What Costs Do We Share?
Medical costs are shared on a per person, per incident basis, for illnesses or injuries incurring medical expenses when treated by physicians, urgent care facilities, clinics, emergency rooms, or hospitals (inpatient and outpatient).
Members share these kinds of costs:
These are the kinds of expenses we do not share (not limited to those below) :
See Sharing Guidelines for a complete list of shared and unshared costs.
*A medical expense eligible for sharing must exceed an accumulative Annual Preshare Amount which is $500 for a single, $1,000 for a couple and $1,500 for a family. It is calculated on each member’s initial effective date and renews annually.