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Direct Primary Care of Boca Raton

Direct Primary Care of Boca Raton

Direct Primary Care of Boca Raton

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Patient-Centered Healthcare


Zion Health

Direct Primary Care of Boca Raton

Direct Primary Care of Boca Raton

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HealthSharing Reimagined!


Overview of Zion Health

Direct Primary Care of Boca Raton

is there for you for all of needs that can be taken care of within the office.


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 are shareable 

with the Zion Health community at 100% and without an annual or lifetime limit.


The IUA is met one time for the Need and not does not reset annually.

 It reamins open with all medical expenses related to the Need being shared 

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 

Members may 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. 


Exceptions

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:


Sharing Schedule

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 Guidelines

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 an Ala Carte membership type to DPC members: 

Ala Carte Membership Costs

Base Costs Ages 18 - 29

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Base Costs Ages 30 - 49

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* Tobacco surcharge of $50 per household.

Base Costs Ages 50 - 64

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* Tobacco surcharge of $50 per household.



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Network

This is a Foundational Piece 

Monthly Add On Cost:

$5 Member

$5 Member & Spouse

$5 Member & Children

$5 Member & Family

Zion Health offers pre-negotiated rates for many medical services 

with medical providers in the PHCS network. 

The network is required for preventive services 

and offers pre-negotiated rates and simplified use for other medical services. 

The Network feature is automatically added 

when members chose to enroll in the Connected add-on.

Search The Network:

PHCS MultiPlan Network
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The Network

This is a Foundational Piece 


Monthly Add On Cost:


$5 Member

$5 Member & Spouse

$5 Member & Children

$5 Member & Family


Zion Health offers pre-negotiated rates for many medical services 

with medical providers in the PHCS network. 

The network is required for preventive services 

and offers pre-negotiated rates and simplified use for other medical services. 

The Network feature is automatically added 

when members chose to enroll in the Connected add-on.

Search The Network:

PHCS MultiPlan Network

Connected Care

Rx Share Program

Rx Share Program

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Monthly Add On Cost:


$20 Member

$40 Member & Spouse

$40 Member & Children

$60 Member & Family


Connected is an add-on to your Zion Health Essential Membership made to help share in the costs of standard screening services. Connected helps you stay on top of your health with yearly office check-ups and early-detection procedures. Currently, Connected must be paired with the Network add-on feature and services completed within the PHCS network.


No cost yearly office visit (1 per member)

Preventive mammogram* (6 mo. waiting period) 

Immunizations* for ages 0-16  (6 mo. waiting period)

Preventive colonoscopy* (6 mo. waiting period)

*Must use PHCS Network

Rx Share Program

Rx Share Program

Rx Share Program

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Monthly Add On Cost:


$20 Member

$40 Member & Spouse

$40 Member & Children

$60 Member & Family


Helps cover the cost of prescriptions. 

Prescriptions for medication(s) that are both billed by a provider and related to an eligible need are considered shareable and can take advantage of the Rx Share program through 

OptumRx, 

Zion Health members can receive discounts 

on their prescriptions. 

Additionally, Rx Share gives members access to many generic prescriptions for as low as $5. 

Rx Share is automatically included with Zion Health Direct 

Memberships &  is available as an add-on to the Zion Health Essential Membership.

TelaDoc

Rx Share Program

LifeWorks

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Monthly Add On Cost:


$5 Member

$10 Member & Spouse

$10 Member & Children

$15 Member & Family


Teladoc gives members 24/7 access to a certified provider by phone or video chat. Through Zion Health, regular Teladoc visits cost members $0. Medical experts can offer medical advice, write prescriptions, and share visit results instantly with your primary care physician. 

Unlimited consultations, $0 regular visits, $75 dermatology visits, 

Medication prescriptions for many illnesses

LifeWorks

Additional Giving

LifeWorks

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Monthly Add On Cost:


$5 Member

$40 Member & Spouse

$40 Member & Children

$60 Member & Family


LifeWorks is a mental wellness program that shares in expenses related to counseling services without the need to meet your IUA. With LifeWorks, well being resources are available 

24/7 via phone, web, or mobile app. 

Members also have the option to meet with therapists virtually or to set up in-person sessions with 

local mental health professionals.

Clinically appropriate number of sessions

No session fees, Phone, online, and in-person sessions

Partner Program - LifeWorks

Tobacco

Additional Giving

Additional Giving

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Monthly Add On Cost:


$50 Per Household


Please see restrictions below.

Zion Health prioritizes individual responsibility and healthy living. 

For this reason, members who use any tobacco products, (Within the last year) including cigarettes, cigars, chewing tobacco, snuff, pipe tobacco, or vapes will receive a monthly tobacco surcharge of $50 per household.  


 Smoked cannabis products are considered tobacco for purposes of the tobacco surcharge.  

Medical needs for tobacco users age 50 and above are limited to $50,000 for the following disease categories: cancer, heart conditions, COPD, and stroke.

Additional Giving

Additional Giving

Additional Giving

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Zion Health was built on the idea that members should work together to help those in need. Members are encouraged to contribute funds in addition to their required monthly contributions, a program known as additional giving. 

100% of contributions from additional giving are placed in the Benevolent Fund, which is used solely to assist members who have a special need that would not normally qualify for sharing. Additional giving is not mandatory, and members may contribute however much they feel is appropriate.  

All members who fulfill their membership responsibilities and follow membership guidelines are eligible to apply for assistance through the additional giving program when they have a need that does not meet sharing eligibility guidelines. To be considered, member needs must meet a $500 threshold.

Additional giving funds are used only 

to help pay for member medical needs

Receive aid for medical expenses that would not normally qualify as shareab

Zion Health & the Initial Unshared Amount

Zion Health Members pay the initial unsharable amount directly to their provider when a need occurs.  

The remaining eligible medical expenses are shared with the community.

Zion Health & Medical Needs Processing

Zion Health Members enjoy a full service team that makes processing a need easy and efficiently.  


Once all information is collected from the provider and member, most needs are processed within three business days..

Zion Health & Alternative Care

Providers can work with our Members to suggest alternative medical treatments and not limited to the treatments that traditional insurance companies would cover.

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Membership Guidelines

Find out more

Next Steps

Enroll

Set up a 1:1 Consultation

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Ready to complete your DPC Solution with Zion Health?

Please complete the contact form below.

Enroll Now!

Set up a 1:1 Consultation

Set up a 1:1 Consultation

Set up a 1:1 Consultation

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Want to review any questions you may have on a 1:1 basis? 

I am here to help. Reach out! We can talk for have a Zoom meeting.

Lets Connect!

Enrollment Links Provided

Karen Torsoe

"The HealthShare Lady"

845-641-9123

Certified Sedera, Zion and Alliance for Shared Health Affiliate

Guiding Individuals and Businesses in to  health empowering &  Cost Effective Health Care Solutions since 2014

330 Southeast 20th Avenue, Deerfield Beach, Florida 33441, United States

(845) 641-9123


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