With the rising cost of healthcare, more and more people are looking for solutions outside of traditional health insurance. For some, health share plans can be the ideal alternative solution.
Provided by nonprofit ministries, health care sharing plans allow members of the same religious faith to share the costs of medical bills while contributing to a program that supports their beliefs. They’re traditionally more affordable than plans purchased on the health insurance marketplace, while still offering comprehensive coverage to members.
In this blog, we’ll explain the ins and outs of shared health insurance, including how it works, what’s covered, and who is eligible
Health share plans allow individuals to pool their financial resources together to cover the members’ medical costs. Members pay into the program through a monthly fee (similar to health insurance premiums), as well as a set annual amount they must pay out-of-pocket (like a deductible) before coverage kicks in.
While this might sound similar to traditional health insurance plans, there is one major difference: medical cost-sharing plans are not subject to the same regulations as Affordable Care Act (ACA) health insurance plans. The administrators of health share plans create their own regulations, including eligibility requirements, exclusions and coverage limitations, as well as pricing structure. We’ll dive into the specifics of how these plans work below.
Health share plans allow participants to pool their financial resources to cover the healthcare costs of its members. With their own unique eligibility requirements and coverage limits, these plans allow members to participate in a program that promotes their shared values while receiving coverage for a range of services including preventive and emergency care.
Medical share plans rely on monthly and annual contributions from members to create a communal fund for health care costs. When a member receives treatment, they submit the bill to the plan for reimbursement. So long as the claim meets the plan’s requirements, the member will be either partially or fully reimbursed.
A medical sharing plan is not held to the same standards as an ACA plan. For example, health share plans are not required to provide minimum essential coverage. Furthermore, these plans can exclude individuals due to pre-existing conditions and set their own coverage limits. Put simply, health share plans may not offer the same protections as ACA plans for financially vulnerable individuals, or those living with chronic conditions.
Shared values are at the foundation of shared health plans, which is why each one sets eligibility requirements rooted in those values. Applicants must adhere to certain lifestyle guidelines set forth by the plan to receive coverage. Most of these guidelines involve making healthy choices, such as abstaining from illegal drugs and not abusing alcohol. Some plans have stricter guidelines than others, so make sure you are comfortable with the rules set forward by your plan.
Shared health plans can be terrific complementary plans to direct primary care programs (DPCs). Through a DPC, you pay a primary care physician a set monthly fee, and in exchange, you receive access to a wide range of common and preventive care services, such as checkups, lab work, vaccines, and screenings. Health share plans generally don’t cover these routine services and are more focused on accidents and illness. So pairing a health share plan with a DPC can get you comprehensive coverage for routine care, and unexpected medical bills.
So, what is a health sharing plan going to offer you that traditional health insurance doesn’t? There are a few key differences between these two types of plans that are important to understand. But, we’ll lay the groundwork by starting with their similarities.
Both traditional health insurance and medical sharing plans require you to pay a monthly fee to keep your membership active, and an out-of-pocket amount for medical costs before coverage kicks in. As for provider networks in health sharing plans vs insurance plans, the rules are comparable. You can find health-sharing plans that have a preferred network of providers, as well as those that let you see any doctor you want. That sounds a lot like your options in ACA plans, right?
We’ll start with the question on everyone’s mind: what is a health sharing plan going to cost? People like these types of plans because they typically have lower monthly fees than insurance plans. In fact, health share plans tend to cost as little as $100 to $300 per month per individual. Private health insurance plans will cost an average of $621 per month per individual in 2025.
How your bills are paid is different, too. With a regular insurance plan, you pay your portion of a bill upfront (i.e. your co-pay), and the provider bills your insurance carrier for the rest. However, shared health insurance plans require you to pay the full provider’s fee upfront, and submit your claim for reimbursement. The good news is that many providers offer a significant discount to cash-paying customers, so you could ultimately save money by not going through regular insurance.
Health share plans also make their own rules regarding what they cover. They do not cover services that they feel go against their beliefs. So it’s important to understand these coverage limitations before signing up to ensure they align with your values and your health needs. Finally, unlike ACA plans, health share plans don’t have an open enrollment period — or any requirements surrounding when you apply. You can apply year-round, regardless of employment status or any “qualifying life events.”
Keep in mind that you must adhere to the plan’s lifestyle requirements and, in some cases, pledge your commitment to the plan’s faith to receive coverage. We’ve listed the upsides and downsides of health care sharing programs to help you decide if they make sense for you.
Health share plans have a unique set of advantages and disadvantages, and it’s important to understand these when deciding if such plans are right for you. Remember that if you cancel your traditional plan to switch to a health share plan and are not satisfied with it, you’ll need to wait until open enrollment to re-apply for standard insurance.
Like with ACA market plans, you have many options when it comes to health care sharing ministries. Below you’ll find a list of the most popular organizations:
Make sure to research each plan’s eligibility requirements, what’s covered, and how cost-sharing is structured to ensure you find the program that fits your needs. If you belong to a church or other faith-based community, ask if they offer health care share plans. Then, you can share medical costs with a group that is already meaningful in your life, and contribute to the wellness goals of people with whom you have a personal connection.
So, is a health share plan right for you? These non-traditional healthcare programs could be right for you if:
If traditional ACA health insurance plans don’t align with your financial or wellness goals for any reason, a health sharing plan could be a viable alternative.
Ready to get professional guidance in selecting a health share plan? Simply fill out a quote form and you’ll be matched with a licensed health share agent, ready to answer all of your questions.
At Insurance ‘N You, we’re all about finding coverage that meets your unique health and budget goals. We know that when it comes to something as important as health insurance, making the right choice is crucial. Let us help you compare health insurance quotes and find competitively priced, comprehensive health share plans today.
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