Like most other healthshare programs, DPC DIRECT imposes a waiting period before the cost of treating most pre-existing conditions becomes shareable.
Specifically, there’s a 24-month “lookback” period for pre-existing conditions. If you’ve been treated for a pre-existing condition within the last 24 months, then the following sharing limitations will apply:
First 12 months of membership: Costs for pre-existing conditions are not shareable.
Months 13-24: Costs for treating pre-existing conditions are shareable up to $25,000.
Months 25-36: Costs for treating pre-existing conditions are shareable up to $50,000.
Months 37 and beyond: Costs for treating pre-existing conditions are shareable up to $125,000.
Exceptions apply for high blood pressure, high cholesterol, and diabetes. For details, contact your Personal Benefits Manager.