HEALTHSHARE

Maybe. Preventive Basic, Preventive HSA, and Preventive Copay plans do not cover maternity. However, all Care+ health plans do include coverage for maternity care. Additionally, many members with a preventive health plan also become Zion HealthShare members. A Zion HealthShare membership is designed for larger, medical needs like maternity.

No. You are not required to enroll in a health plan. You can enroll in Zion HealthShare only if you prefer. However, we do recommend pairing a preventive health plan with a Zion HealthShare Membership if possible for a more well-rounded solution.

Using a HealthShare membership and a preventive health plan together is an alternative to traditional insurance that can effectively meet many, if not most of your healthcare needs. The key to using these two pieces together is to understand what each one is for and when to use it. Your Preventive Health Plan The main part of your healthcare solution focuses on your routine needs like an annual checkup, medications, immunizations, and preventive screenings. Your HealthShare Membership The other part of your healthcare solution works best for bigger medical concerns, such as emergency care, maternity, and hospitalization for planned or unplanned surgery.

Zion HealthShare defines a pre-existing condition, or what they call a “pre-membership medical condition,” as any medical issue for which a member has received treatment, taken medication, or experienced symptoms in the 24 months leading up to their enrollment. There is a one-year waiting period before such conditions become eligible for sharing within the community. However, there are exceptions for certain conditions like diabetes, high cholesterol, and high blood pressure. If an employee has not been hospitalized for these conditions in the past 12 months and can manage them through medication or diet, they will not be classified as pre-membership medical conditions.

If you are a Zion HealthShare member, for major medical events like hospitalizations, surgeries, or maternity you should identify yourself as a self-pay patient at the provider's office and request an itemized statement that includes a self-pay discount. To manage these expenses, you will need to coordinate directly with Zion HealthShare. This involves using your Zion HealthShare Member Portal to upload statements, facilitate bill payments, or process reimbursements if you have already paid these costs out-of-pocket.