Basic & Preventive Health Insurance Plans
The benefits with your Planstin Plan depends on your chosen plan.
Touch below to see the summary sheet of available plans
Pros: Pairing with Zion HealthShare means no deductible to meet, rather, you pay the first $1K (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 $1K IUA. More money can go to HSA in HSA Plan or a Copay plan can be chosen. All Preventive care 100% covered. Telemedicine is free. Rx Discount up to 75%.
Cons: 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 $1K IUA using your HSA (if applicable). Your responsibility to learn the Zion HealthShare Member Guidelines. 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:
Copays (except HSA Plan)
HSA Acct (If HSA Plan selected)
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.
1. Touch button above
2. Touch “Change Network”
3. Select PHCS Network
4. Touch “Specific Service”
5. Search for Provider
Providers may change, so we recommend contacting your provider to ensure they are still a part of the PHCS Network
Provider not Listed as part of PHCS Network?
While it is easier to use providers that are a part of the PHCS Network,
Planstin may still pay for services rendered by an out of network provider through their “Reference Based Pricing (RBP)”
1. Give your Planstin information to your providers and have them submit to Planstin
2. Tell them Planstin will pay 150% of Medicare negotiated pricing.
3. You will be responsible for any add’l expense beyond.
Planstin Contact Info
Have an immediate need?
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
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
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.
Your Company-Paid HSA Contributions
When > 120 points are claimed in Learn & Earn ea/mo, you qualify for your Earned Healthy Behavior Contributions in addition to the Automatic Contributions by your company shown below. HSA contributions only apply to those with Planstin Preventive HSA plans.