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HealthShare ministries operate similarly to traditional insurance: members pay a monthly fee to belong to the ministry, and then must pay a fixed amount before their HealthShare helps with medical bills. This looks so much like an insurance deductible, it’s no wonder that people ask “do HealthShares count as insurance?” The very simple answer to this question is “no,” but that doesn’t take into account the many complexities of this topic and leaves out some important information. We hope that this blog gives better insight into how HealthShares work and clears up some confusion.
The first thing to know is the federal government regulates health insurance. A national standard prevents insurance companies, and employers, from offering customers sub-par plans. These regulations also prevent insurance companies from refusing to pay expensive bills, or bills related to expensive health conditions (such as diabetes). Subscribers to traditional insurance have legal recourse if their insurance doesn’t pay a bill. They also expect that many pre-existing conditions and long-term diagnoses, therapies, and treatments will be covered. These laws ensure that traditional health insurance pays for much more comprehensive care than most HealthShares offer.
The flip side of this, of course, is that comprehensive care is much, much more expensive. Sometimes, members of traditional insurance find themselves paying for care they don’t actually need. That’s where HealthShares come in.
HealthShares look similar to health insurance—members pay a monthly fee, then a set amount similar to a deductible, and then the company helps pay eligible bills (called “sharing”). However, HealthShares aren’t federally regulated. This means that HealthShares can choose which bills are considered eligible. Membership guidelines for HealthShares tend to be very detailed and lengthy for this reason; the guidelines explain to members which costs are shareable and which are not.
Restricting which bills are shareable helps lower the cost of care. If you’ve been wondering why joining a HealthShare seems so much less expensive than insurance, it’s because the HealthShare is not paying for the same wide range of conditions and needs as traditional insurance does. They can charge members less.
Some common examples of not-shareable bills, per the guidelines of several different HealthShares:
Not necessarily! HealthShare members are still protected by consumer law—they are paying for a service, and the HealthShare must provide that service. If you belong to a HealthShare and you have a bill that should be paid per the member guidelines, but the company refuses, you can report them to consumer protection in your state.
Yes! Before joining a HealthShare, read the member guidelines several times over. Take notes. HealthShares are not insurance and will not pay for everything. They can save people a lot of money and be a great alternative to traditional insurance, but only when members know what they’re getting into! Write down what costs the HealthShare says are not shareable, and take some time to decide whether you would need help paying bills related to those costs or not. If you know that you have a pre-existing condition and need regular treatment for it, saving some money every month with a lower membership fee may not be worth having to pay out of pocket for doctor’s visits and needed medications. Do your research.
The Affordable Care Act, passed in 2010, had the admirable goal of encouraging more Americans to get healthcare after decades of way too many people not having any health coverage at all. The law is one of the most complicated and controversial examples of recent legislation, and far beyond the scope of this blog post, but what is important to know is that the ACA penalized people with no healthcare.
The government eventually amended that, but some states still require citizens to pay a fine for not having qualifying healthcare. If you live in one of these states, know that HealthShares do not count as insurance—but they do count as healthcare. If you join a HealthShare operating since 1995 (or earlier), you’re exempt from paying that fine.
HealthShares don’t count as insurance because they aren’t regulated by the government and they pick which kinds of bills are shared. However, they do count as healthcare if you’re trying to avoid penalties related to the ACA.
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