FAQ: Health Sharing Explained

A health share is a nonprofit organization that facilitates voluntary medical cost sharing within a like-minded community. Members follow written guidelines, align with stated principles or beliefs, and contribute a set monthly amount that is typically pooled and distributed to help share eligible medical expenses of others.

Health share guidelines help determine:

• Membership requirements and eligibility standards
• What types of medical needs may be eligible for sharing
• How needs are submitted and reviewed
• How pre-share amounts apply
• How pre-existing medical conditions are addressed

Health sharing is not health insurance.

Health sharing programs operate under a different structure. They are voluntary cost-sharing organizations in which members agree to share eligible medical expenses according to written guidelines.

Health insurance is a regulated product issued by insurance companies and governed by state and federal laws. It operates under a legally binding contract that requires claims to be paid according to the terms of the policy.

Because of these differences:

For a closer look at why many people are turning to health sharing, see:
Why Health Shares Are a Great Alternative to Traditional Insurance

Health shares are designed for a variety of household types and stages of life. The way these options are structured can vary from one organization to another, but programs commonly offer the following:

Individuals
Individual memberships allow a person to enroll independently and share eligible medical expenses within the community.

Couples
Couples may enroll together under one membership, allowing eligible medical expenses to be shared as a household.

Families
Family memberships may be offered in several ways, including two-parent households, single-parent households, or children-only options.

Businesses and Teams
Some health shares offer programs designed for business owners seeking an alternative to traditional group insurance. Employers may enroll their company or organization in a membership program that allows employees and their families to participate in a health share.

Health shares that offer business or team plans include:
Zion HealthShare
Christian Healthcare Ministries (CHM)
Impact Health Sharing
Sedera
Samaritan Ministries
Solidarity HealthShare

Seniors and Those Approaching Medicare
Once a member reaches age 65, certain health shares offer memberships that may be used alongside Medicare. These memberships are available to individuals only, and members must be enrolled in Medicare Parts A and B. Eligible medical expenses not paid by Medicare may be submitted for sharing according to the health share’s guidelines.

Health shares that offer senior programs include:
Christian Healthcare Ministries (CHM)
Impact Health Sharing
Samaritan Ministries
Liberty HealthShare
Medi-Share

A pre-share amount is the portion of eligible medical expenses a member is responsible for before sharing may begin. It functions similarly to a deductible, but it is applied according to the program’s written guidelines. Depending on the health share, this amount may be referred to as an Initial Unshareable Amount (IUA), a Personal Responsibility Amount (PRA), or other similar terms.

A small number of health share programs include a co-share amount, which requires members to pay a percentage of eligible medical expenses after the pre-share amount has been met.

A co-share typically applies up to a specified limit outlined in the guidelines, after which eligible expenses are shared.

A pre-existing condition generally refers to a medical condition for which a member was examined, diagnosed, treated, took medication, or experienced symptoms prior to becoming a member.

Most health shares use a look-back period, meaning they review a defined period of time before membership to determine whether a condition qualifies as pre-existing. They also apply a waiting period during which expenses related to that condition are not eligible for sharing.

After the waiting period ends, many programs use a phase-in approach, gradually increasing the dollar amount eligible for sharing over time. Some health shares maintain a specific sharing limit for pre-existing conditions, while others may share eligible expenses without a dollar cap after a specified number of years.

Health sharing programs generally involve the following member costs:

Monthly Contribution
The amount members contribute each month to participate in the health share. Contribution amounts vary based on factors such as age, household size, selected pre-share amount, and the specific program chosen.

Pre-Share Amount
The amount a member is responsible for before eligible medical expenses may be shared (similar in concept to a deductible).

Co-Share Amount
Used by a small number of health shares, this is a percentage of eligible medical expenses that a member pays after the pre-share amount has been met.

Expenses Not Eligible for Sharing
Some medical services may fall outside the program’s guidelines and would remain the member’s responsibility.

Health share programs differ in their written guidelines, but many share a wide range of eligible major medical expenses, including:

In addition to major medical services, some health shares also offer sharing for other types of care, including:

These service types may be included in the standard program or available as optional add-ons for a small additional fee. Sharing limits and requirements may apply.

For a full breakdown of major medical, less common and rare services that may be available for sharing, explore:
What Medical Expenses Are Shared by Health Shares?

Dental and Vision Services 
Health shares vary significantly in how they handle dental and vision services. Here’s a breakdown of the most common approaches:

• Routine dental and vision care: Typically not eligible for sharing.
• Conditions related to injury or disease: Limited sharing may be available through many health share programs.
• Discount programs: Some health shares provide access to discount networks.
• True dental sharing: Altrua HealthShare and Liberty HealthShare offer true dental sharing as add-on programs.
• True vision sharing: Liberty HealthShare offers true vision sharing as an add-on program.

