What is a ‘Need’?
All of the medical expenses related to a single accident or illness that exceeds the Member’s Initial Unshareable Amount (IUA). Such as: new illnesses, new injuries, immunizations for children under 18. Maternity costs including prenatal, delivery, postnatal are covered after 1 year of membership, and standard screenings like mammograms and colonoscopies (some limitations may apply).
What is an IUA: Member’s Initial Unshareable Amount
The amount that Members are required to bear on their own prior to any amount that may be eligible for sharing; IUAs are applied per injury or illness. Members can choose between three IUA options ($500, $1500, or $5000) for eligible Needs.
Individuals will not pay more than 3 IUAs per year and families will pay no more than 5 IUAs per year. If these limits are met in a calendar year, any additional eligible medical Need will no longer be subject to an IUA and will be shareable immediately.
Included
- Choosing any doctor/hospital you wish to see, no networks or limitations.
- Maternity: No maximums or limitations. Estimated date of delivery must be after a full year of membership in order to be eligible to share maternity expenses.*
- Prescriptions: Prescriptions prescribed by a doctor or hospital can be shared for the first 120 days if part of a new, eligible need.
- 24/7 Telemedicine: Immediate medical consultations, free of charge.
- Pre-existing medical conditions: Pre-existing health conditions have limitations on sharing but can become partially eligible for sharing after the first year on an incremental scale, some limitations may apply.
- Billing concierge: Complementary negotiation on your medical bills to keep expenses low; averaging a reduction of 53% in cost.
- Health coaching: Two annual, personal sessions with a certified Health Coach to help you reach and maintain your goals.
- Discounts on labs and supplements: 35% discount on supplements, discounted lab services, and savings on other wellness resources.
- 2nd Opinion services: Consult with a physician if members receive a new diagnosis, new prescription regimen, or prior to major medical intervention/ procedure in order to re-assess medical necessity and available alternatives.
