Health Sharing Compass

Health Sharing Basics

How to Know If a Health Share Will Pay a Medical Bill

Health shares don't guarantee payment, but you can check eligibility first: guidelines, pre-notification, waiting periods, deadlines and appeals.

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

With insurance, people ask "Am I covered?" With a health share, the honest question is "Is this bill eligible for sharing, and have I done everything the guidelines require?" Even then, there's no guarantee. Sharing is voluntary, and you're always responsible for your own bills (Nebraska DOI).

You can, however, avoid most preventable surprises. We use America's HealthShare's published sharing guidelines as the example below. Other ministries have similar steps with different details.

Step 1: Check that the service is eligible at all

Find the service in the guidelines' list of shareable services, then check the exclusions list. America's HealthShare, for example, lists dental care, eye care, durable medical equipment and hazardous hobbies among its exclusions, along with care that conflicts with the ministry's beliefs. If it's excluded, it won't be shared, no matter how expensive.

Also confirm which program you're on. America's HealthShare BLUE, for example, is limited to catastrophic needs, while RED shares a broader range (guidelines).

Step 2: Check timing rules

  • New member period. For the first 60 days, America's HealthShare limits sharing to accidents, emergencies and acute illness.
  • Pre-existing conditions. Not shared in year one, then phased in with caps. See pre-existing condition rules.

Step 3: Pre-notify when required

Many big-ticket services need advance notice. America's HealthShare requires pre-notification, except in emergencies, for things like:

  • surgeries (inpatient and outpatient, but not in-office procedures)
  • inpatient admissions, at least 7 days before
  • MRIs and nuclear imaging such as PET scans
  • pregnancy, OB/GYN and fertility services
  • home health, hospice, organ transplants, and alternative or integrative treatments

Emergency and maternity admissions must be reported within 48 hours or by the next business day. Skipping a required notice can make an otherwise eligible bill ineligible.

Step 4: Know your Annual Unshared Amount

Eligible bills aren't shared until they exceed your Annual Unshared Amount (AUA) for the program year. Track what you've paid so you know when sharing should start.

Step 5: Get a fair price and the right paperwork

Health shares usually don't have provider networks, so you may be charged full price unless you negotiate (NAIC). If your provider doesn't work with health shares, ask for a self-pay discount, pay, and submit the itemized bill and receipt (how it works).

Step 6: Submit on time

America's HealthShare asks for sharing requests within 120 days of the service, extendable to one year if earlier submission wasn't reasonably possible.

Step 7: If it's ruled ineligible, appeal in writing

America's HealthShare's guidelines lay out written appeals: first to member services, then two internal committees, then a committee of three members, and finally mediation and binding arbitration. Members agree to waive lawsuits in civil court over these disputes. Read this section before you join, because it replaces the outside help you'd have with insurance.

A pre-care checklist

  • Service is listed as shareable and not excluded
  • I'm past any waiting period that applies
  • It isn't related to a pre-existing condition still in its phase-in
  • I've pre-notified, if required
  • I know how much of my AUA is left
  • I've asked for a self-pay or cash price
  • I'll submit the itemized bill within the deadline

Want to know what's typically eligible in the first place? See what health share plans pay for.

Frequently asked questions

Can a health share guarantee it will pay my bill?

No. Sharing is voluntary, and you remain responsible for your own medical bills whether or not they're shared (Nebraska DOI).

What is pre-notification?

It's telling the ministry about certain care in advance. America's HealthShare's guidelines require it, except in emergencies, for services such as surgeries, inpatient stays (at least 7 days before admission), MRIs and PET scans, and pregnancy and fertility services (guidelines).

How long do I have to submit a bill?

It varies by ministry. America's HealthShare asks for sharing requests within 120 days of the service, with up to one year allowed if earlier submission wasn't reasonably possible (guidelines).

What if my bill is ruled ineligible?

Use the ministry's appeal process. America's HealthShare's guidelines describe several written appeal levels ending in mediation and binding arbitration, and members waive the right to sue in civil court over these disputes (guidelines).

Sources

  1. Sharing Guidelines (Pre-Notification, Sharing Limitations, Dispute Resolution and Appeal) (America's HealthShare (Melita Sharing Ministry, Inc.))
  2. How Health Sharing Works (America's HealthShare)
  3. Consumer Alert: Health Care Sharing Ministries (Nebraska Department of Insurance)
  4. Not All Products Are Health Insurance (National Association of Insurance Commissioners)

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

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