*Official Member Guideline
Individual membership eligibility is primarily based on:
- Adherence to the Zion HealthShare Principles of Membership.
- Participation in the community by submitting monthly contributions.
- Under the age of 65
- Residency in the United States or Puerto Rico.
After committing to these primary eligibility requirements, prospective members are eligible to join the Zion HealthShare community. Membership may begin on a date selected by the prospective member or specified by Zion HealthShare, known as the membership start date. The prospective member’s monthly contribution must be received within 15 days of the agreed-upon membership start date. Once the first monthly contribution has been received membership is considered active.
Commitment
Members commit to abide by a set of personal standards as outlined in our Principles of Membership. If a violation of the Principles of Membership is discovered through review of a member’s submitted medical records, all sharing for that member will be put on hold. This hold will begin on the date the violation was discovered or recorded. Notification of the hold and an explanation of the discovery will be issued to the member.
Members will have 30 days to submit documentation supporting compliance with the Principles of Membership. If submitted documentation does not satisfactorily demonstrate compliance, membership may be revoked. If membership is revoked due to a violation of the Principles of Membership, Zion HealthShare will not return the offending member’s contributions received prior to the date of revocation.
Participation Through Contributions
Members submit monthly contributions to participate in the medical cost sharing community. Direct members make their contributions directly with Zion HealthShare. Essential members make monthly contributions through their employer or DPC practice.
Participation in the medical cost sharing community is voluntary, but monthly contributions are required for active membership and sharing eligibility. Monthly contributions must be received no later than 30 days after the contribution date. If a monthly contribution is not received by the last day of the billing month, the membership will become inactive, and the member will be withdrawn from the medical cost sharing community.
Withdrawn members may reapply if they meet all eligibility requirements. Once the member reapplies and membership is reinstated by Zion HealthShare, the member will become eligible to participate in our medical cost sharing community. All sharing requests submitted after the membership is inactive and before reinstatement will be ineligible for member-tomember sharing, and any medical conditions existing before the member is reinstated will be considered pre-membership medical conditions.
Qualification
Applicants must meet all criteria in the Member Guidelines, Principles of Membership, and membership application form to qualify for membership. If, at any time, it is discovered that a member did not submit a complete membership sign-up form, membership may be retroactively withdrawn or revoked.
While member health status has no effect on eligibility for membership, there are sharing limits for some pre-membership medical conditions. Sharing requests that are not eligible for sharing may still be eligible through the Additional Giving fund.
See the Additional Giving section for details.
Active Membership
Membership is considered active when the member has paid their monthly contributions on time and is in good standing with Zion HealthShare. For a sharing request to be shared, membership must be active during the date(s) of service, when medical bills are received, and when the IUA is paid. If a membership becomes inactive before a sharing determination is made, the bills may not be shared with the community. Any pre-membership medical condition limitations are applied based on the first date of active membership.
Residency Statement
Zion HealthShare members must reside within, and be a resident of, the United States or Puerto Rico to participate in and contribute to medical cost sharing. Members who choose to move outside of the United States or Puerto Rico for missions, military, or serving abroad can maintain their membership with the following requirements:
- Regular monthly contributions,
- Member(s) must have a physical address in the United States or Puerto Rico, and
- Cost sharing for medical care outside of the United States or Puerto Rico will follow the international Medical Treatment guidelines. That is, only acute and sudden onset medical expenses will be considered for sharing. Preventive, scheduled, or the like will not be considered for sharing.
Zion HealthShare is unable to register new members who reside in the state of Washington. See Zion HealthShare's Washington Statement for more information.
Member Guideline Notice
Notice
Please note all article sections formatted like this are official member guidelines and will be marked “*Official Member Guideline” when applicable. Anything else is simply helpful information to assist you in understanding the member guidelines and how to use your Zion HealthShare Membership.
Members who call the Zion HealthShare office asking about eligibility of medical expenses will be given an opinion, not a decision. Sharing Requests and medical expenses cannot be authorized over phone. For more information on submitting bills to Zion HealthShare, review the Member Guidelines or login to your Member Portal.
These guidelines are effective as of January 1, 2025.
Note
The Member Guidelines that go into effect January 1, 2025 will only be applicable to sharing requests that are submitted on or after that date. If a sharing request was submitted prior to January 1, 2025 the sharing request will be reviewed for sharing eligibility according to the Member Guidelines in effect at that time.