Who Can Join a Health Share Plan? Eligibility Requirements

Millions of Americans rely on health share plans to get the best possible coverage, but many still wonder who can join this type of care program. The good news is that if you’re asking yourself about health share plan eligibility, you’ve come to the right place. 

In this article, we will explain who is eligible for a health share plan and what you need to do to join one of these programs. 

Health Share Plan Eligibility

Who has health share plan eligibility? The truth is that every entity has its own requirements and eligibility regulations, so it depends on the company that’s managing the program. 

With that said, there are a few common eligibility requirements that health share plans implement to provide the best care to all of its members. This list includes:

Health Status

Your current and past health status can greatly influence whether or not you’re allowed to join a health share plan. In most cases, pre-existing and chronic conditions aren’t covered, but you may also get medical attention for other unrelated issues. 

Type of Household

The type of household you live in doesn’t usually influence your eligibility. But, we do mention it in this section because singles, couples, and families all pay different monthly amounts. As such, enrolling a larger family can have a higher cost and work as an additional eligibility barrier, so it’s worth considering it. 

The Will and Desire to Share Medical Responsibilities

Share health plans are effective because members are committed to helping each other even during difficult periods. As such, you should only join a health share plan if you have the intention of supporting fellow members when necessary. 

What is a Health Share Plan?

A health share plan is a cost-sharing program where members contribute funds to cover each other's medical expenses.

Members typically pay lower monthly costs for the plan, but coverage may be limited, particularly for pre-existing conditions. 

Health share plans emphasize community support, with participants helping others within the group. While these programs offer a more affordable alternative to insurance, they don't tend to provide the same level of comprehensive coverage or legal protections.

Similarities and Differences Between Insurance and Health Share Plans

While health share plans and traditional insurance both aim to assist with medical expenses, there are key differences. 

Health share plans look to foster a community-based approach, where members share each other’s medical costs in order to lighten the burden and contribute to better medical attention at a social level. 

Insurance, on the other hand, operates under legal contracts and guarantees payment for covered services. 

Unlike insurance, health share plans are not bound by regulations, leading to potential coverage gaps, especially for pre-existing conditions. This means that there is no guarantee for medical expense reimbursement. 

However, both options provide financial support for healthcare, with insurance companies typically offering broader, more comprehensive protection, whereas health share plans come with lower costs but less certainty as well.

Pros and Cons of a Health Share Plan

Health share plans are not meant to replace healthcare, but these programs can help detect potential threats and keep a healthier workforce. That said, there are pros as well as cons to implementing this type of program into your business. 

Let’s take a closer look.

Pros of a Health Share Plan

Let’s start by discussing the pros of healthcare plans. 

To begin, it’s important to note that individuals, families, and businesses that choose shared health plans are often committed to helping the community. 

In these programs, members share each other’s medical expenses to reduce the load and ensure that everyone gets the necessary medical care. 

Here are some of the main pros and cons of creating a shared health plan for your company. 

• Extensive medical coverage for certain conditions
• Lower monthly costs than traditional insurance
• Receive help from and support people with similar beliefs
• No enrollment periods and more freedom to choose healthcare providers
• A community-oriented approach that results in a closer-knit community

Cons of Choosing Shared Health Plans

With the above in mind, it’s also important to understand the cons of signing up for a shared health plan. These are:

• Shared health plans cannot be used as a replacement for insurance policies
• Often have restrictions on pre-existing and chronic issues
• Payment for medical care is not guaranteed, so members may have to cover the bills and only get a partial reimbursement
• Health share plans usually have limited coverage when compared to insurance

Ready to Create a Health Share Plan for Your Business?

Maintaining a healthy and happy workforce is an outstanding way to move your business forward. 

Besides ensuring that your employees are healthy and focused on their professional responsibilities, health share plans will make your team members feel like valued members and help you build a relationship based on trust. 

With that said, it’s important that you create a health share plan that is beneficial for your employees. If you have a program that doesn’t provide great benefits or contribute to the well-being of your team, you should change it and make sure to get one that truly takes care of your employees. 

LG Resources provides simple, affordable, and accessible healthcare through shared plans for families and individuals. Contact us to learn more about joining our programs!