Answering Your Biggest Questions about Cost-Sharing Health Plans

Health Insurance is a big decision for anyone, but particularly as small business owners it can feel daunting to determine the right coverage for you! We have used cost-sharing health plans for over a decade now and hands-down believe it is the right fit for our growing family! 

📌 Related: Why we chose a cost-sharing plan over traditional insurance. 

I share more on why we chose a cost-sharing plan over traditional insurance in this post, but wanted to follow-up with some of the biggest questions I’ve received about our experience with this health care alternative. 

We use Christian Healthcare Ministries so all of my answers will be about this provider. I do not have experience with other cost-sharing providers but I know there are several other options available!

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Question: Which cost-sharing plan, in particular, do you and your family have … ? 

Answer: We use Christian Healthcare Ministries and have since 2013. With a brief break in 2019 when we had coverage through Kyle’s employer and regretted ever leaving CHM after getting hit with a massive ER bill (with traditional health insurance). 

Question: Do I have to be a christian to use Christian Healthcare Ministries?

Answer: CHM is a faith-based provider. There are several other cost-sharing providers to choose from should you not want a faith-based company.

Question: How does a cost sharing plan work with routine care that can be really expensive. 

Answer: It is really important to understand what is/isn’t covered with the plan you choose. Just like traditional health insurance some medical expenses are covered (“shared”) while others are not. However, in the eyes of the medical system, you will receive self-pay or cash payer pricing for all medical costs. 

As a cash payer you will typically receive a discount of 10-70% off the charge that is billed to insurance, always as for pricing for routine medical visits or any other procedures up front and let them know you are a cash payer. 

From there, you’ll submit your bills to Christian HealthCare ministries and if it meets their share requirements, then the amount will be reimbursed to you. 

We usually go ahead and pay the bills out of pocket and then get a reimbursement from CHM, but you can also have CHM pay the provider directly. In the event of large expenses (like maternity, labor and delivery), we set up a payment plan with our provider to make monthly installment payments so it was less out of pocket up front until we received the full amount from CHM and then paid the bill in full. 

Question: Was your cost-sharing plan THERE FOR YOU when you needed it — when your medical expenses exceeded your (usually) very high deductible? Did they abide by and honor their contract with you? 

Answer: Such a great question. Like any type of “insurance”, it is only as good as the company backing the promise. We have had an excellent experience with Christian Healthcare Ministries and have used them for over ten years.

We are fortunate to not have a lot of medical expenses, so most of the time we pay for routine care out of pocket. On the flip side, we utilized CHM for my maternity expenses, labor and delivery, and postpartum care. Now that I am pregnant again we will count on CHM to cover the majority of expenses.

My advice? Read the details of your plan carefully and understand what is and isn’t covered so there are no surprises. 

When doing your research just know that (as with insurance), the coverage provided is only as strong as the company you are using. Sometimes the lowest cost option isn’t the best option! CHM has been around since 1981 and we have personally used them for over a decade. 

Question: Do cost-sharing plans (yours or others) qualify for a Health Savings Account, HSA? 

Answer: This is one of the only “cons” I see to using a Cost-sharing plan. As far as I know, the cost-sharing model does not qualify to pair with an HSA since it is not “traditional health insurance”. 

While it’s not the same, we have gotten around this by opening a separate personal savings account on our own earmarked for health expenses. While this doesn’t provide the tax advantages of an HSA, at least you are setting money aside to pay for health costs as they arise. 

Question: We have health insurance available through a provider, can we still utilize a cost-sharing plan? 

Answer: As far as I know, you can choose to decline employer provided health insurance and opt-in for a cost sharing plan. Some employers may even offset the savings by providing additional income should you choose to opt-out of the company provided health insurance, worth asking at least! 

If you do have health insurance through work, you can still have a cost sharing plan but it only pays after your health insurance has been utilized first. If you have health insurance you cannot choose to self-pay. 

Question: What is a cost-sharing health plan? 

Answer: it’s important to know that a cost-sharing plan through christian healthcare ministries is not traditional health insurance. 

I believe a cost-sharing plan was the original design for any form of “insurance”. A group of people pool their money together and then distribute the funds as needed to those in the community in need. 

I appreciate that CHM (Christian Healthcare Ministries) is a non-profit. The goal isn’t to make money off member funds, but to collect enough premiums (monthly payments from members) to ensure they can provide for members when needs arise. 

Question: Does a Cost-Sharing health plan abide by mandated health coverage? 

Answer: Yes! Coverage through Christian Healthcare Ministries qualifies for a federally certified exemption. 

Have More Questions? 

Have questions about pre-existing conditions, pricing, tax deductions, etc. You can find other FAQs directly from CHM. 

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We have used CHM now for more than 10 years, one baby and another on the way. We are so grateful for this healthcare alternative for our family and I hope sharing more about our experience helps with your own decision! 

Shanna 

ps. We love CHM and bonus they have provided us with a unique referral link (used throughout this post). Should you decide that CHM is the right choice for you and your family, you can use our referral link [CLICK HERE].

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