Sharing Guidelines Are Changing

← Back to Blog April 10th, 2017 Tags: account-updatessharing-guidelinesmember-vote

This past week, the following message was distributed to Liberty HealthShare members by e-mail.

Each year, we invite Liberty HealthShare members to cast their vote on possible changes to our Sharing Guidelines. On March 1st, we distributed information and instructions for this year's annual member vote. If you took the time to voice your opinion on the three potential amendments to our Sharing Guidelines, thank you. We are grateful for you, our members, and we value your opinion on the future direction of our ministry.

As we mentioned in the initial member vote e-mail, Liberty HealthShare is a 501(c)3, nonprofit organization, and as such, our ministry is led by a board of directors. Following the closing of the member vote, our board of directors met to consider the results and discuss any further clarifying language that should be added to the Sharing Guidelines. This message is to inform you of the outcome of the vote and to detail how the accompanying changes will impact eligible and ineligible medical costs related to your sharing membership.

8772 members responded to the three questions below with the following results:

  1. Shall we create a 60-day waiting period for new members before they may submit medical expenses for sharing (excepting certain specific conditions)? Yes - 75% and No - 25%
  2. Shall we cap the shareable portion of wellness exams/physicals at $400 of fair and reasonable charges? Yes - 62% No - 38%
  3. Shall we limit sharing of prescriptions to Tier Four pharmacy costs within the first 45 days after acute illness? Yes - 65% No - 35%

The results of the member vote and our board's deliberation are the following changes, which can be found in section IV. Member Medical Expenses of the Sharing Guidelines.

  • guideline IV. C 2. First 60 Days of Participation
  • guideline IV. C. 20 Screening and Wellness
  • guideline IV. C. 18 Prescription Drug

Please note: There are also changes to definitions and descriptions of Preexisting Conditions, how we handle Excess Charges from doctors and facilities, requirements for members to Pre-Notify Liberty HealthShare for impending larger expenses, and some new ways we address the complicated issues of supporting less proven medical interventions (Partial Sharing). Please be sure to review those sections, as they may affect you.

The updated Sharing Guidelines are now available and will go into effect as of May 1st, 2017.

Again, we want to thank you for your membership and for contributing your voice as we seek to serve our membership with wisdom and care. We are a community of self-pay patients in a healthcare market that is geared to distance us from the true cost of our care. We have made the decision to exercise our freedom from insurance, and with that freedom comes the responsibility to be engaged patients and to steward our own resources and those of this community. Our Sharing Guidelines are designed to encourage this mindset.

Each day, our staff receive calls and e-mails from members and healthcare providers seeking clarity concerning our guidelines. We ask you to review the above changes within the new Sharing Guidelines document so you understand the way in which we share in eligible medical costs. Please note, you can always access the Sharing Guidelines on the Liberty HealthShare website, under "Resources". If you have any questions about how these guideline changes will affect you, don't hesitate to call Member Services at 855-585-4237.

*PLEASE NOTE: AS THE GUIDELINES UNDERGO REVIEW AND CHANGES FOLLOWING EACH YEAR'S MEMBER VOTE, THIS INFORMATION MAY NOT BE THE MOST CURRENT. BE SURE TO REVIEW THE SHARING GUIDELINES TO OBTAIN THE MOST CURRENT INFORMATION.