Health Sharing Compass

Health Sharing Basics

Health Sharing vs. Other Types of Health Coverage

The main types of U.S. health coverage (Marketplace, job-based, Medicare, Medicaid & CHIP) compared with health sharing, discount plans and risk-sharing.

By Health Sharing Compass Editorial Team · Published · 3 min read

If you search for "types of insurance coverage," you'll find lists that mix health, auto, home and life insurance. For paying medical bills in the U.S., the useful question is narrower: which arrangements are actual health coverage, and where does health sharing fit?

The four main types of health coverage

HealthCare.gov gives these as examples of plans that count as minimum essential coverage (HealthCare.gov):

  1. Marketplace plans: individual and family insurance bought through HealthCare.gov or a state marketplace, sometimes with subsidies.
  2. Job-based plans: insurance offered through an employer.
  3. Medicare: the federal program, mainly for people 65 and older.
  4. Medicaid and CHIP: programs for people and children with limited income, run by states.

All four come with legal obligations to pay for covered care.

Arrangements that are not health coverage

Regulators group several products together as "not insurance" (NAIC; Mass.gov):

  • Health care sharing ministries: members voluntarily share eligible bills; no guarantee.
  • Discount plans: a monthly fee for discounts on care; not insurance.
  • Non-licensed risk-sharing plans: groups that pool payments to help with costs; not insurance.

Short-term health insurance sits in between: it is insurance, but exempt from many ACA rules. See health sharing vs. short-term health insurance.

Side by side

Marketplace / job-basedMedicareMedicaid & CHIPHealth care sharing ministry
Is it insurance or health coverage?Yes (insurance)Yes (government program)Yes (government program)No
Legal obligation to payYes, per plan termsYes, per program rulesYes, per program rulesNo, sharing is voluntary
Pre-existing conditionsMust be coveredCoveredCoveredOften limited or phased in
Who regulates itState and federalFederalState and federalGenerally not insurance regulators
Faith statementNoNoNoUsually required

Where health sharing fits

Health sharing is an alternative some people choose instead of insurance, usually because of cost or values. It isn't a type of health coverage, and if it's all you have, you're considered uninsured. There's no federal tax penalty for that anymore (HealthCare.gov), but some states have their own rules.

A few ministries offer programs that sit alongside government coverage. America's HealthShare COMPANION, for example, is for members 65+ on Medicare Parts A and B and shares eligible costs after Medicare processes them (programs). See our COMPANION guide.

How to choose

  • If you may qualify for Medicaid, CHIP or Marketplace subsidies, check those first. They may cost little or nothing and come with legal protections.
  • If you have job-based insurance, compare your share of the premium with a health share's total yearly cost, including what you'd pay before sharing starts.
  • If you're healthy, unsubsidized and comfortable with risk, a health share may be worth comparing. Start with health sharing vs. insurance and whether health sharing is a good idea.

Frequently asked questions

What are the main types of health coverage in the U.S.?

HealthCare.gov's examples of plans that count as minimum essential coverage are Marketplace plans, job-based plans, Medicare, and Medicaid and CHIP (HealthCare.gov).

Is a health share one of the types of health coverage?

No. A health care sharing ministry isn't insurance and doesn't guarantee payment (NAIC). It's a voluntary sharing arrangement.

Can I combine a health share with Medicare?

Some ministries offer programs built around Medicare. America's HealthShare COMPANION, for example, is for people 65+ enrolled in Medicare Parts A and B and is always secondary to Medicare (programs). It's still not insurance or Medigap.

Can I get temporary health insurance?

Short-term, limited-duration insurance is designed for temporary gaps, with length rules that vary by state (DOL). See health sharing vs. short-term insurance.

Sources

  1. Minimum essential coverage (MEC) glossary entry (HealthCare.gov)
  2. Health coverage exemptions: Forms & how to apply (HealthCare.gov)
  3. Not All Products Are Health Insurance (National Association of Insurance Commissioners)
  4. What You Should Know About Health Care Sharing Ministries, Discount Plans, and Risk-Sharing Plans (Massachusetts Division of Insurance)
  5. America's HealthShare Programs (America's HealthShare)

Sources were accessed on October 9, 2026. Linked pages may have changed since then.

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