1. What Benefits Do AlternaCare Membership & AlternaShare Provide?AlternaCare Health Insurance Alternative Includes;
- AlternaCare membership ensures exclusive benefits
- AlternaCare is a health & prevention education platform+ (in development)
- AlternaCare brings proven solutions for better health & life
- AlternaCare is focused on efficacy, vitality+, and cost efficiency
- AlternaCare fuses science, technology, efficacy w/holistic-functional medicine+
- AlternaShare is an innovative health insurance^^ replacement alternative
- AlternaShare Protects enrolled members from ACA penalty^^
- AlternaShare is HSA qualified for tax savings^
- AlternaCare is the first Health Insurance Alternative founded on prevention
- Alterna is year-round enrollment – no enrollment periods
- AlternaShare is an insurance alternative for people committed to clean living
- AlternaShare includes unlimited alternative medicine for new needs^^
- AlternaShare includes unlimited conventional medicine for new needs^^
- AlternaShare is a membership for people who don’t want faith-based sharing
- AternaShare is a group whose shared beliefs are not religious
- AlternaShare is group sharing with no religious affiliations
- AlternaShare is freedom from high health insurance costs, limits, and controls
- AlternaShare saves $ vs unsubsidized insurance or group health insurance
- AlternaCare/Share group solution Employers can pay for
- AlternaCare/Share empowers members with choice of provider & modality
- Alterna focus is personalized needs to improve health, quality of life & save money
- AlternaShare brings holistic to tax savings of an HSA^
- AlternaShare includes a non-profit donation in the monthly cost for tax deductions
2. Is AlternaCare Insurance or an Insurance Company?
No, AlternaCare is NOT an insurance company and this is NOT health insurance. Instead, AlternaCare is member education platform and AlternaShare is a Health Insurance Alternative managing health costs without health insurance as follows.
Layer 1– For health costs covered by the MEC (Minimum Essential Coverage) are 60+ items outlined by law, the MEC pays plus protects from the ACA penalty.
Layer 2– Healthcare not included in the MEC is paid by a member-funded HSA (Health Savings Account) per need or issue as the first $500.00 in IUA (Individual Unshared Amount) must be met first. (capped at 3 per year single, and 5 per year for 2+ members).
Layer 3– For health costs not covered by the MEC and over $500.00, sharing picks up the balance and ensures no member is alone.
2. a. Is There A Provider Network Like Health Insurance?
No there is no network which means you can see any provider as a self-pay patient.
3. Are Pre-Existing Included in AlternaShare?
No and Yes. In sharing there is no day 1 pre-existing medical expense sharing. However, at 13 months of membership, sharing pre-existing is allowed as follows;
First 12 months No sharing pre-existing
Month 13 – 24 Shareable to $25,000
Month 25 – 36 Shareable to $50,000
Month 37 and after Fully shareable
High Blood Pressure, High Cholesterol, Sleep Apnea, and Non-Insulin Dependent Diabetes, when well controlled, do not have sharing restrictions. A condition is considered pre-existing if a member had symptoms or received treatment within the last 36 months prior to their membership effective date.
Because most of us is a product of ‘bad healthcare’, we all need help to improve the quality of our health. That’s where AlternaCare comes in. Our membership platform is a research/testing products and modalities creating education for members to advise each on how to invest in prevention and find cost-effective results. Seeking to ensure no matter the pre-existing condition, such can be reversed and the body can heal is the AlternaCare pledge to each member.
4. How much does AlternaCare membership cost monthly?
5. What Does AlternaShare Cost?
For members under 30, the monthly health solution is reduced $50.00 a month. For age 30+ the monthly the share amount is;
Member Single +++ $405.00 month
*Members receive up to $1,200.00 charitable donation tax deduction And HSA^ qualified is tax deductible up to $3,400.00# for funding your HSA
Couple +++ $813.00 month
*Members receive up to $2,400.00 charitable donation tax deduction And HSA^ qualified is tax deductible up to $6,700.00# for funding your HSA
6. How is My Membership & Monthly Share Paid?
Each member pays through their financial institution via auto-pay to the following account and routing number
R/T (ROUTING) # : 114924742
ACCOUNT # : 9821080777220
All monthly shares must be received by the 15th of the month for the following month’s enrollment. Once submitted, please email firstname.lastname@example.org with proof of payment and we will respond with an application.
