Home Health Exploring Medical Cost-Sharing Plans Before Choosing One

Exploring Medical Cost-Sharing Plans Before Choosing One

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The requirement of health insurance has become a necessity. Indeed, there are so many new options that are coming up in the market that investment in the right plan has become confusing. That is why health insurance these days has come up with an option where customers can pay some of the prices of the covered health care services. These are known as medical cost sharing plans. The cost-sharing of course would vary as per the plan of health insurance that has been chosen. However, there will be mostly coinsurance, co-payment and even the deductible price.

Understand the working of health care sharing

The plans of the medical cost sharing plans are usually offered by the companies whose members have signed for the ‘share’ medical value. As with the health care sharing plan, the individual will be responsible to pay off certain prices as a premium every month and some annual unshared value as well.

Usually, the unshared price is between $300-$500 for individuals. If it’s the couple then rice can go up to $1,000 while for the families it can vary between $900-$5,000.

On a monthly average value usually, the price can range between $64-$627 but it entirely depends on the plan that the individual has chosen along with the coverage that it offers.

Who should opt for a medical cost-sharing plan

This option is not necessarily designed for all. But certainly, this type of plan is best for those:

l  Those who are medically healthy.

l  Those who are not eligible for the tax credit depending on the income.

l  Those who don’t have much access to the insurance from the programs that the government or an employer has offered.

l  Those who are not able to get the whole cover from the open enrollment.

l  Those who are not able to be afraid of the premium of the current health insurance.

Types of Cost Sharing Plans:

  • Copay

In the traditional plan of copay an individual needs to pay a fixed value for every service. Suppose if the copay values $ 40 then the individual should pay $40 and the insurance would pay the remaining $45. Usually, such a plan is best to have during emergency problems.

  • Co-Insurance

This is another efficient model in which an individual needs to pay a fixed percentage for every service. Suppose, if the insurance is 30% then the individual needs to pay 30% of the overall value to the doctor while the insurance company would pay the remaining balance.

  • Deductible

In this type of plan, the individual will have to pay the whole amount for all the services that are offered until the deduction is met. If the insurance has $1000 annual deductions an individual would have to pay the whole value that the doctor charges before the insurance starts paying off to the doctor directly.


The concept of medical cost sharing plans can be a great complex for those who wish to opt for direct primary care. Usually, DPC, the individual primary health care required, is offered for one less monthly payment. For this, there are no deductibles that shall be done. Besides, an individual will get the best clinical services, consultations, medications and even low-cost lab services. It is one great way to get access to the doctors even virtually or don’t even have to stand in the long visiting hour’s queue.

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