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Why Impact Health Sharing?

by Impact Health Sharing

 

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.

Impact has a unique partnership with Team National, a membership savings company. Team National provides a strong launching point for Impact Health Sharing, and the organization’s group buying power will enable members to access a discounted price approach that will be revolutionary for the healthcare sharing industry. In addition to Team National member savings, Team National’s reach helps to grow a powerful network of Impact Health Sharing members to share each other’s medical bills.

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 of 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 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. Telehealth is free for Impact members and there are no consult fees to pay.

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.

What About Prescriptions?

Prescription medication expenses may be credited toward the PRA if they are not considered 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:

 

•  After the first $25 on generic drug prescriptions.
•  After the first $50 on brand name prescriptions when a generic is unavailable.
•  Prescription medications must be purchased using the Member ID card (see Rx information on the card).
•  Members pay 100% of the (discounted) prescription amount at the pharmacy.
•  Prescription drugs* that may be dispensed, injected or administered.
 
*Psychotropic medication and birth control expenses are not eligible for Sharing.

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?

Impact follows the American Cancer Society recommendations when it comes to Sharing in Preventative Care which, includes the following:

  • For women:  Pap test - one every three years from 21-65 yrs. Mammogram – Age 45-54 yearly, every two years starting at age 55.
  • Men:  PSA test – yearly, starting at age 45.
  • All:  Colonoscopy – one every 10 years starting at age 50, or one every five years for members at high risk.

 

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?

Membership Requirements:

· Members cannot use tobacco on a regular basis, vape, or use illegal drugs.

· 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 cancelled.

· 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.

Family Members

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.

Non-U.S. Citizens

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.

 

 

Tags: Healthcare Sharing