One of the most practical benefits of being a member with Zion Health is that your membership includes sharing for common preventive services.
Some preventive services are shareable right away! Others only have a six-month waiting period before they are shareable. Even more exciting, these preventive services may be shared without having to meet your IUA.
Accessing Preventive Care
Accessing your shareable preventive care is as simple as presenting your Zion Health Membership ID Card to your provider. Your ID card contains all the information your provider will need to apply available discounts and send billing data to Zion Health for processing.
As an alternative to having a bill sent for future payment, Zion Health can pay providers at the time of service, if the provider is willing.
It’s important to note that Zion Health will not reimburse members for payments made directly to providers for preventive services. This might become an issue if your provider does not understand how to bill Zion Health—or just doesn’t want to do it.
Fortunately, the Zion Health Member Care Team is available answer any questions you or your provider may have, and they are ready to help you and your provider process a payment by phone if necessary.
What Preventive Services are Shareable?
There are four main preventive services available to Zion Health members: annual provider visit, colonoscopy, mammogram, and youth immunizations.
Annual Provider Visit
Your annual provider visit is shareable on day one of your membership. The sharing limit for the visit is $250. If your annual provider visit includes a Pap test, the test will be shared at 100% as long as it is billed along with the provider visit.
Your shareable provider visit is designed to be flexible to meet your needs. The annual provider visit may be used for a routine checkup, a sick visit, or even a specialist visit.
Preventive colonoscopy screenings are shareable after six months of membership for members 45 and older. A colonoscopy screening is shareable every 10 years, and both the screening and the anesthesia are shared at 100%. You may also share expenses for any diagnostic testing that is part of your screening, such as a biopsy or related pathology.
If you will need a separate appointment as a follow up, that service will not be shareable as a part of the colonoscopy.
A preventive mammogram(exam, appointment, and evaluation of imaging) and one follow-up visit are shared at 100% up to $600. In order for your preventive mammogram to be shared, you must be a member for six months and have a provider recommendation.
Preventive immunizations for children up to the age of 16 are shareable after six months of membership. The list of shareable immunizations is based on CDC guidelines (cdc.gov).
The appointment or visit fees are not shareable as part of the preventive immunizations.
Alternative Preventive Testing
Alternative testing, such as at-home colon cancer tests and thermography, have become more popular and widely used. These alternatives may be shareable if pre-approved by Zion Health.
Please contact Zion Health at firstname.lastname@example.org with any questions about alternative testing.
Use Your Discounts
Though not everything in your preventive care wish list may be shareable, Zion Health offers a wide range of discounts through the PHCS Network.
If something is not shareable as a preventive care service, you may still be able to share the service if it relates to an eligible medical need. Check out the Zion Health Membership Guidelines for more information.