Phoenix Preventive Sharing
The base Phoenix membership does not share routine preventive care. This optional add-on does, for five things, with its own limits and its own clock.
This is an optional, paid add-on. It is not part of the base Phoenix membership and not part of a CoreMed membership. If you have not bought it, none of the limits on this page apply to you. Ask us whether you have it.
What it shares
Five services, and eligible expenses are not subject to your IUA, which is the point of the add-on. You do not have to meet anything first.
Annual preventive visit
$250 per visitshareable
- Includes the routine physical, the age-appropriate health assessment, preventive counselling given as part of the visit, and the ordinary measurements taken during a preventive exam.
- A visit mainly about symptoms, an illness, an injury or a condition you already have is not a preventive visit. It goes back under the core guidelines, and your IUA applies.
Well child visits
The AAP recommended schedule
Routine immunizations
Routine age-appropriate vaccines
- Travel vaccinations, employment-required vaccinations and anything not considered routine preventive care are not eligible unless Phoenix approves them specifically.
Screening mammogram
$600 allowable amountshareable
- Exempt from the $500 Non-Navigated Hospital Fee, so a screening mammogram at a hospital does not trigger it.
- Choose a substantially higher-cost hospital setting when a cheaper one was reasonably available and Phoenix shares up to $600, with the difference on you.
- Ultrasound or MRI instead may be considered when a provider says it is medically appropriate. Some of those need Care Coordination or prior review.
Colorectal screening
Cologuard, or a coordinated screening colonoscopy
- Care Coordination is required for a screening colonoscopy. Phoenix's words: a colonoscopy obtained without required Care Coordination is not eligible for sharing. Call them before you book, not after.
- A positive Cologuard result makes the follow-up colonoscopy eligible, still subject to Care Coordination.
- If the colonoscopy finds something that needs treating, the treatment is not preventive. It goes under the core guidelines.
The waiting periods run from when you bought the add-on
This is the part that catches people. Where a service has a six-month wait, Phoenix measures it as six months of continuous membership in the add-on, not in the Phoenix membership. If you have been on Phoenix for three years and added preventive sharing last month, you have one month served, not three years.
Call before a colonoscopy
Of everything on this page, this is the one that can cost you the whole amount. Care Coordination is required for a screening colonoscopy. In Phoenix’s own words, a colonoscopy obtained without required Care Coordination is not eligible for sharing under the add-on. Not reduced. Not eligible. Call Planstin on 435.571.0011 before you schedule it, and they will help find the provider and the price as well.
Cologuard does not need that call. And if a Cologuard comes back positive, the follow-up colonoscopy becomes eligible, still subject to Care Coordination.
What you have to do
- The add-on has to be active on the day you receive the service.
- Where Care Coordination is required, it has to be done before the service, not after.
- Expenses have to be submitted inside the deadline in the member guidelines.
- Care has to be medically appropriate and from an appropriately licensed provider or facility.
Everything else in the Phoenix member guidelines still applies on top of this. The add-on adds services, it does not switch the other rules off.
How this compares with Zion
CoreMed offers both sharing communities and does not steer between them. Both sell preventive sharing as an add-on rather than building it in, and the two sets of limits are genuinely different, so read each one from its own page rather than assuming they match.
Zion’s preventive sharing, with its own limits →
Zion and Phoenix side by side →
Phoenix HealthShare is not health insurance. Membership does not create an insurance contract or guarantee payment of any medical expense. Members remain ultimately responsible for their own medical expenses. Sharing is voluntary and governed by the Phoenix Member Guidelines. Questions about eligibility, sharing, Care Coordination or a bill go to Planstin on 435.571.0011 or Individual@Planstin.com.
Common questions
Is this included in my membership?
No. It is an optional paid add-on on top of a Phoenix membership, and it has to be active on the day you receive the care. Ask us if you are not sure whether you have it.
Do I pay my IUA first?
No. Eligible preventive expenses under the add-on are not subject to your Initial Unshareable Amount. That is the main thing the add-on buys you.
I have been on Phoenix for years. Have I served the six months?
Not unless you have had the add-on for six months. The waiting period counts continuous membership in the add-on, not in the Phoenix membership.
My doctor wants a mammogram because he felt something. Is that shared under this add-on?
No, and this is the important distinction. Imaging done to look into a symptom or an abnormal finding is diagnostic rather than preventive, so it falls under the core guidelines and your IUA applies. It is not that it cannot be shared, it is that it is shared a different way.
Can I just book the colonoscopy and submit the bill?
No. Care Coordination is required first, and a colonoscopy obtained without it is not eligible for sharing under this add-on at all. Call Phoenix before you schedule.
Are my kids' shots shared?
Routine age-appropriate immunizations are eligible for both adults and children. Travel vaccinations and employment-required vaccinations are not, unless Phoenix specifically approves them.
What does the add-on cost?
Pricing depends on your household, so there is no fixed figure to quote. Run a quote or ask us.