Med-Share Comparison
 Share
The version of the browser you are using is no longer supported. Please upgrade to a supported browser.Dismiss

 
View only
 
 
ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
QualificationsC O S T SC O V E R A G E
2
ProviderBasic PriceAdd-OnEstimated Monthly for a family of 4DiscountsBasic CoverageAdd-OnPre-ExistingDoctor's VisitsPhysical Therapy/ Home HealthcareMaternityPrescriptionsDentalVisionChiropractic/ AlternativeAdoptionDeathNotes/ Misc.
3
Medi-Share (Christian Care Ministry)ChristianNo TobaccoNo DrugsNo Sex Outside of Christian MarriageAHP = $500 Monthly = $0 AHP = $1250 Monthly = $790 AHP = $2500 Monthly = $628 AHP = $3750 Monthly = $508 AHP = $5000 Monthly = $422 AHP = $7500 Monthly = $329 AHP = $10000 Monthly = $240Health Partner $80 per month in addition to the monthly shareAHP = $500, Monthly = $0 AHP = $1250, Monthly = $790 AHP = $2500, Monthly = $628 AHP = $3750, Monthly = $508 AHP = $5000, Monthly = $422 AHP = $7500, Monthly = $329 AHP = $10000, Monthly = $240 **one time new member fee $120 upon application approval ** one time $50 application fee **one time $2 fee to set up your ACCU account and a $2 monthly admin fee and an additional $1 for paper statements20% Discount for being healthy, may require blood work and/or physicalAnnual Household Portion (AHP) is the dollar amount a household pays toward their eligible medical bills during a 12-month period before their bills can be published for sharing. The share amount is the total of the monthly share contribution, including the administrative portion. PPO (you are not required to use an in network provider but you may pay a penalty for going out of network - the additional responsibility is either 20% of total charges or $500 per eligible bill, whichever is lower); Includes 24/7 access to Telehealth Providers; Provider fee of $35 is due for all office visits and $135 for emergency room visits (this must always be paid even after the AHP has been met the reset of the bill should be submitted by your provider for discounting and eligibility. Then the provider will bill you for the net amount - discounted amount minus the provider fee). No annual lifetime limit.A member who is designated as a mandatory Health Partner enjoys the same medical bill sharing privileges as other members, but must participate as a Health Partner due to specific health factors identified in the application process. Senior Assist option for age 65 and older with Medicare parts A & B, starting at $70 per month•Up to $100,000 per Member per calendar year if:
- the medical records state the diagnosis/condition has gone 36 consecutive months without signs/symptoms, treatment or medication OR
-the member has been faithfully sharing for 36 consecutive months.

• Up to $500,000 per Member per calendar year if:
-the medical records state that the diagnosis/condition has gone 60 consecutive months, without signs/symptoms, treatment or medication OR
-the Member has been sharing faithfully for 60 consecutive months

High blood pressure or cholesterol that is controlled through medication or lifestyle will not be considered a pre-existing medical condition for purposes of determining eligibility for future vascular events.

Where there has been a lapse in Membership, a condition will not be considered pre-existing if the first instance of the condition appeared during the previous Membership. An exception would be maternity that occurred outside the current Membership period, which will not be eligible for sharing.
