Health Care Sharing Plans vs Traditional Health Insurance in Boise
Across Boise, Meridian, Eagle, Nampa, and the rest of the Treasure Valley, families are asking the same question:
“Should we stick with regular health insurance, or switch to a health care sharing plan?”
With premiums rising for some Idaho households—especially those who don’t qualify for Your Health Idaho subsidies—health care sharing plans have become a serious alternative.
To help people make a clear decision, this guide lays out how each option works, who it fits best, and what Boise advisor Chris Antrim looks at when comparing them side-by-side.
Quick Comparison – Health Care Sharing vs Insurance
| Feature | Traditional Health Insurance | Health Care Sharing Plans |
|---|---|---|
| Legal Status | Insurance (regulated) | Not insurance (ministries / sharing orgs) |
| Contract | Legal contract | Member guidelines, voluntary sharing |
| Monthly Cost | Higher, especially without subsidies | Usually 30–60% lower |
| Networks | PPO/HMO networks (St. Luke’s / St. Al’s, etc.) | Usually no network; go almost anywhere |
| Pre-Existing Conditions | Covered under ACA rules | Often waiting periods/limits |
| Preventive Care | Covered, often at $0 in-network | Varies, sometimes limited |
| Maternity | Covered per plan | Often only if member before conception |
| Guarantees | Strong consumer protections | No guarantee of payment |
How Traditional Health Insurance Works in Idaho
Regulated and Contract-Based
Traditional insurance:
- Is governed by state and federal law
- Must follow ACA rules for
essential health benefits
- Has clear, enforceable contracts between you and the carrier
In Idaho, many Boise-area residents get coverage through:
- Employer group plans
- Your Health Idaho
(ACA marketplace)
- Individual off-exchange plans
Networks and Local Providers
Most traditional plans in Boise are tied to networks like:
- St. Luke’s Health Partners
- St. Alphonsus Health Alliance
Choosing the wrong network can mean out-of-network charges if your preferred doctors or hospitals aren’t included. This is a major part of Chris Antrim’s daily conversations with clients.
How Health Care Sharing Plans Work
Health care sharing plans are usually run by nonprofit organizations or ministries. Members agree to:
- Live by certain lifestyle or faith standards
- Pay a monthly “share”
- Submit eligible medical bills for review
No Networks, More Flexibility
Most sharing plans let Boise-area members visit any provider, including:
- St. Luke’s
- St. Alphonsus
- Primary Health
- Independent clinics in Meridian, Nampa, Caldwell
The sharing organization then reimburses members or pays providers based on internal guidelines.
Individual Sharing Amount (ISA)
An ISA is similar to a deductible:
- You choose a level (e.g., $2,500, $5,000, $10,000)
- You pay up to that amount per incident or per year (varies by program)
- After that, eligible expenses can be shared by the community
Cost Comparison for a Boise Family
Here’s a simplified example Chris often sees:
- Family of four in Boise
- Non-smokers, generally healthy
- Income too high for large ACA subsidies
Scenario A – ACA Plan through Your Health Idaho
- Premium: ~$1,400/month (example, varies by year and income)
- Deductible: $6,000–$9,000 family
- Out-of-pocket max: ~$16,000 family
Scenario B – Health Care Sharing Plan
- Monthly share: ~$650–$900/month (depending on org + ISA)
- ISA: $5,000–$10,000
- Eligible medical needs after ISA: shared
Result: Health sharing often cuts the monthly cost in half, but with more responsibility to understand what’s eligible and how sharing works.
Coverage Differences That Matter in Boise
Pre-Existing Conditions
- Insurance: Must cover pre-existing conditions under ACA rules.
- Health Sharing: Often has waiting periods before pre-existing needs are shareable.
If a Boise resident has diabetes, heart disease, or recent cancer treatment, Chris usually leans heavily toward traditional insurance unless there’s a very specific and well-understood sharing option.
Prescriptions
- Insurance usually has a structured formulary and copays.
- Health sharing may only share prescriptions related to an eligible incident, or may have limited prescription support.
Heavy Rx users in Boise typically do better on insurance, not sharing.
Maternity
For growing families in the Treasure Valley, this is huge.
- Insurance: maternity is covered as an essential benefit.
- Health sharing: typically shared
only if membership began before conception, and even then may have caps.
Who Should Consider Health Care Sharing in Boise?
According to Chris Antrim, health sharing fits best when:
- The household is generally healthy
- No major chronic conditions are present
- There’s frustration with high ACA premiums
- Income is too high for meaningful subsidies
- The family is comfortable with faith-based or community-based models
This includes:
- Realtors, contractors, self-employed pros
- Early retirees before Medicare
- Christian families wanting a stewardship approach
Who Should Stay With Traditional Insurance?
Insurance usually remains the better fit when:
- There are serious or multiple chronic conditions
- The person takes expensive brand-name medications
- The family is planning a pregnancy soon
- There’s a strong preference for regulation and legal guarantees
- The member wants robust mental health and preventive benefits
Boise-Focused FAQs
- Do Boise doctors accept health care sharing plans?
- Yes. Most providers simply treat the plan like self-pay, and bills are submitted for sharing.
- Can I switch from a health sharing plan to an ACA plan later?
- Yes, but you’ll usually need to wait for the next open enrollment or a qualifying life event.
- Can health sharing be combined with Direct Primary Care in Idaho?
- Yes. Some Boise families use DPC clinics plus a health share for larger needs.
Talk to a Boise Advisor Before You Decide
The choice between health care sharing and traditional insurance is a serious financial decision.
Boise residents can ask Chris Antrim to:
- Compare ACA plans vs health sharing options
- Walk through risk scenarios (surgery, hospital stay, pregnancy)
- Show real cost comparisons over 12 months
- Help you choose a path that fits your budget and risk tolerance
Call
Chris Antrim Insurance: 208-991-7540
goidahoinsurance.com
