Welcome to MPB Health!

We are very happy to have you in our community! Congratulations on making the decision to take care of your health! Our health plan "SAÚDEMAX" works in a simple and accessible way. Our model is designed especially for the Brazilian community in the United States, serving everyone, regardless of their Social Security status. With HEALTHEMAXyou will have the financial support to deal with planned or unforeseen expenses.

How does it work?

It's very simple! Imagine it like car insurance: you pay a fixed monthly fee every month. When you need medical attention, you pay an initial amount, called a UA (Unsharable Amount). This is the amount you cover directly before the plan covers any medical expenses. The initial amount is paid per incident, for example:

Your child falls and breaks his arm, totaling $30,000 dollars for surgery, you only pay the initial amount of $1,500 dollars and the rest is covered by the plan. If another incident occurs during the same year, you pay the initial cost again, but best of all, under our plan you pay a maximum of 2 initial values (AUs) per year. In other words, even if you need several medical appointments (for the same incident), after paying these two initial amounts, the rest of the costs will be shared, and you won't have to worry about any more large expenses.

The initial amount (UA) must be paid within 6 months of the date of the service.

It is important to read and understand the guidelines well to be aware of any exclusions.

With the HEALTHEMAXYou'll have the peace of mind to organize your finances and focus on what matters: your health and well-being.

We are here to take care of you. Welcome to a new way of protecting your health economically, safely and efficiently!

Eligibility for the Plan

1. Compliance with the Principles and Guidelines of MPB Health and its HealthShare partners.
2. Participation in the plan and community through a monthly contribution.
3. Residence in the United States, in states where MPB Health services are available.
4. Under 65 years of age.

Principles of the Plan

Each member of the MPB Health must meet the following requirements in order to join and maintain their plan and remain eligible to participate in the Health Share program and related services. Adhering to the Plan Principles reduces medical risks, promotes good health practices and guarantees the integrity and responsibility of members. All members must agree to the following statements:

• I believe that a community of ethical, health-conscious people can take care of each other more effectively by directly sharing the costs associated with each other's health expenses.
• I recognize that MPB Health and its partners have a responsibility to higher principles.
• I welcome members of all faiths. I understand that MPB Health and its partners is a benevolent organization, not an insurance entity, and cannot guarantee payment of medical expenses.
• I commit myself to practicing good health measures and pursuing a balanced lifestyle. I agree to abstain from the use of any illicit or illegal drugs, as well as excessive alcohol consumption and practices harmful to the body.
• I have an obligation to take care of my family. I believe that mental, physical, emotional or any other kind of abuse against a family member or any other person is morally wrong. I pledge to always treat my family and others with care and respect.
• I agree to submit to mediation and, if necessary, binding arbitration for any dispute with MPB Health or its affiliates.

Commitment

Members of the programs offered by MPB Health undertake to follow the personal standards defined in the Principles, Guidelines and Rules. A medical need may be suspended if a violation of the plan's Principles is identified when reviewing the medical records submitted by the member. This suspension will begin as soon as the violation is discovered or recorded in the member's medical documents. MPB Health and its partners will send a notification and explanation to the member within 30 days. The member will have 30 days to submit documentation proving their compliance with the Principles of the plan. If the documentation submitted does not satisfactorily meet the Principles of the plan, the plan will be canceled as of the date the violation was identified.

Participation through Contributions

Members must make the monthly payment corresponding to the initial value level chosen and agree to the Principles of the plan in order to begin participating in the programs offered by MPB Health and its partners.

All contributions from members are voluntary, but it is necessary for monthly payments to be up to date in order for medical needs to be processed. Monthly contributions must be received within 30 days of the due date. If they are not paid within this period, the association will be considered inactive. The due date coincides with the day of the month in which the membership becomes effective.

MPB Health offers different types of plans for individuals and families. The amount of the monthly contribution is determined based on the size of the family, tobacco use and the initial amount, Unshared Amount (UA).

Declaration of Residence

MPB Health members must reside in the United States and notify MPB Health within 15 days if they move outside the country. For members who turn 65, the plan will be terminated on the first day of the month following their 65th birthday. Medical needs must be submitted within 30 days of the plan termination date.

Defining the Family Plan

There are three plan levels, based on the number of people in the family:

• Level 1: Member Only: An individual member between the ages of 18 and 64.
• Level 2: Member & children or member & spouse: An individual between the ages of 18 and 64 and one of the following options: spouse/domestic partner or children.
• Level 3: Family: An individual between the ages of 18 and 64 with a spouse and child(ren).

