A
AHP (Association Health Plan)
A type of health plan offered by an association or group of employers. Some health sharing programs operate under the AHP model to provide healthcare cost-sharing services to members.
Annual Sharing Limit
The maximum amount a health sharing program will share (pay) for eligible medical expenses in a single year. This varies by program and plan level, typically ranging from $125,000 to unlimited.
C
E
Eligible Expenses
Medical costs that qualify for sharing under a health sharing program's guidelines. Each program defines what is and isn't shareable - common exclusions include elective procedures, pre-existing conditions (during waiting periods), routine care, and preventive services.
H
HCSM (Health Care Sharing Ministry)
A faith-based organization where members with shared religious beliefs agree to share each other's medical expenses. HCSMs are exempt from ACA insurance regulations and typically require members to sign a Statement of Beliefs and adhere to specific lifestyle standards.
I
IUA (Initial Unshareable Amount)
The amount you pay out-of-pocket before the community begins sharing your medical bills. Similar to a deductible in traditional insurance. IUAs typically range from $1,000 to $10,000, with lower IUAs resulting in higher monthly shares.
L
Lifetime Sharing Limit
The maximum amount a program will share for a member over their entire membership. Many modern programs offer unlimited lifetime sharing, while older programs may cap at $1-2 million. Critical to review before joining.
M
Member Responsibility
The portion of medical costs that members must pay themselves, including the IUA, any co-share percentages, non-eligible expenses, and costs above sharing limits. Understanding total member responsibility is key to evaluating a program.
P
Per-Incident Sharing Limit
The maximum amount the program will share for a single medical incident or condition. Common limits are $125,000, $500,000, or $1,000,000 per incident. Important for catastrophic care - multiple incidents may each receive full sharing up to this limit.
Pre-Existing Condition
A medical condition that existed before joining a health sharing program. Unlike ACA insurance (which must cover pre-existing conditions immediately), health sharing programs typically impose waiting periods of 6-36 months before pre-existing conditions become eligible for sharing.
PPO Network Access
Many health sharing programs partner with PPO (Preferred Provider Organization) networks to give members access to negotiated discounts. Members can see any provider but get better rates (40-60% off) at in-network providers. Not the same as insurance network requirements.
S
Sharing Request / Need
The formal submission of medical bills to a health sharing program for community sharing. Members submit eligible medical expenses after meeting their IUA. Programs review for eligibility, then process payments from the community fund - typically within 30-90 days.
Statement of Beliefs
A faith statement that members of religious health sharing ministries must agree to and sign. Typically includes affirmation of Christian beliefs and commitment to biblical principles. Required by most HCSMs but not by secular health sharing programs.
T
Telemedicine
Virtual healthcare consultations via phone or video. Many health sharing programs include free or discounted telemedicine as a member benefit. Telemedicine visits often don't count toward the IUA and can save on routine care costs.
U
W
Waiting Period
The time between joining a health sharing program and when certain conditions become eligible for sharing. Most programs have 90-day waiting periods for non-emergency care and 6-36 month waiting periods for pre-existing conditions. Maternity often has 10-12 month waiting periods.
Now That You Know the Lingo...
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