Optional services that may be added to, or included with, existing household memberships. These include preventive sharing, Zion RxShare, and Primestin Care.

The date Zion HealthShare receives a complete membership enrollment.

In the Member Portal, an active list of shareable sharing requests indicating how the household's contributions are being shared.

The uninterrupted period of time when a household or individual has been an active member of the medical cost sharing community, by which sharing limitations requiring phase-in or waiting periods are determined. A membership may remain continuous as long as uninterrupted monthly contributions are received. These changes may include changes to your membership, a change in membership type, or a reinstatement after withdrawal as long as it is within thirty (30) days. 

The date medical services were rendered on behalf of a member.

Medical expenses are considered eligible for sharing within the medical cost-sharing community if they adhere to the Member Guidelines and Principles of Membership and receive a final determination indicating eligibility of sharing. These eligible expenses are also known as “shareable.”

A sharing request that is eligible for sharing with the medical cost sharing community.

A group of members, including the primary member, their spouse or domestic partner, and/or unmarried children under 26. A household can only have one household membership. Individual members within the household can have unique membership start and termination dates.

A member, and applicable household member(s) thereof, who have withdrawn from the household membership or have had their membership revoked.

A medical expense incurred by a member that is excluded from sharing based on our Member Guidelines and Principles of Membership. Also known as unshareable. 

A sharing request ineligible for sharing by the medical cost sharing community, for reasons stipulated in our Member Guidelines and Principles of Membership.

The amount members are required to pay on their own before associated eligible medical expenses may be shared. Members have six (6) months from the initial date of service to meet their IUA.

An individual who has successfully completed a prescribed program of study in one of a variety of health fields, and who has obtained a license or certificate indicating their competence to practice in that field (MD, DO, ND, NP, PT, PA, Chiropractor, etc.), and whose license or certificate is both active and recognized by the state where services are rendered.

A membership-based, nonprofit organization whose primary purpose is to care for the medical needs of the members, or what is referred to as the Zion HealthShare community. A medical cost sharing organization is not an insurance company. A medical cost sharing organization is not an insurance company.

A scientifically validated, and evidence-based service, procedure, medication, evaluation, or treatment necessary to improve or restore physiological function and that is provided in the most cost-effective setting consistent with the member's condition. The fact that a provider may prescribe, administer, or recommend services does not always make them eligible for sharing. This applies even if the recommended service is not listed as a sharing limitation or mentioned in the Member Guidelines. To help determine medical necessity, Zion HealthShare may request medical records and information from licensed medical professionals. 

The reason for which a member submits a sharing request. This includes, but is not limited to, preventive visits, maternity, an accident, or a serious medical incident. A medical need may be related to one contributing incident (i.e. car accident) or separated based on medical evidence indicating no relation (see Basal & Squamous Cell Cancer guideline) and determined by our Determination Adjudicators. 

The individual(s) within a household who, demonstrated by their participation, have agreed to abide by our requirements and are therefore eligible to share medical expenses with other members in accordance with the Member Guidelines, and their membership type. This includes the primary member, their spouse or domestic partner* and any unmarried children (by birth, marriage, or legal guardianship) under the age of 26.

*Domestic Partner is an unrelated and unmarried person who shares common living quarters with a Primary Member and lives in a relationship that is not legally defined as marriage by the state in which the member resides.

Any amount paid by the member for medical costs that is ineligible for sharing with the medical cost sharing community. These amounts are in addition to the IUA.

The age group, as defined by Zion HealthShare, which the oldest household member belongs to.

The IUA that is chosen by the primary member, usually at the time of joining, and applied to the household’s sharing requests.

The date on which a person’s membership begins.

Determined by the number of individuals participating in a household membership and their relationship to the primary member.

Defined as either Direct or Essential.

Members voluntary sharing of one another’s medical expenses.

A set monetary amount voluntarily submitted by a member and placed in the care of Zion HealthShare, for the purpose of maintaining active membership and sharing in the medical expenses of fellow members. Funds are disbursed each month for members’ medical expenses, other than the small portion of these funds allocated for administrative and vendor costs, as allowed by law. 

The member who created the household membership. The primary member may or may not be the oldest member in the membership household.

Membership may be revoked for multiple reasons including, but not limited to, a violation of our Principles of Membership. Members who have their membership revoked may not have it reinstated or reestablished for a minimum of five (5) years.

Revocation of membership causes a membership to become inactive. 

The maximum amount that can be shared for any individual eligible sharing request or type of medical service, as described in the Member Guidelines.

A form required to notify the medical cost sharing community of a member’s medical need and associated medical expenses. Sharing Requests must be submitted via the Member Portal.

See the applicable sections of the Member Guidelines for qualifying requirements.

Identified as either regular, surgery, preventive, maternity, alternative, or Additional Giving depending on the type of medical services and treatment the member is receiving.