AlieraCare is a type of medical sharing plan and is a great health insurance alternative. It is not administered by an insurance carrier, but rather it is administered by an organization that only allows its members to purchase the plan. The organization processes claims, disburses payments, and provides customer service for the members. It is not insurance, but acts like insurance and is considered a qualified plan in the eyes of the government due to the level of coverage provided.
Aliera Healthcare partners with Unity Healthshare to create the AlieraCare plan. Aliera Healthcare provides the medical services while the hospitalization and surgery services are provided by Unity Healthshare. As Unity Healthshare is a religious organization, members are required to agree to a Statement of Beliefs. Those include:
We believe that our personal rights and liberties originate from God and are bestowed on us by God.
We believe every individual has a fundamental religious right to worship God in his or her own way.
We believe it is our moral and ethical obligation to assist our fellow man when they are in need, according to our available resources and opportunity.
We believe it is our spiritual duty to God and our ethical duty to others to maintain a healthy lifestyle and avoid foods, behaviors, or habits that produce sickness or disease to ourselves or others.
We believe it is our fundamental right of conscience to direct our own healthcare, in consultation with physicians, family, or other valued adviser.
Predictably, the biggest advantage to enrolling into this type of plan is the lower monthly premiums compared to the qualified Affordable Care Act plans. The monthly pricing is much lower than the full cost of the insurance plans available through the Health Insurance Marketplace, and will help someone whose income falls outside the requirements for a tax credit purchase coverage at an affordable rate.
Another reason these plans are preferred over short term plans is that they provide wellness/preventive care which short term plans exclude. Also, while maternity is never covered by a short term health plan, AlieraCare will provide coverage after ten months of continuous membership.
Best of all, as Aliera Healthcare and Unity Healthshare do not have to adhere to the rules and restrictions of Open Enrollment, these plans can be purchased at any point during the year.
The member chooses the Member Shared Responsibility Amount (which acts like a combined deductible and maximum out of pocket), and which plan level they want. Price points are broken down into three categories: Individual, Individual plus one, and Family.
There are three different plan levels of AlieraCare: Value, Plus, and Premium. Plans are assigned limits per incident of the maximum amount that will be paid on their behalf, but all three plan levels have a lifetime maximum limit of $1,000,000. All plans include Telemedicine services, which are 100% covered before meeting the Member Shared Responsibility Amount (MSRA). Consult fees and prescription costs do not count toward the MSRA.
The Value plan level provides the least amount medical benefits and the lowest per incident limit of coverage. It almost looks likes a catastrophic plan. For this reason, it is the plan level with the lowest monthly premium. Most of the services that are available prior to the member meeting the MSRA are preventive only – The screenshot below shows the basic coverage layout for the Value plan.
The Plus level adds more primary care visits and an urgent care visit that can be utilized before meeting the MSRA. The per incident limit is increased to $250,000, and a $500 MSRA is provided for Emergency Room visits. With this benefit, if the emergency room visit is assessed as a life threatening, true emergency, the $500 MSRA would be all that the member would pay for that ER visit.
The Premium level of AlieraCare is the most popular plan, offering the most primary care visits and urgent care visits, and the highest limit per incident. Also, this level is the only one to offer coverage for specialty care visits, and has the lowest MSRA due to the Emergency Room for qualified visits.
What provider networks does AlieraCare utilize?
AlieraCare uses four different provider networks for the services their plan provides.
Medical Network – PHCS (Multiplan) network
Prescription Drug Discounts – Rx Valet
Telemedicine Services – FirstCall Telemedicine
Labs – Quest Diagnostics
PHCS (MultiPlan) Network
The MultiPlan network is a national network that a lot of insurance alternative companies utilize. Essentially, they rent this network to these companies, which allows the carriers to eliminate the contracting and administration of creating and maintaining a direct network. This is another reason that the prices for these insurance alternatives, like Aliera Healthcare, are much lower than the qualified, full cost plans of carriers under the Affordable Care Act.
RxValet is a prescription drug discount/savings program. RxValet gives members significant discounts on a variety of prescriptions at the pharmacy counter. Depending on the prescription, members can save an average of 55%.
FirstCall Telemedicine is a network of US board certified doctors (family practitioners, pediatricians, and internists) which can be reached by telephone or video consultation. They are able to write prescriptions if needed, and are a great alternative to having to miss work or rearrange busy schedules to make it in to see a doctor in person.
Quest Diagnostics is a well-known and often utilized lab facility that processes lab tests for doctors and hospitals.
If you would like more information about AlieraCare, please call one of our agents at 423-424-0586 (or 888-995-1674 if outside the local area). Detailed brochures are available on request.