Health Shares · 2026 guide
Health Shares explained —
what they are, how the cooperative model works, and who it’s right for.
Health Shares are member-funded cooperatives — communities where members pool their monthly contributions to pay each other’s eligible medical bills. Members share costs directly with one another rather than paying premiums to an insurance company. They are not insurance, have different rules, different costs, and different risks than ACA plans. This page explains exactly how they work — including what is and is not shared, and who they work best for.
For individuals under 65
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Not employer-sponsored
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Updated 2026 · Multiple verified sources
$115–$470
Typical individual monthly share amount (Medi-Share 2026)
Alliance of Health Care Sharing Ministries · ministry published 2026 pricing
What is a Health Share
A member-funded cooperative — not an insurance company
A Health Sharing Ministry — also called a Health Share, Health Sharing Ministry, or HCSM — is a member-funded cooperative where members agree to share each other’s eligible medical costs. When a member has a qualifying medical bill, the community’s pooled contributions are used to pay it. There is no insurance company in the middle — money flows directly between members, facilitated by the ministry’s administration.
Health Shares are not insurance. They are not regulated under state insurance laws, but they are not unregulated either — Health Sharing Ministries operate under contract law, are subject to state consumer protection statutes, and fall within the oversight authority of state Attorneys General. State AGs have taken enforcement action against ministries that engaged in fraud or deceptive marketing. The legal framework governing Health Shares is different from — and generally less protective than — the one governing licensed insurance.
Health Shares and insurance — a different framework, not a lesser one
Health Shares are not regulated by state insurance law — but being less regulated does not mean your bills are less likely to be paid. Both Health Shares and traditional insurance have situations where medical costs are not covered. Insurance uses network requirements, prior authorizations, and coverage exclusions to limit what it pays. Health Shares use sharing guidelines and eligibility rules to do the same. The meaningful difference is in the recourse framework: if an insurance company wrongly denies a claim, you have a defined appeals process and state regulatory oversight. If a Health Share declines to share a bill, your path is through contract and consumer protection law — different, and less defined, but not without teeth. State Attorneys General have taken enforcement action in cases of outright fraud and deceptive marketing by some ministries. The takeaway: Health Shares are not inherently unreliable — but understanding exactly what your membership covers before you need it matters more than it does with regulated insurance. Read the membership guidelines carefully. Sources: Commonwealth Fund · California AG · Georgetown CHIR.
What it is
A member-funded cooperative (co-op) where members voluntarily share each other’s eligible medical costs — money flows between members, not through an insurance company
Is it insurance?
No — not regulated under state insurance law; governed instead by contract law and state consumer protection statutes under AG oversight
Monthly cost
Typically $115–$470/month for individuals, depending on plan and provider (2026)
Subsidies
None — Health Share contributions are not eligible for ACA premium tax credits
Pre-existing conditions
Often excluded or subject to waiting periods — varies significantly by ministry
Provider network
Generally no network restrictions — members can see any provider (some ministries use preferred networks)
Enrollment
Open year-round — no open enrollment period or qualifying event required
Membership requirements
Varies — most require a statement of faith; some are based on principles of membership
Health Shares tend to work best for
Health Shares are typically a poor fit for
Key terminology
Health Share terminology explained
Different Health Sharing Ministries use different terminology for the same concepts. Before comparing plans, it helps to understand what these terms mean — they are not standardized across ministries.
