FAQ
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Breckpoint Benefits
What is Breckpoint?
How do I use my Breckpoint Benefit?
What if my provider is not in the PHCS network?
You can see your provider even if they are out-of-network with PHCS. Anynon-preventive service can be submitted to Breckpoint for reimbursement. You can download the reimbursement form from your Member Portal, fill out the requested information, and follow the submission instructions.
Why does Breckpoint have a network and Zion does not?
Breckpoint participates with a Network in order to provide cost-efficient access to in-office provider care. Zion has chosen not to participate with a Network in order to allow members who need to be seen in an emergency, or who need to have expensive services provided, the freedom to see any provider without worrying about staying within a Network.
My provider did not collect my $25 copay. Why?
There are a variety of reasons why this would occur. If you are being seen by a network provider for preventive visit, no copay should be collected. The provider could also be waiting to collect the $25 copay until after the claim has been processed. At that time you will receive a bill for any amount over the $200 payment made by Breckpoint. If you have questions, contact your provider
Can my $25 copay be applied to my IUA?
If a situation arises where you are being seen by a provider under your Breckpoint benefit, and it is determined that you will need additional high-cost services, you can submit any out-of-pocket payment to Zion for review. Zion will make the final determination if the out-of-pocket amount is Need related, and therefore, can be applied to your IUA.
Why can’t I use my Planstin Card? It’s still the PHCS Network?
Planstin was the previous TPA that administered and paid the medical claims. Planstin no longer manages the ECHS health memberships. They will be unable to pay claims on our behalf because they no longer have funding. Please destroy your previous Planstin cards and download your Breckpoint cards.
Zion HealthShare
What is Zion Healthshare?
Zion Healthshare is a medical cost sharing community. Health share programs have grown as a low-cost alternative to health insurance. A health share is a group of people who have agreed to help with each other’s medical costs. Zion’s focus is to provide an avenue for members to health each other bear their immediate healthcare expenses.
How do I use my Zion benefit?
As soon as you are aware of a high-cost medical expense, or as soon as you are able, contact Zion Healthshare to open a Need Request. You can do this by logging in to the Zion Member Portal and filling out the requested information. You will need to request self-payment option from your providers and obtain all itemized statements. You can then submit this information to Zion. Please refer to the Sharing Request information page on the Zion website.
What is an IUA?
An IUA is your initial unshareable amount. This amount is determined when you register for the membership. It is the amount that you must pay out-of=pocket before Zion will begin reviewing your Need Request and/or making payments to your providers. You can contact Zion Member Services at 888-920-9466 for assistance with a Need Request.
What is a pre-membership condition?
What is a Need?
A Need is any high-cost service, or services, that is submitted to Zion for consideration. These services must be related to the same medical condition or incident. For example, if you are injured while hiking, and require treatment in an emergency room, this could be submitted to Zion as a Need Request, as long as the out-of-pocket costs exceed your IUA. Please refer to the Zion Healthshare Need Request information page for additional information.
What information do I need to submit a Need Request?
When you submit a Need Request to Zion, you will need to submit any receipts for out-of-pocket payments that you have made, and itemized bills for all services rendered related to the medical condition of the Need. Additional information, such as medical records, will be requested by Zion. It is important to keep all itemized receipts on the chance that an office visit could reveal a major medical concern.
Can I provide my Membership Card for Zion services?
No, you cannot submit your membership card to a provider’s office when Zion will be used to make payment. Breckpoint is a separate entity from Zion. Zion does not provide physical membership cards. When you are to be seen by a provider for services related to a Need submitted to Zion, you should request that you be provided the self-pay payment rate and do not provide a membership card.
What contributes to my IUA?
Any amount that is paid towards a specific, significant medical condition or event will be counted towards your IUA. If you are injured while playing a sport and have to be seen at a hospital to receive x-rays and treatment, any amount paid towards that injury will be counted towards your IUA for that condition or event.
Are pre-membership conditions covered?
Pre-membership conditions have a phase-in period wherein sharing is limited. Starting from the membership start date, there is a one-year waiting period before the condition(s) is shareable. After the waiting period, the shareable amount increases with each membership year. Refer to the Member Guide-lines for additional information.
Is there a network to worry about?
Zion Healthshare does not participate with any health care network in order to allow it’s members the freedom to choose the provider that they feel will best treat their medical needs.
Can I receive proof of coverage from Zion Healthshare?
Proof of coverage can be obtained by calling Zion Healthshare Member Services. Provide your membership number to the Member Services Representative. You can request the Proof of Coverage from Member Services.
How do I contact Zion Healthshare?
You can contact Zion Healthshare Member Services by calling 888-920-9466. Or you can email Zion Healthshare at [email protected]
WALMART / MeMD
What is Walmart Health / MeMD?
Walmart Health joined with MeMD to create a an accessible and cost effective way to receive medical care. By joining with Walmart Health/MeMD, Eagle Care Health Solutions is providing the opportunity for our members to receive quality, $0 cost access to provider services. If the member requires a Primary Care visit, or an Urgent Care visit, MeMD can fulfill that need.
How do I access my MeMD/Walmart Health Benefit?
Members can access MeMD by clicking the following link and registering their account.
www.memd.me/eaglecare
Use the numeric portion of your member ID, found on your Membership Card, and your email to register the account, to access your benefits.
What should I do in my portal?
The primary membership holder should register their account and add any dependents on the membership. Click the “Family” tab, then click “Add Family Member”. Once you add family members, any dependent over the age of 18 will receive their own log-in information. Minor dependents will show on the primary membership holder portal.
Some of my dependents have their own log-in, is this right?
What is included in my MeMD membership?
What is the difference between Virtual Urgent Care and Virtu- al Primary Care?
Can I see the same Virtual PCP?
MASA MTS
What is MASA MTS?
What MASA benefits are part of my membership?
Are there additional benefits that I can purchase?
How do I use my MASA MTS benefit?
How do I submit a claim to MASA MTS?
QUESTIS
What is Questis?
How do I access my Questis benefits?
Go to go.myquestis.com/new-user to confirm your account. Once you’ve confirmed your account, you will be instructed to create your log-in credentials. For additional information, contact Questis by emailing [email protected].
What can I expect from Questis?
MEDPLAN CREDIT
What is MedPlan Credit?
How do I access MedPlan Credit?
Accessing MedPlan Credit is easy. Click the following link to submit an application.