ClearShare member guidelines.

Learn more about how ClearShare works and what’s included in a membership.

Our Story

Healthcare in America is due for a major overhaul. It’s too complex and notoriously puts profit before people. We believe healthcare should be transparent and affordable, and always put the patient first. Above all, we believe healthcare should be on your side and invested in your wellness. That’s why we started ClearShare in 2022.

ClearShare is a 501(c)(3) non-profit organization that allows you to pay monthly contributions to have your medical needs shared by a community of other generally healthy individuals. The concept of healthshares isn’t new. It dates back to the 1700s when small religious communities would pool their money to help each other bear the burdens of medical costs during hard times. Healthshare communities have multiplied and expanded over the years, becoming increasingly popular over the past three decades. Today, over two million people participate in healthshares. 

While Healthshares have grown in popularity, they’ve also earned a reputation for being exclusive, especially when it comes to religion, and being difficult to work with when it comes to getting needs paid. 

ClearShare is different because we’re devoted to the health of our members, and we pride ourselves in saying “yes” when other healthshares say “no.”

  • We don’t discriminate based on background, nationality, ethnicity, sexual orientation, or denomination. 
  • We offer medical cost-sharing for a broad range of health needs as defined in our Member Guidelines. 
  • We put our members first and work hard to make sure health needs are covered. 
  • We’re transparent about what needs can be shared so there are no surprises.
  • We keep costs low by vetting the health of individuals who join our community, and by offering value-based solutions like care coordination and virtual care.
  • We strive to offer members the lowest fixed amount each month and the lowest out-of-pocket costs.
  • We strive to allow members the broadest access to providers.
  • We pride ourselves in giving members a simple, fair, easy-to-understand experience.

While other healthshares might look for ways of getting out of sharing medical needs, we measure our success by: 

 

  1. The number of people who feel cared for, and who are happy with their plan.
  2. The number of providers who are paid quickly for eligible member needs to build a good reputation and ease the administrative burden on our members. 

Join us on our mission to lower healthcare costs for all, while keeping members happy and healthy along the way.

Statement of Beliefs

A. I believe in a higher being or power.

B. I understand that ClearShare is a membership-based, non-insurance community of individuals established for the purpose of sharing eligible healthcare expenses between Members, as described in the Membership Guidelines.

C. I believe in personal responsibility to pursue a healthy lifestyle and not abuse my body by taking illegal recreational drugs, excessive alcohol use, driving while intoxicated, or otherwise abusing my body or that of my family with harmful acts. I believe it is wrong to abuse others and that any mental, emotional, verbal or physical abuse of a family member is morally wrong.

D. I believe that ClearShare is a benevolent organization dedicated to helping lower the cost of healthcare and that it is not an insurance company therefore it cannot legally guarantee payment of medical expenses.

E. I acknowledge that ClearShare considers itself accountable to a higher power to ensure all members from all backgrounds, nationalities, ethnicities, and faiths are treated fairly and with the highest ethical conduct.

If you share these beliefs, we welcome you to join our membership community.

Membership eligibility

If you agree to our community guidelines and qualify for our plans based on your age, we welcome you to join our membership community.

ClearShare members pay their monthly contributions, and in exchange, medical needs are shared as they arise. Monthly contributions must be received within 15 days of the agreed-upon start date for the membership to be considered active.

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1. ClearShare Statements of Beliefs

Members of ClearShare commit to abide by a set of personal standards as outlined in the ClearShare Statement of Beliefs. If a violation of the Statement of Beliefs is discovered through review of a member’s submitted medical records, all cost sharing for the needs of that member will be put on hold. This hold will begin on the date in which the violation was discovered or recorded in the member’s medical records. A notification of the hold and an explanation of the discovery will be issued to the member.

The member will be granted 30 days to submit documentation supporting compliance with the Statement of Beliefs. If the submitted documentation does not satisfactorily demonstrate compliance with the Statement of Beliefs, the member will automatically be withdrawn from the sharing program and membership will be revoked. If membership is revoked due to a violation of the Statement of Beliefs, ClearShare will not return the offending member’s contributions received prior to the date of withdrawal.