Mental Health Services
Most health shares offer sharing for certain mental health services, though guidelines vary by organization and program. Some common offerings include:

• Virtual care: Mental health services are typically provided through telemedicine or online consultations.
• Postpartum depression: Some programs offer limited sharing for postpartum depression.
• Short-term psychiatric hospitalization: Eligible for sharing with some health shares, subject to guidelines.

When using a health share, the billing process looks different than what most people are used to with traditional insurance.

At the Provider’s Office
Members will present themselves as self-pay at the time of service. However, various health shares also provide resources that can influence how a provider bills or prices services, such as:

• Member ID cards: These may include billing instructions or contact details to help the provider submit the bill correctly.
• Member support teams: Assistance with billing questions, documentation requirements, and, in some cases, price negotiations or payment arrangements.
• Network access: Certain health shares partner with PPO networks, which may offer reduced pricing when visiting participating providers.

Note: Health shares typically allow members to see any provider they choose. For organizations offering PPO network access, using a provider outside the network may lead to additional charges or balance billing.

Documents You’ll Need
Whether the health share pays the provider or the member pays first, most programs require clear documentation, such as:

• Itemized statement: Detailed statement listing each service provided and its corresponding charges.
• Billing code summary: A document or section of the bill that includes the medical billing codes (such as CPT or ICD-9 codes) to identify the services performed.
• Proof of payment: Documentation showing that payment was made, such as a receipt or payment record, if the member paid the provider directly.
• Standard billing forms: These may include HCFA (CMS-1500) or UB-04 forms, which may be submitted as part of the documentation.

It’s important to maintain organized medical records. Keeping organized copies of bills, forms, receipts, medical records, and communication with providers helps to ensure timely submission and can prevent delays in the review process.

Submitting a Need or Request
A need refers to a medical illness or injury a member experiences.
A request is the documentation submitted to the health share to determine whether that need and its related expenses are eligible for sharing.

Most health shares have members submit a request through an online member portal, though alternative submission methods may also be available. All required documentation must generally be provided to the health share within six months of the date of service. The health share reviews the submission to determine whether the expense meets guideline requirements and whether any waiting periods, phase-ins, or limits apply.

How Payment Is Handled
Health shares generally use one of the following payment methods:

• Reimbursement
  The member pays the provider directly at the time of service and submits the required documentation for review. If the medical need meets the program’s guidelines and exceeds the pre-share amount, the health share reimburses the member according to the sharing guidelines.
• Direct Payment
  The health share sends funds directly to the medical provider after the need has been reviewed and approved for sharing. The member may still be responsible for any applicable pre-share amount or other costs outlined in the program’s guidelines.
• Combination
  Some health shares may use both methods depending on the type of service, the provider’s billing preferences, or the health share’s specific guidelines.

Health sharing programs are not health insurance and generally are not considered Minimum Essential Coverage (MEC) under the Affordable Care Act (ACA). In other words, a health share membership itself does not count as an ACA-qualified insurance plan.

Federal
At the federal level, there is currently no tax penalty for not having MEC. However, several states maintain their own individual health coverage mandates. Whether a health share membership satisfies those state requirements depends on how that particular state defines and treats health care sharing ministries.

State
Some states recognize qualifying health care sharing ministries under specific statutory definitions. Others do not treat them as acceptable “coverage” for mandate purposes. Because rules vary by state, health shares provide state-specific notices explaining how their program is classified and what members should understand before enrolling.

To learn more about how these state notices work and where to find them, see:
Understanding Health Share State Notices — What They Are, Why They Exist, and Where to Find Them

When comparing health share organizations and programs, a careful evaluation is key. Consider the following questions to guide your decision:

• What monthly budget fits my situation?
• What is my total annual cost? (See “How Much Do Health Sharing Programs Cost?”
• Do I have any pre-existing conditions? (See “Are Pre-Existing Conditions Eligible for Sharing?”
• How often do I typically use healthcare services?
• What are my priorities and healthcare needs?

It is also important to evaluate:

• Financial planning: Consider how frequently you use healthcare services and whether those services generally fall within the program’s eligible sharing guidelines.
• Sharing limits: Review any annual, per-need, or lifetime limits to understand how expenses may be capped under the program’s guidelines.
• Transparency: Evaluate how openly and clearly the program communicates its processes, requirements, rules, limits, and member responsibilities.

You can explore our Healthsharing Reviews comparison page to see how different health sharing programs stack up.