HOW DOES UNITED REFUAH HEALTHSHARE VALUE COMPARE WITH OTHER HEALTH CARE SHARING PROGRAMS’ COST?

United Refuah HealthShare is the first and ONLY Jewish-based Health Care Sharing Organization. This is important because now Jewish Americans may join a Health Sharing organization without making representations which are contrary to their faith beliefs.

The founders of United Refuah designed it with the unique characteristics of the American Jewish population in mind. The goal was to be the best health care sharing organization for its members, which doesn’t necessarily mean the lowest monthly contribution.  The founders have taken  the best of other health care sharing organizations  in order to provide the best value to our members.  The best health care sharing organization does more than allow for low monthly share amounts: It brings like-minded members together to share their eligible medical expenses, and it provides the members with the tools necessary to maintain and improve their health, as well as navigate the medical provider systems, for cost effective and quality medical services. That’s what we do at United Refuah Health Share.

In addition to facilitating the sharing of medical expenses, United Refuah assists its members in keeping medical needs low by having them become healthy and stay healthy.  We do this for all members, through the following methods:

  1. Health Assistance
  2. Access
  3. Advice

1 – We are Health focused – Our members are best served when the eligible medical needs of our members are lower. We therefore exert significant effort to improve and maintain the health of our members.  Each member participates in health coaching to discuss and set realistic goals.  Through the proactive management of our members’ health, the membership becomes healthier, which drives down medical costs and saves everyone money.

2 – Access:  Each member has  24 / 7 access to a doctor through a telehealth platform, which saves members’ time and money. Each time Telehealth is used, the average savings  is $250, in addition to the time saved.  United Refuah also includes access to Mental Health services.  URHS offers 10 visits for mental health per year, subject to the preexisting condition limitations.

3 – Advice: We provide a medical concierge service for our members.  Whether you are looking for a GI specialist, or need advice on where to get the lowest cost for an MRI, or when calling in for sharing of medical needs services, our Advice team will assist you with any and all those questions. Navigating the health care system, with nontransparent prices and confusing choices can be difficult; United Refuah provides advice to its members.  Note: United Refuah has an open network.  All members can see any Provider they choose.

Bottom Line Value:  What is your health worth?    Is the cheapest car the best car?  In addition to facilitating the sharing of eligible medical expenses, United Refuah is also concerned with improving your health and keeping you healthy. Your health is the true value of a membership in United Refuah Health Share.  When you are healthy, life is better (and less expensive).

WHO FOUNDED UNITED REFUAH HEALTHSHARE?

United Refuah HealthShare was founded by successful businessmen, employers, and parents of the Cleveland Jewish community who saw the problems with trying to provide appropriate healthcare to their employees and their families.  Over the past three years, the founders engaged industry and community leaders to ensure that the  culture and the needs of the Jewish community within the Health Share were maintained and revered, while creating a superior HealthShare organization.

We believe that we have engaged a very strong team that is well equipped to manage a health care sharing organization for the Jewish community.

ARE MONTHLY CONTRIBUTIONS REQUIRED FOR MEMBERSHIP EVEN IF I DON’T HAVE ANY OF MY OWN MEDICAL EXPENSES?

Yes. Your monthly payment will depend on your membership type (single, couple, or family), the number of persons in your family and your level of participation in WellCheck℠. Each month, your monthly payment will be placed into your Refuah ShareFund, less a nominal administrative fee, which is shared with other members that have medical bills regardless if you have any medical expenses of your own. Giving consistently each month will allow you to be eligible to have your medical bills shared with other members. To determine your monthly contribution amount, please refer to the ‘Program Summary’ menu choice under the “United Refuah Program” tab.

ARE PRE-EXISTING CONDITIONS ELIGIBLE FOR SHARING?

A pre-existing condition is any condition at the time of enrollment that has evidenced symptoms, received treatment or medication, or required continuous monitoring during in the past 36 months. We share in pre-existing conditions according to the following schedule:

  • First year of membership:        Not eligible for sharing
  • Second year of membership:   Up to $25,000 is eligible
  • Third year of membership:      Up to $25,000 is eligible
  • Fourth year and following of continuous membership: the condition is no longer considered pre-existing.

