Summary of Sharing


	A Convenience Based Alternative to Health Insurance.	A Choice Based Alternative to Health Insurance.
Program Description
	Annual Household Portion (AHP)The dollar amount a Member Household must pay toward their Eligible Medical Bills during a 12-month period before their Eligible Medical Bills will be approved for sharing. per family per year	Initial Member Responsibility (IMR)The dollar amount either “per day” or “per stay,” that each Member is responsible for before sharing takes place. per individual per incident (applied per day/per stay)
Program Options
	AHPThe dollar amount a Member Household must pay toward their Eligible Medical Bills during a 12-month period before their Eligible Medical Bills will be approved for sharing. Options	IMRThe dollar amount either “per day” or “per stay,” that is each Member is responsible for before sharing takes place. Options
	$3,000	$500
	$6,000	$1,000
	$9,000
	$12,000
Services that can be accessed prior to meeting program requirements (AHPThe dollar amount a Member Household must pay toward their Eligible Medical Bills during a 12-month period before their Eligible Medical Bills will be approved for sharing. or IMRThe dollar amount either “per day” or “per stay,” that is each Member is responsible for before sharing takes place.)
24/7 TeleHealth with Board Certified Doctors
TeleBehavioral Health
Dental & Vision Discounts
Provider Access
Provider Network	Large Network of Providers	No Network - Healthcare Bluebook quality & price insights
Notification Process	Providers notify when indicated	Members notify when indicated
Provider Costs	Provider Fee ($35 in-office visit/$200 ER)	Self-payAs a self-pay patient, you are not limited by a network. You’re empowered with information to shop providers by quality and price. When you speak with providers, you simply tell them you are a self-pay patient and request a self-pay discount. at visit
Cost - Total	Negotiated by Medi-Share on member's behalf	Fair Pricing Search Tool tiered pricing guidance
Bill Submission Process	Providers submit bill(s)	Members submit bill(s) for reimbursement
Bill Discounts	Eligible for in-network PPO discounts	Self-pay discounts
Out of Network	Sharing limited to usual and customary charges. For non-PPO hospital or other facility, Member has an additional responsibility of 20% of total charges	No Network - Healthcare Bluebook Fair Price* quality & price insights
Sharing Details
No Lifetime Or Annual Sharing Limits
Eligible Medical BillsAn incurred medical bill that meets the criteria for sharing as established in the Guidelines. The Eligible Medical Bill will be reduced by any discounts, fees or other sources of payment.	100% of Eligible Medical BillsAn incurred medical bill that meets the criteria for sharing as established in the Guidelines. The Eligible Medical Bill will be reduced by any discounts, fees or other sources of payment. shared once AHPThe dollar amount a Member Household must pay toward their Eligible Medical Bills during a 12-month period before their Eligible Medical Bills will be approved for sharing. is met. *Conditions Apply	100% of Eligible Medical BillsAn incurred medical bill that meets the criteria for sharing as established in the Guidelines. The Eligible Medical Bill will be reduced by any discounts, fees or other sources of payment. shared once IMRThe dollar amount either “per day” or “per stay,” that is each Member is responsible for before sharing takes place. is met. *Conditions Apply
First Month Sharing Eligibility	Up to $50,000 of Eligible Medical BillsAn incurred medical bill that meets the criteria for sharing as established in the Guidelines. The Eligible Medical Bill will be reduced by any discounts, fees or other sources of payment. and incurred medical bill that meets the criteria for sharing as established in the Guidelines. shared during first month of membership.	Up to $50,000 of Eligible Medical BillsAn incurred medical bill that meets the criteria for sharing as established in the Guidelines. The Eligible Medical Bill will be reduced by any discounts, fees or other sources of payment. and incurred medical bill that meets the criteria for sharing as established in the Guidelines. shared during first month of membership.
