ShareWELL HealthShare Information

ShareWELL covers care that goes beyond the First Health Network PPO component of your plan.  ShareWELL provides emergency, surgery, hospitalization, maternity, alternative care, and worldwide health care.

What is a Sharing Request

A Sharing Request is a method through which members can submit their medical expenses. Instead of traditional deductibles, the Healthy PPO plan operates on a per-member, per Sharing Request basis. This means that each Sharing Request is the total number of bills related to a single request. Bills are incurred from licensed medical professionals and facilities, such as physicians, emergency rooms, and hospitals.

As a self-pay patient, use the following instructions to facilitate your medical bills. Not all providers and all methods of payment will be the exactly same, but these guidelines will help you navigate the billing process efficiently. 

Emergency Room

When asked for your insurance or ID card, let them know you are a self-pay patient. Request any available discounts. Do not show any other ID cards you may have for healthcare benefits at the emergency room. You can pay up to your UA amount directly to the provider while you are at the visit or after they send your bill in the mail. Open a Sharing Request as soon as its convenient and send the bills to ShareWELL via HealthWallet as you receive them.

Out-Patient Care

Use the First Health PPO for preventive care. Sharing Requests may include non-preventive care when not covered by the First Health PPO Network, including doctor visits, urgent care, imaging, and recovery therapy. preventive, physicians, Rx, imaging, etc, use your First Health Network PPO copay first. Anything not covered by First Health Network PPO is eligible for Sharing. Present yourself as a self-pay patient and ask for applicable discounts. You may also contact ShareWELL for prepayment or at time of service payment options.

Pills

Medications

Medications for healthcare needs may be eligible for sharing if not covered by your Rx plan and after the Unshared Amount is met.

Types of Sharing Requests that can be submitted

Unshared Amount (UA) Sharing Requests should be submitted once a medical incident exceeds your selected Unshared Amount of $1,500, $3,000, or $6,000. 

Preventive Care is covered through your First Health PPO Network and not eligible for sharing. If you have questions on how to access preventive care, please contact us via the Help Desk in your portal.

Helpful information about sharing requests

Request Self-Pay Discounts. To make a sharing request, provide itemized bills, and provider notes via HealthWallet

Determinations of a Sharing Request are made quickly and based on the Member Guidelines

Request medical records proactively with your provider for UA Sharing Requests only

Helpful timelines about sharing requests

Maternity Sharing Requests are considered UA requests and have a 30-day waiting period from the start date of membership to be eligible

Reaching the UA must be within 6-months from the initial date of service

Submit bills in a timely manner as you receive them

Member Guidelines

Download Member Guidelines
View Pre-existing Medical Condition Info
View Alternative Care Sharing Information
Viwe Maternity Sharing Information

Frequently Asked Questions

Members may choose to change their UA once per membership year. If it’s decreased, a 60-day waiting period will apply to all Sharing Requests other than those resulting from an accident.

No. Your preventive care is covered by your First Health Network PPO portion.  Refer to the SBC for details.

Login to your HealthWallet account to submit a Sharing Request. 

Requests should be submitted to as soon as possible. Non-emergency Sharing Requests, such as surgical procedures, should be submitted before the care. Required documentation for Sharing Requests must contain, but is not limited to, the following:

  • Itemized medical bill(s)
  • Provider notes Proof of
  • Unshared Amount payment

Yes! Some alternative care is eligible.  For details, refer to the Member Guidelines section.

Yes. 

For more information regarding Maternity Sharing, refer to the Member Guidelines section.

Yes. If a member or a member’s dependent dies after one year of active membership the ShareWELL community will assist upon receipt of a copy of the death certificate. Financial assistance will be provided to the surviving family as follows: $10,000 upon the death of a primary member $10,000 upon the death of a dependent spouse $5,000 upon the death of a dependent child

Yes. In certain instances, members can go above and beyond to keep costs down for the community. ShareWELL may authorize the reduction of a member UA when a member has done one or multiple of the following steps:

  • They gathered and arranged prepayment for a scheduled surgery or procedure, resulting in significant savings.
  • Demonstrated willingness to work with and, in some instances, change to a fair cost provider.
  • They traveled a significant distance to a fair cost provider.
  • They applied for or received financial assistance. They worked with a legal representative to negotiate or lower medical bills.
  • Used a Center of Excellence approved by ShareWELL.