What Are Health Share Plans and Health Sharing Ministries?
Health share plans are alternatives to traditional insurance.
- Members pay a monthly fee to help pay for the medical costs of everyone in the share plan.
- Health share plans are often made up of groups of people with similar religious or ethical beliefs. For example, many health share plans are affiliated with churches.
- Health share plans don't count as health insurance under the law and they don't have to cover the same things as traditional health insurance.
- These plans aren't regulated like insurance, and consumer protections vary by state.
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How do health share plans work?
Members in health share plans pay a monthly fee to help cover each others' medical costs.
You usually have to pay a portion of your own medical costs, sometimes called an "unshared amount," "member responsibility" or "household portion," each year before the health share plan starts to help with your bills. This is similar to a traditional health insurance deductible.
After you've met your member responsibility amount, you can submit medical bills to the health share plan for review. Your health share ministry will review your bills against their program guidelines. If the costs are eligible, your bill will be paid. If not, you'll have to pay the full amount yourself.
Health share plans and ministries are not the same thing as health insurance. Although they can seem similar, health sharing ministries put you at greater risk for having to pay your own medical bills. That's because the plans aren't regulated in the same way as health insurance, and they aren't required to cover the same things.
Health share plans might be a good option for some people, but you should always compare the price and coverage to a traditional health insurance plan to make sure you understand what you're buying and what it covers.
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What are the pros and cons of health share plans and health sharing ministries?
Pros
- Usually cheaper than health insurance
- You can often use any doctor
- Plans can help foster a sense of community
Cons
- Coverage can vary depending on the plan
- No legal guarantee that your bills will be paid
- You might not have coverage for preexisting conditions
Health share plans vs. health insurance
Health share plans are not health insurance
This means they often don't have the same coverage or legal protections as health insurance plans do.
Health share plan | Health insurance | |
|---|---|---|
| Counts as insurance? | ||
| Legally required to pay covered claims? | ||
| Required to cover preexisting conditions? | ||
| Required to cover certain health issues? | ||
| Subsidies available? | ||
| Religious requirements? |
Medical sharing plans costs and coverage
The coverage and costs associated with a health share plan vary.
Because the plans aren't regulated as tightly as health insurance, there's no guarantee that any specific type of medical care will be covered. Before you join a health share plan, check the coverage carefully so you know what's covered and what isn't.
What's covered?
- Injuries
- Sicknesses
- Emergency care
- Hospitalization
Maternity care is also sometimes covered, although it may have different rules than other types of care.
What's not covered?
- Routine tests
- Chronic conditions
- Mental health care
- Medical costs outside the U.S.
Remember that the health share plans ministries set their own coverage rules. Some plans may cover chronic conditions or mental health care, for example Each plan is different, which means it's impossible to create an overall list of what is and isn't covered. Be sure to check the coverage before you buy.
How much do health share plans cost?
Single adults usually pay between between about $115 to $315 per month for a health share plan.
But your monthly rate is only part of your cost. You'll also have to pay your member responsibility, similar to a deductible, before your share plan will start to pay your medical bills. These costs vary widely between plans. It's common to have to pay between $1,000 and $6,000 or more yourself before your plan shares your medical bills with the rest of the community. Some plans require you to pay a portion of each medical bill, such as $500 per bill, instead of one overall amount.
Some plans also have copays and coinsurance, just like health insurance. This means you pay a flat fee or a percentage of your medical bill.
Finally, many plans put an incident or lifetime maximum amount on your bills.
- A per-incident maximum means that the plan won't pay more than a certain amount for any one injury or illness. For example, you may have a limit of $125,000 per illness or injury. If your doctor bills for a specific medical need go over that, you'll have to pay the excess yourself.
- A lifetime maximum means the plan will only pay up to a certain amount toward your medical expenses during your life. After that, the plan will no longer pay any of your medical bills. For example, some plans cap their lifetime limits at $1 million. Once the plan has paid that amount toward your bills, you effectively no longer have coverage.
Health share plan and healthcare sharing ministries regulations
Because health share plans aren't insurance, they aren't regulated in the same way.
This usually means there are fewer protections in place if something goes wrong with your plan. Before joining a health sharing ministry, make sure you understand your state's laws around the plans.
State safe harbor laws
In 30 states, the law specifically removes health sharing ministries from insurance regulations. This means that health share plans don't have to follow the same laws that health insurance has to follow.
