13: What do I do if my bills are over $125,000 and I'm not a part of the catastrophic program (GUARDIANS GROUP)?
Each month we ask you to send a Monthly Share Amount to your ShareBox with will be shared with another member who has medical bills regardless of whether you have medical expenses. Giving regularly each month is how you remain eligible to have your bills shared by other active members. That amount varies depending on your program choices, age, and whether you are a single, couple or family. See the current Monthly Share Amount under the 'Sharing Programs' tab.
A pre-existing condition is any condition at the time of enrollment that has evidenced symptoms, or received treatment or medication in the past 24 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 $50,000 is eligible
- Fourth year and following of continuous membership, the condition is no longer considered pre-existing
You can drop at any time. But, when you join, you pay your first annual dues of $125.00. Your Sharing Membership then lasts for one year. If you drop out within 30 days, your dues are refunded. If you drop your membership any time after 30 days, your annual dues are not refunded. You then become an inactive member. An inactive Member will remain on the list of members until their next renewal date. Inactive members can give as much as they can when they can. And if an inactive member has a need, it is shared among the other inactive members.
Accountability and financial integrity are vital concepts at Liberty HealthShare℠. All that we do at Liberty HealthShare℠ is done in a spirit of public trust. That trust is precious to us and there are numerous ways in which we practice that creed.
- We track all monthly assignments and verify that giving members send their Monthly Share Amounts.
- Receiving members are subject to oversight, accountability and accounting controls through Liberty HealthShare℠ to make certain those funds are used only to pay medical expenses.
- Monies received for administration undergo strict scrutiny and annual audit. The Board of Directors is the final authority. They oversee the administrative staff and operations of the organization. A strict conflict of interest policy is adhered to by the Board so that independent, non-compensated Board members make the decisions.
- Most importantly, with the exception of an administrative fee, you don't send your money each month to Liberty HealthShare℠. Money designated by members for cost sharing is never owned or invested by Liberty HealthShare℠. The money in your Sharebox is sent directly to another member's ShareBox who has a medical expense need.
Members highly value the spiritual principle that our bodies are gifts from God and we must respect and care for our physical bodies. Further, we have an ethical obligation to our fellow members to live healthy as this keeps medical costs down. As a community of people we try our best to live out Jesus Christ's mandates. In general, a healthy lifestyle requirement includes, but is not limited to, the following:
- Abstain from tobacco use in any form.
- Follow biblical teachings on the use or abuse of alcohol.
- Avoid abuse of prescription drugs, which means consuming prescription medications in a manner not intended by the prescriber that would likely result in bodily harm or dependency.
- Abstain from the use of illegal drugs. Illegal drugs includes, but is not limited to, any hallucinogenic substance, barbiturates, amphetamines, cocaine, heroin, marijuana, illegal intravenous drugs, or narcotics.
- Exercise regularly and eat healthy foods that do not harm the body.
- Some individuals who qualify for our medical cost sharing program but have certain pre-existing health conditions that can be improved through lifestyle changes will be enrolled in HealthTrac℠. This required program is in place for Sharing Members to improve their health while reducing the risk of developing or exacerbating serious diseases.
- If a condition is accepted as pre-existing, that member will be accepted with that limitation (see question about Pre-Existing Conditions).
- All decisions for membership approval are made in consultation with the prospective member and with the most complete information available.
Members are asked to send their Monthly Share Amount by the 5th day of the month.
If the full Monthly Share Amount is not received by the end of the month, the Sharing Membership becomes inactive.
If your Sharing Membership is inactive for less than 60 days, you can reactivate. Simply contribute a Monthly Share Amount for each month that your membership was inactive!
But remember, medical expenses that occur when your membership is inactive are not eligible for health sharing.
For more information, see Guidelines III. G: Notify When Withdrawing Membership
Simply explain to any doctor or hospital that you are self pay, but you are part of a community of people who have pledged to share your expenses called "Liberty HealthShare℠". Show them your membership card and explain that your bills should be sent either electronically or by mail as directed on your Membership card. Explain that reimbursement will come from the funds you receive from the group in about 30 days.
Each member, when they join, is assigned an on-line secure funds exchange account called a "ShareBox". Each month Liberty HealthShare℠ transfers your Monthly Share Amount directly to another member's secure "ShareBox". If you wish, you can send well wishes, greetings or a personal message of cheer. When you have qualifying expenses, members' contributions are sent from their Monthly Share Amount directly to your ShareBox in proportion to your eligible medical expenses. When all the funds are accounted for and received, sufficient to meet your expenses, Liberty HealthShare℠ transacts checks directly to your providers. Those checks are disbursed from your "ShareBox" and you receive an "Explanation of Sharing" verifying payment to each provider. You are also on the receiving end of messages of cheer and well being!
Liberty HealthShare℠ does not have deductibles or co-pays since we are a medical cost sharing ministry. However, There is an annual first dollar amount that members have agreed to not share together. We call it our Annual Unshared Amount. The Annual Unshared Amount accumulates throughout your membership year, and is $500 for a single, $1000 for a couple, and $1500 for a family. When your eligible medical expenses exceed the Annual Unshared Amount during the year, then sharing commences. If you are enrolled in Liberty Complete℠ or Liberty Plus℠, your expenses are shared at 100% up to your program’s limit. If you have chosen to enroll in Liberty Share℠, then your bills are shared at 70% up to your program’s limit.