7. How Are Dependents Categorized?
- Children age 18 and younger
- Unmarried children ages 19 through 25 who are dependents of a member parent
- Unmarried children over 26 that are dependent on their member parent(s) due to special needs
- Grandchildren meet all of the following criteria:
a. They live permanently with their grandparents (their residence), and
b. The grandparents have legal custody, or the grandchild is the child of a minor, and
c. They meet the eligibility guidelines for children, and
d. They have no other agency, person, or group responsible for their medical bills.
8. What Are Conditions for Medical Expenses Eligible for Sharing?
9. What Must I Agree to In Order to Be an Alterna Member?
A. I believe a community of moral, ethical and health-conscious people can most efficiently and effectively care for one another by sharing each other’s medical needs.
B. I understand AlternaCare nor our administrator, is an insurance entity.
D. Agree to practice good health measures and strive for a balanced lifestyle.
E. Agree to refrain from using any form of illegal substances.
F. Agree to submit to mediation and arbitration, if needed, for any instance of a dispute with AlternaCare or affiliates.
G. Agree to sign and submit a membership continuation agreement each renewal year confirming commitment to adhere to these principles.
H. I understand every effort is made to make sure members fulfill their monthly sharing commitment, but I am not guaranteed payment of medical expenses as this is not insurance but member sharing.
10. What Advantages Do I Receive Because this is NOT Insurance?
There are many and some of them are
- healthcare paid by insurance provides no holistic education for the people
- healthcare paid by insurance offers no holistic medicine for primary care
- healthcare paid by insurance requires no prevention don’t commit to a lifestyle change
- healthcare paid by insurance means people not modifying habits drive up costs for everyone and catastrophic, a premature disease the result
- healthcare based on pharmaceuticals result in more expense
AlternaCare members take ownership and pledge;
- To live an educated prevention lifestyle (see Pledge & Enroll)
- Enjoy savings over health insurance and its ever-rising costs
- Have freedom to choose provider, treatment & modality for medical needs
- Access to unlimited alternative & functional medicine when needs happen
- Free from ACA penalty when enrolled in Sharing
- Have no penalty for being “Out of Network” – there is no network
- Free to use any provider anywhere in the U.S. or international
- Worry-free travel no matter where you are your solution is with you
- Offers all the tax savings of an HSA
- No open enrollment – enroll when you want
11. Is This Legal? Are Members Penalized by the ACA?
12. How Does Sharing Handle Medical Claims?
When health issues happen (called ‘needs’) sharing medical expense over $500.00 (at one time or combined with multiple visits). the $500.00 IUA (out of pocket) is paid with the HSA debit card (we have an HSA for members who need one ). The HSA pays the first $500.00 and the member requests invoicing the balance(s) over $500.00.
When a member receives the balance statement, such is submitted with a ‘Claims Processing Form’ and includes proof the IUA $500.00 is met. Then negotiators work with a provider(s) to reach an agreed amount to settle the balance which is shared. Within 60 days from receipt of your invoice, shared money is paid directly to the member for the provider agreed amount directly.
- Sharing is a 60-day process as long as the Needs Processing Form is correct and complete and no ongoing negotiations with the provider are needed.
- All needs are shared the first of the month after receipt. To illustrate, a need received in September is negotiated in October and shared November and you receive the amount thereafter.
- Members receive an Explanation of Needs Shared letter which explains the dollar amount applied to each provider.
13. How Does Sharing Work?
Because sharing is NOT insurance, each member(s) contributes a determined amount monthly called a “share amount” to ensure a reserve is available to share medical needs over $500.00 is available.