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. Not eligible for sharing: Routine and preventive care – including, but not limited to, all well-patient care and screening tests and procedures, such as: Physicals, Immunizations and vaccinations, Lab studies, Screening mammograms, Screening colonoscopy, Routine optometric care and refractions, Genetic testing not required for treatment of an existing condition, Prophylactic and preventive surgery without personal history of diagnosis and doctor recommendationPhysical Therapy (PT) and Occupational Therapy (OT) are eligible for sharing if performed by a licensed therapist, related to an eligible diagnosis, and ordered by a qualified provider (See Section VI.A) for up to 20 visits combined per referral. / Home Care is limited to treatment related to an eligible need ordered by a qualified provider for Members who are homebound for that need. A copy of the provider’s order for the care must accompany the bill. Home care services are limited to 60 calendar days from the first date of service for Home Care.Pregnant Members with an Annual Household Portion of $1,250 or higher who have faithfully shared from the month of conception through the month of delivery are eligible for maternity sharing. Members with a $500 AHP are not eligible for sharing of any maternity or adoption expenses. To be eligible, delivery must be performed by one of the following:

• Medical Doctor
• Doctor of Osteopathy
• Midwife who is properly licensed, certified and/or registered in the state of delivery as required by state law
Through included Carington Discount Plan Prescription medications, including allergy injections, are eligible for sharing for six months per each new condition that is not pre-existing.Through included Carington Discount PlanThrough included Carington Discount PlanChiropractic care and manipulation therapy— In cases which have been diagnosed by a licensed physician (M.D. or D.O) and the Member is offered only a surgical option, a chiropractic resolution may be eligible for sharing in lieu of surgery. The Member's physician must provide a case history, x-rays and a recommendation for chiropractic resolution. If approved, chiropractic care is limited to a maximum of 20 visits within a six week period. Tests ordered by a chiropractor are not eligible for sharing.Up to two adoption events can be shared per Member Household. The adoption of multiple children at the same time is considered one event. Amount based on monthly Portion (AHP).Up to $5,000 of the final expenses listed below are eligible for sharing if the Member met the Membership Qualifications at the time of death. Up to $5,000 in burial expenses for stillborn children are eligible for sharing per pregnancy.1. Participation in activities that represent a willful disregard for personal safety are not shareable. 2. Abortion not shareable 3. Alcohol and drug related injuries and illnesses are not shareable 4. STDs contracted due to the actions of others will be shared, not shared when contracted by consensual sex outside of marriage or through irresponsible behavior. 5. Any expense, disability, or condition resulting from being engaged illegal acts is not shareable. 6. Bills from self-inflicted incidents are not shareable. 7. Does not share pregnancy costs for unwed mothers, except in the case of rape 8. Psychological/ Special Education/ Counseling for Learning Deficiency treatments are not shareable. 9. Dental nor shareable, including complications or infections related to dental procedures 10. Fertility treatments or testing are not shareable, including birth control procedures 11. Expenses resulting from transportation by ambulance for conditions that will
not seriously jeopardize the Sharing Member's health or life are not eligible for sharing. Also, the additional expense for transportation to a facility that is not the nearest facility capable of providing medically necessary care is not eligible for sharing. 12. Elective cosmetic surgery is not shareable.
4
Christian Healthcare Ministries (CHM) - GoldChristian who attends church regularlyNo TobaccoNo DrugsNo Sex Outside of Marriage150/ unit per month (maximum 3 units per family - all children are considered one unit)Quarterly variable designated gift amount (average amount: $75 per family) and a $40 annual, nonrefundable fee per family$450/ month (Optional Add-on: $340 annually)If you tell your friends about CHM and they join as the result of your
efforts, you will receive a free month of ministry membership after
your friends send their third monthly financial gift.
$500 personal responsibility per incident. In other words, you need to pay $500 (or receive at least $500 worth of discounts on your medical bills) per incident before CHM helps share your expenses. You can receive assistance up to $125,000 per illness.Brother's Keeper Add-on: For bills exceeding $125,000 per illness. Unlimited cost support per illness (diagnosis)Medical bills cannot be shared if, at the time you join CHM, the bills are for pre-existing conditions that are actively undergoing treatment other than with maintenance (routine) medications. After the incident is over and your doctor states that you are on a maintenance treatment regimen, bills for any new incident related to the pre-existing illness are eligible for sharing according to the following: In the first year of participation, bills incurred for a pre-existing condition are eligible for sharing up to $15,000. In the first two years of participation, bills incurred for a pre-existing condition are eligible for sharing up to $25,000 ($15,000 during the first year plus $10,000 during the second year). In the first three years of participation, bills incurred for a pre-existing condition are eligible for sharing up to $50,000 ($15,000 during the first year plus $10,000 during the second year plus $25,000 during the third year). After the third year of participation, the condition will no longer be considered pre-existing. Bills exceeding the three-year schedule listed above may be eligible to appear on the ministry’s Prayer Page. Prayer Page contributions are tax-deductible.Incident-relatedUp to 45 visits per incidentUp to $125,000 per pregnancy or unlimited w/Brother’s Keeper **If a member joins CHM while she is pregnant, bills for that pregnancy cannot be shared through the regular CHM sharing program or through the Prayer Page. Members must have a due date for delivery at least 300 days after joining CHM for bills to be eligible for sharing.Incident-related prescription costs are eligible for sharing. All programs: Prescriptions used for maintenance treatment cannot be shared by CHM members.Not CoveredNot CoveredNot CoveredN/AN/A1. STDs contracted due to the actions of others will be shared, not shared when contracted by consensual sex outside of marriage or through irresponsible behavior. 2. Elective cosmetic surgery is not shareable. 3. Fertility treatments or testing are not shareable 4. Abortion not shareable 5. Does not share pregnancy costs for unwed mothers 6. Psychological treatments are not shareable. 7. Bills from self-inflicted incidents are not shareable. 8. Bills incurred as a result of motorized vehicle accidents in which members were not wearing proper safety equipment are not shareable.