STEP ONE: Make a call. There can always be differences of opinion. Most disputes can be resolved with a simple phone call. If you disagree with a decision, always call and one of our helpful advisors will exhaust every possibility. STEP TWO: Follow the "DISPUTE RESOLUTION AND APPEAL" process outlined in the Guidelines(see VI. A-D.) STEP THREE: Regardless of who wins or loses, remember who and what we are. Liberty HealthShare℠ is a voluntary association of like-minded people who come together to assist each other by sharing medical expenses. Such a sharing and caring association does not lend itself well to the mentality of legally enforceable rights.
Of course. In fact many participants have insurance through work or another source. They participate with us for the sheer excitement of helping others. They never expect to submit bills. And in those cases where money is still owed after insurance makes its payments, Liberty HealthShare℠ will share the balance!
- MINIMUM: Once the annual unshared amount has been met, there is no minimum sharing amount.
- MAXIMUM: For Liberty Share℠ and Liberty Plus℠ $125,000 per incident
And if you participate in our program for sharing catastrophic expenses within Liberty Complete℠, the maximum shared per incident increases:
- Liberty Complete℠ MAXIMUM: $1,000,000 per incident
13: What do I do if my bills are over $125,000 and I'm not a part of the catastrophic program (Liberty Complete℠)?
There is no recourse for expenses that exceed the sharing limit of $125,000 when the member is not a part of Liberty Complete℠. In today's high cost medical environment, it's prudent to take caution. Enroll in Liberty Complete℠ today and don't let this happen to you!
Based upon our Shared Belief that we are all creatures of God and have a moral and spiritual obligation to care for our bodies, HealthTrac℠ was created so that Liberty HealthShare℠ could enroll those who have chronic conditions particularly responsive to lifestyle changes. Those conditions are identified in the application process. These members want to participate in our medical cost sharing ministry while improving conditions such as diabetes, hypertension, cancer, heart disease, high cholesterol and obesity, as well as smoking cessation. HealthTrac℠ assists members in making lifestyle changes that foster better health and reduce the prospect of progressive disease.
HealthTrac℠ participants are assigned a Health Coach. The coach assists them in developing personal goals, tracking progress, and reaching their health related goals. HealthTrac℠ participation is required for Sharing Members who have been identified in the enrollment process as having conditions at the time of enrollment that can be improved through lifestyle changes. A participant fee of $80 per month is assessed in addition to the Monthly Share Amount while the member demonstrates progress and until their personal goals are met.
First of all, congratulations on your decision to address conditions that are putting your health at risk. So much of our satisfaction with life is dependent on good health. You will be receiving a Health Risk Questionnaire via email from your Health Coach. You and your coach need to discuss the reasons you were added to HealthTrac℠ and start setting goals. It may be necessary to have some lab work done and your coach can guide you through that.
Your Health Coach is a partner in your journey to better overall health. The program is about supporting you through changes, big or small. Take advantage of it!
You are required, at minimum, to communicate with your coach once a month. More communication may be necessary depending on the particulars of your individual health profile. You are encouraged to communicate with your coach as often as you feel is necessary. You will receive tips, encouragement and support, and even recipes for adjustments to your daily diet. This program is designed for you!
Yes! People do graduate from HealthTrac℠ (formerly our Provisional Program) every month. We often share their stories in our HealthShare letter and on our blog. While every participant and coach set customized goals and benchmarks for progress, Liberty HealthShare℠ expects to see significant changes within the first year of enrollment.
Some aspect of the Medical Questionnaire you completed during the application process caused a review by our Health and Wellness department and revealed a condition particularly suited to health coaching. Based on your answers, in order to confirm your membership as a Sharing Member, you are required to participate in HealthTrac℠ as a condition of membership. Our Health and Wellness department will contact you.
You must cease use of tobacco products within 6 months of enrollment. Testing for nicotine is required.
You and your coach will discuss your personalized goals and timeline. If necessary, you may need to consult with your doctor. Liberty HealthTrac℠ coaches recognize that lifestyle changes require time. Rest assured, continual progress is important as every little adjustment results in better health outcomes.
You and your coach will have agreed upon goals, defining when you have reached the point of graduation. It may be necessary to conduct lab tests or visit your doctor. Maybe not. Each member works individually with their coach so requirements are different. The goal is better overall health and a reduced risk of serious disease. This will be defined for each individual.
Maybe. If smoking cessation is your goal, then yes, you will have to submit to nicotine tests. If lowered blood pressure, better management of diabetes, or weight loss is required, a visit to a lab or doctor may be necessary.
A participant fee of $80 is assessed for each person in HealthTrac℠, in addition to their suggested monthly share amount.
Continuation beyond the first year of membership will be assessed and determined by Liberty HealthShare℠, in consultation with the assigned Health Coach.
We take seriously our pledge to take care of our bodies and be responsible for our health. As a HealthTrac℠ participant, responsiveness to guidance by a Health Coach is required as a condition of Liberty HealthShare℠ membership. Failure to make progress or being unresponsive to health coaching, violates your responsibility to other members and may result in termination of Liberty HealthShare℠ membership.