health trust financial certification training...

Health Trust Financial Certification

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Biblically-Based • Members are part of a community of more than 200,000 Christians dedicated to sharing in each other’s healthcare needs, as Galatians 6:2 commands.

• No money will ever go to financially support unbiblical lifestyle choices.• Each month you will receive notification of whom your share is helping so you can pray for that person/family.

Peace of Mind • Christian Care Ministry has been in operation since 1993.• More than 200,000 members.• More than $1.4 billion in medical expenses shared/saved by members.

Annual Household Portion

• Annual Household Portion (or “AHP”) is the dollar amount that you select as your level of burden toward your own medical expenses. This amount is satisfied yearly by your payments towards eligible medical bills (new injuries, new accidents, or new illnesses).

• After you satisfy your AHP, your fellow members share in 100% of all eligible medical bills. • Seven (7) AHP choices:• $500 (for unmarried, 18-29-year-old members)

• $1,250 $5,000• $2,500 $7,500• $3,750 $10,000

• The AHP will reset yearly on your effective date.

No Sharing Limits Beyond First Month of Membership

• Sharing is limited to $50,000 the first month of membership.• Members share in 100% of all eligible medical bills after your AHP has been satisfied. • Some limitations on sharing of pre-existing conditions. See Guidelines for details.• No 90/10, 80/20, or 70/30 co-insurance with Medi-Share.• No yearly or lifetime sharing limits for eligible expenses.

PPO Network – Private Healthcare Systems (PHCS)

• One of the largest PPO networks in the country – more than 700,000 providers of varying specialties to choose from.• Bills are subject to significant discounting through PHCS – on average 35% savings.• PHCS’ logo on the Medi-Share membership card gives instant credibility when checking in with a doctor or hospital office.

Provider Fees • Provider Fees will be paid directly to providers during your office visit.• Office Visit and Hospital – $35• ER Visit – $135

Prescriptions • Members are given a prescription discount card that provides them with an average discount of 45% on most prescriptions.• Prescription costs go towards the AHP for six (6) months if need is related to a new injury, new accident, or new illness.

Dental, Vision, and More!

• Medi-Share has partnered with a national discount program that provides significant discounts on dental procedures, as well as vision and hearing care.

• Members have 24/7 access to physician consultations by video or phone for non-emergency medical needs through MDLIVE, at $0 cost to the member!

Maternity Program • Maternity costs will be shared at 100% by the members if conception occurred after membership began and the AHP has been met.

• “Global Billing” means that most pregnancies have one (1) provider fee of $35 that includes your pre-natal visits, hospital stay, delivery fees, and check-up of the mother following delivery.

• No maternity provisions for members with a $500 AHP.

ACA Penalty Exemption • No ACA penalties for Medi-Share members.• Christian Care Ministry is part of a “healthcare sharing ministry” exemption.

Medi-Share is not insurance.

Sharing Summary

Medi-Share is a healthcare sharing ministry. Healthcare sharing ministries are identified in the Affordable Care Act.

1. Although a very unique concept, there are more than 500,000 Americans who use a healthcare sharing ministry for their healthcare needs, with over 200,000 participating in Medi-Share. Designed by and for Christians

a. No compromise on biblical standards

b. All needs are supported with prayer

c. Visibility as to who you are helping each month

d. Belonging to a community of hundreds of thousands of Christians

2. 100% of Eligible Needs have been published for sharing

a. 23+ year history

b. Over 1.4 billion in medical needs shared and discounted

3. Affordable Care Act compliance

a. Not a way around the law, a way to obey it

b. Healthcare sharing ministries defined in the law

c. Not for profit and must have been in existence since at least 1999

d. Must have independent certified annual audits

4. PHCS PPO network

a. Members have access to one of the largest networks in the country

b. Many insurance providers use the same network

c. Discounts average 35%

5. Careington Vision/Dental/Hearing discounts

a. Nationwide network

b. No extra cost to members

c. Discounts average 50%

d. Freedom to choose any in-network provider

6. MDLIVE

a. Telehealth consultations available 24/7

b. No cost consultations

c. Unique partnership with Medi-Share that no other sharing ministry has

d. Time and money saving solution for minor illnesses

7. Prescription discounts

a. Accepted at most pharmacies

b. Significant discounts

c. Discount lookup at MyRxPrice.com

Sharing Summary

The 4 Anchors

How to Deliver the Anchors

ANCHOR 1: Medi-Share Is Not Insurance

• You must specifically state: “Medi-Share is not insurance.”

• The importance of this anchor is to provide prospective members with a clear differentiating statement about this form of health provision.

