Big Stuff Health Share is a Utah nonprofit corporation with a home office in St. George, Utah. Big Stuff Health Share administers a membership-based health care medical cost-sharing program. This program allows participating members to share each other’s unexpected medical expenses from a collective pool of funds.
Health Insurance is a contract where the insurance company takes on legal responsibility for the insured’s risk of loss in exchange for a monthly premium payment. A health share is a fund set up to allow members to share the costs of health care with one another.
A health share includes the Member in the process of obtaining and paying for health care. In a health share model, you are free to choose your provider and facility based on merit, expertise, and price, rather than a limited list of pre-negotiated “in-network” providers. This model allows empowers you to take back control of your health care! Big Stuff Health Share will also go to work on your behalf by prenegotiating all your medical bills! Among these benefits, you will also enjoy:
• Lower monthly costs
• No annual deductibles
• No annual caps
As of 2019, you are free to choose any type of health care coverage for yourself and/or your family, without penalty.
Medical Needs, as we call them, are first evaluated for Eligibility and Shareability based on the Big Stuff Health Share Member Guide.
An Eligible Medical Need:
1. Is the occurrence of an injury or illness on a per member, per incidence basis
2. Results in medical expenses
3. Is a medically necessary treatment performed by a licensed medical professional
4. Is related to the same medical condition
5. Is not deemed a Pre-Existing Condition
6. Has not resulted from illegal activities
If deemed an Eligible Medical Need, the need is considered shareable if:
1. All required documentation (itemized bill, IUA receipt, etc.) is submitted
2. The IUA has been paid in full within a period of Active status and a receipt for the IUA payment has been submitted
3. The need is submitted within 6 months of the service date, and
4. The date of service is within a period of Active status
Once the Eligible Medical Need is deemed Shareable, Big Stuff Health Share will then pay according to the Member’s contributions and IUA and Membership elections.
Follow these simple steps to get your hospital bills paid:
1. Inform the staff that you are “self-pay” or “cash-pay.”
2. If possible, pay your IUA upfront, asking for a receipt.
3. Ask for an itemized bill of services rendered.
4. Submit the bill, receipt, and explanation of your medical need to Big Stuff Health Share via the online member portal.
Once all required information and documentation are submitted to Big Stuff Health Share, we promptly reimburse you for paid-out expenses.
Yes! You are completely free to choose your provider and facility based on merit, expertise, and price, rather than a limited list of pre-negotiated “in-network” providers.
Big Stuff Health Share will share in any eligible, shareable need, regardless of the facility location. We only request that you submit the documentation in English with U.S. dollar amounts.
Because Big Stuff Health Share is not insurance, it does not charge premiums, but rather Members may voluntarily contribute a predetermined amount each month, called a share. The share amount will vary depending on what kind of responsibility you would like to carry for your own medical needs.
Big Stuff Health Share is not insurance. Because it is a health share, the member responsibility is called an Initial Unshareable Amount or IUA, rather than a deductible or co-insurance. This IUA is how much of each medical Need you would like to be responsible for, or pay before the community will share the rest of your expenses.
Yes! Because Big Stuff Health Share is a benevolence program, any amount you contribute over your monthly contribution amount will be added to a fund set aside for Needs that are deemed Unshareable, called the Additional Assistance Fund.
In the cases where a Medical Need is deemed Unshareable (Ineligible Needs will not be shared, regardless of circumstance), Big Stuff Health Share may use funds from the Additional Assistance Fund. This fund is comprised of voluntary additional contributions over and above members’ regular contribution amounts and is reserved to help those whose needs aren’t shareable but are still experiencing financial hardship.
A small portion of Member contributions is reserved for the costs of maintaining and administering the health share program.
Participating in Medicare/Medicaid if Medicare/Medicaid eligible.
Filling out the Big Stuff Enrollment Form completely, accurately, and honestly;
Meeting Big Stuff Health Share’s qualifications based upon lifestyle choices and medical history;
Agreeing to abide by the Foundations of Membership; and
Paying a full, monthly contribution amount in accordance with the Member’s Participation and IUA Elections, with the first contribution being due on or before the Effective Date and all subsequent contributions being due on the first day of each calendar month.
