Zion HealthShare offers superior quality service to our community. Our goal is to change the healthcare industry by connecting like-minded individuals to an innovative and affordable medical cost sharing community. We are a community that employees are proud to be a part of, medical professionals prefer for their patients, and members love and recommend to their family and friends.
Principles of Membership
Adherence to the Zion HealthShare Principles of Membership minimizes medical risks, encourages good health practices, and ensures member integrity and accountability. Our members must comply with certain requirements to maintain membership and remain eligible to participate in our medical cost sharing community.
Zion HealthShare members are expected to act with honor and integrity. Members should not falsify a sharing request, medical records, or use other deceptive practices. If a member abuses the trust of our community, their membership may be revoked or withdrawn.
All Zion HealthShare members must attest to the following statements:
1. I believe that a community of ethical, health-conscious people can most effectively care for one another by directly sharing the costs associated with each other’s healthcare needs. I acknowledge that Zion HealthShare affiliates itself with, and considers itself accountable to, a higher power. I recognize that Zion HealthShare welcomes members of all faiths.
2. I understand that Zion HealthShare is a benevolent organization, not an insurance entity, and that Zion HealthShare cannot guarantee payment of medical expenses.
3. I will practice good health measures and strive for a balanced lifestyle. I agree to abstain from the use of any illicit or illegal drugs and refrain from excessive alcohol consumption, acts which are harmful to the body. I understand that members who use tobacco will have an increased monthly contribution (per household) of $50.
4. I am obligated to care for my family. I believe that mental, physical, emotional, or other abuse of a family member, or any other person, is morally wrong. I am committed to always treating my family and others with care and respect.
5. I agree to submit to mediation followed by subsequent binding arbitration, if needed, for any instance of a dispute with Zion HealthShare or its affiliates.
Membership eligibility is primarily based on:
1. Adherence to the Zion HealthShare Principles of Membership.
2. Participation in the community by submitting monthly contributions.
3. Reside in the United States or Puerto Rico.
After committing to these primary eligibility requirements, prospective members are eligible to join the Zion HealthShare community. Membership may begin on a date selected by the prospective member or specified by Zion HealthShare, known as the membership start date. The prospective member’s monthly contribution must be received within 15 days of the agreed-upon membership start date. Once the first monthly contribution has been received membership is considered active.
Zion HealthShare offers different membership options for individuals and families. Monthly contributions are based on the membership type (Direct or Essential), age group, and initial unshareable amount (IUA).
Submission of Sharing Requests
We strive to share medical expenses in a timely, accurate manner. To do this, it is crucial for members to submit sharing requests correctly and include all required documentation.
Pre-Membership Medical Conditions
To keep membership contributions low for all members, we implement a waiting period for sharing of medical conditions that existed prior to a member’s membership start date. We call such medical conditions: pre-membership medical conditions. This section defines pre-membership medical conditions and outlines related sharing limitations.
Medical Expenses Eligible for Sharing
The following list reflects sharing limitations for certain conditions or requirements for certain expenses to become eligible. All shareable expenses are subject to the member’s IUA.
Medical Expenses Ineligible for Sharing
The Zion HealthShare medical cost sharing community chooses not to share in some medical expenses. Decisions for sharing eligibility are made to benefit all members by keeping monthly contributions low and sharing in medical expenses based on our Principles of Membership. The following expenses are excluded from sharing with the Zion HealthShare community.
Zion HealthShare shares in specific preventive services with the Direct Membership or with the additional Preventive Sharing service added to the Essential Membership. Preventive sharing is not subject to the IUA.
Zion HealthShare references the following resources regarding preventive sharing:
· US Preventive Services Task Force
· American Cancer Society
· Centers for Disease Control (CDC) and Prevention Guidelines
· American Academy of Pediatrics
· American Academy of Family Physicians
See the Preventive Medical Sharing Guide for more details.
Maternity Sharing Requests
As a general rule, maternity sharing requests are shareable and are treated like any other sharing request. View Zion HealthShare’s Maternity Guide to learn more.
Members are encouraged to give funds in addition to their standard monthly contributions. One hundred percent of Additional Giving contributions are placed in the Additional Giving fund, which is used solely to assist members who have a sharing request that would not normally qualify for sharing. Additional Giving funds are not subject to any administrative costs. Additional Giving is not mandatory, and members may contribute however much they feel is appropriate.
All members who adhere to the Principles of Membership and follow the Member Guidelines are eligible to apply for assistance through the Additional Giving fund via an Additional Giving sharing request. Members may apply when they have an ineligible sharing request.
End Of Life Assistance
If a member, or a member’s dependent, dies after one year of uninterrupted membership,
we will provide financial assistance to the surviving family. Our community will provide assistance after we receive a copy of the death certificate.
Financial assistance will be provided to the family as follows:
· $10,000 upon the death of a primary member
· $10,000 upon the death of a dependent spouse
· $2,500 upon the death of a dependent child
Zion HealthShare is not an insurance company. Neither this publication nor membership in Zion HealthShare are issued or offered by an insurance company. The purpose of the Member Guidelines is to help members understand and identify medical needs that may qualify for member sharing and the process by which member-to-member sharing is facilitated. The Member Guidelines are not for the purpose of defining the amounts that Zion HealthShare community will reimburse or share into. While the Zion HealthShare community has shared in all eligible member sharing requests to date, membership does not guarantee or promise that all eligible sharing requests will be shared. Rather, membership in the Zion HealthShare community merely guarantees the opportunity for members to share the financial burden in another member’s time of need. The financial assistance members receive will come from other members’ monthly contributions and not from Zion HealthShare.
THIS PUBLICATION AND MEMBERSHIP IN ZION HEALTHSHARE SHOULD NEVER BE CONSIDERED A SUBSTITUTE FOR A HEALTH INSURANCE POLICY. IF THE COST-SHARING COMMUNITY IS UNABLE TO SHARE ALL OR PART OF A MEMBER’S ELIGIBLE MEDICAL SHARING REQUEST, THE MEMBER WILL REMAIN SOLELY FINANCIALLY LIABLE FOR ANY AND ALL UNPAID MEDICAL EXPENSES. THESE GUIDELINES DO NOT CREATE A LEGALLY ENFORCEABLE CONTRACT BETWEEN ZION HEALTHSHARE AND ANY OF ITS MEMBERS. NEITHER THESE GUIDELINES NOR ANY OTHER ARRANGEMENTS BETWEEN MEMBERS AND ZION HEALTHSHARE CREATE ANY RIGHTS FOR ANY MEMBER AS A RECIPROCAL BENEFICIARY, A THIRD-PARTY BENEFICIARY, OR OTHERWISE. AN EXCEPTION TO A SPECIFIC PROVISION OF THESE GUIDELINES ONLY MODIFIES THAT PARTICULAR PROVISION AND DOES NOT SUPERSEDE OR VOID ANY OTHER PROVISION. THE DECISION BY ZION HEALTHSHARE TO REIMBURSE A MEMBER’S ELIGIBLE SHARING REQUEST DOES NOT AND SHALL NOT CONSTITUTE A WAIVER OF THIS PROVISION OR ESTABLISH BY ESTOPPEL OR ANY OTHER MEANS ANY OBLIGATION ON THE PART OF ZION HEALTHSHARE TO REIMBURSE A MEMBER’S ELIGIBLE SHARING REQUEST. TO SEE YOUR STATE NOTICE AND REGULATIONS PLEASE VISIT OUR WEBSITE.
Click here to see historical Member Guidelines.