The United States is the country with the most startups in the world, so many of our readers probably work for one, or know someone who does. Startups can be exciting—a brand-new business with new ideas and ways of doing things offers a lot of opportunity for employees to make a mark on the company and be recognized for their work. However, employment with a startup can also come with a lot of risks. 50% of startups fail within 5 years, for one; those that don’t usually take a couple of years to make profit. And there is the matter of benefits. With limited funds from owners and investors, health care often isn’t offered as a perk for working with a startup. This is unfortunate, because 33% of employees say that health care is the only reason they haven’t quit their jobs! Health benefits are a fantastic way to retain workers. With that said, nearly all startups begin with fewer than 50 employees. For companies that small, they don’t have to provide health insurance, and with tight money, they usually don’t. If you’re considering a job position at a startup and wondering “do they offer health insurance?”, the answer is: probably not.

Other possibilities: Health sharing

However! Just because a startup doesn’t provide health insurance, that doesn’t necessarily mean that they don’t offer any healthcare at all. A newer alternative to insurance, health sharing, is a lower-cost compromise. Health shares don’t cover the same range of conditions as insurance does, because they are not federally regulated. Instead, health shares (non-profit companies) keep monthly costs low by restricting the types of conditions they’ll help pay for and, sometimes, what percentage they’ll pay. Although health sharing memberships are less comprehensive than insurance, they work well for the large medical bills that people really worry about. Emergencies such as serious injuries, illnesses, or hospitalizations are what health shares were designed to help with.

For more information about health shares, our website reviews the 10 main health shares with large, open memberships. If health sharing is something your startup offers, you can see what that benefit may look like for you.

Other possibilities: Direct primary care

Direct Primary Care memberships (DPC) may be less common than insurance or health shares, but might still be a possibility. Unlike health shares, which focus on large, unexpected medical costs, direct primary care memberships allow patients easy access to primary care providers. DPC providers pride themselves on being more accessible and devoting more time to their patients than is experienced in traditional doctor’s offices. Appointments can last up to an hour, and wait times to get in are generally much shorter than at standard clinics.

The idea behind DPC clinics is that focusing on primary, or preventive care, helps avoid big problems before they form. You know, “an ounce of prevention is worth a pound of cure.” Membership is also significantly more affordable than insurance and even health sharing, so there is a chance a startup may offer such a membership as a perk. It won’t be very helpful for emergencies, but regular care really does promote better health. If this benefit is offered, it’s worth accepting.

For Start-Up Owners

If you run a startup, please consider including a health perk. The more attractive you can make yourself as an employer, the more likely it is that you’ll find great employees and keep them on board from the startup phase to becoming a successful business.


We hope this provided some insight about what healthcare, if any, you might expect from working with a startup company. We hope that more new startups try to offer health benefit for their employees—research shows that health care is a key factor in attracting, and keeping, good talent. While insurance is probably out-of-reach for most brand-new companies, there are healthcare compromises that may help them stand out from competitors. Don’t expect health benefits from a startup, but if you see some perk other than health insurance, don’t dismiss it out of hand either! A health share or DPC membership might be just enough to make the job worthwhile.