Understanding the Member Guidelines: Eligibility and Enrollment

Zion Health is unique from other HealthShares. We welcome all potential members. You can even sign up online—no need to wait for a callback that you’ve been approved! In this post we will cover the primary eligibility and enrollment concerns as well as a list of FAQs related to membership eligibility.

Eligibility and Enrollment Requirements

Membership eligibility is straightforward. To be eligible for enrollment as a Zion Health member you must be willing to:

  1. Abide by the Principles of Membership
  2. Submit monthly contributions

Principles of Membership

By agreeing to the principles of membership, you are stating that:

  • You believe in the concept and effectiveness of medical cost sharing
  • You accept that members of all faiths are a part of your sharing community
  • You recognize that Zion Health holds itself accountable to a higher power
  • You understand the difference between Zion Health and an insurance agency
  • You promise to refrain from substance abuse and maintain healthy habits
  • You pledge to treat your family, and all others, with care and respect
  • You agree to mediation and arbitration if any issues arise

Monthly Contributions

Your monthly contribution will be based on your membership type, your IUA, and your age. To be an active Zion Health member you must submit a monthly contribution for your type of membership. Submit your contribution:

  • to Zion Health directly
  • through a direct primary care (DPC) practice
  • through a participating employer

All member contributions are voluntary, but a monthly contribution is required to be active and eligible for sharing. If your monthly contribution is not received by the last day of the billing month, your membership will become inactive, and you will be withdrawn from the medical cost sharing community. If this happens, any needs that occur while your membership is inactive will be ineligible for sharing.

If your membership has been withdrawn you may reapply, but if your membership has been inactivated three times you cannot reapply.

Your Household, Your Membership

There are four types of membership households:

  • Member only
  • Member & spouse
  • Member & child(ren)
  • Member & family

Any dependents under your roof who meet the membership guidelines may join your household membership. Your monthly contributions will partly depend on the participating members in your household. If you are the primary member, or the head of household, you will be responsible for the members in your household.

Dependents

Your dependents are welcome to join the Zion Health community. Keep in mind that, as the head of household, you are responsible for each individual participating under your membership. This responsibility includes making sure each member complies with the membership guidelines and the Zion Health Principles of Membership.

Your unmarried dependents may participate under your membership until they turn 26. Once your dependent reaches the age of 26, or marries, they can no longer participate under your membership. However, if your dependent wishes to continue membership, they may, of course, enroll in their own Zion Health membership.

If your dependent experiences any medical needs in the time between your membership and their own membership, those needs cannot be shared with the Zion Health community. Additionally, any health issues from the previous membership may be treated as pre-existing conditions if their membership lapses at any point.

Newborns

If you are welcoming a newborn into your household whose birth is part of your shareable maternity need, your baby will automatically be enrolled in a Zion Health membership.

If the new addition changes your household type, Zion Health will adjust your monthly contribution amount automatically. If you do not want your newborn added to your membership, just let Zion Health know 30 days before the baby is born.

If your newborn is not connected to a shareable maternity need, you will need to enroll the baby by contacting Zion Health. Your baby’s membership will begin on the date of enrollment. Though your baby will be a welcome addition to the Zion Health community, any health issues that your newborn has prior to the enrollment date will be considered pre-existing.

Adopted Children

At Zion Health, your adopted children are the same as your biological children. Just like any pre-existing conditions your biological child might have had prior to membership, if your adopted child had any health issues prior to adoption, they will be treated as pre-existing conditions.

Grandchildren

Your grandchildren may be included in your membership under the following guidelines:

  • You are your grandchild’s legal custodian or guardian
  • Your grandchild lives with you at least nine months out of the year
  • No one else is responsible for your grandchild’s medical care

All are Welcome!

At Zion Health, we like keeping membership simple. All you have to do is adhere to the Principles of Membership and submit monthly contributions.

Zion Health will never decline membership based on factors like religious affiliation or pre-existing conditions. At Zion Health, we are serious about acceptance—we are seriously open to everyone!

Membership Eligibility FAQs

What if I use tobacco?

The tobacco surcharge for monthly membership is $50 per household. Zion Health will consider a member a tobacco user if they have used any tobacco product one or more times a month in the past year.

For the purposes of the surcharge, Zion Health includes some cannabis products as “tobacco products.” Members who use smoked cannabis products will be subject to the tobacco surcharge.

Do I have to participate in a specific religion?

Zion Health does not deny membership based on religion. Members of all faiths are welcome to participate in the Zion Health community.

What if I have pre-existing conditions?

Zion Health does not deny membership due to a prospective member’s pre-existing health conditions. Zion Health shares in pre-existing conditions under a phase-in program.

What if my dependent gets married?

If your dependent marries or reaches the age of 26, they can no longer be included on your membership. However, your dependent may transition to their own membership. Take note that your dependent’s medical needs that may occur between leaving your membership and starting their own are not shareable.

What happens if I violate the Principles of Membership?

If you violate one of the Principles of Membership, all cost sharing will be put on hold. This hold will begin on the date the violation was discovered or reported. Zion Health will issue you a notification of the hold.

You will have 30 days to submit documentation showing that you are adhering to the Principles of Membership. If the documentation you provide does not effectively demonstrate that you are complying with the Principles of Membership, your membership will be revoked, and you will not receive a refund.

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