The very concept for and purpose of insurance is to protect one against unpredictable and large expenses, such as damage to your vehicle from an accident, or to your home from a hurricane. In health care where there is virtually no transparency, most health care costs are purposedly unknown, falsely creating a need for insurance for even routine care. Charges are frequently inflated, and “discounts” off these inflated charges by health care facilities are advertised by insurance companies as evidence that they are working on your behalf to get your value and savings for your insurance plan.
The Direct Primary Care (DPC) memberhsip model absolves the need for insurance for non-emergency care, from physician consultations to ancillary services, such as laboratory and radiology services. All costs are transparent, affordable and predictable with the all-inclusive monthly membership. Various private surgical groups are now publishing all-inclusive non-emergency surgical procedures so insurance is even not needed for them.
The DPC model allows members to purchase insurance or other plans purely for catastrophic needs at a much lower cost by forgoing inclusion of routine care in their plans. Unless you have chronic medical conditions that truly require the care of a specialist physician and expensive medications (about 15% of you), a health cost sharing plan may be just what you need. These programs dovetail with a DPC membership perfectly, at a combined cost that is usually half of traditional insurance offerings.
Please refer to Sedera Health’s website for full information.
The following applies to Sedera Health Access+ Program only. Other programs may differ.
- Pre-existing conditions: Eligible for sharing at up to $15,000 in the 2nd year, $30,000 in the 3rd year of membership; No restrictions afterwards, subject to Guideline
Exemptions: Hypertension, Cholesterol, Hemorrhoids, Sleep Apnea, or Fully cured conditions in the prior 36 months
- Limits on Tobacco users age>50: $25,000 each for Cancer, Heart conditions, COPD, and Stroke (until confirmed tobacco free)
- Maternity IUA of $5,000 for normal or $7,500 C-section deliveries applies regardless of routine IUA plan chosen (IUA reduced by 50% for using a birthing center) for delivery date beyond first 12 months of membership
- Mental Health: Pscyhological services shareable up to $750/need, and $750/year
- Other program – Sedera Health Access+: Higher monthly cost, No DPC Membership required; Save up to 14.5% monthly cost if also enrolling in a DPC practice
Please refer to Zion Health’s website for full information.
The following applies only to the Zion Health DPC Program. Other programs may differ.
- Pre-existing conditions: Might be shareable under Additional Giving Fund in 1st year, up to $25,000 in 2nd year, $50,000 in 3rd year, and $125,000 max per year afterwards
Insulin for diabetes: not shareable regardless
Exemptions: Hypertension, Cholesterol, Hemorrhoids, Sleep Apnea, and Fully cured conditions in the prior 24 months
- Sharing for colonoscopies and other preventive services requires 1 year of Direct Membership or in Connect Health program with a DPC practice.
- Maternity: 1xIUA may be waived for home births | Pregnancy 60 days prior to start of membership not shareable | Premature birth shareable
- Death benefits require 2 years of uninterrupted membership: $10,000 primary member or spouse, $2,500 dependent child
- Connected Health add-on: colonoscopies, mammograms and youth (ages 0-16) immunizations (IUA waived)
Please refer to Samaritan Ministries’ website for full information.
- Pre-existing conditions: shareable after 2 years of no symptoms or treatment, or 3 years for genetic defects, hereditary diseases, cases of related cancers, back programs, implants, and heart conditions
Exemptions from Pre-existing conditions limitations: Diabetes, Hypertension, Cholesterol. Pre-existing is considered any that requires medical attention within the prior 12 months.
- Rate of $200-250/month for single-parent (divorced/widowed) household for Samaritan Basic, $305/month for Samaritan Classic
- DPC Memberships are eligible for sharing at up to $100 for the month in which a physician is consulted, makes a referral, or charges for services related to a shareable need.
- Sharing after IUA is 90% for Samaritan Basic, 100% for Samaritan Classic. Max shared expenses for Medical Equipment up to $4,950.
- Maternity: Due date must be 260 days or more from membership start date; Individual Membership not eligible;
- Basic/Classic: $1,500 or 10% Co-share, and Sharing limit of $5,000, then no sharing until cost exceeds $13,500, and then max $236,500; Given: per plan limitations.
Please refer to Medi-Share’s website for full information.
- Monthly Amount depends on age, family size, and selection of AHP amount.
- Cost might be higher when not using MultiPlan, such as a co-liability of 20% at non-PPO hospitals.
- The $35 and $200 co-payments are required even after the member has met the AHP amount.
- Pre-existing conditions: shareable only after 36 months of membership, up to $100,000/year if no symptoms in the last 36 months, or $500,000/year if in the last 60 months.
- Maternity: Conception has to be after joining, with maximum amount shared at $125,000.
Mental health: Short-term counseling available through telemental health service
Please refer to Christian Healthcare Ministries’ website for full information.
- Pre-existing conditions: Conditions requiring no treatment for 1 year, except for cancer (when it is 5 years)
- Gold members: Eligible for sharing at up to $15,000 in the 1st, additional $10,000 in the 2nd, additional $25,000 in the 3rd years, and no more restrictions after 3rd year, subject to Guideline
- A unit can be an adult, or all dependent children of an adult: One unit: 1 adult | Two units: 2 adults, or 1 adult + children | Three units: 2 adults + children
- Extended Coverage with Brothers’ Keeper Program: Annual fee $40 per year, plus $45 per quarter per unit
For Bronze and Silver, amount is increased by $100,000 per year of renewal up to $1 million maximum.
For Gold, it is unlimited.
- Maternity: Gold members only, and due date must be 300 days from start of membership
Please refer to Altrua Healthshare’s website for full information.
- Doctor’s Office Visits: Maximum $300/visit can be counted towards 1st MRA, then 2nd MRA
- Maternity: max $4,000 normal delivery, $6,000 non-elective C-section, and after 10 months of a Couple Membership
- Colonoscopy: Not shareable in the first year; Maximum 1 per year, 3 per lifetime, unless having genetic diseases
Please refer to Liberty Healthshare’ website for full information.
- Most sharing requests have restrictions, and may require pre-approval. Enrollment requires completion of a health questionnaire.
- Pre-existing conditions: Eligible for sharing at up to $50,000 for in the 2nd and 3rd year of membership combined; No restrictions afterwards, subject to Guideline
Exemption with HealthTrac Program (additional $80/month): Diabetes, Hypertension, Heart disease, Cholesterol, Obesity, and Tobacco Use
- Maternity: Conception has to be after joining
- Direct Primary Care (DPC) Membership often include office visits in the monthly membership fee at no additional cost.
- DPC Membership fees can be reimbursed at up to 75%, to max of $40/month for individual, $60/month for couple, and $75/month for families, subject to change by Liberty Healthshare.