How GraceWell Works Alongside Medicare

GraceWell is designed for seniors enrolled in Medicare Parts A and B.

GraceWell works alongside Medicare to help members share eligible medical expenses that Medicare does not fully pay.

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Here’s how the process works.

Step 1: Use Your Medicare Coverage as You Normally Would
- Visit any doctor or hospital that accepts Medicare nationwide.
- Your provider will send your bill directly to Medicare for processing.
- Medicare reviews the claim and typically pays about 80% of approved expenses.
Step 2: Review What Medicare Didn't Pay
After your visit, you’ll receive:
- A Medicare Summary Notice (MSN) showing what Medicare paid and what remains
- A bill from your provider for any remaining balance
In many cases, your provider will also send this information using your GraceWell member details.

If they don’t, you can submit your bill and MSN—and our team is here to help if you need it.
Step 3: You Meet Your Responsibility, Then Sharing Begins

Your $1,000 Primary Responsibility Amount (PRA) is the most you pay out-of-pocket each year for eligible medical expenses before bills are shared.

As bills come in, they count toward that amount.

Once your PRA is met, eligible expenses that Medicare does not fully pay may be shared by the GraceWell community, according to the Guidelines.
A Simple Example
80% + 20% = 100%

If your medical bill is $100:
- Medicare typically pays $80
- The remaining $20 is what may be shared—after you've met your $1,000 PRA