PrimaCare Premium

The PrimaCare Plan is Aliera’s individual MEC plan. Of all the plans this is the only one that is not going to be ACA exempt but it will include 100% preventative wellness and 100% access to our First Call Telemedicine Service. It has all the benefits for first dollar coverage including PCP visits and urgent care visits with no MSRA tied to it. This plan is great for individuals just looking for the basics.

  • Not ACA exempt
  • Unlimited PCP visits with a $25 consult fee (including chronic maintenance)
  • 2 Urgent Care visit with a $40 consult fee
  • All labs and diagnostics included from PCP and Urgent Care
  • 5 Pediatric Visits each at $25 consult fee

States Available

AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MA, MI, MN, MO, MS, NC, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, WA, WI, WV


States Not Available

AK, HI, ME, MD, MT, ND, PR, SD, VT, WY
Age    
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Aliera Healthcare Plan Disclosures

This is not a contract. This is a voluntary program offered by Aliera Healthcare, in relationship with a HealthCare Sharing Ministry (HCSM) program offered within certain plans.  Your membership is with Aliera and cannot be transferred to anyone else.  Only you and your enrolled dependents are eligible under the membership.

All Aliera members utilizing any Health Care Sharing Ministry services are required to declare their acknowledgment of the Statement of Beliefs and make an attestation that they are of like mind with the ministry beliefs.

Statement of Beliefs

  1. We believe that our personal rights and liberties originate from God and are bestowed on us by God.
  2. We believe every individual has a fundamental religious right to worship God in his or her own way.
  3. We believe it is our moral and ethical obligation to assist our fellow man when he/she is in need according to our available resources and opportunity.
  4. We believe it is our spiritual duty to God and our ethical duty to others to maintain a healthy lifestyle and avoid foods, behaviors or habits that produce sickness or disease to ourselves or others.
  5. We believe it is our fundamental right of conscience to direct our own healthcare, in consultation with physicians, family or other valued advisors.

DISCLAIMER

 

THE MINISTRY IS NOT AN INSURANCE COMPANY AND THE MINISTRY DOES NOT OFFER ANY INSURANCE PRODUCTS OR POLICIES.  THE MINISTRY DOES NOT ASSUME ANY RISK FOR YOUR MEDICAL EXPENSES, AND THE MINISTRY MAKES NO PROMISE TO PAY.  HEALTH CARE SHARING MINISTRIES ARE NOT GOVERNED BY INSURANCE LAWS.

 

THE HEALTH CARE SHARING MINISTRY OFFERS VOLUNTARY PARTICIPATION IN ITS HEALTH CARE SHARING MINISTRY.  MINISTRY SERVICES ARE ADMINISTERED BY ALIERA HEALTHCARE, INC. 

 

This is not Insurance

 

A Health Care Sharing Ministry (“HCSM”) is a group of individuals that share a common set of ethical or religious beliefs and share their medical expenses in accordance with those beliefs without regard to the state in which a member resides or is employed. 

 

Services are based on a religious tradition of mutual aid, neighborly assistance, and burden sharing. The ministry does not subsidize self-destructive behaviors and lifestyles but is specifically tailored for individuals who maintain a healthy lifestyle, make responsible choices regarding health and care, and believe in helping others. A Health Care Sharing Ministry program is NOT health insurance.

 

Tax Exemption

 

YOU SHOULD CONSULT WITH A TAX PROFESSIONAL FOR DETAILS REGARDING YOUR EXEMPTION.

 

Health Care Sharing Disclosures

 

Promise to Pay

 

The ministry does not make a promise to pay or any guarantee of payment of your medical expenses.  You will be responsible for the payment of your medical bills.  The ministry does not assume your risk.  The ministry does not guarantee that your medical expenses will be shared by other members participating in an Aliera Plan that utilize health care sharing services.

 

Voluntary

 

Participation in the ministry HCSM is voluntary.  Enrollment as an Aliera member and participant of the ministry HCSM is voluntary and the sharing of monetary contributions are also voluntary.  Enrollment in the ministry sharing plan is not a contract.  You are free to cancel your participation at any time. The ministry requests a Monthly Share Amount, to be collected each month you are enrolled, to facilitate the payment of sharing requests published on behalf of other participants.

 

Guidelines

 

The ministry manages its sharing contributions by establishing guidelines that define eligible sharing (“Guidelines”).  The Guidelines are not a contract of insurance.  They do not constitute an agreement, a promise to pay, or an obligation to share.  The Guidelines are intended to ensure that every participant has paid their own medical expenses, as they are financially able, before requesting others to share with you to assist in paying remaining medical expenses.  The Guidelines specify what type of expenses are eligible for sharing requests, so all participants of the ministry HCSM can expect a reasonable and equitable level of sharing requests to be published monthly.

 

The ministry is authorized to exclude sharing for pre-existing conditions.  You are required to fully disclose pre-existing conditions as part of your participation in the HCSM.  The ministry reserves the right to exclude sharing eligibility for any pre-existing conditions, whether disclosed at the time of your enrollment or discovered after the effective date of the membership.

 

AlieraCare Value, Plus, Premium      

  • Pre-existing conditions have a 24-month waiting period.
  • Cancer diagnoses after enrollment have a 12-month continuous membership requirement before sharing is eligible.  This means that if you are diagnosed with cancer after you become a member, you are not eligible to request cost sharing of your expenses until you have been an Aliera member for 12 consecutive months.
  • There is a maximum limit of $1 million on this Plan.

