Healthcare-Marketplace_3

Direct Primary Care/Health Share

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.

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.  Right Choice Plan™ provides three different levels of coverage, Blue, Gold and Platinum.

Smart Choice Plan™ - Blue Level

(Direct Primary Care)

Smart Choice Plan™ is designed to provide access to preventative care, Telehealth, chronic disease management and discounts on drugs and medical supplies for everyone ages 2 to 65. This service also provides access to online mental health and therapist services.  (Mental Health Services for primary member only)

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 doctor office visits and unlimited urgent care, 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)

Unlimited Direct Primary Care

  • Unlimited doctor office visits for $10 per visit
  • Unlimited urgent care visits for $25 per visit

Chronic Disease Management

Unlimited treatment of certain chronic diseases. Acceptance of all pre-existing conditions.

  • Anxiety
  • Arthritis
  • Asthma
  • Blood Pressure
  • CHF
  • COPD
  • Depression
  • Diabetes
  • Fibromyalgia
  • GERD
  • Gout
  • Hypertension
  • Thyroid

Unlimited Telehealth

  • Unlimited, 24/7 access to board-certified physicians via telehealth
  • No co-payments
  • Unlimited therapist access for mental health

Discounts

  • Prescription discounts up to 65%
  • Dental discounts up to 50%
  • Vision discounts up to 50%
  • MRI and imaging discounts up to 70%
  • Lab discounts up to 70%
  • Diabetic supply discounts up to 70%
  • Daily living supply discounts up to 10%

Acute Medications

  • If you have an immediate need for these types of medications, we include the top 95 most prescribed acute medications for a $5.00 payment, for up to a 21-day supply at over 64,000 pharmacies nationwide.

More Included Benefits

Couples Counseling – Allows couples to go through interactive technology to assist in growing and strengthening the relationship.

My Notification Services– In the event someone is unconscious, provides emergency personnel, via a sticker on driver’s license, information on individual’s emergency contact information, allergies, pet information, etc.

Evacuation and Repatriation – Provides up to $500,000 of coverage in the event covered person is traveling in a foreign country and needs medical assistance to get back to the U.S. for treatment along with money assistance in transferring remains.

ALL THE ABOVE BENEFITS INCLUDED FOR ONE LOW PRICE!!!

(For Dental, Vision, MRI and Imaging, and Lab Discount brochures, please scroll down below the Platinum Level)

Smart Choice Plan™ - Gold Level

(Hospitalization and Out-Patient Surgery)

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.

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

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

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 IUAThe 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.

Another benefit to the healthshare program is that in some cases, coverage may be 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.

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.

IMPORTANT HEALTH SHARE TERMINOLOGY

  • Health Share Program vs Insurance
  • Member Responsibility Amount (MRA) 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:

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.

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 affordable unlimited doctor office visits and unlimited urgent care, but also hospitalization and out-patient surgery benefits…ALL in one low price.

In addition to all the Blue Level office visits, Telemedicine, and Discounts, the following benefits are also included:

  • Accidental Death and Dismemberment
  • Couple’s Counseling
  • My Notification
  • Evacuation and Repatriation

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.  The $50,000 in coverage provided, will typically be enough to cover the average hospital stay or surgery, according to debt.org.

(NOTE: Hospital and surgical costs may be much higher).

Pre-existing conditions apply for a 12-month look-back.  In other words, a pre-existing condition is any condition for which the individual has received medical advice or treatment, or for which symptoms were present and a prudent person would have sought treatment within the past 12 months prior to enrollment in a new insurance plan.  Any condition deemed to be pre-existing will be excluded from coverage for 12 months after the coverage effective date.  Normal childbirth will be included 10 months after effective date.

 Smart Choice Plan™, Gold or Platinum Level, has an unlimited annual and lifetime payout maximum.

Call 888-536-5585 today to speak with a representative who can provide a comparison quote.

NOTE:  None of the benefits in the Smart Choice Plan™ are insurance products.