Is Medical Cost Sharing an Alternative to Traditional Health Insurance?

Is Medical Cost Sharing an Alternative to Traditional Health Insurance?

| Medical Cost Sharing

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Healthcare has become increasingly unaffordable for ordinary people in the US. It has started to cost more than house payments in many cases. It should be noted that almost 2 out 3 people who had to declare bankruptcy due to healthcare costs have had health insurance. So what is the point of insurance if it doesn't provide financial security? Adding insult to injury, there are the ever-increasing complexities of premiums, deductibles, copays, networks, out-of-pocket costs. This is why no one has any idea how much a medical visit may end up costing.

Medical Cost Sharing (MCS) is an innovative and cost-effective, membership-based solution that is NOT an insurance plan. It is meant to provide assistance in paying for major medical expenses like ER visits, hospitalizations, surgeries, etc.

How Does Medical Cost Sharing Work? 


Medical care is obtained in two main settings; routine outpatient care and major medical care. Routine outpatient care costs less than $400/year for most adults; that is about a dollar a day! Most people can pay for this care on their own. Then there is the rare, but high-cost care like hospitalizations, ER visits, serious illnesses and injuries that can cost in the thousands. For such events, everyone needs financial assistance; this is where membership in the Medical Cost Sharing community comes in. Members pay a monthly membership to become part of a community, and when one of the members has a medical need that meets the guidelines for assistance, the community assists the member-in-need with paying the medical bills. 

What are the advantages of Medical Cost Sharing over traditional health insurance?


Medical Cost Sharing (MCS) is a transparent way to obtain healthcare. With a health insurance plan, members never know the true cost of their healthcare because every encounter is complicated by codes, copays, deductibles, and other insurance jargon. With MCS, members tell their medical providers that they are a “cash” pay patient and can get one bundled price for their medical encounter. If the bundled price exceeds the IUA for the member, the remaining amount can be shared with the MCS community. Also, there are no networks so members are free to go to any facility and medical provider. As a good steward of community resources, every member tries to be a responsible consumer of healthcare by evaluating the price and quality of their healthcare providers. Most members end up saving over 50% compared to traditional insurance plans due to better control, transparency, and visibility. 

Are there Deductibles and copays in Medical Cost Sharing Plans?


No, MCS does not use deductibles and copays which apply to every visit, and are not based on the whole medical encounter. For example, if you have to go see a doctor a few times to have the medical issue addressed, you have to pay at every encounter. 

MCS uses two main terms--Need and IUA.

A Need is a medical event that costs more than the member’s Initial Unshareable Amount (IUA). This means that if a member has a medical condition that requires multiple doctor visits, diagnostics, procedures, medications, etc., all treatments are considered one Need. Therefore, the member pays the first $1,000 or $5,000 which is his/her IUA, and the remaining amount is shared with the MCS community.

Initial Unshareable Amount (IUA) is the member’s contribution towards the total cost of a Need. There are two levels available, $1,000 or $5,000, which means that the member either has to pay the first $1,000 or the first $5,000 towards the total cost of a Need. As you can imagine, the $5,000 IUA level is cheaper than the $1,000 IUA level.

How do I pay for the Medical Cost Sharing program?


WoW Health members can enroll for the MCS program directly from the WoW Health website, and pay the monthly membership fee. There are no long term commitments so members can cancel and stop anytime.

We welcome you to learn more about Medical Cost Sharing on our website at mywowhealth.com where you will find answers to many questions, and be able to connect with a customer service representative to answer any questions.


About Author

Dr. Jawad is a practicing physician with extensive administrative experience, who has firsthand knowledge of running a medical practice and working in employed models. WoW Health aligns incentives for the healthcare ecosystem so all stakeholders benefit from transparent and direct relationship between patients and medical service providers.