Mango
Ben’s wife gives birth and afterward seeks help from a lactation consultant for breastfeeding support. Will those services be included as part of postpartum care under Medi-Share—yes or no
No...
—Counseling or consultation expenses including, but not limited to: o Dietary counseling o Diabetic counseling o Lactation counseling
At Medi-Share, there are typically no annual or lifetime maximum sharing limits. However, there are four specific exceptions. What are those four types of events?
Pre-existing conditions
Maternity
Motorcycle events
First month of membership
Kevin, a U.S. citizen, gets married to a beautiful Colombian gal and wants to add his new wife Sophia to be on his Medi-Share. Sophia lives in the U.S. with him full-time but does not have legal residency status yet. Shortly after, she’s tears her MCL playing futbol with his homies and needs surgery. Will her medical bills be eligible for sharing and why or why not?
No
⸻
💡 Why:
Non-U.S. citizens must be legal residents to qualify
Bills incurred while not a legal resident are not eligible for sharing Pg. 11
Luciano gets a treatment ordered by a Medical Doctor and has it performed at a medical spa that offers advanced therapies. He assumes it will be shared. Is he correct—yes or no
No
What would have made this potentially eligible?
👉 Answer:
Pre-eligibility review:
ONLY: Hospital • Surgery center • Clinic • Doctor’s office • Diagnostic facility For other locations to be considered,
OTHERWISE: a pre-eligibility review is required
pg.21
Diego schedules a minor outpatient surgery at a small clinic—no hospital stay, quick in-and-out procedure. Because it’s not a major surgery, he assumes he doesn’t need to involve Medi-Share ahead of time. Does Diego need to pre-notify Medi-Share—yes or no?”
Yes:
Inpatient hospitalizations
• Non-emergency surgeries
• Elective cardiac procedures • Cancer diagnosis or treatment (including medication) • Organ/tissue transplant services • Specialty medication
Albert had a heart procedure last year and is now starting cardiac rehab because his doctor recently recommended it. He’s excited because Medi-Share will cover up to 36 sessions. Since he has a valid cardiac condition and a doctor’s order, is Mark good to go—yes or no?
No
💡 Why (This is the punch)
Rehab must begin within 6 months of the cardiac event
Albert waited too long → not eligible for sharing
Page 24
Valentino, a member, pays his Monthly Share late. As part of Medi-Share guidelines, he must contribute to the Extra Blessings Fund. How is that contribution calculated?
$5 or 5% of the late amount, whichever is greater.
Pg 13
Felica chooses a non-PPO provider for a planned surgery because it’s a well know surgeon. The provider charges well above Medicare rates. Medi-Share shares up to certain limits… who pays the rest?
Felica
💰 Real-Dollar Example
“Let’s say Medicare allowable for the surgery is $10,000
Medi-Share may share up to 200% for facility → $20,000
But the hospital charges $35,000
👉 Felica is responsible for the $15,000 difference
A couple gets married on June 1. They submit the spouse application on June 29. A pregnancy (conception) occurs June 15. When does sharing for the pregnancy begin or does it not?
Bonus — when does the share increase take effect?
Sharing begins: June 1 (marriage date)
Share increase: First day of the month after approval
pg.9 If the application to add a spouse is submitted and approved before or within 30 days after the marriage date, sharing in eligible needs including a pregnancy occurring on or after the marriage date will start on the marriage date. The share increase will take effect on the first day of the month following approval.
Changes to the Guidelines may be made by the following: By the Members – _______ a year, ballots with significant proposed changes to the Guidelines are submitted to the Members for voting. If at least ___% of the Members voting approve a Guideline change, then the change will be implemented.
By the Members – Once or twice a year, ballots with significant proposed changes to the Guidelines are submitted to the Members for voting. If at least 67% of the Members voting approve a Guideline change, then the change will be implemented.