Summary of Sharing


	Our most comprehensive program offering a seamless health care experience.
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
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
	$3,000
	$6,000
	$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.The 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	900K+ PHCS Providers
Notification Process	Providers notify when indicated
Provider Costs	Provider Fee ($35 in-office visit/$200 ER)
Cost - Total	Negotiated by Medi-Share on member's behalf
Bill Submission Process	Providers submit bill(s)
Bill Discounts	Eligible for in-network PPO 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
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
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.
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.
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.
Routine Child Care Visits	Sharing for routine well-child care is eligible until the child reaches the age of six.
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
Adoption	Up to $4,100
Burial Expenses	Up to $5,000
Out-of-Pocket Costs *Once program requirements are met
Preventative Care (Annual Visits/physicals with limited labs)	$35 Fee
Hospitalizations	$35 Fee
Surgery	$35 Fee
Other Medical Conditions	$35 Fee
Urgent Care	$35 Fee
Emergency Room	$200 Fee
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
Adoption
Direct Bill Management
CoShare Options
Referral Rewards
Healthcare Bluebook Fair Price* guidance	N/A
PHCS Search ToolProvider search tool within the PCHS network.

*Maternity exceptions or Reference guidelines.

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