As we announced on July 25th, effective September 1, 2018, Solidarity HealthShare has revised its Sharing Guidelines, adding several new features. These are just a few highlights, but you can find all of the Guidelines here.
New Program Names (See Guidelines Section III)
- Solidarity Premier (formerly Solidarity Whole): our most comprehensive program, allowing Members to share eligible medical expenses up to $1 million per incident. (See Sixty-Day Wait, VI.C.11.)
- Solidarity Plus (formerly Solidarity Extend): allows Members to share eligible medical expenses up to $125,000 per incident. (See Sixty-Day Wait, VI.C.11.)
- Solidarity Primary (formerly Solidarity First): allows Members to share 70% of eligible medical expenses up to $125,000 per incident. (See Sixty-Day Wait, VI.C.11.)
Eligible dependents (See Guidelines Section IV.E.2.)
An unmarried dependent child who is twenty (20) through twenty-six (26) years of age may participate, upon verification, in his or her parent/guardian’s Sharing Membership only if he/she is a full-time student, assigned to a multi-month church-related mission or internship, or actively discerning the priesthood or religious life.
New and modified services eligible for sharing (See Guidelines Section VI.A.)
- Alternative and/or Integrative Treatments Alternative and/or Integrative Treatments are eligible for sharing if such treatment meets certain criteria.
- Braces New and replacement braces of the leg, arm, back, neck, or artificial arms or legs, if there is sufficient change in the Sharing Member’s physical condition to make the original device no longer functional.
- Cosmetic Procedures Cosmetic care and treatment provided for disfiguration caused by amputation, disease (including Acne), accident, or breast reconstruction following a mastectomy are eligible for sharing.
- Eating Disorder Eating disorders are eligible for sharing under the Mental Health Services (see VI.A.15.).
- Fertility Expenses for Fertility treatments relating to the restoration or healing of the reproductive system in order to support procreation in the marital act (see NaPro Technology VI.A.16).
- Home Health Care Skilled care services at home by a Home Health Care Agency for each related medical incident provided such home care reduces the expected medical expense and replaces hospital or nursing home services.
- Hospice Care Hospice Care is limited to thirty (30) days of respite and/or comfort care in any 30-day period.
- Hysterectomy Expenses related to a Hysterectomy if it is medically necessary and approved by the Solidarity HealthShareSM Ethics Board. The Sharing Member must pre-notify Solidarity HealthShareSM prior to surgery, unless it is a medical emergency.
- Immunizations Immunization and vaccinations unless the vaccine is derived from aborted fetal tissue and an alternative pro-life vaccine exists (see https://cogforlife.org/).
- Mental Health Services Expenses for office visits, treatment, medication, and emergency hospitalization are eligible for sharing up to twenty (20) visits per membership year for psychiatric or psychological counseling, diagnosed and prescribed by a physician.
- NaPro Technology Expenses for NaPro Technology, which includes evaluation, treatment, therapies, surgeries, education and supplies.
- Natural Family Planning/Fertility Awareness Based Methods Expenses for individual instruction and the initial supplies on approved fertility awareness-based methods, also known as Natural Family Planning. Such approved methods include, but are not limited to, Creighton, Couple to Couple League, Billings, Family of the Americas, SymptoPro, and Marquette.
- Naturopathic Care
- Physical Therapy Up to twenty (20) visits per membership year.
- Prescription Drugs Prescription drugs and supplements, including, but not limited to, phytotheuraputics, vitamins, herbs, and approved drugs are eligible for sharing ninety days (90) days before and after each related medical diagnosis or incident. Also, refer to Solidarity PharmacySM Program for discounts on recurring prescription drugs.
- Sterilization Reversal Reversal of a tubal ligation or vasectomy but limited to one reversal attempt only.
- Therapies Other therapies such as occupational, respiratory, and speech therapy by a licensed therapist in accord with a Physician’s order to improve function are eligible up to twenty (20) visits per membership year.
- Wellness Visits All well-baby visits up to 24 months; 1 per year after 24 months.
Not Eligible for Sharing (See Guidelines Section VI.B.)
- Artificial Insemination and In vitro Fertilization
- Non-Emergency Transportation Expenses resulting from transportation by ambulance for conditions that will not seriously jeopardize the Sharing Member’s health or life. Also, the additional expense for transportation to a facility that is not the nearest facility capable of providing medically necessary care.
- Sterilization Expenses for direct surgical sterilization, including vasectomy and tubal ligation are not eligible for sharing.
- Surrogacy Medical expenses for surrogacy.