How Does Impact Health Sharing Work for Adults Over 65 With Medicare?

As an adult over 65, healthcare is a big deal. There are so many choices and options available that it can feel overwhelming. Finding the option that is best for you takes time and patience, and I'm glad you're considering Impact. Although Impact for Seniors is not a perfect fit for everyone, for those who understand how it works, it can lead to significant savings.Medicare supplement plans are highly competitive. The ads on television promise a lot of things, but what matters most is your health and your budget. You need to understand what your healthcare costs could be annually, both if you remain healthy and if your health situation changes and you need care.When evaluating Medicare supplement plans, it's important to consider both the monthly premium costs and any additional expenses that may arise when you actually use the plan. Some plans may offer a $0 monthly premium but can end up costing more over time when you need to access benefits.

Let's get into the details.

Original Medicare Parts A and B only cover a portion of medical expenses, leaving you responsible for the remaining costs. This can be especially challenging for individuals on fixed incomes or those managing chronic health conditions. That's why many people look for a supplement to help with those remaining expenses.
Although Impact isn't insurance and isn't a Medicare Part C plan, Impact for Seniors picks up where Medicare stops. Impact members share the portion of eligible medical bills that Medicare allows but does not fully pay. With sharing secondary to Medicare, this program can be an incredible option for seniors.

Why?There are two big reasons.First, visibility and transparency. Impact for Seniors members know exactly what they are responsible for each year. The most they will pay for healthcare annually is their monthly share and Primary Responsibility Amount, or PRA. If you need healthcare services, you'll first meet your PRA, but beyond that there are no provider fees, no out-of-network fees, and no coinsurance.

Second, community. Members become part of a community that cares for one another and shares in each other's healthcare needs.There are many Medicare supplement options available, each with different benefits and costs. It can be overwhelming to understand the differences and determine which option is best for your needs.Impact is simple, and we're here to help when you have questions.

Will it be difficult to access care?Some Medicare supplement plans have provider networks that may limit your choices. Impact members are not restricted to a network and may visit any provider they choose.

Concerned about premiums or deductibles?Some Medicare supplement plans require monthly premiums that can become expensive over time. Others may have deductibles or out-of-pocket maximums. Every plan is different, so it's important to understand the costs involved.The beauty of Impact is its simplicity. There are only two costs to consider: your monthly share and your annual PRA.

No provider fees. No co-share. No pre-existing condition limitations.Just one Primary Responsibility Amount of $1,000.So, is Impact right for you?Are you age 65 or older?

Do you have Medicare Parts A and B?Are you excited about being part of a community of support?Do you want greater visibility into your annual healthcare costs?

And finally, are you willing to upload your Medicare bills to Impact?Because Impact is not insurance and not a Medicare plan, members must upload their Medicare bills and explanations of benefits for processing. Impact makes this process easy through an online member center, but it is an additional step that not everyone wants to manage.So how does it work?

Let's look at an example.
Carl's wife took him to the emergency room for severe abdominal pain. He was admitted to the hospital and stayed for three days, eventually having surgery for a blockage in his lower stomach.

Medicare Part A covered the surgery and hospital stay. Medicare Part B included a deductible that Carl needed to meet. This is where Impact comes alongside him.
All medical bills should first be submitted to Medicare. Medicare will then send a Medicare Summary Notice (MSN) or an Explanation of Benefits (EOB).

The MSN is mailed every three months, but if you enroll in electronic delivery through Medicare, you can receive it monthly. Receiving these notices monthly is recommended because it allows you to submit them to Impact for faster processing. the MSN shows all Medicare-covered services and supplies, what Medicare paid, and the maximum amount you may owe the provider.

Here's what you should do:Create an online Medicare account at Medicare.gov.Once your account is created, you can download your MSN or EOB documents whenever needed.To prevent delays, download these documents monthly and upload them to Impact using the Medical Expense Tool. Waiting for Medicare to forward information can significantly delay processing.

Impact cannot process bills until Medicare has completed its review.When completing a Medical Expense Form, provide as much detail as possible. Missing information can delay processing.

One of the most important documents to include is a CMS-1500, HCFA form, or UB-04 form, which your provider can supply. Submit this along with your MSN or EOB.

After Medicare pays its portion and you satisfy your $1,000 PRA, Impact members share the remaining eligible portion of your medical bills.

What about prescriptions?In order for Impact to share prescription costs, you must have Medicare Part D.Impact is more than another healthcare option. We're a community. We're here to support you, lift you up, and help provide access to the care you need so you can live your best life.