As your chosen Health Care Sharing Ministry (HCSM), OneShare Health strives to provide access to the best possible care for you and your family. In order to help you better navigate your Membership and some of the associated health share terminology, we’ve put together a ‘Glossary of Health Share Terms.’
For your convenience, we've outlined terms that OneShare, as an HCSM, acknowledge and which you may continue to reference throughout your OneShare Health Membership1. OneShare Health is not insurance, we are a Health Care Sharing Ministry (HCSM) that facilitates the sharing of medical bills among its Membership. You can also find all of our terms, definitions, disclaimers, and a full list of your Eligible and Ineligible Services in your Member Guidebook.
To view an online copy, go to your Member Portal or visit https://www.onesharehealth.com/member-guidebook
An act or event which is unforeseen, unexpected, and unanticipated, and which is the direct cause of any injury occuring after the Member's Active Date.
The date on which a Member’s OneShare Membership becomes active and certain Medical Expenses become Eligible for Sharing according to the Guidelines.
Any illness characterized by signs and symptoms of rapid onset and short duration. Signs and symptoms may be routine or severe and temporarily impede normal functioning.
A medically equipped land or air vehicle which transports patients to Hospitals. Ambulances are used to respond to medical emergencies by emergency medical services.
Full range of mental, emotional well-being, and developmental challenges.
A disease caused by an uncontrolled division of abnormal cells in a part of the body.
Complications in labor and delivery are relatively rare, but they can occur. While most complications can be managed quickly and easily, some have the potential to cause serious outcomes for mother, child, or both. Complications of labor and delivery may include, for example: preterm labor; placenta issues; bleeding issues; or fetal distress. False labor is not a complication of labor and delivery.
A complication of pregnancy is a condition separate from pregnancy but is affected or caused by pregnancy, and occurs during the pregnancy, not at the onset of labor and delivery. Complications of Pregnancy does not include false labor; occasional spotting; Physician prescribed rest during pregnancy; morning sickness; hyperemesis gravidarum; pre-eclampsia; and similar conditions associated with a difficult pregnancy.
The date on which a health care service was provided.
A Primary Member’s spouse or unmarried child, including a natural child (from the moment of birth if born after the Program Active Date), a stepchild, adopted child, eligible foster child, or grandchild (residing with the Primary Member). The Dependent child must be a legal dependent of the Primary Member for maintenance, support, and health care decisions, and must be age twenty-six (26) or younger as of the Active Date. For Members on any Program other than Catastrophic365, a Dependent will be removed from the Membership at the end of the billing cycle in which the Dependent reaches age 27, but may enroll in a new Program without starting over on applicable Waiting Periods or Lifetime Sharing Maximum Accumulations. Disabled Dependent children age twenty- seven (27) and older who are financially dependent upon the Primary Member are eligible to continue on the Program as a Dependent. Proof of disability and dependency (such as a court order and/or the Primary Member's claim of the Dependent on his or her income taxes) is required within 31 days following such 27th birthday. For Members on the Catastrophic365 Program, a Dependent who reaches age 27 after the Active Date may continue on the Membership until its natural expiration at the end of the Program Year, but thereafter must enroll in their own new Program without starting over on Lifetime Sharing Maximum accumulations.
A type of Medical Expense which is listed as Eligible in the Membership Guidelines.
Medical care provided for the stabilization or treatment of a Life-Threatening or Life-Altering condition.
Emergency Care provided on an Outpatient basis at a Facility.
Non-experimental health care treatment which may deliver care that is more cost effective, less invasive, and within generally accepted medical practice, may be Eligible for Sharing. Pre-Notification is required from OneShare Health.
A statement sent to the Member and Provider(s) with an explanation of OneShare Health’s assignment to Member sharing of Medical Expenses submitted.
Refers to any Facility that provides medical services on an Outpatient basis, whether a Hospital-affiliated or independent Facility.
The terms Guidelines, Sharing Guidelines, and Membership Guidelines all refer to the Membership Guidelines.
A nonprofit religious organization that facilitates the sharing of Medical Expenses among its members in accordance with as an expression of their commonly held religious beliefs.
