Popular Alternatives to Traditional Health Plans
Getting health insurance can feel overwhelming. Add in short-term plans, faith-based plans, subscription models and other alternatives and it's hard to know where to start. Understand how traditional health plans, like ones offered by Blue Cross and Blue Shield of Montana, compare to alternative health plans.
What are traditional health insurance plans?
When you think of health insurance coverage, you probably think of traditional plans and their benefits. According to the 2024 Census , most people with health plans have traditional health insurance coverage. You fall into this group if you have a health insurance plan that:
- You enrolled in through your employer, a state or federal Marketplace or private insurance company like BCBSMT.
- Is compliant with the Affordable Care Act (ACA), meaning it covers essential benefits and can't deny care for existing conditions.
- Typically has an HMO, PPO or POS plan structure.
What are some popular health plan alternatives?
Short-term health insurance plans, faith-based plans and subscription models with care providers are some of the most popular ways to get care outside of traditional health insurance:
- Short-term plans: temporary policies, often month-to-month, meant to help cover gaps in coverage
- Faith-based plans: non-profit cost-sharing often for members of religious groups, also called health care sharing ministries (HCSM)
- Subscription models: month-to-month flat payments to a doctor's office for on-demand care that often bypasses insurance and claims, also called concierge care or direct primary care (DPC)
Why do short-term health plans seem more affordable?
Short‑term plans and their monthly costs may seem like they can help keep costs low. They offer lower premiums, sometimes half as expensive as traditional health plan deductibles, but they may not offer the coverage standard plans offer.
- Pre‑existing conditions may not be covered. Have you gotten treatment for things like cancer, asthma, allergies or high blood pressure or cholesterol? Short‑term plans aren't required to cover pre-existing conditions.
- Essential benefits may not be covered. Under ACA, essential benefits are always covered. Short-term plans might not include coverage for preventive care, emergencies, maternity or pediatric care, prescription drugs and more.
- Claims may not be approved after frequent use. Short‑term plans aren't required to keep your coverage active if you file too many claims, get sick with a serious condition or meet their “high-risk” criteria.
- Costs and coverage are month-to-month. Between lower premiums and month-to-month coverage options, a short-term plan might be a more affordable option if you're young and don't have dependents or health concerns.
How are faith-based health plans different than traditional insurance?
While traditional options are offered by the government or private insurers, faith-based options are offered by churches, ministries or non-profit organizations. Faith-based health sharing plans, like short-term plans, don't have to cover many of the essential benefits more traditional plans do. Sometimes, they have a maximum amount that can a person can claim each year.
- Coverage can be driven by moral, religious or lifestyle reasons. Some programs won’t share costs for things like contraceptives, behavioral health support or substance-use treatment or rehabilitation.
- Claim appeals can vary. With faith‑based plans, you may not be able to appeal a claim or get the benefit more traditional health care plans are required to offer.
- Members feel supported with their community and care options. In some cases, faith based plans don't have a network of doctors members need to stick to. Between that and the benefits of a close community, members may feel more emotionally, mentally and physically supported.
What are the key features of subscription-based primary care?
A subscription model can be an affordable option for everyday, preventive care — but it likely doesn't cover all the same benefits of traditional insurance.
- Primary care is covered, but more advanced care might not be. Your primary care provider can help diagnose you when you have a cold or minor illness, give you vaccines, run standard labs or help manage chronic conditions. But for more advanced care, emergencies or behavioral health support, you might need to cover the full cost on your own.
- Doctor appointments could be easier and faster to get. Your monthly subscription helps ensure you might be able to more quickly, easily and often get an appointment to see your doctor.
Options to Keep Your Traditional Plan
If you can't keep or renew your BCBSMT plan, you have options. Find ways you may be able to stay covered if you're looking to keep your current plan after losing a job, have a gap in your health care coverage coming up or want or need a lower-cost option.
BCBSMT Coverage
Depending on the time of year, you might be able to compare your traditional health insurance options with BCBSMT.
Catastrophic Plans
BCBSMT offers some catastrophic level individual and family plans. Catastrophic plans offer annual coverage, often with lower premiums but higher deductibles.
COBRA
With COBRA, or the Consolidated Omnibus Budget Reconciliation Act, you may be able to keep the employer-offered plan you already have.