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  • What is Reference-based Pricing in HealthShare?

    Reference-based pricing (RBP) is a strategy used by HealthShare plans to contain healthcare costs while ensuring quality care for their members. RBP works by setting a pricing benchmark for certain medical services or procedures, typically based on Medicare rates or other established pricing standards. Here's how RBP saves members money on medical expenses: Transparency and Cost Awareness: RBP promotes transparency by clearly defining the pricing for specific medical services or procedures. This transparency enables members to compare costs across different healthcare providers and make informed decisions based on value and affordability. With a clear understanding of the reference price, members can avoid unnecessary expenses and choose cost-effective options without compromising on quality. Negotiation and Competition: By establishing a reference price, RBP encourages competition among healthcare providers to offer services at or below the benchmark. Providers have an incentive to compete based on price and quality, driving down costs and offering members more affordable options. Additionally, RBP allows employers and health plans to negotiate directly with providers, leveraging their purchasing power to secure favorable pricing agreements and pass on the savings to members. Incentivizing Value-Based Care: RBP incentivizes providers to deliver high-quality, cost-effective care by aligning reimbursement with the reference price. Providers who offer efficient and effective care within the reference price are rewarded, while those who exceed the benchmark may face financial penalties or negotiation pressure. This encourages providers to focus on value-based care delivery, emphasizing outcomes and patient satisfaction while minimizing unnecessary tests, treatments, or procedures that drive up costs. Empowering Consumer Choice: RBP empowers members to take control of their healthcare decisions and seek out providers who offer the best value for their money. Members have the flexibility to choose healthcare providers based on cost, quality, convenience, and personal preferences, rather than being limited by narrow networks or restrictive reimbursement policies. This freedom of choice encourages members to actively engage in healthcare decision-making, leading to better outcomes and lower costs over time. Reducing Overutilization and Price Variability: RBP addresses the issue of overutilization and price variability by establishing a standard reference price for specific medical services or procedures. This helps mitigate the tendency for providers to order unnecessary tests or procedures, knowing that they will be reimbursed at a predetermined rate. By aligning reimbursement with the actual cost of care, RBP encourages prudent resource utilization and discourages unnecessary spending, ultimately resulting in cost savings for members and employers alike. In summary, reference-based pricing offers a proactive approach to managing healthcare costs while promoting transparency, competition, and value-based care. By empowering members with cost information and incentivizing providers to deliver high-quality, cost-effective care, RBP helps save members money on medical expenses while ensuring access to quality healthcare services. To learn more about better healthcare with HealthShare, join us at WhatIsHealthShare.com.

  • Join the HealthShare Revolution: Embrace Community, Not Just Coverage!

