What are health care sharing plans and ministries?
If you received double digit rate increases during the recent open renewal for ACA health plans...
And you don't get a tax credit based on income...
You probably went on line frantically looking for options.
You also don't want to pay the 2.5% of income penalty.
There's really only one option that address both of these concerns.
Health sharing plans.
Which begs the question....
It's a new term to many people so let's really dive into and discuss the good and bad so you can make an informed decision.
You can jump to any of the main topics here:
Lots to cover.
You can always jump to the online quote here:
Let's get started!
Like the detectives always say, "From the beginning, Mam"
Health sharing plans have been around for a long long time.
Just under the radar and with a pretty small footprint.
It's been around.
Originally, they were just a way for similarly minded individuals to share health care costs.
This was in lieu of health insurance.
This usually revolved around a shared religious belief but we now have options that are pretty relaxed.
We'll get to that part in a minute.
So we have companies that coordinate the sharing of health care costs among members.
A pretty small phenomenon for decades.
Enter the ACA (Affordable Care Act) law.
The ACA law is literally 1000's of pages.
Especially with such a contested law where every vote was needed to pass.
For this reason, there are lots of carve-outs, add-ons, and footnotes.
One of them specifically dealt with health sharing ministries and plans.
Let's first talk about the "bat" that the ACA law uses.
Basically, you have to have a certain level of qualified health insurance or pay a penalty.
That's a pretty big bat especially for people who earn too much to get a tax credit.
Back to the Congressional sausage maker.
Some of the legislators wanted to offer people an exemption for having to get ACA coverage along religious lines.
A religious exemption.
These were more conservative politicians of course.
The health sharing ministries were the logical choice to fit this role since they already existed and were loosely based on religious affiliation.
We have our exemption for the ACA penalty.
That's only half the story.
It was all right there in the design of the plan.
Needless to say, costs have roughly doubled or tripled since 2014.
If you don't get a tax credit, you've been hit very hard.
A collective "duhhh" is probably emanating from this statement.
"Why do you think we're reading THIS??"
So back to health sharing...
And back to millions of people looking for an alternative to ACA health plans.
So...what are health sharing plans?
First, understand that health sharing plans are not health insurance.
Essentially, health sharing plans are memberships.
In return, the company will coordinate payment of health care costs among its members.
Which begs the question...isn't that what health insurance does?
Yes...but there are some important differences we'll discuss below in the health sharing versus health insurance section.
Here are some important points on sharing plans:
These are some of the big ones.
It's very important to really understand the differences.
The word "ministry" usually throws people that are just desperately trying to afford health coverage and avoid the penalty.
Essentially, health share plans were adopted as a way to get out of the ACA requirement.
For this reason, they are health share ministries.
That being said, AlieraCare is the most secular plan offered by a health share ministry (Trinity Healthshare in the case of AlieraCare)
For this reason (and many others), they are definitely our favorite of the 6.
Which brings up a good point.
There were 6 health share ministries that were officially given an exemption under the ACA law.
They are (in order or popularity and strength):
We have a comprehensive comparison of the the major health share companies here.
The clear winner across many fronts is AlieraCare (Trinity Healthshare is the underlying ministry) which why we focus on them.
More information on them here.
20 years in the health market has taught us a few things!
The key point is that we avoid the penalty while getting coverage for health care costs so this is the list to start with.
Let's talk about which one might be best and why.
In our view, after researching and dealing with these companies, AlieraCare (Trinity Healthshare is Ministry, AlieraCare is administrator) is the clear winner.
We get into more detail at our best health share company page, but here are the highlights.
Reasons AlieraCare is the best health share ministry plan
They're just doing everything right in this market segment and we fully expect them to run away with it.
This is important!
They are growing significantly now which gives them more strength.
That's AlieraCare (Trinity Healthshare) by far!
What about health sharing pro's and con's?
This is really the key question.
Of course, we're comparing health sharing plans like AlieraCare to Obamacare or ACA health insurance plans.
First, one main difference may make the decision pretty easy.
