While there is no maximum dollar limit on the amount that can be shared towards a specific medical need, the need must be within the scope of the Medical Cost Sharing Guidelines before it will be eligible for sharing. Because of the economic impact of very large medical bills (e.g. those over $150,000), there is an internal mechanism to ensure that adequate shares are available to meet both our Member’s normal and high-cost needs. For the very large medical expenses that occur from time to time, 15% of each Member’s monthly shares are set aside to help offset these situations. Our Medical Cost Sharing Partner reserves the right to negotiate medical expenses with providers, and to prorate available shares, as necessary, in order to address all Member’s medical expenses.
Articles in this section
- Is there any time limitation on sharing a medical Need?
- Are mental health needs shareable?
- Are prescription costs considered a shareable need?
- Are my monthly shares a pre-tax deduction like health insurance premiums?
- Is surrogacy a shareable need?
- Can there be multiple needs during one pregnancy?
- What if I have a medical need that is not shareable?
- Are maternity needs that occur prior to membership or in the first 12 months of member shareable with the community?
- How are maternity needs shared?
- Don't I have to have health insurance? Isn't there a penalty to pay if I don't?