Do deductibles and co-insurance apply?

In medical cost sharing, the process differs significantly from insurance practices in this regard, to our Members’ advantage. Health Insurance deductibles are cumulative over the course of a plan year. Co-insurance is the portion of the medical expense owed by the patient. These insurance measures can amount to thousands of dollars in out-of-pocket costs to insurance policyholders annually. Conversely, Medical Cost Sharing Members select an IUA (Initial Unshareable Amount) when they join the community. An IUA is the financial portion ($500, $1500, or $5,000) that members pay their chosen medical providers prior to any amount becoming eligible for sharing. When Medical Cost Sharing Members incur an eligible medical expense that exceeds their per-event Initial Unshareable Amount (IUA), any eligible amount above the IUA is then considered for sharing, effectively reducing the Member’s burden to their selected IUA for any single medical incident.

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