For some pre-existing conditions, United RefuahSM may require a permanent waiver, so that a condition is never eligible for sharing, even though the applicant becomes a member.

ONCE I JOIN, AM I REQUIRED TO REMAIN A MEMBER FOR A CERTAIN AMOUNT OF TIME?

Membership is month to month; you can withdraw your membership at any time. If you decide to withdraw membership, you will become an inactive member. Please note, that if you decide to withdraw membership mid-month, you will be considered a member until the end of that month (no partial month refund).  If you withdraw membership and rejoin, you will  be required to pay an additional Enrollment Fee.

WHAT IS THE REFUND POLICY FOR THE ANNUAL MEMBERSHIP FEE AND MONTHLY CONTRIBUTIONS?

If any family member on your application is not eligible to join United Refuah HealthShareSM, the application may be totally withdrawn, and the Initial Enrollment Fee will be refunded in full.

If one or more family members is/are required to participate in WellCheckSM Assist or WellCheckSM Support all members of the family may withdraw and the Initial Enrollment Fee will be refunded in full. You may choose to continue membership without the ineligible person, and there will be no refund of the Initial Enrollment Fee.

HOW ARE MY MONTHLY SHARE AMOUNTS HANDLED?

Except for the administrative fee and WellCheck fees, United Refuah HealthShare℠ does not own any of the remaining funds. They are held for you in your Refuah ShareFund to share with other members. Members can view their ShareFund balances at any time by logging into their member portal.

We will take every reasonable precaution to ensure that funds are used appropriately and ethically, in line with the principles outlined in the Sharing Guidelines.

WHAT DOES IT MEAN TO LIVE A HEALTHY LIFESTYLE?

Members of our organization believe that our bodies are gifts from G-d and require respect and care. Furthermore, we believe that there is an ethical obligation to the United Refuah community to lead a healthy lifestyle and  keep medical costs down.  In general, healthy lifestyle requirements include, but are not limited to, the following:

  • Abstain from tobacco/nicotine use in any form.
  • Follow biblical teachings on the use of alcohol.
  • Never abuse prescription drugs. (i.e. Consuming prescription medications in a manner not intended by the prescribing physician, or that would likely result in harm or dependency.)
  • Abstain from the use of illegal drugs, including, but not limited to, hallucinogenic substance, barbiturates, amphetamines, cocaine, heroin, marijuana, illegal intravenous drugs, or narcotics.
  • Exercise regularly and eat healthy foods that are beneficial to the body.

DO I NEED TO COMPLETE A HEALTH SCREENING IN ORDER TO BE APPROVED FOR MEMBERSHIP?

Applicants are required to complete a Health Questionnaire for each family member within the application and enrollment process.  This form provides information needed to determine whether each person in the family is eligible for membership.

Individuals who qualify for membership but who have certain pre-existing conditions that may improve through lifestyle changes will be enrolled in WellCheckSM Assist or WellCheckSM Support. These programs are mandatory for those individuals.  Applicants can choose to participate in WellCheck or decline membership. There is an additional monthly fee for the WellCheckSM Assist or WellCheckSM Support program.

All decisions for membership approval are made in consultation with the prospective member and are based upon medical and lifestyle information obtained from the member and/or medical records.

WHAT IF I AM UNABLE TO MAKE A MONTHLY PAYMENT?

Members are required to remit payment by the last day of the current Sharing Month.. If the member is unable to make the payment by then, their Sharing Membership status will be changed to inactive, retroactive to the beginning of the month.  Inactive members have no sharing eligibility for any bills during an inactive month. A member will be able to reactivate his or her membership by paying in full the inactive month(s’) payment(s), provided that the membership has been inactive for less than 60 days. Medical expenses incurred during inactive membership will never be eligible for sharing even if the membership is reactivated.  If a members has been inactive for more than 60 days, the member(s) would need to reapply as a new member(s) if he or she wishes to reactivate.

For more information, see Sharing Guidelines.

HOW DO I LET MY PROVIDER OR HOSPITAL KNOW THAT I AM A MEMBER OF UNITED REFUAH HEALTHSHARE℠?

You can let a provider or hospital know that you are uninsured, but part of a Health Share,“United Refuah HealthShare℠”. Simply present your card at visits, and most providers will scan or copy it for reference. Your member ID card will have the information that the provider or facility needs to submit the bills for service.

DO I HAVE A CO-PAY OR DEDUCTIBLE?

United Refuah HealthShare℠ does not have deductibles or co-pays. Each member has an Annual Preshare Amount, which varies by membership type. Once the member has surpassed the Annual Preshare Amount, United Refuah HealthShare℠ will share 80% of eligible medical bills up to the threshold explained below. Once this threshold has been reached, United Refuah will share 100% of all eligible medical bills for the remainder of the membership year, up to $1 million dollars per incident.

Each pregnancy has an additional Pregnancy Fee of $1,500 for Couple memberships and $2,500 for a Single (married woman) membership.

United Refuah also has a Maximum Co-Share Amount per Sharing Year, based on the membership type as follows:

  • $2,000 for a single
  • $4,000 for a couple
  • $8,000 for a family

In addition to your enrollment fee, monthly contributions, and WellCheck fees (if applicable) the maximum expenses that can be incurred in a year are your Annual PreShare, Maximum Annual Co-Share, and Pregnancy Fee.

Single:     $500 (Annual PreShare) + $2000 (Maximum Annual Co-Share) + $2500 (Pregnancy Fee) = $5000

Couple: $1000 (Annual PreShare) + $4000 (Maximum Annual Co-Share) + $1500 (Pregnancy Fee) = $6500

Family:  $1500 (Annual PreShare) + $8000 (Maximum Annual Co-Share) = $9,500

IF MY MEDICAL BILLS ARE INELIGIBLE FOR SHARING AND I DO NOT AGREE WITH THE DECISION, WHAT DO I DO?

STEP ONE:

Call member services to receive clarification and to understand why the decision was made. There may be differences of opinion or a misunderstanding that can be easily reconciled. Many disputes can be resolved with a simple phone call.

STEP TWO:

Follow the “DISPUTE RESOLUTION AND APPEALS” process outlined in the Guidelines (see section. XIII.)

CAN I HAVE MEDICAL INSURANCE WHILE BEING ENROLLED IN UNITED REFUAH HEALTHSHARE℠?

Many participants have insurance through an employer or another source. In cases where there is an outstanding balance even after insurance payment, United Refuah HealthShare℠ will share the balance, in accordance with the Sharing Guidelines.

IS THERE A MINIMUM AND MAXIMUM AMOUNT IN MEDICAL BILLS I AM ALLOWED TO SUBMIT FOR SHARING?

MINIMUM: Once you’ve paid your Annual Preshare Amount, there is no minimum.

MAXIMUM: The maximum shared per incident is $1,000,000. This limit is applied to a medical incident even if the medical expenses occurred in more than one Sharing Year. For acute medical illnesses, accidents, or injuries that have occurred during the first 60 days, sharing is limited to a maximum of $10,000 for all incidents and all members combined.

DO ALL DOCTOR’S ACCEPT UNITED REFUAH HEALTHSHARE℠? IF NOT, HOW DO I KNOW IF MY DOCTORS WILL ACCEPT IT?

Many doctors and providers will accept healthsharing and bill United Refuah HealthShare directly, since they are usually reimbursed  quicker and without the hassles of insurance.   Always ask your doctor and present your ID card in advance of receiving services.

If a doctor or provider is not willing to bill United Refuah HealthShare directly, you can request that they bill you as an uninsured patient, and then submit the bill to United Refuah for processing. If the practitioner or facility requires advance payment and is unwilling to work with our team, your self-paid bills can be submitted to United Refuah for reimbursement.  In order to qualify for reimbursement, bills must be within Usual and Customary and submitted via secure upload, fax, or mail.  Pictures are not accepted.  Ask your provider for a Superbill or HCFA (the bill the provider would have sent to an insurance company) and a payment receipt if you remitted payment.

