Pre-existing Conditions: Waiting Periods, Eligibility, and What 'Shareable' Means

Pre-existing conditions and waiting periods are among the most important factors to understand when evaluating healthcare sharing. This guide explains Liberty HealthShare's approach to pre-existing conditions, compares waiting periods across programs, and clarifies what "shareable" actually means during different phases of membership.

What "Shareable" Actually Means (And Doesn't Mean)

What It Means

"Shareable" or "eligible for sharing" indicates that an expense may be shared by the members of Liberty HealthShare according to Liberty HealthShare's Sharing Guidelines, subject to:

• Meeting your Annual Unshared Amount (AUA - the amount you pay before expenses become eligible for sharing)
• Paying applicable co-share percentage after AUA is met
• Staying within program sharing limits
• Fair and Reasonable repricing
• Submission within 180 days
• All other program requirements

What It Doesn't Mean

"Shareable" does NOT mean:

• Guaranteed payment or sharing
• Insurance coverage
• Legal obligation for Liberty HealthShare or members to pay or share
• Specific payment or sharing timeline
• Payment or sharing of full billed amount

The Reality of Healthcare Sharing

Liberty HealthShare operates on voluntary giving principles. Sharing is facilitated based on available member contributions and number of eligible needs submitted.

You remain responsible: You’re ultimately responsible for your medical bills regardless of sharing eligibility.

Quick Answers: Pre-Existing Conditions & Waiting Periods

What is a pre-existing condition? A chronic or recurrent medical condition that exists at or prior to the enrollment date or can be reasonably expected to require medical intervention in the future.

Can I join with a pre-existing condition? Liberty HealthShare has absolute discretion to accept, reject, or modify membership applications (Liberty HealthShare Enrollment Application). Members may be accepted with pre-existing conditions, though acceptance depends on various factors, including condition severity and member sharing capacity.

When do pre-existing conditions become shareable? For most programs: Year 1: Not eligible for sharing. Years 2-3: Eligible for sharing of up to $50,000 total. Starting in month 37 of continuous membership: Pre-existing condition sharing limitations may no longer apply. Note: Pre-existing conditions are not eligible for sharing under the Liberty Freedom sharing program.

Which programs have no general waiting period? Liberty Freedom and Liberty Assist have no initial two-month waiting period for sharing eligibility for routine care. Accidents and acute illnesses are eligible for sharing immediately across all Liberty HealthShare sharing programs.

Which programs have the shortest waiting periods overall? Liberty Freedom and Liberty Assist provide eligibility for sharing immediately for most needs (with specific exceptions). Other programs have a two-month initial waiting period for routine care.

Do I need to be a member before getting pregnant? Yes. You must be a member of an eligible Liberty HealthShare sharing program for at least 6 consecutive months immediately preceding conception for maternity expenses to be eligible for sharing.

What happens if my membership lapses? Continuous membership is required for the month-37 milestone. If you cancel and later re-enroll, conditions present before the new enrollment date may be treated as pre-existing under the guidelines.

Key Takeaways

• Most programs: Pre-existing conditions not eligible for sharing in year 1; sharing eligibility is limited to $50,000 total years 2-3; pre-existing condition sharing limitations may no longer apply starting month 37
• Liberty Freedom: Pre-existing conditions not eligible for sharing
• Maternity: 6 months membership in an eligible Liberty HealthShare sharing program prior to conception required for sharing eligibility

Understanding "Pre-Existing Condition" at Liberty HealthShare

The Definition

A pre-existing condition is a chronic or recurrent medical condition that exists at or prior to the enrollment date or can be reasonably expected to require medical intervention in the future.

The 36-Month Lookback Period: Liberty HealthShare uses a 3-year lookback window. If you had any of the following within 36 months before enrollment, it's considered pre-existing:

• Signs or symptoms of a condition
• Medical treatment for a condition
• Medications prescribed for a condition
• Diagnosis of a condition

Examples

Typically Considered Pre-Existing:

• Diabetes managed with medication
• High blood pressure under treatment
• Asthma requiring inhalers
• Depression treated with medication
• Chronic conditions requiring ongoing care

May Not Be Pre-Existing:

• Conditions fully resolved more than 36 months ago with no recent symptoms or treatment
• One-time injuries that healed completely more than 36 months ago
• Conditions you had as a child but haven't required treatment for more than 36 months

The Pre-Existing Condition Timeline: Year by Year

Year One (Months 1-12): Not Eligible for Sharing

During your first full year of continuous membership, medical expenses related to pre-existing conditions are not eligible for sharing.

