Annual Physicals With Limited Labs

 

One of the great advantages of being a Medi-Share member is that you have a say in what your program should look like through the member vote process. In May 2020, Members voted to maximize their membership in a few new ways, including having access to annual physicals, which will be eligible for sharing along with limited labs at each of the new sharing levels.

One annual physical per member is eligible for sharing. A provider will bill Medi-Share for the annual physical and associated labs for cholesterol and diabetes screening and those bills will be processed. If you have met your AHP, the bill(s) will be eligible for sharing. If not, bills will be applied to your AHP.

The only routine lab tests that are eligible for sharing as part of the annual physical are basic labs for cholesterol and diabetes: basic Lipid panel and HbA1C.

If your doctor recommends a test outside of these two tests, unless you have symptoms that warrant the test, it will not be eligible for sharing. For instance, a colonoscopy simply because you are 50 years of age would not be eligible for sharing vs. a colonoscopy because you have symptoms that you discussed at your annual physical.

 

Member FAQs

What lab tests are eligible for sharing?

Basic labs for cholesterol and diabetes screening only. Specifically, basic Lipid panel and Hemoglobin A1C.

What if, at my physical, the doctor notes something problematic and recommends a test; for example, a mammogram?

If, while at your physical, the doctor feels that a symptom or condition needs further diagnosis, he/she may recommend a test which would be considered diagnostic and not routine/preventive.

Can I have more than one annual physical per year?

You are only permitted one limited preventative annual physical with two labs (basic Lipid panel and Hemoglobin A1C) per year. These are eligible for sharing if your AHP has been met, or otherwise applies to your AHP.

What about children?

Medi-Share highly values the importance of family and wants to ensure newborns and children receive the very best care in the early stages of their life. Sharing for routine well-child care is eligible until the child reaches the age of six. Well-child care is defined as recommended, routine check-ups and associated lab work, excluding vaccinations and/or immunizations.

Children 6 and older will also qualify for the annual physical, provided they are on one of the new program levels.