| Term | Also called | What it means |
|---|---|---|
| Monthly share amount | Monthly contribution, share payment, membership fee | The fixed amount you pay each month — similar to a premium, but not technically a premium since Health Shares are not insurance |
| Annual Unshared Amount (AUA) | Member Responsibility Amount (MRA), Initial Unshared Amount (IUA), Annual Household Portion (AHP), Personal Responsibility Amount (PRA) | The amount you pay out of pocket for eligible medical costs before the community shares your bills — similar to an annual deductible. Higher AUA = lower monthly share |
| Shareable expense | Eligible expense, covered need | A medical cost that meets the ministry’s guidelines for sharing. Not all medical costs are shareable — each ministry has its own list of what qualifies |
| Non-shareable expense | Excluded expense, non-eligible need | A medical cost that the ministry will not share. Common exclusions include pre-existing conditions, mental health, substance use treatment, preventive care, and costs related to non-approved lifestyle choices |
| Sharing guidelines | Member handbook, sharing standards | The ministry’s rules about what is and is not shareable, how bills are submitted, and how sharing decisions are made. Should be reviewed carefully before joining any ministry |
| Per-incident limit | Per-illness maximum, sharing limit | The maximum amount the community will share for a single medical incident. Some ministries have no per-incident limit; others cap sharing at a set dollar amount per illness |
Read the membership guidelines before enrolling
The sharing guidelines document is the most important thing to read before joining any Health Share. It defines exactly what is and is not shareable, how to submit bills, and what happens if sharing is declined. These guidelines are not standardized — they vary significantly between ministries. Do not assume one ministry’s rules apply to another.
Coverage gaps
What Health Shares typically do and do not cover
Health shares are not required to cover the ACA’s ten essential health benefits. Each ministry sets its own sharing guidelines. The list below reflects common patterns across major ministries — but it is not universal. Always verify with the specific ministry before enrolling.
Typically shareable
Hospitalization
Most inpatient hospital stays for illness or injury, after AUA is met
Surgical care
Most surgical procedures for eligible conditions
Emergency care
Genuine emergencies — ER visits for acute illness or injury
Specialist visits
Specialist consultations for eligible conditions, varies by ministry
Diagnostic tests
Labs, imaging, and diagnostics related to a shareable condition
Prescriptions
Often limited — typically acute prescriptions only, not ongoing maintenance medications
Commonly not shareable
Pre-existing conditions
Most ministries exclude or limit pre-existing conditions, often with waiting periods of 1–3 years before sharing begins
Mental health
Mental health treatment is commonly excluded or heavily limited — a significant gap for many people
Substance use
Treatment for alcohol, drug, or substance use disorders is typically not shareable
Preventive care
Routine physicals, screenings, and immunizations are often not shared — though some ministries offer a wellness benefit
Maternity
Varies significantly — some ministries share maternity for married members only, others have waiting periods
Dental / vision
Typically not included — members purchase separate dental and vision coverage
Lifestyle exclusions
Conditions related to tobacco use, alcohol, recreational drugs, or sexual activity outside marriage are typically excluded
Faith requirements
Faith-based vs. secular Health Shares — what’s the difference?
Most Health Sharing Ministries were founded on Christian principles and require members to share their faith. A smaller but growing number of secular or principle-based Health Shares have emerged that do not require religious affiliation. The differences go beyond membership requirements — they affect sharing guidelines, lifestyle exclusions, and the conditions under which costs are shared.
Which type is right for you?
Faith-based Health Shares are the better-established option with larger member pools, longer track records, and more published financial data. If you share the faith requirements, they typically offer more financial stability. Secular Health Shares are a meaningful option for people who are not Christian or who do not wish to agree to religious lifestyle standards. For any Health Share — faith-based or secular — the most important step is reading the full membership guidelines before enrolling. The sharing guidelines document, not the marketing materials, defines what your membership actually covers.
What actually matters when evaluating a Health Share
Member pool size alone is not a reliable indicator of whether a Health Share will cover your medical expenses. What matters more is the strength of the ministry’s member guidelines, the clarity of their sharing standards, the quality of their member support and bill negotiation processes, and their track record of actually sharing eligible claims. Before enrolling in any Health Share, review the full membership guidelines, look for published sharing data, and ask directly how they handle disputed or declined claims.
Industry context
Health Share failures — what went wrong and what it means
A few Health Shares have failed or been shut down in recent years, leaving members with unpaid medical bills. Understanding what happened in these cases helps illustrate the risks of joining an organization without the financial transparency and operational maturity to fulfill its commitments.
