Secure Membership
- Includes all ACA preventative services per HealthCare.gov
- https://www.healthcare.gov/coverage/preventive-care-benefits/
- Is Health Savings Account Compatible
- Meets all state mandates - important for NJ, CA, VT, MA, RI, DC residents
- Eligibility: Sole Proprietors, Free lancers, 1099 recipients
- Small business - beginning at a group of one!
Listen to an Audio Overview
Less than 10 minutes -- Learn if healthcost sharing with MPB.Health is a good fit for you!
Initial Unshared Amount Options (IUA)
Choice of $1000, $2000, or $5000.
What is an IUA?
The Initial Unshared Amount is the out of pocket amount the member has prior to cost sharing for the NEED.
All qualified medical expenses after IUA is met are shareable at 100% and without an annual or lifetime limit.
The IUA is met one time for the Need and not does not reset annually. It remains open with all medical expenses related to the Need being shared until symptom free for 12 months.
Members usually benefit with an IUA vs a yearly deductible.
Secure members must use the PHCS Multiplan Network for all ACA Preventative Services
For expenses outside of the ACA Preventative Services- there are two options:
- Present themselves as SELF PAY Patients - this will typically save 50%
- Utilize the PHCS MultiPlan Network and present your Zion Health Card at time of service. After the discounting the member is then responsible for the payment to the provider until they reach their IUA.
What is a Need?
A "Need is the ALL of the medical expenses surrounding a new illness, accident or diagnosis.
Once the total expenses for any new need exceed the Initial Unshared Amount, the member no longer contributes to the need and further medical expenses are shared by the community.
Worse Case Scenario 3 Max IUA's within a rolling year
Any member household that experiences 3 IUA's within a membership year may have any further medical expense fully shared after only reaching a $500 threshold to further protect the member
Pre-Existing Conditions
Pre-Existing Conditions - 24-month look-back:
- Months 1-12: No sharing,
- Months 12-24: Sharing up to $25,000
- Months 24-36:Sharing up to $50,000,
- After 36 Months: Sharing up to $125,000 for the pre-existing condition.
Exceptions for High Blood Pressure, High Cholesterol & Diabetes as long as there has not been a hospitalization for the condition in the past 12 months and able to control through medication or diet.
$50 Surcharge and Restrictions for Smokers over age 50
$50 monthly surcharge per household.
Furthermore, there is a sharing limit for smokers age 50 or more of $50,000 for Heart Conditions, Cancer, COPD & Stroke.
Included in Your Membership
- All preventative care and screenings outlined in Healthcare.gov
- https://www.healthcare.gov/coverage/preventive-care-benefits/
- Preventative care and screenings must be done within the MultiPlan Network
- This includes all age appropriate screenings such as Immunizations, Paps, Mammography, Colonoscopy, some birth control methods - more than 60+ items
- Genetic Testing is not included within this membership
- MPB.Health is designed to meet all state mandates
- This is especially important if you are a NJ, CA, VT, MA, RI, DC resident
- MPB.Health Secure Membership is Health Savings Account compatible
- https://www.hsabank.com/hsabank/homepage is one HSA resource
- HSA Qualified Expenses - (Link to set up an Individual account) (Employer Account) This is just one resource for a Health Savings Account
- Unlimited Virtual Healthcare 24/7/365 - Immediate Access
- MPB.Health's Care Concierge Team - M-F 9am -8 pm EST
- Member Assistance Plan with up to 12 counseling sessions per person / per year - virtual or in person counseling, light legal assistance, professional & personal development
- Alternative Care Healthcare Discounts on Chiropractic, Acupuncture, Massage, Physical Therapists, etc.
- Pharmacy Benefit Plan & Resourcing Concierge Service
- Personal Medical Records Vault QR Life Code
- Well being Platform
- Medical Cost Sharing for larger & catastrophic expenses with Zion Health
- No sharing limits or lifetime maximums
MPB.Health's Concierge Team
Monday - Friday from 9 am - 8 pm EST
Members experience concierge care second to none!
When a members needs to access care outside of the DPC relationship, the MPB.Health concierge team is there for your every step of the way.
