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Sharing Guidelines

Summary of 03.25.25 changes

Summary of 1.1.25 changes

Summary of 11.01.24 changes

I. Foundational Overview

A. Principles of Ministry

We believe the following Biblical principles are basic to the life of every believer; therefore foundational to our health care sharing ministry:

Jesus Christ is our Provider for every need.
As the Creator of all things, He is the only One with all the resources necessary to meet every need.

Our needs are more than physical.
Human beings are more than just a collection of cells, and we have needs that go beyond the physical body. Our members come together to meet the financial, physical, and spiritual aspects of each medical need.

God has made us stewards of His resources.
As a first line of defense, members of the Body of Christ are responsible for using the resources they've been given by God to care for themselves, their families, and others.

Our local Christian church offers us support.
We seek to support and supplement the local Body, not replace it. We depend on local Christian church leaders to provide accountability for the REDEEM™ members under their care.

Mankind is the crown of His Creation.
Because we bear the image of God, we are to respect all human life at all stages of development. Therefore, we live according to Biblical principles in all aspects of our lives by treating our bodies as temples of the Holy Spirit.

B. Membership

To become a member you must meet all the requirements of this section and submit an application, including an Accountability Verification Form. As long as you continue to meet these requirements and fulfill all membership responsibilities, your membership will continue.

We believe the following membership requirements (Statement of Faith and Lifestyle Requirements) benefit all members by being Scriptural, and also by minimizing medical risks and costs, ensuring proper accountability, and encouraging good health practices. REDEEM HealthShare retains the discretion to remove from membership any member whose behavior violates Biblical standards such that they may bring the ministry into disrepute.

C. Statement of Faith and Lifestyle Requirements

  • Be a professing Christian living by Biblical principles. Every adult on the membership must affirm the following member Statement of Faith:

    • I believe in the triune God of the Bible. He is one God Who is revealed in three distinct Persons—God the Father, God the Son, and God the Holy Spirit.

      GEN 1:26 | LUKE 1:35, 3:21-22 | 2 COR 13:14 | MATT 28:18-20

    • I believe Jesus Christ was God in the flesh and continues to be such even after His resurrection—fully God and fully man. He was born of a virgin, lived a sinless life, died on the cross to pay the penalty for our sins, was bodily resurrected on the third day, and now is seated in the heavens at the right hand of God the Father.

      ISA 7:14, 9:6 | MATT 1:22-23, 26:64 | MARK 16:19 | LUKE 24:38-40 | JOHN 1:1-2, 1:14, 1:29, 2:18-21, 5:18, 8:46 | ACTS 2:32-33 | 1 COR 15:3-4, 15:20-21 | 2 COR 5:21 | COL 1:15-20, 2:9 | HEB 1:1-4, 4:14-15, 7:26, 9:11-14, 10:10-12 | 1 PETER 2:22-24 | 1 JOHN 3:5

    • I believe that all people have sinned and fallen short of God's glory and can be saved from eternal death only through faith in Jesus Christ, Whose atoning death and resurrection secure for us eternal life.

      JER 17:9 | JOHN 3:3, 14:6, 20:30-31 | ROM 3:9-11, 3:23, 5:12-21, 10:8-13 | EPH 2:8-9

  • As a community of Christians helping other Christians with their medical bills, every adult on a membership must attend a Biblical, Christian church regularly (at least three out of four weeks per month that your health or weather permits). If it is not possible for you to regularly attend a Biblical, Christian church, please submit a letter giving the details. HEB 10:25

    • Fellowships, churches, temples, wards, and denominations that fall outside of Biblical, Christian faith—such as the Church of Scientology, Unitarian, Jehovah's Witnesses, and The Church of Jesus Christ of Latter-day Saints— do not qualify for the church attendance requirement.

  • Believe you are to bear one another's burdens. GAL 6:2 | PHIL 2:4

  • Believe that your body is a temple of the Holy Spirit and that abusing any substance is sin. Empowered by the indwelling Holy Spirit, you are committed to living a holy and consecrated life in which you abstain from illegal drugs, legal or prescribed substance abuse, recreational marijuana, and tobacco (a rare celebratory cigar or pipe is allowed). ROM 13:1 | 1 COR 6:12

  • Believe that your body is a temple of the Holy Spirit and that drinking to drunkenness is sin. Empowered by the indwelling Holy Spirit, you are committed to living a holy and consecrated life in which you limit consumption of alcohol to moderate amounts and do not drink to drunkenness or cause another brother or sister in Christ to stumble. EPH 5:18

  • Believe that your body is a temple of the Holy Spirit and that any sexual activity outside traditional Biblical marriage as designed by God between one biological man and one biological woman is sin. Empowered by the indwelling Holy Spirit, you are committed to living a holy and consecrated life in which you abstain from any such activity. GEN 1:27, 2:24 | MATT 19:5 | 1 COR 6:18

  • Agree to practice good health measures in accordance with the principle that your body is the temple of the Holy Spirit. 1 COR 6:19-20

  • Keep your membership active by ensuring that your monthly share is deposited into your Share Account each month. A notice will be given to members who are late in sending shares, and they will lose eligibility to have their own needs shared until the issue has been corrected. If financial need is the cause of these problems, assistance may be available through the Sponsorship Program (Section IV.L). LUKE 16:10

  • Agree that when you have a dispute with a fellow Christian, and your fellow Christian is willing to submit that dispute to fellow believers for resolution, you are not to sue each other in the civil courts or other government agencies, A person initiating a legal proceeding against REDEEM HealthShare Ministry would disqualify himself from membership. 1 COR 6:1-8

  • Submit your Membership Continuation Agreement each year, confirming that you are still meeting the membership requirements. PROV 10:9

  • Have someone to whom you are accountable (pastor, elder, church official, small group leader, accountability partner, etc.) and sign an Accountability Verification Form confirming that you meet the above requirements. HEB 13:17

  • Agree to these requirements when you apply for membership and provide background information including your date of birth. Annually, you will need to reconfirm that you still meet these requirements along with an Accountability Verification Form.

Nationality / Citizenship Requirements: The following individual(s) can join REDEEM HealthShare:

  • U.S. Citizens

  • Those who possess a U.S.-issued Social Security Number and a valid Identification Card issued by a U.S. government agency.

  • Those who possess a U.S.-issued Individual Taxpayer Identification Number (ITIN) and who also have a government-issued Identification Card issued by Mexico, Canada, Guatemala, or the United States and who have a United States mailing address.

If at any time you no longer meet all these membership requirements, you must notify REDEEM HealthShare immediately, and your membership and all privileges will be suspended unless otherwise indicated.

Your health status has no effect on your eligibility for membership. However, there are limitations on the sharing of needs for some conditions that existed before membership. For a detailed explanation of the types of needs that are shared or not shared by the members, see Sharing of Expenses (Section III).

To be eligible to submit expenses, a member must meet all the requirements of membership including being current with all Monthly Shares, and the expense must not be caused by conduct inconsistent with membership requirements.

D. Health Care Sharing in General

REDEEM HealthShare programs are designed for sharing of eligible medical expenses related to conditions resulting from a new illness, injury, or accident.

To participate, members voluntarily contribute a monthly share amount according to the age of the oldest participant on the household membership, the sharing level, any optional programs chosen, and the number of participants on the household membership.

REDEEM HEALTHSHARE MINISTRY IS NOT AN INSURANCE COMPANY. HEALTH CARE SHARING IS NOT INSURANCE OR A CONTRACT FOR INSURANCE.

THE PAYMENT OF MEDICAL BILLS BY MEMBERS THROUGH REDEEM HEALTHSHARE MINISTRY OR OTHERWISE IS NOT GUARANTEED IN ANY WAY.

II. Health Care Sharing Programs

REDEEM HealthShare is a not-for-profit health care sharing ministry that facilitates direct member-to-member sharing of eligible medical expenses.

A. How Health Care Sharing Works

Health care sharing is a voluntary arrangement that unites individuals and families in the REDEEM community through acts of mutual support and love, reflecting the early Christian church's commitment to caring for one another (Acts 2:44-45). Guided by our shared faith and Biblical principles, we come together to bear each other's burdens and demonstrate the love of Christ in practical ways.

There is no transfer of risk from a member to REDEEM HealthShare or from a member to other members, and there is not a contract of indemnity between REDEEM HealthShare and any member or between the members themselves.

REDEEM HealthShare Ministry is not an insurance company and some of the terminology and processes may be different than you are used to or be unfamiliar. REDEEM members do not pay "premiums" and money is not collected by REDEEM HealthShare to "cover" medical expenses. Members receive Share Notifications that inform the members who they'll be sharing with and what the need was for. Members submit voluntary Monthly Shares to assist other members with their eligible medical expenses and support the administration and program services of the Ministry. Members are always responsible for their medical bills and expenses.

Overview: The REDEEM™ Sharing Process

Members select a sharing program that aligns with their desired level of medical expense sharing and financial considerations. Members deposit their monthly share amounts into a specific member-owned (not-REDEEM-owned), bank account—called a Share Account—opened by the member during the application process with our third-party fiduciary, America's Christian Credit Union. Medical bills will be submitted to REDEEM HealthShare directly by medical providers or by the member. Medical bills that are eligible for sharing per the Guidelines are matched, allocated, and published to the membership prior to sharing. REDEEM HealthShare implements a member-to-member approach to sharing which means that members share funds directly with one another, rather than drawing funds from a common pool. Members who are matched to share will be notified through a process called Publishing as to the amount that is due to be withdrawn from their Share Account for the payment of another member's assigned bill. They will be notified as to who will be receiving their funds. The amount shared to each receiving member is transferred to a Virtual Bill Account for the payment of the bill. Once completed, the funds are directly transferred to the medical provider as payment for the bill or to the member where applicable.

Complete details on how the sharing, publishing, and payment process work can be found in REDEEM™ Sharing Platform (see Section V).