The IUA (individual unshared amount) $500.00 applies to the first three eligible ‘needs’ or incidents during a 12-month membership for one member, when a fourth need or incident occurs, there is NO IUA for a single member. (subject to any restrictions)
For members 2 or more, a maximum of five IUAs of $500.00 applies per 12-month membership year, and a sixth need in the same membership year occurs, there is NO IUA (subject to any restrictions).
14. What If I Have a Medical Needs Not Shareable?
15. Can I Choose My Own Doctors / Hospitals Without Penalty?
16. What if My Provider Demands Payment In Full Up Front?
When providers require up-front payment prior to service, we suggest limiting up-front payment to $500.00 to be paid from your HSA debit card. Members are requested to not pay full billed charges for services over $500.00 as this eliminates our third-party negotiator’s ability to reduce inflated medical bill costs.
When paying the full billed amount for medical services reduces the effectiveness of the self-pay patient and results in higher costs for everyone. When members don’t follow the directives, the admin reserves the right to reduce sharing by up to 25% per bill when members repeatedly pay full-billed charges over $500.00.
17. Am I Required to Get a Second Opinion in Non-Emergencies?
18. Is There a Penalty if I Don’t Use 2nd.MD?
Yes, and yes. Since treatment protocols and quality of care vary dramatically in medicine, cost-sharing requires members use a program called ‘2nd.MD’ before undergoing non-emergency or elective surgeries. Needs sharing may be reduced by up to 25% on bills over $500 when members refuse to utilize the 2nd.MD program or intentionally skip the process.
By using 2nd.MD, the member’s IUA will be reduced by 50%. For example, the member’s $500 IUA will be reduced to $250 if 2nd.MD is consulted. The advantage of using 2nd.MD is a member’s IUA is reduced by 50%. For example, a member $500 IUA is $250 if 2nd.MD is consulted before and has the same diagnosis.
19. Does the Cost Share Use Deductibles and Copay?
20. What About Needs That Go From Year to Year?
21. Are Medical Costs Incurred Outside the United States Shared?
22. Can I Lose Membership if I Have High Medical Needs?
23. Is There a Lifetime or Yearly Maximum for Sharing?
24. What Kinds of Needs Can Members Share?
25. What Kinds of Needs do Members Not Share?
- Needs resulting from medical conditions that existed prior to the membership effective date are typically not shared. (First 12 mo, then restricted see Member AlternaShare for details).
- Medical expenses from the use of illegal drugs, or while participating in unlawful activities will not be shared.
- Routine checkups included through the Minimal Essential Coverage (MEC) self-insurance plan are not eligible for sharing.
- Maternity costs related to a conception before membership is limited.
- For any needs that do not qualify for sharing
- For needs that create a financial burden, members may qualify for the Special Needs Sharing program.
26. Can My Family Participate in Sharing?
- Yes as long as the following applies;
- All are enrolled in AlternaCare & AlternaShare
- Take the AlternaCare Pledge
- Listed on your member health solution application
27. What Are the AlternaCare Membership Requirements?
28. I’m a Cancer Survivor, Does That Mean I Can Never Cost Share a 2nd Bout?
No, you can cost share a second or more bout with cancer because:
1) Expenses for the second occurrence of cancer would be ineligible for sharing if it is the “result from” the first episode of cancer. In many instances, the second episode of cancer is unrelated to the first and is eligible for sharing.
2) Except for insulin-dependent diabetes, all conditions before your membership may be fully shareable after 3 years when there are no symptoms or treatments.
3) Expenses not eligible for the basic sharing membership may be shared among our members through the Special Needs Sharing program.
29. How Are Expenses for Medical Occurring Internationally Handled?
30. What About Routine Medical Care?
31. How Are Large Medical Expenses Handed?
Sharing is designed to help members with costs from injury and illnesses.
- There is no maximum dollar limit on the amount of that is shared for a specific medical need within the scope of the Health Plan Guidelines before it will be eligible for sharing. (Because of the economic impact of very large medical bills (e.g., those over $100,000), our administrator has an internal mechanism to ensure adequate shares are available to meet member’s normal and high-cost needs.
