5 Low Cost Health Plans:
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Self-Directed Healthcare

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Self Directed Healthcare

Designed For A "Self-Pay" Patient With A Medical Cost Sharing Back-Up Plan

This option doesn’t include a "MEC" that provides all of the ACA-required preventive care services. However, the Medical Cost Sharing program makes available colonoscopies to members age 50 and over, mammograms to members age 40 and over, and childhood immunizations (excluding flu shots) and vaccinations at no cost. These are the three most costly preventive care services.

SELF-DIRECTED HEALTHCARE

You can choose any doctor or facility at any time. There’s no network of providers (this is referred to as "open access"). Tell the provider you're a "self-pay" patient and want their “best cash price." Providers will usually be happy to give you a large discount because they won’t have to deal with an insurance company or meet the company's oversight requirements and interference with the way they practice medicine.

If your “Need” (i.e. a large medical expense) exceeds the Initial Unshareable Amount (similar to a deductible if this were traditional insurance) you selected, Medical Cost Sharing will share the full amount at 100% unless your Need is subject to sharing limitations for any conditions listed in Sections 8 or 9 of the Access Membership Guidelines.

My Academy of Health Excellence Member and Concierge Services will help you research doctors, facilities and hospitals if you need access to care. They’ll assist you in selecting fair-priced, quality services, and your Sedera Member Advisor is available to help you, as well.

Benefits for contraception, abortion, and sterilization are NOT included in this plan. Those with spiritual and moral beliefs that conflict with the use of these services have an attractive option for enrolling in a totally pro-life, less costly, non-Affordable Care Act solution for reducing their health care costs.

Since this program doesn’t include a "MEC," members will be subject to a tax penalty for 2018. However, all tax penalties are eliminated under the ACA effective January 1, 2019

SELF-DIRECTED HEALTHCARE

Designed for the Self-Pay Patient with a Back-Up Plan

A Totally Self-Directed Plan that combines all WellFit Wellness services, SOME Preventive Care services, the Manage and Mitigate portions of the strategy, AND Medical Cost Sharing using any provider who accepts cash or credit (“Open Access”).

Plan Features
Avoid

AVOID medical costs with education and a proactive and interactive wellness program (called WellFit Wellness) provided by My Academy of Health Excellence. You become a member of WellFit Wellness when you join the MPowering Benefts Association. As a member of the Association, you’re entitled to become a member of the Self-Directed Healthcare Program.

  • Single Point of Access for Services
  • Fully Integrated Health and Wellness Program
  • Wellness Assessment Program
    (health risk assessment to inform you are your current health status)
  • QR For Life Code for Emergencies and Personal Medical Vault
  • WellFit Community(on-line forum for blogs and group interaction)
  • Twelve Habits of Highly Healthy People
  • Artifcial Intelligence Based on Functional Medicine
    (functional medicine-based risk assessment, personalized recommendations, and coaching service)
  • On-line Resource Center
    (webinars, podcasts, interviews with experts, newsletters and e-books)
  • Healthy Rewards Program
Prevent

PREVENTIVE SERVICES are provided under the Medical Cost Sharing portion of the program administered by Sedera Health (see the CONTAIN section, below) and are limited to colonoscopies for members 50 and over, mammograms for members 40 and over, and childhood immunizations (excluding flu shots) and vaccinations.

Manage

You are NOT permitted to establish a tax-advantaged Health Savings Account with this option.

Money Management: You CAN elect to establish a patented, proprietary Health Matching Account™ (HMA) provided through Health Matching Account™ Services, Inc. to help pay for expenses that are either unshareable or subject to high Individual Unshareable Amounts (IUA) under the Medical Cost Sharing portion of the program. Call us at 877-734-3884 to see how an HMA may beneft you.

Mitigate

Mitigate using My AHE Pharmacy Programs, My AHE Member and Concierge Services, TelaDoc™ (telemedicine), the Second Opinion Program (2nd MD™), and Counseling services.

