A. Bringing Believers Together
B. No Ministry Liability or other Member Liability for Payment of Medical Bills
C. Basis for Sharing
D. Current Guidelines Govern    

 A. Bringing Believers Together

Medi-Share is a program of Christian Care Ministry, Inc., a Florida not for profit corporation that is recognized as tax exempt under Internal Revenue Code 501(c)(3) (“Christian Care Ministry” or “CCM”). Medi-Share brings believers together to share the blessings God has bestowed on them according to the example of Scripture and the early Christian Church. CCM matches a Participant's Eligible Medical Bill(s) (as defined in Section II.) with Participants who have volunteered, in faith, to share in the payment of medical bills through the biblical concept of Christian mutual sharing. These Guidelines specify the medical expenses that will be published for sharing to Participants and explain how sharing may be accomplished on behalf of a Participant in need.

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 B. No Ministry or Other Participant Liability for Payment of Medical Bills

A Participant remains solely responsible for the payment of his or her medical bills at all times. All sharing by Participants is on a voluntary basis. Shared medical bills are paid solely from contributions of Participants, not from funds of Christian Care Ministry itself. Neither CCM nor Participants are responsible for the payment of a Participant’s medical bills and neither shall be held liable for any part of a Participant’s medical bills. Neither CCM nor Medi-Share is insurance or an insurance company. The payment of your medical bills through Medi-Share or otherwise is not guaranteed in any fashion. Medi-Share is not, and should never be construed as, a contract for insurance or a substitute for a contract guaranteeing medical or hospitalization benefits of insurance. There is no transfer of risk from a Participant to CCM. 

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 C. Basis for Sharing 

These Guidelines are based on the expressed wishes of the Medi-Share participants. Changes to the Guidelines may be effected in one of three ways:

1) By the Participants – Periodically (usually once or twice a year), ballots with significant proposed changes to the Guidelines are submitted to the Participants for voting. If at least 67% of the Participants voting on a particular proposed change to the Guidelines approve the proposed change, then the change will be implemented.
2) By the Medi-Share Steering Committee – The Medi-Share Steering Committee, which is a group of Participants who are independent of CCM staff and who are not controlled by its Board of Directors, may act on the Participants’ behalf if there are changes to the Guidelines that do not involve significant new restrictions or relaxations of the Guidelines. A list of approved changes will be maintained on the website for at least 24 months from the date of the respective change.
3) By the Board of Directors – The CCM Board of Directors, acting to protect or strengthen the Medi-Share program or its Participants, may override these Guidelines. Such Board action must be presented to the Participants on the next ballot, which must be presented to the Participants no later than 12 months from the effective date of the Board action. If the change is ratified by at least 67 percent of the Participants voting on that question, then the change will become permanent. If the Participants do not so ratify the change then on the date that the ballot in question is closed, the Guideline change in question shall revert to its previous version, unless the Participants voted to enact a different provision on such ballot.

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 D. Current Guidelines Govern 

The current Guidelines govern, not the Guidelines in effect when a Participant joined. The Guidelines are definitive and will overrule any verbal statement made by anyone regarding the Medi-Share programs. The current Guidelines appear on the website at www.MyChristianCare.org. 

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Annual Household Portion (AHP) – The dollar amount that a Participant Household must pay toward its Eligible Medical Bills during a 12 month period, which begins with its Effective Date, before Eligible Medical Bills can be published for sharing.

Additional Participant Portion (APP) – An additional dollar amount above the AHP that a Participant Household must pay toward its Eligible Medical Bills in instances of maternity or motorized vehicle accidents (see Sections IX. and XIII.).

Effective Date – The month and day participation begins or the month and day of the most recent Annual Household Portion (AHP) switch. Effective Date is used to determine when the 12 month period for the purpose of the Annual Household Portion begins and ends.

Participant - Any Participant of Medi-Share, including each family member participating in a Participant Household.

Participant Household – Every participant, taken or viewed as one collective unit, of an immediate family, that is, husband, wife, and children (including children for whom full legal custody and/or guardianship has been awarded to the husband and/or wife) that participate in Medi-Share together under the same Monthly Share. A single Participant is also considered a Participant Household.

Incident - The occurrence of an illness or an injury that requires a diagnosis of symptoms and treatment of a specific condition for an individual Participant.

Eligible Medical Bill – An incurred medical bill that has been determined to be eligible for sharing pursuant to the Guidelines, reduced by any applicable discount, Provider Fee, penalty, insurance or other source of payment.

Monthly Share - The dollar amount that a Participant agrees to send faithfully each month to take care of his or her Monthly Sharing Portion and Monthly Administrative Portion.

Monthly Sharing Portion - The dollar amount of a Monthly Share that pays all or part of one or more Eligible Medical Bills. The Monthly Sharing Portion is subject to change without notice.

Monthly Administrative Portion - The dollar amount of a Monthly Share that is transferred to CCM for the payment of its administrative expenses.

Provider Fee – Amount that a Participant pays at each visit to a medical provider, which applies even after the Annual Household Portion (AHP) has been met or exceeded. The Provider Fee does not apply toward the AHP.

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A.  Christian Testimony
B.  Spouse and Children
C. Adult Children of Participants
D. Children of Participants Who Apply for Individual Participation
E. 65 Years of Age and Older 
F. Application Review
G. U.S. Citizens Who Have Lived Abroad
H. Non-U.S. Citizens
I. Health Partnerships

 A. Christian Testimony

All adult Participants (18 years of age or older) must have a verifiable Christian testimony indicating a personal relationship with the Lord Jesus Christ and profess the following Statement of Faith:

Statement of Faith:
• I believe that there is one God eternally existing in three Persons: the Father, the Son, and the Holy Spirit.
• I believe that the Bible is God's written revelation to man and that it is verbally inspired, authoritative, and without error in the original manuscripts.
• I believe in the deity of Jesus Christ—His virgin birth, sinless life, miracles, death on the cross to provide for our redemption, bodily resurrection and ascension into heaven, present ministry of intercession for us, and His return to earth in power and glory.
• I believe in the personality and deity of the Holy Spirit, that He performs the miracle of new birth in an unbeliever and indwells believers, enabling them to live a godly life.
• I believe that man was created in the image of God, but because of sin was alienated from God. That alienation can be removed only by accepting through faith alone God's gift of salvation which was made possible by Christ's death.

A church leader may be interviewed to verify the applicant's testimony. All Participants agree to live by biblical standards, agree that believers are to bear one another's burdens, attend a fellowship of believers regularly, and actively support that ministry (Galatians 6:2, Romans 10:9-13; Psalm 133; Hebrews 10:24-25). Participants believe the biblical doctrine that their bodies are temples of the Holy Spirit and are therefore to be kept pure. Violations of this doctrine include, but are not limited to, the use of tobacco in any form and the abuse of drugs, including legal drugs, such as alcohol. Applicants must have abstained for at least the 12 months prior to application from the use of tobacco in any form. In accordance with Scripture, Participants must not engage in sex outside of traditional Christian marriage. A child and a Participant parent must certify to CCM within 60 days after the child reaches the age of 18 that the child understands and lives by the lifestyle requirements for participation in his or her parent(s) household to continue. If certification is not received by the due date, the child's participation will be cancelled and only medical bills that were incurred prior to the child's 18th birthday will be considered for sharing.

