Key Differences Between ShareWELL and Traditional Insurance

1. Healthcare Sharing vs. Insurance:
   • ShareWELL: Operates on a healthcare sharing model where members contribute funds to share each other's medical expenses. It is a community-driven approach focusing on mutual aid and support.
   • Insurance: Operates on a risk-based model where policyholders pay premiums to an insurance company, which then covers medical expenses based on the terms of the insurance policy.
2. Membership vs. Policyholder:
   • ShareWELL: Members join a community with a shared commitment to support each other's healthcare needs. There is a strong emphasis on community, wellness, and preventive care.
   • Insurance: Individuals or employers purchase insurance policies, and policyholders are covered based on the terms of their policy. The relationship is primarily between the insurer and the insured.
3. Cost Structure:
   • ShareWELL: Members contribute monthly shares, which are used to pay for eligible medical expenses of other members. There is a focus on keeping healthcare costs transparent and affordable.
   • Insurance: Policyholders pay premiums and may also have deductibles, copayments, and coinsurance. The cost structure can be complex and varies based on the plan.
4. Flexibility and Choice:
   • ShareWELL: Offers flexibility in choosing healthcare providers and services. Members have the freedom to explore both traditional and nontraditional healthcare options.
   • Insurance: Coverage is typically limited to a network of providers and services. Out-of-network care may involve higher costs or may not be covered.
5. Pre-Existing Conditions:
   • ShareWELL: Pre-existing conditions may not be eligible for sharing in the first year of membership and have a phase-in period after the first year.
   • Insurance: Insurance companies may deny coverage or charge higher premiums based on pre-existing conditions, although some regulations (e.g., ACA in the U.S.) have addressed this issue.
6. Claims Process:
   • ShareWELL: Members submit sharing requests for eligible medical expenses, and the community shares the costs. As members navigate healthcare as self-pay patients, the process is designed to be transparent and member-focused.
   • Insurance: Policyholders file claims with their insurance company, which then processes and reimburses based on the terms of the policy. The process can involve more bureaucracy and administrative steps.