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Glossary
Affordable Care Act. It’s sometimes referred to as Obamacare. The ACA also created the Health Insurance Marketplace, where people can compare and purchase health plans—often with income-based subsidies.
Care Coordination in a healthshare refers to the support members receive to navigate medical care and billing, especially during a significant health event. It’s a key feature that helps members avoid surprise bills, find quality care, and make the most of the sharing community.
The cash pay rate (also called self-pay rate or direct pay rate) is the price a healthcare provider charges a patient who is paying out of pocket, without using insurance.
Concierge service in a health share typically refers to personalized support that helps members manage their healthcare with ease, acting as a single point of contact for navigating care, billing, and benefits.
In a health share, a contribution is the monthly amount a member pays into the community to help share medical expenses with others
- Instead of paying an insurance premium, you make a monthly contribution.
- That money is used to help other members pay their eligible medical bills—and when you have a medical need, the community helps share yours.
Cost sharing as a model of healthcare is a system where medical expenses are shared between the patient and a larger group—a community.
It’s designed to make healthcare more affordable upfront, while encouraging personal responsibility and smart use of care.
A “dedicated provider” as referred to in our prime memberships is a virtual primary care provider you can see every time for more continuity of care.
DPC stands for Direct Primary Care and refers to a practice wide healthcare system where you pay a monthly membership fee in exchange for services from that specific practice or a specific provider within that practice. For more information please see our DPC resource page.
A detailed document of features and services that are included in your healthcare membership and detailed information about the eligibility, cost and processes for specific healthcare needs. They outline membership requirements, medical expense sharing, and plan specifics.
GLP-1 stands for Glucagon-Like Peptide-1, which is a natural hormone in your body that helps regulate blood sugar, appetite, and digestion. For more information on GLP-1, please see our GLP-1 resource page
HSA stands for Health Savings Account. It’s a special, tax-advantaged savings account you can use to pay for qualified medical expenses.
Your Initial Unshareable Amount (IUA) is the upfront amount you’re responsible for when a high cost medical need arises. Unlike a deductible, it’s not tied to the calendar year—instead, it applies per incident and caps your cost for major medical events.
Routine services are available without needing to meet your IUA first.
Once you’ve met your IUA (up to three times per year), you won’t pay anything more for that medical need—the community shares all eligible expenses beyond that.
Important: Always review pre-membership medical condition guidelines before enrolling.
A lookback period refers to the amount of time prior to starting a membership that the health share will look into your medical history to determine eligibility of existing conditions.
A medical advocate bridges the gap between the patient and the complex healthcare system, aiming to make healthcare more affordable and manageable for members and providing transparency in healthcare costs. They empower members to be proactive and informed consumers of healthcare, encouraging them to ask questions about costs and options.
Any medical incidents, illnesses, treatments, or hospitalizations related to a single health condition.
This is a clear, concise document or overview that outlines the key features, benefits, and terms of a healthcare membership program (like a healthshare or direct primary care membership
A summary of what features and services that are included in your healthcare membership without specific or case by case information.
Refers to a large, nationwide provider network used by many health plans and healthcare programs to give members access to discounted rates with doctors, specialists, hospitals, and other healthcare providers.
A pre-membership medical condition is any illness or injury for which a person has been:
- Examined
- Diagnosed
- Taken medication
- Had symptoms or,
- Has a personal history of or known increased risk of conditions that may arise or worsen in pregnancy or
- Received medical treatment within the 36 months prior to their membership start date.
Each membership will have their own lookback period, exclusions and phase in period for sharing. Please see membership page or guidelines for more details
What’s included in your membership
Refer to how medical expenses are handled within the community.
What these terms mean:
- Shared: The medical costs that the healthshare community actually pays or reimburses on behalf of a member after they meet their personal responsibility (like the Initial Unshareable Amount).
- Shareable: Medical expenses that are eligible to be paid by the community according to the healthshare’s guidelines. For example, surgeries, hospital stays, and prescriptions might be shareable, while cosmetic procedures usually are not.
- Sharing: The process or act of the community pooling contributions to help pay eligible members’ medical bills.
Virtual Primary Care – A healthcare service model where you access your primary care provider remotely via phone, video calls, or online messaging instead of in-person visits.
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