Care for your family. Support your team. Explore healthcare benefits with predictable outpatient copays and options for larger medical needs.
| Unlimited doctor visits | Prescriptions & labs | ER, hospital, surgery & maternity |
Primary care & specialist visits
Virtual urgent & behavioral care
Starting prescription copay
for max. out of pocket cost
Unlimited use for listed outpatient services, with no outpatient deductible. Use participating providers for eligible in-network care.
Primary care, specialist visits and urgent care through the participating Claritev / MultiPlan PHCS network.
Primary care & specialist visits
$25
Urgent care visits$50
Laboratory services & X-rays$50
Eligible preventive & wellness care$25
Out-of-network services are excluded from these outpatient benefits. Preventive services must be on the covered schedule.
Unlimited virtual urgent care, available 24/7 for everyday concerns such as colds, flu, allergies and rashes.
Unlimited virtual behavioral health counseling is also included, by appointment.
Access through the HealthWallet app / provider's mobile app / toll-free number 24/7/365
Prescription benefits with no deductible, plus $0 copays for covered preventive medications.
Subject to the formulary. Listed copays are based on a 30-day supply or quantity of 30; pricing varies by quantity and supply.
Medical sharing is a non-insurance community arrangement for eligible expenses. It follows separate membership guidelines from your outpatient benefits.
Large medical needs such as ER visits and surgery are facilitated through the medical share plan benefits. Eligible expenses are 100% shareable after the applicable MRA, subject to membership guidelines, exclusions, waiting periods and benefit-specific limits.
Emergency room visits & hospitalization
Inpatient & outpatient surgery
Catastrophic illness & advanced imaging
Physical rehabilitation & eligible maternity care
There is no provider-network requirement for medical sharing needs.
The MRA is the amount you pay per eligible sharing request before community sharing begins.
Lower MRA options have higher monthly costs. An MRA can apply to the first two sharing needs per plan in a 12-month period. This is not a cap on all healthcare spending: non-shareable expenses and outpatient copays are separate.
For your own care, your family or your small business, start with a conversation about what you need.
Discuss your household or team, location and healthcare priorities with an SHC advisor.
Compare monthly costs, MRA choices, participating providers, medications and eligibility.
Review the plan documents, limitations and effective date before deciding to enroll.
Have a question we haven't covered?
We're here to help, speak with a SHC Benefits advisor -
No. The SHC Everyday VitalCare plan is not major medical insurance and is not intended to replace it for individual who require the level of care associated with those policies.
For listed outpatient benefits, your provider must participate in the applicable Claritev / MultiPlan PHCS network. Ask an advisor to help verify the specific provider and service before receiving care. Medical sharing has no network requirement and uses a separate self-pay and sharing process.
Your personalized quote will confirm the monthly amount for the people enrolling and the MRA option selected. The brochure does not provide a monthly rate table. Ask your advisor to review all applicable premiums, fees and surcharges. Get my personalized quote
Yes, but restrictions apply for pre-existing conditions. There is a 24-month lookback for most pre-existing conditions and separate cancer rules. Ask for the current membership guidelines and an explanation of how they apply to your needs.
Yes. SmartHealth supports small business employers with less than 50 full-time equivalent employees (FTE), subject to applicable eligibility. Many SmartHealth plans can be utilized by small business employer groups.
A copay is your stated cost for an eligible outpatient service, such as a $25 primary care visit. The MRA applies to eligible medical sharing requests for larger medical needs. Meeting an MRA does not remove outpatient copays or make excluded expenses eligible.
Affordable. Accessible. Reliable.
Healthcare benefits built around you.
