Resources

No, there are no restrictions for you to use any of the WoW Health services; however there are certain services like medications and diagnostic tests that require a prescription by a treating medical provider.

No, WoW Health is not an insurance product so there are no copays or deductibles. You pay what the stated price is, no surprises. Unlike insurance, you will not be billed for any product or service that you have not agreed to before you obtain the service. It is price transparency at its best.

No, the money used does NOT count towards the deductible because WoW Health is not an insurance product. We are able to bring you affordable and high quality healthcare because the medical service providers do not have to submit claims and bills, thus decreasing their overhead costs.

Yes, you can use your HSA or FSA debit cards to pay for costs at provider clinics and pharmacies. However, due to IRS rules, you may not use your HSA or FSA funds to pay for any memberships including WoW Health plans which are considered memberships. Please use a regular credit or debit card to pay for WoW Plus memberships.

You are charged the full amount of service when you make an appointment because that money is kept in an "escrow-type" account so when the encounter is completed, money can be released to the medical service provider. This ensures timely payment for the medical service which allows the medical provider to give you the very best price for their services by eliminating paperwork and possibility of non-payment.

Yes, you can cancel your appointment but you have to abide by the rules of the medical service provider. Our medical service providers charge as low as 30% of the regular market rate so they can not afford cancellations and no-shows. Usually most appointments can be canceled without penalty up to 48-hours ahead of time.

WoW Health is a service but all of our medical service providers are independent businesses. We ask that you contact the medical service provider first and try to obtain resolution of any issues. However, if there are any outstanding issues, we would love to hear from you so we can facilitate a solution that would be acceptable to both parties.

Any software or technology related issues should be addressed with WoW Health directly. Our trained staff are available 24-hours, 365-days a year to address any need.

If you do not see the provider that you are looking for, please check your search parameters. Sometimes your desired date of service or distance or type of service does not match what that medical service provider may be offering. Also WoW Health is a voluntary marketplace and it is possible that the particular medical service provider is not part of our ecosystem. Please send us the name and any contact information so we can reach out to the particular provider and invite them to be a part of our free market healthcare system. WoW Health is FREE for all medical providers so there is no barrier to joining.

No, there are no membership fees or costs to be a part of the WoW Health free market healthcare ecosystem for any users. You only pay for services or membership plans once you have established an account and decide to obtain that service or product.

Your security is our top priority. WoW Health follows best practices for security, and is HIPAA compliant. All of your information is encrypted and kept in Google Cloud Platform. We use SSL certificates to ensure the privacy and protection of our platform.

No, WoW Health does not sell or share any of your information or health records with any vendors or third parties. We may use DE-IDENTIFIED health meta-data for research purposes but that does NOT identify you personally.

No, we do not share any of your medical records with your employers. You may share this information for employer related reimbursement but that is your choice.

No, sharing the wallet with a family member for financial purposes does not expose or share any of the health records between accounts. Even the health data and records for your minor children are kept in separate accounts--we just give you the ability to manage their accounts until they reach the legal age to consent for treatment.

Virtual Urgent Care allows healthcare providers to evaluate, diagnose, and treat patients using technologies like telephone or video calls. WoW Health's Telemedicine plan is a HIPAA secured way for a patient to get a medical evaluation, 24/7, from anywhere, with licensed medical providers like doctors, psychologists, therapists, etc.

Virtual Urgent Care has been practiced for over 25 years. While it is not appropriate for every clinical scenario, it is estimated that about 3 out 4 medical encounters can be effectively performed via Telemedicine. All Telemedicine encounters are performed on our HIPAA secure platform so you have the peace of mind that your information is always kept safe.

You can request an urgent care visit 24/7/365. Are there any additional charges for VUC in WoW Plus? No, you get virtual urgent care in your WoW Plus plan without paying any additional charges.

Yes, when deemed appropriate by the treating doctor, a prescription will be sent electronically to your pharmacy.

Virtual Counseling allows licensed professionals to provide therapy or mental counseling remotely, using technologies like telephone or video calls.

All your counseling encounters are performed on our HIPAA secure platform so you have the peace of mind that your information is always kept safe.

Yes, as Behavioral Health Virtual Counseling, gives you immediate access to thousands of Masters – level professionals who are specialized in guiding you through these problems.

You can request an urgent care visit 24/7/365.

YCounseling is beneficial in managing many common psychological problems. You will get great insight in your first session if it is a good fit for you, and you will be able to gather more resources to take better care of yourself.

Diagnostic and imaging services can be complicated with different billing entities like the facility and the radiologist. WoW Health ensures that you are given one price for the whole event which is inclusive of the report by a certified radiologist. It is a great way to ensure that you do not end up with surprise bills.

All of our centers are accredited and licensed. Also before you accept and pay for the imaging service, you will be given the name of the center so you have an opportunity to perform your own search and due diligence for your peace of mind.

Yes, you can cancel an appointment but you have to clarify cancellation rules with the medical practice to make sure that you are not responsible for any cancellation fees. As you can imagine, imaging centers can not function with last minute cancellations, especially when they are providing discounted services to our members.