Aliera Healthcare
Dissolved 2021
Marketed as a health sharing ministry but operated as a for-profit company. Multiple state insurance regulators ordered it to stop operating as an unlicensed insurer. Georgia, Washington, and other states took enforcement action. Members were left with unpaid medical bills when operations ceased. The case highlighted the risk of for-profit entities using the Health Share label to avoid insurance regulation. Source: FTC consumer resources.
Trinity HealthShare
Shut down 2021
Associated with Aliera Healthcare. Regulatory actions across multiple states found that Trinity was operating as unlicensed insurance rather than a genuine health sharing ministry. Members reported unpaid claims and difficulty reaching support. The case reinforced that the legal structure of a Health Share — ministry vs. for-profit — matters significantly for member protection.
OneShare Health
Ceased operations 2023
OneShare Health ceased operations in 2023, leaving members with unprocessed claims. The organization cited financial difficulties. Members reported bills totaling millions of dollars that were never shared. The case illustrates that even organizations operating as genuine ministries can become insolvent — and that without insurance regulation there is no state guarantee fund to cover unpaid claims.
What these failures mean for you
Health Shares are not insurance — there is no state guarantee fund. If a Health Share becomes insolvent, unpaid medical bills are your responsibility. This does not mean all Health Shares are high-risk — established organizations with decades of operation, audited financials, and transparent sharing ratios represent a meaningfully different risk profile than newer or financially opaque ministries. But the absence of regulatory backstop means due diligence is not optional.
Modern healthcare approach
Building your modern healthcare combination
A Health Share is the major medical foundation. What you build around it determines how well the combination covers your day-to-day health needs. The five coverage types below are the building blocks — mix and match based on your budget, health needs, and what gaps matter most to you.
The building blocks
Foundation · Major medical
Health Share
$115–$470/mo individual
Primary care
Direct primary care
$50–$150/mo
Preventive · ACA-compliant
MEC plan
$40–$120/mo
On-demand access
Virtual medicine
$5–$80/mo
Event-based offset
Indemnity benefits
$20–$80/mo
Common combinations — choose what fits your needs
Essential — major medical only
The minimum. Covers hospitalizations, surgeries, and large bills after your AUA. No routine care coverage — you pay primary care visits out of pocket. Best for very healthy individuals who rarely see a doctor.
Health Share
$115–$470/mo
individual est.
Most popular — Health Share + DPC
The most common combination above the subsidy cliff. The Health Share covers major medical; DPC covers unlimited primary care with same-day access and no per-visit cost. Eliminates the biggest gap Health Shares leave open: routine care.
Health Share+Direct primary care
$200–$550/mo
individual est.
Preventive-first — Health Share + MEC
Pairs the Health Share for major medical with a MEC plan for 100% preventive coverage — annual exams, immunizations, and screenings at no cost. Some MEC plans also include copays for office visits, urgent care, and labs. Good for those who prioritize preventive care and want ACA minimum essential coverage status.
Health Share+MEC plan
$180–$560/mo
individual est.
Always-on access — Health Share + Virtual medicine
Adds on-demand telehealth access to the Health Share foundation. On-demand physicians, mental health providers, and specialists available via video or phone — for minor illnesses, prescription refills, and follow-ups that don’t require an in-person visit. A low-cost layer that fills the urgent care gap at minimal added expense.
Health Share+Virtual medicine
$120–$500/mo
individual est.
Comprehensive — Health Share + DPC + Virtual medicine
Full-spectrum routine care: major medical (Health Share), unlimited in-person primary care (DPC), and on-demand telehealth (virtual medicine). The DPC handles in-person visits; virtual medicine handles off-hours and remote access. Together they eliminate nearly every routine care gap the Health Share leaves open.
Health Share+Direct primary care+Virtual medicine
$210–$620/mo
individual est.
Maximum coverage — Health Share + DPC + MEC + Virtual + Indemnity
The most complete layered approach. Health Share for major medical. DPC for unlimited primary care. MEC for 100% preventive coverage. Virtual medicine for on-demand access. Indemnity benefits to offset out-of-pocket exposure during hospitalizations and the AUA period. Total cost still typically well below an unsubsidized ACA premium for a 40-year-old in most states.
