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What is Considered a Pre-Membership Condition?
A pre-membership medical condition is anything where a member has experienced one or more of the following:
- been examined
- been diagnosed
- taken medication
- had symptoms
- a personal history of or known increased risk of conditions that may arise or worsen in pregnancy
- received medical treatment within the 24 months prior to their membership start date. Sharing requests related to pre-membership medical conditions are only eligible for sharing if the condition was regarded as cured and did not require treatment or present symptoms for 24 months prior to the membership start date.
Zion HealthShare’s Limitations for Pre-Membership Conditions
Pre-membership medical conditions have a phase-in period wherein sharing is limited. Starting from the membership start date, there is a one-year waiting period before pre-membership medical conditions are eligible for sharing. After the waiting period, the amount eligible for sharing increases with each membership year.
Amounts eligible for sharing for pre-membership medical conditions:
• Year One: $0 (waiting period)
• Year Two: $25,000 maximum per sharing request
• Year Three: $50,000 maximum per sharing request
• Year Four: $125,000 maximum per sharing request
After four years of membership, expenses related to pre-membership medical conditions will be eligible for sharing up to a maximum of $125,000 in a 12-month period. The maximum resets each membership year.
Members who enroll in the Zion HealthShare Bridge Program through their employer are subject to the limitations in the program outline.
Source: Zion HealthShare Member Guidelines
Be sure to check the Zion HealthShare Reviews to learn more and read other member’s reviews!
Health shares are not insurance and do not offer insurance coverage. Membership in a health share does not guarantee the payment or reimbursement of medical expenses. Each organization operates under its own membership guidelines, which determine what expenses may be eligible for sharing. This publication is for informational purposes only and is not provided by an insurance company. For state-specific notices and full program details, please visit the respective health share’s official website.
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