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Obamacare Alternatives In California


Everyone knows health insurance is an absolute necessity.  You may believe Affordable Care Act plans, otherwise known as Obamacare plans, are the only options that are available to you.  And while the benefits of ObamaCare plans are comprehensive, for a growing number of consumers, Obamacare is simply not affordable.  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.

Many experts believe 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.

Alternatives to ObamaCare in California.

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, however, 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.

Good to know:  Get your prescriptions via mail order.  For medications you use long-term, you'll reduce hassle and cost if you order pills on a subscription service through your insurer.  "Utilizing 90-day supplies and mail order can decrease dispensing fees," says Diana Graalum, clinical pharmacy manager at MedSavvy

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.

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.


Good to know:  Starting around their first birthday, kids should get twice-yearly checkups from the dentist, says Keith Morley, DMD, president of the American Academy of Pediatric Dentistry.  Preventive care, nips problems in the bud before they become more costly.  You should also talk to your dentist about getting sealants for your child's molars.  (Sealants are a liquid plastic material applied to your child's back teeth to prevent them from decaying.) Many insurance companies cover the cost, but even if they don't, get them anyway: They'll probably save you money in the long run.
courtesy of Parents.com

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 California, will be used to pay for medical costs that arise within California.

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.

Cedars-Sinai Medical Center - health care sharing
Cedars-Sinai Medical Center
8700 Beverly Blvd
Los Angeles, CA 90048
Telephone: (310) 423-3277
Plus Code: 3JG9+4R California




Good to know:  Discuss health plans options with your doctor.  Go over your insurance company's list of covered prescription medications with your doctor.  Some medicines will cost you more than others.  If your doctor knows what's on your insurer's list, he can select the best medication for you at the lowest price.  Also, if your plan requires you to get a referral to a specialist, take your insurance plan's preferred-provider list to your primary-care appointment.  Your doctor can easily pick out the best specialist who participates in your plan.
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.

Good to know:  Get copies of all your medical test results and records.  Bringing those with you to consultations can cut the number of tests and office visits you need.  Often, if you've had a test recently, there is no need to repeat it.  Plus, if you visit a doctor with test results in hand, she can advise you immediately rather than needing to set up another appointment after test results arrive.



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