Understanding Your Medi-Share Options

As the most trusted name in Health Care Sharing, Medi-Share is the affordable health care solution that provides you with Membership choice.

Understanding Your Medi-Share Options

All Medi-Share Programs offer affordable, reliable health care that fits your needs. 

Medi-Share Programs

As the Most Trusted Name in Health Care Sharing, Medi-Share is the affordable health care solution that provides you with membership choice. All Medi-Share program options provide members with:

Blue Checkmark

High quality, affordable health care that aligns with Christian values

Blue Checkmark

No annual caps, no lifetime caps

Blue Checkmark

Convenient 24/7 telehealth access to board-certified physicians

Summary of Sharing

  Medi-Share Complete Medi-Share Value
 

Our most comprehensive program offering a seamless health care experience.

A 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. reimbursement approach to health care savings.

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 is each Member is responsible for before sharing takes place. per individual
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 Checkmark check-mark-icon_blue

TeleBehavioral Health

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Dental & Vision Discounts

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Provider Access    
Provider Network 900K+ PHCS Providers No PPO Network
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

Bill Submission Process

Providers submit bill(s)

Members submit bill(s) for reimbursement

Bill Discounts

Eligible for in-network PPO discounts

Discounts available through Healthcare Bluebook*

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

Sharing Details    
No Lifetime Or Annual Sharing Limits Checkmark check-mark-icon_blue
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 Checkmark check-mark-icon_blue
Maternity Care* Checkmark check-mark-icon_blue
Hospitalizations Checkmark check-mark-icon_blue
Emergency Care Checkmark check-mark-icon_blue
Surgery Checkmark check-mark-icon_blue
Sharing in Unlimited TeleHealth Checkmark check-mark-icon_blue
Sharing in TeleBehavioral Health Checkmark check-mark-icon_blue
Dental and Vision Discounts Checkmark check-mark-icon_blue
Additional Prescriptions Discounts Checkmark check-mark-icon_blue
Direct Primary Care Checkmark N/A
Adoption Checkmark check-mark-icon_blue
Direct Bill Management Checkmark N/A
CoShare Options Checkmark N/A
Referral Rewards Checkmark check-mark-icon_blue
Healthcare Bluebook Fair Price* guidance N/A

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PHCS Search ToolProvider search tool within the PCHS network. Checkmark N/A

*Maternity exceptions or Reference guidelines.

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