How do I use my HealthShare membership with my health plan?
June 3, 2024
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.
Knowing When & How to Use Your HealthShare
If this healthcare pairing is new to you, you will likely have questions about when to use which piece.
The chart below can help you decide which service to use, and what steps to take to use it effectively.
Of course, if you have any questions, we are here to help. Contact a Benefit Advocate at 888-920-7526 with any questions.
While your situation may involve details that are best discussed with a Benefit Advocate or Zion HealthShare member care specialist, here is some general guidance to help get you started.
Getting routine care?
Show your health plan ID card to your provider
They will bill your health plan, and you will pay $0 for all preventive visits.
Getting a preventive screening?
Show your health plan ID card to your provider. They will bill your health plan, and you’ll pay $0.
Filling a prescription?
Use your included prescription service to order your medications and have them delivered.
Getting lab work done?
Before getting your tests, ask your provider to contact Planstin and verify if the labs are covered by your plan.
In need of a flu shot?
Your health plan covers it if you receive it at a doctor’s office. The same applies to COVID vaccines and other standard immunizations.
Newly pregnant?
Congratulations! Submit a sharing request as soon as you know you are expecting.
Having surgery?
Inform the provider you are a self-pay patient. If
possible, submit a sharing request prior to surgery.
Getting emergency care?
nform the provider you are a self-pay patient.
Submit a sharing request immediately. You’ll pay for care up to your IUA amount, and share the rest
Recently injured or suddenly ill?
Submit a sharing request as soon as possible. Call your HealthShare for further guidance.
Do Your Homework
Whether or not you’re new to a HealthShare and health plan combo, it's important to get a full picture of what these services can do for you. The most important steps you should take include reading your plan documents, which will explain what your health plan covers, and reading the Zion HealthShare member guidelines, which will detail which medical costs are eligible for sharing.
Learn More
- Download a PDF version of this article here.
- Learn more about the sharing process here.
- Visit zionhealthshare.org/member-guidelines to learn more about eligible medical costs.
- Are you a HealthShare member? Contact a Benefit Advocate to verify your benefits: 888-920-7526
Explore
Most Planstin-managed health plans do not use a provider network . That means you are free to work with any provider with out fear of any out-of-network penalties. Very few Planstin-managed health plans still use a provider network. In this case, your health plan uses the PHCS network of providers. Fair-priced healthcare & care coordination The majority of Planstin-managed health plans use an innovative healthcare pricing strategy called fair-priced healthcare. This strategy does not require the use of a provider network, and instead relies on a care coordination team to help you work with your provider, make appointments, and locate providers that work well with your benefits. To learn more about fair-priced healthcare, click here . To learn more about care coordination click here .
Preventive Core is a health plan that focuses on preventive care. This health plan meets ACA requirements for minimum essential coverage (otherwise known as MEC). Fair-priced healthcare This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . Care coordination Preventive Core health plans have no network restrictions and include care coordination services to help you make appointments and locate providers that work well with your benefits. To learn more about care coordination click here . To view information about your Preventive Core health plan, click here and select your specific plan name.
All Planstin-managed health plans now feature care coordination services as a part of a fair-price healthcare strategy. The Planstin Care Coordination team will help match members with providers that work best with their plan.