Spouse/Domestic Partner

A domestic partner is an unrelated, unmarried person who shares the same household with the Primary Member and lives in a relationship not legally defined as marriage by the member's state of residence. A spouse is a significant partner in a marriage recognized by the state. This can also apply to civil unions or common law marriages in specific contexts.

Children

An unmarried child under the age of 26 can participate in the family plan with the Principal Member. The Principal Member is responsible for ensuring that each individual participating in the family plan complies with the Guidelines and Principles. When a child turns 26 or gets married, they can no longer participate in the family plan. To ensure continuity of the plan, the child must re-enroll individually within 30 days of being removed from the family plan.

Adoption

MPB Health and its partners consider adopted children in the same way as biological children in relation to the plan. An adopted child cannot be added to the plan before birth, and the plan start date for newborns cannot be earlier than seven days after birth. Any genetic condition or complication for newborns that does not arise from an Eligible Maternity medical need will be considered a pre-existing medical condition and will be subject to the same limitations defined in the pre-existing medical conditions section.

Grandchildren

A grandchild (or grandchildren) can be included as part of their grandparents' family plan, provided they meet the following criteria:

1. The grandparents have legal custody of the grandchild.
2. The grandchild lives with their grandparents for at least nine months of the year.
3. No other group, agency or person is responsible for the grandchild's medical needs.

Tobacco

MPB Health members, or households with one or more tobacco users, must pay a higher monthly surcharge to maintain the plan. The surcharge is $100 per family. A member, or one or more members of a household, who has used any tobacco product at least once in the past year is considered a tobacco user. Tobacco products include, but are not limited to, cigarettes, cigars, chewing tobacco, snuff, pipe tobacco and products inhaled by vape, hookah and similar devices.

When home tobacco users have not used tobacco products for more than 12 months, the surcharge can be removed on presentation of documentation from a responsible doctor confirming abstinence.

Plan Cancellation Request

The request must be made via our form on the website and include the reason for the cancellation and the month in which the cancellation of the plan is due to take effect. The member must provide notice at least 15 days prior to the expiration date. MPB Health does not issue pro-rata refunds or credits for cancellations. Cancellation requests become effective the following month.

Active Plan

The plan is considered active when members pay their monthly contributions on time and are in compliance with the requirements of MPB Health and its partners. In order for a Medical Necessity Request to be processed, the plan must be active in the following situations: during the date(s) of service, when MPB Health and its partners receive the medical bills, and when the Unsharable Amount (UA) is paid. The Medical Needs Request may become ineligible if the plan becomes inactive before these three criteria are met.

Submitting a Payment Request

Medical Necessity Claims for Payment are submitted by members on a per medical incident and per person basis. Each claim covers related and eligible medical expenses resulting from treatment deemed medically necessary and performed by licensed professionals and institutions, such as doctors, emergency rooms and hospitals.

Requests for Medical Needs subject to the Unshared Amount (UA)

All eligible medical expenses are subject to the Initial Value (UA). This includes maternity, unexpected medical events and care related to pre-existing conditions after the first year of membership.

Processing Payment for Medical Needs Claims

MPB Health and its partners strive to process Medical Needs Requests quickly. Payment of funds for these requests can occur in a number of ways:

• Down payment: Prepayment for services not yet performed.
• Directly with members: The funds are sent directly to the member.
• Directly with the providers: The funds are paid directly to the service provider.
• Instant debit cards: The funds are made available to the member via an electronic debit card.

Deadlines for Medical Needs Requests

Eligible medical expenses related to a Payment Request must reach the Unshared Amount (UA) within six months.

• Once eligible, the application will remain open for as long as there is a continuing need, provided there is no more than a six-month gap between the related expenses. After this interval, a new application will have to be submitted.
• Original, itemized medical bills must be submitted within six months of treatment. Bills submitted after this period may be subject to limitations, such as interest, late penalties or loss of discounts for late submission of documents.
• MPB Health must be provided with proof of all payments that have contributed to the Initial Value (UA) being met. Community funds will only be made available once MPB Health and its partners have received documentation proving that the Initial Value (UA) has been met.