What this means:

• You pay 100% of costs related to the pre-existing condition
• Other new conditions that develop during membership ARE eligible for sharing (subject to other program limitations)
• Accidents and acute illnesses unrelated to pre-existing conditions are eligible for sharing
• Wellness visits, preventive screenings, and other non-pre-existing care follow normal program rules

Planning for Year One:

• Budget for out-of-pocket costs related to your pre-existing condition
• Use GetMoreRx for prescription savings (50%-95% off generics)
• Take advantage of cost comparison tools (Claritev HST Connect)

Years Two and Three (Months 13-36): Limited Sharing

After your first full year of continuous membership, up to $50,000 of the total eligible medical expenses incurred from a pre-existing condition may be eligible for sharing during the second and third years of membership combined.

Key Details:

• $50,000 is the total sharing limit for years 2 and 3 combined, not per year
• This amount still requires you to meet your AUA and pay any applicable co-share
• Expenses subject to normal program rules (Fair and Reasonable repricing, etc.)
• Sharing limitations only apply to the specific pre-existing condition, not other health needs

Example: Understanding the $50,000 Sharing Limitation

Many members mistakenly believe the $50,000 sharing limit applies per year. Here's how it actually works:

• Year 2: Member has $40,000 in eligible pre-existing condition expenses → eligible for sharing within $50k limit
• Year 3: Member has $25,000 in additional eligible pre-existing condition expenses → Only $10,000 is eligible for sharing (reaching $50k total limit)
• Member must pay remaining $15,000 beyond the cumulative sharing limit

Starting in Month 37: Pre-Existing Condition Sharing Limitations May No Longer Apply

Starting in month 37 of continuous membership, your pre-existing condition may no longer be subject to pre-existing condition sharing limitations.

What this means:

• The condition may no longer be considered "pre-existing" under Sharing Guidelines
• Eligible expenses related to this condition become eligible for sharing according to your program's standard sharing limitations
• Subject to same rules as any other condition (AUA, co-share, program sharing limitations)
• Continuous membership is required for sharing limitations to no longer apply

General Waiting Periods by Program

Programs with No General Waiting Period: Expenses incurred under the Liberty Freedom and Liberty Assist sharing programs are immediately eligible for sharing for most needs, making them the fastest options for members who are eligible to enroll in these programs needing immediate sharing eligibility (with noted exceptions for cancer care under Liberty Freedom and pre-existing conditions).

What "2-month waiting period" after enrollment means:

• Immediate (Day 1): Expenses for accidents, acute illnesses, injuries are eligible for sharing
• After 2 months: Expenses for doctor visits, wellness care, preventive screenings are eligible for sharing

Always Immediate (All Programs):

• Well-baby visits through 13 months (includes immunizations, not subject to AUA)
• Newborns added to membership within 60 days of birth

Maternity Waiting Period: The 6-Month Rule

Maternity has its own specific waiting period separate from general and pre-existing condition timelines.

The Rule

The mother must be a member in an eligible Liberty HealthShare sharing program for at least 6 consecutive months immediately preceding conception for maternity expenses to be eligible for sharing.

Key Details:

• Conception date is verified through medical records
• 6-month membership must be completed before conception occurs
• Sharing limit: Up to $125,000 per pregnancy
• Maternity expenses are not eligible for sharing on Liberty Rise, Liberty Freedom, or Liberty Assist programs
• Must add newborn to membership within 60 days of birth for sharing eligibility

Planning for Pregnancy

If actively trying to conceive: Join an eligible Liberty HealthShare Sharing Program at least 6 months before you anticipate conception. Many members join 9-12 months in advance for safety margin.

If already pregnant when considering membership: Conception before membership start date makes maternity expenses ineligible for sharing.

Cost-Saving Tools During Waiting Periods

GetMoreRx: 50%-95% savings on generic prescriptions at 56,000+ pharmacies

Claritev HST Connect: Compare providers, see pricing and quality ratings, and more

DialCare: Telehealth access for minor illnesses and follow-ups; pricing varies by program

Strategic Planning with Pre-Existing Conditions

If You Have a Pre-Existing Condition

Before Joining:

• Honestly assess condition severity and costs
• Calculate potential financial costs for year 1
• Verify you can afford maintenance care without sharing
• Research prescription costs and available discounts
• Understand the 37-month timeline to sharing limitations no longer applying
• Note: Liberty Freedom does not offer member sharing for pre-existing conditions

After Joining:

• Use GetMoreRx immediately for medication savings
• Build relationship with PHCS providers who accept Fair and Reasonable pricing
• Track your pre-existing condition expenses separately
• Maintain continuous membership
• Plan financially for the gradual increase in sharing eligibility

