Due to the ever-rising cost of health insurance premiums, finding alternatives to traditional health insurance, including participation in healthcare sharing programs, has dramatically increased. Typically, healthcare sharing programs operate outside of traditional health insurance, allowing them to operate at a cost that is substantially less than traditional health insurance. Savings compared to traditional plans, can be as much as 60% less.
Direct Primary Care/Health Share
Take a few minutes to check out the various options to provide coverage,
based on your need and your budget.
SMART CHOICE PLAN™
The Smart Choice Plan™ program has been created to provide an affordable alternative to typical expensive major medical health plans. The need for healthcare is always there. Your ability to afford it, is not. Smart Choice Plan™ provides three different levels of coverage, Blue, Gold and Platinum.
Smart Choice Plan™ - Blue Level
(Direct Primary Care)
Smart Choice Plan™ members with the Blue Level have direct access to planned care, Telehealth, chronic disease management and discounts on drugs, lab tests and x-rays for everyone ages 2 to 65. Provides personalized treatment and care.
Smart Choice Plan™ - Gold Level
(Hospitalization and Out-Patient Surgery)
Gold Level provides hospitalization and out-patient surgery coverage, along with other benefits, through a healthshare plan. Allows individual to pick the most cost-effective coverage for hospital and surgical amounts, as well as access to physicians 24/7 via Telemedicine.
Smart Choice Plan™ - Platinum
(Combines Blue and Gold Levels)
The Platinum Level provides the best of both worlds…..Direct Primary Care AND Hospitalization with Out-Patient Surgery Benefits. This level not only provides affordable unlimited virtual doctor office visits with no co-payments, but also hospitalization and out-patient surgery benefits, and many other benefits…ALL in one low price.
Smart Choice Plan™ - Blue Level
(Direct Primary Care provided through Akos)
Why do I need a Direct Primary Care plan?
Although there are many reasons why someone uses a Direct Primary Care plan, the most common reasons are: People are without any healthcare coverage, has an HSA plan or high-deductible healthplan (both of which the individual has to pay 100% of doctor office visits, drug, x-rays, etc.), prefer to have a dedicated relationship with same physician at an affordable rate, tired of paying high co-payments or full costs of doctor office visits. Great for students and coverage is nationwide.
Unlimited Direct Primary Care
- Unlimited virtual consults with your provider $0 copay, no deductible
- Unlimited 24/7/365 virtual sick and urgent care visits
- Dedicated 1:1 primary care provider
- Prescription and refills to pharmacy of choice
- Dedicated 1:1 care navigator to make sure you get the right care, at the right time at the most appropriate location and at the fair price
- Provides greater healthcare than standard telemedicine
Member Discounts
- Prescription discounts up to 65%
- MRI and imaging discounts up to 70%
- Lab discounts up to 70%
Chronic Disease Management
Management of chronic disease, including programs to help you get the care that you need while minimizing out-of-pocket costs. Acceptance of all pre-existing conditions. By allowing our physicians tor treat chronic diseases, we reduce the demand for specialist visits. Covered chronic diseases include, but not limited to: Anxiety, Arthritis, Asthma, Blood Pressure, CHF, COPD, Depression, Diabetes, Fibromyalgia, GERD, Gout, Hypertension, and Thyroid.
Unlimited Telehealth
- Unlimited, 24/7 access to board-certified physicians via telehealth
- No co-payments
Direct Primary Care, is a new model for delivering primary healthcare, and its simplicity is its genius. DPC members receive an all-access pass to a dedicated doctor through virtual office visits, phone calls, text messaging and even video calls – with a $0 copay and no deductible! Physicians are accessible 24/7/365.
You could see a doctor in person, but who wants the hassle. It’s the 21st century, so we give you the tools to reach us from your home, your car, the office, the store, or even out on the beach during your relaxing vacation. The goal of Direct Primary Care is to make it simple and affordable to get the help you need whenever and wherever you need it, day or night.
A concierge doctor can refer you to specialists as necessary, refill a prescription, or help you manage a chronic condition. The care provided through a DPC plan allows for a more hands-on approach as compared to a standard telemedicine plan. The DPC physician is able to prescribe pain medicine, and prescriptions for more chronic conditions which a telemedicine plan cannot. A dedicated Care Navigator will help you through the other parts of the healthcare system, should the need arise – making sure you always get the right care, at the right time and place and fair price. DPC isn’t a replacement for insurance or a medical cost sharing membership that covers catastrophic events. It works with your health insurance plan or medical cost sharing membership to make it even better!
Sounds simple enough, but can I really get quality care through a virtual consult?
Yes. Having an ongoing relationship with a primary care provider is the best way to keep you and your loved ones healthy and minimize your out-of-pocket costs. Leveraging technology, like chat, video and secure messaging to facilitate this relationship makes receiving care convenient and easy. Your dedicated care team will help you receive the right care, without the hassle of having to visit an office. In-fact about 80-90% of the medical needs of members can be addressed and resolved through a virtual visit. When the need does arise for in-office services, your care navigator will refer you to high-quality services in your area at a discounted rate.
ALL THE ABOVE BENEFITS INCLUDED FOR ONE LOW PRICE!!!
(For MRI and Imaging, and Lab Discount brochures, please scroll down below the Platinum Level)
Smart Choice Plan™ - Gold Level
(Hospitalization and Out-Patient Surgery)
(Administered through Zion Health)
The Gold Level provides coverage for hospitalization and out-patient surgery benefits, along with other medical expenses through a healthshare plan.