2. Participation by monthly contributions

To participate in the member-to-member medical cost sharing community, members must submit the monthly contribution amount associated with their level of membership.

Members have multiple options for submitting their monthly contributions. Individual members can make contributions directly to ClearShare. For members who enroll in ClearShare through their workplace, payments can be made through their employer.

All member contributions are voluntary, but the monthly contribution is required to be active and eligible for sharing. Monthly contributions must be received by the last day of the month after the billing date. If a monthly contribution is not received by the last day of the billing month, the membership will become inactive, and the member will be withdrawn from the medical cost sharing community. 

Any member that has been withdrawn may reapply, provided they meet all enrollment and eligibility requirements. Once the member reapplies and membership is reinstated by ClearShare, the member will become eligible to participate in cost sharing. All member needs occurring after the membership is inactivated and before reinstatement will be ineligible for cost sharing, and any medical conditions existing before the date of reinstatement will be considered pre-membership medical conditions. Any member whose membership has been inactivated three times will not be eligible to reapply.

3. Qualification

To be qualified for membership, an applicant must meet all criteria set forth in the membership guidelines and the membership enrollment form. If at any time it is discovered that a member did not submit a complete membership enrollment form, the incomplete form could result in either a retroactive membership limitation or a retroactive denial of membership. While member health status has no effect on eligibility for membership, there are limitations on medical cost sharing for some conditions that existed prior to a member’s effective date.

Primary members must be at least 18 years old to enroll in their own plan, and all members must be under 65 years old.

Enrollment requirements

ClearShare offers different enrollment types for individuals and families. Monthly contributions are based on the enrollment type, annual maximum, and member age. This section outlines the different household memberships and who is eligible for enrollment therein.

Member responsibilities

All members of ClearShare share certain responsibilities to remain a part of the sharing program. Because the actions of one member can affect the entire community, each member will be held accountable for following these standards.

How needs are shared

Medical needs are submitted on a per-member, per-need basis. Medical needs may be injuries or illnesses that result in medical expenses. These medical expenses may be incurred by receiving medically necessary treatment from licensed medical professionals and facilities, such as physicians, emergency rooms, and hospital facilities.

When a member has a medical expense to be shared, the member must have their providers submit original, itemized bills for the medical expense within six months of treatment. Bills submitted more than six months after the service date of treatment will not be shareable. There is no lifetime limit on the number of conditions or the total dollar amount that may be shared.

Submission of medical needs

ClearShare strives to share in its members’ medical needs in a timely, accurate manner. To do this, it is crucial for members and providers to submit medical needs correctly and include all required documentation.

Pre-membership medical conditions

To keep membership contributions low for all members, ClearShare implements a waiting period for the sharing of medical conditions that exist prior to the effective date of a ClearShare membership. This section defines medical conditions prior to membership and outlines the sharing limitations.

Specific sharing qualifications

Member needs not associated with a pre-membership medical condition are generally shareable. The following list reflects limitations on sharing for certain conditions or requirements for certain expenses to become eligible. All shareable expenses are subject to the member Annual Maximum.

Medical expenses ineligible for sharing

The ClearShare community chooses not to share in some medical expenses. Decisions for sharing eligibility are made to benefit the community as a whole, to keep monthly contributions low for our members, and to share in medical expenses based on our Statement of Beliefs. The following expenses are excluded from sharing with the ClearShare community.

Maternity needs

As a general rule, maternity needs are shareable and are treated like any other medical need. Learn more in the ClearShare Maternity Guidelines.

End of life assistance

If any member dies after one year of uninterrupted membership, financial assistance will be provided to the surviving family. The ClearShare member community will provide assistance upon receipt of a copy of the death certificate. Financial assistance will be provided to the surviving family as follow:

  • $10,000 upon the death of a primary member
  • $10,000 upon the death of a dependent spouse
  • $2,500 upon the death of a dependent child
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Amending Guidelines

ClearShare reviews and may amend the Member Guidelines twice per year. ​​Amendments to the Guidelines take effect immediately and members will be notified of Member Guidelines updates. ClearShare reserves the right to update and change its Guidelines at any time.

