How Does an Annual Physical Work with Medi-Share?

Medi-Share offers its members the opportunity to have one annual physical per year as part of their membership at no additional cost. Here’s how you can take advantage of this:

Eligibility for Annual Physicals

• One Physical Per Member Per Year
  Each individual member is eligible to receive one preventative annual physical per year. This includes adults and eligible children on the program.

• Requirement to Meet Annual Household Portion (AHP)
  To make the cost of your annual physical eligible for sharing, you must first meet your Annual Household Portion (AHP). If your AHP hasn’t been met, the expense for the physical will be credited toward it.

• Children’s Eligibility
  For young children (newborns through age 5), routine well-child care check-ups are eligible under Medi-Share sharing guidelines. Children ages 6 and older can also receive one annual physical per year, as long as they are enrolled in the program.

What's Qualifies?

• Routine Physical Costs
  During your annual physical, the cost of the visit is covered and eligible for sharing. Your provider will bill Medi-Share for this visit, and Medi-Share will process it under the program guidelines.

• Basic Lab Tests Included
  The following routine labs are also eligible for sharing as part of your annual physical:

  • Lipid Panel (Cholesterol screening)
  • Hemoglobin A1C (Diabetes screening)

  If you’ve met your AHP, these labs will be eligible for sharing.

What Doesn't Qualify?

• Preventative Tests Beyond the Basic Labs
  Additional routine or preventative tests beyond the standard cholesterol and diabetes labs (e.g., mammograms or colonoscopies) are not eligible for sharing. However, if a doctor identifies a concerning symptom during your physical and orders a diagnostic test, it will be reviewed under different guidelines and may be considered for sharing.

• Vaccinations and Immunizations
  While well-child care is supported, routine vaccinations and immunizations are not covered under the Medi-Share program.

Things to Keep in Mind

• Make sure your health care provider is familiar with billing Medi-Share for your annual physical.
• Tests or screenings recommended by a physician based on new symptoms or risk factors may qualify as diagnostic rather than preventative. Be sure to ask your doctor about the reason for any additional tests.

Getting Started

To schedule your annual physical:

1. Contact your health care provider and inform them you will be using Medi-Share.
2. Ensure you’ve met your AHP if you’d like the visit and labs to be eligible for sharing.
3. Discuss any lab work or diagnostic tests in advance to clarify what’s eligible for Medi-Share sharing.

Medi-Share supports its members in maintaining their health by providing access to an annual physical, so be sure to take advantage of this each year to stay proactive about your well-being!