Frequently Asked Questions

No, Impact Health Sharing is not insurance. We're a 501(c)(3) nonprofit healthcare sharing community that brings individuals and families together to help one another with eligible medical expenses.

Instead of paying premiums to an insurance company, members voluntarily contribute to a community where medical expenses are shared through our technology platform, according to our Membership Guidelines and shared beliefs.

Health insurance and healthcare sharing offer two different approaches to managing medical expenses.

Healthcare sharing takes a community-based approach. Members contribute a Monthly Share that helps pay for other members' eligible medical expenses, following established Membership Guidelines that outline what is eligible for sharing and how the process works.

Unlike insurance, healthcare sharing is voluntary and is not a contractual guarantee of payment. However, eligible medical expenses are reviewed and processed according to the community's established Guidelines.

Impact Health Sharing brings a modern approach to healthcare sharing through a 501(c)(3) nonprofit community focused on affordability, transparency, and giving members more flexibility in how they manage their healthcare costs.

Impact Health Sharing is built around financial transparency and accountability.

Member sharing funds are managed by an independent, third-party fiduciary and kept separate from Impact's operational funds. This means member contributions designated for sharing are not commingled with funds used to operate the organization.

This structure provides an additional layer of financial oversight and helps ensure member sharing funds are managed for their intended purpose: helping fellow members with eligible medical expenses.

Members can also view sharing activity across the entire Impact community, 24/7, through the Member Center, with full transparency into where and how every dollar of member sharing contributions is being used.

Impact Health Sharing welcomes individuals, families, and small businesses who agree with our Statement of Shared Beliefs & Ethics.

Membership is open to people of all backgrounds, with no restrictions based on religion or creed.

Impact Health Sharing offers year-round enrollment, so you can join any time of year without waiting for a specific enrollment window.

Memberships begin on the first day of each month, and you can choose your preferred start month when you enroll.

For example, if you enroll on November 15, your membership can begin as soon as December 1.

The monthly cost is based on the age of the oldest person in your household, the number of people applying, and the Primary Responsibility Amount that you choose.

Visit https://www.impacthealthsharing.com/pricing to see your options.

Prices start at $73/mo. for singles and $378/mo. for families. Senior Program pricing starts at $96 per Monthly Share, per person age 65-69.

See the Guidelines for complete details.

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 prescription.
• After the first $50 on brand name prescription 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 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. For more info. on how it works click here. 

Yes, you can join Impact Health Sharing if you have a pre-existing medical condition. However, eligibility for sharing medical expenses related to that condition depends on the specific condition, your medical history, and our Membership Guidelines.

It's important to understand how our Pre-Existing Medical Condition Guidelines work before joining.

A pre-existing medical condition is generally one for which you've experienced signs or symptoms, received testing or a diagnosis, or undergone treatment or taken medication within the 36 months before joining.

Medical expenses related to a pre-existing condition become eligible for sharing once the condition has gone 36 consecutive months without signs, symptoms, testing, diagnosis, treatment, or medication, as documented in medical records.

A few important exceptions and considerations:

• High blood pressure or high cholesterol: When controlled with medication, these conditions are not considered pre-existing for determining sharing eligibility related to future vascular or cardiac events.

• Cancer in remission: Special Guidelines apply to cancer surveillance testing and when related medical expenses become eligible for sharing.
• Members age 65 and older: Pre-existing medical condition limitations do not apply.

Not sure how these Guidelines may apply to you? Start by watching our Pre-Existing Conditions Explainer Video, then take our quick Pre-Existing Conditions Quiz to better understand how your medical history may affect eligibility for sharing. Or call Member Services to speak with an Enrollment Specialist.

For complete details, review our Membership Guidelines.

Watch this video for information on using Impact at any provider, and read through these simple steps.

When you need to go to the doctor, using your Impact Health Sharing membership is easy.

 To see details click here.

Impact Health Sharing is not insurance, so our terminology and approach are different. Members contribute a Monthly Share amount and have an Annual Household Primary Responsibility Amount (PRA).

The Annual PRA is the amount your household is responsible for paying toward eligible medical expenses before sharing begins. It's one annual amount for your household that resets every membership year, not a separate amount for each family member.

There are four annual household PRA options: $2,500, $5,000, $7,500, or $10,000.

Once your household PRA has been met, new eligible medical expenses are shared at 90%, with your household responsible for the remaining 10%, up to the annual co-share maximum limit of $5,000 per household, per membership year.

For Seniors (65+), the Annual PRA is $1,000 per person, with different sharing provisions.

