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HSA Secure Pre-Existing Conditions
HSA Secure runs a 12-month pre-existing wait, then phases in: up to $25,000 per year in months 13 through 24, $50,000 through month 35, and $125,000 per year from month 36. Under the Zion guidelines updated January 1, 2026, controlled high blood pressure, high cholesterol, and diabetes types 1 and 2 share from day one when you have been hospitalization-free for them.
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Because HSA Secure's sharing runs on Zion's community, its rules track Zion's schedule closely. Here is the full timeline.
The Timeline
| Day one | Controlled HBP, high cholesterol, and diabetes types 1 and 2 (per Jan 2026 guidelines) |
| Months 1 to 12 | Other pre-existing conditions not shared |
| Months 13 to 24 | Up to $25,000 per year |
| Months 25 to 35 | Up to $50,000 per year |
| Month 36 onward | Up to $125,000 per year |
The HSA Angle
The pre-existing schedule is nearly identical to plain Zion Direct. What HSA Secure adds is the bundled MEC structure that keeps HSA contributions possible while you ride out the wait. If tax advantage matters more than a slightly different schedule, this is the version built for it.
Editor’s pick
HSA Secure
from $114/mo · ★ 4
If the HSA structure fits your household: Zion-powered sharing with no annual or lifetime limits plus regulated preventive care through MEC.
The Bottom Line
Same community, same day-one chronic exception, same phase-in as Zion, wrapped in an HSA-compatible product. Compare both in our Zion vs HSA Secure comparison and see all waits in our pre-existing comparison.
Frequently Asked Questions
What is the HSA Secure pre-existing wait?
Twelve months with no sharing. Then phased limits apply: up to $25,000 per year months 13 through 24, up to $50,000 per year months 25 through 35, and up to $125,000 per year from month 36.
Do any conditions share from day one?
Yes. Per the Zion guidelines updated January 1, 2026 that power HSA Secure's sharing, controlled high blood pressure, high cholesterol, and diabetes types 1 and 2 share from day one when the no-hospitalization condition is met.
How far back does it look?
The underlying Zion guidelines use a 24-month look-back to define pre-existing conditions. Read the current guidelines for the exact definition before enrolling.
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Last updated: August 2026. Facts verified against Zion HealthShare's published Member Guidelines (updated January 1, 2026). See our footer disclosure regarding affiliate commissions.
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Our top pick
Zion HealthShare
from $114/mo · ★ 4.8
Our highest-rated plan (4.8/5): no faith requirement, HSA-compatible, broad coverage, and managed conditions shared from day one.
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