Sharing Guidelines

These guidelines introduce who we invite to join, the purpose behind our model, and how sharing works at Cowboy Christian.

It is a faith-based health cost sharing platform. Membership is not an insurance policy, the sharing of costs between members is entirely voluntary, and no payment or sharing is guaranteed.

Who do we invite to join?

We invite Christian Americans who share our values and our way of life:

Christian Americans who love our great United States of America.
Practicing Christians who attend church regularly.
Individuals and families looking for a like-minded community to support one another in paying their medical needs.
People who believe in freedom, heritage, honesty, honor, character, integrity, family, and a deep faith in our Lord, who have kindness in their hearts and keep their word.
Members who use and teach common sense and pursue a healthy lifestyle.

We ask that our members share our love of America and our belief in the principles of faith, hard work, personal responsibility, and community.

What is the purpose behind this business model?

The purpose of Cowboy Christian is to help Christian Americans save money on their healthcare bills and to lead them toward a more efficient and effective healthcare experience. For too long, the healthcare system has trended downward in both service and financial burden to the American people. Our purpose is to advance free-market principles for a better healthcare system, for Americans and for anyone who wishes to pay for care directly.

This is a service for payment. We provide value to our subscribers through safe, efficient, honest, and effective financial transactions, and we want you to receive healthcare at a fair price. Members commonly pay 50% to 90% less than they would through traditional insurance, because cash-pay patients often pay only a fraction of the billed charge. Our goal is to help you settle the price of your care before you receive it, wherever that is possible, adding downward pressure to an inefficient and overpriced system. We are pro-American, pro-physician, and pro-patient.

By removing the middleman and most administrators, we work to lower what you pay for care.

The most common cause of bankruptcy in America is healthcare, and we are working to change that.

Subscribers to Cowboy Christian are self-pay. Make it known whenever you receive care that you are paying cash. Cowboy Christian is not insurance. You may see the doctor you believe will help you best, at any hospital. Because subscribers are self-pay, the cash price is often far lower than the billed charge.

By joining Cowboy Christian, we stand together to negotiate healthcare at the best price. Our physician uses his years of experience and familiarity with the industry to build a curated list of healthcare facilities where both skill and price are strong. We update this information for our members as subscribers and their locations come online, which benefits the whole community. Through these resources, you can find solutions that include transparent pricing for many outpatient procedures.

Do I need to be an American citizen?

Membership is open to United States citizens and to others who are lawfully present in the United States. This is a membership requirement, and you confirm it when you join. To join, you must also live in the United States and have an account at a United States bank. Enrollment is not open yet to residents of Washington. We are proud to serve our country and our fellow Americans.

These requirements continue for as long as you are a member, and sharing moves only between accounts at United States banks. If you move your residence outside the United States, tell us through the contact form at cowboychristiansharing.com/contact or by calling us toll-free at 1-888-915-2776. You are no longer eligible from the date of the move, and your membership ends on that date. A need that was already approved keeps what members have already shared toward it, and nothing further is shared.

How old do I need to be to join?

You must be at least 18 to hold a membership. Children you add to your membership can be younger.

Can I join if I am 65 or older?

Yes. People 65 and older can join. Cowboy Christian is not Medicare and is not a Medicare supplement plan, and membership does not replace Medicare. If you have Medicare or are eligible for it, do not drop or delay it because you are joining Cowboy Christian.

What lifestyle do we ask of our members?

Health is closely tied to our mental and physical strength, and we are a common-sense company. To help minimize the risk of health events in our lives, we encourage our community of members to pursue a healthy lifestyle.

We encourage every member to work toward and maintain good overall health, including a healthy body weight, regular activity, and good nutrition.

Are prior medical conditions eligible for sharing?

No one is turned away from membership because of a prior medical condition, and we do not ask for your medical history when you join.