All eligible medical bills are subject to an Annual Unshareable Amount (AUA), which is the dollar amount a household membership must pay toward their own eligible medical bills during a twelve (12) month period before their eligible medical bills can be published and shared by REDEEM HealthShare. Some REDEEM programs have Co-Share amounts and other limits described herein.

REDEEM HealthShare offers three sharing programs which offer different sharing levels and health care sharing support and an optional add-on program providing additional flexible sharing options.

B. Important Membership Terminology

REDEEM HealthShare is defined using certain terms, vocabulary and definitions. A complete list may be found in the Appendix.

Annual Unshareable Amount (AUA). The Annual Unshareable Amount (AUA) is the dollar amount a household membership must pay toward their own eligible medical bills during a 12-month period before their eligible medical bills can be published and shared by the membership. All eligible medical bills are subject to the AUA unless otherwise specified. The AUA 12-month period begins on your membership date. The AUA resets on the anniversary of your membership date or upon switching between programs or AUA levels.

Membership Date. Your membership date is the date that your membership in REDEEM HealthShare started.

Co-Share Amounts and Limits (REDEEM Essential only). For REDEEM Essential only, once the AUA is met, REDEEM HealthShare shares 80% of eligible medical bills. The remaining 20% (the Co-Share amount) is paid by the member up to the annual Co-Share limit. There is a $5,000 Co-Share limit per household membership per year. The Co-Share limit will reset on the anniversary of the membership date or on the effective date of any AUA reset occurring during the membership year.

Samaritan Ministries Legacy Member. A member who migrates without membership interruption from Samaritan™ Classic or Samaritan™ Basic in good standing to REDEEM HealthShare membership.

C. REDEEM™ Essential

REDEEM Essential offers a reliable solution at a low monthly cost and allows the member household to select the level of sharing participation to determine their monthly share amount and AUA. Members mutually share eligible medical expenses, subject to the AUA, a Co-Share amount, and up to $1 million per household membership maximum per year.

D. REDEEM™ Enhanced

REDEEM Enhanced is our most comprehensive sharing program and allows the household membership to select the level of sharing participation to determine the monthly share amount and AUA. Members share eligible medical expenses as well as certain preventative screenings, wellness visits, and prescription costs subject to the AUA as documented herein. REDEEM Enhanced has a $2 million per membership maximum per year and is not subject to a Co-Share.

E. REDEEM™ SeniorSaver

REDEEM SeniorSaver is a program for members 65 years of age and older. It is designed to work with Medicare Parts A and B, providing a significantly lower monthly share. Medicare Parts A and B will cover 80% of the costs of bills incurred for services that Medicare covers; the REDEEM community shares the remaining 20%. Members are not required to join REDEEM SeniorSaver when they turn 65; they can participate in REDEEM Essential or REDEEM Enhanced for as long as they like. REDEEM SeniorSaver has a $500 AUA.

Additional REDEEM SeniorSaver Requirements

  1. You must have Medicare Parts A and B to participate in REDEEM SeniorSaver.

  2. You must also have Medicare Part D to have prescriptions shared.

  3. You may only participate as an individual. Those wishing to have a "couple" or "family" membership will need to participate in REDEEM Essential or REDEEM Enhanced.

  4. All other membership requirements in Conditions of Sharing (Section IV) and Foundational Overview (Section I) apply.

Shareable in REDEEM SeniorSaver

  1. Items that Medicare Parts A and B cover will also be shareable with REDEEM members after Medicare's coverage has been applied and the $500 AUA has been reached.

  2. Prescriptions may be shared only for REDEEM SeniorSaver members with Medicare Part D after Medicare's coverage has been applied and the $500 AUA has been reached.

  3. The exceptions to the above would be any bill related to services declared as not eligible for sharing in Section III.H.

F. FlexShare™

FlexShare is an optional add-on program, permitting the submission of additional items for sharing, such as vision, dental, and supplements. The program provides a per membership annual allowance for eligible expenses of $1,000 for REDEEM Essential, $1,500 for REDEEM Enhanced, and $1,000 for REDEEM SeniorSaver. There is no Co-Share or AUA for FlexShare.

A membership may submit bills in the FlexShare program after six months of participation. The annual allowance amount resets on the membership anniversary date, and any unused balance does not carry over to the next year.

FlexShare expenses must comply with the Statement of Faith and Lifestyle Requirements, and bills or receipts must be submitted through the Member Center bill submission portal as a FlexShare expense. This feature is intended to offer additional support within the stipulated FlexShare annual limit and under the specified terms and conditions and is subject to the list of items not eligible for sharing.

See the Appendix for examples of expenses that are eligible for FlexShare.

G. Annual Sharing Caps and Lifetime limits

  REDEEM™ Essential REDEEM™ Enhanced REDEEM™ SeniorSaver
Annual Sharing Maximum $1 Million $2 Million None
Lifetime Sharing Limits None None None
Co-Share Amounts 20% Membership responsibility None None
Co-Share Limits $5,000 Membership per year None None

H. Liability

Members of REDEEM HealthShare Ministry share one another's medical expenses. REDEEM HealthShare facilitates this member-to- member sharing by directing member's shares to those who have eligible expenses. REDEEM HealthShare is not insurance. A division of Samaritan Ministries International, REDEEM HealthShare is a health care sharing ministry, as outlined in the Patient Protection and Affordable Care Act and facilitates the sharing of medical bills and expenses among members, one with another, according to these Guidelines, at REDEEM HealthShare's reasonable discretion.

REDEEM HealthShare is not liable for the payment of a member's medical bill. If sharing occurs, the shared medical bills are paid by the member that incurred the bill from other member's share contributions only, not from funds of REDEEM HealthShare itself.

REDEEM HealthShare's programs are not insurance. However, REDEEM HealthShare may be used to avoid the "Affordable Care Act" federal mandate that became effective January 1, 2014, requiring "applicable individuals" to maintain "minimum essential [insurance] coverage" and to be exempt from similar mandates in California, New Jersey, Rhode Island, Massachusetts, and the District of Columbia.

These are the only exceptions. Otherwise, members must not certify that REDEEM HealthShare is insurance to avoid purchasing insurance required by law, rule, or regulation, such as worker's compensation insurance.

III. Sharing of Expenses

A. Expenses Eligible for Sharing

To be eligible for sharing a bill must meet the following criteria:

Be the Result of Condition, Injury, or Illness:

The bill must be for a condition, injury, or illness and have a Date of Service (DoS) after the membership start date.

Bills for pre-existing conditions are also shareable under certain circumstances. The guidelines for pre-existing conditions are discussed in detail in Section III.D. In every case, bills must always have a Date of Service (DoS) after the membership start date to be eligible for sharing.

Bills not related to a condition, injury, or illness—such as preventive and routine wellness visits—may only be shareable in REDEEM Enhanced (See Section III.G) or in FlexShare.

For Incurred Services or Qualifying Estimates:

In most instances the bill must be for actual services incurred. However, for maternity or in cases where significant savings can be achieved, the submission of bill estimates may be acceptable.

Be Not Listed as Not Eligible:

The bill must not be included in the Not Eligible for Sharing category in Section III.H.

Submission Timeframe:

The bill must be submitted to REDEEM HealthShare within 12 months of the Date of Service (DoS).

Many medical providers are willing to submit their bills electronically directly via the Member Card EDI number. However, if a member must manually submit a bill for processing, it must be submitted using the online submission portal in the Member Center. Bills submitted by the provider must follow standard health care industry submission and coding guidelines. This is necessary for bills to be considered for sharing.

Bills must include itemized details, including:

  • Name of member/patient

  • Diagnosis/ICD10 Codes

  • Procedure/CPT Codes

  • Provider's TAX ID

  • Provider's NPI

  • Provider's Billing Address

  • Facility Service/Physical Address

  • Date of Service

  • Charged Amount(s)

When submitting a medical bill for processing, the member is responsible for obtaining all information needed for processing per the prompts in the online submission portal.

B. Approved Sharing of Bills

To be eligible for sharing, bills for professional services—including assessing, diagnosing, treating, reporting, or giving advice in a medical capacity—must be submitted by the medical provider via the EDI on the REDEEM Member Card, on a CMS 1500 form, or UB and IB form, or uploaded by the member through the online bill submission portal in the Member Center. These bills must be ordered by a:

  • Medical Doctor (M.D.)

  • Doctor of Osteopathy (D.O.)

  • Naturopathic Doctor (N.D.)

  • Nurse Practitioner (N.P. or A.P.R.N.)

  • Physician's Assistant (P.A.)

  • Doctor of Podiatric Medicine (D.P.M.)

  • Dentist (D.D.S. or D.M.D.)

  • Midwife (if certified)

  • Ophthalmologist

  • Chiropractor

These tests and treatments must occur at one of the following:

  • Hospital

  • Surgery center

  • Clinic

  • Doctor's office

  • Diagnostic facility

  • Residential setting (for home births only)

C. Sharing Limits

Certain conditions may be eligible for sharing, subject to a Membership AUA and co-share amounts and other conditions that may apply. See each category below for details.

First 90 Days of Membership: For the first 90 days, only bills resulting from injury, acute illness, or accident are eligible for sharing, up to a maximum of $50,000. This waiting period does not apply to Samaritan Ministries Legacy Members.

Non-Shareable Conditions in First Membership Year: The following conditions are not shareable for the first 12 months of Membership, except through FlexShare if that option is selected. This waiting period does not apply to Samaritan Ministries Legacy Members.

  • Arthritis

  • Autoimmune conditions

  • Bone spurs (bone calcification)

  • Cataracts

  • Glaucoma

  • Lyme disease

  • Macular degeneration

  • Sleep related restricted airway conditions (e.g., sleep apnea) including CPAP equipment

  • Varicose veins

Non-Shareable Treatments in First Membership Year: The following treatments are not shareable for the first 12 months of Membership, except through FlexShare if that option is selected. This waiting period does not apply to Samaritan Ministries Legacy Members.

