What is Medical Cost Sharing?

With the rising costs of health insurance, businesses and individuals are looking for a cost-effective and efficient way to provide financially for their medical needs or for those of their employees that also complies with the Affordable Care Act (ACA). Whatever the goals and motivation behind the law, the net result has been neither “Affordable” nor improved access to “Care.” Through a combination of proactive wellness programs from My Academy of Health Excellence, preventive health insurance from ASi Benefits (that ensures that both employers, their employees, and individuals comply with the Affordable Care Act), a health savings account from HSA Bank and an organized benevolence Sedera Health, we help those individuals or businesses to provide and control the medical expenses of their employees or themselves.

The best way to CONTROL YOUR Health Care Costs is a Health Strategy NOT Health Insurance – the strategy builds one component on top of the other – therefore to understand how the components function with each other start from the bottom of the image and work your way up.

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My Academy of Health Excellence Plus is built upon the principles used by some of the Christian healthcare sharing groups. For the past 70 years, either the insurance model or the government has dominated the economic model of healthcare. However, in the late 1980’s and early ‘90’s, some modern-day Christian groups began comparing the escalating costs of healthcare with the simple and effective manner in which older Christian groups (such as the Amish) handled their property and casualty needs. We have all heard of the proverbial Amish “Barn Raising.” There is no need to insure the “barn” because the community will come together for a “barn raising” if it should burn down.

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These Christian groups decided to follow the Biblical mandate of “bearing one another’s burdens” by sharing healthcare costs in a similar fashion, members of the community literally share one another’s medical bills. This method of meeting needs proved effective as it withstood court challenges from its “outside the box” approach (which was, in reality, a reintroduction of the historical sharing approach modeled by the Amish!).

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Now fast-forward to 2010 and the ACA. The impressive growth of the Christian health care sharing movement had, by now, led to hundreds of thousands of individuals and families not using an insurance model, but rather trusting to the sharing of needs as administered by these health care sharing groups. So the ACA, in recognizing the effectiveness of these groups and their sound legal history, enshrined their legitimacy in law by granting an exemption to the law’s penalties for those who were a part of these recognizable groups.

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Although the exemption of the law only applies to a very limited number of qualified Christian health care sharing groups and their members, the model of health care sharing has proven legitimate and effective. As long as one can find other ways of fulfilling the law’s mandates, the health care sharing methodology can teach us much.

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This is where Sedera Health was born as a concept. Businesses need a group health insurance solution that will fulfill the requirements of the Employer Mandate of the ACA. Employees need a plan that fulfills the Individual Mandate so they are not subject to the penalties individuals face if they do not have insurance. Both of these can be found within the Minimum Essential Coverage (MEC) as defined within the law.

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Using this insurance model for handling preventative care needs, the minimum requirement of the law for both employer and employee are fulfilled. But what about actually handling the escalating costs of illness? This is where the health care sharing model, which is not insurance, can be applied. But now it is applied within the corporate context, not just for people of faith, but for groups of employers and employees who choose to share common health-related goals.