Typically, medical needs for an illness or injury resulting in visits to licensed medical providers, emergency rooms, testing facilities, surgery centers, or hospitals are considered shareable if the need meets the Eligibility and Shareability standards.
There are no annual maximum shareable amounts for most Eligible Medical Needs. However, there is a $1,000,000 maximum lifetime limit per member. See the Big Stuff Health Share Member Guidelines for more information.
To participate in the health share, all Members must agree to follow the Foundations for Membership; this includes Primary Members, spouses, and children. The Primary Member will be held responsible for their dependents’ adherence to the Foundations for Membership. For example, if a spouse were to injure themselves while under the influence of an illegal substance, the need would be deemed unshareable.
Yes! Spouses and children can join you in your health share membership if:
• They are legal dependents (by marriage, biological birth, or adoption)
• They live in the same household
• Children are unmarried, and
• Children are under age 26
No. There are no annual limits for sharing in Eligible Medical Needs.
You are considered Active if your monthly contribution is received by the 30th of the effective month. Should you go more than 30 days past the due date for the effective month, your membership will be suspended until your monthly contributions are caught upon your committed shares.
Yes! Your employer is welcome to pay any portion of your monthly contribution they choose.
Big Stuff Health Share offers several predetermined contribution amounts depending on your membership and IUA election. Please see Pricing on our website.
Big Stuff Health Share will generally exclude from sharing:
• Routine medical care
• Medical Needs whose total falls below the Member’s IUA amount
Yes! As long as you meet our Eligibility Requirements, you may participate in health care sharing. Please see the Member Guide regarding Pre-Existing Conditions.
If shareable needs are ever significantly greater than shares available in any given month, Big Stuff Health Share 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. For example, if the Monthly Contributions received for a given month equals 80 percent of the needs submitted for a month, only 80 percent of each need would be shared that month. This does not necessarily mean that Members would not receive enough money through other Member shares to pay their medical bills. We seek fair pricing on every medical need, so if we are able to get Members costs below eighty percent (80%) of the billed charges, there would still be enough to meet all of the needs in that month. If prorating occurs three months out of six at any time, Big Stuff Health Share will evaluate, with Community input, whether there needs to be an increase in the Monthly Contribution.
Expenses related to prenatal, birth, and postnatal Needs are considered shareable, though care for the baby and care for the mother are considered two separate and distinct Needs, thus requiring the payment of two IUAs. In addition, Maternity Needs may only be Sharable if conception occurs 90 days or longer after the applicable Member’s Effective Date.
Yes! Pre-Existing Conditions are shared according to the schedule below:
1st Year – Waiting Period (no sharing) for all Pre-Existing Conditions
2nd Year – Up to $25,000 of Pre-Existing Conditions is shareable
3rd year – Up to $50,000 of Pre-Existing Conditions is shareable
4th year and beyond – Up to $100,000 of Pre-Existing Conditions is shareable per year
No. Your monthly contribution is a voluntary contribution for a membership-based health share program, and as such, cannot be paid with pre-tax dollars.
Yes. Tobacco is clinically proven to cause serious health issues. Because of the increased likelihood that a tobacco user would have significantly higher medical costs, Big Stuff Health Share assesses a $50 Tobacco Fee for each household in which a tobacco user lives.
Big Stuff Health Share is a benevolent organization that manages a Member-contributed fund for sharing in other’s medical expenses. Because Big Stuff Health Share is not insurance, we cannot promise payment of medical expenses for our members. To help alleviate that risk, Big Stuff Health Share has a proration policy. If there are more Needs submitted than contributions received in a month, Big Stuff Health Share will prorate the amount paid for each need submitted. For example, if the contributed funds for a month are 90% of the needs submitted, then Big Stuff Health Share will pay 90% of each Need submitted for that month.
Yes! We will send the company one bill for all employees, and the employer can deduct the amount due from each employee’s paycheck.
Very little! Our enrollments and cancellations are very simple and easy to process, and we will educate your employees about the health share program for you!