Impact Health Sharing
Completing your application is fast and simple!
Enter in as many relevant fields that you know. If you have any questions please call Member Services at 855-378-6777.
Extra Impact Application
Primary Member First Name *
Primary Member Last Name *
Membership Number *
Person Requesting Extra Impact *
Phone Number
Address *
City *
State *
Email *
Brief description of the condition and the reason for the application *
Amount owed *
Impact Health Sharing is not insurance. It is a not-for-profit organization and does not guarantee payment of members’ medical bills. Impact Health Sharing is not regulated as insurance. Certain states require health sharing organizations to publish a disclosure to more clearly be exempted from insurance regulation. While Impact Health Sharing is not insurance and therefore, need not necessarily qualify for such exemptions, Impact Health Sharing has elected to publish these exemptions. You can review the disclosure required for the state in which you reside here: View Disclosures.
Copyright 2022. All rights reserved. Not available in NJ., RI., and WA.