- For large medical expenses, 15% of member’s monthly shares remain available through a benevolence fund whose right to negotiate medical expenses with providers, is based on a prorated share, as necessary in order to address all members medical expense needs. See AlternaShare for details
32. What Happens if Members’ Needs Are More than the Shares Received?
- Sometimes an overlapping need happens, to ensure there is enough money for all the member’s needs, our administrator uses a prorating method to evenly distribute the burden.
- If the monthly shares received for a given month equals 80% of the needs submitted for a particular month, only 80% of each need would be shared that month. This does not necessarily mean that members would not receive enough money through other member shares to pay medical bills. Administration seeks fair pricing on every medical need. As long as the team can get members costs below 80% of the billed charges, there is enough to handle all of the needs in a month.
- If prorating occurs three months out of six at any time, the Board will evaluate, with AlternaCare input, whether there needs to be an increase the monthly share.
- Every member provides a specific share amount each month, 90.1% of shares are used to help pay other members’ medical needs, while 9.9% of the monthly share is retained to support infrastructure and administrative expenses.
- Administration may also retain each new member’s monthly shares for up-to-the first 90 days of their membership in order to cover membership expenses and costs related to expanding the community.
- The monthly share amount varies depending on each member household’s dependent status and age (under 30 or over 30).
- Monthly share amounts are subject to change by the vote of the board, following consultation with participating member
33. Can My Employer Pay Some, or All my AlternaCare/Share?
34. Are Monthly Shares Higher for Tobacco Use?
Yes, $100.00 more per month are added and households with one or more tobacco users, who are required to cease tobacco use within the year. In addition, tobacco users age 50 and older are limited to $25,000 for each of the following four disease categories:
- Heart conditions
Exceptions: The occasional celebratory cigar or pipe, for example, at the birth of a baby, is acceptable, as is the use of electronic cigarettes (vaping) during the process of attempting to quit smoking.
35. AlternaCare Sounds Very Different, Does This Really Work?
Yes as proved by the member model of retail giants Costco & Sams Club, fusing membership with sharing is a new concept, but sharing has been highly successful in faith-based Christian groups for over 25 years who have over 600,000 members, and share hundreds of millions of dollars in medical expenses each year.
This proven solution is the answer to solve what a community of health-conscious individuals who care for each other can successfully achieve in escaping the clutches of health insurance. Sharing is not a guarantee to pay like insurance, (which is not paying as millions know) this promise is to guide voluntary shares through a third-party admin who provides our group health sharing.
36. Are Monthly Share Contribution Pre-tax or Deductible?
Yes and No. Monthly membership is not pre-tax and depending on your tax filing may be a deduction for education. Additionally, a portion of the monthly share amount is tax-deductible as a donation outlined in the AlternaShare.
The tax-deductible portion of the monthly share is an estimate based on a 12-month membership beginning in Jan-Dec. Each member will receive a statement for the donation annually.
Also, because AlternaShare qualifies as an HDHP (high-deductible health plan), it offers tax savings with pre-tax dollar contributions to an HSA (Health Savings Account) that reduce tax burden as allowed by law.
37. How Often Can Monthly Share Amounts Be Changed?
38. Is Dental Included?
39. What Alternative Medicine is Included in Sharing for Health Issues?
Costs are shareable pending prior written approval by the administration and shareable if prescribed by a licensed doctor of naturopathy or functional medicine who demonstrate a proposed value of the prescribed alternative such as monetary savings, less-invasive treatment, shortened treatment protocol, etc. Modalities Included;
- Alternative Clinics
- Herbal Regimes
- Pain Management
- Massage Therapy++
- Emotional Clearing
- Detoxification Protocols
- Holistic Clinics
- Energy Therapy
- Chinese Medicine
- Energy Healing
- Intravenous Vitamin C
- Curaderm cream
- RGCC ONCOSTAT PLUS Test
- ONCOblot Blood Test
- CBD Hemp Oil
- CBD Hemp Oil Cancer Treatments
- Rife Technology
- Essential Oils
- Oxygen Therapy
- IV Therapy
- Intravenous Sodium Bicarbonate
- Stem Cell Treatments
- Herbs & Supplements
- Neurotransmitter Testing
- Micronutrient Testing
- Food Allergy Testing
- Hormone Testing
- Inflammation Testing
- Labs & blood work
- Isador (Mistletoe)
