With medical costs constantly ballooning and showing no signs of slowing down, more and more people are looking for alternative ways to get healthcare. Health sharing programs (also known as “medical cost sharing,” “healthcare ministries”, and “sharing ministries”, among other terms), have become more popular over the years. In 2022, health share ministries have a combined membership of over 1 million members, and counting—a drastic difference from the few thousand people enrolled in the 1980s. Health sharing might be a good option for you, but before you sign up, there are some things you should know.
What is a health share?
A health share is not health insurance. Instead of a company agreeing to take responsibility for medical bills in return for monthly premiums, health sharing ministries pool the funds gathered from all their members per month and use that money to pay for medical needs. Health shares are non-profit entities and generally keep about 10% of costs to cover administration needs; the rest of the money they take in is dedicated for medical bills.
This is feasible for health shares specifically because they keep medical costs low by being particular about what bills they will share. Health sharing ministries are not federally regulated and therefore, not required to cover the same conditions as health insurance.
The other feature separating health sharing ministries from insurance is their focus on membership values. Most health shares are religious in nature, but even the secular companies ask their members to agree to certain values, such as treating other people well and living a healthy lifestyle. Membership values are part of the contract for all health shares and violating these can end your membership.
What conditions are covered?
This changes from health share to health share. However, in general, health share members can expect the following restrictions:
- Any costs related to pre-existing conditions have a waiting period of at least one year. Chronic medical conditions are a significant expense for health insurance companies, and health shares try to mitigate this by making new members wait to share these expenses. Typically, after 3 years of membership, pre-existing conditions are fully shareable. Some companies also make exceptions for diseases that can easily be managed with diet or medication, but in most cases, people have to wait.
- Costs for medical issues that break the sharing ministry’s Member Guidelines are never shareable. Common examples of non-eligible bills include medical costs related to professional sports, abortion, substance abuse, and extra-risky leisure activities (like skydiving).
- Medications, unless related to a specific incident, are almost never shareable. If a member needs a surgery and is prescribed short-term pain medications afterward, those costs are generally shareable. Maintenance medications for long-term conditions, however, are not. (Note: The SolidarityOne membership now does share long-term medications).
- In many cases (although not always), preventive care such as wellness visits, lab work, and immunizations are not shareable. There has been a rising trend of health shares beginning to accept these costs, but in general, health sharing ministries expect their members to pay smaller costs such as doctor visits.
At the root, health shares are designed to help pay for large medical costs, such as emergencies or sudden illnesses. While more sharing ministries are providing ways for their members to use preventive care such as doctor visits, the sharing restrictions help keep monthly costs much lower than premiums for health insurance.
Should I join a health share?
That depends! We can’t recommend health sharing for people who have long-term, expensive conditions such as insulin-dependent diabetes. Although chronic conditions become shareable after a waiting period, health shares do not help with long-term medications. Maintenance meds can be extraordinarily expensive without insurance (and in some cases even with insurance!). Frequent specialist visits can also be pricey, so joining a health share that offers no assistance for medications or provider visits may not be a great financial decision.
However, health sharing may still work for some people who have long-term conditions. Mild-to-moderate depression and anxiety, for example, are frequently manageable by a primary care doctor, low-cost, generic medications, and counseling. Enough health sharing ministries allow at least one annual wellness visit and/or basic mental health resources that might make membership worth it.
Generally healthy people with no ongoing health concerns are the best fit for health sharing memberships. Monthly costs are usually significantly lower than insurance premiums, and with some research it is possible to find a company that best fits your needs.
What to look for in a health sharing ministry
- Do I fit their membership conditions? For example, someone who does not attend a Christian church every week would not be a good candidate for Samaritan. Someone who wants a religious community would (probably) not be interested in Sedera or Zion. A professional athlete most likely would not be a good candidate for any health share.
- Do they fit my needs? If you want help with preventive care and/or office visits, don’t join a company that doesn’t offer these. If you would like some kind of counseling service, don’t join a ministry that does not offer any kind of mental health benefit. Make a list of what you need, health-wise, then review companies’ membership guidelines to check that they offer everything you need.
- Do they reimburse quickly for bills? Many health shares expect their members to pay their bills and then be reimbursed by the sharing ministry. How well a ministry would work for you depends a lot on your financial situation, and if you can afford to wait to get that money back.
- Are the monthly costs reasonable? In some cases, health share membership can actually be close to the same price as health insurance. If that seems likely, it’s probably a good idea to look elsewhere.
Hopefully, this overview makes it easier for you to research health sharing companies and decide if health sharing could be a good solution. Please reach out if you still have any questions!