Medi-Share FAQs

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Medi-Share Value FAQs

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Notification

Why is Notification required?

  • Notification is required so the Navigation Team can guide and support members who require costly or complex care.
  • For additional information about the Navigation Team please refer to the Navigation Team FAQ section.

When is Notification required?

  • Members are required to complete the Notification process as indicated by Healthcare Bluebook* in advance of seeking certain care, including:
    • Inpatient Hospitalizations
    • Cancer Diagnosis or treatment (including medication)
    • Organ/tissue transplant services
    • Maternity
  • Specialty medications (including infusions/injections given at home or in a doctor’s office)require pre-notification to our pharmacy partner, Navitus, call 833- 837-4307. You can also call with prescription questions or visit memberportal.navitus.com to search pricing at local pharmacies for non-specialty medications.
    • Any time the procedure or services are anticipated to exceed $5,000
    • Any time Healthcare Bluebook* indicates notification is required
    Advance Notification of medical care does not guarantee eligibility or sharing. See the Medi-Share Value Guidelines Section VI. Details of Sharing for more details about medical bill sharing eligibility.
  • For additional information about the Navigation Team please refer to the Navigation Team FAQ section.

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