Services for intermittent skilled nursing care and rehabilitative therapy that can be given in a Member's home for an illness or injury. Services provided by an individual who ordinarily resides in the Member’s home or is a member of the immediate family of the Member are Not Eligible for Sharing.
An institution that is licensed to provide medical and surgical treatment for sick and injured individuals and is accredited by the Joint Commission on Accreditation of Hospitals sponsored by the AMA and the AHA.
An injury or illness of the Member that requires medical attention from a licensed Provider.
The amount that a Member is responsible for paying to the Provider of medical services before the Member’s Medical Expenses are Eligible for Sharing under the Program. ISA applies to Program Year.
Medical services received at a Facility for a period of 24 hours or more or for which there is an overnight admission.
A medical laboratory or clinical laboratory is a laboratory where tests are usually done on clinical specimens in order to obtain information about the health of a Member as pertaining to the diagnosis, treatment, and prevention of disease.
A condition which, if not immediately in receipt of medical treatment, has a high likelihood of causing death, or causing major irreversible bodily harm (including, for example: loss of arm, leg, hand or foot; loss of sight or hearing; paralysis; or loss of brain function). The following are key signs and symptoms of Life-Threatening emergencies: respiratory distress or cessation of breathing; severe chest pains; shock; uncontrolled bleeding; choking; poisoning; prolonged unconsciousness; severe burns; any complaint or observation which indicates head or spinal cord injury. The following are examples of Life-Altering emergencies: broken bones; visible bones; or dismemberment.
The maximum amount of sharing which may be administered for a Member in their lifetime, regardless of whether the Membership is continuous, ended and re-enrolled later, or (with regard to Catastrophic365 Members), the Member enrolls in multiple Programs.
The spiritual and legal union under the covenant of matrimony and the laws and regulations of the state in which such union was formed.
The Medical Expenses for the mother’s prenatal, delivery, and hospital, birthing center, or midwife services (related to home-birthing expenses). Maternity does not include Complications of Pregnancy or medical needs for the Newborn, which are subject to other provisions in the Membership Guidelines.
The charge(s) or expense(s) for medical services from a Provider for a Member.
Those health services provided by a Provider for the purpose of preventing, diagnosing, or treating an injury or illness according to the accepted standards of medical practice.
The service must be:
A Primary Member or Dependent enrolled in the Program.
A Member’s status of being enrolled and active in a OneShare Health Program and eligible to submit Medical Expenses for sharing.
The monetary contribution voluntarily given by a Member to OneShare. It is a fixed dollar amount, a portion of which will be dedicated to share in other Members’ Eligible Medical Expenses as assigned by OneShare Health according to the Guidelines. This amount must be submitted by the Member to remain active and eligible to submit Medical Expenses incurred during the applicable period for sharing.
A child enrolled in the Program as a Dependent within 31 days after the birth.
A type of Medical Expense which is either listed as Not Eligible for Sharing or not listed as Eligible for Sharing in the Guidelines.
An operation in which a bodily organ is transplanted.
Medical services received at a Facility for a period of less than 24 hours and for which there is not an overnight admission.
The maximum amount which may be shared for all Eligible Expenses related to a single Incident under the terms of the Membership Guidelines.
Licensed Medical Professional/Physician Office visits for the diagnosis, non-surgical treatment, or management of an illness or injury.
A person who is licensed to perform certain medical services issued by a state medical board. A Physician cannot be the Member or relative of the Member by blood or marriage and cannot reside in the household of the Member.
Refers to a person legally entitled to perform certain medical services who holds one of the required licenses or degrees, and who is acting within the scope of his or her licensure when performing such services. A Practitioner cannot be the Member or a relative of the Member by blood or marriage and cannot reside in the household of the Member.
A process the Member or the Member’s health care Provider follows to notify OneShare Health prior to receiving the specified medical services.
(1) Any sickness or injury for which a Member, within 24 months before the Member’s Active Date, received medical treatment, advice, care, or services (including diagnostic measures), took prescribed drugs, or showed signs and symptoms (whether treated or not). (2) Or, any chronic, persistent, or long-lasting medical condition which is unresolved and known to the Member, regardless of whether, within 24 months before the Member’s Active Date, the condition required treatment, advice, care, services, or prescription drugs, or exhibited any signs or symptoms. Eligibility for a Pre-Existing Condition, or for any medical condition caused by or directly related to a Pre-Existing Condition, has a 24- Month Waiting Period. Because Catastrophic365 Programs expire at the end of one Program Year and thus cannot reach the full 24-Month Waiting Period, Pre-Existing Conditions are never Eligible for Sharing on Catastrophic365.