    Joining a HealthShare community feels like stepping into the world of entrepreneurship. It's like leaving behind a stable job to venture into self-employment. Initially, it can be intimidating because there are so many unfamiliar procedures and questions about how to manage different aspects of the business. Managing your own healthcare is quite similar. What do you do when you need to see a doctor? What if there's an emergency? The potential problems seem endless. But just like in business, when challenges arise, having the right community in place can help you navigate through the unknowns. Having a community and knowing the tools like the Membership Guidelines, are essential for finding answers to problems as they arise. Here's why having a community drive HealthShare membership is so important. Sense of Community: HealthShare organizations often emphasize a sense of community among members. Unlike traditional insurance companies where the relationship is primarily transactional, HealthShare members often share similar values and beliefs, fostering a supportive community sentiment. Alignment of Values: Community membership guidelines typically reflect the values and beliefs of the members, which can include ethical, religious, or lifestyle considerations. This alignment often leads to greater satisfaction among members, as they feel their contributions are supporting causes they believe in. Transparency: HealthShare organizations often have transparent guidelines that outline member responsibilities and how funds are distributed. This transparency can build trust among members, as they have a clear understanding of how their contributions are being used and who they are helping. Cost-Effectiveness: Community membership guidelines can be more cost-effective compared to traditional insurance premiums. Since HealthShare organizations often have lower administrative costs and may negotiate discounted rates with healthcare providers, members may enjoy lower monthly contributions without sacrificing quality of care. Flexibility: HealthShare organizations may offer more flexibility in terms of coverage options and eligibility criteria. This flexibility can be especially beneficial for individuals with unique healthcare needs or those who don't qualify for traditional insurance plans. Shared Responsibility: In HealthShare organizations, members share responsibility for each other's medical bills. This shared responsibility fosters a sense of solidarity among members and can lead to more responsible healthcare decisions, such as seeking cost-effective treatments and practicing preventive care. Exemption from ACA Mandates: HealthShare organizations often operate outside the regulatory framework of the Affordable Care Act (ACA). This exemption allows for greater flexibility in designing membership guidelines and coverage options, which can be advantageous for both members and the organization. Focus on Wellness: Some HealthShare organizations prioritize wellness initiatives and preventive care, incentivizing members to adopt healthy lifestyles and participate in wellness programs. This proactive approach to healthcare can lead to better health outcomes and lower overall healthcare costs. To learn more about what a HealthShare membership can do for you, visit www.WhatisHealthShare.com for more information. We love our HealthShare community, and I think you will too!

  • Understanding Major Medical Need Support with HealthShare

    In times of medical emergencies or unexpected health crises, having comprehensive support becomes paramount. HealthShare membership is a great solution when it comes to finding support for major medical needs and we provide access to our Member Advocacy Team during such challenging times. Defining Major Medical Needs A major medical need encompasses a broad spectrum of health events that require professional medical attention. These can range from life-threatening emergencies demanding immediate intervention to less severe but still critical situations necessitating medical care. Life-Threatening Emergencies: These are situations where every second counts, such as severe injuries, heart attacks, strokes, or other critical conditions. Immediate medical attention, including ambulance services and emergency room care, is crucial to preserving life and limb. Unexpected Injuries: While not immediately life-threatening, unexpected injuries can significantly impact one's health and well-being. These may include fractures, sprains, cuts requiring stitches, or other traumatic injuries that require prompt medical assessment and treatment. Comprehensive HealthShare Support for Medical Needs HealthShare Membership plans are designed to support members through every stage of their medical journey, from diagnosis to recovery. Our support extends to a wide range of services and treatments necessary to address major medical needs effectively: Initial Doctor Visits: Access to primary care physicians or specialists for prompt evaluation and diagnosis. Diagnostic Services: Medical screenings, x-rays, MRIs, and other diagnostic procedures to aid in accurate diagnosis. Specialists' Visits: Consultations with specialized healthcare providers to address specific medical conditions or concerns. Surgical Procedures: Surgical interventions deemed necessary for treatment or management of health conditions. Medication: Support for prescription medications prescribed as part of the treatment plan. Physical Therapy: Access to rehabilitative services and physical therapy to aid in recovery and restoration of function. Supporting HealthShare Members Towards Recovery At What is HealthShare, we understand the importance of holistic care in achieving optimal health outcomes. Our support doesn't end with medical expenses; we strive to assist our members throughout their recovery journey. This includes offering guidance, resources, and assistance to ensure a smooth transition back to health and well-being. But be aware, Members must take active steps to utilize this support. Contacting the HealthShare community to submit a medical need request is the first step. In conclusion, major medical needs can arise unexpectedly and significantly impact individuals and families both emotionally and financially. With a quality HealthShare at your side, members can rest assured knowing they have comprehensive support to navigate through such challenging times. Our commitment to providing quality healthcare solutions empowers members to focus on their recovery with peace of mind. For more information about our favorite HealthShare and major medical need support, please visit our website or contact one of our HealthShare Coaches for personalized assistance. Visit: www.WhatisHealthShare.com By prioritizing the health and well-being of our members, we continue to uphold our mission of making quality healthcare accessible and affordable for all. Disclaimer: HealthShare or Medical Cost Sharing communities are not health insurance, that’s why it works!

