Traditional and Innovative Health Insurance Plans
With Planstin Preventive HSA – All Preventive care per healthcare.gov is 100% covered. Rx Discounts coverage is also included.
There is no waiting period for preexisting conditions on this plan.
There are two lanes for using this plan
Lane 1: Contact Care Coordination to coordinate all care. You choose your provider or facility and then contact Care Coordination. Care Coordination coordinates the care and ensures you are charged correctly. If you use the plan in this manner, the Deductible and Max Out of Pocket is waived and replaced with the HSA Gateway. Emergencies can be handled in this manner as long as they are true emergencies and you contact Care Coordination as soon as possible once the emergency is stabilized. You are guaranteed not to have a balance bill when using Care Coordination. Because this is an Open Access Plan, you can use any doctors or any facilities via Care Coordination.
Lane 2: You choose not to contact Care Coordination for your medical care. The plan will pay per the plan docs with you being required to pay the deductible and coinsurnace up to the out of pocket limit. There is a potential for a balance bill in rare circumstances which would be your responsibility. All balance bills can be avoided by using Care Coordination
Planstin Preventive MEC Plan Pairing with Zion HealthShare means no deductible to meet, rather for any qualifying expense (see Zion HealthShare member guidelines), you pay the first $1,250 (known as your Initial Unshareable Amount or IUA) of qualifying medical events and the HealthShare pays the rest. After you pay 3 IUAs, in a 12 month period, any other major event over $500 is paid by Zion HealthShare w/o requiring another $1,250 IUA. More money can go into your Health Savings Account if the HSA Plan is selected or choose the Copay plan if you prefer a copay instead of receiving HSA dollars. All Preventive care 100% covered. Rx Discounts.
See Member Guidelines and talk to an HCap Insurance Agent to learn how Pre-Membership Conditions are handled on this plan.
With these plans you present yourself as a “Self-Pay” Patient for anything that is not preventive coverage and pay at time of service or when billed. Your responsibility is for first $1,250 IUA using your HSA (if applicable). You have responsibility to learn the Zion HealthShare Member Guidelines. Your employer will also contribute to your Health Savings Account Plan.
Note: High blood pressure, high cholesterol, and diabetes (types 1 & 2) are not considered pre-membership medical conditions as long as 1. no hospitalization for the condition in 12 months prior to joining and 2. the member is able to control the condition through medication or diet.
Your employment with Total Rehab can be combined with a Zion HealthShare Membership as a powerful way to control costs on medical expenses and be a comprehensive health strategy.
For larger claims that can’t be treated at a Total Rehab Clinic or for Maternity, a Zion HealthShare Membership can provide comprehensive coverage. Pre-Membership conditions do have a phase in period per the Zion HealthShare Member Guidelines on this plan.
Plans above that included Planstin, are actual insurance products and include preventive services defined by healthcare.gov covered at zero cost. Many of these preventive services can be received at Total Rehab as these clinics also do primary care also at no cost. However, with this membership only plan, the cost for colonoscopies and mammograms (to name the two most common, but not limited to just these two) will need to be paid for by the employee as they are not covered in this membership only option. This membership only plan is not recommended for those needing specialty medications.
Planstin Contact Info
Member Services 888-920-7526 or
member@planstin.com
Claims Fax 435-631-9478 or
claims@planstin.com
The mission of Doable Wellness is to increase motivation to live a healthier life by providing incentives and tools that make healthy behaviors doable.
Earn Swag in Your Prize Pantry on the app and additional HSA Contributions in the following amounts for earning 120 healthy behavior points each month:
Employee Only Coverage + $50/mo
Employee +Spouse/Children + $75/mo
Employee + Family + $100/mo
Watch for your Welcome Email for More Information
Your plan may include a Health Savings Account. Contributions can be made to this account per the chart below. Some contributions may be included in your health plan. Some contributions may be included due to your healthy behaviors through Doable Wellness. You can take full advantage of your HSA by adding additional contributions per the limits below. All HSA Contributions are tax free and can be used for any qualified medical expenses (click below).
Health Equity Bank Contact Info
Member Services 1 (866) 346-5800 or www.healthequity.com