Appendix A: defined terms

Annual limit – The maximum amount shared for eligible needs per participating member per year. ClearShare does not have annual or lifetime sharing limits for our members unless specifically stated in the Member Guidelines.

Annual Maximum – The specific financial amount that members are required to bear on their own prior to any amount that may be eligible for sharing.

Application date – The date ClearShare receives a complete membership application.

Benevolent Fund – A fund maintained by ClearShare created from the contributions of members for the exclusive purpose of reimbursing eligible needs of members.

Benevolent organization – An organization whose primary purpose is to care for the needs of the persons/members who make up the membership. A benevolent organization is not an insurance company.

Congenital condition – Any disease or physical abnormality present at birth or that is identified or diagnosed within the first year of life.

Contribution list – A list of members who are being billed by payroll deduction through a company opposed to direct billing from ClearShare.

Date of service – The day medical services were rendered on behalf of a participating member.

Dependent – The head of household’s spouse or unmarried child(ren) under the age of 26, who are the head of household’s dependent by birth, legal adoption, or marriage, and who are participating under the same combined membership. Unmarried children under 26 years of age may participate in the membership as a dependent.

Effective date – The date a person’s membership begins.

Eligible need – A medical need that qualifies for sharing via the contributions of ClearShare members.

Head of household – The oldest participating member in the household.

Household membership – One or more family members participating under the same membership.

Healthcare sharing – A membership-based, non-insurance arrangement established for the purpose of sharing legitimate healthcare expenses between members.

Inactive member – A contributor, and contributor’s dependents, if applicable, who has/have not submitted monthly contributions in the manner established by the Member Guidelines. An inactive member is not eligible for sharing.

Ineligible Need – A need disqualified from voluntary sharing of contributions from member contributions due to a policy set forth in the Member Guidelines.

Licensed medical professional – An individual who has successfully completed a prescribed program of study in a variety of health fields and who has obtained a license or certificate indicating their competence to practice in that field (MD, DO, ND, NP, PT, PA, DC, etc.)

Lifetime limit – The maximum amount shared for eligible needs throughout an individual members’ lifetime of membership.

Maternity need – A need request that must be submitted once a member becomes pregnant within 45 days of confirmation of pregnancy from a licensed medical professional.

Maximum shareable amount – The maximum dollar amount (limit) that can be shared for any one need. Certain medical needs have a maximum shareable amount as described in the Guidelines.

Medically necessary – A service, procedure, or medication necessary to improve or to maintain physical function and that is provided in the most cost-effective setting consistent with the member’s condition. The fact that a provider may prescribe, administer, or recommend services or care does not make it medically necessary. This applies even if it is not listed as a membership limitation, or in the Member Guidelines. To help determine medical necessity, ClearShare may request medical records and information from licensed medical professionals.

Member(s) – A person or people (or dependent thereof) who has agreed in writing to abide by the requirements of ClearShare and is thereby eligible to participate in the sharing of medical needs with other members in accordance with the Member Guidelines and membership type.

Membership – This term applies to the collective body of all active, participating members of ClearShare.

Membership cancellation request – A request by a member to ClearShare that their membership be canceled. The request must include the reason for cancellation, and the requested month in which the cancellation of the membership is to be effective. ClearShare requires 30-day notice prior to your payment draft date. ClearShare does not prorate cancellations or give refunds. Cancellations become effective on the last day of your monthly billing anniversary following the timely receipt of your membership cancellation request.

Members have 30 days from the membership cancellation date to reactivate membership in order to qualify for continuous membership. For example, employers who terminate employee memberships.

Membership commitment – The required principles and ongoing behavioral code attested to by members as required for membership.

Membership responsibility amounts – Amounts needed to be paid by the member for medical costs that are not shareable with the ClearShare community.

Membership update – A communication from the member to ClearShare providing any changes to the details of their membership information (ie: change of address, phone number, etc.). The change request or update may take up to three business days to complete.