Contain
  • Contain large medical expenses with Medical Cost Sharing powered by Sedera Health
  • Services included:
    Sedera Medical Advisor and Medical Bill Negotiation
Plan Specifications
  • THERE IS NO AFFORDABLE CARE ACT TAX PENALTY FOR THIS PLAN EFFECTIVE 1/1/2019
  • WELLFIT WELLNESS PLATFORM - Managed by My Academy of Health Excellence
  • PREVENTIVE CARE SERVICES - Colonoscopies for members 50 and over, mammograms for members 40 and over, and childhood immunizations (excluding flu shots) and vaccinations are shareable at no cost (i.e. with no Individual Unshareable Amount) under the Medical Cost Sharing portion of the program. No other preventive care services mandated by the Affordable Care Act are covered
  • NETWORK - Open Access network; can use any provider who accepts cash payment for any service under the program, including shareable preventive care services mentioned above and large medical expenses mentioned below
  • SMALL MEDICAL EXPENSES - Mitigate using My AHE Pharmacy Programs, My AHE Member and Concierge Services, TelaDoc™, the 2nd Opinion Program (2nd MD™), and Counseling services
Large Medical Expenses
  • Contain With Medical Cost Sharing Powered By Sedera Health
  • Initial Unshared Amount (IUA) Options - Choice of $500, $1000, $1500, $2500, or $5000
  • Maximum Number Of IUA’s Annually - 3 per individual/5 per membership unit
  • Prescription Drugs - normal sharing rules apply for curative medications;
    120 days for maintenance medications (blood pressure, cholesterol, etc.)
  • Pre-Existing Conditions - 36 month look-back: no coverage for 1st 12 months;
    $15K 2nd year; $30K 3rd year; unlimited thereafter
  • Maternity Benefts - $5K IUA for normal deliveries and $7.5K for non-emergency/elective C-sections;
    conception must have occurred after membership per section 9 of the Guidelines
  • Therapies And TMJ - range from $1.5K to $2.5K/Need under Section 8 of the Guidelines
  • Psychiatric And Behavioral Health - $5K inpatient maximum/Need; $1.5K outpatient/Need
  • Tobacco Use - $75 surcharge per membership unit.
    If age 50 or over, $25K sharing restriction for cancer, stroke, heart conditions and COPD
  • Sharing Limits - No annual or lifetime limits unless restricted by Sections 8 or 9 of the Guidelines
Review the 5 types of plans
health excellence plus

SELF-MANAGED PLAN OPTIONS
Self-Directed Healthcare
Self-Directed Healthcare
Totally Self-Directed Program Combining Wellness Services AND Medical Cost Sharing For Large Expenses And Mammograms, Colonoscopies and Childhood Immunizations
LEARN MORE
Partially Self-Directed Healthcare
Partially Self-Directed Healthcare
Partially Self-Directed Program Combining Wellness Services, Preventive Care, An Optional Health Savings Account, AND Medical Cost Sharing For Large Expenses
LEARN MORE
PHYSICIAN-DIRECTED PLAN OPTIONS
Co-Pay Network Healthcare
Co-Pay Network Healthcare
Provider-Directed Program Combining Wellness Services, Preventive Care, Co-Pays For Most Small Expenses, AND Medical Cost Sharing For Large Expenses
LEARN MORE
DPC - Direct Primary Healthcare
DPC - Direct Primary Healthcare
Provider-Directed Program Supplementing Direct Primary Care With Wellness Services AND Medical Cost Sharing For Large Expenses And Mammograms, Colonoscopies, and Childhood Immunizations
LEARN MORE
Provider-Directed Healthcare
Provider-Directed Healthcare
Provider-Directed Program Combining Wellness Services, Redirect Health for Preventive Care And Most Small Expenses, AND Medical Cost Sharing For Large Medical Expenses
LEARN MORE
Designed for individuals who want to live a healthy lifestyle
and share the costs with other like-minded community members.

Through an innovative layering of healthcare services, the MPowering Benefits Association provides individuals and families access to high quality healthcare that is affordable, flexible and effective.

Members join the Association to promote personal health and well-being and, as a result, have access to a complete set of wellness tools provided through My Academy of Health Excellence.  Members of the Association have the choice (see above) of electing to join one of five different programs.

The program provides healthcare through community; you share medical expenses with a community of like-minded, health-focused individuals. By enrolling in this new program you’ll often be able to save 30-90% or more over traditional approaches.

By reviewing this website you’ll be able to choose between two self-managed programs and three physician-managed programs. Whether you want to take back control of your own healthcare and related costs, want someone to manage healthcare costs for you, or you’re somewhere in between, there’s an option to fit your specific needs.

You can learn more by reviewing this site and then calling us at 877-734-3884 to answer any remaining questions you might have. Enrollment is available on a year-round basis. Individuals who enroll by the 20th of a specific month will have an effective date as of the first of the following month.

NOTE: Medical Cost Sharing members share medical expenses with a community of like-minded people. Medical Cost Sharing is not insurance and there is no sharing of risk.

Learn more about the problem with
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