As a primary care clinic, we think insurance is absolutely necessary. We are confident that we can take care of 80% of your health care needs.
There are absolutely times when insurance is necessary. We want to bring your attention to an alternative to traditional health insurance plans called Health Sharing Plans. Read below for more information.
By Itself
As an individual, you don’t have to go without care because of the lack of insurance. 90% of medical needs for 90% of the people can be managed through primary care. We recommend that all members have some type of insurance coverage for the unexpected; however, it is not required.
As an Employer, offering Direct Primary Care as a
By Itself
As an individual, you don’t have to go without care because of the lack of insurance. 90% of medical needs for 90% of the people can be managed through primary care. We recommend that all members have some type of insurance coverage for the unexpected; however, it is not required.
As an Employer, offering Direct Primary Care as a stand alone benefit will help reduce out-of-pocket costs for employees who have purchased their own plans.
Paired with High Deductible Health Plan (+HSA)
Pairing Simply Direct Health with a high deductible health plan allows for coverage for catastrophic events while also providing concierge level quality and access to primary care services. Switching from a “Silver” or “Gold” level plan to a “Bronze” plan will typically save more than the cost
Paired with High Deductible Health Plan (+HSA)
Pairing Simply Direct Health with a high deductible health plan allows for coverage for catastrophic events while also providing concierge level quality and access to primary care services. Switching from a “Silver” or “Gold” level plan to a “Bronze” plan will typically save more than the cost of membership at Simply Direct Health and will significantly reduce out-of-pocket expenses incurred over the year.
Adding an HSA account will allow for tax deferred payment for incidental medical expenses like labs, prescriptions, supplements, imaging, and payment toward the high deductible if necessary.
Paired with Medical Cost-Sharing Plan
Medical cost-sharing is an ACA-compliant alternative to health insurance. In this option, the medical cost-sharing organization would help pay for medical expenses incurred outside of Simply Direct Health.
A national medical cost-sharing organization sees the value of direct primary practices like SDH.
Paired with Medical Cost-Sharing Plan
Medical cost-sharing is an ACA-compliant alternative to health insurance. In this option, the medical cost-sharing organization would help pay for medical expenses incurred outside of Simply Direct Health.
A national medical cost-sharing organization sees the value of direct primary practices like SDH. Membership fees incurred at SDH may be submitted for partial reimbursement as a participant in a medical cost-sharing program.
See below for more details about these plans.
Health Sharing Plans are alternatives to mainstream insurance plans that offer "per event" coverage for medical complications that occur outside the scope of primary care.
Here are a few HealthShare plans we are aware of:
1) Zion HealthShare https://zionhealthshare.org/?affiliate=170117
2) Samaritan Ministries http://samaritanministries.org/
3) Christian Healthcare Ministries https://www.chministries.org/
4) MediShare https://mychristiancare.org/medi-share/
5) Liberty Direct Health Sharing http://www.libertydirect.org/
*HealthShares are not insurance, nor sold by an insurance company. They vary in their rules and patients should check each for up-to-date information on ACA (Affordable Care Act) compliance, ability to quualify as a taxable benefit, for 125 Pre-Tax benefits or guaranteed payment of any medical bills.
Each of these non-profit companies has its own unique plan, but the overall premise is a low premium (usually about $300-$500/month) with non-sharable amounts ranging from $500-$3000. They function on a "per event" basis. For example, if you have a medical need that is less than $300, it would be your responsibility. If that need exceeds $500-$3000, you would submit that information to the health sharing plans for reimbursement that is shared among other members. The monthly premium is shared with those that have need.
The mindset that you are a healthy family and sharing the cost burden of those chronically ill around you makes it challenging to continue paying >$1,000/month premiums for health insurance that you don’t use. The majority of Americans will not hit a $3,000 deductible during the year, and even less will meet a $5,000 deductible.
I need health insurance to avoid a fine, right? Again, the above Health Sharing Plans are ACA Exempt. Your tax accountant can show you the forms to fill out to state your exemption. In addition, there was recently signed legislation lifting the ACA Fine.
These options are great ways for uninsured people to maintain ACA exemption, while having catastrophic coverage opportunities. They are great for small businesses to offer as added incentives for a fraction of the price of traditional health insurance. These health sharing plans work perfectly in SDH's system of health care, where we take care of your primary needs for a low monthly membership fee and for anything requiring specialty care, you can utilize these resources. These plans work great for large, self-insured companies in a similar vein. We have found that these alternatives to health care really opened our eyes to finding affordable health care, and we are happy to work alongside these organizations in offering you the best, most affordable health care possible.
Lots of families are growing and have questions about pregnancy. Each respective Health Sharing Plan has built in it a maternity portion, but uniformly, they will NOT cover it if you sign up AFTER you become pregnant. However, paying cash for pregnancy care is actually more affordable than you may think.
The views and opinions expressed by SDH are our own and do not represent the official policy and/or position of Zion HealthShare, its members, employees or the like. Any content provided by [Affiliate Name] is of our own opinion and is not intended to represent the views and/or opinion of Zion HealthShare. Zion HealthShare is not responsible for any error or omission of information regarding the membership program. For full membership information, see ZionHealthShare.org. Additionally, any and all treatment received from SDH is still subject to the Zion HealthShare Member Guidelines. Zion HealthShare members should read and understand the Zion HealthShare Member Guidelines concerning what is considered shareable and not shareable with the community.
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