Health and Wholeness Credit Form
Health and Wholeness Credit Requirements
- Requests must be submitted 60 days from the date services were rendered or products purchased in order to be considered. Any submissions that fall outside of this timeframe will not be accepted.
- This credit will only be applied for the month that products were purchased and/or services rendered. Amounts in excess of $100 will not be applied to future months.
- Submissions for future dates will not be accepted.
- Products or services related to pre-existing conditions will not be eligible for this credit.
- This credit is up to $100 per household per month toward PRA (Primary Responsibility Amount) balance. Once PRA has been met the credit is no longer applicable.
- Receipts/invoices must clearly indicate what products were purchased and/or services rendered in order to considered.
- Not available for members on the Impact for Seniors program.
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Email *
Member that Incurred Expenses (Full Name) *
Membership ID *
Company/Provider *
Total Amount Spent *
Date of service (date services were rendered or date product was purchased) *
Copy of Invoice
Drag & drop a file to upload it.
Impact Health Sharing is a not-for-profit corporation that exists to create, exercise, and express practical applications of Christian faith, beliefs, and ethics. We believe in bringing together individuals and families in shared acts of common good. 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 2024. All rights reserved. Not available in NJ., RI., and WA.