ANCHOR 2: Members Share Voluntarily

• You must mention that the program is voluntary.

• The main reason is to provide clear distinction that this program is not backed by a financial institution, as further explained in the next Anchor.

ANCHOR 3: There Are No Guarantees

• Anchor 3 is best delivered in the same sentence as Anchor 2. It defines and gives proper context to anchor 2. Due to the voluntary nature of the program, there are no guarantees.

• Example: “The members share voluntarily, so there are no guarantees.”

ANCHOR 4: Members are Notified of Their Sharing

• The process through which bills are shared is unique to Medi-Share, so it is essential that prospective members understand the difference in this process vs. traditional healthcare methods.

• Members receive an automated notification once a month as to who their shares will be helping.

• This notification is sometimes referred to as “Published for Sharing.”

Sample 4 Anchors Presentation

“Medi-Share is not insurance; it’s a sharing ministry. Medi-Share has no obligation to pay any member’s medical bills from Medi-Share’s own funds. The members all share voluntarily so there are no guarantees from other members or from Medi-Share. Medi-Share notifies each member household once a month providing the name(s) of the other member(s) that the household has been matched to share with that month.

The 4 Anchors of Medi-Share

1. Medi-Share is Not Insurance

2. Members Share Voluntarily

3. There Are No Guarantees

4. Members are Notified of Their Sharing

Correct Medi-Share Terminology

IMPROPER PROPER DEFINITION

DEDUCTIBLE ANNUAL HOUSEHOLD PORTION (AHP)

The annual dollar amount that the member must meet be-fore eligible bills can be shared. Similar to a deductible.

COVER /COVERAGE ELIGIBLE FOR SHARING

Bills are not covered as a member does not have coverage, and this program does not “cover” anything. Members’ bills are eligible for sharing if the services are included in the Guidelines.

CO-PAY PROVIDER FEE The amount the member pays to a provider at the time medical services are rendered ($35 for an office visit or $135 for ER visits). It is like a down payment or good faith payment that is credited to the total amount billed, it can be described as somewhat similar to a co-pay.

CLAIM BILL Members have bills, not claims. Medical bills may be shared, but they are not paid by other members or using Medi-Share funds.

GUARANTEE NO GUARANTEE There is no contract with Medi-Share to guarantee a bill will be shared. Eligible bills are processed for sharing after the AHP has been met.

DECLINED/DENIED INELIGIBLE FOR SHARING

Medi-Share does not decline or deny a bill; rather, it’s consid-ered ineligible for sharing.

INSURANCE /HEALTHPLAN

BILL SHARING MINISTRY

Medi-Share is a program that facilitates the sharing of mem-ber’s medical expenses. Medi-Share is not “like” insurance and should not be compared to “traditional” insurance, as it is not “untraditional” insurance.

PAY SHARE Medi-Share does not pay members’ bills from Medi-Share funds. The ministry facilitates the sharing of members’ funds to pay medical bills.

BENEFITS PROVISIONS Medi-Share does not have benefits. Provisions are for condi-tions and services based on the member-voted Guidelines.

WE/OUR MEDI-SHARE/THE MEMBERSHIP

Medi-Share is a program that has a membership. Avoid using terms like “we” or “our,” as the ministry is made up of both employees who administer the program and the membership.

EXPLANATION OF BENEFITS (EOB)

EXPLANATION OF SHARING (EOS)

Medi-Share issues an EOS for each bill that is processed, not an EOB.

IMPROPER PROPER DEFINITION

UNFORTUNATELY, THE GUIDELINES

ACCORDING TO THE GUIDELINES

The Guidelines that govern Medi-Share are member-voted Guidelines. Members vote on certain issues, which is a priv-ilege of membership. The members have a say in how their share dollars are spent. Never be negative in conveying this.

PLAN/POLICY OR HEALTHPLAN

PROGRAM A plan is purchased, Medi-Share members voluntarily partic-ipate in a program.

TERMINATION CANCELLED/WITHDRAWN

Medi-Share members are cancelled or withdrawn, not terminated.

PROVIDE FACILITATE SHARING Medi-Share does not provide healthcare. Instead, CCM facili-tates the sharing of medical bills amongst the membership.

POOL FACILITATE SHARING Medi-Share does not pool resources. Members have indi-vidual ACCU accounts and the ministry facilitates sharing amongst the membership.

GIFTS SHARE Members are not giving “gifts” to other members.

CO-OP/COOPERATIVE MINISTRY Co-op is actually defined as a non-profit organization in which the same people who own the company are insured by the company.

