Straightforward by Design. Personal by Nature.
We believe feeling confident about your healthcare starts with understanding how it works. That’s why we make it easy to know what’s eligible, how the sharing process works, and what you can expect along the way.
How Health Sharing Works
Unshared Amount (UA)
Your personal responsibility before community sharing begins. Options: $1,500, $3,000, or $6,000. No annual or lifetime limits after the UA is met.
Safeguard Limit
You'll never pay more than two UAs in a rolling 12-month period. After that, the community shares any additional eligible requests exceeding $1,500 with no UA.
Timelines
Bills must reach the UA within 6 months. Submit itemized bills within 6 months of treatment. Maternity requests within 15 days of pregnancy confirmation.
How Sharing Requests Work
Types of Sharing Requests
Sharing requests cover eligible medical expenses after your UA is met. Requests are reviewed for eligibility based on your membership tier and the nature of the service.
How Funds Are Delivered
Approved sharing funds are sent directly to you or your provider. Reimbursements for out-of-network care typically arrive within 7 to 10 days of approval.
UA Reduction Program
Members may qualify for UA reduction through consistent healthy behaviors and preventive care participation as outlined in the member handbook.
Scheduled Care Review
For non-emergency procedures, a pre-review is recommended to confirm eligibility before scheduling. This helps avoid unexpected out-of-pocket costs.
Appeals Process
If a sharing request is denied, members may submit a formal appeal within 60 days. Appeals are reviewed by the member services team and resolved within 30 days.
Who Can Join
Who can join and how households are structured.
Individual (Tier 1)
Single member aged 18–64.
Member + Dependents (Tier 2)
Member aged 18–64 with either a spouse/domestic partner or child(ren).
Family (Tier 3)
Member aged 18–64 with spouse and child(ren).
Children
Unmarried children under 26 may participate under a household membership.
Age Limit
Membership terminates the 1st of the month following a member's 65th birthday.
Tobacco Surcharge
$100/month per household if any member uses tobacco products. Removed after 12 months tobacco-free with documentation.
Service-Specific Sharing Limits
Certain services have a specific sharing allowance after the UA is met. If costs exceed the allowance, the excess can still count toward your UA.
Not Eligible for Sharing
These services are not eligible for sharing under UA-based requests. Some may qualify under preventive sharing — check your specific membership for details.
Pre-Existing Conditions
These conditions become eligible after the initial pre-existing waiting period, following the standard phase-in schedule. The community supports you — it just takes a little time.
Everything You Need to Know
Find Providers
Search the PHCS network for in-network doctors near you.
Learn more →FAQs
Straightforward answers to the most common questions.
Learn more →Maternity
A complete guide to maternity sharing and timelines.
Learn more →See My Options
Find providers, pricing tools & medication savings.
Learn more →Want the Full Guidelines?
Our team can walk you through the complete member guidelines and help you understand exactly what's included with your membership.