Expiration Date - The day the member is no longer effective.
AUA - Annual Unshared Amount.
The amount of medical expense eligible for sharing must exceed an annual accumulative amount assigned for each single, couple or family membership. The annual amount shall be calculated upon each member’s Enrollment Activation Date until his or her next annual renewal date or program level change. All eligible medical expenses that exceed the applicable AUA shall then be subject to the program limits per incident selected by the member.
Liberty HealthShare encourages our members to see their Primary Care Physician or provider yearly to maintain their health and well-being. After the first two months of membership, an annual preventative wellness visit and related lab work for which there are no medical symptoms or diagnosis in advance are eligible for sharing, up to a maximum of $400 of the fair and reasonable charges as determined by Liberty HealthShare and not subject to the AUA nor subject to guideline limitations for medical expenses $200 or less.
Well baby visits including immunizations are eligible for sharing
within the first 13 months after birth and not subject to the AUA
or the two-month waiting period.
Any new condition based on symptoms discussed during a preventative wellness visit and any additional diagnostics or labs that are ordered to determine treatment may be shareable according to Sharing Guidelines and are subject to the AUA.
- a. The following preventative screenings are not subject to the AUA:
- i. Screening pap smears are eligible for sharing once every year.
- ii. Screening mammograms, PSA tests, and Cologuard® are eligible for sharing once every two years up to and including age 49.
- iii. Screening mammograms, PSA tests, and Cologuard® are eligible for sharing once every year for members 50 years of age and older.
- b. The following screenings are eligible for sharing and are subject to the AUA:
- i. Screening colonoscopies and bone density screenings
- ii. Ultrasound/MRI/Thermogram screening conducted in lieu of a screening mammogram
- iii. All diagnostic screenings
- Liberty Unite: Up to $1,000,000 (per incident) of fair and reasonable eligible medical expenses are shareable after AUA has been met. There is no co-share.
- Liberty Connect: Up to $1,000,000 (per incident) of fair and reasonable eligible medical expenses are shareable after AUA has been met. Member pays a 15% co-share.
- Liberty Essential: Up to $600,000 (per incident) of fair and reasonable eligible medical expenses are shareable after AUA has been met. Member pays a 25% co-share
- Liberty Assist: Up to $100,000 (per membership year) of fair and reasonable eligible expenses are shareable after AUA has been met and secondary to Medicare Parts A and B.
- Liberty Rise: Up to $50,000 (per membership year) of fair and reasonable eligible medical expenses are shareable after Unshared Amount per Visit has been met.
|Medical Expenses Eligible for sharing
||Unshared Amount Per Visit
||Maximum Sharing Limit
|Primary Care Physicians
|In-/Outpatient Surgeon Fees*