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Alternatives To Health Insurance In Fresno, California


Everyone knows health insurance is an absolute necessity.  But there's a problem:  For a growing number of consumers, health insurance is simply not affordable.  According to Peterson-Kaiser, pricing for health care is growing faster than prices in the general economy.  In California, since the end of 2007, healthcare prices have grown 21.6%, while prices in the general economy (measured by the GDP deflator) have grown 17.3%.  According to the Congressional Budget Office (CBO), premiums for benchmark plans - i.e., the second-lowest-cost silver plan listed on ACA exchanges - are expected to rise by 15% in 2019, and then average a 7% increase in 2020 and every year thereafter, through 2028.

Some experts consider these estimates to be conservative.  Being unable to repeal and replace the Affordable Care Act outright, The Trump administration has been chipping away at many of the ACA premium containment components.  The result of these actions will almost certainly lead to runaway increases in health insurance premiums for all ACA plans.

Interesting Fresno Facts
Named for the abundant ash trees lining the San Joaquin River, Fresno was founded in 1872 as a railway station of the Central Pacific Railroad before it was incorporated in 1885.  The city has since become an economic hub of Fresno County and the San Joaquin Valley, with much of the surrounding areas in the Metropolitan Fresno region predominantly tied to large-scale agricultural production.  Fresno is near the geographical center of California.  It lies approximately 220 miles (350 km) north of Los Angeles, 170 miles (270 km) south of the state capital, Sacramento, and 185 miles (300 km) southeast of San Francisco.
Health Insurance Alternatives in Fresno.

Increasingly, families across the nation are making the switch to a lesser-known healthcare option:  healthcare sharing plans.  Healthcare sharing plans, (also known as faith-based health plans, faith-based health insurance, or healthcare sharing ministries), are one of the fastest-growing healthcare options in the nation, but chances are, you've never heard of them.  Below, we'll walk you through some of the important information you need to know about this fast-growing healthcare option.

The advent of healthcare sharing plan.

Healthcare sharing plans (faith based plans), have grown exponentially beyond what anyone could have possibly imagined, when such plans were exempted from the Affordable Care Act health plan requirements.  At the time, the exemption was a way to sooth objections from conservative leaning congressmen who had reservations on the passage of the ACA.  This exempted niche, is now a fast-growing segment of the health plan industry.  From all appearances, this trend will continue well into the foreseeable future.  What was once a fringe idea, limited to devout Evangelicals and rural churches has found acceptance with a wide swath of the American populous.

Good to know:  You shouldn't promptly pay medical bills.  Yes, you read that right.  The reason is, healthcare providers tend to send bills well before the insurance company has decided what part of the claim they are obligated to pay.  The average person sees a bill and thinks they are obligated to pay it.  This couldn't be further from the truth.  Health care companies routinely shoots out bills to everyone one involved - regardless of who is actually responsible for paying it.  You need to know what the insurer is going to pay before you do anything.  Our advice? Don't pay a dime until you get an EOB (Explanation of Benefits) from your insurer that explains your claim and how much they are paying.
How do these faith-based plans work?

To put it simply, healthcare sharing is about like-minded people voluntarily coming together to share the burden of medical expenses.  Healthcare sharing plans are typically faith-based, meaning the core concepts are based upon religious beliefs.  However, in most cases, consumers do not need to be affiliated with any religious group, or be religious at all, in order to purchase a faith-based health plan.  Faith-based health plans are not considered insurance and are not regulated by the California department of insurance.

These plans are designed to accomplish the same fundamental goals as traditional health insurance:

  • Help people maintain good health by offsetting the costs of health care access.
  • Assist people with the cost of medical bills.
  • Protect people from catastrophic financial loss due to major medical expenses.

The mechanics.

The workings of faith-based health plans offered by various entities are quite similar.  Each month all the members pay a set contribution or "share" amount.  This contribution is based on the health plan style they have purchased.  Other factors that may contribute to what the contribution will be are age, gender, and health history.  Contributions are placed into a pool and managed by the healthcare sharing company.  The funds are "shared" with members who have immediate medical bills, according to their chosen plan and company guidelines.

Usually, funds to pay medical bills are dispersed within the same community that the members reside.  in other words, membership dues collected from plan members living in the Fresno, California region, will be used to pay for medical costs that arise within the very same Fresno, California region.

Good to know:  Keep an eye out for health plan discounts for using fitness technology like Fitness Trackers.  As technology makes data about the state of our health easily available, many insurers are starting to look at using tools like fitness trackers to minimize risk.  Some insurance providers currently offer discounts or incentive plans that will save you money, or provide financial rewards.
Ask a broker about plans that give discounts using new fitness technologies, or plans with health incentives.  One example is "UnitedHealthcare Motion" which offers financial reimbursement incentives of up $1,500 per year.  These types of plans provide good opportunities for savings.  Also, make sure to inquire about the possibilities every year, since these types of programs will become more common over time.
Advantages of Faith-Based Healthcare Sharing Plans.

Because Faith-based health plans do not fall under Affordable Care Act regulations, there is enormous flexibility in plan structure.  This is one of the factors that contribute to a lower monthly premium when faith-based health plans are compared with traditional health insurance plans with similar benefits.  Another contributing factor to lower premiums is the comparative lack of bureaucracy within entities that offer faith-based health plans.  Insurance companies in the U.S. have had over a century to build up a virtual mountain of bureaucracy.  The stifling bureaucratic excess is invariably passed on to the consumer, in the form of high plan premiums.  Also, in many cases, the lack of bureaucracy, translates into your physician, medical facility, or hospital being paid much more quickly for services provided.  Consequently, medical providers generally like health care sharing plans.

Fresno Heart and Surgical Hospital - health care sharing
Fresno Heart and Surgical Hospital
15 E Audubon Dr
Fresno, CA 93720
Telephone: (559) 433-8000
Plus Code: V656+XG Fresno, California




Disadvantages

One big advantage of an ACA backed plan is you cannot be declined coverage due to health issues.  Healthcare sharing companies can choose to decline coverage to any individual due to medical issues or history. Also, certain ACA plan benefits and protections are mandated by law.  Some benefits, like maternity, for example, may be very important to you.  Your faith-based plan may not offer it.

There are also lifetime maximum benefit limitations with most any faith-based health plan.  ACA plans have no such limitation.

For these reasons, faith-based healthcare sharing plans are not the perfect alternative healthcare plan solution for everyone.  Whether or not a faith-based plan makes good sense, depends upon your medical and financial circumstance.  Be certain to understand benefits and limitations thoroughly, before purchasing any faith-based plan, or traditional health insurance plan.

For more information on Faith-Based / health care sharing ministries, please contact us directly.



Other articles:
Explaining the Growth of HealthCare Sharing Plans.
5 Strategies For Reducing Medical Bills.
Resources



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