Overwhelming increases in healthcare costs have accelerated the development of some amazing solutions. One innovation is healthcare sharing, with 1.5 million people participating in these communities.
Today, we’ll focus on Medi-Share, the largest and leading sharing ministry in the United States.
Medi-Share describes what they do as “an organized way in which Christians share their money to pay for each other’s eligible medical bills.”
Medi-Share stands apart from other sharing ministries in several key ways. Their approach is innovative and they help members transition from insurance to sharing smoothly .
One of the best things about Medi-Share are the hybrid strategies already included, plus ones employers can implement, making their solution much more powerful. The following are our six favorite hybrid strategies with healthcare sharing:
1. Customizable Share Amounts
Let’s take a look at a practical example of a family from Indiana with two adults, both 35 years old, with two children, ages 10 and 8. They have a household income of $100,000 with no preexisting conditions.
The cheapest individual insurance plan they can buy is $455 per month, with a $16,300 out-of-pocket max. That is obviously a lot of money, both per month and in their worst year. They want better options.
There’s no “out-of-pocket max” with Medi-Share since it’s not insurance. Instead, there’s an Annual Household Portion (AHP), which is the amount a member pays toward their own medical bills (in one year) before the rest is shared.
For a $10,500 AHP with Medi-Share, the standard monthly share (which feels similar to a premium) is only $269. The family in the scenario above would save $2,232 the first year on monthly costs, and also lower the cost of their “worst” year.
If the family wanted to lower the potential cost of their “worst” year even further, there are 7 different AHP levels members can choose (similar to traditional insurance, the higher your monthly share, the lower your AHP). If they qualify for the Health Incentive Discount, they save an extra 20%.
One size never fits all when it comes to healthcare, which is why this hybrid strategy works so well for Medi-Share. Each family can customize their own financial situation to ensure they have what they need.
2. PPO Network Access
For some, strong networks are really important for personal healthcare. Unlike other sharing programs, Medi-Share provides access to a national PPO. In fact, Medi-Share provides PHCS, the same network many insurance plans use. Continued access to a PPO provides a sense of security that’s helpful when transitioning from insurance to sharing.
Maintaining PPO network access usually allows you to keep your doctor, and it allows bills to be processed in a way that feels similar to traditional insurance — automatically updating to your AHP.
This hybrid strategy of PPO network access can allow a family to visit the doctor without having the “self-pay” conversation some people may find intimidating. Keep a great network, at a great cost.
Telehealth is one of the most innovative healthcare solutions of the past decade. Medi-Share provides access to telehealth as well, at no additional cost to members. This means access to real doctors using innovative technology, with $0 copays and an unlimited number of visits.
Not only can a family save money every month and lower their “‘worst” year on medical expenses, they can also save money on doctors visits for the cold, flu, sinus or ear infections, and more.
The hybrid strategy of using telehealth alongside sharing helps members care better for their families and steward their medical expenses more responsibly.
4. Rx Discounts
Because prescription drugs can be expensive and difficult to obtain, some incredible solutions have been developed to make things easier. Maintenance Rx does not count toward your Medi-Share AHP, but there are many tools to help cover those costs!
- GoodRx is known for helping consumers find the same medicine for $9 at Walmart that costs $53 at Walgreens.
- Drexi compiles deep research to find even greater Rx discounts.
- Prescription Hope offers full-service medication management.
- Rx Help Centers researches every discount program available, prepares and submits all applications, and won’t charge a fee unless they save you money.
By using one or more of these innovative tools, this strategy works alongside Medi-Share and allows families to budget healthcare costs without losing their prescriptions.
5. Minimum Essential Coverage
One sure way to lower overall healthcare costs is by staying healthy to begin with. Preventative health services — like screenings, checkups, etc. — provide a proactive approach to health. Sadly, only 8% of Americans actually use these services.
Medi-Share is not insurance, so it does not cover the costs of preventative care. Furthermore, these expenses aren’t eligible for sharing, which means it doesn’t count toward the AHP either.
While this fact may turn you away from using preventative services, don’t go so fast. It’s important to first make a few family-specific calculations.
The CDC cites that, on average, Americans visit the doctor 2-3 times per year (that includes annual physicals). Calculate how much these visits might cost your family. Also account for how often you may use telehealth. Remember how the family above saved $2,232? Even with their average doctor visits, they’ll still save money.
Many families still want preventative care covered, and they want access to copay visits at the doctor. Preventative care is valuable enough to them that they’ll pay more to have it covered. This is where the Minimum Essential Coverage (MEC) plan comes into play.
A MEC is a separate plan a family can purchase to work alongside Medi-Share. The plan covers preventative services, offers copay doctor visits, and can even provide some Rx coverage.
While this hybrid strategy does cost more, it can be a great solution for families wanting an even greater sense of security and benefit. The best part is that it works seamlessly alongside Medi-Share’s core solution.
6. Offering an HSA or HRA (Employers Only)
Health Savings Accounts (HSAs) and Health Reimbursement Arrangements (HRAs) are great options for employers who want to help their employees with their healthcare costs. Plus, these tools are very customizable.
Due to ever-rising healthcare costs, many employers think they can’t do anything to help their team. But, recent developments to group Minimum Essential Coverage (MEC) plans can create HSA or HRA eligibility.
Since Medi-Share is not insurance, it doesn’t counteract the HSA or HRA eligibility. Employers, therefore, can use this hybrid strategy to help their employees with healthcare expenses in a manageable and affordable way.
This strategy harnesses the power of the lower cost sharing model while including preventative coverage and the perks of either an HSA (employee-owned) or HRA (employer-owned). Now, you can care better for your team, while also ensuring that resources are wisely invested back into the organization.
If you’re interested in learning more about these hybrid strategies to cut costs and care better for your team, be sure to get connected with one of our benefits consultants by emailing [email protected].