Sharing Guidelines

5. Conditions of Sharing

5.1. Family Members Defined

REDEEM HealthShare limits membership to members of the same nuclear family. Nuclear families include only husband, wife, and children, but may include grandchildren in the circumstances described in section 5.1.5 Grandchildren.

Children 18 and over must meet the membership requirements by signing an application form.

5.1.1. Spouse

Spouse means a legally married person. Marriage is defined as being between one biologically born man and one biologically born woman.

5.1.2. Adult Children (Age 18 and over)

  • Your single children from age 18 to 25 may be on your membership if they are living at home (which includes while away at school full-time).
  • A disabled child may remain on your membership after turning 26 if you provide more than 50% financial support and claim your child as a dependent on your federal tax return. You must apply for your child to remain on your membership. Contact Member Care before the date your child turns 26. Otherwise, REDEEM HealthShare will automatically remove the child from your membership at the end of the month in which he or she turns 26. If you apply after the child is removed from membership, the child’s membership will start on the Member Start Date assigned to the new application date.

5.1.3. Newborn

To add a newborn to your membership, at least one parent must be a member at the time of birth, and you must submit the application titled, To Add-on Family Members. Adding a newborn might increase your monthly share amount.

If you apply:

  • Within 30 days of birth, Member Care will add your child to your membership retroactively to the birth date.
  • After 30 days of birth, your child’s membership will start on the date of application.

See section 3.10.1 Maternity and Newborns for details on sharing Needs for your newborn.

5.1.4. Adoption

REDEEM HealthShare considers your adopted children the same as biological children. See section 3.8 Pre-existing Conditions and section 3.8.1 Adoption for additional details on sharing Needs for Adoption.

5.1.5. Grandchildren

You may include your grandchildren as part of your membership if your grandchildren meet all the following criteria:

  • You have legal custody, or your grandchildren are the children of a minor.
  • They live permanently with you at your residence.
  • They meet the eligibility Guidelines for children.
  • They have no other agency, person, or group responsible for their medical bills.

5.1.6. Guardianships

REDEEM HealthShare allows for guardian memberships. As the guardian, you must be 18 years old or older to manage the membership on behalf of a minor.

5.2. Inactivation of Membership

Upon inactivation of your membership, whether voluntary or involuntary, REDEEM HealthShare will accelerate the matching of any of your remaining pledged Share Wallet balance and will share any available balance in your Share Wallet to a member in need.

5.2.1. Voluntary Inactivation

You may voluntarily inactivate your membership at any time. Your inactivation will take effect at the end of the month in which you inactivated your membership.

5.2.2. Involuntary Inactivation

As a member of REDEEM HealthShare, you must maintain an active membership in good standing to avoid involuntary inactivation.

REDEEM HealthShare determines your membership does not meet good standing requirements in the following situations:

In cases of failure to meet membership requirements, to resolve KYC or continuation requirements, or to fully fund your Share Wallet, the ministry will notify you if your membership is not in good standing:

  • If after a period of 30 days of not resolving the notices received, the ministry will suspend your membership. Suspension means that you cannot share any new bills or participate in membership voting.
  • If after a period of 60 days of not resolving the notices received, the ministry may inactivate your membership. Note: Upon involuntary inactivation, REDEEM HealthShare might not allow future membership.

If financial need prevents you from meeting good standing requirements, then assistance might be available through the Sponsorship Program. See section 5.13 Sponsorship.

5.2.3. Voluntary and Involuntary Inactivation

A request to withdraw Share Wallet funds that you have voluntarily pledged for sharing with the membership community, made upon or after notice of voluntary or involuntary inactivation, is inconsistent with your pledge and will result in your membership not being in good standing.

If you inactivate not in good standing, you are subject to the Restart of Membership requirements in section 5.3 Restart of Membership, including the obligation to make good on any previously withdrawn pledged amounts as a condition to return to good standing with the ministry. Nothing in this section creates a legally enforceable obligation on the part of any member or constitutes a guarantee of sharing by REDEEM HealthShare. The pledge reflects a voluntary, non-legally binding commitment to the sharing community.

5.3. Restart of Membership

If you voluntarily or involuntarily inactivate your membership, you may apply for a new membership. All membership requirements, waiting periods, and conditions will apply as a new membership. Restarted memberships are also subject to the following requirements:

  • You must pay back-shares, in full.
  • Eligible bills under your previous membership are shareable under your restarted membership if the bill has a date of service prior to your membership inactivation date.
  • REDEEM HealthShare considers Needs for conditions in which known signs, symptoms, testing, treatment (routine or maintenance) diagnosis, or use of medication (routine or maintenance) occurred after inactivation as pre-existing and are not eligible for sharing until applicable pre-existing waiting periods have lapsed.

