Samaritan Ministries

Section VI	Table of Contents	Section VIII
VII. Needs for Conditions Existing Prior to Membership Expenses for any medical service/treatment provided during your membership which meets these Guidelines are publishable while you are a member in good standing except as explained below or as otherwise agreed prior to membership. A. Twelve Months Symptom and Treatment Free A member must go twelve months without symptoms, treatment, or medication for any conditions that existed prior to membership. Tests or a doctor’s statement may be required to verify a cure. Exception: For Congenital Defects you need not show the condition was cured to qualify for publication. (Section VIII:A) B. Exception for Cancer, Diabetes and Heart Conditions Needs resulting from heart conditions, cancer, or diabetes that existed prior to a membership will not be published even though the member went twelve months without symptoms, treatment, or medication. Be aware that even though a condition may appear at one time to have been cured, there could be a subsequent relapse or complication which is a result of the original condition. If there is a question whether a member’s need is the result of a previous heart condition, cancer, or diabetes, the burden will be on the member to demonstrate the lack of a connection. Exception: High blood pressure will not be considered a “condition existing prior to membership” even if you have not gone twelve months symptom free, as long as you have not been hospitalized for high blood pressure in the past, and you are able to control the condition through medication or diet. Medication for treatment as a chronic condition will not be published. C. Organ Transplants and Pre-Existing Conditions Expenses for organ transplants will be published only if a problem was not evident prior to your membership. D. Twelve Month Waiting Period for Certain Conditions Expenses during the first year of membership from tests, medication, treatments or surgery occurring for back problems, bunions, foot disorders, carpal tunnel syndrome, hernia, hemorrhoids, prostate conditions, sleep apnea, and temporomandibular joint will not be published. After the first year of membership, eligible expenses for treating these conditions will be published if a doctor and the member verify either that the member was symptom free of the condition for at least twelve continuous months after becoming a member, or for the twelve month period immediately prior to becoming a member. E. Time Limit for Submitting Documentation Original bills for the incident you want published must be submitted within one year of treatment. Bills submitted more than a year after treatment will not be published.
Section VI	Table of Contents	Section VIII

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