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Medical Cost Sharing Plans

At Digital Nomad Health, we are experts at helping patients navigate Medical cost-sharing plans and help them maintain their ideal health. This article will discuss what MCSPs are and why we focus our care on their members. These are alternatives to health insurance with key differences to consider.

Some groups, like CrowdHealth, refer to their Cost-Sharing plans as crowdfunding. The basic idea is that these are used by those who don’t want to have health insurance or can’t afford it.

Health Care Sharing Ministries

HCSM are organizations where individuals with a common ethical or moral belief come together to share the cost of their healthcare expenses. It’s a risk-pooling model, and famously, people in these plans were excluded from the health insurance mandate of the Affordable Care Act.

Based on the success of such Cost Sharing ministries, other non-religious entities arose, the most famous of which might be Sedera Health and now CrowdHealth.

Medical Cost-Sharing Plans

MCSPs come in different flavors, but they all have these things in common:

  • Monthly membership fee
  • Basic health requirement
  • Age requirement
  • ineligible diagnoses and conditions
  • Medical bill negotiation
  • Initial out-of-pocket expense

They are different from each other in the way they are structured or how they refer to themselves.

In general, CrowdHealth views itself as a crowdfunded healthcare platform. Your eligible healthcare expense is submitted to the crowd for funding.

Sedera refers to them as a cost-sharing membership that shares large and unexpected medical expenses with fellow members.

The Advantages

If you are generally healthy and putting a good deal of effort into maintaining your health, then a health-sharing membership can make sense.

You have a predictable monthly expense (~$200) along with a set out-of-pocket fee for the first portion of your spending.

You are sharing the cost of care with like-minded individuals who also are likely quite healthy. Such programs tend to be selected for that kind of individual.

It’s usually accepted to get your care even overseas, which makes this a great option for digital nomads and expats.

The Disadvantages

There are a few disadvantages to such Cost Sharing plans, but they are generally well-known upfront. This can help you make the best choice when choosing such options.

1. Denial of Care

You can have your medical reimbursement denied because it doesn’t meet the membership’s guidelines, which is perhaps the biggest drawback.

However, unfortunately, many traditional health insurance plans also routinely deny certain medications, procedures, and even imaging studies.

2. Denial of Ongoing Prescriptions

Many such cost-sharing or crowd-funding plans may deny long-term prescriptions for their members. It’s often not a big deal if it is a generic medication, but certain autoimmune medications can be expensive.

3. Age Limitations

Some of these programs only allow you to enroll up to age 65. This could be because of Medicare requirements and the fact that Medicare covers many in the US after that age.

4. Pre-Existing Conditions

There are terms in place that will deny care for pre-existing conditions for the first few years or up to a certain amount of reimbursement.

The details are often laid out well in their bylaws and membership agreements.

5. Complex Billing

Once you pay for a medical service, the membership plan asks you to submit it to their department so that they can negotiate it with the clinician.

In fact, they will often request that you don’t pay the full amount until they have a chance to negotiate the fees.

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