Straight Answers, Not Sales Pressure
Start with the fundamentals. Each answer links to an official source and a deeper guide so you can understand the tradeoffs before taking a next step.
We use membership, monthly contribution, sharing request, and eligible for sharing—not insurance shorthand.
Each answer points to a current Zion HealthShare guideline, glossary, or membership page.
Education helps you compare; it does not replace reading the current guidelines for your circumstances.
Core Questions
HealthShare is a membership-based medical cost-sharing community. Members make monthly contributions, and medical expenses may be eligible for sharing according to the Member Guidelines. It is not insurance, and sharing of medical expenses is not guaranteed.
No. Zion HealthShare describes itself as a benevolent organization rather than an insurance entity. It facilitates member-to-member sharing of eligible medical expenses under its Member Guidelines; members remain responsible for their medical bills.
An IUA is the amount a member is required to pay before associated eligible medical expenses may be shared. The current individual membership options are $1,250, $2,500, and $5,000. A household is responsible for no more than three IUAs in a rolling 12-month period; after three IUAs are paid, additional eligible Sharing Requests over $500 may be shared with no additional IUA.
Direct is the individual-and-family membership pathway and includes Preventive Sharing, Zion RxShare, and Primestin Care. Primestin Care provides virtual-care and self-guided mental-health resources as membership services. Essential is designed for companies and organizations; Preventive Sharing, Zion RxShare, and Primestin Care may be added at an additional cost.
The Member Guidelines state that health status does not determine membership eligibility, but some pre-membership medical conditions have sharing limits or phase-in rules. The published schedule is $0 in Year 1, up to $25,000 in Year 2, up to $50,000 in Year 3, and up to $125,000 each membership year beginning in Year 4 for qualifying conditions. Read the current Member Guidelines before making a decision about your situation.
Yes. If a member has other insurance, a group plan, government assistance, or similar coverage, those sources are considered first. Zion HealthShare may consider any remaining eligible medical expenses after those options are exhausted. Members should disclose other coverage with their Sharing Request.
Mental-health treatment expenses and treatment for neurodivergent conditions such as ADHD or autism are not eligible for sharing through the community pool. Direct Membership includes Primestin Care, while Essential Membership can add it. Primestin Care includes TalkspaceGo, a free self-guided resource for members age 13 and older; it is not licensed therapy. Members using Primestin Care may also access a licensed-therapy offer at $50 per month for the first three months, then $200 per month if they continue.
Zion HealthShare states that eligible medical expenses for cancer diagnosis and treatment may be shared under the Member Guidelines. A Sharing Request is evaluated under the guidelines, so eligibility is determined for each situation.
The 2027 Board Approved Member Guidelines state that midwifery care from legally regulated providers is generally eligible for sharing. Home births and birthing centers are generally eligible after the household IUA is met, with a sharing maximum of $9,000. If care becomes co-managed with a physician, complications arise, or delivery occurs in a hospital, the standard maternity IUA applies before remaining eligible expenses may be considered for sharing.
Under the 2027 Board Approved Member Guidelines, prescribed home healthcare related to an eligible accident, illness, or injury is limited to 30 days, with possible 30-day extensions only when it is more cost-effective than verified viable options. Qualifying prescribed medical supplies may be considered for up to 120 days, generally require a cost above $100 per item, and have a $500 limit per eligible medical need. Therapeutic treatments are limited to $7,500 or 35 treatments per medical need, whichever limit is reached first.
The 2027 Board Approved Member Guidelines state that a dependent who gives birth before age 18 and the newborn may remain on the current household membership until the dependent turns 18. If the dependent is 18 or older at the time of birth, the dependent and newborn must establish their own household membership. A legal-custody exception may apply when the household primary member or spouse obtains legal custody, subject to the Guidelines and any requested documentation.
Members, including spouses and adult dependents, may request withdrawal of an individual membership, a whole membership, or a specific household member. The 2027 Board Approved Member Guidelines say requests can take until the next business day to process and should be submitted at least 48 hours before the next billing cycle to avoid the next charge. Withdrawals are not backdated or prorated, and memberships administered through an employer, group plan, or another entity must be withdrawn through that administrator.
A sharing request notifies the community of a member’s medical need and associated expenses. Eligibility, documentation, timing, and the IUA are evaluated under the Member Guidelines before expenses can be considered for sharing.
The current guidelines list several individual eligibility requirements, including adherence to membership principles, active monthly contributions, being under age 65, and residency in the United States or Puerto Rico. New Washington residents cannot currently enroll. Always check current state notices and guidelines.
Start with your household type, age range, preferred IUA, routine-care needs, prescription needs, provider preferences, and any questions about guideline limits. Then use a personalized estimate and the Member Guidelines to understand the tradeoffs before choosing a next step.
Ready for Your Numbers?
A personalized estimate shows membership contribution choices. Use it alongside the Member Guidelines to decide whether a conversation makes sense.
