2020 Ballot Results

One of the privileges of being a Medi-Share member is to vote on changes to the guidelines that have either been requested by members, or are clarifications that will aid in understanding, or suggestions we feel will enhance the program.

In May 2020, members had the opportunity to make their voices heard on a handful of Medi-Share initiatives and the ballots have been tallied:

              

               Direct Primary Care option – Passed

               Annual Physicals with Cholesterol and Diabetes Screening – Passed

               Tele-mental Health Counseling – Passed

               Modify Guidelines Concerning Telehealth – Passed

               Remove $500 Max for OON Hospitals & Facilities – Did Not Pass

 

What is Direct Primary Care (DPC)?

The Direct Primary Care (DPC) model is a practice and payment model where patients/consumers pay their physician or practice directly in the form of periodic payments (monthly, quarterly, or annually), rather than a traditional fee-for-service billing to third party plans/programs. This fee covers all or most primary care services including clinical and laboratory services, consultative services, care coordination, and comprehensive care management.

This model is structured to emphasize and prioritize the power of the physician/patient relationship to improve health outcomes and lower overall health care costs. DPC is a great option for members who prefer to have a high Annual Household Program (AHP) level, where they might otherwise be paying out of pocket for primary care services or chronic care services. 

To learn more about Direct Primary Care or to find a DPC provider in your area, click here.

Annual Physicals and Basic Labs

In 2011, members voted to include routine care for children under the age of 6. To remain an affordable option, Medi-Share is expanding the program in Fall 2020 to include the option for a program level that includes a physical and basic labs for cholesterol and diabetes screening.

Telemental Health Services

Medi-Share members have already embraced the use of our free telehealth service through MDLive, saving millions of dollars a year for non-emergency visits. Now, Medi-Share has negotiated an agreement to provide members with some basic mental health counseling by phone at no cost to the member. Members will be able to utilize this telemental health option with unlimited visits, provided they use the Medi-Share provider.  

Although psychiatric evaluation for mental illness related to an eligible medical condition, for example, post-partum depression, is eligible for sharing, counseling has never been eligible for sharing. By utilizing an exclusive telemental health provider, members can access the care they need without incurring any out of pocket costs.

Because CCM is committed to providing this benefit at no cost to members, the minimal charge for this service ($5.00 per household/per year) will be paid out of the administrative portion of members' monthly share amount.  

Modify Guidelines Concerning Telehealth

As the COVID-19 crisis has illustrated, today’s healthcare environment is changing. As providers adapted to serve their patients safely, Medi-Share made exceptions to this guideline provision for members who sought care this way.

Unlike the no-cost care available to Medi-Share members through MDLive for non-emergent sick care, specialty care providers, like cancer doctors, need to be able to safely continue care for their chronically ill patients and telehealth provides a way to do so.

To adapt to this new way of doing health care, we are eliminating this guideline restriction.

 

Removing the $500 Max for Out-of-Network Hospitals & Facilities (Did not pass)

As the cost of medical care can fluctuate significantly between facilities, members are always encouraged to seek care at a PHCS network facility to take advantage of the significant discounts offered. Medi-Share members have the option for treatment at out of network facilities; however, without the network relationship, there is no way to manage or control charges. This change to the guidelines would have put more of the burden on the member when they make an out of network choice, rather than on the membership as a whole. As the stewards of the Medi-Share program, we will likely revisit this initiative in the future.

+ As a Medi-Share member, how can I use Direct Primary Care (DPC)—is it shareable?

Medi-Share is launching new program levels in the fall, including a $12,000 AHP, where this option would be available. Any member on the 12,000 AHP level who chooses a Direct Primary Care Provider arrangement, can have their DPC membership fees applied to their AHP (up to $1,800), available December 2020.

+ How Can I qualify for a physical and associated labs?

This new feature should be available by the fall. You will have the choice at that time to change program levels, or stay on your current program level where physicals are not eligible for sharing.

+ What Kind of Services Will be Provided for Telemental Counseling?
A telemental health provider can provide initial assessments, short-term counseling, referrals, and follow-up services for:

- Family/relationship issues
- Workplace concerns
- Alcohol and drug problems
- Stress-related challenges
- Personal and emotional difficulties
- Grief, anxiety, and depression

A telemental health provider cannot prescribe medication.