You can search for the needed imaging service and initiate a request. You will need a prescription/order for the imaging study by a doctor, which is required by law. You will be contacted in one business day to gather information, and all of your questions will be answered. After this call, you will be sent a written proposal with the particulars of your imaging test--when, where, how much will the whole thing cost, etc. Once you are satisfied, you will pay and accept the proposal to confirm the appointment.

You will have the contact information of your concierge to ask any questions. On the day of the test, you will go to the center and follow the instructions provided to you by your concierge.

Diagnostic and imaging services can be complicated with different billing entities like the facility and the radiologist. WoW Health ensures that you are given one price for the whole event which is inclusive of the report by a certified radiologist. It is a great way to ensure that you do not end up with surprise bills.

All of our centers are accredited and licensed. Also before you accept and pay for the procedure, you will be given the name of the doctor and the center so you have an opportunity to perform your own search and due diligence for your peace of mind. Many times the doctor will meet with you before the procedure as well, which is a great way to assess your rapport withthe doctor as well.

You can search for the needed imaging service and initiate a request. You will need a prescription/order for the imaging study by a doctor, which is required by law. You will be contacted in one business day to gather information, and all of your questions will be answered. After this call, you will be sent a written proposal with the particulars of your imaging test--when, where, how much will the whole thing cost, etc. Once you are satisfied, you will pay and accept the proposal to confirm the appointment.

You will have the contact information of your concierge to ask any questions. On the day of the test, you will go to the center and follow the instructions provided to you by your concierge.

Over 90% of events in healthcare take place in the outpatient setting like office visits, mammograms, routine medications, etc.--what we refer to as Everyday Care. WoW Health provides directpay access to members for this Everyday Care. However, 5-7% of events are large medical needs like ER visits, hospitalizations, pregnancy care, surgeries, etc. which are expensive. WoW Health provides access to a NON-INSURANCE solution called HealthShare. In this arrangement, a community of users agree to pay for routine or Everyday Care themselves, and then have the community pay the balance of large medical needs after the member has paid his/her share called IUA. WoW Health offers two IUA levels of $1000 and $2500. This approach of paying directly for smaller everyday care expenses, and being a member of the HealthSharing community for large medical expenses, saves WoW Health members over 50% for their complete healthcare.

No. Insurance arrangements are a contract whereby one party agrees to be legally responsible for and accept another party’s risk of loss in exchange for a payment—a premium. HealthSharing is an arrangement whereby members agree to share medical expenses through the act of voluntary giving. HealthSharing does not assess applicants’ health risks because neither the HealthShare nor its members are assuming financial liability for any other member’s risk. Unlike insurance, the focus of HealthShare is to provide an avenue for members to help each other bear their immediate healthcare expenses.When health care costs are paid by someone other than the person receiving care, as is typically the case when an insurance company or government entity agrees to cover such costs, the healthcare model can be undermined. HealthShares believe many of the current problems with the healthcare system are the direct result of restricting personal freedom and responsibility through dependence on third-party payers. HealthSharing is designed to allow members to help one another while maintaining freedom of choice and personal responsibility.ontract whereby one party agrees to be legally responsible for and accept another party’s risk of loss in exchange for a payment—a premium. HealthSharing is an arrangement whereby members agree to share medical expenses through the act of voluntary giving. Zion Health does not assess applicants’ health risks because neither Zion Health nor its members are assuming financial liability for any other member’s risk. Unlike insurance, the focus of Zion Health is to provide an avenue for members to help each other bear their immediate healthcare expenses.When health care costs are paid by someone other than the person receiving care, as is typically the case when an insurance company or government entity agrees to cover such costs, the healthcare model can be undermined. Zion Health believes many of the current problems with the healthcare system are the direct result of restricting personal freedom and responsibility through dependence on third-party payers. Zion Health is designed to allow members to help one another while maintaining freedom of choice and personal responsibility.

Because HealthSharing is not insurance, it does not charge premiums. Rather, HealthShare members freely choose to assist other members with their medical expenses by contributing a predetermined amount each month via a membership. Ninety percent (90%) of each member’s monthly membership are designated solely for assisting other members’ needs.

HealthShares are nonprofit organizations, and are required to abide by certain state and federal regulations.

HealthShare is not a substitute for insurance as defined by the Affordable Care Act and therefore does not meet the requirements by itself.

Because there is no transfer of risk, as defined in applicable insurance rules and regulations, with respect to the HealthSharing program, no “claim” is ever owed by the HealthShare on behalf of any member. When members incur eligible medical expenses for a new accident, injury or illness that they anticipate likely to be in excess of their chosen Initial Unshared Amount (IUA), they may contact the HealthShare and open a Needs Case. A Need includes all of the eligible expenses surrounding that new issue, accident or illness. The member is required to meet the IUA once for a given Need. A Need is considered closed after 12 months have passed without further expenses attributed to that particular Need. Once a Need Case is opened, providers can send bills directly to the HealthShare using standard electronic correspondence tools in the medical industry (EDI). If not sent directly from the provider, members are required to submit proof of their medical expenses to the HealthShare which then evaluates each submission for eligibility or ineligibility based on the Member Guidelines. Eligible needs are designated for sharing using the funds accumulated through monthly memberships by the HealthShare community.

