What about pre-existing conditions?

A pre-existing medical condition is a condition for which the applicant has either received medical treatment, taken medications for, or exhibited observable symptoms of within the immediate 36 months prior to Membership. Any condition that meets one of these criteria is generally not initially shareable. Our Medical Cost Sharing Partner may request medical records to validate pre-existing conditions.

Medical costs (except some medications*) associated with pre-existing conditions are

• Not shareable at all during the first twelve months of membership (following the effective date of services).   
• Shareable up to a maximum of $15,000 cumulative during months 13-24 (following the effective date of services).   
• Shareable up to a maximum of $30,000 cumulative during months 25-36 (following the effective date of services).   
• Fully shareable in month 37 and beyond (following the effective date of services).   
• However, * the cost of maintenance (vs. curative) medications and related maintenance equipment associated with pre-existing conditions are never shareable.