  • Allergy treatments

  • Hormone therapy

  • Joint replacement

  • Lipedema/Lymphedema/Liposuction

  • Prosthetics

D. Pre-existing conditions

Pre-existing medical conditions are defined as conditions in which known signs, symptoms, testing, treatment, diagnosis, or use of medication occurred within 36 months prior to the member's start date. Routine or maintenance medications are considered treatment and are included in this definition. Testing for the purpose of monitoring a prior resolved condition will not be counted for pre-existing conditions so long as the tests indicate the continued resolution of the issue. Any pre-existing condition known to exist at the start of membership has a three-year waiting period from the start of membership for bill sharing outside of FlexShare. After this waiting period, up to $125,000 will be shared per member, per year towards pre-existing conditions. In the sixth year of membership and every year thereafter, this limit increases to $500,000.

Adoption: Any physical condition of which the adopting parents had reason to be aware that the adopted child had prior to the adopting parents being legally responsible for the child's expenses, or prior to his effective date within his parents' membership, will be considered a pre-existing condition.

Pre-Existing Condition Exceptions:

  • Heart and Cancer Conditions: Bills for pre-existing heart and cancer conditions are subject to a five-year waiting period from the start of membership. After this waiting period, the sharing limits in Section III.D will apply. This waiting period will not apply to a new heart or cancer condition that occurs after membership begins.

  • Type 1 Diabetes: Bills for pre-existing type 1 diabetes are not eligible for sharing.

  • High Blood Pressure: Bills for pre-existing high blood pressure can be shared provided the member has not received hospital treatment for high blood pressure in the last five years, and the condition is controlled through medication or diet.

  • Elevated Cholesterol: Elevated cholesterol alone is not considered a pre-existing condition, even if a statin is prescribed. However, if the statin is prescribed for a pre-existing condition such as arteriosclerosis, it will be considered pre-existing.

  • Samaritan Ministries Legacy Members: Conditions and Treatments that were eligible for sharing according to the Pre-Existing Conditions in the Guidelines for Health Care Sharing in SamaritanTM Classic and Basic are eligible to be shared without waiting in REDEEM HealthShare.

E. Medically Necessary

Eligible bills may be submitted to be approved for sharing subject to permitted sharing levels when medically necessary. Medically necessary is defined as health care services that are clinically appropriate in terms of type, frequency, extent, site, and duration for the diagnosis or treatment of the member's sickness or injury or maternity and ordered by a physician exercising prudent clinical judgment for the purposes of evaluation, diagnosis, or treatment of that member's sickness or injury.

The medically necessary setting and level of service is that which, considering the member's medical symptoms and conditions, cannot be provided in a less intensive medical setting. Such services, to be considered medically necessary must be no more costly than alternative interventions—including no intervention—and are at least as likely to produce equivalent therapeutic or diagnostic results without adversely affecting the member's medical condition. To be considered medically necessary in REDEEM Essential, REDEEM Enhanced, or REDEEM SeniorSaver, the service must meet all of the following requirements:

  • It must not be maintenance therapy or maintenance treatment;

  • Its purpose must be to restore health;

  • It must not be primarily custodial in nature;

  • It must not be a listed item or treatment not allowed for reimbursement in the United States by CMS (Medicare).

REDEEM HealthShare reserves the right to incorporate CMS (Medicare) guidelines in effect on the date of treatment as additional criteria for determination of medical necessity and/or eligibility of a bill.

The mere fact that the service is furnished, prescribed, or approved by a physician does not mean that it is medically necessary.

The determination of whether a service, supply, or treatment is or is not medically necessary may include findings of the American Medical Association, CMS, and REDEEM HealthShare's own medical advisors.

F. Permitted Sharing Levels

“Permitted Sharing Levels” means charges for medical care, which is medically necessary for the care and treatment of illness or injury, but only to the extent that the fees charged therefore are within all applicable limitations and restrictions established by the REDEEM HealthShare Sharing Guidelines including, but not limited to, the following:

Hospitals (both inpatient and outpatient services), Ambulatory Surgery Centers, Independent Facilities, and Other Medical & Surgical Services. The Permitted Sharing Level for medical care established by the Guidelines shall be based upon the average of 150% of the Medicare Allowable Amount for the medical care included in the Guidelines and 135% of the cost of the medical care included in the Guidelines; provided, however, that any such Permitted Sharing Level based on the cost of the medical care included in the Guidelines shall be limited to an amount not to exceed 175% of the Medicare Allowable Amount or the amount of Usual, Customary and Reasonable Fees for the medical care included in the Guidelines.

Professional Services. The Permitted Sharing Levels for professional services shall be determined based upon the chart for the professional service identified. This chart is available upon request. Professional services refer to shareable services provided by medical professionals identified in Section III.B.

Dialysis Services. The Permitted Sharing Level for dialysis services (which shall include dialysis, facility services, supplies, and medications provided during treatment) shall be determined by review of the Medicare Allowable Amount for the billing hospital or physician in light of clinical considerations pertinent to the patient being treated.

Medical Care Provided Under Direct Contract. The Permitted Sharing Levels for medical care provided by directly contracted hospitals or physicians will be the rates or fees established under the applicable contract; provided, however, that the amounts of such rates and fees shall be presumed to be Usual, Customary and Reasonable only to the extent that they do not include otherwise improper balances, which charges shall be outside of the Permitted Sharing Levels.

If the Permitted Sharing Level exceeds the actual charge billed for the treatment, service, or supply in question, sharing and payments to providers will be based on the actual billed charge. The Permitted Sharing Level for medical care will not include charges related to unbundling, errors, unclear description, or misidentification.

Off-label Drugs. Sharing of off-label drug use is considered medically necessary when all of the following conditions are met:

  • The drug is approved by the FDA;

  • The prescribed drug use is supported by one of the following standard reference sources:

    • DRUGDEX;

    • The American Hospital Formulary Service Drug Information;

    • Medicare approved Compendia; or

    • Scientific evidence is supported in well-designed clinical trials published in peer-reviewed medical journals, which demonstrate that the drug is safe and effective for the specific condition; and the drug is medically necessary to treat the specific condition, including life threatening conditions or chronic and seriously debilitating conditions.

Prepayment. When pre-payment is requested, REDEEM HealthShare will make every effort to negotiate with the provider/facility to ensure that we obtain a rate that is consistent with our Permitted Sharing Level. If the provider/facility is unable to provide a rate that meets our Permitted Sharing Level, we will make every effort to find a provider/facility whose fees are closer to our Permitted Sharing Level. The member can choose to see the provider of their choice, but if the rate is more than our Permitted Sharing Level, then prepayment and sharing will be limited to 200% of the CMS rate, and the member will be responsible for the remaining balance.

Any bills paid in full by the member will be shared based off what was actually paid by the member.

Right to Reject Charges: REDEEM HealthShare has the discretion to declare amounts ineligible for sharing it finds unreasonable, excessive, or duplicate charges.

G. Limited Sharing

Medical bills for specific conditions might be eligible for limited sharing, depending on a member's AUA, any Co-Share amount, and other applicable conditions. Refer to each category below for detailed information.

i) Maternity and Newborns

Due Date Requirements: Maternity expenses are eligible for memberships where two or more members (one of whom must be the mother) have been active for at least 12 months before the estimated due date. This 12-month waiting period also restarts after a switch from REDEEM Essential to REDEEM Enhanced or from a higher to a lower AUA.

Maternity Services Eligible for Sharing

  • Antepartum care

  • Labor and delivery

  • Postpartum care

  • Well-baby visits for the first three years are shareable if the membership has been part of REDEEM Enhanced for 12 months prior to the delivery date. Well-baby services are not subject to the AUA.

Adding Newborns to Membership. The baby must be added to the household membership within 30 days of delivery to be considered a member from birth.

Birth Defects and Conditions. Any known birth defects or conditions in the baby from a pre-existing maternity are not eligible for sharing. If birth defects or conditions are discovered after the mother joins, these will be shareable after the AUA is met.

Approved Providers for Delivery. To be eligible, delivery must be performed by a Medical Doctor (M.D.), Doctor of Osteopathy (D.O.), or Midwife who is properly licensed, certified, and/or registered in the state of delivery.

Ectopic Pregnancies

Expenses Shared—Procedures related to a ruptured fallopian tube (including postoperative recovery of the mother, follow- up care, and treatment of any complications), and, where an ectopic pregnancy is diagnosed before a rupture, all preoperative tests and consultations and expenses related to keeping the mother under medical care while determining what care should be offered for the mother and child.

Expenses Not Shared—Procedures directly related to the termination of a living, unborn child and/or removal of the living, unborn child from the mother due to an ectopic pregnancy are not shared (e.g., methotrexate, salpingectomy, salpingostomy), unless the removal of the child from its ectopic location was for the primary purpose of saving the life of the child or improving the health of the child.

ii) Prescription Medications

Inpatient Prescriptions. Prescriptions administered as part of inpatient treatment are shareable. These are subject to the AUA, applicable Co-Share amounts, and annual maximums.

Outpatient Prescriptions (REDEEM Enhanced only). Outpatient prescriptions are shareable only within the REDEEM Enhanced program. There is an annual cap of $1,000 per household membership, per year. Outpatient prescriptions are not subject to the AUA. Prescriptions medications must be purchased using the Member Card (see Rx Information on the card).

FlexShare Prescriptions. Any prescription costs not shareable under the above categories can be submitted to FlexShare.

iii) Mental Health

Costs for involuntary commitment up to $50,000 per year are shareable and subject to AUA and Co-Share.

Outpatient mental health treatment, such as counseling and therapy, is shareable only through FlexShare.

iv) Therapies

Therapies delivered in a repetitive protocol are subject to limitations and must be prescribed by a licensed medical professional. For each therapy category, there is a $5,000 cap per household membership per year:

In-office therapies ($5,000 cap per household membership per year):

  • Acupuncture/Acupressure

  • Cardiac

  • Chiropractic care

  • Disc decompression

  • Dry needling

  • Hyperbaric treatments

  • Massage therapy

  • Occupational therapy

  • Physical therapy

  • Platelet Rich Plasma/Stem Cells

  • Prolotherapy

  • Respiratory

  • Softwave therapy

  • Speech therapy

  • Vision

Hormone therapies ($5,000 cap per household membership per year).

