Understanding Your Member Responsibility
At Vativis, we want every member to feel confident about how costs are shared — and what part you may need to cover.
Instead of traditional insurance deductibles, Vativis plans often include a Unshared Amount (UA) or the amount the member is responsible for before sharing benefits apply. This guide explains how it works so you can plan ahead and avoid surprises.
What makes the UA different?
Here’s how the Vativis approach differs from typical health insurance:
Per Medical Event, Not Annual Deductibles
Instead of a deductible that resets each calendar year, the UA applies per medical situation. If a health issue continues for several months, you don’t start over with new costs each January.
Maximum Protection for Families
No household pays the UA more than twice in any rolling 12-month period.
After two separate medical situations requiring the UA, any new incident over $1,500 is shared in full.
Focus on Fairness
If your medical event costs less than your UA, there’s no need to submit it for sharing — you simply pay those bills directly.
What Medical Costs Are Eligible?
Most healthcare expenses are eligible for sharing once your UA is met.
Preventive services might already be included in your plan at no extra cost and do not require you to meet your UA first.
Always check your specific membership details for a complete list of covered services.
Per Incident vs. Annual Deductibles — Key Difference
Traditional health insurance uses an annual deductible:
You pay costs out-of-pocket each year until you hit the deductible.
The deductible resets every January, even if you’re still treating the same condition.
With Vativis:
The UA applies to a single medical event, regardless of how long it lasts.
For example, if you start treatment for a condition in October and continue into the following year, you only pay the UA once for that incident.
Submitting a Sharing Request
Here’s how it works if you have expenses above your UA:
Gather your bills. Keep all invoices related to the same medical situation.
Reach your UA threshold. Once costs exceed your UA for that incident, you’re eligible to submit a sharing request.
Submit your documents to Vativis. We’ll help guide you through the process.
No need to send bills for smaller expenses under your UA or for preventive care already covered by your plan.
Household Protection Limit
Vativis ensures members aren’t burdened with unlimited out-of-pocket costs:
No more than two UA per household in a 12-month period.
Once you’ve met your UA twice, any new medical situation over $1,500 is shared entirely.
If a medical situation costs less than your UA, it does not count toward this two-incident maximum.
Key Takeaways
The UA replaces traditional deductibles with a per-incident approach.
Preventive services may be included without cost-sharing.
Your household will never pay more than two MRAs per year.
Vativis makes healthcare costs more predictable and fair.
Have Questions?
Our Member Services team is here to help clarify any details about how your UA works or how to submit a sharing request.
Vativis — Health Benefits That Work for Real Life
At Vativis, we believe in making healthcare costs transparent and manageable. Let’s keep your health — and your finances — on the right track.