5.4. Changing Programs

You must meet the qualifying life event criteria to change between programs or Unshareable Amount levels. You may change your membership Unshareable Amount level or program at least 30 days before your Membership Anniversary Date or a qualifying life event, with the effective date being the first day of the following month.

5.4.1. Qualifying Life Events

Qualifying life events include:

  • Change in marital status
  • Change in child or dependents
  • Birth or Adoption
  • Loss of spouse
  • Loss of employment
  • Dependent turns 26
  • Turning 65 and would like to join REDEEM SeniorSaver

The Program Change Request form is available in the Forms section of the Member Center.

5.4.2. Membership Anniversary Changes

You may change your Unshareable Amount level or program each year, effective on the first day of your anniversary month. REDEEM HealthShare will email the Membership Anniversary Program Change Request form 60 days before your Membership Anniversary Date. You must submit the requested changes 30 days in advance of your Membership Anniversary Date.

5.4.3. Switching Fee

Changing your program or Unshareable Amount level requires a switching fee of $100. You may choose the first day of any future month for your switch to occur. The Total Amount Due will include the $100 switching fee within one to two months after the switch is effective. Note: You may add or remove members from your membership at any time without incurring a switching fee.

5.4.4. Resetting the Unshareable Amount

Changing your program or Unshareable Amount level will reset the Unshareable Amount.

5.4.5. Switching Between Programs and Unshareable Amounts

The 12-month waiting period for the conditions and treatments listed in section 3.7 Sharing Limits resets in the following situations:

  • You switch from REDEEM Essential to REDEEM Enhanced.
  • You move from a higher Unshareable Amount to a lower Unshareable Amount.

5.5. Member Privacy

For fellowship and support, you, and other members might share deeply personal prayer requests and detailed health information with one another through Share Stream in the Member Center. Do not post names or details on other social media, blogs, or websites without permission, or use the information in any way that violates privacy.

5.6. Guidelines Govern

These Sharing Guidelines explain the program requirements and govern the sharing of Needs. The Guidelines in effect at the time you receive service, govern the program. The Guidelines are available online at redeemhealthshare.org/guidelines and in your Member Center.

5.7. Changes to the Guidelines

REDEEM HealthShare may amend the Guidelines at any time subject to approval by the Samaritan Ministries Board of Directors. You will receive notification of the changes. A history of changes will be available in the Member Center online for two years from the date of the change.

5.8. Balancing Needs and Shares

In any month, the funding of Shares across REDEEM HealthShare Ministry might not meet the eligible bills submitted for sharing. In that event, the ministry will share eligible Needs proportionately (referred to as proration), which means sharing a percentage of eligible Needs within that month and holding back the balance of those bills to share in a subsequent month.

If there isn’t enough funding for Shares to meet the eligible bills submitted for sharing over a 60-day period, then REDEEM may increase the suggested monthly share amount in sufficient proportion to satisfy the eligible bills. The ministry may take this action temporarily or ongoing.

If member sharing cannot fund an eligible bill within 90 days of entering the normal sharing queue, then the ministry removes that bill from the normal sharing queue and shares the amount through the Member Assistance Fund, if possible. REDEEM HealthShare will send any money currently in the bill account to the provider as partial payment.

To balance expenses and shares calculations, the ministry might share across two or more Samaritan Ministries programs or keep them separate as allowed by the Samaritan Ministries Board of Directors.

5.9. Other Responsible Parties

If you have insurance or are eligible for any insurance benefits or other health or welfare benefits, REDEEM HealthShare expects you to take all reasonable steps to qualify for such payments and to exhaust benefits available under those resources before submitting a request for sharing. The following are examples (not an exhaustive list) of other resources:

Additionally, if you intend to submit a medical bill to REDEEM HealthShare for sharing that involves another responsible party, you must take all necessary steps to make sure the party responsible pays the amounts applicable to their respective responsibilities. This includes pursuing payment through litigation, insurance, or other appropriate means before submitting the bill for sharing. You must pursue these legal remedies unless you demonstrate that doing so would violate your Biblically based conviction against initiating a lawsuit. Contact Member Care if you have any questions.