5
CHM - Silver85/ unit per month$255/ month (Optional Add-on: $340 annually)$1,000 personal responsibility per incident. In other words, you need to pay $1,000 (or receive at least $1,000 worth of discounts on your medical bills) per incident before CHM helps share your expenses. You can receive assistance up to $125,000 per illness.Brother's Keeper Add-on: For bills exceeding $125,000 per illness. An additional $100,000 of cost support. With each annual Brother’s Keeper renewal, participants receive an additional $100,000 of assistance, up to $1 million per illness.If you’re a Silver or Bronze member and you’re not in the middle of an active incident, your bills will be shared through CHM’s Prayer Page program.Not IncludedNot IncludedOnly hospital treatment (up to $125,000 per pregnancy) or up to $2,500 for midwife services per pregnancy. **If a member joins CHM while she is pregnant, bills for that pregnancy cannot be shared through the regular CHM sharing program or through the Prayer Page. Members must have a due date for delivery at least 300 days after joining CHM for bills to be eligible for sharing.No provisions for any prescription medication. All programs: Prescriptions used for maintenance treatment cannot be shared by CHM members.Not CoveredNot CoveredNot CoveredN/AN/A
6
CHM - Bronze45/ unit per month$135/ month (Optional Add-on: $340 annually)$5,000 personal responsibility per incident. In other words, you need to pay $5,000 (or receive at least $5,000 worth of discounts on your medical bills) per incident before CHM helps share your expenses. You can receive assistance up to $125,000 per illness.Brother's Keeper Add-on: For bills exceeding $125,000 per illness. An additional $100,000 of cost support. With each annual Brother’s Keeper renewal, participants receive an additional $100,000 of assistance, up to $1 million per illness.If you’re a Silver or Bronze member and you’re not in the middle of an active incident, your bills will be shared through CHM’s Prayer Page program.Not IncludedNot IncludedOnly hospital treatment (up to $125,000 per pregnancy) or up to $2,500 for midwife services per pregnancy. **If a member joins CHM while she is pregnant, bills for that pregnancy cannot be shared through the regular CHM sharing program or through the Prayer Page. Members must have a due date for delivery at least 300 days after joining CHM for bills to be eligible for sharing.Not CoveredNot CoveredNot CoveredN/AN/A
7
Samaritan's Ministries - BasicChristianNo TobaccoDo not abuse drugs or consume alcohol to drunkenessNo Sex Outside of Marriage$300Save to Share $399 per year + $15 annual administrative fee$300 (Optional Add On $414 per year) **one time start up fee $200Payments by insurers and other organizations, and
reductions by health care providers will be applied first, dollar for dollar, to
the initial unshareable amount ($300 or $1,500) of each need. Referral Program
Sharing starts once a need exceeds $1500. From then on 90% of costs can be shared. Maximum shareable amount is $236,500 Expenses for all types of physical conditions are generally shareable—subject to the treatment limitations outlined in the guidelines—and with special provisions for some conditions.Save to Share optional program to help members with qualified needs exceeding $250,000Needs that result from a condition that existed prior to membership (known or producing observable symptoms) are only shareable if the condition appears to be cured, and 12 months have passed without any symptoms (whether or not benign), treatment, or medication (even if the cause of the symptoms is unknown or misdiagnosed). Tests or a doctor’s statement may be required to verify the lapse of symptoms, treatment, and medication.