A 36-month look-back applies to conditions and procedures in the following categories:

Neurosurgical procedures: brain and spinal surgeries, including but not limited to tumor resection, aneurysm repair, spinal fusion, and deep brain stimulation.
Cardiac procedures: open-heart surgery, bypass grafting (CABG), valve repair or replacement, heart transplant, and implantable cardiac devices such as pacemakers and defibrillators.
Intravascular stent procedures: coronary, carotid, renal, or peripheral artery stenting.
Severe trauma: injuries from a major accident, including polytrauma, traumatic brain injury, spinal cord injury, and severe burns requiring extended hospitalization.
Cancer and oncology: all malignant neoplasms and their treatment, including but not limited to chemotherapy, radiation therapy, immunotherapy, surgical oncology, and CAR-T cell therapy.
Organ transplant: all solid organ transplants (heart, lung, liver, kidney, pancreas) and hematopoietic stem cell (bone marrow) transplants.
Chronic disease under active management: conditions requiring ongoing specialist care, including but not limited to end-stage renal disease requiring dialysis, advanced heart failure, and insulin-dependent diabetes with complications.
Autoimmune conditions and biologic therapy: conditions treated with biologic or biosimilar medications, including but not limited to rheumatoid arthritis, Crohn's disease, ulcerative colitis, psoriasis, and multiple sclerosis.
Joint replacement surgery: total or partial replacement of the hip, knee, shoulder, or another major joint.
Bariatric and metabolic surgery: weight-loss and metabolic surgery, including gastric bypass, sleeve gastrectomy, and adjustable gastric banding.

If you had a condition or procedure in one of these categories during the 36 months before you joined, costs for that condition or procedure, and for a new problem related to it, are not eligible for sharing until you have been a member for 36 months. This applies to those costs only. A new problem that is not related to it, and your other medical needs, remain eligible for sharing under these guidelines.

The look-back is applied when you ask for sharing, based on what you tell us then. Whether a need is related to an earlier condition is decided by Cowboy Christian, case by case, at that time.

Are prescription drugs eligible for sharing?

Prescription drugs are not eligible for sharing, except those given during an eligible health event. We encourage every member to focus on regaining health through a healthy lifestyle.

Are dental and vision care eligible for sharing?

Dental and vision care are not eligible for sharing unless they are related to an eligible health event.

Can you help me get a fair price for my care?

Yes. The best time to settle a price is before you receive care. Wherever a price can be worked out with a facility ahead of time, we will help you work it out. Once you have received care, you are the one who talks with the hospital or clinic about what you owe, and we coach you on how to approach that conversation and what a fair cash price looks like. As the patient, you have real influence in those conversations. Everyone in the community shares the same goal: reasonable prices for every healthcare event, and a better healthcare system for our country.

Is this insurance?

No. This is not insurance. We do not file claims with insurance companies. We do not bill insurance companies.

Can I keep a health plan I already have?

Yes. Membership does not require you to give up a health plan you already have. If another source pays, or agrees to pay, part of a bill, that part is not shared, so we ask that you seek payment from that source first.

Is Cowboy Christian a faith-based company?

Yes. Cowboy Christian is a faith-based company rooted in Christian values. We believe that Jesus Christ died for our sins, and we want to support all of our Christian families, including single parents who are practicing Christians and attend church regularly. Members of our community are like-minded, and we want to help our Christian brothers and sisters reach their true potential by reducing the impact of a medical event.

Cowboy Christian, LLC is a for-profit company. It is not a church or a ministry.

Are payments guaranteed?

No. Sharing is voluntary, and no payment or sharing is guaranteed. When an eligible need is approved, it is shared from members' deposits. Accountability and transparency are at the core of how we operate.

It is your responsibility to make certain that all of your bills are paid.

When is the membership fee due?

Your monthly membership fee is due on the same day of the month that you joined, or on the last day of any month that has no such day. If your membership fee payment does not go through on its due date, a flat $5 late fee is added to your next monthly payment to help cover the cost of handling a late payment. This applies even if a later attempt to collect that payment goes through. Only one late fee applies for each due date, and no late fee is charged on a late fee.

Are elective cosmetic procedures eligible for sharing?

No. Elective cosmetic procedures that are not associated with trauma or cancer are not eligible for sharing. This service is primarily for catastrophic, necessary, and unexpected medical needs.

Can you help me find places to have surgery?

If you need surgery, we will work with you on the cost side of that decision: what it is likely to cost and where it can be obtained at a fair self-pay price. The best time to settle the price of a non-emergent surgery is before the surgery is performed. Clinical decisions stay between you and your own physician.

