How HealthPass Pays for Large Medical Expenses

Corporate Insurance Is Not Working

Most people think of corporate health insurance accomplishing two primary functions.

  • Provide access to care
  • Protect patients financially in the case of a significant medical event

As we talked about in another article, most insurance providers do not actually fulfill their presumed function of providing access to quality care. Appointments are far too short and take far too long to book. That is why HealthPass utilizes our network of DPCs, most of which take no insurance whatsoever.

But we also believe corporate insurance does not provide sufficient financial protection in the case of a significant, expensive health event. In fact, in 2022, over 200,000 families with insurance were forced into bankruptcy due to medical bills.

According to Kaiser Health News...

  • 1 in 8 Americans owe $10,000 or more in medical debt
  • 20% believe they will never be able to fully pay their medical debt

We believe much better tools exist to protect HealthPass members financially when they need to access medical services outside of their DPC.

Direct Primary Care providers can address 85% of the most common medical needs in their office at no additional cost to our members. This leaves about 15% of medical needs which cannot be addressed by DPCs. Some of the 15% includes procedures like tests, labs, scans, and minor surgeries, most which can easily be addressed through cash payment and included coverage of preventative care. Another portion will be significant medical events like pregnancy and childbirth, car accidents, major surgery, and cancer. These event are relatively uncommon but often cost more than a patient can pay.

To pay for event while offering financial protection to our members, HealthPass utilizes two proven tools.

  • Small organizations with under 50 enrolled: medical cost sharing through Zion Healthshare
  • Larger organizations with over 50 enrolled: partial self-funding with a captive through Pareto Health

Each of these tools puts the patients in control of their healthcare decisions with better care at better prices.

Groups With Under 50 Enrolled

Again, having a corporate insurance plan does not guarantee you and your family will be financially protected if you get severely sick or injured. This fact is worth repeating: over 200,000 families with insurance went bankrupt in 2022 due to medical bills.

For businesses and nonprofits with under 50 enrolled, we offer access to medical cost sharing through Zion Healthshare, one of the nation's highest-rated cost sharing providers. Through Zion Healthshare...

  • Members save 40-60% on their healthcare expenses, and even more when they have a large medical event
  • Members can visit any provider to receive care, regardless of the network of the provider
  • There are no annual or lifetime sharing limits

This is how Zion Healthshare works:

  • Patients choose an Initial Unshareable Amount, or IUA. This is the amount they we will be responsible for in relation to any medical event.
  • If the cost of the medical event surpasses their IUA, the medical cost sharing company covers the rest for the remainder of the event.
  • Sharing covers through the entire event and IUAs do not reset at the end of the year

Compare this to the standard deductible, out-of-pocket max model. Out-of-pocket max amounts for individuals can reach up to $9100. This amount resets (and can even rise) every year. That means if you have had a persistent medical problem for over 3 years, you might pay $27,300.

Our team at HealthPass works closely with the team at Zion Healthshare and will gladly guide members through the process of submitting share requests.

Groups With Over 50 Enrolled

For businesses and nonprofits with over 50 enrolled, HealthPass utilizes partial self-funding with a captive.

Self-funding is a common methods for larger organizations to pay for healthcare. Through our model of partial self-funding with a captive, organizations can be in direct control of their healthcare costs while sharing large healthcare expenses with other members of one of the largest captive groups in the country.

Through this innovative model, businesses can cut their annual premiums roughly in half. Plus, with their lower premium, they cover access to DPCs, gym memberships, and other benefits.

For employees, this model means they can communicate directly with their employee when they have a large medical event, instead of a distant insurance provider. They will no longer need to fight a phone tree to have their questions answered and their concerns heard and addressed.

Plans are designed by the organization so they better fit the needs of the staff and reflect the organization's unique value and culture.

More + Better Options

When renewing their health insurance plan, employers can feel stuck with a limited menu of increasingly expensive options.

Through these two methods for handling large medical events, employees now have proven alternatives which will provide better care and better financial protection for more of their staff and their families.

If you’re ready to bring HealthPass to your company and begin saving money on healthcare (while offering better care), contact us directly at