Exception: For genetic defects, hereditary diseases, cases of related cancers, and for heart conditions, the symptom/treatment-free period is five years. Non Shareable: Needs resulting from Type 1 diabetes that existed prior to a membership will not be shared even though the member went 12 months without symptoms, treatment, or medication. High blood pressure will not be considered a “condition existing prior to membership” even if you have not gone 12 months symptom free, as long as you have not been treated at a hospital for high blood pressure in the past five years, and you are able to control the condition through medication or diet. Medication for treatment as a chronic condition will not be shared. Elevated Cholesterol—Is not by itself considered a pre-existing condition, nor the mere fact that a person is taking a prescribed statin drug. However, if the prescription is for diagnosed arteriosclerosis for a particular location (e.g. heart, carotid artery), that condition would be pre-existing as to that location.
Routine Care not shareable; Direct Primary Care—Both “Direct Primary Care” and “Concierge Medicine” are methods by which consumers pay a regular fee, usually monthly, to secure more favorable access to a primary care physician. That monthly fee for a member (or his allocable share of a family fee) is shareable, within the limit for tests and checkups (Section VIII.B.36), as part of a shareable need, up to $100 for any month in which, in regards to that need, the physician is consulted, makes a referral, or charges for services.Physical Therapy that is shareable is intended to result in a direct physical change, or measure a physical marker, to move the patient towards healing a physical condition. It must be lawfully prescribed by a medical professional. Documentation of the prescription may be required.Maximum shareable amount $5000; Can be covered if you join while pregnant as a Special Prayer NeedThrough included EnvisionRX discount program —We share up to a 120-day supply of any prescription for medication related to a qualifying medical condition purchased within 120 days of the date of the first prescription purchased for a need. Direct treatments for cancer, anti-rejection drugs, and sublingual immunotherapy are not subject to this limitation. All medication administered during inpatient hospital stays will be shareable.
Note: We do not share the cost of prescriptions for maintenance of chronic or recurring conditions We do not share expenses for psychotropic medications for chemical imbalances unless they are verified by laboratory tests.
NoneNoneChiropractic—Services are shareable, including ancillary items, such as prescribed nutritional supplements for up to 120 days and X-rays. Each office visit where adjustments, manipulations, or other therapy occurs counts towards one of the 40 total therapy-type visits allowed for any one need. See Section VIII.B.37. To be shareable, billings for each treatment must indicate the condition being treated. Maintenance treatments are not shareable. Alternative Medical Practices - The member must present the request in writing, describing in detail the proposed treatment, the length of time envisioned for the treatment, their source of information about the treatment, and why it is not being prescribed by their provider. Homeopathic so long as prescribed by a licensed providerN/AN/A1. When Shares are Greater Than Needs—If the shares available for a particular month are greater than the needs to be shared, and all of the unshared prorated needs from the previous month are also met, needs for the following month may be shared or the share amounts assigned to the members may be reduced for the month.
2. When Needs are Greater Than Shares/Prorating—It is our goal that all qualifying needs presented by the members will be shared. However, in the event that the shareable needs are significantly greater than the shares available for that particular month, we may use a prorating contingency plan. 3. STDs contracted due to the actions of others will be shared, not shared when contracted by consensual sex outside of marriage or through irresponsible behavior. 4. Elective cosmetic surgery is not shareable. 5. Fertility treatments or testing are not shareable (Embryo adoption can be a Special Prayer Need) 6. Abortion not shareable
8
Samaritan's Ministries - Classic$495$495 (Optional Add On $414 per year) **one time start up fee $200Sharing starts once a need exceeds $300. From then on 100% of costs can be shared. Maximum shareable amount is $250,000. Expenses for all types of physical conditions are generally shareable—subject to the treatment limitations outlined in the guidelines—and with special provisions for some conditions.Maximum shareable amount $250,000; Can be covered if you join while pregnant as a Special Prayer NeedNoneNoneN/AN/A
9
