Zion HealthShare and Self-Pay
Zion HealthShare is not insurance; if you do not have another health insurance provider, you should present as a self-pay patient when seeking services from your provider. This will allow for the appropriate application of self-pay discounts, as most providers tend to offer these discounts automatically upon being informed. These discounts allow us to keep membership contributions low.
If your membership began before 2022, you may have received a membership card.
This card was originally designed as a quick reference guide. However, we discovered that it sometimes caused confusion—some members believed they needed to present the card to their healthcare providers. This led providers to mistakenly assume Zion HealthShare is an insurance company and attempt to bill us directly. We cannot accept claims from providers as we are not insurance. You should obtain itemized bills and receipts to request payment or reimbursement from the Zion HealthShare community. In some cases, prepayment may be an option.
If you are also covered by any relevant insurers, third-party administrators, or government assistance plans, please do not present as self-pay. These plans will be the primary payor, and Zion HealthShare will be secondary.
*Official Member Guideline
Insurance, Third-Party Administrators, & Government Assistance Plans
If you have other insurance, a group plan, or government assistance, or the like, those will be responsible for covering your medical expenses first. The Zion HealthShare community will only step in to share any remaining eligible medical expenses. If you've hired a lawyer to handle medical expenses related to a specific need or because of issues with medical services, Zion HealthShare will wait to see the outcome of your case before deciding if the community can share any leftover eligible medical expenses.
It's important to let us know if you have any other coverage, including through a spouse, family member, employer, or government program. If you don’t disclose this information, your expenses may not be eligible for sharing.
Before Your Appointment
Look for providers who accept self-pay patients. Some clinics or providers may offer discounts or have special rates for self-pay patients.
During Scheduling
When scheduling your appointment, clearly state that you are a self-pay patient. This will help ensure a smoother process for sharing. Additionally, ask about any available self-pay discounts they may offer. Being transparent about your payment status can also open the door to discussing the cost of services and exploring affordable options. For some services, request an estimate of the costs for the services you expect to receive in advance.
At the Appointment
When you arrive, remind the front desk staff or billing department that you are a self-pay patient. Please be sure to request itemized receipts for all services provided.
After the Appointment
Once you receive your bill, please carefully review it to ensure there are no errors. While billing errors are rare, they do happen. If you notice an error on your bill, call your provider to request the error be corrected before submitting any bills to Zion HealthShare.
Once you have an accurate bill, submit all documents to your member portal under your open sharing request.
If you have not opened a sharing request for this medical need, please do so as soon as possible. For more information on submitting a sharing request, visit How to Submit a Sharing Request.
Member Guideline Notice
Notice
Please note all article sections formatted like this are official member guidelines and will be marked “*Official Member Guideline” when applicable. Anything else is simply helpful information to assist you in understanding the member guidelines and how to use your Zion HealthShare Membership.
Members who call the Zion HealthShare office asking about eligibility of medical expenses will be given an opinion, not a decision. Sharing Requests and medical expenses cannot be authorized over phone. For more information on submitting bills to Zion HealthShare, review the Member Guidelines or login to your Member Portal.
These guidelines are effective as of April 1, 2025.
Note
The Member Guidelines that go into effect April 1, 2025 will only be applicable to sharing requests that are submitted on or after that date. If a sharing request was submitted prior to April 1, 2025 the sharing request will be reviewed for sharing eligibility according to the Member Guidelines in effect at that time.
Zion HealthShare is not an insurance company. Neither this publication nor membership in Zion HealthShare are offered by an insurance company. Visit ZionHealthShare.org to view your state-specific notice.