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  2. What is Eligible for Sharing?

Do you Share in Preexisting conditions?

Conditions existing prior to membership with NO symptoms, diagnosis, medication, or treatment for more than 36 months prior to membership are considered Eligible for Sharing.

Pre-Existing Medical Conditions are conditions in which known signs, symptoms, testing, diagnosis, treatment, or use of medication occurred within 36 months prior to membership (based on medical records). A known sign is any abnormality indicative of disease, discovered on examination/diagnostic testing before joining membership. A symptom is any subjective evidence of disease. In contrast, a sign is objective. A Pre-Existing Medical Condition is eligible for sharing after the condition has gone 36 consecutive months
without known signs, symptoms, testing, diagnosis, treatment, or medication (based on medical records). If you have been diagnosed with cancer that is in complete remission, and you are only undergoing testing for surveillance purposes, then bills related to
those services will not be eligible for sharing for the first 36 months of membership. If after 36 months you are without signs, symptoms, testing (other than surveillance testing), diagnosis, or treatment (medication), medical expenses related to that cancer diagnosis will be eligible for sharing. High blood pressure or high cholesterol that is controlled through medication will not be considered a Pre-Existing Medical Condition for purposes of determining eligibility for future vascular or cardiac events. The Pre-Existing Medical Condition limitations do not apply to members 65 years old and older.


Take our quick and easy quiz to understand your pre-existing conditions and their impact on your membership.