Any written authorization by a medical Practitioner that authorizes a Member to be provided a medicine or treatment.
Routine health care that includes checkups, patient counseling and screening to prevent illness, disease, and other health related problems. A wellness visit is prevention focused and not medically necessary to treat illness or injury.
A Physician in family practice, internal medicine, obstetrics/gynecology, or pediatrics who is a patient’s first contact for health care in an ambulatory setting. A Primary Care Physician cannot be a Member or relative of the Member by blood or marriage and cannot reside in the household of the Member.
The Primary Member is the Member who completed the Membership application.
A type of sharing Membership administered by OneShare Health, such as the Catastrophic Program or Classic Program.
The different levels of features within a Program, such as the Basic or Enhanced or Crown Tiers within the Classic Program.
The first Program Year is 12 months beginning on the Active Date. For all Programs other than Catastrophic365, each additional Program Year is 12 months beginning on the anniversary of the Active Date. The Catastrophic365 Program expires at the end of the first Program Year, the day before the first anniversary of the Active Date.
An artificial device to replace or augment a missing or impaired part of the body.
A Provider is any type of medical care, including a Physician, Practitioner, Specialist, Facility, or Hospital, or any other individual authorized by his or her State and performing within the scope of his or her practice as defined in State law.
A facility licensed under state laws to provide intensive rehabilitative services. An inpatient Rehabilitation Facility means a free-standing facility or a unit of a Hospital, providing coordinated multidisciplinary physical restorative services to inpatients under the direction of a Physician knowledgeable and experienced in rehabilitative medicine.
A free-standing facility or section or wing of a Hospital, operated as part of a Hospital, duly licensed under applicable law as a Skilled Nursing Facility, providing Skilled Nursing Care 24 hours per day. Delivered by licensed graduate registered nurses (RN’s) or unlicensed personnel supervised by RN’s, with such care directed or supervised by one or more Physicians.
The provision of remote healthcare using technology, artificial intelligence, and population health data via smart questionnaire, chat, call, or video.
A Physician who is a licensed Physician qualified by advanced training and certification by a specialty examining board to limit his or her practice. A Physician cannot be the Member or a relative of the Member by blood or marriage and cannot reside in the household of the Member.
Any game, competition, or physical activity which voluntarily puts an individual at a high risk of bodily injury. This includes, but is not limited to: bungee jumping; ‘free climb’ rock climbing; parachuting; paragliding; boxing; fighting; martial arts; cliff diving; air, auto, motorcycle, or powerboat racing; extreme or backcountry skiing; wingsuit; or practicing for, participating in, officiating, or coaching any college or professional or semi-professional sport for which the Member receives any scholarship, compensation or remuneration.
Medical care received for a sudden illness or injury that is not Life-Threatening or Life-Altering but does require immediate care to avoid severe pain, suffering, or complications.
The voluntary ingestion of any narcotic, poison, gas, fumes, or any illegal drugs; the use of prescription or over-the-counter drugs for purposes or in amounts other than those for which they are prescribed or indicated to be used; excessive/binge drinking; or a pattern of heavy alcohol use.
The branch of medicine that employs operations in the treatment of disease or injury. Surgery can involve cutting, abrading, suturing, or otherwise physically changing body tissues and organs.
The provision of health care remotely by means of telecommunications technology.
Medical care received for a sudden illness or injury that is not Life-Threatening or Life-Altering but does require immediate care to avoid severe pain, suffering, or complications.
Walk-in clinic focused on the delivery of ambulatory care in a dedicated medical Facility outside of a traditional Emergency Room.
The amount that a Member is responsible for paying to the Provider of medical services for a specific visit before the Medical Expenses for the visit are Eligible for Sharing under the Program.
An X-ray is produced by the collision of a beam of electrons with a metal target in an X- ray tube. Also known as a roentgen ray.
'Therefore encourage one another and build one another up, just as you are doing.'
1 Thessalonians 5:11 (ESV)
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