Summit-DPC

Summit-DPC Sharing

Summit-DPC Sharing Level is a health share program and is NOT a contract for payment or insurance. Members of Alliance for Shared Health (ASH) do not have a contract. Instead, members attest to a set of Statement of Beliefs to join the ASH community to share in their medical expenses per the specific sharing level chosen.

Summit-DPC Sharing Level members receive access to one of the largest Preferred Provider Networks in the nation - the PHCS PPO network.

Additionally, a wrap network, PNOA, is also offered to ensure members are able to be in-network as much as possible. While seeing an in-network provider is not required, it will help members to further reduce their member share amounts.

Summit-DPC Sharing Level

Provider PPO Network

PHCS Network Access;
All Providers Accepted

PNOA (Wrap)

Annual Sharing Maximum

$1,000,000

Lifetime Sharing Maximum

Unlimited

Annual MRA (Member Responsibility Amt)

$500 | $1,000 | $2,500 | $5,000

(3x MRA for Single | 5x MRA for Family)

Preventive Care (waiting period applies)

In-Network: $0 Visit Fee

Non-Network: $100 Visit Fee

MRA Does Not Apply

NOTE: Max share amount for mammograms is $500 and colonoscopies is $1,500

PCP Doctor Visits

MRA per Incident or Contact your DPC

Specialist Doctor Visits

MRA per Incident or Contact your DPC

Urgent Care

MRA per Incident or Contact your DPC
In / Out Patient Surgery

100% Shareable after Annual MRA

Hospital / Facility Services

100% Shareable after Annual MRA

Emergency Room / Ambulance

100% Shareable after Annual MRA, if admitted to the hospital

Additional $1,500 MRA applies (Waived if admitted into hospital)

Maternity

Subject to $5,000 MRA

NOTE: Members must have an expected due date for delivery at least 300 days after joining for bills to be eligible for sharing.

Prescription Sharing

Level 1 Medications: under $50 for 30 Day Supply for $10 MRA;

Level 2 Medications: $50-$149 for 30 Day Supply for $20 MRA or $20 minimum;

Level 3 Medications: under $150-$400 for 30 Day Supply for 40% MRA (Limit 1 fill only)

Pre-Existing Condition Limitations: Pre-existing conditions within the preceding 24-months of the program effective date will have sharing restrictions for the first 36-months of membership. Please refer to the Member Guidelines for the pre-existing condition graduated sharing schedule.

States Available

AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WI, WV, WY


States Not Available

MD, WA
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