The U.S Census Bureau notes that nearly 27 million people are still uninsured despite the Affordable Care Act being implemented nearly a decade ago. This means that thousands of Americans have no access or limited access to medical care when they need it the most. Furthermore, those same individuals often find it difficult to cover medical expenses when an unexpected emergency arises without any form of health insurance.
Non-profit health insurance is a great option for individuals who find the cost of traditional health insurance to be too expensive. It often provides more comprehensive coverage at a fraction of the price, and can help those who need access to quality healthcare but cannot afford it otherwise. Non-profit plans are typically regulated by state governments and offer lower premiums with higher deductibles compared to other insurance options. Many non-profits also provide additional services such as assistance with medication costs, mental health services, or vision care benefits. Furthermore, members usually have access to an extensive provider network so they can receive care from an array of specialists without having to pay out-of-network rates. This makes non-profit health insurance an attractive option for those looking for affordable coverage that still meets their needs.
What Is Non-Profit Health Insurance?
Just like regular health insurance, non-profit health insurance, sometimes called co-op health insurance, provides you with coverage for healthcare and other medical expenses. Non-profit health insurance is a model for insurance where the company is run for the purpose of providing health insurance to its members more than for increasing the wealth of the owner, board, or shareholders. Despite their different business model, non-profit health insurance companies still offer strong policy options that meet federal standards.
Non-profit plans may also provide additional benefits such as assistance with medication costs, mental health services, or vision care benefits. Members usually have access to an extensive provider network so they can receive care from a variety of specialists without having to pay out-of-network costs.
When comparing non-profit vs for-profit health insurance, the difference is that non-profit health insurance companies don’t operate to make a profit for their shareholders, they operate mainly to provide services to their members. Non-profit health insurance networks are also more focused on primary care and preventative care than other types of insurance providers. If your priority is cheap health insurance for basic coverage, non-profit health insurance may be a good option.
How Does Non-Profit Health Insurance Work?
There is really no difference between the basic principles of how non-profit and for-profit health insurance companies work. Non-profit healthcare companies require you to pay a monthly premium in order to remain covered under their policies. With non-profit health insurance plans, you will most likely have out-of-pocket expenses like you would on any regular plan. These expenses typically include your deductible, copay, and coinsurance.
Non-profit healthcare companies can follow several different models, including co-op, mutual society, or charitable health coverage models.
- Co-op health insurance is one of the most popular models for non-profit health insurance. A co-op is a member-owned, democratically controlled organization that negotiates with healthcare providers for lower rates and services for its members. Co-op health insurance typically offers limited provider networks, meaning members will have access to fewer medical professionals than in a larger plan. However, these plans usually offer more affordable premiums and may include additional benefits such as telemedicine or vision services. Because co-ops are member-run organizations, they can provide personalized customer service and greater transparency when it comes to understanding the cost of care.
- Mutual society models are another popular option for non-profit health insurance. Mutual societies are member-owned organizations similar to co-ops, but they rely on a mutual fund or pool of funds to pay for care. This means that members contribute to the pool with premiums and then receive claims payments from it. While these plans typically offer lower premiums than other non-profit plans, they may have higher deductibles or out-of-pocket costs than traditional health insurance plans. Additionally, like co-ops, they offer personalized customer service and greater transparency when it comes to understanding the cost of care.
- Charitable health coverage models are a type of non-profit health insurance plan that is typically administered by religious organizations or other charities. These plans offer members a low premium and limited financial assistance for medical expenses. Additionally, members may be eligible for additional services such as wellness programs or mental health care. As with co-ops and mutual societies, charitable health coverage plans offer personalized customer service and transparency when it comes to understanding the cost of care.
The Benefits of Non-Profit Health Insurance
One of the main benefits of a not-for-profit health insurance company is that they typically have lower premiums compared to for-profit insurers. This can be especially important when it comes to providing essential coverage, as the high cost of private health insurance can make it difficult for many people to access treatment. Additionally, these not-for-profit companies tend to be more focused on providing members with the best care instead of prioritizing profits. When it comes to making decisions about services and treatments, most not-for-profit companies operate in a collaborative manner with their members in order to ensure everyone’s needs are met. As such, there is often a greater sense of trust between members and their health insurer which can increase member satisfaction levels. Finally, by keeping costs low and focusing on quality care, these types of companies help promote better overall public health outcomes.
Who Qualifies For Non-Profit Health Insurance?
Non-profit health insurance plans are available for individuals, families, and small businesses. In most cases, applicants must meet the eligibility requirements set by their state. These typically include age limits, residency requirements, and proof of income. Some states may also require applicants to be uninsured for a certain amount of time before being able to qualify for non-profit health insurance. Additionally, some plans may have additional requirements such as agreeing to participate in wellness programs or having a job with a minimum number of hours per week.
Types of Non-Profit Health Insurance
Not-for-profit health insurance models come in a variety of forms, from traditional HMOs and PPOs to more modern forms such as accountable care organizations (ACOs) and value-based plans. Traditional HMOs typically require members to select a primary care physician and have treatments preapproved before services can be rendered. On the other hand, PPOs are more lenient, allowing members to choose their provider without prior approval and often featuring limited out-of-network coverage as well. ACOs are organizations that operate as networks of providers who act together to coordinate care for their patients while also creating incentives for delivering effective and efficient services. Finally, value-based plans offer an innovative approach to healthcare by paying providers based on the quality of care they provide instead of the quantity or utilization of services. All these different types of not-for-profit health insurance models offer unique benefits that make them worth considering when selecting a plan.