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 B. Spouse and Children
An applicant's spouse and biological children for whom they are legally responsible can be included in the applicant’s Participant Household if they otherwise meet qualifications. Application can also be made for legally adopted children, for children in legal custody whose adoption is pending or for children for whom full legal custody and/or guardianship has been awarded to the Participant.

Applicants and Participants who wish to have non-biological children considered for inclusion in the Participant Household must provide a comprehensive medical history and physical examination performed by a U.S. licensed medical doctor along with the results of all indicated laboratory studies. These examinations must have been performed within two years of application. Children who were adopted more than three years prior to application for Medi-Share and have resided continuously in the U.S. with the adoptive parents are exempt from this requirement.

A new spouse must apply and qualify to be added as a Participant (application at www.MyChristianCare.org).

• If the application is submitted prior to the marriage date, once approved, the participation will begin on the marriage date. Standard sharing limitations for new participants apply (see Section VII. D.). However, a pregnancy that occurs at any time on or after the marriage date will be considered for sharing pursuant to Section IX.

• If the application is submitted after the marriage date but within thirty days of that marriage date, once approved, standard sharing limitations for new participants shall apply (see Section VII. D.) with the sharing start date to be the first day of the month following such approval. However, a pregnancy that occurs at any time including on the marriage date or thereafter will be considered for sharing pursuant to Section IX if the application is approved.

• If the application is not submitted before or within thirty days of the marriage date, standard sharing limitations for new participants apply (see Section VII. D.) and there will be no exception for maternity that occurs before the effective date.

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 C. Adult Children of Participants

Unmarried adult children of Participants may be part of the parent(s) Participant Household until they reach age 23 if they meet one of the following qualifications:

• The child continuously lives at the home of his or her parent(s);
• The child is enrolled in an institution of higher education as a full-time student. The child may live away from home for school holiday recesses and a single period of up to 150 days between school terms per calendar year;
• The child is engaged in full time Christian missions work;
• The child is enrolled and participating in Christian education programs; or
• The child is enrolled and participating in a certified technical school.

When an adult child no longer qualifies to be a part of his or her parent(s) Participant Household, it is the responsibility of the Participant to promptly notify Member Services at (800) 264-2562. Continuing to submit the Monthly Share at the level that included the adult child does not extend his or her participation in the Participant Household if he or she no longer meets one of the five qualifications listed above. An adult child may return to a Participant Household provided he or she meets one of the five qualifications listed above; a processing fee will be applied.

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 D. Children of Participants Who Apply for Individual Participation  

Upon reaching 18 years of age, a child that participates under his or her parent(s) Participant Household may apply for individual participation. Such applicant must submit to the standard application process. If the applicant is still an active participant in a Participant Household at the time the application is received by CCM, the application fee will be waived. If the applicant qualifies for participation, the new Participant restrictions stated in Section VII. D. will be waived and any medical conditions that were previously eligible for sharing will continue to be eligible under the individual program.

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 E. 65 Years of Age and Older

Participants must be enrolled in Medicare Parts A and B effective the first day of the month in which they turn 65 years of age. In order to continue as a Participant, a copy of the "Medicare Health Insurance Card" listing Part A and Part B coverage must be submitted to CCM by the last day of the month of the Participant’s 65th birthday. Pursuant to Section VII. F., sharing of medical bills for Participants 65 and older is limited.

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F. Application Review 

Christian Care Ministry relies on the medical and lifestyle information provided during the application process to determine whether or not an applicant qualifies for Medi-Share. Applicants who have a history of serious medical condition(s), who are significantly overweight or who are at significant risk for major disease may not qualify for Medi-Share. In some cases, it may be necessary for the applicant to have providers submit medical records. No attempt is made to identify unresolved medical conditions except those that could disqualify an applicant for participation. However, if it is clear to the application reviewer that diagnosis and treatment of a medical condition may not be eligible for sharing, the applicant may be notified when he or she is invited to join Medi-Share. Such notification is provided as a courtesy; if such a notification is given, it is not necessarily an exhaustive list of all medical conditions that may not be eligible for sharing. Medical conditions not listed in such a notification may be ineligible for sharing. Therefore, a prospective Participant must never assume that a condition is eligible for sharing because the applicant was not notified that the condition might be ineligible.

Failure to disclose medical or lifestyle information that would have disqualified the applicant from participation may result in medical bills not being shared and/or future cancellation. If a Participant or applicant recalls or becomes aware of any medical history that was not reported during the application process, that information should be immediately submitted in writing to CCM.

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 G. U.S. Citizens Who Have Lived Abroad   

U.S. citizen applicants who have lived abroad for more than 12 consecutive months during the past three years may be required to have a physical examination and other medical tests.

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  H. Non-U.S. Citizens 

U.S. citizen applicants who have lived abroad for more than 12 consecutive months during the past three years may be required to have a physical examination and other medical tests.

Only permanent U.S. residents with a green card or visa and a Social Security number who live full-time in the U.S. can qualify for Medi-Share participation. A physical examination and other medical tests may be necessary to determine whether or not the applicant qualifies. On the day that such a Participant ceases to be a legal resident of the U.S., he or she no longer qualifies for Medi-Share. Medical bills incurred on or after that date are not eligible for sharing, even if the Participant continues to submit Monthly Shares. 


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 I. Health Partnerships 

Christian Care Ministry is dedicated to promoting the health of its Participants through educational initiatives. CCM is also committed to creating initiatives that allow the greatest number of applicants to qualify for Medi-Share. Applicants whose risk of major disease falls within a specified range and whose condition is likely to be reversed through a healthful lifestyle may qualify for participation as a Health Partner.

A Health Partner enjoys the same medical bill sharing privileges as other Participants, but participates in the Restore Program, which is designed to reduce the risk for major disease. In Restore, each Health Partner works with a Health Coach to develop and implement a personal plan for achieving required health-related goals. Failure to adhere to the plan or failure to achieve the designated goals within 12 months could result in cancellation of the Medi-Share participation. Health Partners pay a monthly Restore Program fee in addition to their Monthly Share. 

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A. Annual Household Portion (AHP)
B. Provider Fee
C. Maximum Sharing Limits
D. Switching Annual Household Portion
E. Participation Milestones
F.  Health Incentive

 A. Annual Household Portion (AHP)

The Medi-Share program has multiple Annual Household Portions (AHPs) from which Participants can choose. The AHP is the dollar amount that a Participant Household must pay toward its Eligible Medical Bills during a 12 month period, which begins with its Effective Date, before Eligible Medical Bills can be published for sharing. For this reason Participants should have their providers submit all medical bills to CCM for processing, even if they have not met their AHP. After a Participant Household’s AHP is met, Eligible Medical Bills are published to the Participants for sharing, subject to other limitations in these Guidelines. 

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 B. Provider Fee   

Providers may collect $35 for every office visit or hospital stay or $135 for every emergency room visit. If these fees are not collected, the Participant will be responsible for them. If any other charges for that visit are deemed ineligible they will not be published for sharing. The Provider Fee is not applied to the AHP and continues to be paid after the AHP is reached. 

