Welcome back to Healthsharing Reviews’ FAQ Series, where we answer some of the most frequently asked questions about health share companies and how they work. In this episode, we will be focused on Zion HealthShare, which is one of the fastest-growing health shares in the industry. We have gathered questions from online inquiries, emails, and social media in hopes of providing you with a clearer understanding of Zion HealthShare and what they offer.
What are the membership requirements for Zion HealthShare?
Zion HealthShare welcomes members of all walks of life and does not require its members to declare any specific religious beliefs. This inclusive approach allows a broader range of individuals to participate in the health share program without the necessity of aligning with a particular faith.
To become a member of Zion HealthShare, it is important to understand their specific membership requirements. Here is a brief overview of what is required.
- Adhere to the Zion HealthShare Principles of Membership: Although all faiths are welcome, members are expected to act with honor and integrity and attest to five statements or principles found here.
- Participate in the community by submitting monthly contributions: Members submit a monthly contribution, based on their chosen membership Initial Unshareable Amount (IUA) option. This monthly contribution allows you to become and remain eligible for medical cost sharing within the community.
- Under the age of 65: Members must be under the age of 65 to participate in a Zion HealthShare program.
- Reside in the United States or Puerto Rico: Members must be residents of the United States or Puerto Rico to participate in and contribute to the medical cost sharing community.
How does the sharing process work with Zion HealthShare?
- Upon receiving treatment, you will present yourself as a self-pay patient to negotiate and obtain self-pay discounts on services, as well as obtain itemized bills and receipts to request payment or reimbursement. In some cases, like non-emergency services and surgeries, it is recommended that you contact Zion HealthShare’s Medical Advocacy team directly or submit your sharing request prior to being seen, as prepayment may be an option.
- Members create a Member Portal, in which you will submit your sharing request. The sharing request, along with all completed documentation, must be submitted within six months of treatment. Documents can include, but are not limited to, proof of payment, itemized bills or statements, and medical records if needed.
- Medical costs are then shareable only after members have met their Initial Unshareable Amount (IUA). Each household membership will only be responsible for three IUAs in a rolling 12-month period. If a household has paid three IUAs within that period, any additional request over $500 will be shared.
In short:
- Present yourself as self-pay
- Obtain itemized bills and receipts
- For non-emergencies/surgeries, contact Zion HealthShare’s Medical Advocacy team for possible prepayment
- Submit a sharing request/documents/receipts through the Member Portal in a timely manner
- Pay the Initial Unshareable Amount (IUA); Never pay more than three IUAs per household per rolling 12-month period
- Zion HealthShare will then share eligible medical costs over $500
Can I choose my own providers with Zion HealthShare?
With Zion HealthShare, you have the freedom to see any healthcare provider of your choice within the US and Puerto Rico. If the healthcare provider is a licensed medical professional in the location where services were rendered and they provide medically necessary services, treatment will be considered eligible for sharing. While it is not required, it is recommended that you contact the Medical Advocacy team for assistance in finding a low-cost provider for non-emergency services prior to your visit.
How does Zion HealthShare address pre-existing conditions?
A pre-existing or pre-membership medical condition, as Zion HealthShare calls it, refers to any condition for which a member has been examined, diagnosed, taken medication for, exhibited symptoms of, or received medical treatment within the 24 months prior to the membership start date.
Sharing requests related to these conditions are only shareable if the condition is cured, has not required treatment, or has not had any present symptoms for 24 months prior to the membership start date.
Pre-membership medical conditions have a waiting period along with limited sharing. Upon the membership start date, there is a one-year waiting period before these conditions are shareable. In the second year, $25,000 is the maximum sharing amount; $50,000 max in the third year; and $125,000 max in the fourth year. After year four, pre-membership conditions will be shareable up to a maximum of $125,000 in a 12-month period, which resets each membership year. However, there are exceptions for high blood pressure, high cholesterol, and diabetes where member guidelines dictate.
Here is a condensed look at the waiting period and limitations:
- Year One: Waiting period; Not eligible for sharing
- Year Two: Maximum of $25,000, per sharing request
- Year Three: Maximum of $50,000, per sharing request
- Year Four: Maximum of $125,000, per sharing request
- After Four Years: Maximum of $125,000 in a 12-month period; Resets each membership year
Does Zion HealthShare share expenses related to maternity, mental health, or other special conditions?
Zion HealthShare has specific guidelines when it comes to sharing maternity, mental health, prescriptions, or other special conditions.
Maternity expenses are subject to a waiting period during the first six months of membership. A separate Maternity IUA then applies, ranging from $2,500 to $5,000 based on the selected Household Membership IUA. Shareable costs include prenatal care, postnatal care, delivery, birth-related complications of the mother, and miscarriage. Conception must occur after six months of continuous membership to be eligible for maternity sharing, except in the case of miscarriage, for which conception must occur on or after the membership start date.
Zion HealthShare offers mental health resources through Primestin Care, which is included with the Direct Membership and available as an add-on to the Essential Membership for a small monthly fee. This service provides access to acute counseling sessions, offering tools and support during challenging times. However, expenses related to medications or other treatments for mental health conditions—including anxiety, depression, and other psychological illnesses—are not shareable. Members may instead use Zion RxShare to receive discounts on those related medications.
According to Zion’s guidelines, prescriptions are considered shareable if they are related to the treatment of an approved sharing request, ordered by a licensed provider, and approved by Zion HealthShare. For other prescriptions that do not meet those guidelines, Zion HealthShare offers Zion RxShare, which is a discount program providing members access to prescription savings of up to 80%, home delivery, and a customer support team.
Other special conditions shared through Zion HealthShare often have sharing limitations and are subject to the IUA. For example, therapeutic treatments such as acupuncture, chiropractic care, massage therapy, and physical therapy are shareable up to a maximum of $7,500, or 35 treatments per need. After reaching either limit, these treatments are no longer shareable. For a complete list of eligible medical expenses for sharing, click here.
We hope this information has been helpful in answering any questions you have about Zion HealthShare, including their membership requirements, sharing processes, provider choices, pre-existing condition policies, and other services. For a more in-depth look at their policies and guidelines, please refer to the links provided.
Stay tuned for more episodes in our FAQ series, where we will examine other leading health share companies and provide answers to help you navigate your health share journey.
