VIII. 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 which includes the participants in all Samaritan Ministries International programs. 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. Each household membership receives one vote. 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, extra 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
- Pre-existing conditions
- Bills for eligible treatments that have exceeded their specific shareable amount (e.g., therapies)
- Routine and preventative care
- Dental
- Immunizations
- Bills related to sleep apnea
- Vision
- Audiological
- OTC medications, vitamins, supplements
- Essential oils
- Direct Primary Care Fees
- Mental health counseling or therapy
- Durable medical equipment
- Prosthetics
- Home health
- Weight reduction
- Gym membership
- Gym equipment
- Other alternative/holistic/naturopathic treatments such as:
- Acupuncture/Acupressure
- Disc decompression
- Dry needling
- Hyperbaric treatments
- Massage therapy
- Ozone injections
- Platelet-rich plasma
- Prolotherapy
- 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.
North Dakota Century Code 50-37: The organization facilitating the sharing of medical expenses is not an insurance company and its guidelines and plan of operation are not an insurance policy. Whether anyone chooses to assist the participant with medical bills is voluntary. Participation in the organization or a subscription to its documents is not insurance, and regardless of whether the participant receives payments or the organization continues to operate, the participant is responsible for the payment of the participant's 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 nonprofit 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+ who participate in 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: $3,000 $6,000 $9,000 $12,000 |
Levels: $2,000 $4,000 $6,000 $8,000 |
$500 | $0 | Generally, you must directly pay all the costs from providers up to the Annual Unshareable Amount (AUA) before bills qualify 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 directly 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. | Yes. | |
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 Assistant (P.A.), Doctor of Podiatric (D.P.M.), Dentist (D.D.S. or D.M.D.), Midwife (if certified), Ophthalmologist, Chiropractor |
Are there annual limits or caps? | $1 Million per household membership | $2 Million per household membership | No. | REDEEM Essential: $1,000 REDEEM Enhanced: $1,500 REDEEM SeniorSaver: $1,000 |
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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. Other providers are shareable subject to AUA/Co-Share. | |
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. |
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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 |
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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. |
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If you need sustained, repeated Therapeutic Care | ||
Category A: Physical and Manipulative Therapies
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Subject to AUA/Co-Share; Maximum annual household membership share limit of $5,000. |
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Category B: Hormone Therapies
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Subject to AUA/Co-Share; Maximum annual household membership share limit of $5,000. |
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Category C: Injection Therapies
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Subject to AUA/Co-Share; Maximum annual household membership share limit of $5,000. |
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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 |
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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 |
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If you need Preventative Screenings | ||
Mammogram or Breast Ultrasound | 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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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. |
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Colonoscopy | REDEEM Essential: Not shareable REDEEM Enhanced: One (1) per every five years age 45. Not subject to AUA. Not shareable in first six months of membership. |
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Gynecological | REDEEM Essential: Not shareable REDEEM Enhanced: One (1) per year. Not subject to AUA. Not shareable in first six months of membership. |