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  C. Maximum Sharing Limits   

Providers may collect $35 for every office visit or hospital stay or $135 for every emergency room visit. If these fees are not collected, the Participant will be responsible for them. If any other charges for that visit are deemed ineligible they will not be published for sharing. The Provider Fee is not applied to the AHP and continues to be paid after the AHP is reached. 

Sharing for Participants under the age of 65 is limited to a maximum of $1,000,000 per individual of Eligible Medical Bills incurred in a 12 month period with a lifetime maximum of $5,000,000 per individual. Participants age 65 or older, please see Section VII. F. for sharing limits. No increase in the sharing limits results when an individual participates in multiple Christian Care Ministry programs. No provision in these Guidelines shall cause the sharing limits to be exceeded.

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 D. Switching Annual Household Portion

Participants must apply in writing to switch Annual Household Portion (AHP). All Participants in a Participant Household must switch together to the new AHP. There is an administrative fee of $75 to change AHP, and certain limitations apply as shown in the chart below:

*Only Participants age 18-29 applying for a single program can qualify for a $500 AHP. Participants with a $500 AHP are not eligible for sharing of maternity or adoption expenses.

Bills will be processed according to the AHP that was in effect the date the bills were incurred. Please note that any change in the AHP causes the amount of Eligible Medical Bills paid toward the AHP to reset to $0 since the Effective Date also resets as described above.

For example: On 3/30 you are an active Participant with a $2,500 AHP; you have incurred $1,000 towards your AHP and are approved for a switch to a lower AHP. On 7/1 your AHP switch becomes effective. The amount of Eligible Medical Bills paid towards your AHP resets to $0 on 7/1 and bills incurred prior to 7/1 will continue to be applied toward your $2,500 AHP.

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 E. Participation Milestones   

At certain points during participation, life changes will occur that may require action on the part of the Participant to maintain or add to their participation.

1. Adult Child

At certain points during participation, life changes will occur that may require action on the part of the Participant to maintain or add to their participation.

•18 to 23 yrs of age – Participant must qualify to remain on (see Sections III. A., C. and D.).
• 18th birthday – If remaining a participant under his or her parent(s)’ Participant Household, Participant must complete a Medi-Share Commitment form (see Sections III. A., C. and D. and www.mychristiancare.org) or apply for individual participation.
• 23rd birthday – Prior to child turning 23, he or she should apply for individual participation, as he or she no longer qualifies to participate as part of his or her parent(s)’ Participant Household (see Section III. C.).
• Getting Married - Participant may no longer participate under his or her parent(s)’ Participant Household and must apply for his or her own program (application at www.mychristiancare.org ).

2. Marriage/Divorce

• Marriage - Spouse must apply and qualify to be added as a Participant (application at www.mychristiancare.org ).
The application can be submitted before or after the marriage; however, there are advantages to applying prior to or within thirty days of the marriage date. (See Section III. B.).
• Divorce – Participant should contact Member Services for information on participation and program options.
• Participant on $500 AHP marries and would like to add spouse and/or child – If spouse and/or child becomes a Participant, AHP must be changed.

3. Add Children

• If the mother is a Participant, a newborn can be a Participant from birth if the Add a Newborn Form is completed and submitted within 30 days of delivery (see Section IX. E.).
• Application can be made for legally adopted children, for children in legal custody whose adoption is pending, or for children for whom full legal custody and/or guardianship has been awarded to the Participant (see Section III. B.) (application at www.mychristiancare.org).

4. Turning 65  

• If the mother is a Participant, a newborn can be a Participant from birth if the Add a Newborn Form is completed and submitted within 30 days of delivery (see Section IX. E.).

• Application can be made for legally adopted children, for children in legal custody whose adoption is pending, or for children for whom full legal custody and/or guardianship has been awarded to the Participant (see Section III. B.) (application at ). 
• Participant must verify that they are enrolled in Medicare Parts A and B effective the first day of the month in which they turn 65 (see Section III. E.). Sharing limitations apply (see Section VII. F.).

5. Age Affects Share Amount 

• Participant must verify that they are enrolled in Medicare Parts A and B effective the first day of the month in which they turn 65 (see Section III. E.). Sharing limitations apply (see Section VII. F.). 

• When a 29 year old Participant on $500 AHP turns 30 then the AHP will automatically be moved to the $1,250 single AHP with no fee or waiting period.

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 F. Health Incentive

At any time after the first month of participation, a Participant Household may qualify for a reduction of their Monthly Share amount if the adult Participants meet specified health criteria. For detailed information, visit www.MyChristianCare.org.

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A. Individual Bank Accounts
B. Sharing Faithfully Each Month
C. Assistance
D. Praying and Sharing
E. Termination
F. Reapplication After Termination
G. Withdrawals and Cancellations

 A. Individual Bank Accounts 

In order to facilitate Participant to Participant sharing, each Participant Household must establish a bank account with a Christian Care Ministry-specified financial institution and sign a Limited Power of Attorney agreement that gives CCM the ability to facilitate sharing on behalf of the Participant Household in accordance with these Guidelines. Participation cannot begin until these actions are properly completed.

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 B. Sharing Faithfully Each Month  

Each month CCM sends notice of the Monthly Share amount that is due on the first day of the next month. To encourage timely sharing, Participants whose Monthly Shares have not been deposited in their individual account by the seventh of the month are required to contribute $5.00 or 5% of the late amount, whichever is greater, to Extra Blessings (see Section VII. G.).

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 C. Assistance

If a Participant's illness or injury causes a Participant to lose his or her income, Christian Care Ministry may waive the Participant’s Monthly Share for up to 3 months. This assistance is subject to approval and monthly review by CCM. Supporting evidence from the Participant is required. The illness or injury cannot be related to a medical condition or treatment listed in Section VIII. E. or be caused by the diagnosis or treatment of such a condition.

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 D. Praying and Sharing

The names and addresses of the Participants assigned to receive each Participant's Monthly Sharing Portion are published on a secure website at www.mychristiancare.org. Participants must register a user name and password to view Participant-specific information at this website. Participants are encouraged to pray for each other and their families and send cards, letters or emails of encouragement as many have expressed how blessed they are by their fellow Christians who take the time to contact them.

To review the latest urgent prayer needs of Participants, visit www.mychristiancare.org. To request prayer support for a medical event, Participants should call Member Services at (800) 264-2562 or e-mail prayer@medi-share.org.

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 E. Termination 

If a Monthly Share is more than two months overdue, the Medi-Share participation will be cancelled. The effective date of the cancellation will be the last day of the month for which the last Monthly Share deposit was made. Medical bills with a date of service after that date are not eligible for sharing.

A Medi-Share participant may bring his or her program current at any time prior to the passing of two months from the due date of his or her last Monthly Share by depositing each Monthly Share and Extra Blessing late fee amount then due by such date. In that case, medical bills incurred during that time period may be submitted for consideration of sharing.

