Because there is no transfer of risk, as defined in applicable insurance rules and regulations, with respect to GoldCare+’s medical cost sharing program, no “claim” is ever owed by GoldCare+ on behalf of any member. When members incur medical expenses, they submit medical need requests that may or may not be eligible for reimbursement from the Benevolent Fund. Members are required to submit proof of their medical expenses to GoldCare+. GoldCare+ then evaluates each submission for eligibility or ineligibility based on the Member Guidelines. Eligible medical need requests are designated for sharing using the funds accumulated through monthly member contributions.
We "bear each other's burdens" - the expectations on both sides are clear. GoldCare+ provides a safety net for large and/or unexpected healthcare expenses, GoldCare+ saves you a great deal of money compared to health insurance premiums/deductibles/copay/co-insurance, and GoldCare+ gives you complete medical freedom of choice.