Zion Health Offers 2 Membership types
* HealthSharing with DPC
* DPC Connected Health
Direct Primary Care of Boca Raton
is there for you for all of needs that can be taken care of within the office.
Zion Health is there for the 'What If's"
Should you need to go to any Specialist, Hospital or Facility.
Zion Health supports you by cost sharing any expenses outside of the practice that exceeds
your Initial Unshared Amount.
What is an Initial Unshared Amount - IUA?
The out of pocket amount the member has prior to cost sharing for the NEED.
All qualified medical expenses after IUA is met is shareable
with the Zion Health community at 100% and without an annual or lifetime limit.
This amount paid by the member does not need to be paid again
until symptom free for 12 months.
Members usually benefit with an IUA vs a yearly deductible
What is a NEED?
A "Need is the ALL of the medical expenses surrounding a new illness, accident or diagnosis.
How can I access care?
Members may use the
PHCS Multi-Plan Network
they can alternately have their providers submit expenses directly to Zion Health
Or self pay and submit to Zion Health
Are there any restrictions to sharing?
Zion Health has a pre-existing condition clause.
A pre-existing condition is any condition that existed prior to membership
in which the member had symptoms of or have received treatment for
in the 24 months preceding enrollment.
High blood pressure, high cholesterol and diabetes (type 1 & 2)
are not considered a pre-existing condition,
as long as there has not been a hospitalization for the condition
in the past 12 months and able to control through medication or diet.
All Pre-Existing Conditions are gradually eligible for sharing within the
Zion Health Medical Cost Sharing Community in the following manner:
Months 1-12: No sharing, Months 12-24: Sharing up to $25,000,
Months 24-36:Sharing up to $50,000,
After 36 Months: Sharing up to $125,000 for the pre-existing condition.
Does Zion Health Share in Alternative Medical?
Alternative Health Eligible with pre-authorization.
Maternity Needs eligible after a 60 day waiting period.
Please see Maternity Sharing Guidelines PDF for more information.
Are there any limits?
No lifetime or maximum sharing limits for most medical expenses.
Any other features?
Zion Health Assists Up To $10,000 with End Of Life/ Funeral Expenses
after two years of uninterrupted Membership as a Sharing Member,
$10,000 secondary member, $2,500 dependent children
Zion Health offers 3 IUA levels to choose from:
$1,000, $2,500 and $5,000.
Member households choose their IUA on enrollment and
can adjust annually on their membership anniversary
Any member household that experiences 3 IUA's within a membership year
may have any further medical expense fully shared
after only reaching a $500 threshold
to further protect the Zion Health member
Zion Health offers 2 membership types to DPC members:
Health Sharing with DPC and Zion Health DPC Connected
HealthSharing with DPC
Does not include any preventative screening
Zion Health DPC Connected
Includes preventative screenings
Mammograms (after age 40)
Colonoscopy (after age 50)
Childhood Immunizations
1 outside visit per member
Utlizing the
PHCS Multi-Plan Network