Health Share+DPC+MEC+Virtual+Indemnity
$300–$720/mo
individual est.
All cost ranges are illustrative estimates for a single individual. Actual costs depend on your age, the specific Health Share and Annual Unshared Amount selected, your state, and the specific DPC, MEC, virtual medicine, or indemnity products chosen. These are not quotes. Use the comparison tool for estimates based on your income and state.
See Health Share costs vs ACA premiums for your income and state
Enter your ZIP code, household size, and income. The tool shows what ACA plans and Health Shares cost side by side — no forms, no data collected.
Common questions
Health Shares — questions people ask most
Is a Health Share the same as health insurance?
No — and this distinction matters, though not always in the way people assume. Health Sharing Ministries are membership organizations — sometimes described as health care co-ops — where members voluntarily share each other’s medical costs. They are not insurance and are not regulated under state insurance law. However, being less regulated does not automatically mean your bills are less likely to be paid. Both Health Shares and traditional insurance have situations where medical costs are not covered — insurance through network requirements, prior authorizations, and coverage exclusions; Health Shares through sharing guidelines and eligibility rules. The practical difference is in recourse: with insurance, a wrongful denial has a defined appeals process and state regulatory oversight. With a Health Share, your path is through contract and consumer protection law, which is less defined. State Attorneys General have taken enforcement action in cases of fraud and deceptive marketing by some ministries. The most important step before joining any Health Share is reading the full membership guidelines — they define what your membership actually covers.
Will a Health Share cover my pre-existing condition?
It depends on the ministry and the condition. Most Health Shares impose waiting periods before they will share costs related to pre-existing conditions — typically 1 to 3 years. Some conditions may be permanently excluded. Unlike ACA plans, Health Shares are not required by law to cover pre-existing conditions. This is one of the most important distinctions between the two coverage types. If you have a condition requiring ongoing treatment, read each ministry’s sharing guidelines carefully before enrolling.
Do I need to be Christian to join a Health Share?
Most major Health Sharing Ministries require a statement of Christian faith and evidence of active church participation. Some ministries — including a smaller number of non-faith-based Health Shares — accept members with broader ethical or values-based commitments. Read the membership requirements carefully, as non-compliance can affect what costs are shared.
What is an Annual Unshared Amount and how does it work?
The Annual Unshared Amount (AUA) — also called the Member Responsibility Amount, Initial Unshared Amount, or Annual Household Portion depending on the ministry — is the amount you pay out of pocket for eligible medical costs before the community begins sharing your bills. It functions similarly to an annual deductible. You typically choose your AUA when you enroll: a higher AUA results in a lower monthly share amount. Common options range from $1,000 to $10,500 per year.
Does a Health Share have a network of doctors I must use?
Most Health Shares have no network restrictions — you can see any doctor or hospital. Some larger ministries (like Medi-Share) offer access to preferred provider networks that may offer discounted rates, but network participation is typically not required. This is one of the most frequently cited advantages of Health Shares: the freedom to choose any provider without worrying about in-network vs out-of-network coverage.
Who should consider a Health Share?
Health Shares are most likely to make sense for individuals who are generally healthy with no significant pre-existing conditions, earning above the ACA subsidy cliff ($62,600 for a single adult in 2026) and therefore facing full unsubsidized ACA premiums, comfortable with less regulatory protection than insurance provides, and aligned with the faith or values requirements of the ministry. For people with pre-existing conditions, significant medical needs, or incomes that qualify for ACA subsidies, an ACA plan typically offers better protection.
Are Health Share contributions tax deductible?
No. Health sharing ministry membership fees are not deductible as health insurance premiums under IRS rules, because Health Shares are not insurance. They also cannot be reimbursed through health reimbursement arrangements (HRAs) or paid with health savings account (HSA) funds. Consult a tax advisor for guidance specific to your situation.