Medical cost sharing is revolutionizing the way everyday Americans access the health system. The dynasty of traditional health insurance is coming to an end. No longer will people be forced to pay hefty premiums and outrageous co-payments, only to be told, “Oops, sorry, your insurance doesn’t cover that…”
Medical cost sharing got started in Christian church settings. It has been tried, tested and improved for over three decades. Even though this was over thirty years ago, most current medical cost sharing communities still insist on ‘proof of faith’ to be a member. In the Sedera medical cost sharing community, we have no requirement of any particular faith. Your faith is a personal spiritual matter. So, you don’t need to prove your faith to us to be a member with Scoop Health. The truth is that the more healthy people who enroll in our medical cost sharing community the better it is for every other member.
We are going to take a look at the history of medical cost sharing, and show how Scoop Health and Sedera are bringing medical cost sharing into the future.
Medical Cost Sharing in the Beginning
The first medical cost sharing communities were started in church congregations by members who cared about each other’s well being. Groups of hard-working Christian Americans took decisive action and formed together to pay the bills for each other during times of sickness. You could say they were sick of being sick and entirely fed-up with the uncertainty of over-priced care. They were tired of watching their friends and family stress and suffer when something as petty as money could solve the problem.
Even thirty-five years ago, these communities could see how unaffordable healthcare was becoming – if they only knew how bad things would get in 2020. So, they made their own system to get their members access to care and pay the bills. By coming together to pool their financial resources, the community was able to pay for the care of those who needed it most. And so, the first medical cost sharing community was born.
Most traditional cost sharing communities still have stiff faith-based requirements, though the rules differ from ministry to ministry. So, a person’s faith impacts the community they can be a part of.
But this is America and we don’t want to dictate what people are allowed to believe just as long as they can agree to live healthy. In contrast, the Scoop Health and Sedera medical cost sharing community has no faith-based requirements to be a member. Because every American, no matter their creed, deserves access to quality, affordable healthcare.
How We’re Different at Scoop Health
Instead of uniting around a common faith, the Sedera medical cost sharing community is united around our commitment to health. Every member of our community commits to leading a healthy lifestyle whenever possible. So, in this way, we manage the financial risk to the community. It makes sense because healthy lifestyles decrease the chances of major sickness and related medical expenses.
Our commitment to health is about more than watching out for the nickels and dimes, it’s about improving the overall health and the lives of hard-working people. Once you become a part of our community through Scoop Health you will have a support system to help in times of medical need. So, members have a real person to help them when making everyday healthcare choices.
Did you know that every Scoop Health member has a personal member helper?
By opening up our Sedera membership to anyone who is healthy, we expand the size of our community. This ‘dilutes’ the risk and ensures the sustainability of our medical cost sharing community. We also can share every member’s health care risk by the way we structure our monthly share fee. Some members who pose a greater health risk pay higher share fees than other members. For example, smokers pay more than non-smokers. This is simply because smokers are at higher risk for a whole host of diseases – different cancers, heart diseases, emphysema, etc.
Another way we allocate risk and protect the community’s ability to pay for every member’s eligible needs, is by using age bands to determine each member’s monthly share amount. Meaning, with every 10 years of age, the member’s monthly share goes up. That’s because the risk of getting sick also increases with age. So a 27-year-old will pay considerably less than a 57-year-old for the same $500 IUA (Initial Unsharable Amount) plan with Scoop Health.
Creating a Financially Stable Medical Cost Sharing Community
Many medical cost sharing ministries are not transparent about their finances. If you have a look at these websites you will find flashy and confusing pages focusing and bringing people together through religion. If you look at their actual medical cost sharing information, the websites tend to be vague at best. If you were a financial wiz-kid, you could ask for the non-profit filings to see where the money goes, or if there is enough to pay all the bills. But most of us can’t do that, so you have to look at things like member reviews.
Medical cost sharing is all about taking financial control over our own health. Signing up for a medical cost sharing a community without transparent finances is asking for trouble. The community needs to understand what is happening to their money. Which is why the Sedera community is established as a non-profit entity managed by Sedera, with enrollment handled through Scoop Health.
Scoop Health recognizes the need to ensure the financial health of the community. The first way we protect member’s investment into the community is by minimizing risk. As we spoke about above, we do this by expanding the number of members in our community and using risk allocation tools like age banding. We also risk avoidance tools like a waiting period for pre-existing conditions. These are not sharable in the first 12 months of membership and phased in over 36 months.
Risk adjustment is not enough to ensure financial sustainability. We also have to be sure there is money to pay for really catastrophic medical expenses. We do this by reserving 15% of every monthly contribution in the Excess Needs Funds. Making certain that there is a stash of cash waiting when the community needs it.
By employing such rigorous financial guidelines and rules, we manage to keep our monthly share prices at a flat rate. Over the past seven years, our monthly share price averaged an increase of just 2% per year. This also allows us not to cap the total sharable amount for any member or single illness i.e. there is no limit to the dollar amount you can share with the community towards an illness. Most all other medical cost sharing communities place a cap on the sharable amount, or you pay extra money to increase the cap on what you can share. With Scoop Health there is no annual or lifetime cap on shareable medical bills.
How We are Modernizing Medical Cost Sharing
Scoop Health and Sedera embrace the power of technology to help our member’s lead healthy lives. It is our mission to make medical cost sharing as efficient and convenient as possible. Here are some important modernizations we have made to the classic medical cost sharing model:
- Our members can choose any provider. Some medical cost sharing ministries restrict the medical providers that their members can use. Even buying into health insurance networks to try to drive down the costs. This really undermines the freedom that is at the heart of pure medical cost sharing. With Scoop Health, our members check in as cash patients, meaning that they can go to any provider they want. After all, cash is king, even in healthcare.
- Access to member resources. Our members have access to several health resources such as “Teladoc” and “Member Helper”. Some help you to directly track your health, while others help members to get discounts on health-related expenses.
- Faster repayment of members’ medical bills. Sedera has twenty-five years’ and billions of dollars experience in medical claim negotiations for the Christian sharing community. This deep experience gives members of our medical cost sharing community a unique edge and remarkable stability in monthly cost, year after year.
The Benefits of Medical Cost Sharing With Scoop Health
Here are some final takeaways to sum up the main advantages of medical cost sharing with Scoop Health:
- No network penalties, so you can go to the provider that best suits your needs. We do have member guidelines to follow, but members are free to choose any doctor or hospital.
- Unlike some of the faith-based medical cost sharing ministries, we don’t have a share limit on a member’s catastrophic medical bills.
- Sedera will negotiate the member’s large medical bills for them. Most large pre-needs can be pre-approved for sharing but sometimes the unexpected hits the fan. The bills for large, unexpected care will be negotiated by the community at zero cost to the member. Then they will be fully reimbursed to the member.
- Member helpers are on call at Sedera to help members find the care they need and get medical pointers when they need help.
- Our members are entitled to a free second opinion when surgery is being advised. It’s paid for by the community and the member’s out-of-pocket is reduced by $250. So they actually get paid to listen to a second doctor, just to be sure the first diagnosis and recommendation makes sense.
At Scoop Health, we believe in the power of the community to revolutionize American healthcare. Our medical cost sharing community is open to everyone, no matter who you are. All Americans deserve access to affordable, quality healthcare.