Impact Healthshare : Primary Responsibilty Amount PRA

What is a Primary Responsibility Amount (PRA) ?

What is a PRA?

A

PRA

is

the

Annual Amount

a

Member Household

is

Responsible for

before

Medical Bills

can

be

Approved for Sharing

The

Primary Responsibility Amount (PRA)

is

the dollar amount

a Household

must pay

toward

their

own

Eligible Medical Bills

during

a

12-month period

before

their

Eligible Medical Bills

can

be

published

and

shared

by

the membership

The

PRA

12-month period

begins

on

the Membership Date

Members

do not have

deductibles

Instead,

our Members

have

a

Primary Responsibility Amount (PRA)

The

PRA

options

are

as follows:

• $1,000 (65 years and older only)

• $2,500

• $5,000

• $7,500

• $10,000

Ebony would like to add

the Monthly Cost is directly different to each PRA tier level

for example coming in at the $10,000 will have a lower monthly cost

while coming into membership at the $2,500 will have a higher monthly cost

than coming in at the $10,000

It is beneficial to consider coming in at $2,500 sometimes and then the household will have one more additional Expenditure of $5,000 in co-share co-sharing of Eligible Medical Bills of 10% up to $5,000 per year

After this it is directed that Service events will then be at the Provider rate for the remainder of a Calendar year

The

PRA

applies

only

to

Eligible Medical Bills

After

the

PRA

has been met,

and

the

co-share

is

applied,

all

Eligible Medical Bills

will

be

submitted

for sharing

for

the

Entire Household