WHAT IF MY MEDICAL BILLS SURPASS THE LIMIT THAT UNITED REFUAH HEALTHSHARE℠ PAYS TO MY PROVIDER?

After meeting the Annual PreShare Amount for your membership type ($500 for Single, $1000 for Couple, and $1500 for Family), United Refuah HealthShare℠ will share 80% of eligible medical expenses and the member will be responsible for 20% up to the maximum Co-Share amount ($2,000 for single, $4,000 for a couple, or $8,000 for family). Once the maximum Co-Share amount has been reached, eligible medical expenses are shared 100% up to a maximum of $1,000,000 per incident. Medical expenses relating to the same medical incident exceeding this amount are not eligible for sharing even in subsequent membership years.

Please note that there are additional limitations during the first 60 days of membership.

DOES UNITED REFUAH HEALTHSHARE℠ FOLLOW THE AFFORDABLE CARE ACT (ACA)?

Membership in a Health Sharing organization satisfies the ACA mandate. United Refuah HealthShare satisfies all  the necessary requirements to exempt our members from ACA penalties. If you or your tax planner require any information regarding the penalty exemption for HealthShare members, or for a more detailed explanation of this topic, please email legal@unitedrefuahhs.org.

HOW DO I ARRANGE PAYMENT FOR MY MEDICAL BILLS VIA MY REFUAH SHAREFUND?

The medical bill is submitted to United Refuah, either by you or your provider. Once it is received, United Refuah HealthShare℠ will initiate the payment process.

HOW ARE MY BILLS PAID?

Once a bill has been submitted to United Refuah HealthShare℠ we will first determine eligibility.  If the bill is deemed eligible for sharing, we will share in accordance with our Sharing Guidelines.  Once  the Annual Pre-Share Amount (APA) has been met, United Refuah will share 80% of eligible expenses for the remainder of your membership year (based on enrollment date) up to the designated maximum limit..

If a member pays out of pocket for an eligible medical expense, the member will be reimbursed by United Refuah HealthShare℠ in accordance with our Sharing Guidelines. Otherwise, we will reimburse the provider directly.

Upon payment or denial of payment, an Explanation of Sharing (EOS) will be provided to help you understand the determination. If you still have questions, the member services line is available to assist you further.

HOW DO I KNOW THAT MY MEDICAL RECORDS AND INFORMATION ARE SECURE?

We take the security of your medical information very seriously.   Like other healthcare organizations, United Refuah HealthShare℠ follows Federal regulations regarding HIPAA Compliance and the safeguarding of medical information. Except as outlined in our privacy policy, we will not use or disclose your personal health information for any purpose unless you have signed a form authorizing the use or disclosure.  For a more comprehensive outline of our privacy practices, please see our Privacy Policy.

WHO CAN BE CONSIDERED A DEPENDENT?

Dependents are able to  join your plan if they are:

  • Unmarried Dependent Child
    • An unmarried dependent child may participate with his or her parent(s) or legal guardian(s) under a Sharing Membership up to and including age 19, until he/she reaches age 20
  • Disabled Dependent
    • An unmarried dependent can continue to be a dependent if they are unable to be a full-time student because of illness or injury, physical or mental. A physician or qualified health professional will be required to verify this disability.
  • Full-time Student
    • An unmarried dependent child age 20-26 may participate in his or her parent/guardian’s Sharing Membership only if he/she is a full-time student or assigned to a multi-month internship.
  • Newborn
    • A newborn may be added as a dependent to a membership. Notification of birth should be submitted in writing within thirty days of the birth. Such notice is the responsibility of the existing Sharing Member.
  • Newly-Adopted
    • A newly-adopted child may be added as a dependent to a membership.  Existing Sharing Member must provide notification of adoption in writing within thirty days of the finalized adoption, including all and any medical history of the child. Existing medical conditions may be considered preexisting and possibly declined for sharing entirely.

WHY WAS WELLCHECK℠ CREATED?

WellCheck℠ was created to improve the health and wellness of members and to provide education and techniques for achieving a healthy lifestyle. It is based upon the moral and spiritual belief that individuals are obligated to care for their bodies, in order to promote the best life possible for themselves and their families, and reduce the medical burden on the community.