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 F. Reapplication After Termination 

A Participant who has been cancelled for not sharing faithfully must re-apply, repeating the full application review procedure. Further, no medical bills will be shared for the first three months of the new participation term. All medical conditions arising prior to the date of reapplication, including medical conditions that arose during the prior Medi-Share participation, shall be subject to all portions of these Guidelines, including but not limited to Section VIII. A.

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 G. Withdrawals and Cancellations 

All changes in participation are effective on the first day of the applicable month. If a Participant wishes to withdraw a family member or cancel the entire program, Christian Care Ministry must be informed by mail, e-mail, fax or phone at least 15 days prior to the desired effective date.

Mail:     P.O. Box 120099, West Melbourne, FL 32912-0099
E-mail:  memberservices@medi-share.org
Fax:       (321) 308-7779

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It is a Participant’s responsibility to present his or her Medi-Share ID card to his or her provider at the time of service and to direct the provider to pre-notify CCM by calling (321) 308-7777. Emergency/urgent care does not require pre-notification; however, notification of emergency/urgent care is required within 72 hours of service. Some services require pre-eligibility review (see Sections VII. C. and VIII. F.) and providers will be informed if that is the case during the pre-notification call. If pre-eligibility is not obtained when required, Eligible Medical Bills may be denied. Notification and pre-eligibility review of medical bills are not a guarantee of eligibility, payment or sharing. CCM does not assume any financial risk or obligation with respect to medical bills. Medi-Share is not insurance or a discount card.

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A. American Medical Association (AMA) Approved Treatment 
B. Exceptions to AMA Approved Treatment
C. Preliminary Eligibility Review for Non-Emergency Surgical/Medical Procedures
D. Sharing During the First Month of Participation
E. Adoption
F. Sharing for Participants 65 and Older
G. Extra Blessing Gifts

 A. American Medical Association (AMA) Approved Treatment  

Only the cost of American Medical Association (AMA) approved testing, treatments, and up to six months of FDA approved prescription drugs per condition will be considered for sharing. They must be ordered by a Medical Doctor (M.D.), Doctor of Osteopathy (D.O.), Nurse Practitioner (N.P.), Physicians Assistant (P.A.), or Doctor of Podiatric Medicine (D.P.M.) and be performed at a hospital, surgery center, clinic, doctor's office, approved lifestyle center, or diagnostic facility, with some limitations (see Sections VII. B. and VIII. E. and F.). To be considered for sharing, diagnosis and treatment must be performed in the U.S. except in cases of emergency or when missionaries are serving abroad.
Medical bills cannot be considered for sharing unless they are submitted by the provider on a CMS 1500 or a UB and IB form (healthcare industry standard).

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 B. Exceptions to AMA Approved Treatment 

Non-AMA approved testing, treatment, or prescription drugs may be considered for sharing in accordance with Section VII. C. Non-AMA approved testing, treatment, and prescription drugs must be ordered by a Medical Doctor (M.D.), Doctor of Osteopathy (D.O.), Nurse Practitioner (N.P.), Physicians Assistant (P.A.), or Doctor of Podiatric Medicine (D.P.M.) and be performed at a hospital, surgery center, clinic, doctor's office, approved lifestyle center, or diagnostic facility. The cost for such treatments will be considered for sharing only for Participants with physical findings and/or symptoms that are suggestive to the medical providers listed above of disease or injury. CCM may offer consultation with CCM-recommended physicians who are knowledgeable in alternative care.

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 C. Preliminary Eligibility Review for Non-Emergency Surgical/Medical Procedures

By requesting a medical history review, a Participant can receive a preliminary determination of whether or not his or her proposed treatment appears to be eligible for sharing. To request a review, Participants should contact their Member Advocate at (800) 264-2562. Final eligibility determination will not be made until the medical bills are submitted for processing. It is possible that a treatment that appeared to be eligible for sharing during the preliminary eligibility review will be determined to be ineligible after medical bills are submitted if:
1. new information or additional medical records are provided that make the treatment ineligible, or
2. if additional procedures that were not reviewed for eligibility were performed.
The number of days required to complete a preliminary eligibility review is largely dependent on the responsiveness of the providers who are asked to send in medical records. The Participant will be notified of the preliminary review determination in writing.

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D.  Sharing During the First Month of Participation  

Sharing of medical bills for diagnosis and treatment of accidental injuries sustained during the first month of participation is limited to $50,000. All other medical bills incurred during the first month of participation are not eligible for sharing. These restrictions will be waived for Participants that participated under his or her parent(s) Participant Household immediately prior and qualify for individual participation (see Section III. D.).

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 E. Adoption 

Up to two adoption events can be shared per Participant Household. Sharing is limited to the amounts in the chart below; however, the AHP does not have to be met for sharing to occur. The adopted child(ren) cannot be related to the Participant or spouse by blood or marriage. The first event is eligible only after the Participant has shared faithfully at a level set for two or more persons for 24 continuous months prior to the adoption becoming final; the second event is eligible after a minimum of 12 additional months of like faithful sharing. The sharing of adoption expenses does not imply that a child automatically qualifies for inclusion in the Participant Household (see Section III. B.). Participants may apply to Extra Blessings Gifts (see Section VII. G.) for monetary assistance for the adoption events that are not eligible for sharing provided the shared faithfully levels above have been met and the Extra Blessings amount cannot exceed the original adoption sharing limit per program.

*Participants with a $500 AHP are not eligible for adoption sharing.

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 F. Sharing for Participants 65 and Older 

Sharing of Eligible Medical Bills incurred on or after the first day of the month in which a Participant turns 65 years of age is based on the difference between the Medicare Parts A or B allowable charges listed on the "Medicare Summary Notice" and the actual amounts paid by Medicare. The provider must submit a copy of the Medicare Explanation of Benefits and the CMS-1500, or UB and IB form. Sharing is limited to a maximum of $50,000 per individual of Eligible Medical Bills incurred in a 12 month period, with a lifetime maximum of $5,000,000 per individual, including amounts shared prior to the Participant turning age 65. Participants do not share in the cost of prescription drugs that are not covered by Medicare Parts A or B.
Participants must be enrolled in Medicare Parts A and B effective the first day of the month in which they turn 65 years of age. In order to continue as a Participant, a copy of the "Medicare Health Insurance Card" listing Part A and Part B coverage must be submitted to CCM by the last day of the month in which they turn 65 years of age.

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 G. Extra Blessing Gifts

A list of Participants with significant medical or adoption bills that have been determined to be ineligible for sharing is published monthly. This "Extra Blessing List" is enclosed with the Monthly Share notices. Extra Blessing Gifts can be sent directly to Participants on the list. However, if the gifts are sent to CCM or if Participants choose to pledge a monthly gift that will be added to their Monthly Share, the contributions may be tax deductible. One hundred percent (100%) of Extra Blessing Gifts received by CCM are distributed on a prorated basis to the Participants on the Extra Blessing List. For more information, Participants should contact their Member Advocate at (800) 264-2562.