Injection therapies ($5,000 cap per household membership per year).

These therapies and treatments are subject to the AUA and Co- Share amounts. They must not be for pre-existing conditions.

v) Joint Replacement

Medical bills related to replacement of orthopedic joints (e.g., knee, hip, or shoulder) will only be eligible for sharing after the initial membership 12-month waiting period and 12 consecutive months of membership in the same program and AUA level.

vi) Motor Vehicle Related

Medical bills incurred for injuries resulting from motorized vehicles will only be eligible for sharing after any insurance entity or other liable third party has paid their portion, provided all other Guideline requirements are met. If the member submitting the bill was operating the vehicle, the vehicle must not have been operated recklessly.

vii) Medical Transportation

Bills for medically necessary, emergency ground transportation (i.e., ambulances) or air transportation (e.g., Life Flight) are eligible for sharing. These are subject to the AUA and Co-Share amounts.

viii) Telemedicine

No-cost urgent care telemedicine conducted using our approved telehealth provider is freely available through the Member Center and is not subject to the AUA and Co-Share. Other telehealth visits through other providers will not be eligible for sharing.

ix) Hospice Care

Hospice care services will be shared for 90 days upon prescription by a physician or certification that the person is terminally ill. Additional 90-day periods will be shared with a renewed prescription/certification subject to the per-year dollar maximum. If the member is in the REDEEM SeniorSaver program, then Medicare must provide their coverage first before any non- covered portions can be shareable by REDEEM members.

x) Skilled Nursing Facility

Skilled nursing facility expenses are shareable for up to $10,000 per member per year subject to AUAs and Co-Shares for a shareable condition requiring rehabilitation or skilled care following a surgery or injury.

xi) Routine & Wellness Visits (REDEEM Enhanced)

Routine and wellness visits are eligible for sharing only if the member is part of the REDEEM Enhanced program. Each member is eligible for one routine visit per year. These routine wellness visits are capped at $300 per person, per year and are not subject to the AUA requirements.

xii) Immunizations (REDEEM Enhanced)

Immunizations and the associated office visit are shareable for children who are part of REDEEM Enhanced from birth until 2 years of age. The cost of immunizations may be shared for children who are part of REDEEM Enhanced between the ages of 3 and 6 years of age as part of the child's annual routine visit subject to the $300 annual per person member cap.

Immunization costs are not subject to the AUA and Co-Share amounts.

xiii) Preventative Screenings (REDEEM Enhanced)

Preventative screenings are limited to the screenings listed below. These are only eligible for sharing if the member is part of the REDEEM Enhanced program and are subject to the following conditions:

Mammogram. Women are eligible for one mammogram per year beginning at age 45. These bills are not shareable within the first six months of membership and are not subject to AUA.

Prostate-Specific Antigen Test (PSA). Men are eligible for one PSA test per year beginning at age 45. These bills are not shareable within the first six months of membership and are not subject to AUA.

Colonoscopy. Adults are eligible for one colonoscopy every five years per person or every two years for high-risk individuals (as determined by their physician), beginning at age 45. Cologuard (or equivalent testing) may be substituted for a scheduled colonoscopy if desired. These bills are not subject to the AUA and are not eligible for sharing within the first six months of membership.

Gynecological. Women are eligible for annual gynecological wellness visits, including Pap tests each year. These bills are not subject to the AUA and are not eligible for sharing within the first six months of membership.

H. Not Eligible for Sharing

Treatment that is in violation of the Statement of Faith and Lifestyle Requirements (listed in Foundational Principles) including illness or injury arising from grossly negligent acts, use of illegal drugs, abuse of alcohol, or any illegal activity, whether an arrest is made, charges are filed, or a conviction results, is not eligible for sharing. Additionally, the following expenses are not eligible for sharing, unless noted:

  1. Cosmetic surgeries, with exceptions:

    1. Breast reconstruction after cancer

    2. Medically necessary breast reduction

    3. Reconstructive surgery from any injury

    4. Cleft palate

  2. Infertility treatment

  3. In-vitro fertilization

  4. Genetic testing

  5. Inpatient psychological treatment, except as specified in Section III.G.

  6. Non-medical expenses*

  7. Bills related to an event while on active military duty

  8. Bills that are required to be covered by worker's compensation insurance

  9. Any injury or illness arising from any illegal activity

  10. Charges outside the US if they traveled to that location for the sole purpose of receiving treatment

  11. Any charges where a third-party is responsible

  12. Charges not submitted within twelve (12) months from the Date of Service (DoS)

  13. Charges for the release of medical records

  14. Charges for anything relating to transsexualism, gender dysphoria, sexual reassignment, or change, including medications

  15. Charges for travel or accommodations to pursue treatment at a non-local site of care unless approved by the Ministry on a case-by-case basis

  16. Drug/alcohol abuse treatment

  17. Procedures or surgery that is not medically necessary

  18. Prophylactic (treatment intended to prevent disease) and preventive surgery without personal history of diagnosis and a doctor's recommendation.

  19. Experimental treatment

  20. Psychotropic medication*

  21. Birth control

  22. Abortion

  23. Complications related to ineligible procedures, conditions, and diagnoses except pre-existing maternity. If complications arise from a medical procedure that is not shareable, expenses for treating the complications are shareable unless the procedure that was the cause was not shareable due to moral reasons (e.g., abortion) or the complication itself is not shareable (e.g., a routine dental problem arising from the treatment of a routine dental problem).

  24. Transportation to appointments

  25. Nutrition services*

  26. Medical supplies*

  27. Gym memberships*

  28. Additional wellness visits beyond the one allowed per membership year in REDEEM Enhanced*

Items with an asterisk (*) may be shared under FlexShare.

IV. Conditions of Sharing

A. Family Members Defined

A membership in REDEEM HealthShare is limited to members of the same nuclear family. Nuclear families include only husband, wife, and children, but can include grandchildren in the circumstances described below.

Children 18 and over must verify that they meet the member requirements by signing an application form.

1. Spouse

Spouse means a legally married person. It can be a person's lawfully married husband or wife. Marriage is defined as being between one biologically born man and one biologically born woman.

2. Adult Children (Age 18 and over)

Your single children from age 18 up to and including age 25 may be on your membership if they are living at home (which includes while away at school full time). A child may be considered disabled and remain on a family membership after turning 26 if the child is receiving more than 50% financial support from their parents and qualifies as a dependent on their parent's federal tax return. Contact your Member Care team before the date they turn 26 if you wish to apply for this status.

3. Newborn

A newborn, whose addition to the membership may increase the monthly share amount, will be included within the membership retroactive to the date of birth, as long as at least one parent was a member as of the baby's birth and you notify REDEEM HealthShare to add him/her to the membership no later than 30 days after the birth; otherwise, the effective membership date will be no earlier than the date of notification to REDEEM HealthShare. REDEEM HealthShare should be notified as soon as possible to add subsequent newborn children to the membership. Please be aware that there are specific Guidelines addressing sharing needs for a newborn (see Section III.G.)

4. Adoption

Adopted, unmarried children are considered members of the family the same as biological children.

5. Grandchildren

Grandchildren may be included as part of their grandparents' membership if they meet all the following criteria:

  1. They live permanently with their grandparents (their residence), and
  2. The grandparents have legal custody, or the grandchild is the child of a minor, and
  3. They meet the eligibility Guidelines for children, and
  4. They have no other agency, person, or group responsible for their medical bills.

6. Guardianships

Guardian memberships are allowed. The guardian must be 18 years old or older to manage the membership on behalf of a minor.

B. Inactivation of Membership

i) Voluntary Inactivation

Members can voluntarily inactivate their membership in good standing at any time which shall take effect at the end of any month.

ii) Involuntary Inactivation

A REDEEM HealthShare membership will be inactivated if:

  • The member fails to fully fund their share wallet for 60 days.
  • The member fails to resolve Know Your Customer (KYC) issues within 60 days of Notice of Failure.

Notice Periods

  • 30 Days' Notice: After 30 days of non-compliance, members will receive a notice informing them of their ineligibility for sharing until the issue is resolved. Membership will be suspended at this point which means that members are not able to eligible to have their bills shared.
  • 45 Days' Notice: After 45 days of non-compliance, members may receive a second notice.
  • 60 Days' Notice: After 60 days of non-compliance, the membership will be inactivated, effective from the date the member should have funded the share wallet or completed the click-to-share requirement.

C. Restart of Membership

If an existing membership is inactivated due to voluntary or involuntary inactivation, a member may apply for a new membership. All membership requirements, waiting periods, and conditions will apply as if the member had no previous membership and include the following requirements:

  • Memberships that have been inactivated involuntarily must have all back-shares paid in full before a new membership can be started.
  • Only eligible bills with Dates of Service (DoS) prior to the inactivation date will be shared.
  • Bills for conditions incurred or discovered after inactivation will be considered pre-existing and will not be shared in the new membership.

D. Changing Programs

There are specific criteria that must be met to change between programs or change AUA levels.

Qualifying Life Event Changes. Members are allowed to change their AUA level or program within 30 days of the following circumstances, with the effective date being the first day of the following month:

  • Membership anniversary
  • Change in marital status
  • Change in child/dependents
  • Birth/Adoption
  • Loss of spouse
  • Loss of employment
  • Dependent turns 26

Switching Fee and Resetting AUA

  • Switching Fee. Changing your program or AUA level requires a switching fee of $100. You can choose the first day of any future month for your switch to occur and the $100 switching fee will be applied within one to two months after the switch is effective.
  • Resetting AUA. Changing your program or AUA level will reset the AUA for the year.
  • Adding or Removing Members Eligibility. You can add or remove members from your membership at any time.
  • Share Amount Adjustment. If the addition or removal of a member impacts your share amount, the change will be reflected in your next Share Notice.

