FAQs + 
Member Guidelines

Summit is a nationwide community where individuals benefit from the shared responsibility of each other's medical expenses.  As self-pay patients, our members enjoy reduced medical bills by utilizing Summit's resources. Our partner Advocacy team collaborates with members to negotiate and secure fair pricing for medical services. Our community network ensures there are no maximum sharing caps or limits on the amount available for larger medical expenses.

The Initial Unshared Amount, or UA, represents the amount members must pay before the Summit community begins sharing eligible medical expenses. Often referred to as personal responsibility, Summit plans offer three UA levels: $1,500, $3,000, and $6,000. The higher the UA, you can expect a lower monthly contribution. Once your UA is met, all qualifying medical expenses are completely shareable with the Summit community, with no annual or lifetime caps. You won’t need to pay the UA for the same medical need again unless you remain symptom-free for 12 months.

Additionally, members are not required to meet more than two UAs within a rolling 12-month period. Wellness and preventive services included with the membership do not require meeting a UA and are immediately shareable without waiting periods. Various preventive and wellness programs are available, so check your specific plan for details.

When a member seeks to share medical bills within the Summit community, they do so through a Sharing Request. These requests are submitted individually for each member and each incident. There are two categories of sharing requests: those for eligible preventive care and those for expenses surpassing a member’s Unshared Amount. Related expenses are assessed according to the Membership Guidelines and the specific preventative services included in your membership to determine eligibility.

Typically, medical events that exceed a member’s Unshared Amount and are associated with a new injury, illness, or pregnancy are eligible for sharing within the Summit community. However, conditions that existed prior to joining are not eligible for sharing during the first year of membership. Your membership might also cover sharing and allowances for preventive and wellness services without requiring members to meet their UA. Additionally, Summit has plans that allow for sharing to encompass alternative and holistic treatment approaches.

There are no lifetime limits, monthly caps, or other restrictions on how much can be shared for eligible medical expenses within the Summit community. Some types of care may have specific sharing allowances, which will be clearly detailed in the Member Guidelines. These allowances are intended to encourage patients to take personal responsibility for their healthcare choices.

Pre-existing conditions that are not part of the Preventive care included in your membership are subject to certain limits. Sharing for these conditions will commence after your first year of membership and will progressively increase over the next four years. If you would like to discuss pre-existing condition sharing options, please reach out to our Advocacy Support Team.

Yes. Our plans offer a comprehensive program for maternity that encompasses prenatal care, delivery, postnatal support, home births, and the services of midwives and doulas. Members who help minimize expenses for the Summit community may even qualify for a reduction in their UA responsibility. Additionally, members can access a broad range of prenatal and postnatal services that are often excluded from traditional plans, enhancing their care options. Summit plans offer significant savings on maternity related costs, enabling members to pay much less than what is typically required with traditional insurance coverage. 

Yes. These expenses can be shared worldwide, provided they meet the eligibility criteria outlined in the Member Guidelines. Additionally, the Summit community is open to supporting holistic and alternative care options internationally.

Consuming tobacco products such as cigarettes, e-cigarettes, vaping, cigars, pipe tobacco, and chewing tobacco more than twice monthly over the last six months is considered tobacco use.

An Explanation of Sharing Summary (ESS) is a document that details how your submitted medical bills were processed and shared. It includes: 

Member Info: Your membership details.
Event Description: Overview of the medical event.
Itemized Bills: List of charges and services.
Unshared Amount (UA): Your out-of-pocket costs.
Sharing Contributions: Amount shared by the community.
Payment Method: How funds were distributed.
Remaining Balance: Any unpaid amount.
Notes: Explanations of any adjustments or non-eligible expenses.

The ESS provides transparency and clarity on how your healthcare costs were managed and supported by the community. 

If you are diagnosed with cancer, eligible medical expenses are treated just like with any other Sharing Request. However, if your cancer was identified as a pre-existing condition within 36 months prior to your enrollment, certain limitations on sharing will be enforced. For more comprehensive information, please consult your Membership Guidelines.

You'll submit itemized medical bills through Summit's Member Portal.  If we have need for further documentation, please respond to those requests promptly to ensure efficient Sharing.

Yes. Summit allows you select any doctor or provider you prefer.