  • Decoding Your Healthcare Equation!

    In today's world, understanding your healthcare equation is more crucial than ever. Yet, many of us haven't paused to ponder this seemingly simple question. Why? Because we've grown accustomed to the safety net of insurance, assuming it will handle everything when the need arises. But times have changed. It's easy to fall into the trap of complacency, especially when terms like "insurance coverage" and "benefits" are thrown around without much explanation. However, taking charge of our healthcare today means taking ownership of our well-being and understanding the intricacies of the system, and of your health. Imagine your healthcare equation as a puzzle, with each piece representing a different aspect of your health and coverage. By piecing it together, you gain insight into what it truly costs and how it operates when you require medical attention. Two important pieces of the puzzle are Primary Care services like those from a Direct Primary Care physician, Wellness Association or Telehealth Service. These provide access to care when you need it and can lighten the burden when medical concerns arise. They are your primary go to for those stressful times. When medical needs create financial burdens, the next piece to have in place is access to a catastrophic HealthShare community. HealthShare membership is designed to support members major medical needs and expenses. They support referenced based pricing to keep costs low. Members contribute a monthly contribution usually lower than most insurance premiums and have a set per need out of pocket expense called an IUA, when a medical need does arise. So, how do you start decoding your healthcare equation? Begin by familiarizing yourself with your healthcare plan. Understand what services are shared, what costs you're responsible for, and any limitations or restrictions. Next, consider your own health needs and habits. Are you generally healthy, or do you have ongoing medical conditions? Do you visit the doctor frequently, or do you rarely require medical attention? These factors will influence how you approach your healthcare equation. Additionally, don't forget about preventive care. Investing in your health now can save you both money and stress down the road. Routine check-ups, screenings, and healthy lifestyle choices can all impact your long-term healthcare costs. Ultimately, taking ownership of your healthcare equation isn't just about saving money—it's about prioritizing your well-being and making informed choices that align with your needs and values. So, don't just toss the responsibility over the fence; grab hold of it and start unraveling the mysteries of your healthcare coverage today. To learn more about the HealthShare solutions mentioned above visit us at www.WhatisHealthShare.com to schedule a call with a HealthShare Coach today!

  • Why HealthShare Terminology Matters

    HealthShare and traditional insurance differ significantly in their terminology and operational models. HealthShare is not insurance and because it doesn't want to be mistaken as such requires different terminology. Here's a breakdown of those distinctions: HealthShare Membership vs. Insurance Plan: HealthShare operates on a membership basis, where individuals join a community that shares healthcare costs collectively. Insurance involves purchasing a plan from an insurer, which provides coverage for specific healthcare services. Membership Guidelines vs. Plan Outline: HealthShare communities have membership guidelines that outline the requirements and expectations for members participating in cost-sharing. Insurance plans provide a detailed plan outline that specifies the covered services, copayments, deductibles, and other terms of coverage. Shared Services vs. Benefits: HealthShare involves shared services where members contribute to covering each other's healthcare expenses. Insurance provides benefits, which are the specific services or treatments covered under the plan. What is Eligible for Sharing vs. Covered: HealthShare determines what medical expenses are eligible for sharing among the community members based on established guidelines. Insurance plans specify what services or treatments are covered under the policy. Monthly Contribution vs. Premium: HealthShare members make monthly contributions to the community fund to cover the shared healthcare expenses. Insurance requires payment of premiums to the insurer to maintain coverage. Initial Un-shareable Amount (IUA) vs. Deductible: HealthShare has an Initial Un-shareable Amount (IUA), which is similar to a deductible but operates differently in that it's not an accumulative annual deductible but applied to each medical need. Insurance plans often have an annual deductible, which is the amount the insured individual must pay out of pocket before the insurer starts covering expenses. Medical Need Request vs. Claim: In HealthShare, members submit a medical need request when they require assistance with healthcare expenses, which is then evaluated by the community. In insurance, individuals file claims to request reimbursement or payment for covered services. Pre-membership condition vs. Pre-ex Condition: HealthShare communities may consider pre-existing conditions differently from traditional insurance, often with less stringent restrictions. HealthShare offers a phase in period helping members with financial support for pre-membership conditions. Insurance plans typically assess pre-existing conditions and may impose waiting periods or exclusions for coverage related to those conditions. Overall, the differences between HealthShare and traditional insurance lie in their operational models, terminology, and approach to covering healthcare costs. HealthShare is often touted as being more community-driven, affordable, and with less bureaucratic paperwork compared to traditional insurance. However, it's essential for individuals to understand the nuances of each option before deciding on their healthcare coverage. To learn more about the fastest growing HealthShare on the market. Visit us at www.WhatisHealthShare.com.

