help to work as alternatives to employer health insurance, as this type of coverage reduces the cost and the risks by sharing them with others. When paired with Direct Primary Care, you receive excellent care and save money on medical costs.
We’d love to hear from you if you’d like to learn more or sign up for any of our individual, family, or direct primary care business membership plans.