Medical share plans and health care sharing ministries are non-insurance organizations that share costs among members who have common ethical or religious beliefs.
These medical share plans and healthcare sharing ministries do not qualify as insurance and do not provide insurance. As a result, many health care providers, including Memorial Hermann Health System, do not contract or are not contracted with these plans/ministries. Payment for medical services that may be received by members of these plans is not guaranteed, consistent, or timely. Consequently, patients may receive bills for amounts far greater than expected. Since there is no contract for the provision of healthcare services by the hospital or physicians, patients who choose to access care at Memorial Hermann Health System that use medical share plans or health care sharing ministries are responsible for payment before services are rendered.
These plans and/or their administrators limit payment to the healthcare provider based on a predetermined amount. There is no agreement with the healthcare provider on the payment amount covered by the plan and, as a result, patients may receive medical bills for amounts far greater than expected. Since the amount reimbursed by the plan is not determined by a contract with the payor, patients are responsible for payment before services are rendered.
Memorial Hermann Medical Share Plans / Referenced Based Pricing Discount and Payment Policy
Medical Share Plans / Health Care Sharing Ministries / Reference Based / No Network Plans / Limited Benefit Plans
In our effort to increase transparency, provide clarity, and further serve those in our community who may not be fully insured through traditional means or governmental programs, Memorial Hermann will automatically apply a 35% discount to Memorial Hermann Cypress, Greater Heights, Katy, Memorial City, Northeast, Pearland, Southeast, Southwest, Sugar Land, and The Woodlands hospital charges and 45% discount to Memorial Hermann Texas Medical Center, Children’s Memorial Hermann, Memorial Hermann Rockets Orthopedic Hospital, and TIRR Memorial Hermann Hospital charges for services provided to patients covered by any of the plans referenced above.
If you are scheduled to receive elective services at Memorial Hermann, our representative will contact your plan to obtain benefit information. If the benefit and/or maximum amount payable is available prior to service, you will receive an estimate for the difference in the amount your plan will pay and the estimated charges with the applicable 35% or 45% discount applied. If the benefits and/or maximum amount payable is not available prior to service, you will receive an estimate with the applicable 35% or 45% discount applied.
For elective services, you will be required to pay 75% of the estimated patient liability before services are rendered. Once services have been provided, a 35% or 45% discount, as applicable, will be applied to the final charges. When your plan has rendered payment, you will be responsible for any amount remaining, if applicable
If you have questions/concerns, contact: