Prosper
Non-Denominational Health Sharing From the Unitarian Universalist Perspective
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By Wiley Long III, President – HSA for America
Reviewed by Leslie Jablonski – Fact checked by Mike Montes – Updated 2/28/2024
About Prosper
Prosper is a new health sharing program offered by Universal Health Fellowship, an established non-profit health care ministry based in Alpharetta, Georgia.
Universal Health Fellowship was founded to provide medical cost sharing members in the tradition of the Unitarian Universalist Church. These principles include communal aid, neighborly assistance, and the sharing of burdens.
A Faith-Based, Non-Denominational Health Share Plan
Prosper membership criteria is non-denominational. There is no specific church membership requirement to become a member.
Membership is open to all who agree to live according to the principles of the Unitarian Universalist movement.
As a result, Prosper and the other Universal health share plans may be a good alternative for people who don’t meet the religious services attendance or church membership requirements of many other faith-based health sharing plans, or who don’t profess a Trinitarian theology.
Universal already offers several health sharing programs designed to meet different niches. Prosper is the latest roll-out, and features a simpler, streamlined fee and cost-sharing structure, along with some very attractive health sharing benefits.
Members share one another’s qualifying medical expenses, and Universal HealthShare programs coordinate this sharing.
Note that Universal HealthShare and the Prosper health sharing plan is not insurance, and their Ministry – Universal Health Fellowship – is not an insurance carrier.
Who Needs Prosper?
Prosper may be an excellent medical cost sharing solution for you and your family if:
- You want a faith-based non-denominational health sharing plan or you aren’t comfortable with the church membership or theological requirements of other faith-based plans.
- You have no major pre-existing conditions that may require treatment in the next three years.
- You want a health sharing plan with a relatively short (3-year) waiting period before costs to treat these conditions become shareable.
- You don’t qualify for a significant health insurance subsidy under the Affordable Care Act.
Availability
Prosper is available throughout the U.S., with the exception of the following states: Alaska, Connecticut, Hawaii, Illinois, Iowa, Maine, Maryland, New Hampshire, Pennsylvania, Vermont, and the State of Washington.
If you’re in one of these states, simply arrange a free consultation with one of our Personal Benefits Managers. We can help you find affordable alternatives, and help you sign up for a plan that works for you.
You Must Commit to a Healthy Lifestyle
Prosper members must agree to live healthy lifestyles, exercise regularly, and eat healthy and adhere to a reasonable, sound diet, and do not eat foods that harm the body.
Additionally, members must agree to refrain from engaging in hazardous activities and behaviors that evidence a willful disregard for personal health and safety.
How Prosper Works
When you join Prosper, you will make a regular monthly contribution to help share the unexpected medical costs of your fellow members.
And in return, if you have a medical need, your fellow plan members will stand ready to help bear that financial burden for you.
Your Non-Shareable Amount (NSA)
Your Non-Sharable Amount or NSA is the amount of medical expense you must pay before any other of your medical expenses can be eligible for sharing.
Conceptually, it functions like a deductible in the health insurance world. The higher your Non-Shareable Amount, the lower your monthly sharing contribution, and vice versa.
After you have paid your NSA for the plan year, Prosper will share 100 percent of all additional eligible medical costs for the rest of that plan year. You will pay nothing out of pocket for eligible costs.
Note: This is different from other Universal Health Share plans, which allow you to select an annual co-sharing amount above your NSA, up to a maximum out-of-pocket amount you select.
The Prosper plan is much simpler, and the amount your plan will share after you cover your annual NSA goes right to 100%.
You can read more details about the Universal Annual Co-share Amount with other plans on our general Universal Health Share profile page.
Prosper NSA Options
When you join Prosper, you’ll select one of these three options for your annual non-shareable amount: PRS 50, PRS 75, or PRS 100. Your monthly contribution requirement will be higher with the PRS 50 option, and lowest with the PRS 100 option.
Universal Health Share Prosper Non Shareable Amount Options
| Household Size | PRS 50 | PRS 75 | PRS 100 |
|---|---|---|---|
| One member per household | $5,000 | $7,500 | $10,000 |
| Two members per household | $10,000 ($5,000 per member) | $15,000 ($7,500 per member) | $20,000 $10,000 per member |
| Three or more members per household | $15,000 ($5,000 per member) | $22,000 ($7,500 per member) | $30,000 ($10,000 per member) |
Consultation Fees
In addition to the NSA amounts described above, Prosper members are responsible for consultation fees, payable per visit, as follows:
Prosper Per-Visit Consultation Fees
| Type of Visit or Therapy Session | PRS 50 | PRS 75 | PRS 100 |
|---|---|---|---|
| Primary Care Office Visit and psychiatric medication management | $25 per visit | $25 per visit | $25 per visit |
| Specialty care office visit and psychiatric medication management | $50 per visit | $50 per visit | $50 per visit |
| Urgent Care Visits | $75 per visit | $75 per visit | $75 per visit |
| Emergency room visits* | $300 per visit | $300 per visit | $300 per visit |
*The Universal HealthShare Prosper Programs allow for immediate sharing for office and emergency room visits related to accidents, sickness, acute illness, and life-threatening emergencies.
- If an emergency room visit results in an in-patient admission unrelated to pre-existing conditions, in-patient services unrelated to pre-existing conditions are also eligible for sharing.
- After your payment of the Consultation Fee, up to $300 of the remaining portion of the physician charges for the office visit as well as charges for diagnostic and procedures that take place during the visit will be eligible under this sharing category.
- Other visits requiring a consultation fee, including emergency room visits that don’t result in an admission, are subject to non-sharable amounts and are sharable at your program rates.
As you can see, plan members have an incentive to use primary care doctor office visits and urgent care centers where possible, rather than an ER visit.
These ER provisions are very favorable compared to many other plans, making Prosper a good choice for families with children and others who are at higher risk of needing ER services – especially if the ER visits are likely to result in a hospital admission.
These figures are current as of January 2024, and are subject to change by Prosper and Universal HealthShare at any time. For the latest, consult your plan guideline documents at the time you sign up.
Or better yet, contact one of our experienced Personal Benefits Managers for a free consultation.
Prosper Program Essential Elements
How Does Prosper Handle Pre-Existing Conditions?
Conditions that exist at the time of enrollment that have evidenced symptoms and/or received treatment and/or medication within the 24 months prior to enrollment are not eligible for sharing, except where specifically noted within Prosper’s Sharing Guidelines.
However, Prosper will begin phasing in cost sharing for pre-existing conditions after you’ve been a sharing member for twelve consecutive months.
In your third consecutive membership year, medical expenses related to pre-existing conditions are shareable up to an annual limit of $50,000.
In your fourth and subsequent consecutive membership year, your condition may no longer be considered pre-existing, and therefore fully eligible for sharing.
Exceptions: Costs related to Type 1 Diabetes (juvenile onset diabetes) are not shareable, even if you go 12 months without symptoms, treatment, or medication.
Note: If you can clearly document that for the four years immediately prior joining Prosper,
- Your condition has neither required treatment nor been treated and there is no anticipated or prescribed need for treatment in the future;
- Your condition has not generated any harmful symptoms
- Your condition has not deteriorated in any way
Then your condition may be deemed as not “pre-existing” for the purposes of qualifying for sharing.
Policies for Diabetes, High Blood Pressure, and High Cholesterol
Diabetes Type 1
Type 1 Diabetes may still be considered pre-existing, even if you can document your condition has not been treated or required treatment over the four-year lookback period.
High Blood Pressure (Hypertension)
High blood pressure will not be considered a pre-existing condition as long as you have been treated for the condition in a hospital setting over the past four years, and you are able to control the condition with diet and/or medication.
However, costs for medications for a chronic condition will not be shared.
See your doctor when you enroll.
It’s a good idea to have your physician evaluate you and document this when you join the plan to document that your health has not deteriorated in the previous four years due to your pre-existing illness or injury, and to establish a baseline for your condition.
Diabetes Type 2
Prosper will not consider type 2 diabetes as a pre-existing condition if:
- You have been symptom-free for 12 months immediately prior to enrollment.
- You have not been treated at a medical facility or practitioner’s office (other than for diagnostic testing).
- Your condition is controlled through diet, lifestyle adjustments, and/or medication other than insulin.
- Your A1C level is 7 percent or lower throughout the previous 12 months.
High Cholesterol
High cholesterol on its own is not considered a pre-existing condition. Also, simply taking a statin drug is not by itself considered cause to deem elevated cholesterol levels a pre-existing condition.
However, if the prescription is for a diagnosed arteriosclerosis for a particular location, such as your heart or carotid artery, the condition for that specific location would be deemed a pre-existing condition, and subject to the pre-existing condition waiting period.
Mental Health Care, Counseling, and Support
Behavioral Health counseling for short-term problem resolution, referral, and crisis intervention services is provided through FlexCare.
Programs may vary in some states.
Members receive 24×7 confidential free counseling via telephone, secure video or mobile app and problem-solving services with a qualified counselor with a minimum of a master’s degree and five years of postgraduate experience.
Services with counselors include depression, anxiety, stress, relationship issues (e.g., divorce), job and work stress/conflicts, family and parenting problems, loss, anger, grief, addiction, eating disorders, mental illness, and others.
See the section on Exclusions below for more details on how Prosper shares costs related to mental health treatment.
Waiting Periods
A 90-day waiting period applies before Prosper will share costs for new members (12 months for maternity benefits).
However, the 90-day waiting period does not apply to office and emergency room visits related to accidents, sickness, acute illness, and life-threatening emergencies.
You must pay a consultation fee for each primary care, specialty care, urgent care, and emergency room visit at the time of your visit.
A 180-day waiting period applies before the plan will share expenses for Cologuard testing or a screening colonoscopy.
A 30-day waiting period applies before expenses for preventive care, an annual routine physical, or well child exam are eligible for sharing.
A 30-day waiting period applies before any other Medical Expense Need may be eligible for sharing. Note: This 30-day waiting period does not apply to sharing eligibility for telemedicine, primary care, urgent care or specialty care visits, or diagnostic testing, in-office procedures, or laceration laceration repair procedures that take place during the visit.
The 30-day waiting period does, however, apply to imaging and office-based surgical procedures.
Telemedicine
Telemedicine services have no 90-day waiting period.
You can access telemedicine immediately upon becoming a member. There are no consultation fees, copays, or any other charges for a telemedicine consultation. It’s included with your monthly sharing contribution as a member.
Maternity Benefits
Maternity Sharing Limits:
- $5,000 for normal delivery or a c-section that is not medically necessary,
- $8,000 for c-section that is medically necessary.
- $50,000 for combined expenses for the member and newborn arising from complications.
- Prenatal visits are limited to nine and are eligible for sharing 90 days after sharing program membership begins.
Adding Newborns to Your Plan
If you or your spouse is expecting a new baby, and you want to add your new baby to your health sharing plan, you must notify Universal HealthShare and add your baby at least three months prior to your expected delivery date.
If either parent of a newborn has insurance coverage through an employer or otherwise, then you should add your baby to that plan. Your new baby will not be eligible for a Universal HealthShare plan.
Can I Add a Grandchild to My Universal/Prosper Health Sharing Plan?
Yes, you can generall add a grandchild to your plan, provided your grandchild lives with you, you have legal custody, and no other person, group, or entity is responsible for their medical bills.
Wellness/Prevention Benefits
The Wellness Center can also help with the following:
- Connection with nutritional support
- Caregiver support
- Requesting cash-pay discounts and reduced cost care from hospitals and other providers
The Multi-Plan/PHCS Network
Universal and Prosper programs do not use a Network for Hospitals or Ambulatory Surgical Centers.
However, for individual doctors and other care providers, Universal HealthShare does use the Multiplan/PHCS Practitioner & Ancillary Network, which includes more than 700,000 providers nationwide.
Multiplan/PHCS also gives Members access to discounted rates from participating physicians, medical professionals, laboratories, imaging centers, urgent care facilities and walk-in clinics.
These providers have agreed to charge members at discounted rates, and to bill your sharing program for any eligible medical needs before billing you.
However, you won’t have to change your family doctor. You can still use your existing primary care physician – subject to the specific program provisions – even if they are out of network.
Note: If your primary care doctor is not in the Multiplan/PHCS network, they are not required to submit a need request on your behalf or accept a discounted amount for their services. They may also require you to pay up front.
Out-of-network primary care practitioners will be reimbursed for eligible shareable services at billed charges or 155% of the allowable amount for those services under Medicare – whichever is less.
If your doctor charges more than 155% of the Medicare-approved amount, you would be responsible for the difference.
If your out-of-network doctor requires you to pay up front, you would submit a sharing request to the Prosper plan. After accounting for your Non-Shareable Amount remaining, if any, you would be reimbursed for any services eligible under your program.
Prescription Drugs
Like most health sharing plans, prescription drug benefits are limited with Prosper.
Under the basic membership, Prosper only shares prescription drugdrugs costs when provided by a hospital as part of inpatient treatment or provided by a facility during an outpatient surgical procedure.
That’s why we recommend Prosper members consider enhancing their plan by signing up for The RxSimpleShare prescription drug program, administered by Liviniti.
This plan is an optional add-on available to all Prosper program members. It provides access to over 60,000 licensed pharmacies nationwide.
Are the drugs I need included in the RxSimpleShare Formulary?
You can view the RxSimpleShare formulary at any time to see if your drug is included. Click here to see the current formulary.
RxSimpleShare Costs
You can add RxSimpleShare to your Prosper health sharing plan for an additional $25 per member per month.
A co-share of up to $5 per 30-day prescription fill may apply. These co-shares do not apply towards your Prosper plan’s Annual Non-Shareable Amount, however.
RxSimpleShare Benefit Limit: $500 per month.
Only a 30-day supply per prescription per month is allowed for the same drug or substitute.
The HSA Advantage Rx Discount Plan
HSA AdvantageRx, which gets you up to 80% off on hundreds of commonly-prescribed generic prescription drugs.
The HSA AdvantageRx Card also gets you discounts on many other medical services, as well, such as lab costs and imaging.
The HSA AdvantageRx program is available at no extra charge for all clients who sign up through the HSA For America website, or through one of our experienced Personal Benefits Managers.
Questions? Request a free personalized consultation, quote, or sign-up assistance!
Ready to Sign Up? Click here to set up a FREE appointment with a Personal Benefits Manager.
Labs, Testing, and Other Ancillary Services
Your primary care, specialty care, urgent care, or emergency room visit may include charges for testing or procedures (such as blood tests, ultrasounds, etc.) in addition to the office visit fee.
Up to $300 combined for the office visit fee and any additional charges incurred during the visit for primary care, specialty care and urgent care are eligible for sharing.
For emergency room visits, any charges beyond the visit charge itself will be applied to your NSA.
Additional Benefits for Prosper Members
- Coast-to-Coast Vision™ – discounted prescription glasses, contact lenses, and eye exams from 20,000 national chain and independent optical center locations in the U.S.
- Aetna Dental Access – Provides members with discounts of 15%-50% on dental procedures at over 238,000 dental practice locations nationwide.
The Health Questionnaire Requirement
Exclusions
The following services and procedures do not qualify for cost sharing under the Prosper program, or any other Universal HealthShare program:
- Abortion of a live fetus – Costs are ONLY shareable if (a) the physical life of the mother is endangered by the continued pregnancy and treatment via a cesarean section has been determined by a neonatologist to be inadvisable, or (b) the pregnancy was the result of a rape or incest for which a police report was filed.
- Alcoholism/drug addiction treatment
- Alternative medicine, except where approved in advance by Universal HealthShare.
- Cosmetic procedures, except for medical care and treatment provided for disfigurement caused by amputation, mastectomy, disease or accident
- Custodial care, defined as services or supplies provided mainly as a rest cure, maintenance, custodial care or other care that does not treat an Illness or Injury, is not shareable.
- Dental care, except as provided for under the Aetna Dental Access discount plan mentioned above. Exception: Repair of damage caused by accident while a sharing member.
Note: Damage to natural teeth that occurs while eating (e.g., breaking a tooth on a popcorn kernel or olive pit) is not sharable. - Durable medical equipment
- Exercise programs, except for physician supervised cardiac rehabilitation and or physical therapy.
- Euthanasia/assisted suicide
- Eye care. Eye exercise therapy, radial keratotomy or other eye surgery to correct near-sightedness. Also, routine eye examinations, including refractions, lenses for the eyes and exams for their fitting.
- This exclusion does not apply to the initial permanent lenses following cataract removal.
- Genetic testing
- Hair loss treatment
- Hearing aids and exams
- Hazardous hobbies. These include but are not limited to rock/cliff climbing, spelunking, scuba diving, skydiving, bungee jumping, hang gliding, kite surfing, paragliding, base jumping and all other extreme sports.
- Hemophilia
- Impotence treatment
- Infertility treatment. Diagnostics, testing, surgical repair, non-surgical repair, surgical impregnation, in vitro fertilization or other procedures and Prescription Drugs for the treatment of infertility are not sharable.
- Illegal acts. Costs incurred as a result of participation in criminal activities are not shareable.
- Long-term care. Contact a Personal Benefits Manager about purchasing long-term care insurance.
- Mental health services. This exclusion includes charges for psychiatric or psychological counseling, mental disability, learning disability, bereavement counseling, biofeedback therapy, psychological testing, treatment, medication, and hospitalization.
- It also includes psychiatric medication management except as stated in the General Sharing Requirements, Restrictions, Limitations & Maximums section of each Program.
- Non-emergency hospital admissions on Fridays or Saturdays.
- Non-emergency medical transportation. Also, the additional expense for transportation to a facility that is not the nearest facility capable of providing medically necessary care is not eligible for sharing.
- Non-emergency use of an emergency room
- Nutritional supplements.
- Nutritionist services, unless they are licensed or certified to provide the service, and the service is prescribed by a licensed medical professional or, if the member is hospitalized, prescribed by a member of the hospital staff.
- Prescription drugs are not generally shareable, except for prescription drugs provided by a hospital as part of inpatient treatment or provided by a Facility during an outpatient surgical procedure.
- Self-inflicted injuries for members over the age of 12, even in cases of mental illness//psychosis.
- Surgical sterilization or reversal
- Injuries sustained due to war, acts of terrorism, or military duty
- Weight loss programs or treatments and surgeries done principally for the purposes of weight loss.
Smokers
The Prosper plan does not normally take on smokers, except as provisional members (see below).
To join Prosper as a standard member, you must attest that you have not used tobacco for at least 12 months prior to joining, and that you remain tobacco-free for as long as you are in the plan.
However, Prosper is open to accepting recent former smokers as provisional members, so long as they agree to quit smoking..
Recent tobacco users accepted as provisional members are subject to an additional monthly contribution amount of $80.
For more information about provisional memberships, see the provisional membership section below.
Alcohol use
Similarly, Prosper members must refrain from the abuse or excessive use of alcohol.
To join Prosper, you must attest that you have not abused or used alcohol to excess in the 12 months prior to joining. You must also continue to refrain from alcohol abuse while a member of the plan.
Prescription drug abuse
To join Prosper, you must attest that you have not abused or misused prescription drugs or over-the-counter medications within the last 12 months.
Conditional Memberships
If you want to join but you have a pre-existing health condition that may be improved or eliminated by a change in behavior, Universal HealthShare may exercise its discretion to accept such applicants on a provisional basis, as a Conditional Member.
In this case, you would be subject to a higher Monthly Share Contribution amount. Universal HealthShare may also ask you to document the modification of certain behavior, and to take reasonable steps to to improve or eliminate your health condition.
Any person accepted for membership who is a smoker/nicotine user or suffers from obesity will automatically be treated as a conditional member.
If you develop a medical condition later, after you’re already a member, it’s possible that Universal HealthShare may change your status to conditional membership.
Again, if this occurs, you may be required to contribute an additional monthly sharing amount, and make behavioral changes designed to mitigate or eliminate your health condition.
Supercharge Your Savings: Combine Prosper/Health Sharing With a Health Savings Account
Health Savings Accounts, or HSAs, are arguably the single most powerful tax savings and wealth accumulation vehicle available to individuals in the U.S. Tax Code.
Until recently, however, it was impossible for most people enrolled in health sharing plans like Universal HealthShare and Prosper to take advantage of them. That’s because the tax code only allows you to make contributions to a health savings account if you are covered under a qualified high-deductible health plan, or HDHP, which are traditional insurance products.
By law, HDHP plans must include ten Minimum Essential Coverages in order to qualify. These qualifying plans are called “MEC” plans, and health sharing plans on their own do not meet the criteria.
However, thanks to recent innovations in the health insurance industry, it is now possible for all health sharing members to combine the savings of health sharing plans with the tremendous tax benefits of health savings accounts.
It’s easy: All you need to do is add the HSA MEC plan to your health sharing plan.
HSA MEC, available through HSA For America, is an inexpensive, streamlined MEC plan that you layer on top of your Prosper or other health sharing plan.
Because HSA MEC is designed to cover just the basics required of a MEC plan under federal law, it’s very inexpensive.
In fact, it costs much less than the direct tax benefits you gain by taking advantage of your eligibility to contribute to an HSA.
Three Steps to Savings
1. Switch to a Health Sharing plan, such as the Universal HealthShare Prosper plan.
This saves up to half off the unsubsidized cost of a traditional health insurance product purchased on the Marketplace.
2. Purchase the HSA MEC policy, to layer on top of your health sharing plan. This provides additional basic coverage for a variety of healthcare needs. Additionally, HSA MEC qualifies you to make pre-tax contributions to a health savings account, or HSA.
3. Get substantial tax savings by contributing as much as you can to your HSA. As of 2024, you can contribute up to $4,150 to an HSA that covers yourself only, and up to $8,300 for a family. If you are age 55 or older, you can make another $1,000 per adult of that age in pre-tax catch-up contributions.
Month Membership Dues
In addition to their monthly cost-sharing contributions, members must also pay monthly membership dues to keep their membership in force. Currently, the monthly membership dues are $15 per person per month.
Enroll Now!
You can self enroll at the Prosper Enrollment link.
Answer about 4 questions, and then choose the PRS50, PRS75, or PRS100. Enter your credit card information to pay for the first month, plus a one-time $75 enrollment fee.
You can also get free personalized assistance, quotes, and enrollment help by setting up an appointment with one of our experienced Personal Benefits Managers.
Designing and Customizing Your Prosper/Universal Health Share Plan
When you enroll in any Universal HealthShare plan, including Prosper, the first thing , you’ll choose is your annual non-shareable amount, or NSA.
This functions similarly to a deductible in the health insurance world.
Your NSA is the amount of medical expense you are willing to pay before your plan’s sharing benefits kick in.
The higher your NSA, the lower your monthly required sharing contribution will be, all other things being equal.
With the Prosper program, as of January 2024, you can choose any of the following NSA amounts, depending on your family size:
Universal Health Share Prosper Non Shareable Amount Options
| Household Size | PRS 50 | PRS 75 | PRS 100 |
|---|---|---|---|
| Self-Only Plans | $5,000 | $7,500 | $10,000 |
| Two-member households | $10,000 | $15,000 ($7,500 per member) | $20,000 $10,000 per member |
| Three or more-member households | $15,000 ($5,000 per member) | $22,000 ($7,500 per member) | $30,000 ($10,000 per member) |
Note: Your NSA is per plan year, which is the 12-month period starting on your effective membership anniversary date.
If you should have a medical incident – say, you have to get your appendix removed, you would be responsible for paying that amount within the 12-month period starting on your effective membership anniversary date.
Once your anniversary date comes round again, your NSA resets.
Annual NSA calculation for family plans:
For two- and three-member households, each member is responsible for their own Annual Non-Sharable Amount.
For households with more than three members, each member is responsible for their own Annual Non-Sharable Amount.
But once all members combined have paid eligible medical expenses in a cumulative amount equal to three times the applicable Annual Non-Sharable Amount, all members in your household will be deemed to have paid their NSA for the year.
Per Medical Incident Limits
The Prosper plan will share up to $500,000 per medical incident. This is a higher amount than those available under other Universal HealthShare plans, which range from $100,000 to $450,000.
Annual Sharing Maximum
The Prosper plan will share up to $1 million per year in eligible medical costs, subject to the following limitations:
Universal Health Share Prosper Non Shareable Amount Options
| Household Size | PRS 50 | PRS 75 | PRS 100 |
|---|---|---|---|
| Self-Only Plans | $5,000 | $7,500 | $10,000 |
| Two-member households | $10,000 | $15,000 ($7,500 per member) | $20,000 $10,000 per member |
| Three or more-member households | $15,000 ($5,000 per member) | $22,000 ($7,500 per member) | $30,000 ($10,000 per member) |
Prosper Annual Sharing Limits
| Preventive Care | $1,000 |
|---|---|
| Annual Combined Limit | $1 million |
| Allergy Testing | $500 |
| Emergency Transport | $10,000 |
| Organ Transplant | $150,000 |
| Prosthesis | $1,500 |
Additionally, Prosper has the following cost sharing limits per member per year:
Prosper Annual Visits and Cost Sharing Limits
| Type of Visit or Session | Cost sharing limitation |
|---|---|
| Primary care, Specialist Care, or Urgent Care visits | 12 visits per year, in any combination |
| Medication Management | 4 visits in total for any Primary Care Practitioner or appropriate mental health professional visits for the monitoring and management of medications prescribed for mental health conditions such as anxiety, depression, bi-polar disorder, and ADHD. |
| Chiropractic Adjustment/Manipulation and Physical Therapy | 12 sessions in total for any combination of these types of sessions |
| Audiological Therapy, Cardiac Therapy, Hyperbaric Oxygen Therapy, Occupational Therapy, Optometric Vision Therapy, Respiratory Therapy, and Speech Therapy | 10 sessions in total for any combination of these types of sessions |
| Prenatal Care Visits | 9 visits per pregnancy |
Prosper Lifetime Sharing Limits
None. Unlike many other health sharing plans, Universal HealthShare plans, including Prosper, have no cap on lifetime sharing benefits.
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