Provider-Directed Healthcare
Designated Provider (Redirect Health) for Preventive Care and Small Medical Expenses with a Back-up Plan
Use Redirect Health as your designated provider for Preventive Care and Small Medical Expenses. Use Redirect Health’s Telemedicine protocol to access services. Includes Wellness services AND Medical Cost Sharing using an Open Access network of care providers. This option provides membership in BOTH Redirect Health AND Medical Cost Sharing.
Provider Directed Healthcare
Provider Directed Healthcare
Plan Specifications
  • NO AFFORDABLE CARE ACT TAX PENALTY
  • PREVENTATIVE CARE NETWORK—Open Access (anywhere) with prior authorization from the Care Logistics Team, no cost for preventative services mandated by the Affordable Care Act
  • PRIMARY AND CHIROPRACTIC CARE NETW0RK—Open Access (anywhere) with prior authorization from the Care Logistics Team. $0 deductible and $0 co-pay for primary care office visits, chiropractic visits, and for labs listed in a published schedule. Discounts are available for some other services. Use this to meet most of your small needs
  • SMALL MEDICAL EXPENSES—$0 deductible and $0 co-pay for primary care and chiropractic office visits and other services/benefits as described in the “PREVENT” and “MITIGATE” sections of the Plan Features section
Large Medical Expenses
  • Contain Unforeseen Incidents With Medical Cost Sharing
  • Medical Cost Sharing Network—Open Access network; can use any provider who accepts cash payment
  • Initial Unshared Amount (IUA) Options—Select IUA of your choice: $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 Benefits—$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 under Section 8 of the Guidelines
  • 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
Is the Provider-Directed Plan the right one for you?

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Call Healthy Care Strategist Charles Frohman (202) 258-8027

Medical Cost Sharing Guide

** This is NOT insurance. Medical Cost Sharing Plans are ACA compliant.