  • Why IUA is better than a Deductible.

    There are several reasons why you might prefer an IUA (Initial Unshareable Amount) over a traditional deductible: Personal Responsibility: An IUA gives the reigns of responsibility back to the member for their healthcare related costs. This promotes personal accountability for health-related expenses and encourage members to make more informed decisions about their healthcare utilization. Immediate Application: Unlike traditional deductibles that may accumulate over the annual agreement or across different medical events, an IUA is applied to each medical need-sharing request as it occurs. This means that members don't have to worry about reaching a certain threshold before their healthcare costs start being shared by the community. Flexible Membership: HealthShare operates on a month-to-month membership basis with no contracts. An IUA aligns well with this structure since it doesn't accrue over time and is applied on a per-incident basis. This can provide members with greater flexibility and control over their healthcare expenses. It's also more cost efficient, a single IUA at $1000 dollars vs a $5000 deductible. Variety of Options: HealthShare offers multiple IUA amounts allowing members to choose the level of financial responsibility that best fits their individual needs and budget. Those who are comfortable with higher out-of-pocket costs upfront can opt for a higher IUA, which typically translates to lower monthly sharing contributions. Lower Monthly Contributions: Since higher IUA amounts result in lower monthly sharing contributions, members who are willing and able to take on more responsibility for their healthcare costs upfront can benefit from potentially lower monthly expenses. In summary, an IUA offers a balance between personal responsibility and community sharing, providing members with flexibility, immediate cost-sharing benefits, and options to tailor their healthcare expenses to their individual preferences and financial circumstances. To see if HealthShare is a fit for you visit us at www.WhatisHealthShare.com to learn more.

  • Six reasons why you should join a HealthShare!

    These are 6 reason's HealthShare is better than traditional insurance plans! Cost Savings: HealthShare programs typically have lower monthly contributions (similar to premiums in insurance) compared to traditional health insurance. Members often pay less on a monthly basis, making it a more cost-effective option for some. Shared Values: HealthShare is often based on religious or ethical principles, and members share common beliefs and values. This shared community is attractive to individuals who prefer to align their healthcare choices with their personal values. Flexibility: HealthShare plans offer more flexibility in choosing healthcare providers, as they often don't have strict networks. This can be beneficial for those who want the freedom to see the healthcare providers of their choice without facing out-of-network penalties. No Network Restrictions: Traditional health insurance plans often have network restrictions, and coverage is limited to in-network providers. HealthShare programs have zero restrictions on where members can receive care, providing more flexibility in choosing healthcare providers. Simplified Process: HealthShare programs have simpler administrative processes compared to traditional insurance. Some people appreciate the straightforward approach, which involves paying direct to providers of medical expenses for members without the involvement of a complex claims process. Personalized Approach: HealthShare often involves a more personalized approach to healthcare, with a focus on the needs of individual members. Members feel a sense of community and support as they navigate their healthcare journeys. We love what our HealthShare does for our family and friends, and we think you will too. Come learn more about what a HealthShare community can do for you! Click here to learn more about HealthShare.

