Health Sharing Plans For The Self-Employed Doctor

Options for Healthcare For The Self-Employed

Over the past few weeks, I have been reviewing various healthcare options that are evolving as alternatives for coverage to traditional insurance. For the self-employed micro-business owner, these options can save you quite a bit of money and are worth considering.

This subject is significant to me because I am a micro-business owner who is retiring before age 60, and whose wife is 10 years younger than myself, I must account for our healthcare costs in my post-retirement days starting in June 2024. I have budgeted for $25,000 annually for healthcare costs under the notion that I will go with traditional insurance. However, I think it is worthwhile to explore cheaper alternatives. The following is what I have found.

I would also like to mention that in the past, my wife and I have been using Christian Medishare for about 5 years and have had a very positive experience. In particular, it provided full coverage for my oldest son's cardiac ablation, which cost over $100, 000, to treat a life-threatening ventricular arrhythmia. However, the process of negotiating a cash price for all medical services, paying for them upfront, and then seeking reimbursement was a significantly different experience compared to what we were accustomed to with insurance. In the end, my wife, who serves as our bookkeeper, preferred the traditional insurance route, even though it cost us more money as a business expense.

So let’s review Health Sharing plans.

Health Sharing Plans: A Viable Alternative to Traditional Health Insurance

As the cost of traditional health insurance continues to rise, many individuals are seeking alternative options that provide affordable coverage without compromising quality. Health Sharing Plans have emerged as a popular alternative, offering an innovative approach to managing healthcare costs. In this blog post, we will explore Health Sharing Plans and their benefits as an alternative to traditional health insurance.

1. Understanding Health Sharing Plans: Health Sharing Plans, also known as Medical Cost Sharing Programs, are arrangements where individuals or families with similar values and beliefs come together to share healthcare costs. Members contribute monthly "shares" instead of paying premiums, and these funds are used to cover medical expenses of the members in need. Health Sharing Plans are typically organized by faith-based or non-profit organizations, and they operate under a set of shared guidelines and principles.

2. Benefits of Health Sharing Plans:

   • Cost savings: Health Sharing Plans often have lower monthly costs compared to traditional health insurance premiums. Additionally, members can benefit from a shared responsibility for medical costs, which can reduce the financial burden on individuals.

   • Flexibility in healthcare choices: Health Sharing Plans allow members to choose their healthcare providers, including doctors, hospitals, and specialists, without being limited to a network. This flexibility offers greater freedom and control over one's healthcare decisions.

   • Shared values and community support: Health Sharing Plans are often established by like-minded individuals who share similar beliefs and values. This sense of community can foster a supportive environment where members help to encourage each other during times of medical need.

   • Focus on preventive care: Health Sharing Plans typically emphasize preventive care and healthy lifestyle choices. Many plans include wellness programs and incentives to encourage members to prioritize their health and well-being.

3. How Health Sharing Plans Work:

   • Membership requirements: Health Sharing Plans often require members to adhere to certain criteria, such as abstaining from tobacco and illegal substances, adhering to a healthy lifestyle, and agreeing to a statement of faith or shared values.

   • Eligible medical expenses: Health Sharing Plans generally cover a wide range of medical expenses, including doctor visits, hospitalization, surgeries, and prescription medications. However, coverage for pre-existing conditions and certain elective procedures may vary among different plans.

   • Sharing process: When a member incurs eligible medical expenses, they submit their bills to the Health Sharing Plan for review. If the expenses meet the sharing guidelines, other members contribute their shares to help cover the cost.

4. Considerations and Limitations:

   • Not insurance: It's important to note that Health Sharing Plans are not insurance policies. They do not guarantee payment for medical expenses, and there is no legal obligation for the sharing organization to cover the costs.

   • Limited state regulation: Health Sharing Plans are not subject to the same regulations and consumer protections as traditional health insurance plans. This lack of oversight may lead to variations in coverage, dispute resolution processes, and financial stability among different sharing organizations.

   • Pre-existing conditions: Some Health Sharing Plans may have restrictions on coverage for pre-existing conditions, and they may require a waiting period before such conditions are eligible for sharing.

Conclusion

Health Sharing Plans offer a unique and cost-effective alternative to traditional health insurance, providing individuals with an opportunity to share healthcare costs within a supportive community. By understanding the benefits, limitations, and membership requirements of Health Sharing Plans, individuals can make informed decisions about their healthcare coverage. It is essential to carefully research and compare different Health Sharing Plans, ensuring that they align with personal values, provide sufficient coverage, and offer financial stability. As the landscape of healthcare continues to evolve, Health Sharing Plans serve as a viable option for individuals seeking an alternative approach to managing their healthcare expenses.

Bottom-Line

Insurance, DPC, or Health Sharing Plan (which I will explore next week) for your healthcare coverage option is a personal decision and also involves your budget and finances. Fortunately, with your high income, you can afford the most expensive and reliable option—insurance.

Regardless, of your choice, you will want to organize your healthcare costs as a business expense through your micro-corporation—this includes the premium or membership costs and any out of pocket healthcare costs (deductibles, etc.)

Out-of-pocket healthcare costs alone are a major concern for many of you. How to best minimize your out-of-pocket expenses involves understanding tax and business laws. The business deduction rules for sole proprietors, S-Corps and C-Corps are all different. In the end, a C-Corp provides the greatest ability to cover your complete healthcare expenses. It’s why my last 5 SimpliMD clients have elected to choose a C-Corp as their tax entity for their professional micro-corporation.

At SimpliMD, when I collaborate with our legal network to establish your micro-corporation, sorting through your healthcare needs is a great example of why you need someone who will assist you in personalizing the entire business setup. At SimpliMD, we prioritize listening to you, understanding your needs, and then assisting you in creating the optimal business structure to ensure your success and growth.

Let me encourage you to go here to get started with your personalized micro-corporation set up through SimpliMD.

If you have a micro-corporation already, let me assist you by providing personal micro-business coaching, where we can discuss important topics such as healthcare coverage. Sign up for my highly popular coaching 4-pack here.

But before you sign up to be coached, I recommend you become a SimpliMD member here, and it will unlock $2500 in savings for you with all my SimpliMD products—including the coaching 4-pack.

Tod