Switching Between Programs and AUAs

When switching from REDEEM Essential to REDEEM Enhanced OR when switching from a higher AUA to a lower AUA, the 12-month waiting period for the conditions and treatments listed in Sharing Limits (Section III.C.) resets.

E. Member Privacy

Members may share deeply personal prayer requests and detailed health information with one another to allow for support, fellowship, and prayer. While it is expected this information may be shared with family and prayer partners, be sensitive; do not post names or details on social media, blogs, or websites without permission, or in any other way misuse the information.

F. Guidelines Govern

These Sharing Guidelines explain the program requirements and govern the sharing of medical bills. The Guidelines in effect at the time of service govern the program, not the Guidelines in effect when a member joins REDEEM HealthShare or changes to the Guidelines that occurred after the time of service. The Guidelines are available online at redeemhealthshare.org/guidelines and in your Member Center.

G. Changes to the Guidelines

Changes to the Guidelines can be made at any time by REDEEM HealthShare as approved by the Samaritan Ministries Board of Directors. Members will be notified of the changes, and a history of changes will be available in the Member Center online for two years from the date of the change.

H. Balancing Needs and Shares/Proration

In any particular month, the funding of Shares across REDEEM HealthShare Ministry may or may not meet the eligible bills submitted for sharing. In that event, a pro-rata sharing of eligible medical bills may be initiated whereby REDEEM HealthShare shares a percentage of eligible bills within that month and holds back the balance of those bills to be shared in a subsequent month. If the funding of Shares is not adequate to meet the eligible bills submitted for sharing over a 60-day period, then the suggested monthly share amount may be increased in sufficient proportion to satisfy the eligible bills. This action may be taken temporarily or on an ongoing basis. If an eligible bill is not funded by member sharing in that bill within 90 days of entering the normal sharing queue, then that bill is removed from the normal sharing queue and will be handled through the Member Assistance Fund, if possible. Any money currently in the bill account will be sent to the provider as a partial payment.

The balancing of expenses and shares calculations may be done by sharing across two or more Samaritan Ministries programs or by keeping them separate, as allowed by the Samaritan Ministries Board of Directors.

I. Other Responsible Parties

If a member has insurance or is eligible/qualified for any insurance benefits or other health or welfare benefits, such as an employment related health or welfare plan, worker's compensation insurance, homeowner's insurance, or fraternal benefits, the member is expected to take all reasonable steps to qualify for such payments and to exhaust benefits available under those resources before submitting a request for sharing. Additionally, any time another individual or entity is or may be responsible for some or all of a medical bill intended to be submitted to REDEEM HealthShare to be shared, whether through litigation, insurance, or otherwise, the member must take all steps necessary to make sure such other individuals or entities pay the amounts applicable to their respective responsibilities before submitting the bill for sharing. Should any member receive a settlement or reimbursement applicable to medical bills already shared, the member must send those funds back to REDEEM HealthShare or to another member in need as directed. Seeking assistance from government aid programs is never required and is contrary to our understanding of God's desire for His people. REDEEM SeniorSaver requires participation in Medicare Part A and Part B.

Funds raised by crowdfunding for shareable medical expenses must be reported and will be applied to reduce the shareable amount.

A member who has the right to a reimbursement from an HRA, FSA, or HSA for a shareable medical expense is not required to pay the bill with those funds, although he should consider whether this resource should be used to lessen the burden that the community will bear. If HRA, FSA, or HSA money is used to pay the expense, then that bill may still be submitted to be shared. Please note: there may be income tax consequences from using reimbursements from an HRA, FSA or HSA to pay for an expense for which you also received share amounts. Please consult your tax advisor.

If a member simultaneously participates in another health care sharing ministry, he may not seek shares/payments from multiple ministries in excess of his shareable bills, for to do so is to obtain assistance beyond his burden.

J. Sharing Appeal

A member can appeal bill-sharing eligibility decisions with which they disagree if he or she believes:

  1. the medical records were misread, or
  2. the Guidelines were misapplied, or
  3. one or more of the member's providers incorrectly recorded their medical history.

After a review by REDEEM HealthShare, if the member still disagrees with the decision, the member has 90 days to request a review by a member Appeal Panel composed of seven to thirteen members. As part of this process, the member may submit a written position statement to the Panel. A teleconference will be held wherein the Panel can ask questions of both the member and REDEEM HealthShare. A simple majority vote will carry the decision to share or not, and the Panel's decision will be binding and non-appealable.

Membership requirement issues related to your payment of shares or your integrity (with respect to the submission and payment of medical bills) may be appealed to the Institute for Christian Conciliation as explained below. All other questions regarding whether you meet membership requirements may be appealed to the Samaritan Ministries Board of Directors who make the final, non-appealable decision.

Any other issue shall be settled in accordance with the Rules of Procedure for Christian Conciliation™ of the Institute for Christian Conciliation. (Complete text of the Rules is available at ICCpeace.com or by contacting ICC Peace at info@iccpeace.com.) However, if both REDEEM HealthShare Ministry and you agree, the dispute may be submitted to a randomly selected panel of members instead. In all events, you will have available the same relief as a court could grant. REDEEM HealthShare will pay all the arbitrator's fees and costs unless the arbitration determines there was no reasonable basis for your complaint, in which case you will be responsible for the fees and costs.

You understand that these methods shall be the sole remedy for any civil controversy or claim arising out of your relationship with REDEEM HealthShare and expressly waive your right to file a lawsuit in any civil court against REDEEM HealthShare Ministry, its employees, members, associate members, and directors, for such disputes, except to enforce an arbitration decision obtained under conditions specified herein. This also includes any determinations as to whether the matter in dispute comes within this arbitration agreement or can be required to be arbitrated. If an arbitration decision has been made and anyone is failing to follow that decision, the decision may be entered only in the Circuit Court of Peoria County, Illinois, or any jurisdiction where the member resides.

Resolving disputes within the Body of Christ is always the command of Scripture and in the interest of all our members (MATT 18:15-20; 1 COR 6). Therefore, even if REDEEM HealthShare or a member participates to some extent in a court proceeding regarding a matter in dispute, this participation will not be forfeiting the ability to later demand that the dispute be resolved by these arbitration procedures.

For all civil matters of procedure and substance regarding any dispute or claim that comes within these mediation/arbitration requirements, the laws of the State of Texas, and if applicable of the United States, shall govern.

K. Misuse of Trust and Accountability

Members commit to act with integrity. Members presenting a falsified need, using deceptive practices, or participating in another member's misuse of trust will be dropped from membership.

Members submitting bills further commit to working with REDEEM HealthShare staff and designated third-parties to determine if the bills are shareable, to seek fair and reasonable prices from providers, and to document amounts paid to providers.

When an issue of misuse of trust by a member arises (whether inactive or currently a member), the administrative office may seek the assistance of the member's Christian church and provide it with the necessary information to address the issue and hold the member accountable. The member may request resolution of the question through the mediation and arbitration provisions of the Guidelines.

L. Sponsorship

There may be circumstances where applicants or current members may not be able to pay the entire Share amount. In certain cases, we may be able to offer temporary reductions in the Share amount to assist a member experiencing financial difficulty. Because we are committed to the central role of the family and the local Christian church in all of life, including health care, application for help through Sponsorship will require that these other avenues of assistance be explored first, so they have the first opportunity to receive the blessing of giving. For more information about how to apply for Sponsorship, please contact us.

V. REDEEM Sharing Platform

To make health care sharing convenient and efficient, we utilize a technology platform called a Virtual Share Exchange (VSE). The VSE enables all members to participate in the health care sharing process electronically, as well as to monitor the transactional activities of their individual share accounts and the community at large. Your membership requires that you activate your own Share Account and enable the Virtual Share Exchange to administer the sharing process on your behalf. By activating your Share Account and accepting the Virtual Share Exchange “Terms and Conditions” and Disclosures, you have given REDEEM HealthShare, and its Service Agents express permission to conduct financial transactions necessary for the administration of the program on your behalf.

A. Share Account

To participate in the REDEEM community, all members must activate a Share Account on the Virtual Share Exchange platform. Your Share Account is a virtual account, and all deposited funds are received by America's Christian Credit Union located in Glendora, CA which holds them “For the Benefit of REDEEM Members.” The Share Account will display your account balances, sharing transaction history, and other relevant information. The money in your Share Account is insured and is fully controlled by you except as described herein.

To activate your Share Account, you will be required to provide the necessary personal information to comply with U.S. Banking Regulations (e.g., “Know Your Customer” KYC). Once your information is submitted and verified, you will be required to link your Share Account to one of your personal external bank accounts (e.g., a financial institution such as Bank of America, Wells Fargo, Chase Bank, or the like). Each month, you will fund your Share Account with an EFT (electronic funds transfer) from your external bank accounts.

B. Monthly Share Notice

REDEEM members will receive a Monthly Share Notice through the VSE to inform them and remind them of the monthly amount that they are to contribute. The monthly amount that you are to contribute (your Total Share Amount Due) is based on the program level that you have selected.

The amount specified in your Monthly Share Notice is transferred through an EFT drawn off your external bank account or a credit card. EFTs are always for the “Total Share Amount Due.” The Total Share Amount Due is displayed on every Monthly Share Notice, and it will include the current monthly share amount, any past due amounts, and any relevant service fees.

Your monthly contribution, the Total Share Amount Due, must be paid manually within the VSE. You will be notified each month when it is time to make your payment.

In addition to their monthly share, members can make additional voluntary contributions, such as donations to the Member Assistance Fund. These contributions can be made by the member in the Member Center and can be added, edited, or deleted at any time. Members will also be able to change their funding source, whether external bank account or credit card, at any time.

C. Account Management

Your Share Account is a financial account that you own and control. You will have the ability to add, edit, and delete your EFT settings, as well as your linked external bank account or credit card, at any time.

