*Official Member Guideline

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

Abortion

Expenses for the abortion of a living, unborn baby are not ineligible for sharing.

ADHD & SPD Treatment

Expenses for evaluations, treatments, and prescriptions related to ADHD and SPD are ineligible for sharing. Members can use Zion HealthShare’s discount prescription program, Zion RxShare, for any prescribed medications that are available at a pharmacy.

Allergy Treatments

Allergy testing and medication is excluded from sharing. Members can take advantage of Zion RxShare to receive prescription discounts. Sharing requests related to non-seasonal allergies, such as an emergency room visit for an allergic reaction, may be considered for sharing.

Breast Implant Removal

Breast implant removal is ineligible for sharing. 

Conflict of Interest

In keeping with the Principles of Membership, and in the interest of protecting the Zion HealthShare community, medical expenses incurred by a member that obtains medical treatment from a provider with which the member has an affiliation, partnership, personal or business relationship, or the like, and receives financial gain, is not considered shareable.

Dental

Dental services, such as caps, crowns, root canals, fillings, wisdom tooth extraction, anesthesia, sedation, and cleanings are not shareable. Expenses related to devices including, but not limited to splints, bite guards, and expanders are ineligible for sharing.

Tooth damage caused by an accident or injury (e.g., car accident) and in relation to an eligible sharing request may be considered for sharing.

Diabetic Medication & Supplies

Any medical expenses related to supplies, testing, medication, or other implements used to treat diabetes are not ineligible for sharing.

Please visit Zion RxShare for more information.

Fees & Interest

Any late payment fees or interest charges that may accrue to medical bills before a member meets their IUA are the member’s responsibility—they are ineligible for sharing, and do not count toward the IUA. Additionally, any late payment fees or interest charges caused by a member’s delay in providing necessary documentation to Zion HealthShare are ineligible for sharing. Credit card transaction fees associated with a payment by the member are ineligible for sharing.

Fertility

Expenses related to fertility evaluations and treatments are ineligible for sharing.

Genetic Screening

Genetic screenings and/or genetic counseling are ineligible for sharing.

Hearing Aids

Expenses related to hearing aids are ineligible for sharing.

Injuries Obtained from Certain Acts

Injuries or illnesses resulting from a criminal act, euthanasia, assisted suicide, participation in a riot, or other such acts that would violate the Principles of Membership are ineligible for sharing.
 
Injuries or illnesses resulting from being under the influence of alcohol or drugs while committing a criminal act, such as operating a motor vehicle while impaired, are ineligible for sharing.

Medical Noncompliance

Failure or refusal to comply with a licensed medical professional’s treatment plan or leaving a facility against medical advice (AMA) may result in ineligibility of the sharing request and any complications that arise.

Medically Stable Conditions

An eligible medical need may be considered medically stable when the condition is chronic and further treatment will not likely result in improvement. At this point, the sharing request is subject to review and may result in determination of ineligibility for future sharing.

Mental Health

Expenses related to medications or other treatment for any mental health illness or condition are ineligible for sharing. Mental health conditions may include anxiety, depression, mental illnesses, and other psychological conditions. Through Primestin Care, Zion HealthShare members may have access to a clinically appropriate number of sessions for acute therapy needs. Primestin Care is available as an additional service to any household membership. Members can use Zion HealthShare’s discount prescription program, Zion RxShare, for any prescribed medications that are available at a pharmacy.

Sleep Apnea

Sleep apnea equipment and testing are ineligible for sharing.

Sterilization

Elective sterilization, such as tubal ligation and vasectomy, is ineligible for sharing.

Subscriptions

Expenses related to subscriptions for Direct Primary Care's (DPC), gym memberships, chiropractor memberships, or anything similar are ineligible for sharing. 

Surrogacy

Expenses related to a surrogate pregnancy, whether or not the surrogate is a member, are ineligible for sharing.

TMJ (Temporomandibular Disorder)

Expenses related to evaluation and treatment of Temporomandibular Disorder, TMJ and other similar conditions are ineligible for sharing. 

Vision

Vision expenses related to hardware, such as glasses and contacts, are ineligible for sharing. Expenses to correct refraction, including but not limited to Lasik, PRK, lens implants, and/or other surgical or non-surgical visual acuity procedures and treatments not related to cataract surgery, are also ineligible for sharing.

Vitamins & Supplements

The cost of vitamins and supplements is ineligible for sharing.