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A. Pre-Existing Medical Conditions
B. Determining Eligibility for Sharing
C. Lifestyle Changes
D. Medi-Share Is Not a Substitute for Insurance Required By Law
E. Medical Conditions and Services Not Eligible for Sharing
F. Medical Procedures Requiring Pre-Eligibility Determination
G. Related Conditions
H. Participant Conflicts of Interest

 A. Pre-Existing Medical Conditions

Medical bills for diagnosis or treatment for a non-congenital pre-existing medical condition, which is defined as treatment, diagnosis, symptoms or medication for the condition prior to participation, will be eligible for sharing as follows:

• If the Participant has been sharing faithfully for 12 consecutive months, and if the condition has gone 36 months without treatment or medication, without being re-diagnosed (following a period of remission), and without symptoms recurring, the condition is eligible for sharing up to $100,000 per Participant per calendar year.

• If the Participant has been sharing faithfully for 60 consecutive months, and if the condition has gone 60 months, without treatment or medication, without being re-diagnosed (following a period of remission), and without symptoms recurring, the condition is eligible for sharing up to $500,000 per Participant per calendar year.

• Ongoing evaluation or treatment of High Blood Pressure/Hypertension that is diagnosed prior to participation will be considered ineligible for sharing. High blood pressure that is controlled through medication will not be considered a pre-existing medical condition for purposes of determining eligibility for future cardiovascular events.

Other Limitations 

• “Mini-Strokes” or Transient Ischemic Attacks (TIA) will be eligible for sharing after 60 months from the last TIA, assuming there have been no further symptoms, diagnosis or treatments.

• Cancer, including metastases, or new cancer of the same type as a previous cancer, regardless of the location of the cancer, will have a seven-year waiting period from conclusion of symptoms and/or treatment before a medical bill for the same type of cancer will be eligible for sharing. In cases of cancer in the following locations, the seven-year limitation will be extended as follows:

• 10 years – brain, colon, liver, ovaries, stomach or pancreas

• 15 years - bone, breast or lung

• Medical bills for the replacement of a joint will not be considered eligible for sharing if the joint was itself previously replaced, if the need for a replacement stems from a pre-existing medical condition, such as, arthritis, and/or if the Participant was informed prior to participating of the future need to replace the joint in question. However, if the joint was first replaced during participation, any necessary subsequent replacement of the same joint will be eligible for sharing, provided that the participation has been continuous, that is, no gaps.

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 B. Determining Eligibility for Sharing 

Except for the medical conditions and procedures listed in Section VIII. F., the eligibility of medical bills for sharing is determined only after medical services are rendered. The medical and lifestyle information provided by the Participant during the application process is used as a starting point for determining eligibility. Depending on factors such as the nature of the illness or the circumstances of the injury, medical records may be required in order to determine eligibility for sharing. If access to requested medical records is refused, the medical bill(s) cannot be shared.

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 C. Lifestyle Changes 

Failure to follow the Christian lifestyle attested to during the application process can result in medical bills not being shared and, for Participants age 18 or older, termination of participation. Examples of behavior that can lead to non-sharing include, but are not limited to, the use of tobacco in any form, the abuse of drugs including legal drugs, such as, alcohol, and participation in activities with willful disregard for personal safety.

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 D. Medi-Share Is Not a Substitute for Insurance Required By Law 

Medi-Share is not insurance; Participants must not certify that Medi-Share is insurance to avoid purchasing insurance that is required by law, rule or regulation. Medi-Share cannot be used as a substitute for any mandated insurance (except health insurance in Massachusetts), including but not limited to, workers' compensation insurance or to satisfy bonding requirements.

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 E. Medical Conditions and Services Not Eligible for Sharing 

Listed below are the treatments, medical conditions, procedures, and services that are not eligible for sharing:

• Abortion of a live fetus (baby)

• Bill(s) originally received by CCM more than 12 months from the date of service. If a bill is submitted within 12 months of date of service and CCM requests more information from the participants and/or providers in order to process the medical bill for sharing, that information must be submitted to CCM within 60 days from the date requested, or 12 months from the date of service, whichever is greater, in order for the bill to still be considered for sharing.

• Birth control procedures (for example, IUD) and/or supplies

• Breast Implants including replacement or removal

• Breast Reduction

• Charges that do not follow proper coding guidelines

• Congenital birth defects, except when the Participant has been continuously a Participant from birth (see Section IX. E.)

• Custodial Care/Long Term Care

• Dental/periodontal services and procedures, including, wisdom teeth removal; orthodontic/oral surgery not as a result of trauma; repair or replacement of dentures, bridges, and appliances; and diagnosis and treatment of TMJ--temporal mandibular joint dysfunction or disease related to the joint that connects the jaw to the skull, including but not limited to braces, splints, appliances or surgery of any type

• Elective cosmetic surgery

• Hearing aids

• Homeopathic cures including herbal/supplements

• Illegal acts—Any charges for any condition, disability or expense resulting from or sustained as a result of being engaged in an illegal occupation, commission of or attempted commission of an assault or felonious act

• Infertility testing and treatment

• Intentionally self-inflicted injuries (e.g. suicide or attempted suicide)

• Non-prescription (over the counter) drugs

• Orthotics

• Prescriptions for pre-existing medical conditions that are active at the time participation begins

• Psychiatric or psychological (mental health) counseling, testing, treatment or hospitalization

• Room charges which exceed the cost of the most common semi-private room will have sharing limited to 80% of the lowest private room cost. If the private room was considered medically necessary or the facility does not offer semi-private rooms then the limitation will not apply.

• Routine screening tests and procedures without medical reasons (for example: colonoscopy, pap smear, mammogram or genetic testing without specific symptoms)

• Special education charges, counseling or care for learning deficiencies or behavioral problems, whether or not associated with a manifest mental disorder or other disturbance

• Sterilization or reversals (vasectomy and tubal ligation)

• Veteran Administration care and treatment

• Weight control and management

• Well-patient care, for example, annual physicals, routine lab studies and well-baby check ups

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 F. Medical Procedures Requiring Pre-Eligibility Determination 

Listed below are the treatments, medical conditions, procedures, and services that will be denied for sharing unless an affirmative pre-eligibility determination is obtained in accordance with Section VII. C. Final eligibility determination will not be made until the medical bills are submitted for processing. It is possible that a treatment that appeared to be eligible for sharing during the pre-eligibility review will be determined to be ineligible after medical bills are submitted.

Participants and/or their providers should contact CCM before scheduling any of these procedures:

• Acts of War: diseases contracted or injuries sustained as a result of war, declared or undeclared

• AIDS/ARC/HIV (HIV contracted from transfusions, verifiable rape reported to law enforcement authorities or contracted in the practice of a health care profession)

• Alternative care (see Section VII. A. and B.)

• Ambulance and air evacuations in non-life threatening situations. In life threatening situations, the destination must be the nearest facility capable of providing the medically required care.

• Blepharoplasty (non-cosmetic eyelid surgery)

• Braces, orthopedic (unless post surgery or in lieu of casting)

• Bunion surgery

• Cataract surgery

• Chelation

• Chiropractic care and manipulation therapy. In cases which have been diagnosed by a licensed physician (M.D. or D.O.) and the Participant is offered only a surgical option, a chiropractic resolution may be eligible for sharing in lieu of surgery. The Participant's physician must provide a case history, x-rays and a recommendation for chiropractic resolution. If approved, chiropractic care is limited to a maximum of 20 visits within a six week period. Tests ordered by a chiropractor are not eligible for sharing.