COLLECTIVE MINISTRY A collective is an organization that is managed without hierarchy. This means that every member has equal deci-sion-making power.

RIDER CONDITIONS INELIGIBLE FOR SHARING

A rider is a plan that can be purchased to cover a medical need not normally covered on the policy. Medi-Share does not have riders for conditions ineligible for sharing.

Correct Medi-Share Terminology, cont.

Helpful Definitions:

Eligible Need – An eligible need is one that meets the requirements per the Guidelines. Eligible does not mean shared. Sharing only occurs when a family has met their AHP AND the medical need is eligible.

Processed for Sharing – Once a medical need is deemed eligible AND the household has met their AHP, the bill will be submitted for sharing.

Effective Date – The month and day a membership begins or the month and day of the most recent Annual Household Portion (AHP) change.

Q. How is Medi-Share biblical?

A. Taking care of each other was a way of life for Christians in the days of the early Church. The book of Acts is a great picture of the fellowship of believers as well as mutual care.

All the believers were together and had everything in common. They sold property and possessions to give to anyone who had need. Acts 2:44-45

Christians view Medi-Share as a way to reclaim their bib-lical mandate to care and provide for their brothers and sisters in Christ.

Q. What kind of oversight is there at Medi-Share?

A. Medi-Share is self-regulated by a Board of Directors. The Board of Directors is responsible for the policy decisions of the ministry.

Q. Who makes the rules for the Medi-Share program?

A. The members make the rules! All members have the opportunity to vote on how they wish to care for one another. The Board of Directors review suggestions from Medi-Share members and recommends changes to the Guidelines each year. Voting is used to help create, amend, and change the program Guidelines; voting is not used for determining whether specific individual bills should be published for sharing.

Q. Why should I consider Medi-Share?

A. Members have chosen Medi-Share for many reasons:

1. Good Stewardship Most Medi-Share members are able to significantly

cut their annual medical expenses, leaving them with more of their income to support their families and the Lord’s work.

2. Not Subsidizing Unbiblical Lifestyles Medi-Share members and their dollars do not pay

for abortions, drug addictions, or any other unbiblical lifestyles.

3. Sharing With Brothers and Sisters in Christ Knowing that a Christian will receive your monthly

sharing gift is very gratifying. Medi-Share members know that they are truly making a difference in the life of a brother or sister in Christ. Those receiving those gifts are greatly encouraged in their time of need by prayer and by the cards and letters that are often sent.

Q. Is Medi-Share Christian insurance?

A. No. Medi-Share is not insurance. Medi-Share is a health-care sharing program where Christians share their finan-cial resources to pay each other’s medical expenses. Medi-Share isn’t insurance. Resources are shared directly between members. There is no pooling of funds as prac-ticed by insurance groups. Christian Care Ministry and the Medi-Share program are not registered or licensed by any insurance entity, nor are they required to be. There is no collection of premiums, promise of payment, or guarantee that your medical bills will be paid. Sharing of medical bills is completely voluntary.

Q. Will my share amount change?

A. Your share amount is subject to change at any time. A share adjustment may be necessary if the amount of medical bills submitted for sharing exceeds the amount of monthly shares coming in. Share amounts also change annually based on the age of the oldest person in your household.

Q. Is my share amount tax deductible?

A. Although Christian Care Ministry is a 501(c)(3) non profit ministry, your share payment (which goes directly to another member) is not deductible for federal income tax purposes as a charitable donation or as a medical expense. Also, your share payment is not tax deductible as an insurance expense because Medi-Share is not insurance.

Q. Why do I need to set up an account with ACCU for sharing?

A. Your monthly shares are deposited in your account with America’s Christian Credit Union (ACCU) solely to facilitate the sharing process. Without an ACCU account, you cannot participate in Medi-Share.

Common Questions about Medi-Share

Q. Is maternity shared?

A. Maternity is eligible for sharing; however, there are certain conditions depending on which AHP level you choose. Please refer to Section VII. for specifics.

Q. Is adoption shared?

A. Up to two adoption events can be shared per household. However, there are certain conditions. For more informa-tion, please read Section VIII.

Q. What is the deductible?

A. Members do not have deductibles. Instead, members have an Annual Household Portion (AHP). Members choose an AHP ranging from $500-$10,000.

The AHP is the annual amount a household is responsible for before medical bills are processed for sharing. The AHP only applies to eligible medical bills. After the AHP has been met, ALL eligible medical bills for the entire household will be submitted for sharing.

