Programs

Programs Overview

Find the Program that Best Meets Your Needs

 

Anabaptist HealthShare offers membership in three unique sharing programs that are designed to meet its members’ specific preferences and needs. It is possible for members to switch programs. However, there are a few stipulations/results if a member changes levels (see “Changing Programs” on our Guidelines page) so it is in your best interest to select a program carefully.

Program 1: Basic

Catastrophic

 

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The Catastrophic Program is our most basic option and is designed to only share medical bills from hospitals or surgery centers. Members’ bills related to hospital-employed physicians and specialist centers within the hospital are eligible to be shared. However, doctor’s office visits, specialist center diagnostics, emergency transportation, all bills related to maternity (including maternity hospital bills), prescriptions, and physical therapy are excluded from the Catastrophic Program.

  • Incident or Illness ISA* – $5,000
  • Incident or Illness Cap – $150,000

*Individual Shared Amount (ISA) is the member’s responsibility per incident or illness.

For more information, see “Pre-existing conditions” and “non-FDA Approved Medicine” on the Guidelines Page

Guidelines

Program 2: Mid-Level

Standard

 

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The Standard Program is our mid-level program and is designed for individuals or families who are interested in sharing all qualified medical expenses including maternity expenses, doctor office visits, specialist centers, emergency transportation, etc. The Standard Program treats each incident or illness as one “case” and therefore all the medical expenses related to that qualified incident or illness are eligible to be shared within the program guidelines. For more information on what is a qualified incident or illness see “Exclusions” and “Items not routinely shared” under guideline details.

  • Incident or Illness ISA* – $1,500
  • Incident or Illness Cap – $500,000

*Individual Shared Amount (ISA) is the member’s responsibility per incident or illness.

For more information, see “Pre-existing conditions” and “non-FDA Approved Medicine” on the Guidelines Page

Guidelines

Program 3: Premium

Complete

 

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The Complete Program is our upper-level program and is designed for individuals or families who prefer a low ISA and an unlimited sharing cap per incident or illness. The Complete Program is similar to the Standard Program in that it treats each qualified incident or illness as one case and all the medical expenses related to that case are eligible to be shared within the program guidelines. The Complete Program has attractive maternity guidelines and features more generous guidelines towards pre-existing conditions and chronic illness.

  • Incident or Illness ISA* – $500
  • Incident or Illness Cap – Unlimited

*Individual Shared Amount is the member’s responsibility per incident or illness.

For more information, see “Pre-existing conditions” and “non-FDA Approved Medicine” on the Guidelines Page

Guidelines

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program for Employers and Employees

Worker’s Aid

Call AHS for further information. This is not worker’s compensation insurance.

 

Workers Aid Plan is an economic job-related injury and time off work mutual aid program. If you wish to have your job-related injuries shared at AHS, you will need to enroll in the AHS Workers Aid Plan. Anyone legally required to have Workers Compensation coverage is not eligible to participate in the Workers Aid Plan.

  • Monthly Membership Cost – $22
  • Sign-on Fee per Employee – $50
  • Employee Responsibility per Incident or Accident – $2,000.
  • Time Off Work Sharing – 2/3 Normal Employee Rate (Begins after 1 week of the incident and has a maximum 2 months sharing payout).
  • All pre-existing conditions or cases are excluded from this program.