• Circumcisions performed more than 30 days from birth

• Durable Medical Equipment (DME) - Rental or purchase of medical and hospital equipment

• Fees billed in addition to basic services for weekend/evening/holiday hours in excess of $50

• Heart/Cardiac Catheterization (non-emergency)

• Home Care beyond 5 visits unless approved by CCM

• Hysterectomy (non-emergency)

• Inpatient Admission to a skilled nursing facility, rehabilitation facility or inpatient Hospice

• Inpatient hospitalization over 72 hours

• Joint replacement (arthroplasty)

• Maternity expenses for children conceived out of wedlock

• Optometrists and vision services

• Osteotomy (surgery on the bone)

• Physical and/or occupational therapy beyond 20 sessions combined- A physician's written justification to extend treatment beyond 20 sessions from the date therapy began must be approved by CCM

• Prescription drugs for treatment of chronic conditions beyond six months. This includes drugs that may be dispensed, injected or administered by a Medical Doctor (M.D.), Doctor of Osteopathy (D.O.), Nurse Practitioner (N.P.), Physicians Assistant (P.A.), or Doctor of Podiatric Medicine (D.P.M.).

• Prosthetic devices

• Reconstructive surgery (for eligible mastectomy and/or cosmetic surgery to correct post trauma defect)

• Rhinoplasty/Septoplasty

• Sexually Transmitted Diseases (STD) -Treatment is only considered for sharing when STDs are contracted from transfusions, verifiable rape reported to law enforcement authorities or contracted in the practice of a health care profession.

• Sleep apnea studies

• Speech therapy for post stroke/post trauma

• Spinal surgery (non-emergency)

• Surgery (“elective”- non life-threatening) during the first three months of participation

• Surgical procedure repeat

• Transplant -These services are only considered for sharing when rendered by a board certified specialist and a second opinion has been acquired by a physician that is not associated with the initial participating physician, and will not be performing the surgery. Both doctors must confirm the medical necessity of the transplant.

• Varicose Vein Surgery

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 G. Related Conditions 

Participants do not share medical bills for diagnosis or treatment of any medical condition or complications associated with or resulting from a diagnosis, treatment or procedure that is not eligible for sharing.

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 H. Participant Conflicts of Interest 

Participants do not share medical bills for diagnosis or treatment when the Participant is related to the provider or ordering physician by blood, marriage or adoption or in cases where the Participant has a financial interest in the provider. Exceptions must be approved, prior to treatment, by CCM.

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A. Eligibility for Sharing
B. Amounts Shareable for Eligible Pregnancy
C. Maternity Complications
D. Multiple Births as a Result of Infertility Treatment
E. Newborn Status
F. Pregnancies of Unwed Mothers

 A. Eligibility for Sharing 

Except as otherwise stated in Section IX. F., for maternity expenses to be considered for sharing there must have been faithful sharing for the mother from the month of conception through the month of delivery and the delivery must have been performed by an M.D., a D.O. or a midwife licensed, certified or registered in the state of delivery. As outlined in Section XII. Part A. Participants Entitled to Insurance or Other Benefits, if a Participant has insurance or is eligible/qualified for other benefits such as Medicaid or any other resources designed to pay all or part of the medical bill(s), the Participant must cooperate fully with Medi-Share in qualifying for such payments. In the absence of such cooperation, the medical bill(s) will not be shared.

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 B. Amounts Shareable for Eligible Pregnancy    

Use the chart below to determine the amount of the Eligible Medical Bills (sharing limits per non-C-section pregnancy) that will be shareable after the Annual Household Portion (AHP) has been met and the Additional Participant Portion (APP) has been paid.

*Participants with a $500 AHP are not eligible for sharing of any maternity expenses.

If a cesearan section (C-section) is performed, use the chart below to determine the amount of Eligible Medical Bills (sharing limits per C-Section pregnancy) that will be shareable after the Additional Household Portion (AHP) is met and the Additional Participant Portion (APP) has been paid.



  C. Maternity Complications    

Use the chart below to determine the amount of the Eligible Medical Bills (sharing limits per non-C-section pregnancy) that will be shareable after the Annual Household Portion (AHP) has been met and the Additional Participant Portion (APP) has been paid. *Participants with a $500 AHP are not eligible for sharing of any maternity expenses. If a cesearan section (C-section) is performed, use the chart below to determine the amount of Eligible Medical Bills (sharing limits per C-Section pregnancy) that will be shareable after the Additional Household Portion (AHP) is met and the Additional Participant Portion (APP) has been paid.

The cost of treatment for life-threatening complications to mother and/or child(ren) can be shared only if the maternity is eligible for sharing. The expense of treatment for complications for each newborn is considered a separate event from the mother's maternity and the mother's life-threatening complication event (if applicable) and are not subject to the maternity sharing limit. The C-Section sharing limits above include the expense of treatment for mother’s life-threatening complications.

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 D. Multiple Births as a Result of Infertility Treatment

When multiple births result from infertility treatment and complications to either mother and/or child(ren) result, the maximum amount shareable, regardless of the AHP and APP, is $25,000, which includes the cost of delivery and complications. If there are no complications, the standard maternity sharing limits apply.

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 E. Newborn Status 

If the mother is a Participant, a newborn can be a Participant from birth if the Add a Newborn Form is completed and submitted within 30 days of delivery. If the notification deadline is not met, the Participant may be required to submit an application for the child to be added to the parent's program. The application to add a family member can be found on the website at www.mychristiancare.org.

If the mother is not a Participant at the time of delivery, an application for the mother and/or the child may not be submitted sooner than 21 days after the birth of the child. In either case, no medical bills for the new Participant that were incurred prior to the first day of the month following the approval date for participation can be considered for sharing, and unresolved medical conditions whose onset was prior to the start date will not be eligible for sharing.

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 F. Pregnancies of Unwed Mothers 

In accordance with the scriptures, Participants must not engage in sex outside of traditional Christian marriage; therefore, Medi-Share participants do not share maternity medical expenses for children conceived out of wedlock, except as a result of verifiable rape reported to a law enforcement authority.  

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A.  No Conflicts of Interest
B.  How to Appeal
C.  Biblically-Based Mediation and Arbitration

 A. No Conflicts of Interest

Christian Care Ministry does not gain financially in any way by determining that medical bills are ineligible for sharing among Participants. CCM is a not-for-profit corporation, recognized as tax exempt under Section 501(c)(3) of the Internal Revenue Code. CCM has no owners, stockholders or investors. CCM impartially carries out the wishes of the Participants as expressed in these Medi-Share Guidelines.

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 B. How to Appeal 

If a Participant believes that his or her medical bills were incorrectly determined to be ineligible for sharing, or if the Participant disagrees with a pre-eligibility decision, the Participant has 90 days from the date of that decision to request review by CCM. Once the decision is reviewed and a decision rendered, the Participant has 90 days in which to request a review by a Seven Participant Appeal Panel. Appeals should be based on the honest belief that: 1) the medical records were misread; or 2) the Guidelines were misapplied; or 3) one or more of the Participant's providers incorrectly recorded the medical history. CCM and the Participant will each submit a written position statement to the Appeal Panel. A teleconference will be held during which the panel participants can ask questions of both the Participant and CCM. A simple majority vote (four out of seven) will carry the decision.

