Health Sharing Compass

Health Sharing Basics

What Is a Health Care Sharing Ministry? How Health Sharing Works

What a health care sharing ministry is, how monthly contributions and sharing requests work, and why regulators stress that health sharing is not insurance.

By Health Sharing Compass Editorial Team · Published · 4 min read

A health care sharing ministry (HCSM) is a nonprofit, usually faith-based organization whose members agree to help pay one another's eligible medical bills. Each member sends a monthly contribution. When a member has an eligible medical expense, the ministry directs other members' contributions toward it, following the program's written sharing guidelines.

That sounds a lot like insurance, but legally and practically it isn't. Understanding the difference is the most important thing to know before you join.

How health sharing works, step by step

Programs use different words, but most follow the same basic pattern. America's HealthShare, for example, describes its process like this:

  1. You make a monthly contribution. The amount depends on whether you're single, a couple or a family, your age, the program you choose and the sharing level you pick.
  2. You get care. You choose a provider and show your member card. If the provider doesn't work with health sharing, you ask for a self-pay price, pay the bill and submit the itemized bill and receipt.
  3. The ministry reviews the bill. If it's eligible under the guidelines, members' contributions are used to share it.

Before any sharing starts, you usually pay a set amount of your own eligible bills each year. Ministries call this an "Annual Unshared Amount," "Personal Responsibility" or something similar. It is not an insurance deductible, but it plays a similar role in your budget.

What regulators want you to know

State insurance regulators have published consumer alerts about health sharing. The key points from the NAIC:

  • Health care sharing ministries are not insurance and can't guarantee that medical bills will be paid. They aren't legally required to share funds.
  • They don't have to follow Affordable Care Act protections, such as covering pre-existing conditions or capping out-of-pocket costs.
  • State insurance regulators don't supervise them.
  • They usually don't have provider networks, so you may be charged full price unless you negotiate.

North Carolina adds that members must agree to the organization's faith statement, and that there may be a dollar limit per need, with costs above it left to you (NC DOI).

Why people choose health sharing

People who join usually mention lower monthly costs, shared values, freedom to choose providers, or access to care that insurance plans may not include. Some programs, for instance, publish starting monthly contributions under $100 for some members (America's HealthShare programs). Your own contribution depends on age, household and program.

Lower monthly cost comes with trade-offs: limits on pre-existing conditions, waiting periods, exclusions, per-incident caps and, above all, no guarantee. Our guide on whether health sharing is a good idea walks through who it fits and who should look at insurance instead.

What about the individual mandate?

There is no longer a federal tax penalty for going without health insurance (HealthCare.gov). Some states have their own coverage requirements, so check your state's rules before relying on a health share alone.

Questions to ask any health sharing ministry

For what's typically eligible and excluded, see what health share plans pay for. To check a specific bill, use our pre-care checklist.

  • Can I read the full sharing guidelines before I apply?
  • What is the Annual Unshared Amount, and does it apply per person or per household?
  • Is there a per-incident or annual sharing limit?
  • How are pre-existing conditions handled, and for how long?
  • Are there waiting periods for maternity or other care?
  • How do I appeal if a bill is ruled ineligible?
  • What legal notice applies in my state?

Frequently asked questions

Is a health care sharing ministry the same as health insurance?

No. State regulators and the NAIC say health care sharing ministries are not insurance, can't guarantee that bills will be paid and aren't supervised by state insurance regulators (NAIC).

Do I have to be religious to join a health sharing ministry?

Most ministries ask members to agree to a statement of beliefs or lifestyle standards. North Carolina's Department of Insurance notes that members must agree to the organization's faith statement (NC DOI). Read the statement before you apply.

Is there still a federal penalty for not having health insurance?

No. HealthCare.gov says you no longer pay a federal tax penalty for not having health coverage (HealthCare.gov). A few states have their own requirements, so check your state's rules.

Who regulates health sharing ministries?

Generally not state insurance departments. Michigan's insurance regulator, for example, says it does not regulate them and points consumers to the state attorney general for complaints (Michigan DIFS).

Is Health Share of Oregon a health sharing ministry?

No. Health Share of Oregon serves Oregon Health Plan members, and the Oregon Health Plan is Oregon's Medicaid program (Health Share of Oregon).

Do health shares have provider networks?

Usually not, so providers may charge full price unless you negotiate (NAIC).

Sources

  1. Not All Products Are Health Insurance: Health Care Sharing Ministries, Discount Plans and Risk-Sharing Plans (National Association of Insurance Commissioners)
  2. Alternate Plans (North Carolina Department of Insurance)
  3. DIFS Reminds Consumers That Health Care Sharing Ministries Are Not Health Insurance (Michigan Department of Insurance and Financial Services, January 23, 2024)
  4. How Health Sharing Works (America's HealthShare)
  5. Health coverage exemptions: Forms & how to apply (HealthCare.gov)

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

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