D. Publishing & Sharing

Participation in the REDEEM community is voluntary. This means that when you are selected to participate in a sharing event if you object to that sharing event for any reason, you may withdraw and terminate your membership during the three-day publishing period (described below) rather than participate.

Medical Bills that are eligible for sharing are matched, allocated, and published to the membership prior to sharing. To cooperate with state requirements and statutes, REDEEM HealthShare implements a member-to-member approach to sharing, which means that members share funds directly with one another, rather than drawing funds from a pool controlled by REDEEM HealthShare.

Your medical bills will primarily be submitted by your medical providers or bills may be uploaded by you. All bills will be processed for eligibility per the Guidelines. Eligible bills are then submitted into the Virtual Share Exchange for sharing. Amounts approved for Sharing are allocated to your fellow members who have been matched to contribute to your bill.

Members who have been matched to share your bill will be notified through a process called Publishing as to the amount that will be withdrawn from their Share Account for the funding of your bill. They will also be notified as to who will be receiving their funds unless you choose the anonymous setting in your Share Account's sharing permissions. Once the three-day publishing period has ended, the amount published to each member is transferred to a Virtual Bill Account for the payment of your bill.

Members who have been matched and allocated to share in another member's medical bill may withdraw from the membership prior to the expiration of the three-day publishing period, in which case no funds will be transferred to the receiving member.

Because a member may refuse to share in a particular medical expense for any reason or no reason, the sharing process remains entirely voluntary for every member. However, as noted above, any sharing refusal requires withdrawal from membership before the end of the three-day publishing period.

E. Virtual Bill Accounts

If you have an eligible medical bill that has been approved for sharing, the VSE will create a Virtual Bill Account for the payment of that bill. Virtual Bill Accounts are unique to a specific medical bill and are linked to your Share Account. Each Virtual Bill Account is unique to a member of your household, a medical provider, and a specific bill. Amounts collected in your Virtual Bill Account(s) are restricted and are displayed as a single line-item transaction in your Share Account.

F. Provider Payments

Virtual Bill Accounts remain open until the amount approved for sharing has been fully collected and transferred to your medical provider as payment for your bill or to you as reimbursement. While Virtual Bill Accounts are aggregated in the transactional view of your Share Account, these funds are restricted and cannot be withdrawn from your Share Account. The transfer of funds out of your Virtual Bill Account will be displayed as a single line-item transaction in your Share Account.

G. Member Sharing Wallet

In order to process and pay medical bills quickly, REDEEM HealthShare implements a practice called Sharing Wallets. REDEEM HealthShare Ministry is NOT insurance, so we do not collect and hold medical reserves in a centralized bank account. Instead, the monthly share amount is set at a level to build a small balance in every member's individual Share Account. These Sharing Wallets allow us to plan for the ebb and flow of medical usage and payments.

VI. Glossary of Terms

Adjusted Amount — The discounted or repriced amount of a medical bill.

Administrator — The third-party company utilized by REDEEM HealthShare to process members' medical bills for discounting and eligibility determinations.

Amount Approved for Sharing — The portion of the adjusted amount that is eligible for sharing as per the program Guidelines.

Annual Unshareable Amount (AUA) — In a sharing ministry, each member is always responsible for all of their own medical expenses. The AUA is the dollar amount of eligible medical bills selected by a membership that are not shareable during a 12-month period in addition to any Co-Shares and prorations. The AUA 12-month period begins on the effective date for the membership and resets annually on the membership anniversary date.

Available Balance — The total sum that is available in a member's Share Account for sharing a new eligible medical bill and/or withdrawal. It is the Total Balance minus the Pending Balance minus the Restricted Balance.

Bill Approved for Sharing — An eligible medical bill that meets the criteria for sharing in the Guidelines and meets the other conditions for sharing, including whether the member's AUA has been met, and other sharing limits have not been exceeded.

Bill Status — References the processing stage/state of a specific medical need or bill.

Cancellation Date — The last day of the month that a membership of an individual or household ends due to the member's withdrawal or an administrative inactivation.

Charge Amount — The gross amount billed by the medical provider.

Sending— A function that enables a primary member to initiate an “on-demand” EFT from an external bank account or credit card to transfer the Total Share Amount Due specified in their Monthly Share Notice to the Membership's Share Account.

Debits & Sharing — The “Negative (-)” transactions debited out of the member's Share Account, which would be Miscellaneous Required Portion (i.e., debits), Optional Portion, and Share Portion.

Deposits & Credits — The “Positive (+)” transactions that are credited to the member's Share Account, such as EFT transfers (i.e., deposits) and Shared Funds Received (i.e., credits) that a member might receive to pay their eligible medical bill.

Effective Date — The first day of the month that the membership's current membership year begins. This date may be different from the membership date if a member has switched some elements of their membership.

Eligible for Sharing — Any testing, treatment, procedure, or service that meets the criteria for sharing as established in the Guidelines, including AUA and Co-Share requirements.

Eligible Medical Bill — An incurred medical bill that meets the criteria for sharing as established in the Guidelines. The shareable amount of an eligible medical bill may be reduced by discounts, fees, or other sources of payment.

Explanation of Sharing (EOS) — A notice sent to a member detailing the eligibility status of a bill, any discounted amounts, what portion of the remaining charge amount has been shared by REDEEM members, and any remaining amount that were not shared and remains to be paid by the member.

External Account — An existing bank account that is linked to the primary member's Share Account and is used to transfer via EFT the Total Share Amount Due into the Share Account each month.

Illegal Drugs — Any controlled substance which has not been legally prescribed and/or dispensed, or a prescription drug which is not used in the way it was prescribed.

Know Your Customer (KYC) — An automated query to ensure that an individual is eligible to open an account at a financial institution. This is a process required by US banking regulations.

Member — Any member of REDEEM HealthShare Ministry, including each family member participating in a member household.

Membership — The related family member, residing in a household, participating in REDEEM HealthShare Ministry through the same membership. May also be referred to as a “household membership.”

Membership Date — The date a member's participation in REDEEM HealthShare Ministry begins. Medical bills incurred on or after this date may be considered for sharing among members.

Membership Anniversary Date — The anniversary date of a member's participation in REDEEM HealthShare.

Monthly Share Amount — The sum of the Share Portion and Required Miscellaneous Portions published in the Share Notice.

Past Due Date — The day of the month that a Total Share Amount Due becomes past due.

Past Due Reminders — Notifications sent to delinquent members, reminding them that their Share Notice is past due.

Payment Reminders — Share Notice Reminders sent to members the Total Share Amount has not yet been paid.

Pending Balance — The sum of EFT(s) that have been initiated but have not yet been posted to the member's Share Account.

Permissions — System related auto-enabled functions (e.g., auto-share) that are set and managed by the primary member.

Pre-Existing — Pre-existing medical conditions are defined as conditions in which known signs, symptoms, testing, treatment, diagnosis, or use of medication occurred within 36 months prior to the membership start date. Routine or maintenance medications are considered treatment and are included in this definition.

Previous Balance — The sum of any past due, unpaid amounts published in the Share Notice.

Primary Member — An adult member that is the main contact for the household membership and Share Account owner.

Published Amount — The portion of the adjusted amount that is eligible for sharing and has been published/allocated to the member for sharing.

Received Date — The date that REDEEM HealthShare receives the medical bill and begins processing the bill for eligibility.

Required Miscellaneous Portion — An amount set by REDEEM HealthShare to fund certain activities, such as its administrative and program expenses.

Restricted Balance — The sum of funds that have been credited to the member's Share Account for the purpose of paying eligible medical bills. These funds have been designated for paying a particular medical bill; they are considered “restricted” because they cannot be diverted by the member and used for another purpose.

Service Date — The date that the member (patient) received services from the medical provider.

Share Account — The member-controlled virtual account that is linked to both the member's external account and the member's Sharing Account at America's Christian Credit Union and is used for all sharing transactions and activities.

Share Due Date — The day of the month by which the Total Share Amount Due must be transferred via EFT in full.

Share Notice — The written notification to a member that details the Total Share Amount Due for the month.

Share Notice Date — The day of the month that the Share Notice is published and distributed.

Share Payment (funding) — Transferring funds (Total Share Amount due) from a member's external account to their Share Account via electronic funds transfer (EFT).

Share Portion — The portion of the monthly share amount that is collected and used specifically for member-to-member sharing of eligible medical bills.

Shared Amount — The published amount that has been shared and collected in the member's Sharing Account.

Sharing (member-to-member transfers) — Moving funds from a sending member's Share Account to a receiving member's Virtual Bill Account.

Total Balance — The sum of the Pending Balance, Restricted Balance, and Available Balance in a member's Share Account.

Total Share Amount Due — The sum of the Monthly Share Contribution Amount (Share Portion and Required Miscellaneous Portion), any Optional Portions (manually configured by the member), Service Fee, and any past due amount (Previous Balance).

VII. Appendix

A. Governance

REDEEM HealthShare Ministry is governed by the Samaritan Ministries Board of Directors, all of whom are members of the ministry's health care sharing programs. Six members of the Board of Directors are elected by the membership. Samaritan Ministries founder, Ted Pittenger, is a permanent Board Member and appoints two unelected Board Members, for a total of nine members. Each Board Member's term is for three years. None of the elected Board Members have a financial or employment interest in REDEEM HealthShare or Samaritan Ministries. No Board Members receive financial compensation for their service, except for reimbursement of expenses incurred attending the meetings. The Board has three regularly scheduled meetings each year and additional special meetings as needed.

Members nominate candidates and vote by digital methods. Elections are announced to the membership and held each fall. The qualifications for Board Members are available upon request.

If the elected positions are contested, the two candidates receiving the most votes are elected. A candidate only receiving a plurality will be the winner unless the Board determines that a runoff should occur between the highest candidates. If there is only one candidate for each position, members will be provided with a “Yes/No” ballot, and each candidate must receive a simple majority of the votes cast to be elected.

