Managing healthcare costs effectively requires a system that is both transparent and flexible. ShareWELL provides just that through its Sharing Request process, which allows members to submit eligible medical expenses for sharing within the community. Whether preparing for a scheduled procedure or dealing with an unexpected medical event, submitting a Sharing Request ensures that members receive the financial support they need fairly and efficiently.
Different Types of Sharing Requests Based on Your Membership
Not all Sharing Requests are the same—what you submit depends on your ShareWELL membership level and the additional plans you have in place. Understanding the types of Sharing Requests available ensures that members utilize the benefits that best align with their healthcare needs.
1. Preventive Care Sharing Requests
Members with Preventive Sharing included in their membership can submit a Sharing Request specifically for preventive services. While others have a separate plan in place to manage these expenses. This includes routine care such as annual wellness exams, vaccinations, and certain screenings.
2. Unshared Amount-Based Sharing Requests
Members submit a UA (Unshared Amount) Sharing Request for other medical needs beyond preventive care once their medical bills for a single event exceed their UA. The UA is the initial amount a member is responsible for paying before eligible expenses are shared. Once this threshold is met, members can submit their bills for sharing with the community.
For example, suppose a member’s UA is $1,500, and they have a medical event with $3,500 in eligible expenses. In that case, they can submit a UA Sharing Request once their total bills exceed $1,500. The remaining $2,000 would be considered for sharing among the ShareWELL community.
By understanding these distinctions, members can better plan for medical expenses and take full advantage of the sharing process.
What Happens Next
Submitting a Sharing Request is the first step in the Determination process. This means that once a request is submitted, ShareWELL will review the expenses, assess eligibility, and provide guidance on the next steps. ShareWELL reviews the medical expenses based on the Membership Guidelines. This determination process ensures that costs are shared fairly and in alignment with the community’s Member Guidelines.
When To Submit A Sharing Request
In many cases, submitting a Sharing Request before receiving care is beneficial, especially for planned procedures. As a self-pay patient, some providers may require an upfront payment or deposit before treatment. Submitting a Sharing Request before care can guide estimated sharing eligibility and help secure lower self-pay discounts. ShareWELL can help facilitate an instant debit card for members to make such prepayments and avoid reimbursements.
A Sharing Request is submitted after receiving care for unexpected medical needs, such as an ER visit. Members simply present as a self-pay patients at the time of service and send the bills directly to ShareWELL through a Sharing Request.
How It Differs from Traditional Healthcare Billing
Traditional healthcare billing involves a complex claims process controlled by insurance companies. Providers submit claims, insurance companies use contracted rates or deny coverage, and patients are often left with unexpected costs. The process can take weeks or even months, and there is little transparency in handling expenses.
With ShareWELL, members take an active role in their healthcare decisions. Instead of relying on insurance approvals, they work directly with providers to secure fair pricing and submit expenses to the ShareWELL community for sharing. There are no network restrictions, and the process is designed to be clear and transparent, ensuring that members always know where they stand financially.
Why This Approach Is Better
Submitting a Sharing Request before planned medical care allows members to maximize savings by securing the lowest self-pay pricing. Many hospitals and clinics offer substantial discounts for upfront payment, which is a benefit not typically available in traditional insurance systems.
Additionally, this process empowers members to make informed healthcare choices. Rather than dealing with claim denials and confusing insurance policies, members know exactly what they are responsible for and how much support they can expect from the ShareWELL community.
Beyond financial benefits, this approach promotes a stronger sense of community and fairness. Unlike traditional insurance, where premiums contribute to large corporate profits, ShareWELL operates as a non-profit and ensures that contributions go directly toward helping fellow members.
Final Thoughts
Understanding how and when to submit a Sharing Request is essential for making the most of your ShareWELL membership. Whether submitting a request for preventive care, exceeding your UA, or handling an emergency medical expense, this process is designed to provide financial support, transparency, and flexibility.
By taking control of your healthcare decisions and utilizing the Sharing Request system effectively, you gain greater financial freedom, lower medical costs, and the confidence of being part of a community that values fairness and mutual support.