Ever considered benefits of medical cost sharing for cash-pay patients? What’s it all about?

Health economists are most likely to encourage that patients opt for cash payment when it comes to medical treatments. This results in patients being more frugal in their spending and medical expenses. Medical cost sharing is a new and innovative form of health community membership that allows individuals with the same principles and beliefs to help each other pay for healthcare-related costs. Medical cost sharing is based on the belief that ‘sharing is caring’, and being part of a like-minded community that is able to assist each other at times when the need for expensive medical care arises.  

As an employer, you have a cost-efficient option that can help to relieve the financial burden that both you, your family, and your employees may experience with traditional medical insurance. Here are some of the benefits associated with using medical cost sharing and remaining as a cash-pay patient. 

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What is Medical Cost-Sharing?

Medical cost sharing memberships have historically been offered by faith-based organizations that help individuals to voluntarily assist each other with large medical costs. Members contribute a monthly share to a group fund. This fund is then distributed among members that need to pay for specific medical expenses.

The monthly contribution towards medical cost sharing tends to be significantly lower than the premiums of traditional medical insurance. Medical cost sharing members are able to experience a predictable monthly payment and cash discounts on healthcare. Because in the case where patients will be paying upfront for their medical visits, they are able to negotiate for lower rates from their service provider, resulting in even more savings for you. These are often referred to as “prompt-pay discounts”. Alternatively, you could end up only paying a portion of the full amount and the medical cost sharing community funds can reimburse for the rest of the outstanding amount before the bill is even due. 

What are the Benefits of Medical Cost Sharing for Cash-Pay Patients?

In addition to being cost-efficient, medical cost sharing allows cash-paying members to select their own medical practitioners and specialists as opposed to having to go to a required in-network doctor or provider. This also means that under a cost sharing membership arrangement you are not limited to any geographical region and are able to use the services of medical practitioners or doctors located in other states or countries.

Furthermore, as the organization encourages that members practice healthy lifestyles, the costs incurred are lower than traditional medical insurance.  Theoretically this means that as members stay healthy, the overall medical costs for the entire group keep the member’s monthly share amount lower. As an employer, you can rest assured that your employees are able to access the medical care of their choice and of the highest quality without the fear of a financial melt-down.

Some medical cost sharing memberships provide their members with telemedicine services. These services allow members to communicate with a medical practitioner over the phone or video conference regarding symptoms that they may be experiencing. A doctor’s recommendation is provided thereafter. In the case where medications are required to treat the condition, a prescription can be electronically sent to the member’s choice of pharmacy. This is yet another way in which members save money, as an appointment and visit to the doctor may not always be necessary and, as such, the time and cost of going to physically see a medical practitioner is eliminated completely through the telemedicine service. 

Benefits of medical cost sharing for cash-pay patients

How You Can Save Money through Medical Cost Sharing

The Affordable Care Act has created a health insurance subsidy which makes the cost of health insurance much lower in the case where patients have a low income. The subsidy does not apply to most average wage earners so you might find yourself on your own to find and pay for health insurance coverage, especially if your employer’s benefits are lacking.

Furthermore, in many cases medical cost sharing costs between 30% – 50% less than conventional medical insurance, increasing the overall savings accrued to you. In the case of cost sharing being cash-pay patients, there are no third parties involved in your care. This means that patients are fully aware of the care they are choosing and all of the costs that they are incurring, as well as what the costs are for.

The absence of a third-party payer leads to the overall cost of healthcare being lower, and the awareness of the patient resulting in prudent spending on their part. Considering that the overall costs are so much lower, employers are also saving money for their businesses yet still allowing their employees to access and pay for high-quality medical care of their own choosing. 

Medical cost sharing has its roots firmly based on the premise of ‘community’. Members of medical cost sharing funds are encouraged to practice healthy lifestyles, eat healthy, and exercise regularly. If these efforts are made by all of the members of the community, this theoretically reduces the need for individual medical care across the community and, as such, allows the medical cost sharing funds to offer access to high-quality healthcare at a lower monthly cost vs health insurance. As a member, you are also provided with the peace of mind that you are in a community of like-minded individuals that share similar principles and are more likely to adhere to the requirements of the medical cost sharing community. Furthermore, when medical expenses do arise, they are willingly shared among members of the community. In some cases, members are even able to see information regarding the allocation of funds to others during set periods, and how members were helped through the medical cost sharing community. 


Let Scoop Health Illustrate the Many Benefits of Medical cost sharing for Cash-Pay Patients

Scoop Health is powered by Sedera a medical cost sharing service provider that seeks to reduce the high cost of high-quality healthcare for its members. Unlike most Christian-based medical cost sharing communities, Scoop Health does not require its members to be affiliated with any specific religious group. Members are required to pay an initial unshareable amount (IUA) that can be as low as $500 per incident. A member’s medical needs are shared first-dollar by the community after an individual’s 3rd medical need in a year, or a family’s 5th medical need in a year. Members have the ability to select their own doctor and are not restricted by Scoop Health or Sedera in terms of the medical providers they can select. The medical cost sharing industry has been around for more than 30 years but it has grown quite substantially in the last few years as a result of an increase in the demand for high-quality, low-cost medical care.


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