One of our great strengths is an intimate understanding of the healthcare business and how to find facilities that will quote a real, all-in cash price before you commit. A complex surgical decision, even one that means a short plane ride, can be well worth the investment for long-term results, both medically and financially. We can walk you through the cost-sharing side of that decision, and our resource page lists cash-pay surgery centers as a starting point for your own research. Where we have called a facility ourselves, what we ask about is price and process: whether they will quote before you arrive, whether they have a practiced path for cash patients, whether the quote is all-in, and whether they can tell you who will be operating. Those questions are about cost and process, not about clinical outcomes, which stay between you and your own physician. A pillar of Cowboy Christian's purpose is to shift care toward free-market facilities built on a strong physician-patient relationship and fair, transparent prices. That is what we work toward for every member.

How is pregnancy shared at Cowboy Christian? (Homestead Rider)

Pregnancy is shared only through the Homestead Rider, which is available on the Bullpen plan. The Homestead Rider includes care for the entire pregnancy and post-delivery follow-up. Pregnancy costs are shared only when the pregnancy occurs after joining. A pregnancy that occurs after joining is eligible from your first day of membership, and a sharing request for it can be submitted once your trust and validation period completes. The rider includes only care for a pregnancy that begins after the rider is added, so a pregnancy that has already begun when the rider is added is not eligible for sharing. Under the Homestead Rider, the child's own care from birth until the child is discharged home from the hospital, a stay in neonatal intensive care included, is eligible for sharing as part of the mother's pregnancy. Within 30 days after the child is discharged home, add the child to your membership with their own subscription. For a child of a pregnancy shared through the rider who is added within those 30 days, the child's needs are eligible for sharing from the day of discharge, and a sharing request for the child's care can be submitted once the trust and validation period for the child's addition completes. The 36-month look-back applies to the child and is counted from the day the child is added. After the child is discharged home, care for a condition present at birth in one of the look-back categories is not eligible for sharing until the child has been a member for 36 months.

Pregnancy-related care, including a complication of pregnancy and emergency care that arises from a pregnancy, is shared only through the Homestead Rider. Without the rider, a pregnancy-related need is not eligible for sharing. Without the rider, a newborn can be added to your membership from 30 days after the child is discharged home from the hospital, and the child's needs are eligible for sharing from the day the child is added. A sharing request for the child's care can be submitted once the trust and validation period for the child's addition completes, and the 36-month look-back applies to the child and is counted from the day the child is added.

For a child born at home with no hospital stay, the day of birth counts as the day of discharge.

What we believe and what we ask

This is what Cowboy Christian believes and what we ask of the community we are building. Members confirm that they have read these statements when they join.

1.We believe in Jesus Christ as Lord and Savior.
2.We believe that marriage is between a man and a woman.
3.We ask members to live a lifestyle consistent with Christian values, including abstaining from illegal drugs, tobacco products, and excessive use of alcohol.
4.We are a community of practicing Christians. We ask members to attend a Christian church regularly and to take part in the life of that church.
5.Cowboy Christian, LLC (“Cowboy Christian”) is not insurance and does not guarantee payment of any medical expense.
6.Sharing is entirely voluntary and is not a legal obligation. No payment or sharing is guaranteed. The network operates on faith and mutual trust.

Member Agreement Detail

The following detail is part of these Sharing Guidelines, which are the member agreement you accept when you join. It explains what is eligible for sharing, how sharing is administered, and the rules that keep the community fair for everyone.

Detailed eligibility and exclusions

The following detail sets out further expenses that are not eligible for sharing, alongside the 36-month look-back in the section on prior medical conditions.

Long-term residential care is not eligible for sharing. This means the room, board, and day-to-day personal care a member receives while living in a nursing home, skilled nursing facility, assisted living residence, or similar facility. This exclusion applies to those expenses only, and a member's other medical needs, including hospital care, surgery, and physician services received while living in such a facility, remain eligible for sharing under these guidelines.
Mental health care, drug addiction, and self-inflicted conditions are not eligible for sharing.
Transition-related procedures and transition-related hormone therapy are not eligible for sharing. This exclusion applies to those expenses only, and a member's other medical needs remain eligible for sharing under these guidelines.
Elective cosmetic procedures that are not associated with trauma or cancer are not eligible for sharing.
Experimental or investigational drugs, devices and procedures are not eligible for sharing. This includes any drug or device that federal law limits to investigational use, such as use in a clinical trial.
Expenses incurred before joining are not eligible for sharing.
Amounts that another source has paid, or has agreed to pay, are not eligible for sharing. This includes amounts paid or agreed to be paid by another health plan, by auto or workers' compensation insurance, by a party responsible for an injury, by a facility's financial assistance or charity care program, or by a government program, agency, or institution. Where another source may be responsible for a cost, we ask that you seek payment from that source first. If you have done so and that source does not pay, the amount you are left responsible for remains eligible for sharing under these guidelines.