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If a state doesn't specifically exempt health share plans from insurance laws, it doesn’t automatically mean the state regulates them like traditional insurance. In fact, the states may just not include a mention of health sharing ministries, which means they still aren't included in the insurance laws.
This gives you more choices when it comes to your health care, because health share plans are allowed to operate separately from insurance and don't have to follow strict legal requirements. However, it also means there are fewer legal protections in place.
For example, a health share plan might run out of money, and it won't be able to fall back on state funds to pay for your bills. If you had traditional health insurance and your company failed, your medical bills would still get paid out of the state's "guaranty fund."
State with safe harbor laws for health sharing ministries
- Alabama
- Alaska
- Arizona
- Arkansas
- Florida
- Georgia
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Michigan
- Mississippi
- Missouri
- Nebraska
- New Hampshire
- North Carolina
- Oklahoma
- Pennsylvania
- South Dakota
- Texas
- Utah
- Virginia
- Washington
- Wisconsin
- Wyoming
States that require health insurance
Four states — California, Massachusetts, New Jersey and Rhode Island — still require that you have what's called "minimum essential coverage" health insurance.
Health share plans don't count as health insurance, which means they likely don't meet the state's laws. That means you might have to pay a fine for not having health insurance if you're part of a health sharing ministry.
Is a health share plan right for you?
Health sharing ministries can be a good alternative to health insurance as long as you understand what you're getting.
If you're mostly healthy and wouldn't get discounts on a marketplace plan, a health share plan might be a good option. It could help keep your costs down while still giving you some help with medical bills.
However, health share plans are risky. That's because without legal protections and guarantees of coverage, you might be left with high medical bills if you need care that the ministry doesn't consider "shareable." For example, some plans don't include coverage for routine medical care, dental coverage, some treatment for preexisting or chronic conditions, or certain medications.
You'll also have to stick to the ministry's moral code. A health share plan might specifically exclude coverage for treating sexually transmitted diseases that you acquire outside of marriage, for example, because the ministry's moral code only allows for sexual activity when you're married.
Frequently asked questions
Are health share plans a good idea?
Health share plans might be a good alternative to health insurance if you can't afford a traditional plan. However, you need to make sure you understand what your plan does and doesn't cover. Health share plans aren't regulated as tightly as health insurance is, which means if your plan doesn't cover something, you have very few legal protections.
Do health share plans count as health insurance?
No, health share plans aren't considered insurance. For that, you need to get what's called a "qualified health plan." The easiest way to get a qualified health plan is to get coverage through work, called a group plan, or buy a plan from HealthCare.gov or your state's marketplace site.
Will I face a penalty for using a health share plan?
You might have to pay a fee if you use a health share plan instead of getting insurance, depending on where you live. In California, Massachusetts, New Jersey and Rhode Island, there's still a penalty for not having health insurance. If you only have a health share plan and not a traditional health insurance plan, you may have to pay a fine in these states.
Are health share plans cheaper than insurance?
Health share plans often have cheaper monthly rates compared to health insurance. However, you run the risk of having to pay for more of your medical care yourself, because health share plans aren't required to have the same level of coverage that health insurance is. Plus, you can't get discounts based on your income with a health share plan the way that you can with a plan from HealthCare.gov.
About the Author
Insurance Writer
Cate Deventer is a ValuePenguin writer who specializes in health insurance, Medicare, auto and home insurance. She's been a licensed insurance agent since 2011.
She started her insurance career working as a customer service agent for State Farm. She later moved to an independent agency, where she worked with several insurance companies and hundreds of clients. She quoted policies, filed claims and answered insurance questions. In 2021, she pivoted her career and began writing about insurance for Bankrate. She moved to ValuePenguin in 2023 and began writing about health insurance and Medicare.
Cate has a passion for helping readers choose insurance to fit their needs. She enjoys knowing that her research and knowledge help people choose insurance products that make a positive difference in their lives.
How insurance helped Cate
Cate used her health insurance knowledge to navigate a surgery in 2023. Understanding how her policy worked let her focus on recovery instead of worrying about bills.
Expertise
- Health insurance
- Medicare & Medicaid
- Auto insurance
- Home insurance
- Life insurance
Credentials
- Licensed Life, Accident & Health Insurance Agent
- Licensed Property & Casualty Insurance Agent
Referenced by
- CBS
- NBC
- Wall Street Journal
Education
- BA, Theatre, Purdue University
- BA, English, Indiana University
Editorial note: The content of this article is based on the author's opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.
