Is One Better Than the Other?
If you are looking for a better solution to deal with your medical bills, you’ve probably heard of health sharing and direct primary care memberships. So how do you know which option is best for you?
Let’s take a look at some of the pros and cons of both approaches.
Direct Primary Care: Why or Why Not?
Direct primary care (DPC) is an alternative approach to the traditional fee-for-service healthcare model. In a conventional healthcare setting, you go to the doctor and are charged a fee for the service rendered. With DPC, you pay a monthly membership fee that allows you unlimited access to your primary care physician.
Not all DPC memberships are created equal. Some offer extensive services including health coaching, body contouring, and advanced cancer screenings.
Here are some highlights of a DPC membership.
What DPC Memberships Offer
Personalized attention
The best part about being a DPC member is the personal attention you will get from your primary provider. Since DPC practices limit the number of patients they serve, they can spend more time with each one. Also, having fewer patients means that it is easy to get an appointment—even on the same day!
When you are a DPC member, you and your doctor can take the time to really dig into your medical history, your personal circumstances, and your current health issues. You’ll develop a plan to improve or maintain your health that often leads to better patient outcomes and better overall health.
Routine care
Direct primary care is specifically for your routine and preventive care. Many memberships include standard lab tests, imaging, and other preventive appointments (e.g., well-woman exams, sports physicals, and pediatric care).
Additionally, DPC memberships are ideal for when you get sick and need something more than rest and chicken soup. Your DPC provider likely offers same-day virtual or in-office sick visits and can send prescriptions to your preferred pharmacy immediately.
What DPC Memberships Don’t Offer
Large provider networks
When you have a DPC membership, there is only one place where you can seek care. So, if you need medical attention out-of-town, or you need to go to the hospital for more urgent care, you will be paying out-of-pocket.
While DPC clinics are springing up all around the country, if there is not a DPC clinic in your area that negates the convenience a DPC membership is meant to provide.
Major medical care
Some DPC clinics offer limited urgent care services (e.g., stitches and sick visits). However, if you have an unexpected major medical event or need surgery, you will pay for that out-of-pocket.
Health Share: Why or Why Not?
If you are reading this blog, you are probably more familiar with health shares than DPC memberships. Health shares are a popular alternative to health insurance. There are a lot of differences between health shares and health insurance, which we cover in other blogs. A health share allows you to share eligible medical expenses with a community of members, can cost less than an insurance policy, but does not guarantee payment for your medical expenses—even eligible ones.
The details of health share memberships vary, but here are some common features.
What Health Shares Offer
Access to provider options
Most health shares don’t use a provider network, so members are free to choose their own provider. You can seek care anywhere in the country (sometimes outside the country).
Health share memberships do not limit you to one provider, so you don’t have to worry about traveling or moving and needing care away from your home base.
Flexibility and freedom are the main draws of health share plans. Health sharing is a great way to get the care you need from the provider you prefer.
Peace of mind
Perhaps the best thing that health shares offer is peace of mind. Major medical expenses have bankrupted far too many families. A health share plan is designed to ease the burden of costly illnesses, accidents, and other medical procedures.
Most people have health insurance to help offset expensive medical bills. Health insurance is there just in case you need it, so you don’t have to worry about what will happen “if.”
Unfortunately, most people with health insurance still don’t feel that peace of mind due to high deductibles and out-of-pocket maximums. While health shares often have sharing limits, they are typically more generous than many insurance companies. In addition, many health shares will continue to share expenses as long as you are undergoing treatment or experiencing symptoms related to a medical concern. That means, your member responsibility for the need doesn’t reset each year. On the other hand, some health shares have a yearly member responsibility amount, so read your membership guidelines carefully.
What Health Shares Don’t Offer
Routine care
Health shares are built to manage large expenses, which means some smaller expenses services won’t qualify for sharing with the community.
Even though this makes sense with the purpose of health shares, members are typically very interested in making sure their routine care is handled. Some health shares are trying, and offer limited routine services, but none come close to offering the kind of everyday care that a DPC can.
Guarantees
With direct primary care, the transaction is pretty straightforward: you pay membership fees, and in return, you get certain services. For example, depending on your contract, your DPC won’t pick and choose which symptoms they can treat you for, or refuse to review your medical history if it involves pre-existing conditions.
Health shares, on the other hand, have the final say on what they will or won’t share. There are member guidelines that outline what is shareable, but health shares do not guarantee payment for medical bills (reputable health shares do not make insurance-like promises). Membership is voluntary, and when you sign up you agree that the health share has control over what can and cannot be shared.
Of course, reputable health shares want to keep members happy, and the main way they do that is by taking good care of members. And many health shares have very happy members who have been helped with all kinds of major medical issues—just check out some of the reviews on our site!
Which One is Better? Health Sharing or Direct Primary Care?
Our answer: neither. The best solution is to combine the two, if possible. While many health shares are offering some preventive and routine care options, none of them offer what a DPC membership will. And a DPC membership won’t help you with those big, scary medical situations that keep you up at night.
If you are lucky enough to have a DPC clinic near you, we highly suggest looking into it. The great news is that some health shares encourage DPC memberships and may offer you a discounted monthly rate or other options that will help consolidate your payments for the separate memberships.
The combination of a DPC and health share is a great way to access quality health care at a lower cost.
If you have to choose just one for financial reasons, we recommend a health share. As we said earlier, those big, unexpected bills can be a source of anxiety. Having a plan to manage large expenses will help you sleep better. There are a few health shares that have some decent preventive options built into their plans. So, if you must choose one or the other, shop for a health share that offers the type of care that is most important to you and your family.