Members are asked to pursue a healthy lifestyle, including working toward a healthy body weight. This is an encouragement, not a requirement to join.

How sharing works, in detail

Every membership pairs a $55 per month membership fee with your chosen sharing tier. The tiers are Bullpen (a $2,000 minimum), Rodeo (a $5,000 minimum), and Chaps (a $10,000 minimum). Your tier's minimum is the part of each health event's eligible costs you handle yourself before sharing begins, and it applies once to each health event. A health event is one illness, injury, or condition, including its follow-up care, such as physical therapy after a hospital stay.

Sharing is voluntary, and no payment or sharing is guaranteed. When an eligible need is approved, it is shared from members' deposits. Sharing is sent on business days, so the time from approval to sharing depends partly on the day the need is approved.

When members share toward your sharing request, other members can see that you were helped. On the monthly report page, every member can see your first name, the first letter of your last name, the state you live in, the amount members shared toward the request, and the short summary you wrote, if any. A member whose balance is drawn toward your request sees the same details. Every request is shown under the account holder's name, and a child's name is never shown. Each adult on the plan agrees to this for themselves when they join the membership or are added to it. This is part of membership, and there is no setting to turn it off; the Privacy Policy describes when a request is shown only as "a member". Please keep what you read about other members' requests to yourself.

To request sharing, submit the itemized invoice for your care. We ask for invoices only, not full medical records. Wherever a price can be worked out with the facility before care, that is the best time to do it, and we will help.

If funds are insufficient to meet a need, the need may be prorated for up to 3 months and then reviewed.

Your first two paid months are a trust and validation period. In each of them you pay Cowboy Christian an amount equal to your monthly share, as trust and validation funding, beside your membership fee. Like the membership fee, that payment goes to Cowboy Christian's administration and is not used for sharing. The count is of paid months, so a month whose payment does not complete does not count toward the two.
During those two months you are not asked to fund another member's need, and a sharing request cannot yet be submitted or funded for your own. Both open at the start of the month that follows your second paid month.
A health event that happens during those two months stays eligible under these guidelines. Once the trust and validation period completes, you can submit a request for it like any other.

Payments and staying current

If a monthly payment does not complete, we try it again. If it still does not complete, that is a missed payment, and your membership moves to Payment Missed. This happens, and it is fixable. While it is being resolved, new sharing requests are on hold, a request of yours still under review is held as well, and you are not asked to help fund another member's need. Everything else about your membership continues as normal, and bringing your account current returns you to good standing.
If a second payment in a row is missed, your membership moves to Membership On Hold. Sharing stays on hold in both directions, and your other membership benefits are on hold as well. Bringing your account current restores your membership, and a sharing request of yours that was already approved can be shared toward again for the time left in its sharing period.
If a third payment in a row is missed, your membership closes. We would be glad to have you back, and the rejoining section below describes how that works.
A sharing request that was already approved can be shared toward only while your membership is active. At Payment Missed it continues through the same sharing process as any other approved request. While your membership is at Membership On Hold, or is not active for another reason, nothing further is shared toward the request. It stays approved, and once your membership is active again it can be shared toward again for the time left in its sharing period, which keeps running while the request waits. When your membership ends, the request closes with it. That is so whether your membership closes after a third missed payment, we end it under these guidelines, a cancellation takes effect, or you move your residence outside the United States. A request that closes keeps what members have already shared toward it, and nothing further is shared.

Rejoining after your membership closes

To rejoin after a subscription closes, bring current anything still owed on the previous subscription.
If you ask to rejoin within three months of your membership closing, the decisions we already made about your conditions carry forward, and we do not make them again.
If you ask to rejoin more than three months after your membership closes, those decisions do not carry forward, and we make them again when you ask for sharing, against these guidelines as they read then.
Where those decisions are made again, a condition that began while you were a member is treated as a prior condition, and the 36-month look-back in these guidelines applies to it as it would to someone joining on the day you rejoin. Whether or not those decisions are made again, rejoining starts your two-month trust and validation period again.
When you start to rejoin, we tell you which decisions will be looked at again before we ask you for any payment.

Accurate information, and what happens if it is not

The information you give us about yourself and your household needs to be accurate, when you join and whenever you update it. If something changes or turns out to be wrong, update it in your account or tell us.