  • Is joining a Healthcare Sharing Ministry a better choice over insurance?

    Introduction: The landscape of healthcare options has expanded beyond traditional insurance plans, with alternative models like Healthcare Sharing Ministries or HealthShare for short, are gaining attention. In this blog post, we'll explore the concept of HealthShare Ministries and weigh the pros and cons against conventional health insurance, helping you make an informed decision about your healthcare coverage. Understanding HealthShare Ministries: HealthShare Ministries are faith-based, non-profit organizations where members pool their financial resources to cover each other's medical expenses. These ministries operate on shared principles emphasizing community support, shared responsibility, and a commitment to a healthy lifestyle. Pros of HealthShare Ministries: Cost Savings: One of the primary attractions of HealthShare Ministries is the potential for cost savings. Monthly contributions (similar to premiums) are often lower than traditional insurance premiums, making it an appealing option for those seeking affordability. Community and Shared Values: HealthShare Ministries foster a sense of community among members who share similar faith values. This communal support can be emotionally uplifting, creating a unique healthcare experience. Exemption from ACA Requirements: HealthShare Ministries are exempt from Affordable Care Act (ACA) regulations, providing members with more flexibility in choosing coverage options. This exemption may result in fewer mandated coverages, giving members the freedom to select services that align with their needs. Cons of HealthShare Ministries: Limited Coverage: HealthShare Ministries might not cover certain medical services or pre-existing conditions. Some offer a phase in period or waiting period before they share in medical needs. Medical sharing decisions are subject to the community driven ministry guidelines, which may vary between organizations. Not Regulated Like Insurance: HealthShare Ministries are not regulated as insurance, which means they lack the oversight and additional costs that get added to your insurance rates. This oversight was mandated because of poor decision making and lack of transparence often plagued by insurance companies. It also means consumers need those protective measures that traditional insurance plans are required to adhere to because of past misdeeds. This can lead to potential risks for members, especially if their ministry is acting like an insurance company. Non-Guaranteed Payments: Unlike insurance policies that “guarantee” coverage for eligible expenses, HealthShare Ministries must operate differently than insurance, hence they must claim sharing is on a voluntary basis. There is no contractual obligation to pay medical bills, if there were they would be considered insurance and then subject to insurance regulations and increased rates. The sharing of medical expenses is contingent on the members’ adherence to membership guidelines and their understanding that it is not insurance. Members usually understand how HealthShare differs from insurance, and that's why they join. Be aware and know that it may not be a fit for everyone. Comparative Analysis: When deciding between HealthShare Ministries and traditional insurance, it's crucial to consider individual needs, preferences, and risk tolerance. Cost Considerations: HealthShare Ministries offer cost savings, but it's essential to evaluate the coverage provided and potential out-of-pocket expenses. Traditional insurance plans may have higher premiums but could offer more comprehensive coverage. You do the math, (Premium x 12) + Deductible + max out of pocket = Total Value for your dollar. Coverage Requirements: Assess the specific medical services you need and compare them against what each option offers. HealthShare Ministries might have limitations, especially for pre-existing conditions and certain treatments. Review the Membership Guidelines for more information. Risk Tolerance: Consider your comfort level with the uncertainty associated with HealthShare Ministries. Traditional insurance plans provide a contractual “guarantee” of coverage, offering more predictability in times of need, but at a higher cost! Conclusion: Choosing between HealthShare Ministries and traditional insurance is a personal decision that depends on factors such as financial considerations, coverage needs, and individual values. It's crucial to carefully review the terms and conditions of both options, weighing the pros and cons to determine which aligns best with your healthcare priorities and lifestyle. Consulting with one of our HealthShare Coaches can also provide valuable insights to guide your decision-making process. We understand this isn’t for everyone, and that’s okay!

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