The Healthshare program provides hospitalization and out-patient surgery benefits, along with other benefits through a healthshare plan. The individual may choose any hospital through a healthshare plan, which has an unlimited annual payout, for a hospital stay or out-patient surgery. The member responsibility portion or Initial Unsharable Amount (IUA), (like a deductible), has three levels: $1,000, $2,500, or $5,000. The plan also includes a Patient Advocacy program, which works with the provider to obtain special reduced pricing. Can’t pay the IUA up front? Most every provider will work out a payment schedule over time.
Rather than paying for massive coverage, thus making it unaffordable, this program provides an avenue to give some coverage, in the event of a catastrophic event.
Medical bills are the number one reason for bankruptcies. Let the affordable healthshare program protect you and your family.
What is a healthshare program?
A healthshare program is a member-based fellowships where like-minded people exercise their right to take charge of their own healthcare. These types of programs have been around for about 40 years and have many millions of participants. In health sharing, monthly share contributions are used to help pay for other members medical expenses.
LEARN HOW THE IUA WORKS
IUA OUTLINE
The Initial Unsharable Amount (IUA) for each member’s medical need is the responsibility of member. All qualified medical expenses after IUA is met are shareable with the Zion Health community at 100% and without an annual or lifetime limit.
ADVANTAGE
For each medical need, the community shares in medical expenses after the initial unshareable amount (IUA) is met. This amount paid by the member does not need to be paid again until you are symptom free for 12 months.
RECAP
The Initial Unsharable Amount (IUA) is better for members than a deductible when a large medical need comes up. Often care for a sickness or injury is not limited to a single calendar year. Members generally save by having an IUA.
Pre-existing condition phased in period
Another benefit to the healthshare program is that coverage is guaranteed issue, which means if you have a previous health condition, you may still be eligible for coverage. However, that particular condition may not be shareable immediately, but other events/conditions which are non-related to a pre-existing condition would be covered immediately. Please see below.
Pre-existing conditions have a waiting or phase in period. Zion Health attempts to negotiate all medical bills received and many membership types include the PHCS network for pre-negotiated medical expenses.
- 1st Year of Membership – Waiting period of all pre-existing conditions
- 2nd Year of Membership – Up to $25,000 of sharing for pre-existing conditions
- 3rd Year of Membership – Up to $50,000 of sharing for pre-existing conditions
- 4th Year of Membership and Beyond – Up to $125,000 of sharing for pre-existing conditions per year
Exceptions For High Blood Pressure, High Cholesterol & Diabetes
High blood pressure, high cholesterol and diabetes (type 1 & 2) will not be considered a pre-existing condition as long as they have not been hospitalized for the condition in the past 12 months and able to control through medication or diet.
A large part of the appeal of healthcare sharing programs is that they are much less expensive than traditional health insurance.
The healthshare program offered is a medical cost sharing program that helps individuals and families address the challenges of escalating health care costs and soaring insurance premiums. It is not insurance, but an alternative where members share in each other’s medical needs. The healthshare company collects the member monthly contribution amounts and pays the providers directly, minus any applicable IUA. The IUA is applicable for each medical event per year. Members voluntarily submit contributions to the program on a monthly basis in order to maintain eligibility for sharing of medical needs and to help share in the needs of others.
NOTE: If you are on COBRA currently, or other coverage, and wish to obtain new coverage, do not cancel coverage until you have been fully accepted. The reason for this is that you, and anyone you wish to have covered, will need to medically qualify for the plan from and underwriting standpoint. In other words, if you have a major health issue, stay where you are.
IMPORTANT HEALTH SHARE TERMINOLOGY
- Health Share Program vs Insurance
- Initial Unshareable Amount (IUA) vs Deductible
- Visit Fee vs Co-pay
- Eligible for Sharing vs Covered
- Monthly Contributions vs Premiums
- Medical Needs Fee vs Claims
- Shared Services vs Benefits
Another benefit to the healthshare program is that in some cases, coverage may be guaranteed issue, which means if you may have a health condition, you may still be eligible for coverage.
NOTE: If you are on COBRA currently, or other coverage, and wish to obtain new coverage, do not cancel coverage until you have been fully accepted. In other words, if you have a major health issue, stay where you are.
Also Includes:
Telemedicine. Access to physicians 24/7 via telephone with no co-payments.
MRI/CT Scans and Imaging discounts. Up to 70% savings.
Lab Test discounts. Up to 70% savings.
Prescription discount card for up to 80% savings. Visit goodrx.com to check out drug pricing and participating pharmacies.
Couple’s Counseling. Allows couples to go through interactive technology to assist in growing and strengthening the relationship.
Smart Choice Plan™ - Platinum Level
(Combines Blue and Gold Levels)
The Platinum Level provides the best of both worlds…..Direct Primary Care AND Hospitalization with Out-Patient Surgery Benefits.
The Smart Choice Plan™ – Platinum Level, not only provides unlimited virtual doctor visits with no co-payments, but also hospitalization and out-patient surgery benefits…ALL in one low price.
In addition to all the Blue Level virtual visits and Telemedicine, the following benefits are also included:
- Lab Discounts
- MRI/CT Scans and Imaging Discounts
- Prescription Discounts
- Couple’s Counseling
Rather than paying for massive coverage, thus making it unaffordable, this program provides an avenue to access affordable coverage, in the event of a catastrophic event.
Medical bills are the number one reason for bankruptcies. Healthshare plan allows unlimited benefit coverage at rates substantially lower than traditional health insurance plans.
Please refer to Gold Level description of Pre-Existing Conditions before participating in Healthshare.
Smart Choice Plan™, Gold or Platinum Level, pays an UNLIMITED Annual and Lifetime Maximum per covered person.
Call 833-722-2363 Ext. 810 today to speak with a representative who can provide a more details.
NOTE: None of the benefits in the Smart Choice Plan™ are insurance products.