Where we determine that information was given to us falsely, we may take action up to and including ending your membership, and we may pursue any legal remedy available to us.

A sharing request we determine to be fraudulent is not shared, and any sharing still to come on it stops.

The people on your membership, and changing your plan

You, the account holder, can add a person to your membership or remove a person from it at any time, from your account page.
A child or other dependent can be on your membership to age 25.
A person you add is on your membership from the day you add them, and that person's needs are eligible for sharing under these guidelines from that day. For a newborn, the pregnancy sections of these guidelines set out when the child can be added and the day from which the child's needs are eligible.
Each person you add has a trust and validation period of their own, which is your membership's first two paid months after the day you add them. A sharing request for that person's care can be submitted once that period completes, and a health event of theirs that happens during it stays eligible under these guidelines. Sharing requests for the other people on your membership continue as before.
When adding a person raises your monthly share, then during that person's trust and validation period you pay Cowboy Christian the amount it rose by, as trust and validation funding for that person. Like the membership fee, that payment goes to Cowboy Christian's administration and is not used for sharing. The rest of your monthly share, and sharing for the other people on your membership, continue as before. Where adding a person does not change your monthly share, nothing more is paid, and that person's trust and validation period still runs.
For a person you add, the 36-month look-back in these guidelines is counted from the day that person is added. It looks at the 36 months before that day, and it applies until that person has been on your membership for 36 months. The same holds for a newborn.
A sharing request is for the medical need of one person on your membership, either you or a person you have added.
When you remove a person, the removal takes effect on your next monthly due date, and until then that person stays on your membership. A sharing request already open for that person's care is not closed by the removal.
A move to a lower plan takes effect on your next monthly due date, with no trust and validation period and no added funding. A move to a higher plan applies to your monthly share from your next monthly due date, and for your first two paid months on it, sharing toward your household's needs follows the terms of your earlier plan.

State rules and accounts

In ACA states, including California, Massachusetts, New Jersey, Rhode Island, Vermont, and Washington, D.C., required minimum essential coverage must be used first. Only the remaining eligible expenses are submitted for sharing.

HSA funds are not a Cowboy Christian payment method. It is your choice whether to apply HSA funds to your bills.

Pregnancy sharing, in detail (Homestead Rider)

The Homestead Rider is available on the Bullpen plan only.
Pregnancy costs are shared only when the pregnancy occurs after joining. A pregnancy that occurs after joining is eligible from your first day of membership, and a sharing request for it can be submitted once your trust and validation period completes.
Pregnancy-related care, including a complication of pregnancy and emergency care that arises from a pregnancy, is shared only through the Homestead Rider. Without the rider, a pregnancy-related need is not eligible for sharing.
The rider includes only care for a pregnancy that begins after the rider is added, so a pregnancy that has already begun when the rider is added is not eligible for sharing.
The event is the pregnancy plus the one-month follow-up.
Within 30 days after a child of a pregnancy shared through the rider is discharged home, add the child to your membership with their own subscription.
Without the rider, a newborn can be added to your membership from 30 days after the child is discharged home from the hospital, and the child's needs are eligible for sharing from the day the child is added. A sharing request for the child's care can be submitted once the trust and validation period for the child's addition completes, and the 36-month look-back applies to the child and is counted from the day the child is added.
For a child born at home with no hospital stay, the day of birth counts as the day of discharge.
Each pregnancy carries a $3,000 added subscriber requirement before sharing begins.
If the newborn needs a NICU stay, let us know as early as you can, so we can help you understand the likely cost and coach you on talking with the hospital about the price.

Important Disclosures

Cowboy Christian, LLC (“Cowboy Christian”) is not an insurance company and does not guarantee the payment of any medical bills. Membership does not constitute an insurance policy.

Sharing of medical expenses is entirely voluntary among members. While Cowboy Christian facilitates the sharing process, no member is obligated to share, and no member is guaranteed that their medical expenses will be shared.

Members should not cancel any existing health insurance policy in reliance on membership in Cowboy Christian without first consulting with a licensed insurance professional.

These Sharing Guidelines are the member agreement you accept when you join. Our Statement of Beliefs is shared so you know the community you are joining, and it is not a condition of membership or of sharing. Your commitment to share in other members' needs is voluntary and is not a legal obligation, and no payment or sharing is guaranteed.