Sending Medical Requests

• Medical requests should be sent to MPB Health as soon as possible.
• For non-emergency procedures, such as surgery, the request must be made before the appointment.
• The documentation required includes, but is not limited to:
  • Detailed medical bills;
  • Notes from the service provider;
  • Proof of payment of the Initial Amount (UA) Or proof that the amount is being paid in installments to the service provider or hospital.

Determination of Medical Claims for Sharing/Payment

The determination process is carried out by the MPB Health team and its partners, who evaluate applications based on the eligibility guidelines described in the rules and the member's guide. All submitted documentation will be reviewed and analyzed to validate your eligibility.

Maximum Shared/Paid Amount

There are no annual or lifetime limits on Medical Sharing Requests. However, some medical expenses may be subject to specific limits, in accordance with the Membership Guidelines and rules, either per request or during the duration of membership.

Payment Limits for Sharing Medical Claims

Some Sharing Requests, such as alternative treatments and recovery services, will have a sharing limit after the Initial Amount (UA) is reached. All limits will be clearly described in these member guidelines and may be based on a lifetime limit or per Sharing Request. The limit covers costs up to the specified amount for accumulated medical expenses. Some memberships also include limits for other services, such as preventive care.

Initial Value Protection Limit - Multiple Requests for Shared Medical Needs

The "protection limit" sets a ceiling for households facing more than two eligible Sharing Requests in a rolling 12-month period. Each household membership will be responsible for only two (2) Initial Amounts (UA) in a 12-month period, counting from the first date of service of each Request for Sharing. In the event that a household reaches two (2) Initial Amounts in a rolling 12-month period, MPB Health and its partners will share the additional amounts of eligible Sharing Requests in excess of $1,500, without the liability of a new Initial Amount UA.

Applying for Self Pay Discounts (Cash Patient)

Members can submit Medical Necessity Sharing Requests before or after receiving medical services. In all cases, members must present themselves as self-pay (cash patient) and communicate costs and discounts to MPB Health as soon as possible. It is the members' responsibility to apply for direct payment discounts and to provide the necessary documentation for Sharing Requests.

Insurance, Third Party Administrators and Government Assistance Plans

If an MPB Health member also has coverage by relevant insurers, third-party administrators or government assistance plans, these entities will be primarily responsible for payment of the member's medical expenses. Members must submit a Sharing Request informing MPB Health of their coverage by insurers, third-party administrators or government assistance plans, and these entities will be primarily responsible for payment.

After final payment by the primary insurance, third-party administrator or government plan, MPB Health will review the remaining expenses to determine eligibility for sharing. Failure to provide coverage information may result in ineligibility for cost-sharing. Primary payment includes, but is not limited to, any form of coverage through a non-member spouse, family member, employer or government entity. If you have primary insurance, MPB Health will act as a secondary payer, and some expenses not covered by insurance may be eligible. Exceptions for maternity-related Sharing Requests can be made - please contact MPB Health prior to your provider appointment.

Pre-existing Medical Conditions Prior to Plan Membership

Members of MPB Health and its partners have a waiting period for medical conditions that existed before the start date of the plan. A limitation for pre-existing medical conditions is applied based on the first active membership date of the plan.

Any illness or injury for which a person has experienced any of the following within 24 months prior to the date of commencement of membership of the plan is considered a pre-existing condition:

• It was examined
• Took medication
• Symptoms
• Received medical treatment
• Pre-Existence for Cancer
  Any examination, preventive or prophylactic treatment or medication carried out by the member in the 36 months prior to the start date of the association related to a previously diagnosed cancer will cause a recurrence of that type of cancer to be considered a pre-existing condition.

Exceptions that are not considered pre-existing

High blood pressure, high cholesterol, hyperthyroidism, hyperthyroidism, hypothyroidism and type 2 diabetes will not be considered pre-existing conditions, as long as the member has not been hospitalized to treat these conditions in the past. 12 months prior to enrollment in the plan.

Adjustment Period for Pre-Existing Conditions

Pre-existing conditions have an adjustment period, in which sharing (payment for medical needs) is limited. Members have a waiting period of one year from the date of initial enrollment before pre-existing conditions are eligible for sharing/payment. After the first year, sharing requests related to pre-existing conditions become eligible with a sharing limit that increases with each year of membership.

Eligible amounts for pre-existing conditions:

Year One: $0 (waiting period)
Year Two: Maximum of $30,000 per requirement
Year Three: Maximum of $60,000 per requirement
Year FourMaximum of $150,000 per requirement
Year Five: The sharing/payment limit is removed for all pre-existing conditions.

Medical Records Addenda

MPB Health and its partners may request medical records to assist in the determination of a Medical Necessity Sharing and Payment Request. After the requested medical records are reviewed and a decision is made, addendums to the medical records will only be considered when combined with an official addendum from the applicable provider. The addendum must be separate and include all of the following:

Signature of applicable provider
Date of signature
Description of what was changed
Reason for change.

Treated as Pre-Existing Conditions for Medical Needs Payment Claims 
The conditions and treatments listed below are eligible after the initial waiting period for pre-existing conditions:

Arthritis
Cataract
Celiac disease
Ear therapies (tubes)
Hashimoto's disease
Hormone therapy
Chronic Pain
Chronic fatigue
Irritable bowel syndrome
Long-Covid
Lyme disease
Preventive Mastectomy
Mold Toxicity
Osteoporosis
Platelet Rich Plasma Therapy (PRP)
Sleep Apnea
Stem Cell Therapy
Treatment for Non-Seasonal Allergies
Basal and Squamous Cell Cancer
Whether new or existing, basal cell or squamous cell cancer is considered eligible.

Congenital disorders
Eligible without limitations, if unknown before the start date of the plan, and the treatment is medically necessary or in an emergency.

Fusion therapies
Eligible without limitations if treatment is medically necessary due to an acute injury while the limb is active.

Joint replacements
Eligible without limitations if treatment is medically necessary due to an acute injury while the limb is active.

Parasites
Eligible without limitations if related to an approved Sharing Request and considered life-threatening.

TMJ (Temporomandibular Joint) Disorders
Surgical treatment for TMJ correction is eligible after the initial waiting period for pre-existing conditions. Therapeutic and non-surgical treatments are not eligible.

Tonsil removal
Eligible without limitations if related to an approved Sharing Request and considered life-threatening.

Specific Limits for Sharing Requests

The limits below describe the sharing concessions subject to the Initial Amount (UA). Certain requests will have a maximum limit per Sharing Request or over the duration of the plan.

Allergy Treatment: After the initial waiting period, you are eligible with a one-time limit of $2,000 to treat or reverse the long-term effects of the allergy.

Alternative Diagnostic Tests: Eligible after the initial waiting period, with a single limit of $2,000 for non-acute conditions such as gut health, fatigue, skin conditions and hormones.

Home Care: Expenses are eligible when prescribed by a licensed physician, with a limit of $3,000 per Sharing/Payment Request.

Hormone Therapy: Eligible after the initial waiting period, with a single limit of $2,500.

Injections: Eligible with a limit of $5,000 per Sharing Request. Includes therapies such as PRP, nerve blocks, and stem cells, but excludes gender transition.

Medical Supplies: Medical Supplies assisting in the treatment or recovery of an eligible Sharing/Payment Request are shared for up to 120 days after the start of treatment, with a minimum cost of $50 per item and a limit of $1,000 per Sharing/Payment Request.

Orthoses: Eligible with a single lifetime limit of $1,000.

Recovery Therapies: These include physiotherapy, chiropractic, acupuncture, occupational therapy and hyperbaric treatments, with a limit of $3,500 per Sharing Request.

Sleep Apnea: Eligible after the initial waiting period, with a single limit of $2,000.

Additional Sharing Requests for serious conditions will be analyzed on a case-by-case basis, with limits adjusted for recovery from debilitating conditions such as heart attacks, strokes or cancer.

Additional Information for Certain Sharing/Payment Requests

Some Share/Payment Requests require additional information due to specific limitations or definitions.

Acute allergic reactions
Each reaction requires a separate Sharing Request and a separate Initial Value (UA). As a result, acute allergies, such as food allergies and reactions, are not considered pre-existing conditions.

Alternative Medicine
Sharing requests for alternative treatments with non-traditional providers (except MD, DO, NP, RN, DC, APRN, Ophthalmologist or DPM) require prior written approval from MPB Health and its partners.

Alternative treatments
Sharing requests for alternative treatments are assessed equally compared to the equivalent conventional treatment. If the member opts for an alternative treatment and returns to conventional treatment, the sharing will be limited in proportion to the amounts already shared in the alternative treatment. Applications must include:

• Medical notes from the prescribing professional
• Estimated costs and discounts for early payment, if available
• Explanation from the medical professional about the choice of alternative treatment to replace the conventional one.

