How does Medi-Share work with pre-existing conditions?

Jan 24, 2017

Reading time: 2 Minutes

Updated as of 2023.

Medi-Share may share in pre-existing conditions after the first 36 or 60 months, with limits on the amount shareable. Controlled blood pressure or cholesterol is not considered pre-existing.

 

Medi-Share & Pre-existing Conditions

Although Medi-Share was designed primarily for new and unexpected illnesses or injuries, some pre-existing conditions may be eligible for sharing. 
 

Medical bills for diagnosis or treatment of a pre-existing medical condition, defined as signs/symptoms, testing, diagnosis, treatment, OR medication for a condition within 36 months prior to membership (based on medical records), will ONLY be eligible for sharing as follows: 
 

  • Up to $100,000 per Member per year (based on effective date) once the member has been faithfully sharing for 36 consecutive months.

  • Up to $500,000 per Member per year (based on effective date) once the Member has been sharing faithfully for 60 consecutive months.
 
Any congenital condition will only be eligible for sharing at the above-referenced amounts once the member has been faithfully sharing for 36 or 60 consecutive months, respectively. 

 
High blood pressure or cholesterol that is controlled through medication or lifestyle will not be considered a pre-existing medical condition for purposes of determining eligibility for future vascular events. 

 

Where there has been a lapse in Membership, a condition will not be considered pre-existing if the first instance of the condition appeared during the previous Membership, unless the lapse was due to cancellation for non-sharing or lifestyle requirements. An exception would be maternity that occurred outside the current Membership period, which will not be eligible for sharing. 

  

The bottom line: If you haven’t been treated or had symptoms for 3 years or more when you join, your condition may be eligible for sharing if it reoccurs, with some limitations on the amount shareable. 

 

If a member has been faithfully sharing for 12 consecutive months and medical costs associated to a pre-existing condition arise, the member can apply to have their need met through the Extra Blessings Program. The Extra Blessings Program helps with members’ medical expenses that are not eligible for sharing. That might include bills related to pre-existing conditions, excess adoption expenses, or those exceeding sharing limits. The ability of the Extra Blessings program to be there for those who need it depends on the voluntary donations of members who give in addition to their monthly share amounts.  

 

If you’re able to donate to the Extra Blessings program (and you don’t even have to be a member!), visit  ExtraBlessings.comfor more information. 

 

Please read the complete Medi-Share Guidelines, Section VI. Details of Sharing, F. Pre-Existing Medical Conditions or Related Conditions 

 

 

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