Liberty Health Share - CompleteReligious Statement of Faith, Christian BasedNo TobaccoNo DrugsNo Sex Outside of MarriageAUA = $1500, Monthly = $399 (under 30) Monthly = $449 (30-65) Monthly = $499 (over 65)$80 per participant$449 + any costs incurred that go toward AUA **annual membership dues $135 due at signing, $75 annually thereafter **SavNet included but requires separate enrollment and a one-time set up charge of $10Referral ProgramMembers share eligible medical costs up to $1,000,000 per incident. This program includes access to SavNet. All eligible expenses are subject to the sharing guidelines and sharing begins after participants fulfill their Annual Unshared Amount (AUA) - $500 for an individual | $1,000 for a couple | $1,500 for a family Access to 24/7 Nurse Hotline through included SavNetHealthTrac is an additional $80 participant fee per month added to the Monthly Share Amount.First year of membership not eligible for sharing; 2nd and 3rd years eligible for sharing up to $50,000; 4th year and following of continuous membership, the condition is not longer considered pre-existing. HealthTrac℠ is for Sharing Members of Liberty HealthShare℠ who qualify for our medical cost sharing program but have certain pre-existing health conditions that can be improved through lifestyle changes. Such as: diabetes, hypertension, cancer, heart disease, high cholesterol and obesity, as well as tobacco users, who are willing to work towards a healthier life. Each HealthTrac℠ participant is assigned a Health Coach to develop a personal plan for achieving goals related to their condition or diagnosis. Regular communication with the coach and tracking of progress is part of the program. HealthTrac℠ fee is an additional $80 participant fee per month added to the Monthly Share Amount. Once goals are achieved, the $80 per month participant fee is removed from the Sharing Member’s Monthly Share Amount.After AUA; Charges for one wellness exam or physical including physician fee per membership year, for which there are no medical symptoms or diagnosis in advance, including routine laboratory tests, radiology, and other ancillary services or procedures that occur during or as a result of the wellness visit are eligible for sharing, after the first 60 days of membership, up to a maximum of $400 of the fair and reasonable charges as determined by Liberty HealthShareSM and not subject to the Annual Unshared Amount (AUA). Pap smears are eligible for sharing once every year not subject to the AUA. Screening colonoscopies, PSA tests, and mammograms are eligible for sharing once every two years up to and including age forty-nine (49), and not subject to the+K7 AUA. Screening colonoscopies, PSA tests and mammograms for members fifty (50) years of age and older are eligible for sharing every year and not subject to the AUA. Well baby visits including immunizations are eligible for sharing within the first year after birth and not subject to the AUA.Ancillary Therapies- Up to 10 visits of each therapy type per membership year provided by a licensed therapist. All visits after the initial assessment visit require prenotification to be considered for sharing. Skilled care services at home for up to 30 days by a Home Health Care Agency for each related Medical Expense Incident, provided such home care reduces the expected medical expense and replaces hospital or nursing home services. All visits after the initial assessment visit require prenotification to be considered for sharing.For a mother who has been a Sharing Member prior to conception, medical expenses for Maternity are eligible for sharing up to the per incident limit per pregnancy, subject to the applicable AUA, including, but not limited to, charges and expenses arising from physician care, hospital or birthing center admissions, attendance by midwives, or home deliveries accompanied by a midwife or physician. Medical expenses for Maternity ending in a delivery by cesarean section that is medically necessary because of complications that arise at the time of delivery are eligible for sharing up to the per incident limit per pregnancy, subject to the applicable AUA. Needs for Maternity ending in a natural delivery but with complications that threaten the life of the mother or infant and requiring care or services not normally rendered at the time of delivery are eligible for sharing up to the per incident limit per pregnancy subject to the applicable AUA. Medical expenses for a newborn, including congenital birth defects, and/or complications at the time of delivery, including, but not limited to, premature birth, are treated as a separate incident, subject to the applicable AUA.Through included SavNet Discount PlanThrough included SavNet Discount PlanThrough included SavNet Discount PlanThrough included SavNet Discount Plan; Up to 12 visits per member per year Treatment provided by a Naturopathic Physician or Doctor of Naturopathy (ND or NMD), a traditional Naturopath or other practitioner of alternative treatments is eligible for sharing or at least Partial Sharing if such treatment meets the following criteria:
a. It treats a medically diagnosed condition.
b. It is less invasive than conventional medical treatment for the diagnosed condition.
c. It is less costly than conventional medical treatment and is expected to prevent more costly future conventional treatment.