Before initiating an appeal, the Participant should engage in careful thought and prayer to make sure that he or she honestly believes that an error has been made. If the Participant is appealing simply because he or she can't afford to bear the cost of the medical bill(s), CCM may assist the Participant in attempting to find other sources of payment and to determine eligibility to have the medical bills published through the Extra Blessings Program.

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 C. Biblically-Based Mediation and Arbitration

As Christians, the Participants and staff of Christian Care Ministry believe that the Bible commands them to make every effort to live at peace and to resolve disputes with each other in private or within the Christian community in conformity with the biblical injunctions of 1 Corinthians 6:1-8, Matthew 5:23-24, and Matthew 18:15-20. Therefore, the parties agree that any claim or dispute arising out of, or related to, this agreement or any aspect thereof, including claims under federal, state, local statutory or common law, the law of contract or law of tort, that may remain after a Participant has exhausted his appeals provided for in Section X. B. shall be settled by biblically-based mediation. The mediation shall be conducted in accordance with the Rules of Procedure for Christian Conciliation of the Institute for Christian Conciliation, a division of Peacemaker Ministries (complete text of the rules is available at www.HisPeace.org), with each party to bear their own costs and attorney’s fees, and with the mediation fee itself to be borne by CCM.

If resolution of the dispute and reconciliation do not result from mediation, the matter shall then be submitted to an independent and objective arbitrator for binding arbitration. The parties agree that the arbitration process will also be conducted in accordance with the Rules of Procedure for Christian Conciliation, with each party to bear their own costs and attorney’s fees, and with the arbitration fee itself to be borne by CCM. Each party shall agree to the selection of the arbitrator. If there is an impasse in the selection of the arbitrator, the parties agree that the Institute for Christian Conciliation shall choose the arbitrator.

The parties agree that these methods of dispute resolution shall be the sole remedy for any controversy or claim arising out of this agreement, and they expressly waive their right to file a lawsuit against one another in any civil court for such disputes, except to enforce a legally binding arbitration decision.

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A. Discounting of Medical Bills
B. Penalty for Use of Non-Network Professional Service Providers
C. Penalty for Use of Non-Network Facility Providers
D. Penalty Waivers for Use of Non-Network Professional Service or Facility Providers
E. Discounting of Bills not Eligible for Sharing 

 A. Discounting of Medical Bills 

In order to keep the Monthly Share as low as possible while maintaining high quality patient care, Participants voted to maximize the use of a preferred provider organization (PPO) by applying penalties for using non-PPO providers. The use of a network offers more savings for Participants, including discounts for routine services. Participants can search for providers at www.mychristiancare.org/pro, or by calling the phone number listed on their Medi-Share ID card. To qualify for a PPO discount the Medi-Share ID card must be presented to the provider before service is rendered. Participants should determine which providers/facilities are in their area prior to any medical bills being incurred.

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 B. Penalty for Use of Non-Network Professional Service Providers

When Participants elect to use professional service providers (e.g. physicians and laboratories) that are not in the PPO Network, sharing is limited to the 70th percentile of Usual and Customary (U&C). The 70th percentile of U&C means that 70% of professional service providers in the same zip code area charge the same amount or less for the service. The out-of-network penalty is the difference between the provider charge and the amount listed as the 70th percentile in the recognized U&C tables for the provider's zip code.

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 C. Penalty for Use of Non-Network Facility Providers

Participants should ask their physician to admit them for treatment to a PPO hospital, to refer them to PPO affiliates, and to use PPO laboratories and testing facilities. A 20% penalty, limited to $500 per bill, is applied to each non-PPO facility bill.

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D. Penalty Waivers for Use of Non-Network Professional Service or Facility Providers 

Out-of-network penalties will be waived in cases where there was a life threatening emergency or the travel distance to the nearest PPO provider qualified to render the required medical care exceeds 25 miles and the travel distance to the out-of-network provider used is less than the travel distance to the qualified PPO provider. If pre-notification as described in Section VI. is not met, the penalty may not be waived. In cases where a professional service provider penalty is waived, the amount that can be considered for sharing is limited to the 95th percentile of U&C. Waivers can only be requested after a balance bill is received from the provider.

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 E. Discounting of Bills not Eligible for Sharing 

PPO providers may, as a courtesy, honor discounts for services listed as ineligible on the Medi-Share Explanation of Sharing. To be considered for the discounts shown, the Participant must make prompt payment to the provider after receiving the Explanation of Sharing.

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A.  Participants Entitled to Insurance or Other Benefits
B.  Injury on Insured Property
C.  Medi-Share and Subrogation

 A. Participants Entitled to Insurance or Other Benefits 

Medi-Share is not insurance. If a Participant has insurance or is eligible/qualified for Medicare, Medicaid, Workers' Compensation, sports or other activity-specific insurance, fraternal benefits or any other resources designed to pay all or part of his or her medical bill(s), the Participant must cooperate fully with CCM in qualifying for such payments. In the absence of such cooperation, the medical bill(s) will not be shared.

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 B.  Injury on Insured Property

Since most prudent property owners maintain insurance coverage for such contingencies as injury on their property, almost all such claims are not contested and are promptly paid. Litigation is rare and almost always unnecessary after a letter of demand has been sent to the property owner's insurance company. In these cases, Participants should contact their Member Advocate for more information on how CCM will assist them with the claims process. The Participant must cooperate fully with CCM in the pursuit of the claim. In the absence of this cooperation, medical bill(s) arising from injuries on the insured property of another will not be shared.

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 C. Medi-Share and Subrogation 

Christian Care Ministry, Inc. (“CCM”), for the benefit of Participants, will be subrogated to any and all rights that a Participant has against any and all parties responsible for causing the injuries or illnesses for amounts Participants provided to or for the benefit of the Participant, including any and all first monies paid (or payable) to or on behalf of the Participant and regardless of whether or not the Participant has been made whole. CCM, for the benefit of Participants, will also be reimbursed for any and all amounts Participants provide to or on behalf of a Participant as a result of injuries or illnesses which result from the actions or liability of a third party, and/or which result in a settlement, judgment or other award or recovery to or by a Participant from a third party tortfeasor, including any person or entity liable for or indemnifying the Participant. CCM’s subrogation rights for the benefit of Participants are listed below and a Participant’s participation in Medi-Share is subject to and conditioned upon fulfillment of the following terms and conditions.