If you are outside open enrollment and do not have a Special Enrollment trigger (usually loss of group coverage, marriage, birth, or move that affects options), we may not be able to enroll in traditional ACA health insurance.
We can apply anytime of the year.
The only constraint deals with effective dates.
So...what if we can get either health insurance or health sharing?
That's where we really need to compare the options.
For more detail, you can check out the health insurance versus health sharing but here are key points.
For this exercise, let's bullet point the pro's and con's.
Health sharing pros
The decision really comes down to cost.
But...if you can't qualify for a tax credit, the cost of ACA health plans have exploded since 2014.
We're seeing monthly costs of $1000/person for people in their 60's and that's on a Bronze plan!
It's just not possible for many couples to pay $25-30K per year in health premium.
It's crazy really.
That's the motivation.
That and of course not getting hit with the 2.5% penalty for not having coverage.
So...what are the downsides?
Cons of health sharing
The conversations usually boil down to this....
Will they pay if something happens?
That question is the one reason we only deal with AlieraCare's plans.
They pass the smell test on monthly costs.
This makes sense.
They also resemble what we had before (waiting periods, $1M life max, etc).
AlieraCare (Trinity Healthshare) sends out a monthly tally of medical expenses processed and paid.
That's a big deal.
A growing member's base is critical to paying future medical expenses.
That's true for health sharing as well as health insurance.
Check out our health insurance versus health sharing for more detail on how to compare the two.
Health sharing plans work well for many people.
But they're not for everyone.
This is because of the waiting period for pre-existing conditions.
AlieraCare plans has a 2 year waiting period for pre-x from the time of enrollment.
This means they won't pay out for expenses related to a pre-x condition for 2 years.
Take this into account when considering health sharing.
There are also waiting periods (shorter) for new situations from time of enrollment (pregnancy, cancer, etc).
Mental health is not a covered benefit with health sharing plans. That's a big difference.
If pregnancy is planned, it probably makes more sense to go with health insurance.
At least for the mother!
You can mix and match plans.
We see this approach all the time.
For all these reason, we provide the member's guide here so everyone can really see how the plans work.
Otherwise, health sharing becomes a question of comparing annual costs versus the limitations of coverage described in the member's guide.
The only impact is on the effective date.
Effective date rules for AlieraCare health sharing plans:
For many people outside Open Enrollment, health sharing plans like AlieraCare will be the only option (other than short term which has duration limits and the tax penalty).
We can enroll anytime during the year with AlieraCare and pro-rate the tax penalty on a monthly basis.
That brings up a good point...
That's a huge deal.
If you make $50K as an individual, you could pay us $1200 in tax credit.
That pays for a big portion of the health sharing plans.
Worst case, get AlieraCare's catastrophic plan to avoid the tax penalty.
Many people enquire about the lowest price way to avoid the tax penalty.
That's AlieraCare's CarePlus Advantage plan.
You can quote and enroll in that here (click on Catastrophic link on left):
With either AlieraCare's Standard plans or their Careplus Catastrophic plans, you have an exemption from ACA tax penalties.
This is more involved.
So much so that we created a separate, comprehensive comparison of health insurance and health sharing.
Below is a nice introduction to their differences but we really recommend reading further at the article above.
Of course, we're happy to help with any questions.
We've covered a lot.
There's definitely more since health sharing is new to most people but growing very quickly.
We always recommend reading the Member's Guide below that gets sent out AFTER a person enrolls.
This really gets into the nuts and bolts of how health sharing plans work with AlierCare's Standard Plans (Value, Plus, and Premium).
If you need additional information or have questions, please feel free to contact us at 800-320-6269 or by email.
Our services are free to you as licensed AlieraCare agents!
Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!
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We can quickly (very important) size up your health coverage needs and clearly explain the options available to you. Our focus is finding the most coverage at the best cost to you.
We are licensed Covered Ca agents with in-depth knowledge of their plans, process, and health sharing plans.
We'll quickly see if health sharing plans like AlieraCare might be a good fit for you.800-320-6269
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