AlieraCare Bronze, Silver, Gold      

  • Pre-existing conditions:
  • Bronze: Chronic or recurrent conditions that have evidenced signs/symptoms and/or received treatment and/or medication within the past 24 months are not eligible for sharing during the first 24 months of membership.
  • Silver: During the first two years (24 months) of continuous membership, sharing is available up to $10,000 of total medical expenses incurred for pre-existing conditions per year, after a separate MSRA equal to two times your plan MSRA.
  • Gold: During the first two years (24 months) of continuous membership, sharing is available up to $20,000 of total medical expenses incurred for pre-existing conditions per year, after a separate MSRA equal to two times your plan MSRA.
  • Cancer sharing eligibility is available immediately for new occurrences of cancer. Any pre-existing or recurring cancer condition is not eligible for sharing. Cancer sharing will not be available for individuals who have cancer at the time of or five (5) years prior to application.
  • There is a maximum limit of $1 million on this Plan.

CarePlus         

  • Cost sharing does not apply (not eligible) to any illness or accident for which a person has been diagnosed, received medical treatment, been examined, taken medication, or had symptoms within the 24-month period prior to the application date.
  • Events covered during the first year of membership become pre-existing condition for the second year, resetting after 24 months.

InterimCare

  • Pre-existing conditions have a 24-month waiting period.
  • Cancer coverage is provided immediately if a pre-existing cancer condition did not exist within 5 years prior to or at the time of application.
  • Charges resulting directly from a pre-existing condition are excluded from cost sharing.
  • The pre-existing condition exclusions for Interim Care plans will apply for all members, including those under the age of 19.
  • There is a maximum limit of $1 million on this Plan.

Dates of Service

 

The ministry reserves the right to make updates to its Guidelines at any time.  The Guidelines in effect at the time of service will supersede all previous versions of the Guidelines.  Members will be notified in advance of updates.

 

Membership Dues and Fees

  • An administrative fee of $25.00 is assigned to administrative costs from each Monthly Share Amount regardless of family size, as provided in the Guidelines.  Collection of this fee will begin in the third membership month and will be collected monthly for each following month.

Assigned Need

 

The ministry will assign a recommended cost sharing amount to the membership each month (“Monthly Share Amount”).  By submitting the Monthly Share Amount, you instruct the ministry to assign your contribution as prescribed by the Guidelines. 

 

Up to 40% of your member contribution goes towards the administration of this plan and other general overhead costs to successfully carry out the duties of administering these services. 

 

Membership Guidelines Details

 

Each Aliera member is responsible for reviewing the HCSM Guidelines provided at the time of enrollment, and to abide by the terms of the Guidelines.  It is your responsibility to understand which of your medical expenses are eligible for cost sharing, and which medical expenses are NOT eligible for cost sharing.  Members are also provided with a toll-free number to contact Member Services with any questions they have.  It is recommended that members call Member Services with any questions regarding eligibility prior to seeking medical services.

 

Authorizations

  • I authorize Aliera Healthcare, Inc. (“Aliera”), on behalf of the ministry, to collect the Monthly Share Amount as a recurring monthly transaction.
  • I authorize my first Monthly Share Amount to be processed immediately upon completion of my enrollment.
  • I understand that the enrollment fee will be refunded automatically if all individuals on my enrollment form fail to attest to the ministry Statement of Beliefs or if I withdraw my enrollment prior to my membership effective date.
  • I understand that the enrollment fee will not be refunded if, in the course of enrolling, I fail to respond to written or verbal inquiries from the ministry or Aliera (as the ministry’s administrator) for more than sixty days.
  • I understand that the ministry offers voluntary participation in the health care sharing ministry, and I understand that Aliera owns and administers memberships on behalf of the ministry.
  • I understand both Aliera and the HCSM have the authorization to contact providers to request the release of medical records on behalf of the member.

Acknowledgment

  • I affirm that the name and personal information provided on this form are true and correct.
  • I affirm that I understand and accept the disclosures presented above.

Refunds

You are entitled to a full refund, including the one-time enrollment fee, if you cancel your membership within 10 days of the effective date of the membership.  You must cancel within 10 days of your effective date to be eligible for a full refund. 

If you are canceling your membership after the first 30 days of your membership, you may be eligible for a refund of the most recently paid membership period, but only if you cancel within 10 days of your scheduled billing date.  Any cancellation requests processed more than 10 days from the scheduled billing date will NOT receive a refund, and the membership will remain active until the end of that billing period.

Refunds will be processed as a credit to the same card or account provided for billing.  Requests involving refunds payable by check may be delayed up to 30 business days.

Standard 1-5 business days $7.95
Two Day 2 business days $15
Next Day 1 business day $30
* Free on orders of $50 or more

Healthcare Plans

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AlieraCare Value

Standard Plans
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AlieraCare PLUS

Standard Plans
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AlieraCare Premium

Standard Plans
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AlieraCare Bronze

Comprehensive Plans
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AlieraCare Silver

Comprehensive Plans
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AlieraCare Gold

Comprehensive Plans
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InterimCare STM Value

Short Term Medical
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InterimCare STM PLUS

Short Term Medical
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InterimCare STM Premium

Short Term Medical
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CarePlus Advantage

Catastrophic Plans
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