Imagine paying hundreds of dollars less each month than you normally would for insurance. You could put that money toward savings, bills, or literally anything more exciting than health insurance. That’s why health care sharing ministries are so appealing – they feel like an insurance loophole.
But before you celebrate your financial genius, there’s something you should know: health care sharing ministries aren’t actually insurance. Sure, they may look similar on the surface. But when the medical bills start showing up in your mailbox, the difference between the two usually becomes pretty clear.
Sharing isn’t the same thing as being insured
Health care sharing ministries (HCSMs) have a simple concept: members contribute money each month to help pay each other’s medical expenses.
Think of it as a community medical fund. Members chip in to help each other with qualifying expenses. When you need care, you submit your bills to the ministry, which decides whether they qualify for sharing.
Many ministries are faith-based, with membership requirements that may include shared religious beliefs and lifestyle rules, such as avoiding tobacco and excessive alcohol use.
While a sense of community is nice and all, the big draw is that monthly contributions can be considerably lower than traditional insurance premiums. Finally, some breathing room in the budget!
But there is a catch, and it’s a pretty big one. Unlike traditional insurers, HCSMs aren’t legally required to pay your medical bills, even if the bills meet their guidelines.
So that just leaves the question of what happens when you actually need medical care. That’s where things can take an expensive turn.
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What you could give up by joining a health care sharing ministry
Because it isn’t actually insurance, ministries don’t have to follow Affordable Care Act requirements. That means they don’t have to:
- Offer essential benefits
- Cover preexisting conditions
- Cap out-of-pocket costs
Some ministries even exclude certain treatments or medical situations. For example, Medi-Share’s guidelines exclude contraceptives and maternity expenses for pregnancies conceived outside marriage, with limited exceptions. Finding out that you’re footing the bill while you’re in the delivery room is one way to make childbirth even more painful.
So in some cases, the financial responsibility will fall on you if the ministry chooses not to pay, even if you thought you would be covered. And because many states exempt these organizations from insurance regulation, your options in a dispute may be limited. Most ministries have an internal appeals process, but it isn’t enforced by state or federal law.
Ministry contributions also don’t qualify for Marketplace premium tax credits, and they generally aren’t tax deductible the way insurance premiums can be.
There’s another potential expense, too: provider bills. Many HCSMs don’t have the same negotiated provider networks as traditional insurers. Depending on the ministry and provider, you may be billed at higher, non-negotiated rates. And just like that, those monthly savings aren’t looking so impressive anymore.
Know what you’re signing up for
Before joining an HCSM, do your homework. This means more than just looking at the monthly contribution. Review membership rules, medical exclusions, payment procedures, and any restrictions on prescriptions or preexisting conditions. Then compare any potential savings against the possibility of paying a major medical bill out of your own pocket.
And if you’re looking for ways to save, check whether you qualify for Marketplace premium tax credits. They’re less generous than they were before the enhanced credits expired in 2025, but you may still find that traditional insurance costs less than you’d expect.
Lower monthly costs and a faith-based community may make health care sharing ministries appealing. Just remember that paying less every month doesn’t necessarily mean paying less when you need medical care.