No, the HealthSharing process differs significantly from insurance practices in this regard to the member’s advantage. When members incur an eligible medical expense that exceeds the initial unshareable amount (IUA), any amount above the IUA may be eligible for sharing. Also members are responsible for a maximum of three IUAs in a 12-month period. On the fourth medical need in a household, the member no longer needs to pay the initial unshareable amount. If the additional medical expenses are more than $500, the remaining costs are fully shareable with the community.

Over ninety percent of all monthly contributions go toward sharing in medical needs. Each month, less than 10% of contributions are retained by the HealthShare for administrative costs. An audit of the HealthShare’s finances is conducted each year by an independent firm and made available online.

Anyone between the ages of 18 to 65 can join the HealthShare by agreeing to follow the Member Guidelines and abide by the Principles of Membership. Membership expires when an individual reaches the age of 65 as those members become Medicare eligible. Newborns who are not born under an eligible maternity need to have a seven-day waiting period before they can be added to the family’s membership. “Children” under a parent’s membership may remain on the family plan until age 26, or unless he/she has a child, or unless he/she gets married.

In general, needs for illnesses or injuries resulting in visits to licensed medical providers, emergency rooms, testing facilities, or hospitals are shared on a per person, per incident basis once the member has met their personal responsibility by paying their initial unshareable amount (IUA).

Needs resulting from medical conditions that existed prior to the effective date are typically not shared or are shared in a limited capacity. For any needs that do not qualify for sharing but that create a financial burden to your family, the Additional Giving program may be of assistance. Each member has an IUA (initial unshareable amount) for which reimbursement from the Benevolent Fund will not be made.

For a pregnancy that begins 60 days after the start of a member’s effective date, maternity needs are shared like any other need. For a pregnancy that began prior to a member’s effective date, pregnancy is treated as a pre-existing condition and not shared.

In the first year of membership, pre-existing conditions are not sharable with the HealthShare community. Pre-existing conditions have a phase-in period wherein sharing is limited. Starting from the initial enrollment date, members have a one-year waiting period before pre-existing conditions are shareable. After the first year, pre-existing needs are eligible for sharing on a limited basis, with the amount increasing each membership year. Members are never required to pay a second IUA for the same need, including pre-existing conditions. HealthShares attempt to negotiate all medical bills received. Even if a pre-existing condition is not shareable, members may still receive discounts for their services through negotiation. Shareable amount for pre-existing conditions are Year One: $0 (waiting period) Year Two: $25,000 maximum per need per year Year Three: $50,000 maximum per need per year Year Four: $125,000 maximum per need per year After year four of membership, expenses related to pre-existing conditions will remain shareable at a maximum of $125,000 in a 12-month rolling period and resetting each membership year.

Yes, high blood pressure, high cholesterol, and diabetes (types 1 and 2) will not be considered pre-existing conditions as long as the member has not been hospitalized for the condition in the past 12 months and is able to control it through medication and/or diet.

Members who are traveling abroad, eligible needs can be shared no matter where in the world they were incurred and treated. Members interested in “medical tourism” need prior written approval from the HealthShare before treatment.

HealthShares keep separate funds to share member needs in the event that medical needs exceed the monthly contributions received. To date, all eligible needs have been shared in full without need to draw from the saved funds. However, if the rare event occurs that all needs cannot be met for a given month, HealthShare will use a prorating method to evenly distribute the available funds among members with needs. For example, if the monthly contributions received for a given month amounts to 80% of the needs submitted for that month, each member would have 80% of their eligible expenses shared that month. The HealthSharing community has not needed to prorate member needs in the past, and is well prepared in the event that needs exceed member contributions.

Yes. Although HealthSharing is an individual and family program, we allow for a company contribution list. Employees who participate can be added or removed from the contributions list at any time and billed directly. Participation in the HealthSharing program is always voluntary, both from the company’s and the employee’s perspectives. Business owners choose to work with HealthShares because they value community and personal responsibility, and because they want to use a cost sharing approach to ensure provision of quality healthcare for their employees. There are numerous factors that contribute to HealthShare's greater efficiencies for both companies and employees.

Yes. Each member’s personal freedom to select the medical providers of their choice is fundamental to the HealthShare’s philosophy. HealthSharing endeavors to provide members with information and recommendations to help them identify and receive treatment from the highest quality health provider(s). Accordingly, there are no out-of-network penalties or other restrictions. There is no penalty for the member for not using the WoW Health’s provider community. If a member finds a better arrangement with a provider not in the WoW Health community, we encourage the member to share that information with us so we can perhaps add that provider to the larger WoW Health provider community to benefit everyone.

Members cannot be dropped from the sharing program due to their medical needs. Neither membership nor monthly contribution is adversely impacted by the amount of medical expenses a member or their family members may have.

There are no limits on lifetime or annual maximum amounts, or even number of needs eligible for sharing for most medical needs. Some conditions, like hormone injections or hyperbaric treatments, have limits which are generally calculated per need. The Membership Guidelines which are available for review during sign up can provide more details.