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Frequently Asked Questions
indipop is the first membership-based healthcare marketplace.
Its dedicated team provides support in understanding how cost-sharing plans work and which ones are right for you.
indipop has also created bespoke plans, in partnership with the cost-sharing services, to create even more attractive and powerful benefits for the independent population.
Our goal is to help guide you to the best membership plan and be a trusted resource while you are a member. membership or
A cost-share, also called a membership or subscription based healthcare option, doesn’t function like traditional insurance, instead of a premium and deductible you become a member of the “community” that shares the cost of medical needs.
Each cost-share can function a little differently and may offer different services, but the goal is the same: to ensure you receive the best care at the right cost.
The most significant difference between health insurance and cost-share are that these memberships aren’t governed by the Affordable Care Act (ACA.) (though there are indipop plans that meet the ACA criteria)
Because of that, the terms a cost-share uses are different than insurance.
So, a “premium” becomes a “contribution” or “membership.”
A “deductible” becomes a “member responsibility or initial unshareable amount.”
A “covered” medical expense becomes a “shared expense” with the community.
And a “claim” becomes a “sharing request(s)”
Where the difference really matters is in what “sharing request(s)” can be “shared” with the community vs. what is “covered” by an insurance company. The ACA mandates health insurance companies to cover all kinds of things that not everyone needs. That means that you often wind up paying for things you never use.
Cost-sharing is different. Because they aren’t insurance and aren’t regulated by the ACA, they are free to tailor their plans to meet members’ needs.
Here’s a great example: let’s say you have seasonal allergies and you need a prescription once a year so you can get some relief. With an insurance plan, you’ll go into an office, speak with a receptionist, who will then put you in an exam room so you can see a medical assistant, and then, finally, your physician.
Your cost-share will connect you with a provider either by phone or virtually. You won’t pay for the office, receptionist, exam room or nurse. You’ll only see the provider– who will write you the same prescription.
Practices like these dramatically reduce the cost of “everyday” medical care. That means there’s a lot leftover in the pool for major medical expenses and emergencies. So, your monthly contribution remains small and affordable.
Another major difference is set rates. This means no surprise bills in a medical emergency and you do not have to stress about networks because you will owe one set fee for care.
Traditional health insurance charges annual deductibles that renew each year. That hurts patients. For example, if you break you leg in December, you’ll probably need post-op care in January. With traditional insurance you’re stuck with paying two deductibles for the same medical event.
Cost-sharing plans don’t work that way. Out-of-pocket maximums are tied to specific medical events. If you break your leg, you shouldn’t have to pay for it twice.
ACA-compliant – individual and small-group policies must include coverage for the ten essential health benefits with no annual or lifetime coverage maximums.
If a plan provides Minimum Essential Coverage, it means that it covers the following 10 Essential Health Benefits:
- Outpatient care—the kind you get without being admitted to a hospital
- Trips to the emergency room
- Treatment in the hospital for inpatient care
- Care before and after your baby is born
- Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
- Your prescription drugs
- Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
- Your lab tests
- Preventive services including; counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
- Pediatric services: This includes dental care and vision care for kids
With monthly rates lower than traditional insurance (an average savings of 20%-70%) plus with set transparent rates for medical care, we’ve heard people say “it is too good to be true.”
This type of healthcare is not mainstream, but yet it is rising in popularity due to the proactive nature of the concierge teams, fair medical pricing and open networks.
Not everyone is a fit and therefore it is not a one size fits all. If you have recently been diagnosed or being treated for a chronic condition this is probably not the best option for you. The reason is the plan will look back at your medical history 1 -3 years and for the first year the “condition” is not shareable. That means you would be responsible for the medical bill for that specific condition if treatment or surgery is needed.
Example: 6 months ago you had ACL surgery, you are finished with rehab and doing great. You’d like to join one of the indipop health plans, the cost-share will look back 1-3 years (depending on the plan) and since you have not gone a full year since your surgery it would be considered a pre-membership waiting period.
A pre-membership medical condition is anything for which a member has
• been examined,
• been diagnosed,
• taken medication,
• had symptoms, or
• received medical treatment
between *12-36 months (depending on the option you select) prior to their membership state date. Sharing requests related to pre- membership medical conditions are only shareable if the condition was regarded as cured and did not require treatment or present symptoms for *12-36 months prior to the membership state date.
