Application
Complete & submit application
and sign the DocuSign
Application is placed in a queue,
addressed in the order it was received
United Refuah Processing Team
reviews your application
and reaches out to speak with you.
If you are age 50 or above,
we will request medical records
from your doctor as well as
a current well visit
If the program is a good
fit for you, you will be APPROVED
for the following 1st of the month.
Single: $199
Couple: $349
Family (3-6): $499
($50 each additional family member)
Upon Enrollment: $125, Recurring thereafter: $75
The total amount of eligible medical bills that the member is responsible for each sharing year before sharing begins.
$500 for a Single
$1,000 for a Couple
$1,500 for a Family
The amount that the member is responsible for once the Annual PreShare Amount has been met. At this point, United Refuah will share 80% of each eligible medical bill and the member is responsible for the remaining 20%. After the Annual Maximum CoShare has been met, United Refuah will share 100% of eligible medical expenses, up to $1 million dollars per incident. Eligibility of medical conditions is subject to the Sharing Guidelines.
$1,000 for a Single
$2,000 for a Couple
$4,000 for a Family
In addition to the Annual PreShare Amount, there is a Pregnancy Responsibility per pregnancy. The Pregnancy Responsibility shall be excluded in determining the Annual PreShare and the Annual Maximum CoShare Amounts.
$2,500 for a Single (married)
$900 for a Couple
No Pregnancy Responsibility for a Family
In order for a pregnancy to be eligible for sharing, the due date must be at least ten months after the date of enrollment (payment of the $125 application fee). If a membership start date is deferred for any reason, the ten month waiting period will begin on the start date of the membership.
United Refuah HealthShare does not limit members to a specific provider network. Members can choose the Doctor or hospital of their choice. Sharing for eligible medical expenses is limited to a maximum of 150% of Medicare allowable for Doctors, Hospitals, and Outpatient facilities.
Applicants with pre-existing medical conditions should make sure that they understand the limitations of the program for such conditions. During the first year of membership, there is no sharing for pre-existing conditions. For the second and third year of membership, sharing for pre-existing conditions is limited to $25,000 per condition. During the fourth and subsequent years of membership, such conditions are no longer considered pre-existing. Certain medical conditions may preclude an applicant from joining or may require a permanent waiver for that condition prior to acceptance.
Please note that for medical incidents that occur during the first two months of membership, total sharing is limited to a maximum of $25,000 per person, and must be a result of an acute illness, injury, or accident. This limit remains in effect even if such needs require additional care after the first 60 days of membership.
Before you begin your application, please make sure to read the United Refuah HealthShare Sharing Guidelines. If you have any questions, we strongly encourage you to contact us prior to enrollment at (440) 772-0700.
Please understand that you are responsible for the accuracy of all information provided on this enrollment form. If, at any time, it is discovered that the information is incorrect or incomplete, sharing eligibility may be limited or retroactively terminated for all members in the membership group.
All applicants age 50+ and applicants meeting other specific criteria will be required to submit three years of complete medical records including a recent complete well visit prior to consideration for membership acceptance. If this requirement applies to your application, you will receive a detailed email upon initial review of your application (5-7 business days).
As a reminder, this is an application and acceptance will only be confirmed once the full application review process has been completed. If you intend on using United Refuah as a replacement for another healthcare arrangement, we strongly recommend that you DO NOT make any changes until your acceptance has been confirmed and the initial 60 day limited sharing period has passed. If you have ANY pre-existing medical conditions, please make sure that you are familiar with the limitations that our program will have for care related to those conditions.
United Refuah is currently NOT accepting applications from California residents. We apologize for the inconvenience.
Please complete the application below.
Please understand that you are responsible for the accuracy of all information provided on your application, in writing or verbally. If, at any time, it is discovered that the information is incorrect or incomplete, sharing eligibility may be limited or retroactively terminated for all members in the membership group.
Once you create your password, you will be required to login with your email address and password to continue the application.
Do not use your browser’s BACK button during the process.