Many health shares have adopted new features that extend their utility beyond sharing major medical expenses. But there are still some features you should not expect from your health share; some of these features are not included in your membership because they would stretch health sharing communities’ resources too thin, and some are not included because they are inconvenient for members.
The features talked about in this blog are not common for health shares at this point, and should not be expected as part of your health share membership. If you would like to request your health share add more mental health sharing, or if you would like them to abandon the use of a provider network, you should contact them and request it. They may not add make the change right away, but the more members that ask, the more likely they are to consider it.
Read below to learn more about features you should not expect from your health share this year.
Your health share will not use a provider network
Provider networks are made up of doctors and other health care providers, as well as certain medical facilities contracted to provide medical care to its members, often at a discount. While provider networks are still commonly used by traditional health insurance plans, many health shares are moving away from them in favor of allowing members to choose their own provider. This freedom of choice is one of the main draws of healthsharing.
These networks can be a burden for those living in rural areas, or who frequently travel, as they may have a more difficult time finding providers in their network. Medi-Share, one of the few health shares that still uses a provider network, uses a Preferred Provider Organization (PPO) (detailed in section V. of their guidelines), which penalizes members who go to out of network providers by making them pay for 20% of eligible medical expenses incurred out-of-network. This extra 20% is on top of any personal responsibility and co-share amount, so it is a sizable penalty.
On the other hand, OneShare Health, a long-time user of the First Health network, has recently moved away from using a provider network. Previously, OneShare members would have to pay 50% of eligible medical expenses incurred out-of-network. Now, OneShare has ditched penalizing their members in favor of giving them the freedom to choose their own provider.
Your health share will not offer dental and vision sharing
What people generally expect from standard vision and dental care is not shareable. Health shares do not share expenses for routine or age-related vision care, nor do they share expenses for routine dental care. So, do not expect the community to help pay for fillings, cleanings, or new prescription lenses, for example.
A good example of how health shares treat routine dental and vision care can be found in Sedera’s member guidelines (pg. 27, section 6.B.17): When a dental procedure can be ordered or provided by a dentist, dental surgeon, oral surgeon, or other dental professional, it is generally not shareable. The only exception is if a procedure is performed to repair dental problems suffered as part of a traumatic injury.
The same is generally true for expenses related to vision care: if it isn’t routine or age-related, but instead related to a shareable unexpected injury, then it is generally shareable. Expenses related to Glaucoma, or other diseases and injuries to the eyes, are also generally shareable.
Despite the lack of dental and vision sharing, many health shares do provide discounts for dental and vision care. Altrua, for example, claims to save their members 5–40% on vision care and 20–50% on most dental procedures.
Your health share will limit mental health sharing
Health shares rarely share in medical expenses related to mental health treatments (one exception being medical expenses related to involuntary commitment to psychiatric facilities). When it comes to shareable behavioral and mental health counseling and therapy, members are usually limited to treatment through telemedicine and telecounseling.
This is not always the case, however. Solidarity HealthShare, compared to just about every other major health share, is well ahead of the curve. Solidarity shares medical expenses for mental health counseling, drug and alcohol counseling, treatment, medication, and emergency hospitalizations.
It is just as important to understand the limitations of your health share membership as it is to understand its benefits, so that instead of being caught off-guard, you can plan around them.
We’ve only discussed a few features that your health share likely does not offer, and of course, this is what you shouldn’t expect from your health share in 2023. Health shares are constantly trying to adapt and add features to attract new members and keep current ones happy. So, if some of the features above are important to you, we would encourage you to contact your health share directly or use our website to find one that’s right for you.