Non-Profit Health Insurance Companies
According to the Alliance for Advancing Nonprofit Health Care’s most recent report, about 63% of U.S. health plans with over 100,000 enrollees are nonprofit. Non-profit health insurance companies are often privately operated companies, and they can be found using a health insurance state marketplace or other online comparison tools. Many of these providers are limited to a specific region. Some of the network health insurance plans may be for profit in some areas and nonprofit in others, like BlueCross BlueShield. Below is a list of major non-profit providers from the AANHC's directory:
- American Postal Workers Union Health Plans
- AmeriHealth Mercy/Independent Blue Cross
- Arkansas BlueCross BlueShield
- AultCare Health Plans
- AvMed, Inc
- Blue Cross & Blue Shield of Mississippi
- Blue Cross & Blue Shield of Rhode Island
- Blue Cross and Blue Shield of Alabama
- Blue Cross and Blue Shield of Florida, Inc.
- Blue Cross and Blue Shield of Kansas
- Blue Cross and Blue Shield of Kansas City
- Blue Cross and Blue Shield of Louisiana
- Blue Cross and Blue Shield of Minnesota
- Blue Cross and Blue Shield of Montana
- Blue Cross and Blue Shield of Nebraska
- Blue Cross and Blue Shield of North Carolina
- Blue Cross and Blue Shield of Vermont
- Blue Cross Blue Shield of Arizona
- Blue Cross Blue Shield of Delaware
- Blue Cross Blue Shield of Massachusetts
- Blue Cross Blue Shield of Michigan
- Blue Cross Blue Shield of North Dakota
- Blue Cross of Idaho Health Service, Inc.
- Blue Cross of Northeastern Pennsylvania
- Blue Shield of California
- BlueCross BlueShield of South Carolina
- BlueCross BlueShield of Tennessee
- BlueCross BlueShield of Western New York and BlueCross BlueShield of Northeastern New York
- Bluegrass Family Health, Inc.
- Boston Medical Center HealthNet Plan
- Capital Blue Cross
- Capital District Physicians Health Plan, Inc.
- CareFirst Blue Cross Blue Shield
- CareSource, Inc.
- Community Health Group
- Community Health Network of Connecticut, Inc. (CHNCT)
- Community Health Plan of Washington
- Cook Children's Health Plan (CCHP)
- EmblemHealth, Inc.
- Fallon Community Health Plan
- Family Health Partners
- Fidelis Care, Inc.
- Geisinger Health Plan
- Government Employees Health Association (GEHA)
- Group Health Cooperative
- Harvard Pilgrim Health Care, Inc.
- Hawaii Medical Service Association
- Health Alliance Plan of Michigan
- Health Care Service Corporation
- Health Partners of Philadelphia
- Health Plus (PHSP), Inc.
- HealthPartners, Inc.
- HealthPlus of Michigan, Inc.
- Highmark, Inc.
- Hometown Health Plan, Inc.
- Horizon Blue Cross Blue Shield
- Hudson Health Plan
- Independent Health Association, Inc.
- Inland Empire Health Plan
- Kaiser Permanente
- Kern Health Systems, Inc.
- Lifetime Healthcare Companies
- Maryland Physicians Care (MPC)
- McLaren Health Plan
- Medica Health Plans
- Medical Mutual of Ohio
- MVP Health Care Preferred Care
- Neighborhood Health Plan, Inc.
- Paramount Care, Inc. (ProMedica Health System)
- Parkland Community Health Plan
- Partnership Health Plan of California
- Phoenix Health Plan/Abrazo Advantage
- Premera, Inc.
- Priority Health
- Priority Partners
- Providence Health Plan
- Rocky Mountain Health Plans
- SCAN Health Plan
- Scott and White Health Plan
- Security Health Plan of Wisconsin, Inc.
- Sentara Health Plans, Inc.
- Texas Children's Health Plan
- The Chartered Health Plan Inc.
- The Regence Group
- Trustmark Companies
- Tufts Associated Health Plans, Inc.
- UAW Retiree Medical Benefit Trust
- University Health Care Health Plans
- UPMC Health Plan, Inc.
- Virginia Premier Health Plan, Inc.
- Wellmark, Inc.
Non-Profit vs. For-Profit Health Insurance
Corporate “for-profit” health insurance companies are businesses owned by shareholders, and have a fiscal responsibility to their shareholders to make profits. This means that they may reduce benefits, decline coverage, or charge higher premiums to grow their financial returns year over year. Not-for-profit health insurance companies, on the other hand, do not have these kinds of investor-related issues.
Instead of annual profits being paid out to shareholders, those funds are re-invested into the non-profit organization to help them fulfill its mission of providing health insurance services. Consumer Reports analyzed private health insurance plans in the US and found that the top-ranking plans were run by nonprofit providers. When comparing health insurance quotes, you'll probably notice that non-profit insurance plans also provide more coverage for your primary care visits and preventative healthcare services. The differing plan options make it important that you take time to compare plans and find a personalized option that will work for your specific needs.
Explore Your Options for Non-Profit Health Plans
Non-profit insurance companies are growing in popularity. You can find out if there are non-profit health insurance providers that operate in your area and get health insurance quotes for their services with the help of FirstQuote Health.
If you’re looking for a new health insurance provider - or cheap health insurance plans that don't break the bank - make sure to include nonprofit options in your health insurance quotes. You'll likely find better coverage for primary and preventative care at a lower price than corporate insurance plans. Start comparing plans with FirstQuote Health today and discover how much you could save.