Major Medical Needs
HealthShare Membership supports major medical events. A medical need is any situation that requires you to seek medical assistance. These needs can arise in different ways.
First, there are life-threatening events that require immediate attention, such as an ambulance ride to save life or limb.
Second, there are less severe but unexpected injuries that still require professional medical care.
Medical needs can include initial doctor visits, medical screenings, x-rays, MRIs, specialist consultations, surgeries, medications, physical therapy, or anything necessary to restore you to full health.
Understanding Medical Needs
Understanding what a major medical need is and how a HealthShare community supports you is essential for a few reasons:
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What is shareable: Knowing what qualifies as a major medical need allows you to identify when to submit a sharing request with your HealthShare community. Whether it’s an unexpected accident, a surgery, or maternity care, recognizing these situations ensures you can promptly submit a sharing request to find support for your medical expenses.
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Sharing Request Period: HealthShare communities require you to submit a request on a per-need basis. Each major medical event, such as doctor visits, hospital stays, or surgeries, can generate significant costs. By understanding these needs, you can ensure your request and bills are submitted within the required six-month timeframe.
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Maximizing Financial Support: With no lifetime limit on eligible expenses, your HealthShare community can support you through multiple medical events. Whether it’s routine care or a serious incident, understanding when and how to submit a request ensures you get the assistance you need.
Staying informed helps you take full advantage of the support HealthShare offers during major medical events. Here are a few examples.
Example 1: Life-Threatening Event
John was enjoying a day hiking in the mountains when he suddenly slipped and fell from a steep ledge, severely injuring his leg. Unable to move, he required immediate medical attention, and a helicopter ambulance was dispatched to the scene. John was rushed to the nearest trauma center, where emergency surgery was needed to save his leg.
As a HealthShare member, John’s major medical need and subsequent sharing request was supported by the community. His emergency transportation, surgery, hospital stay, and post-operative care, including follow-up visits, medication, and physical therapy, were all part of the sharing process, after his IUA was met. John submitted his medical bills and receipts to the HealthShare via his member portal, and the costs were shared among the members. This allowed John to focus on his recovery without the financial burden of his life-threatening accident.
Example 2: Unexpected Injury
Sarah was walking in her neighborhood when she tripped over an uneven sidewalk, causing her to badly sprain her ankle. Though not life-threatening, the injury required medical attention. Sarah visited her primary care doctor, who referred her for x-rays and an MRI to check for further damage. After confirming the severity of the injury, Sarah was prescribed medication and physical therapy to help her heal.
As part of her HealthShare membership, Sarah’s major medical need and sharing request were processed after she met her IUA amount. She submitted her bills and receipts from her doctor’s visits, imaging, and therapy, which were then reviewed and shared by the HealthShare community. With her medical expenses covered, Sarah was able to focus on recovering without financial stress.