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A Convenience Based Alternative to Health Insurance.
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A Choice Based Alternative to Health Insurance.
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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
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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 day/per stay
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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 |
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$3,000 |
$500 |
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$6,000 |
$1,000 |
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$9,000 |
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$12,000 |
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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.)
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| 24/7 TeleHealth with Board Certified Doctors |
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Dental & Vision Discounts
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| Provider Access |
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| Provider Network |
900K+ PHCS 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)
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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
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| Bill Submission Process |
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Members submit bill(s) for reimbursement
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| Bill Discounts |
Eligible for in-network PPO discounts
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| 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
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| Sharing Details |
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| No Lifetime Or Annual Sharing Limits |
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| 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.
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- 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.
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| 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 |
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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 |
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| Preventative Care |
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| Maternity Care* |
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| Hospitalizations |
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| Emergency Care |
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| Surgery |
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| Sharing in Unlimited TeleHealth |
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| Sharing in TeleBehavioral Health |
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| Dental and Vision Discounts |
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| Additional Prescriptions Discounts |
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| Direct Primary Care |
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N/A |
| Adoption |
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| Direct Bill Management |
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N/A |
| CoShare Options |
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N/A |
| Referral Rewards |
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| Healthcare Bluebook Fair Price* guidance |
N/A |
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| PHCS Search ToolProvider search tool within the PCHS network. |
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N/A |
Individuals & Families
Seniors 65+
For Employers
For Missionaries