d. It is presented for prior approval to Liberty HealthShareSM and the member agrees to any alteration of the treatment plan made by Liberty HealthShare
N/APrimary Applicant $10000; Dependent Spouse $5000; Dependent Child $30001. When Needs are Greater Than Shares/Prorating—It is our goal that all qualifying needs presented by the members will be shared. However, in the event that the shareable needs are significantly greater than the shares available for that particular month, we may use a prorating contingency plan 2. Abortion not shareable. 3. Does allow same sex couples to join under separate memberships 4. Fertility treatments or testing are not shareable, including birth control procedures 5. Elective cosmetic surgery is not shareable. 6. Psychological/ Special Education/ Counseling for Learning Deficiency treatments are not shareable. 7. Expenses resulting from transportation by ambulance for conditions that will not seriously jeopardize the Sharing Member's health or life are not eligible for sharing. Also, the additional expense for transportation to a facility that is not the nearest facility capable of providing medically necessary care is not eligible for sharing. 8. For sixty (60) days after Enrollment Date as a Sharing Member, medical expenses for any reason, other than accidents, acute illness or injury, are not eligible for sharing among members
10
Liberty Health Share - PlusReligious Statement of Faith, Christian BasedNo TobaccoNo DrugsNo Sex Outside of MarriageAUA = $1500, Monthly = $374 (under 30) Monthly = $424 (30-65) Monthly = $474 (over 65)$449 + any costs incurred that go toward AUA **annual membership dues $135 due at signing, $75 annually thereafter **SavNet included but requires separate enrollment and a one-time set up charge of $10Members share eligible medical costs up to $125,000 per incident. This program includes access to SavNet. All eligible expenses are subject to the sharing guidelines and sharing begins after participants fulfill their Annual Unshared Amount (AUA) - $500 for an individual | $1,000 for a couple | $1,500 for a family Access to 24/7 Nurse Hotline through included SavNet
11
Liberty Health Share - ShareReligious Statement of Faith, Christian BasedNo TobaccoNo DrugsNo Sex Outside of MarriageAUA = $1500, Monthly = $345 (under 30) Monthly = $395 (30-65) Monthly = $445 (over 65)$449 **annual membership dues $135 due at signing, $75 annually thereafter **SavNet included but requires separate enrollment and a one-time set up charge of $10Members share upto 70% of eligible medical costs up to $125,000 per incident. Medical expenses are met on a per person, per incident basis when treated by physicians, urgent care facilities, clinics, emergency rooms, or hospitals (both inpatient and outpatient). Annual Unshared Amount (AUA) - $500 for an individual | $1,000 for a couple | $1,500 for a familyDiscounts availableNoneNone
12
Altrua - Standard (Gold)Keep body clean and healthyNo TobaccoNo Drugs or excessive alcohol consumptionNo Sex Outside of a Traditional MarriageAge and family size based $240 - $780/ monthMembers whose weight exceeds the membership standard will have a share increase added to their monthly contribution.$275-780For every household referral that joins as the result of your efforts, you will receive a free month of membership after your friends remain members for three consecutive months.Six office visits per person per calendar year are included in the membership. The $35.00 office visit/urgent care Member Responsibility Amount (MRA) must be submitted to the provider and applies to all eligible services received at the time of visit. Up to $300.00 is shared by the membership for each visit. Any services contracted to other providers or facilities and visits for maternity needs are not included. Any amount that exceeds the maximum sharing limit of $300.00 is the responsibility of the member and will not be applied to the 1st or 2nd MRA. After 6 office visits, the member is responsible for 100% of all charges.1. Cancer diagnosis or testing within the first 12 months of effective date is inellgible. 2. Pre-existing for 24 months prior to effective date are inelligible for the first 24 months of membership.6 offices visits per year per person $35 office visit/ urgent care (upto $300) - Not applied to the 1st or 2nd MRA SHARING AFTER 1ST AND 2ND MRAS ARE MET The membership shares 100% of eligible medical needs for the remainder of the calendar year. Altrua HealthShare will share until the Lifetime Limit of $1,000,000 is met.PT unless associated with an eligible surgery or accidental injury within the first 12 months is inelligeableThe membership shares a maximum of $4,000 for a normal delivery or a maximum of $6,000 if a medically necessary C-section is required. Must be married and in a combined membership for 10 consecutive months prior to conception. (Not available in Florida at this time.)Altrua HealthShare offers discounts for name brand and generic prescriptions.Not CoveredNot CoveredChiropractice withthin the first 12 months of the effective date is inelligeable.Not CoveredNot Covered1. Abortion not shareable except in the case of a life-threatening situation to the mother. 2. Medical practitioners outside of the US must be pre-authorized 3. Pre Auth. required for several services 4. ER visits, surgeries, etc from non-affiliated providers will be paid at affiliated prices 5. For cancer to become eligible certain guidelines must be followed, such as screening tests every 2 years for women over 40, and blood tests for men over 50. A cancer diagnosis must be submitted within 30 days or total allowed will reduce to 50% 6. All needs related to recreation activities within the first 90 days are inelligible. 7. Surgery within the first 90 days are inelligible unless life-threatening 8. Illness or injuries due to negligience in obtaining treatment are inelligible. 9. Expenses resulting from transportation by ambulance for conditions that will
not seriously jeopardize the Sharing Member's health or life are not eligible for sharing. Also, the additional expense for transportation to a facility that is not the nearest facility capable of providing medically necessary care is not eligible for sharing. 10. Fertility treatments or testing are not shareable, including birth control procedures 11. Elective cosmetic surgery is not shareable. 12. STDs contracted due to the actions of others will be shared, not shared when contracted by consensual sex outside of marriage or through irresponsible behavior. 13. Maternity outside of marriage is inelligeable. 14. Injuries from extreme sports are inelligeable (indoor skydiving, inline skating, mountain biking, scuba diving, skateboarding, water skiing, trail running, etc.) 15. Psychological/ Special Education/ Counseling for Learning Deficiency treatments are not shareable.
