How Health Sharing Saves Money for Colorado Residents

Colorado Insurance Premiums Are Skyrocketing

In 2023, the Kaiser Family Foundation estimated that the average annual health insurance premiums were $8,435 for an individual, and $23,968 for a family.

That’s a 47% increase in the last ten years.

Colorado legislators have been working hard to keep the rising costs in check. But they haven’t been able to prevent a significant increase in 2024.

Even if your employer provides health insurance as part of a benefits package, workers in 2023 still contributed an average of 17% of the premium for single coverage, and 29% of the premium for family coverage. That’s approximately $1,401 to $6,575 a year out of employees’ pockets as well.

And that doesn’t even include all the other additional out-of-pocket expenses every year, such as deductibles, coinsurance costs, and copayments.

The average deductible in 2023, which must be paid before the insurance plan will cover most services, was around $3,057. But some were over $7,200! It’s becoming clear why so many people now are looking for a more affordable alternative.

Why is Health Insurance so Expensive?

There are many reasons why health insurance premiums have become so unaffordable:

• General inflation, which has an effect on the price of all goods and services. Simply put, the dollar is worth less and less. 
• Obtaining quality medical professionals is expensive. There’s a shortage of skilled medical workers and support staff in general, which drives up wages in those sectors.
• Advancements in technology improve care. But technology is expensive!
• Hospitals continue to evade price transparency rules and overcharge for services.
• Drug prices are out-of-control, with some brands charging thousands of dollars per dose!
• Laws require health insurance plans to cover various services that many people do not want or need, such as drug and alcohol treatment or people who don’t drink and controversial procedures like gender reassignment surgeries and hormone therapies. 
• Health insurance companies must take all comers, regardless of medical history, during open enrollment and special enrollment periods.

The good news is you don’t have to get stuck in the health insurance trap! There are more affordable options, and health sharing – also called medical cost sharing,  is one of the best.

Health Sharing Plans vs. Insurance

It’s important to note that health sharing isn’t insurance.

Instead, health sharing organizations are non-profit associations of like-minded, health-conscious people who share common values, and who agree to help share the medical cost burdens of fellow health sharing plan members.

Some plans are faith-based and require members to adhere to certain guidelines. But others are secular, and focused on promoting a healthier overall lifestyle.

Because health sharing plans are not insurance companies, they don’t have to share costs for everything a traditional health insurance product has to cover.

For example, while ACA-qualified health insurance products must take everyone who applies during open enrollment or special enrollment periods, health sharing plans can impose waiting periods on pre-existing conditions and elective surgeries.

This leads to significant cost savings, which can be passed on to you.

Furthermore, health sharing plans generally allow you to choose your own doctor. Unlike ACA-qualified HMOs and PPOs that dominate the Connect For Health Colorado website, health share plans don’t rely on limited care networks of discount clinics, hospitals, and cheap doctors, health share plans generally let you use your plan with any doctor in the country, and sometimes abroad.

Health sharing plans stand out mainly because of their flexibility, and their ability to offer only the services you need the most. This means you are free to choose any doctor or hospital you want, and you aren’t stuck paying for services that you’ll never use!

How Does Health Sharing Save Money?

There are many reasons health sharing is so much less expensive than health insurance.

Healthshare plans are designed to pay for medical expenses that people are worried about actually incurring. Many plans don’t share expenses for expenses that health insurance is required to cover – including alcohol or drug addiction treatment, gender reassignment surgery, or elective abortions. So if this isn’t something you’ll ever need, why pay for it?

Healthshares are aggressive in negotiating lower costs with doctors and hospitals, which keeps their operating costs more reasonable.

Typically healthshare plans have waiting periods before costs for pre-existing conditions can be shared. Since health sharing programs have more control over their membership, they are able to reduce their risk, and they pass this saving onto their members!

How Much Money Can You Save?

The average unsubsidized health insurance premium in Colorado for a young family of four with an $8,000 deductible is typically more than $1,200 per month.

Costs are even higher in less populated locations in the state, and for older families.

For people who don’t qualify for the Affordable Care Act subsidy, a health sharing plan typically costs 40% to 50% less than a traditional health insurance policy.

Costs vary between plans, depending on your needs. But most cost less than $350 for individuals, and less than $750 for families.

This can save you thousands of dollars per year!

You can save even more money by combining a health sharing program with a Health Savings Account. Contact a Personal Benefits Manager today to find out about the new HSA MEC plan!

Benefits of Health Sharing

Health sharing programs may not be the best fit for everyone.  But if you’re currently in good health with no pre-existing conditions,  and you’re ready to escape your restrictive and overpriced traditional health insurance plan, switching to health sharing can bring some tremendous benefits.

• Lower costs. Since health sharing programs can limit membership to people who make a commitment to live a more healthy lifestyle, they are able to keep their costs reasonable, and this contributes to the lower overall cost of health sharing compared to traditional health insurance.
• Freedom to choose your providers. Unlike ACA-qualified plans, which are mostly HMOs and PPOs, health sharing plans allow members to seek non-emergency care from any provider, offering greater freedom in healthcare decisions. Members appreciate the flexibility these plans offer, including the freedom to choose healthcare providers and the absence of network restrictions.
• Telehealth access. Most programs provide 24/7/365 access to online doctors for a variety of services, including mental health services.
• Cash discounts. Members often qualify for special cash payor discounts at many healthcare providers, reducing out-of-pocket expenses. Many programs also offer discounts on dental, vision, drugs, and other wellness services and devices.
• Concierge service, to help you navigate a complex healthcare system. Most health sharing plans offer a concierge service to help members find providers and negotiate prices for procedures. This saves on out-of-pocket costs for you, as well as for the health sharing plan as a whole.
• Community support. Health sharing plans draw their roots to the mutual aid and fraternal benefit associations of the 19th and early 20th century in America. They haven’t lost touch with those roots. So there’s a strong sense of community and shared responsibility among members, which is appealing to those who value mutual aid. Many health share plans are affiliated with church groups, and some have community prayer support.

Additional Considerations

Even though they’re a great alternative to health insurance, health sharing isn’t a one-size fits-all solution.

For example, most plans don’t include prescription drug sharing, although many plans negotiate discounts on widely prescribed generic drugs. If you depend on costly medication you’ll need to check if your drug is included in the plan’s discount offerings.

If you are currently pregnant, or if you’re single and anticipating pregnancy, be aware that certain health sharing plans might limit maternity benefits to married couples, or place caps on the amounts they will share in complex or severe cases.

It’s important to review the guidelines for each health sharing plan so there are no surprises later.