Traditional Health Insurance and Health Sharing Programs are NOT the same!
Sunvalley Insurance offers products from OneShare Health. OneShare Health is a Health Sharing Product which is NOT the same as traditional health insurance. For example, with traditional health insurance, the insured are charged for a copay and deductibles and patient responsibility amounts besides the premiums that are charged by the insurance agency.
Traditional Health Insurance Products
- Premiums
Every month, premiums are paid by the insured members to insurance companies for coverage. - Deductibles
Traditional insurance does not pay any bills unless the deductible is met. Once the deductible is met, only a percentage of each bill is covered until the member reaches the maximum out-of-pocket. Some insurance companies have, in addition, a separate prescription deductible. - Copays
Every time an insured member visits a doctor, lab, specialist, hospital or picks up a prescription, he or she must pay a copay. The copay is not subtracted from the deductible. - Maximum out-of-pocket
All expenses, except co-expenses, add together to reach the insured's maximum out-of-pocket. Once this maximum is reached, the insurance pays 100% of the healthcare costs - Affordable Care Act (ACA)
Health Insurance must meet the requirements of the Affordable Care Act (ACA), also known as 'Obamacare.' - Affordable Care Act (ACA)
Health Insurance must meet the requirements of the Affordable Care Act (ACA), also known as 'Obamacare.' - Minimum Essential Coverage
Under the Affordable Care Act (ACA), major medical health insurance plans and qualified health plans (QHPs) must meet Minimum Essential Coverage Standards, which generally means they must (1) have an 'Actuarial Value' of 60% or more and (2) cover 10 Essential Health Benefits. - The 10 Essential Coverage
Under the ACA, the 10 'must cover' essentials include: doctor visits and other outpatient care (also called ambulatory services); emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services; prescription drug coverage; rehabilitative and habilitative services/devices (for example, physical therapy after a stroke, speech therapy for children); laboratory services/tests; preventive and wellness care and pediatric services, including oral and vision care.
HealthShare – HCSM
- Contributions
Every month, members send their contributions or member premiums to OneShare Health. These contributions then used to cover the member’s medical bills. - Member Individual Sharing Amount (ISA)
A member Individual Sharing Amount or ISA is similar to a deductible. It is a set amount that must be met before medical bills are paid. Once the ISA is met, the money from members’ OneShare Health will cover all eligible medical expenses. - Co-expenses
Every time a OneShare Health member visits a doctor, specialist or hospital, a required co-expense is paid. - Maximum out-of-pocket
All expenses, except for co-expenses, are added together to reach the member’s maximum out-of-pocket amount. Once the maximum out-of-pocket amount is reached, OneShare Health pays 100% of all remaining, eligible, medical expenses. - Telemedicine
OneShare Health helps members to eliminate expenses. Individuals members can consult a U.S. board-certified doctor over the phone or via video chat at no cost to the member. Doctors participating in this program diagnose, write prescriptions, and make referrals. - Preventative Medicine
OneShare Health helps members to stay healthy. Individuals members can benefit from preventative health services at no cost to the member. Click here for an overview of what's included in preventative care offered by OneShare Health. - Legal note (Small print!)
OneShare Health products are NOT insurance. The organization behind OneShare Health is a facilitator of medical expense shareing among individual members. The programs being offered are ACA exempt programs that is not insurance coverage. The sharing membership does not guarantee or promise that medical bills will be paid or shared by the membership.
Next Steps...
Contact us today and ask for your free no-obligation quote. We will help you explore a variety of insurance options and discounts. Call us at +1 800 645 0297 or email us. Alternatively, have an insurance-licensed Sunvalley Insurance representative contact you.