Impact Health Sharing is a new, innovative healthcare sharing organization that is backed by powerful, industry-leading, modern technology to facilitate safe and secure sharing of healthcare bills among members.
How Does it Work?
Impact Health Sharing is a community of individuals, families, and small business who share in each other’s medical bills. It’s not insurance.
Unlike insurance, there’s no pooling of funds, no premiums, no assumption of risk, no promise of payment, and no guarantee that your medical bills will be paid. In fact, healthcare sharing is completely voluntary.
There’s no guarantee and no promise that your bills will be paid. However, since the early 80s, healthcare sharing has grown to be a credible and reliable alternative to insurance. Healthcare sharing works because its members are committed to continuously share in each other’s medical bills.
This program is designed for sharing medical expenses related to new conditions that develop after joining Impact related to illness, injury, or accident.
To participate, members contribute a monthly amount, called the Monthly Share Amount, that is matched to an eligible medical bill of fellow members and applied to the payment of those bills. The Monthly Share Amount is based on the age of the oldest member in the household, the number of people applying (1, 2, 3 or more), and the choice of Primary Responsibility Amount.
Instead of a deductible, members pay their Primary Responsibility Amount. The PRA is similar to a deductible and is the amount a household is responsible for paying before eligible bills will be published to the membership for Sharing.
There are four Primary Responsibility Amount (PRA) options from $2,500 to $10,000 with monthly shares based on a sliding scale. With Impact, there’s an option for every budget.
Once your PRA has been met, your eligible medical bills will be Shared and paid by other members pursuant to the eligibility criteria. Eligibility of medical bills is determined in accordance with your Impact Guidelines, your original application, and medical information regarding the incident.
Can I Still See My Doctor?
Yes! What’s really exciting is you aren’t restricted by a network or to what doctor you can use.
You’ll also have access to telehealth for non-emergency care.
There’s no loss of coverage from your favorite doctor because your insurance plan has changed. When you see a doctor, just present your Impact Member ID card and pay the provider fee. Impact will handle everything else.
There’s a provider fee of $50 for each primary care visit, $75 for a specialist/urgent care visit and $150 for the hospital. Even better, for a $0 provider fee you can use an MDLIVE board-certified provider from the comfort of your own home, or wherever you may need to speak with a physician.
You can also schedule a time to talk to a Telehealth doctor with a $0 provider fee any time anywhere!
What About Prescriptions?
Prescription medication expenses may be credited toward the PRA if they are not considered a treatment for chronic conditions that were preexisting when the member joined Impact. After the Member’s PRA has been met, the prescription amount may be Shared as follows:
The sharable amount is limited to $1200 per member, per membership year after the PRA has been met.
Exceptions may be made in the case of medications for cancer and transplant recipients.
For example, if the member has met $1000 of their $2500 PRA and has a generic prescription that cost $55 and not for treatment of a preexisting condition, after paying $55 at the pharmacy, they may submit their bill and receive a $30 credit ($55 - $25) toward their PRA.
In the same example, if the member has already met their PRA, they may request that the $30 be Shared among Impact members.
What About Preventative Care?
Wellness visits/screening tests are eligible for sharing as follows:
- One annual/well visit for members 6 years and older per membership year. Includes $150 allowance for the following routine labs as ordered by the provider during the annual/well visit.
- Complete Blood Count with Differential and Platelets
- Comprehensive Metabolic Panel
- Lipid Profile with Lipoprotein Particle Assessment
- Hemoglobin A1C
- Vitamin D-25 OH
- C-Reactive Protein
- Fecal Occult Blood Test
- Pap Smear
Members under the age of 6 receive one annual visit. Additional visits will follow routine well-child guidelines.
Infants and Children: Sharing for routine well-child care is eligible until the child reaches the age of six. Well-child care is defined as recommended routine check-ups and associated lab work, excluding vaccinations and/or immunizations.
Women: Pap test—one every three years from age 21-65.
Mammogram—one every year for ages 45-54, every two years starting at age 55.
Men: PSA test—one every year, starting at age 45.
All: Colonoscopy—one every 10 years starting at age 45 or one every five years for members at high risk.
All: As it pertains to eligible preventive care for both men and women, both the test and coordinated office visit will be eligible for sharing.
How Will I Know If My Bills Are Eligible?
Medical bills related to a new condition, injury or illness are eligible for Sharing, provided they are not listed in Sections III. D. or E. Eligibility for Sharing cannot be determined until after medical services are received and bills are submitted for Sharing.
Bills are to be received by Impact within 12 months from the date of service to be considered for Sharing. Bills are to be submitted by the provider following standard healthcare industry submission and coding guidelines. This is necessary for bills to be considered for Sharing.
For Impact Health Sharing’s full guidelines on what bills have limited eligibility and what are not available for Sharing, visit Section III of our Guidelines.
When Can I Sign Up?
Unlike insurance, you can sign up for healthcare sharing at any time in the year, and even use it as secondary health coverage. There’s no need to wait for Open Enrollment to get started with Impact Health Sharing. However, if you choose to leave Impact Health Sharing and opt for insurance, you will have to wait until Open Enrollment to enroll in insurance.
How Do I Know If I Qualify for Impact Health Sharing?
- No use of illegal drugs in the past 12 months prior to membership.
- An adult child (18-25) needs to meet the same requirements in order to be on their parents' household membership and have their bills Shared.
- Medical information is provided during the application process. If an applicant or member fails to disclose medical history, lifestyle habits, or choices that may disqualify them from membership and that information is discovered, medical bills may not be shared and/or membership may be canceled.
- The Primary Member will establish a Virtual Sharing Account when activating their membership. The Primary Member must be at least 18 years and a legal resident of the U.S.
The following family members may be included or added to the Impact Membership if they meet the following qualifications.
- Member's spouse.
- Unmarried children (biological or adopted) until they reach age 26.*
- Children in full legal custody or guardianship of the member.
*An exception is made for those disabled who are still dependent upon and under the care of their parent(s).
65 Years and Older
Applicants who are 65 or older must have Medicare Parts A & B. Sharing will be secondary to Medicare.
There is only one PRA available to these senior adults. See pricing calculator. This program is available on an individual membership basis.
Legal aliens who live full-time in the U.S. can qualify for membership with Impact Health Sharing. Medical bills incurred while not a legal resident of the U.S. are not eligible for Sharing.