Treatments without a proven conventional solution will be eligible for a single cover of $2,500. Some alternative treatments are included in the "recovery and therapies" section of the guidelines and do not require the above documentation.

Car accidents
In the case of automobile accidents, the plan will only consider sharing medical expenses after payments have been completed by relevant insurers, including automobile insurance, health, government assistance plans or workers' compensation. Failure to provide information on these coverages may result in ineligibility for sharing.

Asthma
Asthma-related treatments and medications are not eligible. Acute asthma attacks that result in emergency care are eligible without pre-existing limitations, with each attack being considered a new Sharing Request.

Basal cell and squamous cell cancer
Each location of basal cell or squamous cell cancer requires a separate Sharing Request. Treatment expenses are eligible after the initial waiting period for pre-existing conditions.

Aesthetic surgery
Expenses related to cosmetic surgery are only eligible in cases of disfigurement resulting from an approved Request for Sharing.

Durable Medical Equipment
The sharing of this medical equipment is limited to 180 days per medical need. Eligible equipment values are based on the prices found at discountmedicalsupplies.com with up to 150% extra.

Genetic testing
Genetic testing is only eligible if necessary to treat an approved Request for Sharing, such as breast cancer.

Palliative Care
Palliative care is eligible for periods of 60 days with certification of terminal illness and prescription from a licensed medical professional.

International care
Medical expenses for emergencies and acute care outside the USA or Puerto Rico are eligible.

Long-term care and specialized nursing
Extended care and skilled nursing are eligible when prescribed by a licensed medical professional for recovery from an injury or illness. Limited to 90 days per Sharing Request.

Mental Health Emergency
Mental health-related emergency room visits and expenses for the first 24 hours of hospitalization are eligible once per member for the duration of the plan.

Prescriptions
Prescriptions are eligible if they are related to the treatment of an approved Sharing Request and without pre-existing limitations. Sharing for prescription costs is limited to 12 months per Sharing Request.

Sports
The plan can share medical expenses related to sports activities. Injuries resulting from professional sports are not eligible. Injuries from recreational sports such as karate, jiu-jitsu, or taekwondo are eligible if the member is not paid to compete.

Suicide and attempted suicide
Expenses related to the suicide or attempted suicide of adolescents up to the age of 18 are eligible after an initial waiting period of one year, with a single limit of $25,000 per plan.

Alternative Medicine

Alternative Sharing Requests with Non-Traditional Providers

Sharing requests for alternative care with non-traditional providers, other than MD (Medical Doctor), DO (Osteopath), NP (Nurse Practitioner), RN (Registered Nurse), DC (Chiropractor), APRN (Advanced Practice Registered Nurse), Ophthalmologist or DPM (Podiatrist), require written approval from MPB Health and its partners in advance. Preventive services with alternative care may not require prior approval. See your association's specific guide for more details.

Alternative treatments

Sharing requests for alternative treatments are analyzed on the basis of equivalence with the corresponding traditional treatment. If a member opts for an alternative treatment and then returns to conventional care, the sharing will be limited in proportion to the expenses already shared with the alternative treatment.

All requests for alternative treatments must include:

• Medical notes from the professional who prescribed the treatment
• Estimated costs and discounts for early payment, if available
• Explanation by the medical professional as to why the alternative treatment was selected instead of the traditional treatment
• Treatments that do not have a proven conventional treatment will be eligible for a single allowance of up to $2,500.

Some alternative treatments and therapies are included in the "recovery and therapies" section of the guidelines and do not require the documentation mentioned above.

Alternative Tests to Determine a Diagnosis

After the initial waiting period for pre-existing conditions, all alternative testing programs and expenses are eligible, with a one-time allowance of up to $2,000 for non-acute injuries and illnesses.

Examples of non-acute conditions include, but are not limited to: intestinal health, celiac disease, fatigue, skin conditions and hormones.

Assistance in the event of death

If a member or a member's dependent dies after one active year in the plan, the community will offer assistance upon receipt of a copy of the death certificate. Financial assistance will be provided to the surviving family as follows:

• $10,000 in the event of the death of the main member
• $10,000 in the event of the death of a dependent spouse
• $5,000 in the event of the death of a dependent child

Surplus Sharing Fund

Since the plan is part of a non-profit organization, funds may be used to fulfill sharing requests that would not be eligible based on these Member Guidelines. Approval will be made based on the availability of funds and the approval of the board of directors of MPB Health Partners.

