Some Pre-existing conditions have a waiting or phase in period. See plan details for more information.

*Once copay limits have been reached, additional costs may qualify for Health Share after UA has been met. Pre-existing condition limitations may apply.

Note: When using Health Share, you can choose any doctor or provider you prefer.

Maternity costs are eligible for cost sharing. In fact many of our members will spend a fraction of what is typically owed for those using traditional methods to cover their care. Our maternity program includes prenatal, delivery, postnatal, homebirth, midwives, and doulas. Members who keep the cost down for the Health Share community may be eligible to have part of their UA responsibility waived. Members are able to use a wide variety of prenatal and postnatal services that are not often covered by traditional plans. *Those who are pregnant or who become pregnant within the first 30 days of joining are not eligible to share the maternity expenses.

The Healthy PPO plan does cover many preventive care costs. You can find a full list of preventive services covered by your plan at healthcare.gov/coverage/preventive-care-benefits.

A UA, or Unshared Amount, is the portion a member pays per incident before ShareWELL begins to share in medical expenses. Similar to a traditional insurance deductible, the UA is the out-of-pocket cost for each medical event. Once the UA is met, additional eligible medical expenses are covered.

For example, if you select a UA of $1,500 and are hospitalized for a heart attack, you pay the UA, and that's it! Members are not required to pay for the same Sharing Request within 12 months of the last treatment date. Furthermore, members will never pay more than two UAs within a rolling 12-month period.

The Healthy PPO Plan comes with Unlimited Virtual Urgent Care, 24/7/365 with Licensed, Board- Certified Physicians at $0 copay.

Health Share protects members in emergency, surgery, hospitalization, and large out of pocket medical expenses. Millions of Americans have chosen Health Share membership for healthcare freedom, savings, and a safety net for the unexpected in life.

Our Advocacy team works with members to negotiate and attain fair pricing for medical services. As direct and self-pay patients, our members experience lower medical bills by leveraging our resources.

You can join PMBMed anytime. Sign up for an insurance plan by the 20th of the month to be covered on the first day of the following month.

There are no long-term commitments. Disenroll from a PMBMed Healthy PPO Plan by the 20th to be effective for the following month.

The Preferred Provider Organization (PPO) is accessible through First Health Aetna which is used for the preventive, provider facility copays as well as lab portion of this plan.

To locate a provider visit https://providerlocator.firsthealth.com/LocateProvider/SelectNetworkType

Select "First Health" as the network and then select provider type and enter zip code.

The Healthy PPO Plan includes insurance benefits which are compliant with Part A of the Affordable Care Act.

Members have access to their program both thru a secure online member portal with dashboard as well as the ability to download a mobile app with accordion plan features including ID card.

Utilize the member ID card with third party administrator and PPO network accessible thru Health Wallet mobile app for the following services:

• ACA Preventive Services
• Virtual Telehealth
• Provider Office Visits
• Urgent Care
• Pharmacy
• Lab & Imaging

Health Share needs are met in the following ways:

• Major medical (Emergency, Hospital and Surgery)
• Out-of-pocket costs after beyond PPO & UA

When anticipating or experiencing a medical out-of-pocket expense beyond the PPO benefits and after the UA, members should immediately establish self-pay for best cash discount and then whenever possible, coordinate with ShareWELL and the Care Coordinator for approval and pre-pay in accordance with member guidelines.

The Healthly PPO plan offers personal service to members via a help desk, direct phone contact and mobile app with access to unlimited care coordination, advocacy and program navigation.

Our HealthShare plans are availabled across the United States with the exception of the following states: Washington and Vermont

Costs that occur abroad can be shared, regardless of where they occur, as long as the Sharing Request is eligible based on the Member Guidelines.