Welcome back to the FAQ Series, where we take a look at different health share companies and answer some of the most common questions we see people asking. Today, we’re focusing on United Refuah HealthShare, the first and only health share that caters specifically to the Jewish community.
What are United Refuah’s membership requirements?
United Refuah is not like most other health shares; it’s uniquely designed to serve the Jewish community and operates in accordance with the values of the Torah. To become a member, you agree to adhere to a set of ethical and religious guidelines that align with Jewish teachings. The full guidelines can be found here, but the main membership requirements are:
- Accept Jewish beliefs
- Maintain a Jewish lifestyle
- Provide truthful and complete medical information
To apply, you’ll need to complete a health questionnaire for each family member that would be on your plan. United Refuah’s website does state that certain conditions may disqualify applicants or necessitate special waivers as a condition of joining. Additionally, applicants over the age of 50 will need to submit three years of medical records and any well-visit notes from the past year.
How does the sharing process work with United Refuah HealthShare
When you incur a medical expense and submit a bill to United Refuah, they will first determine the bill’s eligibility for sharing. If the bill meets the criteria outlined in their sharing guidelines, they generally prefer to reimburse medical providers directly. You will be responsible for your Annual Pre-Share Amount (APA), a designated amount that you pay for eligible medical expenses, and then United Refuah will coshare 80% of eligible bills for the remainder of your membership year (which will vary depending on your date of enrollment), up to a designated threshold, after which bills will be shared 100%.
To sum up the process:
- Pay and meet your APA
- United Refuah coshares 80% of eligible bills
- You pay 20% up to your annual maximum
- United Refuah shares 100% of eligible bills after you meet the annual maximum
While United Refuah may prefer to pay providers directly, there may be instances where you need to pay up front for medical services. In these cases, you’ll pay out of pocket and submit the bill to United Refuah. Once they determine the bill is eligible for sharing, they will reimburse you.
Can I choose my own providers with United Refuah?
While United Refuah doesn’t address the question of provider networks directly, their sharing process and guidelines suggest a lot of flexibility in provider choice for you as a member. They do not appear to restrict members to a specific network of providers, but instead recommend that when you visit a healthcare provider, you present yourself as uninsured but also show your United Refuah membership card. They indicate that some providers will be open to billing United Refuah directly.
If you happen to be working with a provider who does not accept health shares or will only bill you, United Refuah advises that you request to be billed as an uninsured patient. Once you receive the bill, you can then submit it to United Refuah for processing according to their sharing guidelines. So, while you may have to be more involved in navigating the billing process effectively, United Refuah does allow you to choose your own providers.
How does United Refuah address pre-existing conditions?
United Refuah HealthShare has a specific approach to handling pre-existing conditions, which are defined as any condition that has shown symptoms, received treatment or medication, or required monitoring in the past 36 months prior to enrollment. The sharing eligibility for these conditions is based on a tiered schedule:
- Year 1: Pre-existing conditions are not eligible for sharing
- Year 2: Up to $25,000 of expenses related to pre-existing conditions are eligible
- Year 3: Up to $25,000 of expenses related to pre-existing conditions are eligible
- Year 4 and beyond: If you’ve maintained continuous membership, the condition is no longer considered pre-existing and becomes fully shareable.
For certain pre-existing conditions, United Refuah makes note that a permanent waiver may be required, making the condition permanently ineligible for sharing.
Does United Refuah share expenses related to maternity, mental health, or any other special conditions?
United Refuah HealthShare has some specific guidelines for sharing expenses related to maternity, mental health, and other special conditions.
United Refuah shares in pregnancy-related expenses with some limitations. The sharing mother must have been married at the time of conception, and the estimated due date must be at least ten months from the date of enrollment. Additionally, special pregnancy fees are incurred and vary based on your type of membership:
- Single Membership: $2,500
- Couple Membership: $900
- Family Membership: No pregnancy fee
United Refuah shares expenses related to psychiatric or psychological counseling and treatment related to diagnosed mental illnesses. This sharing is limited to a maximum of 10 visits per membership year, with a maximum amount of $125 eligible for sharing per visit. However, they do not share in expenses for other mental health needs that are not classified as a diagnosed mental illness.
While United Refuah doesn’t directly share in standard prescription costs, they do offer a telemedicine program called TeleRefuah, which includes a discount card for medications. This program can help you receive a 30-50% discount on medications nationwide.
We hope this entry of our FAQ Series has been helpful in better understanding United Refuah HealthShare, their processes and policies, and what they might offer you as a member. Each health share company out there has its own set of rules and guidelines, so it can be hard to pin down exactly how each one works without a lot of research. So, if there are any other questions you’d like to see answered here, don’t hesitate to drop us a comment below!