Q. What is the monthly premium?

A. Members do not have a monthly premium. Instead, members contribute a monthly “share” based on age and how many in the household. Members deposit their monthly share into their personal bank account at ACCU and it goes directly into a fellow member’s bank account at ACCU to pay their medical bills.

Q. How does the claim (and sharing) process work?

A. Members do not file claims, nor does the ministry han-dle claims because CCM/Medi-Share is not an insurance company. If your eligible medical bill is paid, it is paid with funds received directly from another member. Our mem-bers present their member ID card to their service provider. The service provider then discounts the bill accordingly, if within the Preferred Provider Organization network. The bill is then sent to CCM where it is negotiated for further discounts. The services provided are reviewed to determine if the bill is eligible for sharing. After the AHP has been met and if the bill is eligible, it is processed for sharing among the other members. For more details on what is eligible and how the AHP works, please review the Guidelines.

Q. Why aren’t well-visits, routine care, or preven-tative care shared?

A. The primary purpose of Medi-Share is to help share mem-bers’ burdens. Burdens are those unexpected medical bills you are unable to plan for (i.e. broken bones, cancer, etc). Low monthly share amounts enable you to budget for your family’s routine care, which can be planned. There are exceptions for well-baby care, Section VII. F.

Q. What is an “Annual Household Portion (AHP)?”

A. The AHP is the dollar amount a Member Household must pay toward their Eligible Medical Bills during a 12-month period before their needs will be published for sharing. The AHP 12-month period begins with the Effective Date.

Q. How do I meet my AHP?

A. You will present your card every time you visit a medical pro-vider. Your provider should submit your medical bills to CCM. They will be processed and discounted, and then your provid-er will bill you for the portion you owe. Once the amount you pay meets your chosen annual household portion level, your Eligible Medical Bills will be published for sharing.

Q. What if I want to change my AHP level?

A. Members must apply in writing to switch Annual Household Portion (AHP). All family members in a household must switch together to the new AHP. There is an administrative fee of $75 to change AHP, and certain limitations apply as shown in the chart in the Guidelines.

Q. How does CCM know I met my AHP?

A. Your providers will submit all medical bills to CCM. At CCM, the bills will be processed and discounted if applicable. Eligible amounts are applied toward your AHP or processed for sharing if your AHP has been met.

Q. What is the health incentive?

A. A household may qualify for up to a 20% off their monthly share amount with the health incentive. All adult Members must meet certain health criteria. To qualify, Members must verify their blood pressure, BMI, and weight/waist measurement within 90 days of each other.

Q. What do I do when I need to go to the doctor?

A. You are encouraged to have your providers submit all your medical bills to CCM. Once received, the following will occur:

1. Every bill is processed for eligibility and the possibility of discounting.

2. Any applicable provider fees are subtracted from the discounted amount.

3. The net amount owed by the member is determined.

4. If the medical bill is eligible for sharing, CCM deter-mines whether the annual household portion has been met. If so, the net amount is processed for sharing. If not, the net amount is applied to the AHP and paid directly by the member.

Q. Do I need to use a PPO provider?

A. You are not required to use the providers in the provider directory. However, you may pay a penalty for using a non-network provider.

Q. How do I search for providers in the PHCS network?

A. Use MyChristianCare.org/pro (use different link), or call (877) 302-7427.

Q. Is there a penalty if I do not use a PHCS provider?

A. Yes, if you choose not to use a PHCS provider you may be penalized as using a PPO provider offers more savings for Members, including discounting. Section XI. explains the penalties, and how to apply for a penalty waiver.

Q. What is the provider fee?

A. The provider fee is $35 for office and hospital visits and $135 for emergency room visits. This is the amount that a member must pay at each visit to a medical provider. Members are always responsible for paying the provider fee, even after the AHP has been met. Please note this does not apply toward the annual household portion.

Q. Besides the provider fee, do I pay anything to the doctor or hospital when I visit?

A. No. Even if you know you have not met your AHP, you should have the providers submit the bills to CCM for discounting, to determine if they are eligible and whether they should be applied to your AHP. Your provider will then bill you for the net amount (which is the discounted amount minus the provider fee).

Q. Are prescriptions shared?

A. Prescription drugs related to the treatment of an eligible medical condition are eligible for sharing. Prescriptions are limited to six (6) months of treatment for each medical condition over the lifetime of the Member. All eligible pre-scriptions are applied toward your AHP and are processed for sharing, if your AHP has been met.

Q. What if I visit the emergency room?

A. The cost of emergency room care may be eligible for sharing. The provider fee for emergency room care is $135. However, if you are subsequently admitted to the hospital, you only pay the $35 provider fee.

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