To be eligible for Board membership, nominees must agree with the Bylaws doctrinal statements, including the following Board Member Statement of Faith:

  • I believe the Bible alone is the inspired Word of God; therefore, it is the final and only source of absolute spiritual authority.
  • I believe in the triune God of the Bible. He is one God Who is revealed in three distinct Persons—God the Father, God the Son, and God the Holy Spirit.
  • I believe Jesus Christ was God in the flesh and continues to be such even after His resurrection—fully God and fully man. He was born of a virgin, lived a sinless life, died on the cross to pay the penalty for our sins, was bodily resurrected on the third day, and now is seated in the heavens at the right hand of God the Father.
  • I believe that all people are born with a sinful nature and can be saved from eternal death only by grace alone, through faith alone, trusting only in Christ's atoning death and resurrection to save us from our sins and give us eternal life.
  • I believe in the bodily resurrection of all who have put their faith in Jesus Christ, and the bodily resurrection to judgment of all who have not.
  • All I believe and do should be for the glory of God alone.

B. Additional Giving

Although we practice good stewardship by adhering to our Guidelines and limiting bills, we share to what members have agreed upon. We also strongly encourage giving above and beyond what is required. Because Samaritan Ministries, which operates REDEEM HealthShare Ministry, is an IRS recognized 501(c)(3) tax-exempt organization, charitable gifts can be tax-deductible when designated to a special fund. Please contact Member Care for more information.

C. Example Shareable Expenses for FlexShare

  1. Pre-existing conditions
  2. Bills for eligible treatments that have exceeded their specific shareable amount (e.g., therapies)
  3. Routine and preventative care
  4. Dental
  5. Immunizations
  6. Bills related to sleep apnea
  7. Vision
  8. Audiological
  9. OTC medications, vitamins, supplements
  10. Essential oils
  11. Direct Primary Care Fees
  12. Mental health counseling or therapy
  13. Durable medical equipment
  14. Prosthetics
  15. Home health
  16. Weight reduction
  17. Gym membership
  18. Gym equipment
  19. Alternative/holistic/naturopathic treatments such as:
    1. Acupuncture/Acupressure
    2. Disc decompression
    3. Dry needling
    4. Hyperbaric treatments
    5. Massage therapy
    6. Ozone injections
    7. Platelet-rich plasma
    8. Prolotherapy
    9. Softwave therapy

D. State Disclosures

Alabama Code Title 22-6A-2 Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. Participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive a payment for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Alaska Statute 21.03.021(k) Notice: The organization coordinating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be voluntary because no other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payment for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Arizona Statute 20-122 Notice: The organization facilitating the sharing of medical expenses is not an insurance company and the ministry's guidelines and plan of operation are not an insurance policy. Whether anyone chooses to assist you with your medical bills will be completely voluntary because participants are not compelled by law to contribute toward your medical bills. Therefore, participation in the ministry or a subscription to any of its documents should not be considered to be insurance. Regardless of whether you receive any payment for medical expenses or whether this ministry continues to operate, you are always personally responsible for the payment of your own medical bills.

Arkansas Code 23-60-104.2 Notice: The organization facilitating the sharing of medical expenses is not an insurance company and neither its guidelines nor plan of operation is an insurance policy. If anyone chooses to assist you with your medical bills, it will be totally voluntary because participants are not compelled by law to contribute toward your medical bills. Participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive a payment for medical expenses or if this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Florida Statute 624.1265 Samaritan Ministries International is not an insurance company, and membership is not offered through an insurance company. Samaritan Ministries International is not subject to the regulatory requirements or consumer protections of the Florida Insurance Code.

Georgia Statute 33-1-20 Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payment for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Idaho Statute 41-121 Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payment for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Illinois Statute 215-5/4-Class 1-b Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation constitute or create an insurance policy. Any assistance you receive with your medical bills will be totally voluntary. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Whether or not you receive any payments for medical expenses and whether or not this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Indiana Code 27-1-2.1 Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor its plan of operation is an insurance policy. Any assistance you receive with your medical bills will be totally voluntary. Neither the organization nor any other participant can be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Whether or not you receive any payments for medical expenses and whether or not this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Kentucky Revised Statute 304.1-120 (7) Notice: Under Kentucky law, the religious organization facilitating the sharing of medical expenses is not an insurance company, and its guidelines, plan of operation, or any other document of the religious organization do not constitute or create an insurance policy. Participation in the religious organization or a subscription to any of its documents shall not be considered insurance. Any assistance you receive with your medical bills will be totally voluntary. Neither the organization nor any participant shall be compelled by law to contribute toward your medical bills. Whether or not you receive any payments for medical expenses, and whether or not this organization continues to operate, you shall be personally responsible for the payment of your medical bills.

Louisiana Revised Statute Title 22-318,319 Notice: The ministry facilitating the sharing of medical expenses is not an insurance company. Neither the guidelines nor the plan of operation of the ministry constitutes an insurance policy. Financial assistance for the payment of medical expenses is strictly voluntary. Participation in the ministry or a subscription to any publication issued by the ministry shall not be considered as enrollment in any health insurance plan or as a waiver of your responsibility to pay your medical expenses.

Maine Revised Statute Title 24-A, §704, sub-§3 Notice: The organization facilitating the sharing of medical expenses is not an insurance company and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. Participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive payment for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Maryland Article 48, Section 1-202(4) Notice This publication is not issued by an insurance company nor is it offered through an insurance company. It does not guarantee or promise that your medical bills will be published or assigned to others for payment. No other subscriber will be compelled to contribute toward the cost of your medical bills. Therefore, this publication should never be considered a substitute for an insurance policy. This activity is not regulated by the State Insurance Administration, and your liabilities are not covered by the Life and Health Guaranty Fund. Whether or not you receive any payments for medical expenses and whether or not this entity continues to operate, you are always liable for any unpaid bills.

Massachusetts The organization coordinating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills.

Michigan Section 550.1867 Notice: Samaritan Ministries International that operates this health care sharing ministry is not an insurance company and the financial assistance provided through the ministry is not insurance and is not provided through an insurance company. Whether any participant in the ministry chooses to assist another participant who has financial or medical needs is totally voluntary. A participant will not be compelled by law to contribute toward the financial or medical needs of another participant. This document is not a contract of insurance or a promise to pay for the financial or medical needs of a participant by the ministry. A participant who receives assistance from the ministry for his or her financial or medical needs remains personally responsible for the payment of all of his or her medical bills and other obligations incurred in meeting his or her financial or medical needs.

Mississippi Title 83-77-1 Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payment of medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Missouri Section 376.1750 Notice: This publication is not an insurance company nor is it offered through an insurance company. Whether anyone chooses to assist you with your medical bills will be totally voluntary, as no other subscriber or member will be compelled to contribute toward your medical bills. As such, this publication should never be considered to be insurance. Whether you receive any payments for medical expenses and whether or not this publication continues to operate, you are always personally responsible for the payment of your own medical bills.

Montana Revised Statute Chapter Sections 33-1-102 and 33-1-201 Notice The health care sharing ministry facilitating the sharing of medical expenses is not an insurance company and does not use insurance agents or pay commissions to insurance agents. The health care sharing ministry's guidelines and plan of operation are not an insurance policy. Without health care insurance, there is no guarantee that you, a fellow member, or any other person who is a party to the health care sharing ministry agreement will be protected in the event of illness or emergency. Regardless of whether you receive any payment for medical expenses or whether the health care sharing ministry terminates, withdraws from the faith-based agreement, or continues to operate, you are always personally responsible for the payment of your own medical bills. If your participation in the health care sharing ministry ends, state law may subject you to a waiting period before you are able to apply for health insurance coverage.

Nebraska Revised Statute Chapter 44-311 IMPORTANT NOTICE. This organization is not an insurance company, and its product should never be considered insurance. If you join this organization instead of purchasing health insurance, you will be considered uninsured. By the terms of this agreement, whether anyone chooses to assist you with your medical bills as a participant of this organization will be totally voluntary, and neither the organization nor any participant can be compelled by law to contribute toward your medical bills. Regardless of whether you receive payment for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills. This organization is not regulated by the Nebraska Department of Insurance. You should review this organization's guidelines carefully to be sure you understand any limitations that may affect your personal medical and financial needs.

New Hampshire Section 126-V:1 IMPORTANT NOTICE: This organization is not an insurance company, and its product should never be considered insurance. If you join this organization instead of purchasing health insurance, you will be considered uninsured. By the terms of this agreement, whether anyone chooses to assist you with your medical bills as a participant of this organization will be totally voluntary, and neither the organization nor any participant can be compelled by law to contribute toward your medical bills. Regardless of whether you receive payment for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills. This organization is not regulated by the New Hampshire Insurance Department. You should review this organization's guidelines carefully to be sure you understand any limitations that may affect your personal medical and financial needs.

North Carolina Statute 58-49-12 Notice: The organization facilitating the sharing of medical expenses is not an insurance company and neither its guidelines nor its plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be voluntary. No other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payment for medical expenses or whether this organization continues to operate, you are always personally liable for the payment of your own medical bills.

Pennsylvania 40 Penn. Statute Section 23(b) Notice: This publication is not an insurance company nor is it offered through an insurance company. This publication does not guarantee or promise that your medical bills will be published or assigned to others for payment. Whether anyone chooses to pay your medical bills will be totally voluntary. As such, this publication should never be considered a substitute for insurance. Whether you receive any payments for medical expenses and whether or not this publication continues to operate, you are always liable for any unpaid bills.

South Dakota Statute Title 58-1-3.3 Notice The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payments for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Tennessee Code Annotated, Section 48-51-201 Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payments for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills.

Texas Code Title 8, K, 1681.001 Notice: This health care sharing ministry facilitates the sharing of medical expenses and is not an insurance company, and neither its guidelines nor its plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. As such, participation in the ministry or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payment for medical expenses or whether this ministry continues to operate, you are always personally responsible for the payment of your own medical bills. Complaints concerning this health care sharing ministry may be reported to the office of the Texas attorney general.

