Seniors with Medicare.
GETTING STARTED CHECKLIST
Welcome to Impact Health Sharing. We are glad you are here. As a new member, we want to make sure you know ALL about Impact Health Sharing. Now, let's ignite the excitement by delving into a few essential aspects. Get ready to unlock the full potential of Impact!
Schedule a Welcome Aboard Call, where our Member Services Reps will guide you through navigating your new membership.
During this call, you'll learn more about the benefits of your membership, how to use our online Member Center, and what your next steps should be.
The Member Center is your hub for all of your sharing details and the key place to manage your membership.
- See who shared your bills.
- Send a note of encouragement
- Change your address
- Print your Member Card
- and More!
Cards will be mailed within 2 weeks of your start date. Please allow sufficient processing time to receive your cards. For any issues, errors, or additional cards, click here to request a new card.
WHAT TO DO WHEN YOU NEED CARE
THE SIX P'S OF YOUR IMPACT MEMBERSHIP
- Preventive Care
- Provider Fees
Understanding your Primary Responsibility Amount
Do I Pay my PRA upfront?
Yes and No...The PRA is the annual amount you are responsible for before medical bills will be approved for sharing. So yes, the PRA has to be paid in advance of sharing but depending on the bills incurred, you may not owe it all at one time. Read More.
What about my co-share?
Seniors do not have a co-share amount. They are simply responsible for the $1000 PRA with sharing secondary to Medicare.
After your PRA (Primary Responsibility Amount) of $1,000 is met prescriptions may be shared as follows:
- For prescription costs to be eligible for Sharing, members must also have Medicare Part D as well.
- 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.
- Members pay 100% of the (discounted) prescription amount at the pharmacy.
- Members must submit their Part D EOB (Explanation of Benefits) to Impact here. Medicare will mail your Part D EOB monthly.
Understanding when you need to Pre-notify Impact
Providers pre-notify by calling (855) 378-6777. In the event of emergency/urgent care, the Member or provider needs to provide notification within 72 hours of when care was given. Pre-notification of medical bills does not guarantee eligibility or sharing.
Members or Providers are required to pre-notify Impact for any of the following treatments to be eligible for sharing:
- Cancer Treatment
- Elective Cardiac Procedures
- Inpatient/outpatient surgery
- Non-emergency hospital/facility admission
- Organ/Tissue Transplant Services
Understanding Preventive vs Wellness Care
Preventive screening as outlined below is subject to PRA and before bills will be shared for the following:
- Women: Pap test
- Men: PSA test
- All: Colonoscopy
Impact follows the American Cancer Society's recommendations when it comes to sharing in Preventive Care.
Wellness Visits Are NOT subject to the PRA. These will be shared at 100%.
One wellness visit is eligible for sharing for members 6 years and older per membership year. This includes a $150 allowance for some routine labs as ordered by the provider during that visit.
Understanding Provider Fees
Impact for Seniors simplifies the healthcare experience.
- No Provider fees.
- No Co-share.
- No Pre-existing limitations.
Understanding Pre-existing Conditions
Impact for Seniors revolutionizes the healthcare journey.
No limits on pre-existing conditions.
THE IMPACT BLOG
A FEW REMINDERS
This Welcome Guide is intended to be an easy-to-read introduction to Impact and in no way replaces, supplements, or overrides the Impact Health Sharing Guidelines. The current guidelines govern, not the guidelines in effect when you joined.
Impact Health Sharing is Secondary to Other Sources
Impact for Senior members must submit their bills and prescriptions to Medicare first, or if you have other health or welfare benefits, such as an employment-related health or welfare plan, workers’ compensation insurance, homeowner’s insurance, or fraternal benefits, the member is expected to take all reasonable steps in order to qualify for such payments and to exhaust the benefits available under those resources before submitting a request for sharing.
During the first 60 days of membership, sharing of eligible medical bills is limited to $50,000 (excluding pre-existing conditions). Discounts for prescriptions and no-cost Telehealth doctor visits start the first month of membership.
Motorized Vehicle Accidents
Treatment related to injuries received while in motor vehicles is eligible for sharing, provided all legally required and industry-recommended safety equipment was in use. Treatment related to motorcycle accidents is limited to $100,000 per incident. Sharing will be secondary to automobile insurance. Treatment resulting from the abuse of alcohol, legal drugs or federally- classified illegal drugs, is not considered medically eligible and will not be shared.