When an in-person visit is necessary, our Care Concierge Team provides navigation and research to find high quality, fair price providers. They also provide price verification and negotiation for services under $5k.
Counseling Sessions Included
Includes up to 12 counseling per person, per year either virtual or in person care - even with your established practitioner.
Includes substance abuse, ongoing depression or anxiety, financial concerns, relationship problems and more.
Concierge Pharmacy Resourcing and Discounting
Prescriptions that are related to a qualified Need are also considered sharable when they are part of treatment or are curative.
Maintenance medications are not shareable.
Your MPB.Health Concierge team can help resource the best prices for medications if help beyond RxGo or GoodRx is needed.
For more expensive medications we have resources who can get medications overseas to our members at a better cost. For example, high cost maintenance meds such as insulin, medicated creams, & asthma inhalers.
MPB.Health also helps members to access to all Manufacturer Savings Programs, Patient Assistance Programs and other savings and discounts offered by pharmaceutical manufacturers.
Complimentary and Alternative Med Discounts
No pre-authorizations are needed, there are no claims to file and members will receive discounts directly to their email
The online portal is easy to access, connecting members to a discounted network of vetted alternative medicine practitioners, lifestyle products, and other products such as massage, acupuncture, chiropractic, etc.
Alternative medical treatments can be shared with the Medical Cost Sharing community. These alternatives generally should be considered safe and effective while being an alternative to a traditional treatment plan. Needs may be considered shareable pending prior written approval by your Medical Cost Sharing provider. Member is required to demonstrate the proposed value of the alternative treatment.
Personal Medical Records Vault
Secure and accessible emergency profile and personal health records.
Members can grant access to their Electronic Medical Records to practitioners, providers, facilities, etc. providing continuity of care.
24/7 Emergency Assistance with your Personal Life Code
24/7 Emergency Assistance with your Personal Life Code allows medical professionals instant access with a 5-digit Life Code ID
Well Being Platform
Members fill out an online health risk assessment which assesses diet, exercise, and lifestyle habits. The results give members tips, tools, guidance and education to help them become and stay healthy.
Additional Discounts
NutriSystem - 50%
Amplifon - 50%
Zeel 15%
And more!
Funeral and End of Life
For a Member, and/or his or her dependents, who die(s) after one year of uninterrupted Membership as a Sharing Member, financial assistance to the surviving family will be provided by the Members according to the following schedule, upon receipt of a copy of death certificate, and as listed on the Member enrollment.
$10,000 Primary Member, $10,000 Dependent Spouse,
$2500 Dependent Child
Medical Cost Sharing for Large or Catastrophic Medical Expenses
All ACA HealthCare.gov Screenings and Preventative Services are accessible without a waiting period. https://www.healthcare.gov/coverage/preventive-care-benefits/
You will work with your MPB.Health Concierge team when ever you need to seek care - or if you have a catastrophic need.
They will help you access quality healthcare at a reasonable cost, they will assist you in being a self pay patient. You will not be alone. You will have assistance every step of the way.
For larger or more catastrophic events, seek care telling the hospital or provider that you are a self pay patient that is part of a healthshared community. You should alert the MPB.Health Concierge team as soon as possible.
You will only be responsible for your initial unshared amount.
Sharing Limits
Sharing Limits - No annual or lifetime limits unless restricted by a pre-existing condition.
Please visit the link below for the most up-to-date guidelines
Maternity Guidelines
Principals of Membership
Principals of Membership
One initial unsharable amounts (IUA’s) are applied to a single maternity need and one for the baby.
(This is the best Maternity option
I have seen )
Pregnancies are considered pre-existing if the pregnancy start date is within the first 60 days of the membership effective date.
IUA may be waived for a Home Birth
Your Guide and Advisor
I am here to answer any questions and concerns you might have and assist if healthcost sharing is a new concept to you.
After your enrollment, this care will continue with the MPB.Health's Concierge Team for any need you may have.
You also have me as an additional resource and as your advisor and advocate.
You will have help every step of the way. You will never be on your own.
Karen Torsoe
"The HealthShare Lady"
845-641-9123
Click HERE to set up a 1:1 Phone or Zoom Call now!
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