The cost of healthcare for employees and employers continues to climb sharply, and access to affordable and transparent health insurance seems to be even more of a challenge. This combination has led Americans to diligently seek alternatives to pay for their rising healthcare costs. One option that provides an economical solution for many is sharing the cost of medical bills with a like-minded community. Enter medical cost sharing programs and ministries.
If you are a new member to Sedera’s medical cost sharing community or are exploring options, let’s break it down into six key questions to help you understand a bit more about how medical cost sharing works:
What is medical cost sharing?
The concept of medical cost sharing is not new. The idea began nearly three decades ago as an innovative approach to manage healthcare expenses in the U. S., as people came together to “share” medical bills instead of paying for insurance. At a basic level, medical cost sharing communities, or healthcare sharing ministries, are groups of like-minded individuals that agree to help each other pay for their medical bills.
How do medical cost sharing programs work?
Medical cost sharing programs are set up so that members can contribute monthly funds to share each other’s medical costs as they arise. Instead of a deductible, there is an “Initial Unshareable Amount” for each medical event, which is the portion that a member will be responsible for. After the Initial Unshareable Amount is met, the remainder of the costs pertaining to that illness are shared by the contributions of the community members. With medical cost sharing there isn’t a provider network. There isn’t an insurance company coming between patients and doctors. Medical cost sharing members are self-pay patients. They share funds with other members and can see any doctor they want.
How is medical cost sharing different from insurance?
Insurance arrangements are a contract whereby one party agrees to be legally responsible for and accept another party’s risk of loss in exchange for a payment – a premium. Medical cost sharing is an arrangement whereby members agree to share one another’s medical expenses through an act of voluntary giving. Once you enroll in insurance, you get a card that you can give to your doctor as proof that your insurance company has taken on legal responsibility for your bills. With medical cost sharing, there is no card. You are responsible for your own bills as a cash pay patient, but you have a community of people standing with you ready to help when you get a bill.
How does the cost of membership compare to health insurance?
According to the Kaiser Family Foundation, annual premiums for employer-sponsored family health coverage reached $18,764 in 2017. Through Sedera’s medical cost sharing model, members save between 30% – 50% of the costs that are typically incurred with health insurance plans. Rather than paying monthly premiums to an insurance company, members contribute a given amount on a monthly basis and draw from community funds as medical needs arise. In addition, all medical bills over $500 are subject to negotiation, which saves money for individual members and the community as a whole.
Are there restrictions?
Medical cost sharing programs do not have policies or plan documents the way that insurance does. They are governed by a set of guidelines that all members voluntarily agree to. These guidelines lay out how the sharing of medical bills will take place including what expenses are shareable and when. Many organizations restrict the use of tobacco and illegal drugs and some may restrict certain preexisting health or lifestyle-related conditions. Sedera never denies membership to anyone based on prior/preexisting medical conditions, however there are limitations around what preexisting expenses can be shared with the community. It’s important to know the guidelines, how they work, and if any restrictions impact you. [Guidelines]
How can Sedera Health help you?
Many business owners have voiced their discontent with the current system and until now have had few options for their employees. The Sedera Health solution poses a viable alternative. Founded in response to the urgent need of companies to find affordable ways to help with the healthcare costs of their employees, Sedera is a medical cost sharing community inspired by the modern sharing economy. Our non-insurance community is centered on a commitment to healthy living and sharing the cost of medical care. In doing so, we provide quality healthcare at affordable prices for our members and their families.
If you are looking for an affordable way to handle your medical expenses as an individual, a medical cost sharing plan could be just what you need. It’s important to talk to your employer about the Sedera Health option.
If you have additional questions about Sedera’s medical cost sharing membership, please reach out to us at sedera.com/contactus.