Utah Section 31 A-1-103 (3) (l) (A) the health care sharing ministry is not an insurance company;
(B) nothing the health care sharing ministry offers or provides is an insurance policy, including the health care sharing ministry's guidelines or plan of operations;
(C) participation in the health care sharing ministry is entirely voluntary and no participant is compelled by law to contribute to another participant's expenses;
(D) participation in the health care sharing ministry or subscription to any of the health care sharing ministry's services is not insurance; and
(E) each participant is always personally responsible for the participant's expenses regardless of whether the participant receives payment for the expenses through the health care sharing ministry or whether this health care sharing ministry continues to operate

Virginia Code 38.2-6300-6301 Notice: This publication is not insurance and is not offered through an insurance company. Whether anyone chooses to assist you with your medical bills will be totally voluntary, as no other member will be compelled by law to contribute toward your medical bills. As such, this publication should never be considered to be insurance. Whether you receive any payments for medical expenses and whether or not this publication continues to operate, you are always personally responsible for the payment of your own medical bills.

West Virginia Statute §35-1B-1-6 Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payments for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills. Complaints concerning this health care sharing ministry may be reported to the Attorney General of your state.

Wisconsin Statute 600.01 (1) (b) (9) ATTENTION: This publication is not issued by an insurance company, nor is it offered through an insurance company. This publication does not guarantee or promise that your medical bills will be published or assigned to others for payment. Whether anyone chooses to pay your medical bills is entirely voluntary. This publication should never be considered a substitute for an insurance policy. Whether or not you receive any payments for medical expenses, and whether or not this publication continues to operate, you are responsible for the payment of your own medical bills.

Wyoming 26.1.104 (a)(v)(C) Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Any assistance with your medical bills is completely voluntary. No other participant is compelled by law or otherwise to contribute toward your medical bills. Participation in the organization or a subscription to any of its documents shall not be considered to be health insurance and is not subject to the regulatory requirements or consumer protections of the Wyoming insurance code. You are personally responsible for payment of your medical bills regardless of any financial sharing you may receive from the organization for medical expenses. You are also responsible for payment of your medical bills if the organization ceases to exist or ceases to facilitate the sharing of medical expenses.

E. Summary of Sharing

This is a summary of the Sharing Guidelines that define REDEEM HealthShare programs. REDEEM HealthShare is not insurance, it's a not-for-profit health care sharing ministry that facilitates direct member-to-member sharing of eligible medical expenses. Health care sharing is a voluntary arrangement that unites individuals and families through acts of mutual support and love, reflecting the early Christian church's commitment to caring for one another (Acts 2:44-45). Guided by our shared faith and Biblical principles, we come together to bear each other's burdens and demonstrate the love of Christ in practical ways.

Common Questions REDEEM EssentialRelialbe and affordable REDEEM EnhancedOur most comprehensive program REDEEM SeniorSaverFor those 65+ as a supplement to Medicare Parts A and B FlexShareAn optional add-on program to extend medical, dental, vision, and wellness options Notes
How much is the Annual Unshareable Amount (AUA)? Levels:
$3,500
$7,000
$10,500
$14,000		 Levels:
$2,000
$4,000
$6,000
$8,000		 $500 $0 Generally, you must pay all the costs from providers up to the Annual Unshareable Amount (AUA) before you may submit bills for sharing. Some exceptions may apply in certain programs.
Are there Co-Share amounts? Yes. Once the AUA has been met, 80% of eligible medical bills are shareable. The remaining 20% (the Co-Share amount) will be paid by the household membership up to the annual Co-Share limit of $5,000. No. No. No.  
Are there bills that may be shared before you meet your AUA? No. Yes. Routine and wellness visits, child immunizations and preventative screenings may be shared before meeting the AUA. No. No.  
May I choose any doctor or provider I desire? Yes. Yes. Yes. Yes. Services or treatment must be ordered by a qualified, licensed medical professional with the following designations: Medical Doctor (M.D.), Doctor of Osteopathy (D.O.), Naturopathic Doctor (N.D.), Nurse Practitioner (N.P. or A.P.R.N.), Physician’s Assistant (P.A.), Doctor of Podiatric Medicine (D.P.M.), Dentist (D.D.S. or D.M.D.), Midwife (if certified), Ophthalmologist, Chiropractor
Are there annual limits or caps? $1 Million $2 Million No. REDEEM Essential: $1,000
REDEEM Enhanced: $1,500
REDEEM SeniorSaver: $1,000		  
Are there lifetime limits or caps? No. No. No. No.  
How do I submit bills? Bills are submitted primarily by the provider using the REDEEM EDI Member Card. If necessary, bills may be uploaded by the member using the online bill submission forms in the online Member Center. Bills are submitted primarily by the provider using the REDEEM EDI Member Card. If necessary, bills may be uploaded by the member using the online bill submission forms in the online Member Center. Bills are submitted primarily by the provider using the REDEEM EDI Member Card. If necessary, bills may be uploaded by the member using the online bill submission forms in the online Member Center. Bills are submitted by the member using the online Member Center.  

Common Medical Events and Conditions

Service you may need Shareable? Limits, Exclusions, Exceptions, and other Important Information
If you need immediate medical attention
Telemedicine REDEEM HealthShare includes Telehealth services at no additional charge through our Member Center day one. No Telehealth bills from other providers are shareable.
Urgent Care (in-person) Subject to AUA/Co-Share  
Emergency Room Care Subject to AUA/Co-Share  
Emergency Medical Transportation Subject to AUA/Co-Share Shareable if medically necessary in emergencies.
If you visit a Provider's Office
Primary care visit to treat an injury or illness Subject to AUA/Co-Share  
Specialist visit Subject to AUA/Co-Share  
Preventative care/screening /immunization REDEEM Essential: Not shareable
REDEEM Enhanced: Shareable, not subject to AUA, $300 annual per member cap.		  
If you need to have a test
Diagnostic test (blood, lipids, hemoglobin, or other fluid) Subject to AUA/Co-Share REDEEM HealthShare provides significant discounted access—up to 69% savings —to nationwide testing facilities such as Quest, LabCorp, and other regional lab networks by presenting the Member Card at time of service.
Diagnostic imaging test (x-ray, MRI, CT/PET scans or imaging) Subject to AUA/Co-Share  
If you need Prescription Drugs
Inpatient Subject to AUA/Co-Share  
Outpatient REDEEM Essential: Not shareable
REDEEM Enhanced: Shareable, not subject to AUA, annual household membership cap of $1,000		 REDEEM HealthShare provides significant prescription discounts through Drexi, our PBM.
Natural supplements REDEEM Essential: Not shareable
REDEEM Enhanced: Not shareable
FlexShare: Shareable subject to allowance		  
If you have Outpatient Surgery
Facility fees (e.g., ambulatory surgical center) Subject to AUA/Co-Share  
Physician/surgeon/provider professional fees Subject to AUA/Co-Share  
If you have a Hospital stay
Facility fees (e.g., hospital room) Subject to AUA/Co-Share  
Physician/surgeon/provider professional fees Subject to AUA/Co-Share  
If you are Pregnant
Prenatal office visits Subject to AUA/Co-Share; must have been member for 12 months prior to due date  
Childbirth/Delivery facility fees Subject to AUA/Co-Share; must have been member for 12 months prior to due date  
Childbirth/Delivery professional fees Subject to AUA/Co-Share; must have been member for 12 months prior to due date  
Post-partum care Subject to AUA/Co-Share; must have been member for 12 months prior to due date  
Well-baby visit REDEEM Essential: Not shareable
REDEEM Enhanced: Well-baby visits for the first three years are shareable if the membership has been part of REDEEM Enhanced for 12 months prior to the delivery date. Well-baby services are not subject to the AUA.		  
If you need sustained, repeated Therapeutic Care
Vision
Cardiac
Respiratory
Physical therapy
Occupational therapy
Speech therapy
Acupuncture/Acupressure
Disc decompression
Dry needling
Hyperbaric treatments
Prolotherapy
Softwave therapy
Platelet Rich Plasma/Stem Cells
Massage therapy
Chiropractic care		 Subject to AUA/Co-Share;
Maximum annual household membership share limit of $5,000.		 This category of therapies is typically delivered in-office and has its own maximum annual household membership share limit of $5,000.
Hormone therapy Subject to AUA/Co-Share;
Maximum annual household membership share limit of $5,000.		 Hormone therapies has its own maximum annual household membership share limit of $5,000.
Injection therapy Subject to AUA/Co-Share;
Maximum annual household membership share limit of $5,000.		 Injection therapies has its own maximum annual household membership share limit of $5,000.
If you need Help Recovering or have other Special Needs
Skilled Nursing/Rehab Subject to AUA/Co-Share; $10,000 per member per year cap.  
Hospice Subject to AUA/Co-Share; bills will be shareable for 90 days upon prescription by a physician. Additional 90-day periods may be authorized.  
If you need Routine or Wellness Care
Annual wellness REDEEM Essential: Not shareable
REDEEM Enhanced: Shareable; one visit per member per year; not subject to AUA, $300 per visit cap		  
Immunizations (children birth to age 6) REDEEM Essential: Not shareable
REDEEM Enhanced: Shareable; one visit per member per year; not subject to AUA, $300 per visit cap		  
If you need Preventative Screenings
Mammogram REDEEM Essential: Not shareable
REDEEM Enhanced: One (1) per year after age 45. Not subject to AUA. Not shareable in first six months of membership.		  
Prostate-Specific Antigen (PSA) test REDEEM Essential: Not shareable
REDEEM Enhanced: One (1) per year after age 45. Not subject to AUA. Not shareable in first six months of membership.		  
Colonoscopy REDEEM Essential: Not shareable
REDEEM Enhanced: One (1) per year after age 45. Not subject to AUA. Not shareable in first six months of membership.		  
Gynecological REDEEM Essential: Not shareable
REDEEM Enhanced: One (1) per year after age 45. Not subject to AUA. Not shareable in first six months of membership.		  

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