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Below are options that can be combined, per your choice, to make up a comprehensive health strategy. You can select which options are the best fit for you and your household.
The HSA amounts listed above are just RECOMMENDED amounts. You can choose to contribute any amount to your Health Savings Account. Your Company will match up to $50 Employee Only, $75 Employee + Spouse or $110 Employee + Family.
Pairing with Zion HealthShare means no deductible to meet, rather for any qualifying expense (see Zion HealthShare member guidelines), you pay the first $1,250 (known as your Initial Unshareable Amount or IUA) of qualifying medical events and the HealthShare pays the rest. After you pay 3 IUAs, in a 12 month period, any other major event over $500 is paid by Zion HealthShare w/o requiring another $1,250 IUA. More money can go to HSA in HSA Plan or a Copay plan can be chosen. All Preventive is care 100% covered. Telemedicine is free. Rx Discount..
If an illness or injury exists that a person with Zion HealthShare coverage has been examined, diagnosed, taken medication, had symptoms or received medical treatment in the last 24 months , these medical needs will qualify for sharing by Zion HealthShare per the Pre-Membership Medical Condition Phase-In Period. Expenses related to mental health are not shareable with Zion HealthShare, but Amaze Tele-Mental Health can be added as a strong compliment for improving mental health and prescriptions are covered through Planstin.
Learning Curve: With these plans you present yourself as a “Self-Pay” Patient for anything that is not preventive coverage and pay for the coverage or the first $1,250 IUA using your HSA (if applicable). You have responsibility to learn the Zion HealthShare Member Guidelines. These innovative plans have Health Savings Account dollars built into the premium that you will receive in your HSA and can use for any qualifying medical expense! Note: High blood pressure, high cholesterol, and diabetes (types 1 & 2) are not considered pre-membership medical conditions as long as 1. no hospitalization for the condition in 12 months prior to joining and 2. the member is able to control the condition through medication or diet.
Your Planstin Plan can be used for:
Preventive Care
Copays (except HSA Plan)
HSA Acct (If HSA Plan selected)
Rx Savings
Remember any medical conditions over $1,000 that are not classified as pre-membership needs will be covered by Zion HealthShare if selecting a plan that includes Zion HealthShare.
A Sterling Urgent Care Membership can be combined with a Zion HealthShare Membership as a powerful way to control costs on medical expenses and be a comprehensive health strategy.
You can visit a Sterling Urgent Care facility for allergies, fever and illness, flu shots, lacerations, physicals (annual and sports), primary care, sprains, broken bones and much more. Most care is included at no additional charge to you with a low cost of $15 for X-Rays, $10 Rx and $15 Lab Work. Some Rx is also available at Sterling Medical Clinics
For larger claims that can’t be treated at a Sterling Urgent Clinic or for Maternity, a Zion HealthShare Membership is also included to provide comprehensive coverage. Pre-Membership conditions do have a phase in period per the Zion HealthShare Member Guidelines on this plan.
Plans that included Planstin, are actual insurance products and include preventive services defined by healthcare.gov covered at zero cost. Many of these preventive services can be received with your Sterling Urgent Care membership as these clinics also do primary care also at no cost. However, with this membership only plan, the cost for colonoscopies and mammograms (to name the two most common, but not limited to just these two) will need to be paid for by the employee as they are not covered in this membership only option. While many medications are available at Sterling, this membership only plan is not recommended for those needing specialty medications.
Where 96% of All Medical Claims Are Treated
Pros: Covers Pre-Existing Conditions. Similar to other all insurance offerings that have a high deductible. No need to ever present yourself as a self-pay patient. Has Telemedicine, Rx Benefit. All preventive is 100% covered (like other plans). No network restrictions.
Cons: No HSA contribution built into the plan. If a major medical event occurs you will paying towards a much higher deductible than the $1K IUA with Zion HealthShare.
Learning Curve: None really. It is generally the more expensive option but may be the best option if dealing with a pre-existing condition or have had an event in the last 24 months that will only be covered according to the Zion HealthShare Pre-Membership Medical Condition Phase-In Period.
Planstin Contact Info
Member Services 888-920-7526 or
member@planstin.com
Claims Fax 435-631-9478 or
claims@planstin.com
Have an immediate need?
Call 888-920-7526
1. If an emergency, get emergency care. Inform hospital you are a “self pay” customer. You can submit your need after you receive needed care.
2. If your need is over $1,000 and is a scheduled procedure, a surgery, or maternity, submit your need before the event by clicking “Medical Need Request” below.
3. Needs are required to be submitted within 6 months of the date care was received.
You can use any network, hospital, or doctor with Zion
Healthshare for your need over
$1,000 as long as your need is
not a pre-membership medical
condition
Hospitalization
Surgery
Critical Illness
Maternity
Quick questions to determine pre-membership needs
1. Is your current medical need request related to an illness that presented symptoms prior to membership?
2. Did your injury happen prior to membership?
3. Are you currently on any medication related to this condition?
4. Did you see your doctor or have testing done prior to membership for this condition?
Year Three: $50,000 max per need
needs@zionhealth.org
Disclaimer: Zion HealthShare is not health insurance, nor is it a discount healthcare program, and it is not regulated by state insurance codes. Your membership with Zion Healthshare is voluntary, as is any financial assistance provided by the community. Though the community aims to help all members with eligible needs, you are ultimately responsible for paying your medical bills.
Mini Doable Wellness is an invitation to decrease health risk and lose unwanted inches and weight by increasing healthy behaviors. If you are using any HCap Health Insurance Product, Mini Doable Wellness is included for Free including Free Body Scans. Take advantage of this great tool for you and your entire household.
Your plan may include a Health Savings Account. Contributions can be made to this account per the chart below. Some contributions may be included in your health plan. Some contributions may be included due to your healthy behaviors through Doable Wellness. You can take full advantage of your HSA by adding additional contributions per the limits below. All HSA Contributions are tax free and can be used for any qualified medical expenses (click below).
Health Equity Bank Contact Info
Member Services 1 (866) 346-5800 or www.healthequity.com
Contact Info
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