Many medical conditions can be mitigated, eliminated and/or prevented through lifestyle changes. In fact, some literature attributes up to 80% of disease to negative lifestyle habits.

The goal of WellCheck℠ is to improve the members’ health. The program is ideal for those with obesity, hypertension, and high cholesterol, among others.

Program highlights include:

  • Development of a health improvement plan with achievable goals
  • Resources that motivate and inspire members to reach their goals
  • Monthly and quarterly check-ins with the team
  • Healthy lifestyle resources including diet and exercise recommendations

WellCheck℠ participation is required for all Sharing Members. For WellCheck℠ Assist and WellCheck℠ Support, a participation fee of either $45 or $65 per month is assessed.  Membership level is reassessed yearly.  Members who reach their goals upon renewal may be assigned a lower level of WellCheck in the following year.

ONCE I HAVE JOINED UNITED REFUAH HEALTHSHARE℠ AND ENROLLED IN WELLCHECK℠, HOW DO I USE WELLCHECK℠ TO IMPROVE MY HEALTH?

WellCheck℠ is a very personalized program designed in a customized way to help you meet your goals towards a healthier life. You and your assigned coach will begin by discussing the reasons you joined the program, and start setting objectives towards the achievement of your goal. Your coach will guide you through the entire program and be there every step of the way to help you achieve the healthiest possible you.

Please keep in mind that as an individually customized program your participation and opinion throughout the process is critical in helping you and your coach develop the most effective strategies for making the changes that will lead to success.

CAN MEMBERS GRADUATE INTO A BETTER HEALTH CATEGORY THROUGH WELLCHECK℠?

Members can graduate to a better health category. Each year (or every six months for Assist and Support Members), we reassess your health for improvement or otherwise. While every WellCheck℠ instance sets a customized goal and timeline for progress, we hope to see significant improvement within the first year of enrollment for those in WellCheckSM Assist and/or Support.

WHY AM I REQUIRED TO ENROLL IN WELLCHECK℠ AS A PART OF MY MEMBERSHIP?

A member will be required to enroll in the WellCheckSM Assist or Support programs  when certain aspects of his/her health can show improvement with health and lifestyle changes. In this situation, membership as a Sharing Member will be contingent upon participation.

This should not be viewed as punitive, but rather as an opportunity to put the necessary measures into place to prevent disease or its advancement. The purpose is to empower you toward the best possible life.

I SMOKE AND/OR USE TOBACCO. CAN I STILL JOIN UNITED REFUAH HEALTHSHARE℠?

We are currently not accepting members who smoke or use any tobacco or tobacco-type products (i.e. vaping, e-cigs). If you have quit smoking for at least six months, and can complete a nicotine screening, you can apply for membership.

IS THERE A TIME LIMIT AS TO HOW LONG I HAVE TO BE ENROLLED IN WELLCHECK℠ ASSIST OR WELLCHECK℠ SUPPORT?

Each member will always be enrolled in one of the WellCheck℠ programs.

Many times, especially with changes that are subtle and require a great amount of discipline, it is easy to backslide into old habits and routines without realizing, or conditions can fluctuate and create variations that were not present during the initial assessment, thereby throwing off management strategies. The aim of this longer-term program is to ensure the sustained success of the participants.

Graduation into a less intensive WellCheck℠ program is determined by United Refuah HealthShare℠ in consultation with the assigned health coach and others who may provide input during the process.

DO YOU SHARE IN PREGNANCY?

We share in pregnancies provided that the sharing mother was married at the time of conception and that the estimated due date is a minimum of ten (10) months from the date of enrollment when membership effective date is the first of the following month. When membership start date has been deferred, a pregnancy will be eligible if the estimated due date is a minimum of ten (10) months from the membership effective date.   Pregnancies of single members are subject to a Pregnancy Fee of $2,500.  Pregnancies of sharing mothers who are part of a couple membership are subject to a Pregnancy Fee of $1,500.  Pregnancies of sharing mothers who are part of a family membership are not subject to a Pregnancy Fee.