Pre-membership medical conditions have a phase-in period wherein sharing is limited. Starting from the membership start date, there is a one-year waiting period before pre-membership medical conditions are shareable. After the waiting period, the shareable amount increases with each membership year.
Shareable amounts for pre-membership medical conditions:
• Year one: $0 (waiting period)
• Year two: $25,000 maximum per sharing request
• Year Three: $50,000 maximum per sharing request
• Year Four: $125,000 maximum per sharing request
After four years of membership, expenses related to pre-membership medical conditions will be shareable up to a maximum of $125,000 in a 12-month period. The shareable maximum resets each membership year.
High blood pressure, high cholesterol, and diabetes (types 1 and 2) are not considered pre-membership medical conditions as long as
1. The member has not been hospitalized for the condition in the 12 months prior to
joining, and
2. The member is able to control the condition through medication or diet.
* each indipop healthcare option has their own pre-membership look back period Complete Plan is 12 months, Secure HSA and Basic are 24 months and Premium HSA is 36 months.
Unlike traditional healthcare, enrollment is all year long. Join on your timeline!
For most memberships benefits will start the 1st of the month after you enroll.
The HSA options through indipop do have specific deadlines, typically the 15th of the month to be active for the upcoming month.
The initial unshareable amount, or IUA, is the amount a member must pay before expenses related to a medical need become shareable with the medical cost sharing community. After the IUA is met, additional eligible medical expenses are shareable with the community. There is no annual or lifetime limit on eligible expenses. Members do not need to pay another IUA for any given sharing request until they are symptom free for 12 months.
What this means is example: if you break your leg at the end of the year and we roll into the new calendar year, you will NOT have to pay your IUA again for the same broken leg, the treatment for your medical condition is included in the 1st IUA.
Yes, the health plan networks are not PPO’s or HMO’s, you have the freedom to choose who cares for you.
Good question. Here’s a short list.
You want to investigate any specific questions before joining, but this will get you started:
- Discounted or inclusive primary care visits
- Discounted prescriptions – some prescriptions can be free based on usage and need
- Mental and behavioral health support
- Pediatric care and women’s wellness discounts
- HSA Health Savings Account
- Discounts and perks on wellness services
- Chiropractic Care
- Electronic vault for medical records
- Lifecare Program including mental health and experts to help in all areas of your life
- End of life benefits
- Concierge care without the VIP sticker shock, a team to help guide and navigate care ensuring you are treated like a human and not an ID card. They help get you well by also saving you time not waiting in congested urgent cares or trying to find a provider in the middle of the night to inquire about your child’s rash. You get quality care right from your own couch.
- Large or open network.
- Transparent fair medical pricing, from Sacramento to Brooklyn you will have access to the fair medical rate not the inflated insurance costs.
- Portable, the plans have identical benefits state to state. Perfect for professionals that travel frequently, kids in college and if you are vacationing outside of your town.
- Flexible- enroll all year long on your timeline.
- Affordable- 20-70% savings.
- No lifetime or annual caps
- Thinking about growing your family? Maternity is included for post and pre-natal care.
The cost-shares will share into acute medical costs incurred outside the United States.
Cancer, injured in a car accident, or a brain aneurysm, these are scary major medical occurrences that can also be expensive. Depending on your plan, you will be responsible for the (MRA) Member Responsibility Amount. The remainder will be shared with the community. There are no annual or lifetime limits with the indipop selected plans.
Forget the days of trying to get a human being from a traditional health insurance company to pick up the phone. With concierge care, you get a team dedicated to serve you. They find providers, negotiate rates, coordinate care for procedures and hospitalization. You are no longer alone in trying to navigate a massive healthcare system.
Whether by phone, text, or through a streamlined app, there’s always someone there for you.
No, indipop plans do not have a statement of faith and are not tied to a specific religion.
Yes! Each plan offers mental health, see the plan details to learn more about what is offered.
The best way to know if a cost-share is a good alternative to traditional health insurance is by asking yourself the following questions:
- What are your typical healthcare bills per year?
- What’s your typical premium?
- What’s your annual deductible?
- What are your regular out-of-pocket expenses?
- Are you primarily interested in major medical and hospitalization care?
Once you add it all up. This is your starting point. Then, start your quote to explore what an indipop membership would cost.