Year-by-Year Strategy:

• Year 1: Focus on cost management, not sharing
• Years 2-3: Track toward $50,000 sharing limit, prioritize most expensive treatments
• Month 37+: Full program sharing eligibility may become available for the condition

If You're Planning for Pregnancy

Timing is everything:

• Join an eligible Liberty HealthShare sharing program at least 6 months before attempting conception
• Many members join 9-12 months early for safety margin
• If you conceive before the 6-month membership mark, maternity is not eligible for sharing
• Conception date verified through medical records

If You Need Immediate Sharing Eligibility

Best program options:

• Liberty Freedom (under 35): No general waiting period, but note: pre-existing conditions not eligible for sharing; cancer care requires symptoms/signs beginning after joining + 12 consecutive months in good standing (Liberty HealthShare Sharing Guidelines)
• Liberty Assist (only for those 65+ with Medicare Parts A and B): No waiting period; no pre-existing condition limitations

What's eligible for sharing immediately:

• Accidents
• Acute illnesses and injuries (new, not pre-existing)
• New conditions that develop after enrollment

Do This to Avoid Surprises

• Honestly disclose all conditions with treatment/symptoms/medications in past 36 months
• Budget for year 1 medical costs for pre-existing conditions
• If planning pregnancy, join at least 6-9 months before attempting conception
• Verify which program best suits your health situation

After enrolling:

• Maintain continuous membership (required for month-37 milestone)
• Use cost-saving tools (GetMoreRx, Claritev HST Connect)
• Track pre-existing vs. new condition expenses separately
• Submit all bills within 180 days
• Communicate with Member Services about what is and isn’t eligible for sharing

Common mistakes to avoid:

• Assuming "controlled" conditions aren't pre-existing (if treated within past 36 months, they are)
• Thinking the $50,000 sharing limitation means $50,000 per year (it's total for years 2-3 combined)
• Joining while pregnant expecting maternity sharing eligibility (6-month rule applies before conception)
• Canceling and re-enrolling (may reset pre-existing condition timelines)
• Expecting month 37 means all medical costs are eligible for sharing (you still pay AUA and co-share before sharing eligibility)

Get Help: Call Member Development at 855-585-4237 to clarify which expenses relate to pre-existing conditions or discuss your specific situation before enrolling.

The Bottom Line

Healthcare sharing works best for new, unexpected medical needs. Pre-existing conditions represent ongoing, anticipated costs that require different planning.

Liberty HealthShare's approach:

• Transparent about sharing limitations upfront
• Provides path where sharing limitations may no longer apply (37 months for most programs)
• Offers cost-saving tools during waiting periods
• Has discretion in membership acceptance decisions
• Liberty Freedom does not offer sharing for pre-existing conditions

Best results when:

• You join with realistic expectations about what "shareable" means
• You can afford year 1 medical expenses for pre-existing conditions
• You maintain continuous membership
• You use all available cost-saving resources
• You plan strategically toward the 37-month milestone

Not ideal if:

• You need immediate, comprehensive sharing eligibility for expensive pre-existing conditions
• You cannot afford year 1 medical expenses for pre-existing conditions
• You have multiple high-cost pre-existing conditions
• You cannot commit to 3+ years of continuous membership
• You're considering Liberty Freedom with pre-existing conditions (not eligible for sharing)

Understanding waiting periods and pre-existing condition rules before joining helps ensure healthcare sharing aligns with your health needs and financial situation. Rules vary widely across healthcare sharing ministries—always check lookback windows, waiting periods, and sharing limitations before joining any program.

Don't just take our word for it—our members have a lot to say!

What Changed Recently:

• Pre-existing condition sharing structure remains consistent: 3-year timeline for most programs
• 36-month lookback period unchanged
• $50,000 sharing limitation combined for years 2-3 limit unchanged
• General waiting periods by program remain as outlined
• Liberty Freedom does not offer sharing for pre-existing conditions

Critical Disclaimer: Liberty HealthShare is not an insurance company nor is it offered through an insurance company. Liberty HealthShare's Sharing Programs do not guarantee or promise that a member's medical bills will be paid or assigned to others for payment. Whether anyone chooses to pay a member's medical bills will be totally voluntary. As such, Liberty HealthShare's Sharing Programs should never be considered as a substitute for an insurance policy. Whether a member receives any payments for medical expenses and whether or not Liberty HealthShare continues to operate, the member is always liable for any unpaid bills.

For more information about Liberty HealthShare programs, pre-existing conditions, and waiting periods, visit www.libertyhealthshare.org or call 855-585-4237.