The following services are available with a sharing/payment limit of $5,000. We recommend requesting a prepayment package for antenatal and postnatal care from your healthcare professional:

Doulas
Birth tub with doula
Midwives
Immunizations for the mother
Pelvic floor services
Routine consultations
Routine laboratory tests
Non-stress fetal test (after 36 weeks)
2D, 3D or 4D ultrasound
STD/STI tests prescribed as part of routine prenatal care
Gestational diabetes (includes care and medication related to treatment)
Breast pumps
Lactation consultant
Postpartum counseling
Acupuncture
Chiropractic
Mother's six-week postpartum examination, including Pap smear
Two-week post-operative consultation after cesarean section

These services aim to support the health and well-being of mother and baby during and after pregnancy.

Eligible Childbirth Services

There is no limit or restriction on sharing for childbirth services.

Labor and delivery performed by an obstetrician-gynecologist (ob-gyn)
Cesarean section
Premature births
Multiple births
Labor and delivery in hospital
Anesthesiologist services
Home births
Expenses related to unexpected complications for the mother
Consultations with specialists in maternal-fetal medicine, provided they are requested by the medical professional monitoring the pregnancy
A pediatric hospital visit, including routine immunizations, laboratory tests and hearing tests
These services ensure that all essential medical needs related to childbirth are covered without restriction.

Maternity Initial Value Reduction Program (UA)

Members with costs not exceeding $10,000 in childbirth, postnatal and prenatal expenses will have their Initial Value (UA) liability reduced by $1,000.

We offer the Initial Amount (UA) Reduction for Maternity Care in order to provide financial relief to expectant mothers during this special time. By lowering the Upfront Amount (UA) for maternity care, MPB Health and its partners help ease the financial burden, allowing expectant mothers to focus on their health and well-being. This initiative also rewards members who are financially responsible and community conscious, demonstrating our commitment to supporting families and promoting a healthier, more connected community.

Grace period

Conception occurring within thirty (30) days of the plan start date is not eligible for sharing/payment. Pregnancies existing before the start of the plan are also not eligible. Medical records will confirm the date of conception. Members who intentionally misrepresent their conception dates may be subject to plan revocation.

Newborns who are not born in connection with an eligible Medical Necessity/Maternity Sharing Request can be added to the family plan by contacting MPB Health via our online form (member portal) by phone or email. If the birth is not related to an eligible Maternity Sharing Request, the newborn's plan start date cannot be earlier than seven (7) days after the birth. Any complications the newborn may present or medical conditions present at birth will be considered pre-existing medical conditions.

Additional Service Provided

The plan will provide a supply of disposable diapers for six months after delivery.

Spontaneous abortion

Expenses related to a miscarriage associated with an approved Maternity Sharing Request are eligible, as long as the costs exceed the Initial Amount (UA). Expenses related to a miscarriage that is not associated with an eligible Maternity Sharing Request are not eligible for sharing/payment.

Separate Sharing Requests 

Any newborn complication that occurs after birth, regardless of whether the complication existed before or after birth (including congenital conditions), will be treated separately from the mother's Maternity Sharing/Payment Claim and will require its own Sharing Claim and Initial Amount (UA). In the case of multiple births, each newborn with complications will require its own Sharing Request and Initial Amount (UA). Expenses related to the mother's complications during pregnancy or childbirth are eligible for sharing as part of the Maternity Sharing/Payment Request.

Any unrelated medical care requires a separate Sharing/Payment Request. Non-related expenses include those that are not considered routine, such as prenatal, delivery or postnatal services listed in this maternity section.

Newborn babies

Newborns whose birth is related to an eligible Maternity Sharing Request must be added to the family plan by the guardian within 30 days after birth. In the event of a change of plan category, the monthly contribution amount will automatically be adjusted to the next contribution. If the guardian does not register the newborn within 30 days, any conditions present at birth or before the start date of the child's plan will be considered pre-existing medical conditions.

If the guardian wishes to add a newborn whose birth is not related to an eligible Maternity Sharing Request, they will need to submit a plan request form for the baby. The newborn's plan start date cannot be earlier than seven days after birth. Any genetic conditions or complications for newborns that are not related to an eligible Maternity Sharing Request will be considered pre-existing medical conditions and will be subject to the same limitations defined in the "Pre-Existing Medical Conditions Prior to Plan" section.