Membership limitation – A specified medical condition for which medical needs arising from or associated with the condition are ineligible for reimbursement from the Benevolent Fund. An associated condition is one that is caused directly and primarily by a medical condition that is specifically ineligible. The membership limitation will be issued during the application process and may be subject to medical record review.

Member plan – A variety of sharing options are available with different annual maximums and sharing limits, as selected in writing on the membership application or enrollment portal and approved by ClearShare.

Membership withdrawal – When a membership has been or will be canceled due to the submission of a Membership Cancellation Request Form, a violation of ClearShare’s Statement of Beliefs, or non-receipt of a voluntary monthly contribution or annual membership fee for more than 10 days past the date such payment was due. Such cancellation of membership is referred to as membership withdrawal.

Monthly contributions – Monetary contribution given voluntarily and placed in the care of ClearShare by a member to maintain active membership and to be disbursed for the eligible needs of its members in accordance with the Member Guidelines.

Need request – A request that is required to process medical needs for accidents, injuries, or medical conditions that result in medical costs. A member’s provider should submit Need Requests directly to ClearShare.. The Need Request must be submitted to ClearShare within six (6) months of the need to be eligible for sharing.

Non-affiliated provider – A non-network, licensed medical professional or facility as determined by ClearShare.

Office visit – Sick visits, wellness visits, specialists, and urgent care are generally considered to be office visits. The medical bill must include an office visit CPT code for the need to qualify as an office visit. 

Plan administration – A collaborative process of planning, evaluating, facilitating, coordinating, and advocating for options and services to meet a participating Member’s Eligible Needs through available resources to promote quality, cost-effective results.

Pre-membership medical condition – Any illness or accident for which a person has been examined, taken medication, has a diagnostic test performed or ordered by a physician, or received medical treatment for 12 months prior to the effective date. For information on sharing for pre-membership conditions, see the section titled “Pre-Membership Medical Conditions.”

Proration – If shareable needs are ever significantly greater than shares available in any given month, ClearShare may prorate the needs amount requested for medical expenses. This involves an across-the-board percentage reduction of needs payments but does not necessarily mean that all member needs will not be met in that month.

Shareable amount – The amount of the need request that remains after the member’s annual maximum has been satisfied and falls within the guidelines for sharing within the membership.

Spouse – A spouse means your spouse under a legally valid existing marriage, unless court ordered separation exists. This also includes a domestic partner, where all of the following requirements apply to both persons:

  • They must not be related by blood or a degree of closeness that would prohibit marriage by law in the state they reside.
  • They must not be currently married to, or a Domestic Partner of, another person under either statutory or common law.
  • They must share the same permanent residence and the common necessities of life.
  • They must be at least 18 years of age.
  • They must be mentally competent to consent to contract.
  • They must be financially interdependent and provide documents to support at least two of the following conditions:
    • They have a single dedicated relationship of at least 6 months’ duration.
    • They have joint ownership of a residence.
    • They have at least two of the following:
      • A joint ownership of an automobile.
      • A joint checking, bank or investment account.
      • A joint credit account.
      • A lease for a residence identifying both partners as tenants.
      • A will and/or life insurance policies which designates the other as primary beneficiary.

Explanation of sharing (EOS) – Correspondence that is delivered to the participating members and their providers once medical needs have been processed, are pending, or have been rejected. The Sharing Summary will state their member responsibility amount as well as any amounts shared by the Benevolent Fund on the member’s behalf.

Special needs – Medical needs that do not fall within the definition of eligible needs but are not a violation of the member requirements and may be eligible for Additional Giving (ie: a prior medical condition).

Unusual, customary, and reasonable costs (UCR) – The general cost of medical services in a geographic area, as determined by ClearShare, based on reasonable charges in the area for the same or similar services. When more than one treatment option is available, and one option is no more effective than another, the least costly option that is no less effective than any other option will be considered within a reasonable charge.

Unsharable amount(s) – A medical expense incurred by a member that is not shareable for one or more of the following reasons: a member’s violation of ClearShare’s Principles of Membership, non-current membership status, or any other condition or requirement that is excluded by the Member Guidelines.