I'm moving to the US from Canada in a few months and have never had to pay for health insurance out of pocket. How do health share programs work, and are they too good to be true compared to traditional insurance?
Health care sharing ministries are not health insurance, do not have to cover pre-existing conditions, and have no legal obligation to pay your medical bills. Because you are moving to the US legally, you qualify for official, guaranteed health insurance through the government Marketplace.
You can cross this worry off your list. You do not have to gamble on unregulated plans to afford care in the US. Because you will be lawfully present, you can buy the same guaranteed health insurance that protects US citizens from medical bankruptcy.
How health share programs work: In a health care sharing ministry, members pay a monthly amount to share the costs of health care with other members. The organization either matches paying members with those who need funds or pools the money to pay members directly. They often attract people because they charge lower up-front costs than traditional insurance.
Are they too good to be true? Yes. State insurance regulators warn that these programs are not insurance products. They often provide very limited benefits and usually do not have provider networks, meaning doctors and hospitals can charge you full price.
No legal protection for pre-existing conditions: Because health share programs are not legally classified as health insurance, they do not have to follow the consumer protection rules of the federal Affordable Care Act. The federal Affordable Care Act is the law that requires real insurance plans to cover treatments for pre-existing conditions and cap your out-of-pocket costs. Health share programs are exempt from these rules.
No legal obligation to pay claims: Health share programs cannot guarantee they will pay your claims. While they might share funds when you have a health need, they are not legally required to do so. If you have a massive medical bill, the program can simply choose not to pay it, leaving you entirely responsible.