Pre-Existing Conditions	Up to $100,000 per Member per year (based on effective date) after 36 consecutive months of faithful sharing. Up to $500,000 per Member per year (based on effective date) after 60 consecutive months of faithful sharing.	Up to $100,000 per Member per year (based on effective date) after 36 consecutive months of faithful sharing. Up to $500,000 per Member per year (based on effective date) after 60 consecutive months of faithful sharing.
Maternity Care	Married pregnant Members with an AHPThe dollar amount a Member Household must pay toward their Eligible Medical Bills during a 12-month period before their Eligible Medical Bills will be approved for sharing. of $3,000 or higher who have maintained membership and are in good standing from the month of conception to month of delivery are eligible for maternity sharing. Sharing is limited to $125,000 for any single pregnancy event.	Married pregnant Members who have faithfully shared from the month of conception through the month of delivery are eligible for maternity sharing. Sharing is limited to $125,000 for any single pregnancy event. There is an additional Maternity IMR of $3,000. See guidelines for details.
Routine Child Care Visits	Sharing for routine well-child care is eligible until the child reaches the age of six.	Sharing for routine well-child care is eligible until the child reaches the age of six. Well-child care is defined as recommended, routine check-ups and associated lab work, excluding vaccinations and/or immunizations
Prescriptions	Eligible for sharingAny testing, treatment, procedure or service that meets the criteria for sharing as established in the Guidelines. for six months per each new condition that is no pre-existing. *Exceptions Apply	Eligible for sharingAny testing, treatment, procedure or service that meets the criteria for sharing as established in the Guidelines. for six months per each new condition that is no pre-existing. *Exceptions Apply
Adoption	Up to $4,100	Up to $3,000
Burial Expenses	Up to $5,000	Up to $5,000
Out-of-Pocket Costs *Once program requirements are met
Preventative Care (Annual Visits/physicals with limited labs)	$35 Fee	N/A
Hospitalizations	$35 Fee	Self-payAs a self-pay patient, you are not limited by a network. You’re empowered with information to shop providers by quality and price. When you speak with providers, you simply tell them you are a self-pay patient and request a self-pay discount. with Reimbursement once IMRThe dollar amount either “per day” or “per stay,” that is each Member is responsible for before sharing takes place. is met
Surgery	$35 Fee	Self-payAs a self-pay patient, you are not limited by a network. You’re empowered with information to shop providers by quality and price. When you speak with providers, you simply tell them you are a self-pay patient and request a self-pay discount. with Reimbursement once IMRThe dollar amount either “per day” or “per stay,” that is each Member is responsible for before sharing takes place. is met
Other Medical Conditions	$35 Fee	Self-payAs a self-pay patient, you are not limited by a network. You’re empowered with information to shop providers by quality and price. When you speak with providers, you simply tell them you are a self-pay patient and request a self-pay discount. with Reimbursement once IMRThe dollar amount either “per day” or “per stay,” that is each Member is responsible for before sharing takes place. is met
Urgent Care	$35 Fee	Self-payAs a self-pay patient, you are not limited by a network. You’re empowered with information to shop providers by quality and price. When you speak with providers, you simply tell them you are a self-pay patient and request a self-pay discount. with Reimbursement once IMRThe dollar amount either “per day” or “per stay,” that is each Member is responsible for before sharing takes place. is met
Emergency Room	$200 Fee	Self-payAs a self-pay patient, you are not limited by a network. You’re empowered with information to shop providers by quality and price. When you speak with providers, you simply tell them you are a self-pay patient and request a self-pay discount. with Reimbursement once IMRThe dollar amount either “per day” or “per stay,” that is each Member is responsible for before sharing takes place. is met
Membership Includes
Preventative Care
Maternity Care*
Hospitalizations
Emergency Care
Surgery
Sharing in Unlimited TeleHealth
Sharing in TeleBehavioral Health
Dental and Vision Discounts
Additional Prescriptions Discounts
Direct Primary Care		N/A
Adoption
Direct Bill Management		N/A
CoShare Options		N/A
Referral Rewards
Healthcare Bluebook Fair Price* guidance	N/A
Network Provider Search Tool		N/A