- Heavy Metal Testing
- DCA IV
- Dark field blood analysis
- DNA testing
- DNA consults
- Medical devices
- Virus Therapy
- Hyperbaric Treatment++
- Infrared Treatments
- Jade Therapy
- Medical Tourism
- And more with the science to back it up
40. What’s Shared in Conventional Medicine?
Cost sharing for conventional medicine includes;
- Urgent Care
- Emergency Room
- Emergency Transport
- Physical therapy
- Hospitals – inpatient and outpatient
- Mental Health^^
- Medical Equipment
- Emergency transport
41. What Are Cost Shared Over the Initial Unshared Amount (IUA)^^
Cost sharing for conventional medicine includes;
- Urgent Care
- Emergency Room
- Emergency Transport
- Physical therapy
- Hospitals – inpatient and outpatient
- Mental Health^^
- Medical Equipment
- Emergency transport
42. What’s Not Shared?
- Injuries or illnesses that directly result from a member abusing drugs or
- alcohol will not be shared, illegal or reckless activity
- Accidents to teeth while chewing
- Armed conflicts
- Infertility expenses
- Injuries obtained from certain acts including acting in self-defense or
in defense of hearth or home, are not shareable
- Injuries or illnesses caused as a result of participation in a public riot,
a criminal act, assisted suicide, or euthanasia will not be shareable
- late charges
- Non-medical expenses
- Over the counter products
- Routine medical care
- Self-inflicted injuries
- long-term maintenance prescriptions (over 120 days)
- travel expenses (unless travel expense is for substantial savings (40% or more)
- psychological services
- elective cosmetic surgery
- elective surgery
- treatment of high blood pressure as a chronic condition will not be shared
43. Can I Lose Membership Privileges?
44. Is There a Health Screening Process?
45. Sharing Denials Include Injuries from:
- Injuries from illegal activity
- Abuse of alcohol
- Abuse of prescription drugs
- Injuries from prescription use not prescribed usage
- Use of illegal drugs not limited to hallucinogenic substance, barbiturates, amphetamines, cocaine, heroin, marijuana, illegal intravenous drugs, or narcotics.
- A medical expense incurred by a member that is not shareable for one or more of the following; violation of member responsibilities, non-current membership, or any other condition excluded by the guidelines.
46. Why Is There No Provider Network?
47. What if I Don’t Pay My Share or I Drop the Membership?
48. What Amounts do Members Share for Maternity?
If a member became pregnant prior to her membership, the amount that she is eligible to have shared for her maternity needs from the pregnancy will be equal to the total amount the member has sent in monthly shares from the beginning of her membership or from when added to an existing membership.
The same amount will also be available for the child’s medical needs. If a member terminates the membership or allows it to lapse for any reason, and later rejoins, the amount available for maternity needs will be calculated from the date of the most recent start of her membership.
49. Is There an Open Enrollment?
There is no open enrollment, in fact, you can enroll any time of year.
++Hyperbaric therapy Shareable for the treatment of specific illness or injury. Outpatient included in 35 visit maximum per condition, to a maximum of $3,500 per separate need.
++Therapeutic massage therapy Shareable if prescribed by a licensed medical provider. Up to 25 sessions, to a maximum of $3,000 per separate need.
++Services related to the treatment of a specific musculoskeletal injury or musculoskeletal disease are shareable for up to 25 office visits (sharing limited to $3,000 per Need), including related items for treating the musculoskeletal injury or musculoskeletal diseases such as prescribed nutritional supplements for up to 120 days and X-rays. Maintenance treatments are not shareable. All other chiropractic services will be treated as “Alternative Medical Practices”
*limited to $3,000.00
^^See the Health Solution for details
+++Members who smoke are $100.00 more per month and required to quit within 12 mo
AlternaCare a Division of Eco Angels Foundation FED ID 45-3841168
HOLLYWOOD, FL 33022