Once your household has met its Annual Primary Responsibility Amount (PRA), new eligible medical expenses are shared at 90%, and your household is responsible for the remaining 10%. That 10% is called your Co-Share.

There is an annual Co-Share max limit of $5,000 per household. Once your household reaches $5,000, you are no longer responsible for Co-Share amounts on eligible medical expenses for the remainder of your membership year.

Your Co-Share limit and Annual PRA resets each year on your membership anniversary date.

Impact Health Sharing's Wellness Rewards program* helps members turn healthy habits into potential healthcare savings. Eligible members ages 64 and under can earn up to $150 per month, per household, for qualifying wellness purchases and activities, including fitness programs, supplements, massages, and other eligible wellness expenses.

A few important things to know:

• Rewards are not cash. They are applied toward reducing your household's annual PRA, not your Monthly Share Amount.

• The maximum is $150 per month, per household. Subject to program requirements.

• Rewards stop once your annual PRA is met. When your household's annual PRA is fully met, Wellness Rewards stop applying for the remainder of that membership year.

• Rewards restart with your annual PRA. When your PRA resets on your membership anniversary, you can begin earning Wellness Rewards again.

* Not available for members on the Senior program

A provider fee is a set amount you pay directly to your medical provider when receiving certain services. These fees are separate from your Annual Household Primary Responsibility Amount (PRA), do not count toward meeting your PRA, and continue to apply even after your PRA has been met.

Provider fees vary by type of care:

• $0 – Telehealth visits through our virtual care partner, Doctegrity

  $50 – Office visit

  $75 – Specialist visits or outpatient services

  $75 – Urgent care visits

  $150 – Emergency room visits and inpatient hospitalizations

For easy reference, your provider fees are also listed on your Impact Member Card.

For Senior Program members: There are no provider fees.

Every member (64 and under) receives a complimentary annual wellness visit per year, 100% shared by the community.
Also included, a $150 allowance for routine labs per member, per year.

Preventive screening, as outlined below, is subject to Annual PRA and Co-Share:

• Women: Pap test—one every three years from age 21-65

• Mammogram—one every year for ages 40-74

• 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
  
  

As it pertains to eligible preventive care for both men and women, both the test and coordinated office visit will be Eligible for Sharing.

Note: Bills are processed in the order they are received to apply allowances and sharing.

Exceptions are made for testing outside of the above timelines when determined to be medically necessary and not related to a pre-existing condition.

Impact's Senior Program (65+) offers a simple, affordable approach to managing healthcare expenses alongside Medicare.

Designed with seniors in mind:

• Pricing starts at $96 per Monthly Share, per person age 65-69

• $1,000 Annual Primary Responsibility Amount (PRA), per person

• No provider fees

• No Co-Share

• No pre-existing medical condition limitations

Here's how it works:

• Medicare Parts A & B are required. Members age 65 and older must be enrolled in both Medicare Part A and Part B to participate in Impact's Senior Program.

• Medicare pays first. Impact works alongside Medicare. Once your $1,000 annual PRA has been met, eligible medical expenses remaining after Medicare's payment may be shared by the community according to the Membership Guidelines.

• Prescription savings are available with Medicare Part D. Senior members can use their Impact Member Card to access prescription savings. Medicare Part D is required for prescription expenses to be eligible for sharing.

Impact's Senior Program is not insurance, a Medicare Supplement, or a Medicare Advantage plan. It's a nonprofit healthcare sharing option designed to help seniors manage eligible medical expenses that Medicare doesn't pay through an affordable, straightforward, community-based approach.

This program is available only on an individual membership basis.

Yes. Impact does not have a provider network and therefore there are no network restrictions. Members can see any licensed medical provider. However, it does not mean every provider will bill Impact directly, or that every bill is eligible for sharing.

On average, 98% of provider bills are submitted directly to Impact via our EDI Payer ID number or by mail, while some providers prefer payment from the member.

Watch this video for more information on how to use Impact Health Sharing at any provider.

The ACA requires employers to offer MEC (Minimum Essential Coverage) to their employees if they have at least 50 full-time employees; this is known as the "employer mandate" and remains in effect today.

As a healthcare sharing organization, Impact DOES NOT meet the standard for MEC (Minimum Essential Coverage).

Therefore, organizations with 50 or more employees offering Impact Health Sharing must also offer a MEC program alongside Impact.

IMPACT’S STATEMENT REGARDING ACA COMPLIANCE FOR HEALTHCARE SHARING ORGANIZATIONS. Read Here.