ShareRight stands as an advanced healthcare sharing organization, leveraging state-of-the-art technology to facilitate secure and efficient bill sharing among members. Our platform ensures a modern and reliable approach to healthcare management.
How ShareRight Works?
ShareRight Health Sharing operates as a community where individuals, families, and small businesses come together to share each other's medical bills. It's important to note that ShareRight is not insurance.
Unlike traditional insurance, ShareRight doesn't involve pooling of funds, premiums, assumption of risk, promise of payment, or guarantees that your medical bills will be covered. Participation in healthcare sharing is entirely voluntary. While there's no guarantee that your bills will be paid, healthcare sharing has emerged as a credible alternative to insurance since the early 80s. Its success lies in the commitment of members to continuously share in each other's medical expenses.
ShareRight is designed to share medical expenses related to new conditions that develop after joining, such as illness, injury, or accidents. To participate, members contribute a Monthly Share Amount, which is matched to an eligible medical bill of fellow members and applied to their payment. The Monthly Share Amount varies based on factors such as the age of the oldest member, the number of people applying, and the chosen Primary Responsibility Amount (PRA).
Instead of a deductible, members pay their chosen PRA before eligible bills are shared. ShareRight offers four PRA options ranging from $2,500 to $10,000, with monthly shares adjusted accordingly, ensuring 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, subject to eligibility criteria outlined in the ShareRight Guidelines, your original application, and relevant medical information.
Do I Still Have Access to my Doctor?
Absolutely! One of the most exciting aspects is that you're not limited by a network or restricted to specific doctors.
Furthermore, you'll have access to telemedicine services for non-emergency care.
Switching insurance plans won't result in a loss of coverage with your preferred doctor. Simply present your Impact Member ID card when you visit a doctor and pay the provider fee. Impact will take care of the rest.
Provider fees are $50 for each primary care visit, $75 for specialist/urgent care visits, and $150 for hospital visits. What's more, you can consult with a board-certified MDLIVE provider from the comfort of your home or any location for a $0 provider fee.
Additionally, you can schedule a telemedicine consultation with a doctor at any time and from anywhere, also with a $0 provider fee.
How Do Prescriptions Work?
Prescription medication expenses play a role in meeting your Primary Responsibility Amount (PRA) and are shared among members according to specific guidelines.
Once your PRA has been met, prescription costs are eligible for Sharing. Here's how it works:
- For generic drug prescriptions, after the first $25, the remaining cost may be shared.
- For brand name prescriptions (when a generic is unavailable), after the first $50, the remainder may be shared.
- Members must use their Member ID card to purchase prescriptions.
- Members cover 100% of the discounted prescription amount at the pharmacy.
- Prescription drugs that can be dispensed, injected, or administered are eligible.
- Psychotropic medication and birth control expenses are not eligible for Sharing.
The amount eligible for sharing is capped at $1200 per member per membership year after the PRA has been met. However, exceptions may apply for medications related to cancer and transplant recipients.
For example, if a member has already met $1000 of their $2500 PRA and has a generic prescription costing $55, which is not for the treatment of a preexisting condition, they pay $55 at the pharmacy. They may then submit their bill and receive a $30 credit ($55 - $25) toward their PRA.
In the same scenario, if the member has already met their PRA, they can request that the $30 be shared among Impact members.
Preventative Care With ShareRight
Here's how ShareRight handles preventative care:
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Annual Wellness Visits: Members aged 6 and older are entitled to one annual wellness visit per membership year. This visit includes a $150 allowance for routine labs ordered by the provider during the visit. These labs may include 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, and PSA.
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Well-Child Care: Members under 6 receive one annual visit, following routine well-child guidelines. Well-child care covers recommended check-ups and associated lab work, excluding vaccinations or immunizations.
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Pap Smear for Women: Women aged 21-65 are eligible for a Pap smear once every three years.
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Mammograms for Women: Women aged 45-54 are recommended to have a mammogram every year, while those aged 55 and above should have one every two years.
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PSA Test for Men: Men aged 45 and above are eligible for an annual PSA test.
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Colonoscopies: All members should undergo a colonoscopy every 10 years starting at age 45, or every five years for high-risk members.
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Eligibility for Preventive Care: Both the test and coordinated office visit are eligible for sharing for both men and women when it comes to preventive care.
Prioritizing preventative care is essential for maintaining good health, and ShareRight is committed to supporting members in their proactive health management journey. If you have any questions or need further clarification on preventative care coverage, feel free to reach out to our support team!
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How can I determine if my medical bills are eligible for sharing within ShareRight?
Medical expenses associated with new conditions, injuries, or illnesses are eligible for Sharing within ShareRight, provided they do not fall under Sections III. D. or E. of our guidelines. The eligibility for Sharing can only be determined once medical services have been rendered, and bills have been submitted for Sharing.
To be considered for Sharing, bills must be received by ShareRight within 12 months from the date of service. It's essential that bills are submitted by the healthcare provider following standard industry submission and coding guidelines to qualify for Sharing.
For a comprehensive understanding of which expenses have limited eligibility and which are ineligible for Sharing, please refer to Section III of our guidelines.
When Can I Enroll in ShareRight?
You have the flexibility to join ShareRight at any point during the year, unlike traditional insurance. Additionally, ShareRight can serve as secondary health coverage if needed. Unlike transitioning to insurance, there's no requirement to wait for an Open Enrollment period to begin participation in ShareRight. However, should you decide to transition from ShareRight to insurance, you'll need to wait until the next Open Enrollment period to enroll
How Do I Know If I Qualify for ShareRight?
Membership Criteria:
- No usage of illegal substances within the 12 months preceding membership.
- Adult children aged 18 to 25 must fulfill the same prerequisites to be included in their parent's household membership and be eligible for bill sharing.
- Disclosure of medical details is required during the application process. Failure to disclose medical history, lifestyle choices, or habits that could disqualify membership may result in non-sharing of medical bills and/or membership termination.
- The Primary Member, who must be a legal resident of the U.S. and at least 18 years old, will create a Virtual Sharing Account upon activating their membership.
Family Members
The ShareRight Membership allows for the inclusion or addition of the following family members, given they meet the outlined qualifications:
- Spouse of the member.
- Unmarried children (biological or adopted) until they reach the age of 26.
- Children under the full legal custody or guardianship of the member.
*Exceptions apply to disabled individuals who are still dependent on and under the care of their parent(s).
65 Years and Older
Applicants aged 65 and above are required to have both Medicare Parts A & B. Medicare Advantage plans do not qualify. Sharing benefits will be secondary to Medicare coverage.
For senior adults, there is a singular Primary Responsibility Amount (PRA) available. Please refer to the pricing calculator for details. This program is exclusively offered on an individual membership basis.
Non-U.S. Citizens
Legal aliens residing full-time in the U.S. are eligible for membership with ShareRight. However, medical expenses incurred while not residing in the U.S. as a legal resident are not eligible for Sharing.
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