REDEEM HealthShare might delay processing a medical bill to allow other responsible parties to pay. If REDEEM HealthShare identifies the party responsible for the issue related to your medical bills, REDEEM HealthShare reserves the right to decline to share any bills related to that party’s responsibility.

If you receive a settlement or reimbursement applicable to medical bills already shared, you must send those funds back for the benefit of REDEEM members. Samaritan Ministries International or REDEEM HealthShare Ministry never requires you to seek assistance from government aid programs and considers it contrary to our understanding of God’s desire for His people.

5.10. Other Sources of Payment

The sharing community provides the funds to pay for your eligible medical bills. You must use these funds to pay the related medical bills and not for another purpose. If you paid all or part of a bill using other means, or someone or some organization forgave the debt or paid it on your behalf, you must contact Member Care for instruction of sending the extra money to another member who has an eligible medical bill.

When you have a Health Reimbursement Arrangement (HRA), Flexible Spending Account (FSA), or Health Savings Account (HSA) there are no requirements to use these types of funds to pay for your eligible medical bills. However, using these types of resources lessens the burden that the community will bear. If you use money from an HRA, FSA, or HSA to pay your eligible medical bills, you can still submit the bill for sharing. However, using these funds and receiving shared amounts could affect your taxes. Please consult your tax advisor.

You must report funds raised by crowdfunding for eligible medical bills. REDEEM HealthShare will apply these funds to reduce the shareable amount.

If you simultaneously participate in another health care sharing ministry, you must not seek shares or payments from multiple ministries that exceed shareable bills. To do so is to obtain assistance beyond your burden.

5.11. Sharing Appeal

5.11.1. Sharing Decisions

If you disagree with a bill-sharing eligibility decision, you may appeal if you believe:

  • REDEEM HealthShare misread the medical records.
  • REDEEM HealthShare misapplied the Guidelines.
  • Your provider incorrectly recorded your medical history.
  • The Guidelines do not address your situation.

REDEEM HealthShare will review the appeal. If you disagree with the decision, you have 90 days to request a review by a member Appeal Panel, involving 7 to 13 REDEEM HealthShare members. As part of this process, you will submit a written position statement to the Appeal Panel. REDEEM HealthShare will hold a teleconference wherein the Appeal Panel asks both you and REDEEM HealthShare questions. A simple majority vote will carry the decision whether to share the bill related to your appeal. The panel’s decision will be binding and non-appealable.

5.11.2. All Other Issues

You must settle all other issues in accordance with the Rules of Procedure for Christian Conciliation® of the Institute for Christian Conciliation. For rules, see AORHope.Org/Rules or contact ICC at ICC@AORHope.Org. However, if both REDEEM HealthShare Ministry and you agree, you will submit the dispute 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 sharing appeal methods will 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 deciding whether the dispute is part of this arbitration agreement or whether it must go through arbitration. Judgment upon an arbitration decision may be entered in any court otherwise having jurisdiction.

Resolving disputes within the Body of Christ is always the command of Scripture and in the interest of you and all members (Matthew 18:15-20; 1 Corinthians 6). Therefore, even if REDEEM HealthShare or you participate in a court proceeding about a dispute, neither give up their right to later demand arbitration to resolve the dispute.

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

5.12. Misuse of Trust and Accountability

As a member, you must act with integrity. REDEEM HealthShare will involuntarily inactivate your membership if you present a falsified Need or bill, use deceptive practices, or participate in another member’s misuse of trust.

When submitting bills, you further commit to working with REDEEM HealthShare staff and designated third parties to determine if your bills are eligible for sharing, to seek fair and reasonable prices from providers, and to document amounts paid to providers.

If REDEEM HealthShare identifies you in an issue of misuse of trust (either as a current or inactive member), the administrative office can seek the assistance of your Christian church and provide it with the necessary information to address the issue and hold you accountable. You may request resolution of the question through the mediation and arbitration provisions noted in section 5.11 Sharing Appeal.

5.13. Sponsorship

You might be in a circumstance where you cannot pay your entire Share amount. In certain cases, if you are experiencing financial difficulty, REDEEM HealthShare might be able to assist you by offering temporary reductions in your Share amount through Sponsorship. Because we are committed to the central role of the family and the local Christian church in all of life, including health care, REDEEM HealthShare requires that you explore other avenues of assistance before applying for help through Sponsorship so that your family and your local church have the first opportunity to receive the blessing of giving. For more information about applying for Sponsorship, please contact Member Care.