Frequently Asked Questions
What is a HealthShare?
A healthshare doesn’t function like traditional insurance plans, instead of a premium and deductible you become a member of the “community” that shares the cost in medical needs.
Each healthshare can function a little differently and may offer different services, but the goal is the same they have a team to help you navigate the massive healthcare industry and set transparent prcing if a major medcial need occurs.
What does indipop do?
With dozens and dozens of healthcare options in the market, how do you know which ones to trust and what to ask when exploring benefits?
indipop did the research, we have strict criteria when searching for a top rated a healthplan. No annual or lifetime caps, open networks, stellar customer care and simple fair medical pricing with no surprise bills!
indipop’s staff is another resource for you while you are on the plan at no additional fee!
We are always searchign for plans and products that serve this population, you can find them all on the indipop site.
What is an IUA?
IUA stands for Initial Unsharable Amount. – This is the amount paid, by the Member, before the healthshare community share in the medical expenses on a per condition or need basis. Typically $1000 Example: appendix removal $1000 for the entire medical need no matter what hospital, surgeon, or anesthesiologist on call. Next month, you break your leg that is an additional 1,000, and the following month you go to the ER with a concussion, now you reached your max annual out of pocket and anything over $500 will be shared with the community.
What happens if I get a dreadful disease, is there an annual limit?
Cancer, injured in a car accident, or a brain aneurysm, these are scary major medical occurrences that can also be expensive. Depending on your healthshare plan, you will be responsible for the member responsibility amount. The remainder will be shared with the community. No annual or lifetime limits with the indipop selected plans.
What about Pre-Existing Conditions?
A condition is considered pre-existing for you or a dependent if symptoms or treatment have occurred within the 12-24 months (depending on the plan) prior to joining the Healthshare
- First 12 months Not shareable
- Months 13-24 Shareable to $25,000
- Months 25-36 Shareable to $50,000
- Month 37 and after Shareable to $125,000
Pre-existing conditions not subjected to pre-existing limitations if medically managed and stable with
- Controlled Diabetes
- High blood pressure
- Seasonal Allergy
- Intermittent Asthma
- High cholesterol
The indipop health plans will accept members, but it is best if you are questioning a medical condition if it falls under a pre-ex to contact indipop to review and clarify.
Can I see any doctor?
Yes, each plan is structured differently and most use a network called PHCS. You may also nominate your provider to be part of this network. You do not need a referral to see a specialist.
If I am having a heart attack when do I loop in the healthshare?
First get stable. Once you or your family member have a moment, alert the healthshare.
What else may be included with a healthshare?
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
- Electronic vault for medical records
- Lifecare Program including mental health and experts to help in all areas of your life
- End of life benefits
What are the benefits of a HealthShare?
- 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 Tulsa to Brooklyn you will have access to the fair medical rate not the inflated insurance costs.
- Portable, use in all 50 states perfect for kids in college or travel.
- Flexible- enroll all year long on your timeline
- Affordable- 20-70% savings monthly and annually
- No lifetime or annual caps on indipop plans
- No reimbursement model, indipop plans do not have you pay the medical bill and wait months to be reimbursed.
- Thinking about growing your family? Maternity is shareable under $3k to have your baby while on the plan.
What happens if something happens when I'm traveling outside the US?
If you are visiting a country and not living there you may still use the plan. Loop in the healthshare if it is an emergencies as soon as you are stable.
What are the differences between the plans?
A couple of differences:
Redirect Health uses their own in house providers for their telehealth, medical doctors, nurse practitioners and even naturoapths! With Zion and MPB Health they have contracted a 3rd party for virtual health.
Also with Redirect Health you have the max out of pocket for eligible medical expenses, $3,000 and with MPB and Zion for major medical it is also max of $3,000 BUT you will pay out of pocket for primary care and specialists. It will be a discounted rate! With Redirect if you go to the dermatologist or another specialist that will count towards your deductible, with MPB and Zion it will only count if that specialist visit turns into a $1000 medical need.
Why does it cost less? What’s the “catch”?
With monthly rates lower than traditional insurance ( an average savings of 20%-70%) plus added discounts like dental/vision and mental health, 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 set transparent rates for surgeries or procedures.
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 -2 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 plans will look back 1-2 years ( depending on the plan) and since you have not gone a full year since your surgery it would be consdered pre-existing. If the ACL needed further repair after you join a health plan, this probabbly will not be elegible for the $1,000 medical need. You would be responsible for the medical bill. If you broke your leg while on the plan or needed your tonsils out that has nothing to do with your ACL and therefore those conditions woud be sharable for the $1,000.
Can I keep my doctor?
Yes! With an indipop plan you may continue to see the provider of your choosing. Check plan benefits to see if they leverage the PHCS network for deep discounts or if your primary care is included in the monthly fee.
Are there networks? How do I know what is in or out of the network?
Plan guidelines for each healthshare determine if it is an open network. Other indipop plans utilize the PHCS network which provides deep discounts and you may even nominate your provider if they are not part of this network.
Is this a religious thing? What if I’m not religious?
No, indipop plans do not have a statement of faith or tied to a specific religion.
What is covered?
Each indipop plan has different benefits, they all include concierge care, major medical/hospitalization, Rx discount plan and mental health. One plan offers a health savings account, electronic vault for medical records, end of life beneficiary and discounts to acupuncturist, maggess etc. Another plan has unlimited primary care in person and virtual for adults and children and 12 chiropractic visits! Another plan features direct virtual primary care so you may see the same provider unlimited from the comfort of your home.
Each plan ensures you are receiving the care you need at the fair medical cost many times it is $0
What isn’t covered?
On a healthshare you have shareable and unshareable medical needs. The guidelines for each plan just like for conventional insurance provides detailed information about shareable medical needs.
What do I say when I'm in the doctor's office about to pay?
To save a lot of frustration the best route is to say you are self-play. Many provider offices are not aware of a healthshare nor what your plan entails. But they DO understand self-pay! You will also receive a medical card from each plan and on the back is the billing address to send claims to.
Example: Redirect Health includes unlimited primary care, you may use the app or call their care logistics number prior to your appointment, your visit will be $0.
Are there mental health services?
Yes! Each plan offers mental health, see the plan details to learn more about what is offered.
Is A Healthshare Program Right For You?
The best way to know if a healthshare 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 open to telemedicine and virtual doctors?
- Are you primarily interested in major medical and hospitalization care?
Once you add it all up. This is your starting point. Then, visit our healthshare plans to explore what an indipop membership would cost. If the savings are there, a plan with indipop may make smarter financial sense versus your traditional insurance.
What is the difference between a healthshare and insurance?
The most significant difference between health insurance and healthshares are that healthshares 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 healthshare uses are different than insurance.
So, a “premium” becomes a “contribution” or “membership.”
A “deductible” becomes a “member responsibility or unshareable amount.”
A “covered” medical expense becomes a “shared expense” with the community.
And a “claim” becomes a “need.”
Where the difference really matters is in what “needs” 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.
Healthshares are 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 healthshare 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.
ACA Compliant and MEC what does it mean?
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
indipop POP Essential and MPB Secure plans are ACA compliant in all 50 states, Redirect Health plans provide companies with an avenue to meet Minimum Essential Coverage (MEC) and Minimal Value Plan (MVP) requirements stipulated by the Affordable Care Act. They fall under a portion of the law that enables employers to self-insure.