Yes, health sharing plans cover emergency room visits. That's the short answer.

The longer answer: there are notification requirements, IUA rules, and some definitions of "emergency" that matter — and getting them wrong can affect your claim. Here's exactly what you need to know before you need it.

The Simple Version

If you have a genuine emergency — chest pain, severe injury, can't breathe, something life-threatening — go to the ER. Don't call your health sharing plan first. Just go.

After you're stable (or the next day), notify your plan. Every plan has a notification window (usually 24–48 hours after ER admission). Missing this window can complicate your claim, but it won't automatically void it for a true emergency.

That's it. The rest of this article covers the specifics.

What Counts as an Emergency

All plans cover "genuine" emergencies, but they define this carefully. Here's what qualifies:

Always covered:

• Chest pain / suspected heart attack
• Difficulty breathing
• Severe bleeding
• Loss of consciousness
• Stroke symptoms
• Severe allergic reaction (anaphylaxis)
• Major trauma (car accident, fall, serious injury)
• Appendicitis / acute abdominal emergency
• Broken bones requiring immediate care
• Severe burns

Gray area — may or may not be covered:

• High fever without other symptoms
• Moderate injury that could wait for urgent care
• Severe back pain

Generally not covered as emergency:

• Visiting the ER for a sore throat or mild cold
• Using the ER because urgent care is inconvenient
• Non-urgent conditions that could be handled by a primary care doctor

ER Coverage by Plan

| Plan | ER Coverage | Notification Window | Your Share | Notes | |------|------------|---------------------|-----------|-------| | Zion HealthShare | Yes | 24 hours after admission | IUA ($1K–$5K) | Cigna network auto-discounts at in-network ERs | | Medi-Share | Yes | Within 24 hours | IUA ($1,250–$10,500) | Any ER; may need to negotiate cash rate | | Samaritan Ministries | Yes | Within 24 hours | $300/month share | Peer-to-peer; process takes longer | | CrowdHealth | Yes | Within 24 hours | Crowdfunded per claim | Acute emergency only | | Sedera | Yes | Varies by plan | $500–$3,000 | Ask employer for specifics | | Presidio (TX only) | Yes | None required | Standard deductible | Actual insurance, ER treated like any other claim |

Real Cost Example: Appendicitis ER Visit

An appendicitis trip to the ER typically involves:

• ER visit and diagnosis: $5,000–$8,000
• Surgery (if same night): $25,000–$45,000
• Hospital stay (1–2 nights): $10,000–$20,000
• Total: $40,000–$73,000

With Zion Standard (IUA $2,500, Cigna network):

• Hospital bills at Cigna contracted rate: ~$25,000–$40,000 (40% discount)
• Your share: $2,500 (IUA)
• Zion shares: $22,500–$37,500

With Medi-Share Silver (IUA $2,700, no network):

• Hospital may negotiate cash rate: ~$28,000–$45,000
• Your share: $2,700
• Medi-Share shares: $25,000–$42,000

Either way, a $65,000 emergency costs you $2,500–$2,700 out of pocket. That's the value of health sharing for exactly this type of event.

The Notification Rule: What You Actually Need to Do

Most people miss this or don't know it exists.

After an ER visit:

1. During the ER visit — you don't need to call your plan. Focus on your care.
2. Within 24 hours of admission — call your plan's member services number to notify them of the visit
3. For follow-up care — if the ER recommends a specialist or procedure, that typically needs pre-authorization before it's scheduled

The 24-hour notification is important. Missing it might not void your claim entirely (especially for genuine emergencies), but it can create friction. Set a reminder while you're still at the hospital.

In-Network vs Out-of-Network ERs (Zion Only)

For Zion users, this matters more than for other plans.

In-network Cigna ER: The hospital automatically applies the contracted rate. No negotiation needed. Your bill is immediately discounted 30–50% before your IUA applies.

Out-of-network ER: Zion will still share the cost, but at a different rate. If you go out of network for a genuine emergency, the cost is still covered — emergencies are treated as in-network emergencies by most plans regardless of network status (similar to how insurance handles this).

In practice: if you're in an ambulance, you don't control where you go. Don't stress about the network in an emergency. Go where they take you, notify Zion after, and let the claims process sort it out.

What Doesn't Apply to Emergencies

A few things that trip people up:

Waiting periods don't apply to emergencies. Most plans waive the new-member waiting period (typically 30–90 days) for genuine emergencies. If you join Zion today and get in a car accident tomorrow, the ER visit is covered.

Pre-existing condition waiting periods may still apply. If you have a pre-existing heart condition and have a heart attack during the waiting period, that's more complicated. The "emergency" exception typically applies to acute, sudden emergencies — not flare-ups of known pre-existing conditions.

The Honest Comparison: Health Sharing vs ACA for ER Visits

For a $10,000 ER visit:

| | ACA Silver | Zion Standard | |--|-----------|--------------| | Annual premium (35yo) | $4,560 | $2,580 | | Your ER cost | $4,500 (deductible) | $2,500 (IUA) | | Total cost for the year | $9,060 | $5,080 |

Health sharing wins on ER coverage for healthy people paying full ACA prices. The IUA is often lower than the ACA deductible, and the monthly cost difference more than offsets any gap.

Bottom Line

Go to the ER if you need it. Health sharing covers genuine emergencies across all plans.

The only things to remember:

1. Notify your plan within 24 hours of admission
2. Keep the member services number in your phone
3. Understand that "urgent care-appropriate" visits may be processed differently

For everything else — major trauma, appendicitis, heart attack, severe injury — you're covered.

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