13
Altrua - Standard (Silver)Age and family size based $216 - $720/ month
14
Altrua - Standard (Bronze)Age and family size based $120 - $600/ monthSix office visits per person per calendar year are allowed. Altrua HealthShare provides an Explanation of Sharing to the member stating the allowed charges members are responsible for. Up to $300.00 per visit is applied to the 1st then 2nd MRA. Any amount that exceeds $300.00 is not applied to the 1st or 2nd MRA. After six visits, the member is responsible for 100% of all charges. Any services contracted to other providers or facilities and visits for maternity needs are not included.6 offices visits per year per person $35 office visit/ urgent care (upto $300) - The membership applies up to $300.00 of charges per visit to the 1st then 2nd MRA. SHARING AFTER 1ST AND 2ND MRAS ARE MET The membership shares 100% of eligible medical needs for the remainder of the calendar year. Lifetime Limit of $1,000,000 with a limit of $50,000 per calendar yearMaternity is not eligible on the Bronze plan
15
Altrua - Advantage (Gold)Age and family size based $200 - $650/ monthSix office visits per person per calendar year are included in the membership. The $35.00 office visit/urgent care Member Responsibility Amount (MRA) must be submitted to the provider and applies to all eligible services received at the time of visit. Up to $300.00 is shared by the membership for each visit. Any services contracted to other providers or facilities and visits for maternity needs are not included. Any amount that exceeds the maximum sharing limit of $300.00 is the responsibility of the member and will not be applied to the 1st or 2nd MRA. After 6 office visits, the member is responsible for 100% of all charges.6 offices visits per year per person $35 office visit/ urgent care (upto $300) - Not applied to the 1st or 2nd MRA SHARING AFTER 1ST AND 2ND MRAS ARE MET The membership shares 100% of eligible medical needs for the remainder of the calendar year. Altrua HealthShare will share until the Lifetime Limit of $1,000,000 is met.The membership shares a maximum of $4,000 for a normal delivery or a maximum of $6,000 if a medically necessary C-section is required. Must be married and in a combined membership for 10 consecutive months prior to conception. (Not available in Florida at this time.)
16
Altrua - Advantage (Silver)Age and family size based $180 - $600/ month
17
Altrua - Advantage (Bronze)Age and family size based $100 - $500/ monthSix office visits per person per calendar year are allowed. Altrua HealthShare provides an Explanation of Sharing to the member stating the allowed charges members are responsible for. Up to $300.00 per visit is applied to the 1st then 2nd MRA. Any amount that exceeds $300.00 is not applied to the 1st or 2nd MRA. After six visits, the member is responsible for 100% of all charges. Any services contracted to other providers or facilities and visits for maternity needs are not included.6 offices visits per year per person $35 office visit/ urgent care (upto $300) - The membership applies up to $300.00 of charges per visit to the 1st then 2nd MRA. SHARING AFTER 1ST AND 2ND MRAS ARE MET The membership shares 100% of eligible medical needs for the remainder of the calendar year. Lifetime Limit of $1,000,000 with a limit of $50,000 per calendar yearMaternity is not eligible on the Bronze plan
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
Loading...
Main menu