Navigating the Pros and Cons of Healthshare Plans

October 07 2024
Group 13034

Medically Reviewed by Melinda Ratini, MS, DO on July 13, 2023

In today's complex healthcare landscape, individuals and families are constantly seeking more affordable and accessible coverage options. Over the years, Healthshare plans have grown in popularity as a solution for many people. These plans offer a unique approach to healthcare financing that is perfect for some people but not suitable for others. 

How can you decide if a healthshare plan is right for you or your family? Learn more about how these plans work and who they can help. 

What is a Healthshare Plan?

Healthshare plans, or healthcare-sharing ministries, are arrangements where members pool their financial resources to help cover each other's medical expenses. These plans are not insurance. Instead, a healthshare is a new way to cover medical expenses.

When healthshares first emerged, these plans were organized by religious organizations. Often, members had to be part of the affiliated religion in order to join. Now, organizations like Clearwater have created healthshare plans that are available to people of any religious group -- or none at all. 

How Do Healthshares Work?

When you sign up for a healthshare plan, you become part of a community. You pay a set monthly fee to continue your membership. That membership grants you access to many benefits.

When you need health coverage, the community uses its resources to pay for a defined portion of your care. Clearshare, our unique healthshare community, also offers Care Coordination. With this service, you can pay little or nothing out of pocket for labs, imaging, and surgery when you go with our recommended provider.

Why Choose a Healthshare Plan?

An estimated 1.7 million Americans are part of healthshare communities. Each member has their own reasons for deciding on this alternate route for coverage. These are some of the most common reasons our members choose ClearShare:

1. Healthshare Plans Often Cost Less

One of the most appealing aspects of healthshare plans is their affordability. Monthly contributions are often significantly lower than premiums for traditional insurance plans, making them an attractive option for those looking to save on healthcare expenses.

Some healthshare plans also come with other cost-saving benefits. For example, Clearshare's Care Coordination service can drastically reduce out-of-pocket expenses, and benefits like 24/7 access to telemedicine can save you a trip to urgent care. Plus, members get virtual mental health care for free through Amaze.

2. You May Gain Increased Access to Care

Unlike traditional insurance plans that may restrict access to certain providers within a network, healthshare plans often allow members to choose their healthcare providers. This flexibility can be especially beneficial for individuals who have established relationships with specific doctors or specialists.

3. Healthshares are Transparent

Healthshare plans often have transparent pricing structures, providing members with a clear understanding of where their contributions are going and how they are being used to cover medical expenses.

Transparency is built into the structure of ClearShare. As a community, every member of a healthshare is invested in each other's success. This makes honesty an integral part of the system.

4. Enjoy Flexibility in Coverage

Some healthshare plans offer flexibility in coverage options, allowing members to tailor their plans to meet their specific healthcare needs. 

For example, ClearShare offers different types of membership. The Advanced plan may be best for someone who visits the doctor more regularly, while the Basic Plan might be better for someone who wants coverage in case of emergencies. This can be particularly advantageous for individuals who require specialized care or treatments.

Healthshare Isn't for Everyone

While healthshare plans offer many benefits, they aren't for everyone. When choosing health coverage, it's important to consider your unique needs.

1. Healthshares are Hands-On

Members of healthshare plans are typically responsible for managing their own healthcare expenses. This may involve more paperwork and administrative tasks than traditional insurance plans. As such, members tend to take an active role in their healthcare management. 

2. Lifestyle and Pre-existing Condition Requirements

Insurance plans cannot deny coverage for having a pre-existing condition or making certain lifestyle choices. Healthshares are allowed to deny coverage for these reasons, as their goal is to keep overall costs down for the entire community. It's important to know a healthshare community's policies before you sign up. 

Some things that can affect healthshare coverage include:

  • Recent or current tobacco use
  • A recent history of cancer
  • Chronic conditions like diabetes
  •  

In some cases, you may be denied membership altogether. In other cases, you may be able to join but not get coverage for related medical issues. For example, someone who smokes may be able to get coverage for some things, but not heart disease or lung cancer related to smoking.

3. Limited Coverage for Certain Services

Healthshare plans may not cover certain medical services or treatments that are deemed non-essential or outside the scope of the plan's guidelines. This could leave members with out-of-pocket expenses for certain healthcare needs. Every plan is different, so it's important to understand your plan's coverage.

Choosing the Right Coverage

Healthshare plans can be a great option for healthcare coverage. They often provide lower costs, community support, and increased access to care for individuals and families. However, it's essential to weigh the pros and cons carefully and consider your unique healthcare needs before deciding.

Every family's healthcare coverage needs differ, and what works well for one person may not be the best fit for another. 

The representatives at Clearwater can help you make the right decision. We'll help you choose the right option for you, whether it's one of our healthshare plans, our major medical insurance, or a completely different option. Book a meeting now to get personalized advice.

 

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