(1) CCM, once Participants have made payment of any amount to or for the benefit of the Participant, is granted a lien for the benefit of Participants on the proceeds of any ayment, settlement, judgment, or other remuneration received by the Participant from a third party tortfeasor, person or entity, and the Participant hereby consents to this lien and agrees to take any actions or steps necessary to secure this lien and help CCM recover same;

(2) CCM is granted a specific right of reimbursement for the benefit of Participants out of the proceeds of any settlement, judgment, or other payment by a third party tortfeasor, person, or entity to or on behalf of the Participant. Until reimbursement is received in full, CCM is entitled to the right of setoff against any eligible sharing requests of the Participant or any participant of the Participant’s family to recover the reimbursement amount on behalf of the Participants. This right of reimbursement is separate and apart from the subrogation rights of CCM and are limited only by the actual amount provided by Participants to or for the benefit of the Participant;

(3) The Participant and his attorney, if he has one, shall execute and deliver a subrogation agreement to CCM and any and all other instruments, documents or papers necessary to affect and/or secure subrogation and reimbursement rights;

(4) The Participant agrees to and is obligated to cooperate with CCM and/or any and all representatives of CCM, including subrogation counsel, in completing discovery, attending depositions, and/or attending or cooperating in trial in order to affect CCM’s subrogation rights for the benefit of Participants. Furthermore, the Participant shall do nothing to prejudice the aforementioned subrogation rights. The Participant must freely give any and all information surrounding any accident that CCM or its subrogation counsel or representatives may deem necessary to fully investigate the injuries or illness or that may affect these subrogation rights.

(5) CCM’s subrogation, reimbursement and lien rights, as stated above, apply to any recoveries made by the Participant as a result of the injuries sustained or illness suffered for which amounts were provided to or for the benefit of the Participant by other Participants, including but not limited to the following;

(a) Any award or settlement or benefits paid under any workers’ compensation law or award;
(b) Any and all payments made directly by a third party tortfeasor, person, entity, or any insurance company on behalf of the third party tortfeasor or any payments or installments made to the Participant on behalf of the third party tortfeasors, person, or entity responsible for indemnifying the third party tortfeasors;
(c) Any arbitration awards, payments, settlements, structured settlements, or other benefits paid by an insurance company under an uninsured or underinsured motorist coverage policy, whether on behalf of the Participant, his employer or any other person;
(d) Any other payments designated, delineated, earmarked, or intended to be paid to the Participant as compensation, restitution, or remuneration for injuries sustained or illnesses suffered as the result of the negligence, or liability, including contractual, of a third party.

(6) No Participant may assign any rights or causes of action that he or she might have against a third party tortfeasor, person, or entity, which would grant the Participant the right to recover medical expenses or other damages, without the express, prior written consent of CCM. CCM’s subrogation and reimbursement rights for the benefit of Medi-Share participants apply even if the Participant has died as a result of his or her injuries and is asserting a wrongful death or survivor claim against the third party tortfeasor under the laws of any state. CCM’s right to recover by subrogation or reimbursement shall thus apply to any settlements, recoveries, or causes of action owned or obtained by a descendent, minor, incompetent or disabled person.

(7) CCM’s right of subrogation and reimbursement, as set forth herein, will not be affected, reduced, or eliminated by the “made whole doctrine” or any other equitable doctrine or law which requires the Participant to be “made whole” before subrogation rights are allowed. Furthermore, it is prohibited for a Participant or beneficiaries to settle a claim against a third party for certain elements of damages, but eliminating damages relating to medical expenses incurred.

(8) CCM’s right of subrogation and reimbursement for the benefit of Participants will not be reduced or affected as a result of any fault or claim on the part of the Participant, whether under the doctrines of imperative causation, comparative fault or contributory negligence, or any other similar doctrine in law. Accordingly, any so called “lien reduction statutes” which attempt to apply such laws and reduce a subrogation recovery for any reason, including contributory negligence, will not be applicable to CCM and will not reduce CCM’s subrogation recovery. Amounts provided to or for the benefit of the Participant by other Participants are secondary to any benefits or coverage provided under any no-fault laws or similar legislation or no-fault-type insurance.

(9) Upon providing CCM with a copy of its fee agreement with the Participant and a copy of the settlement agreement, judgment, arbitration award or other document evidencing a recovery obtained on behalf of the Participant, the attorney for the Participant, if any, may reduce CCM’s lien by an amount equal to the lesser of (1) the proportional share of the attorney’s actual fees incurred in obtaining the recovery for the Participant or (2) thirty three percent (33%). Except as otherwise provided in the preceding sentence, CCM will not be responsible for any expenses, fees, costs, or other monies incurred by the attorney for the Participant or his beneficiaries, commonly known as the common fund doctrine. The Participant is specifically prohibited from incurring any expenses, costs, or fees on behalf of CCM in pursuit of his rights of recovery against a third party or CCM’s subrogation/reimbursement rights as set forth herein. No court costs, experts’ fees, filing fees or other costs or expenses of a litigation nature may be deducted from CCM’s recovery for the benefit of Medi-Share participants. 

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A.  Operator Age, Safety Equipment, and Lifestyle
B.  Motorcycle Injuries
C. Reporting Vehicle/Aircraft Injuries

 A. Operator Age, Safety Equipment, and Lifestyle

Participants do not share the cost of diagnosis and treatment of injuries resulting from any motorized vehicle or aircraft accident if any of the following conditions exist with respect to the vehicle that the Participant was operating or a passenger in: 1) there was abuse of alcohol or legal drugs, or the use of illegal drugs; 2) the vehicle or aircraft was used in a race, to perform a stunt, or in the commission of a crime; 3) the minimum operator age recommended by the manufacturer or required by law was not complied with. In cases where a legally required helmet or seatbelt was not being used, 15% of the first $100,000 of eligible medical expenses related to a motorized vehicle or aircraft accident is applied as an Additional Participant Portion (APP), in addition to the Participant’s AHP.

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 B.  Motorcycle Injuries

Sharing of expenses for diagnosis and/or treatment of injuries sustained as a result of riding on a motorcycle is limited to $100,000 of Eligible Medical Bills incurred per person during each 12 month period of treatment. A motorcycle is defined as a two-wheeled motorized vehicle with an engine size displacement of at least 50 cubic centimeters. This sharing limitation will not apply if, at the time of the accident, the motorcycle is used while performing mission work outside the U.S.

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 C. Reporting Vehicle/Aircraft Injuries 

The details of injuries caused by vehicle and aircraft accidents must be reported by calling your Member Advocate at (800) 264-2562. Before medical bills can be considered for sharing, the following documents may be necessary for determining eligibility, such as:
• a copy of the insurance policy for an owned vehicle or aircraft (or the contract if rented or leased);
• the official accident report; medical records relating to the care and transportation of the injured Participant(s);
• information that pertains to other vehicle(s) and parties involved in the accident

The information must be mailed to:

Christian Care Ministry
P.O. Box 120099
West Melbourne
Florida, 32912-0099
Attention: Third Party
Fax: (321) 308-7787 

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Up to $5,000 of final expenses for active Participants who met the "Qualifications for Participation" at the time of death are eligible for sharing. Final expenses are limited to funeral expenses (including embalming, cremation, casket, headstone, burial plot, funeral director's costs, and flowers) and travel expenses for the Participant's body, if necessary. The Participant must have been under the age of 65 years, or under the age of 70 years and an active Medi-Share participant for the 5 full years prior to the date of death. Incurred burial expenses for stillborn children are eligible; reimbursement is limited to a maximum of $5,000 per pregnancy. The original bill(s) and a certified copy of the death certificate(s) must be submitted to CCM within one year of the death of the Participant or child(ren).

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