The number of people opting for healthshare programs to cover their personal and family medical expenses is rising yearly. So if you too, are thinking of joining the right medical health share plans, you may wonder if this program will meet your personal and medical expenses. Hence, before entering any healthshare program, here are some important questions to ask.
For How Long Has The Program Been In Business?
Knowing the longevity of the medical health share plans community is extremely important, as it will help you determine if they have the right programs for your needs. Though hundreds of healthshare programs exist, only a few have large and open memberships. Depending on your specific medical conditions, a healthshare plan may or may not be suited for you.
How Fast Do They Pay The Medical Expenses?
The time taken by a healthshare program to process medical expenses varies widely. Since these are not health insurance providers, they cannot provide individual sharing timelines legally. Therefore, you need to know how long it may take them to anticipate your medical costs being covered or reimbursed. The turnaround time usually begins once the member of the healthcare provider submits the receipt of all itemized invoices or receipts.
How Much Is The Out-Of-Pocket Costs For Some Expenses?
Out-of-pocket costs are the costs you must pay out of your own pocket. Some healthshare programs have an annual shareable expense amount ranging from a few hundred dollars to more than $10000. While some others have per-incident personal expenses of 200-500 dollars before the costs are eligible for sharing. Yet other programs have both options available, while there are some programs where the costs for some treatments are not shareable. Hence, it would help if you looked at the types of healthcare services that you and your family utilize. Ensure that you also consider how much of their costs will be out-of-pocket.
Do They Cover Wellness Visits?
Routine checkups like pap testing and vaccines should be inquired about. Determine whether you are eligible for wellness visits, preventative screenings and well-baby visits so that you can make the most out of your healthshare plans.
How Many Members Do They Have?
You may ask about the number of members the healthshare program has. Most of them are parts of a religious organization or are non-profit organizations. The more memberships, the more funds will be available for your medical expenses.
What Is Their Sharing Limit Per Incident?
Medical treatments for certain health conditions, like cancers, can be quite expensive. So if you or a member of your family needs costly treatment, find out if the healthshare plan will provide you with enough share to cover your expenses. Do not forget to ask if they have limitations per incident or per year.
Do They Have Any Limit To How Many Times You Can See Your Doctor?
Before you join any healthshare program, determine if there are any restrictions on the type of physicians or hospitals you may visit and how often you can see them. Remember that some healthcare plans do not allow sharing expenses for doctor visits and require members to use telehealth services instead.
Do They Have A Maximum Share Available For Maternity Care?
Maternity care sharing limits vary for each program during the first year of membership. After the second year, each pregnancy usually has a maximum sharing restriction. While some programs do not share maternity expenses at all. Hence, it would be best if you enquire about this before joining.
Do They Accept Medical Expenses By Your Healthcare Provider On Your Behalf?
Ask them if your doctor can submit your medical expenses, as some healthshare programs require the members to pay the provider at the time of services and then cover the costs later.
Do They Share The Cost Of Vaccinations?
Also, ask them if their program shares the cost of vaccinations since you may never know when you or your family member may need to get vaccinated against infectious diseases.
Do They Have Any Limitations To Sharing Pre-Existing Conditions?
If you suffer from a long-term medical condition, the program may not share treatment expenses for months or even years. Some allow you to share a portion of the treatment for pre-existing conditions, while others allow the full costs to be shared. So make sure to ask about how long the pre-existing condition will be excluded from being shareable.
Are You Required To Use A Network Or Free To Choose Your Doctor?
Find out if there are limits to choosing your doctor and hospitals or if you must use certain providers within the program’s network. Some programs only cover medical expenses when you use specific healthcare providers. This is important as it could result in you having to change doctors.
Takeaway
Apart from considering the above factors, make sure that you choose a healthcare program that will allow you to share the expense with other like-minded community members. You should be able to rely on the program even for unexpected medical costs.
