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  2. What is Eligible for Sharing?

Are wellness visits shared?

Can I get my annual physical?

One annual/well visit for members 6 years and older per membership year is 100% sharable and is not subject to the PRA or co-share. No Provider fee is applied to this visit either. This does not apply to the Senior Program. With the Senior Program, Impact shares Secondary to Medicare once the PRA has been met.

Members under the age of 6 receive one annual visit. Additional visits will follow routine well child guidelines as dictated by the American Academy of Pediatrics. These additional visits are subjected to PRA and co-share. Well-child care is defined as recommended routine check-ups and associated lab work, excluding vaccinations and/or immunizations.

 

If you're provider orders lab tests with your annual physical, information about lab eligibility can be found in this article.

Learn more in this short video: