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Terminology

Health cost sharing has a language of its own. Here are the words you will hear, in plain English. This is educational information, not legal, tax, or insurance advice.

18 terms

Annual Unshared Amount
Cost Sharing
The amount a member or household is responsible for before the community begins sharing eligible costs in a given year. It plays a role similar to an insurance deductible, but it belongs to the sharing model.

See also: Eligible for Sharing, Sharing Request

Balance Billing
Billing & Pricing
When a provider bills a patient for the difference between their charge and what was already paid. Transparent cash and bundled prices are designed to prevent it.

See also: Bundled Pricing, Cash Pay / Self-Pay

Bundled Pricing
Billing & Pricing
A single upfront price that covers everything for an episode of care, such as a surgery, including the facility, surgeon, and anesthesia. No surprise line-item bills afterward.

See also: Cash Pay / Self-Pay, Balance Billing, Reference-Based Pricing

Cash Pay / Self-Pay
Billing & Pricing
Paying a provider directly at the time of care, usually at a transparent price, instead of billing insurance. Cost sharing members often pay cash and then submit a sharing request.

See also: Free-Market Medicine, Bundled Pricing, Sharing Request

Direct Primary Care
Care Models
A care model where a patient pays a flat monthly fee directly to a primary care practice for most everyday care, with no insurance billing in between. Often paired with cost sharing for larger needs.

See also: Cash Pay / Self-Pay, Free-Market Medicine

Eligible for Sharing
Cost Sharing
A medical cost that meets the sharing guidelines and can be shared among members. There is no promise to pay.

See also: Sharing Request, Sharing Guidelines

Free-Market Medicine
Care Models
Care delivered by providers who publish real, upfront prices and compete on quality and value, rather than billing through opaque insurance networks.

See also: Direct Primary Care, Cash Pay / Self-Pay, Reference-Based Pricing

Health Cost Sharing
Cost Sharing
A model where members commit to share one another's eligible medical costs directly, member to member. It is not insurance. Cowboy Christian holds no pool of member funds, sharing is voluntary, and no payment is guaranteed.

See also: Sharing Community, Monthly Share, Not Insurance

Membership Fee
Membership
The fee that supports operating the Cowboy Christian platform and network. It is billed alongside the monthly share but is tracked separately from the amount a member commits to sharing.

See also: Monthly Share

Monthly Share
Membership
The amount a member commits each month to help share other members' eligible medical costs. Cowboy Christian does not hold a pool of member funds. It is separate from the platform membership fee.

See also: Membership Fee, Health Cost Sharing

Not Insurance
Cost Sharing
Cowboy Christian is a health cost sharing network, not an insurance company. There is no policy, no promise to pay, and no state guaranty fund behind it. Members agree to share one another's eligible medical costs as a community.

See also: Health Cost Sharing, Sharing Community

Pre-Existing Condition
Cost Sharing
A health condition a member had before joining. Sharing guidelines describe how, and over what waiting period, costs tied to a pre-existing condition may become eligible for sharing.

See also: Eligible for Sharing, Sharing Guidelines

Reference-Based Pricing
Billing & Pricing
Setting a fair payment for a service based on a public benchmark, often a multiple of the Medicare rate, instead of a hospital's inflated list price.

See also: Bundled Pricing, Free-Market Medicine

Safe Harbor
Legal & Regulatory
A state law that expressly recognizes health cost sharing as distinct from insurance, so that sharing organizations are not regulated as insurers. States with a safe harbor rate as more friendly on the State Guide.

See also: Not Insurance, Sharing Guidelines

Sharing Community
Cost Sharing
The members who share one another's eligible medical costs directly. At Cowboy Christian the community is built around shared Christian faith and values.

See also: Health Cost Sharing, Statement of Beliefs

Sharing Guidelines
Legal & Regulatory
The written rules that describe who may join, what is eligible for sharing, and how sharing is administered. Members agree to the guidelines at sign-up.

See also: Eligible for Sharing, Statement of Beliefs

Sharing Request
Cost Sharing
A member's submitted request to have an eligible medical cost shared by the community. Cowboy Christian reviews the request against the sharing guidelines before it is shared.

See also: Eligible for Sharing, Annual Unshared Amount

Statement of Beliefs
Membership
The shared Christian faith commitments that members affirm when they join the Cowboy Christian community.

See also: Sharing Community, Sharing Guidelines