Health Sharing FAQ

Yes, health sharing is legal nationwide. Health care sharing ministries (HCSMs) are explicitly recognized and exempt from insurance regulation under the Affordable Care Act (ACA), Section 1501(d)(2)(B).

However, health sharing is not insurance and is not regulated by state insurance departments. Members are not covered by state guarantee funds if a program becomes insolvent.

Some states have specific regulations for health sharing programs, but all 50 states allow residents to participate in HCSMs.

No, health sharing is not considered insurance for tax purposes. However, membership in a recognized health care sharing ministry exempts you from the individual mandate penalty (which is currently $0 as of 2019).

Important tax considerations:

• Health sharing contributions are not tax-deductible (unless you're self-employed and meet certain criteria)
• You cannot use an HSA (Health Savings Account) with health sharing
• Shared medical bills are not considered taxable income
• Some members may qualify to deduct medical expenses paid out-of-pocket (consult a tax professional)

Most health sharing programs have waiting periods for pre-existing conditions, typically ranging from 6 to 36 months. During this waiting period, expenses related to pre-existing conditions are not eligible for sharing.

What counts as a "pre-existing condition" varies by program, but generally includes:

• Any condition you were diagnosed with or treated for in the past 12-36 months (varies by program)
• Chronic conditions (diabetes, heart disease, cancer, etc.)
• Ongoing medications or treatments

After the waiting period, most programs will share expenses related to pre-existing conditions just like any other medical need.

A few programs (like CrowdHealth) have shorter or no waiting periods, but may have different pricing or sharing structures.

It depends on the program. Health sharing programs fall into three categories:

Bottom line: You have more flexibility than most insurance plans. Check your specific program's provider guidelines.

Here's the typical sharing process from start to finish:

1. Receive medical care — Visit your doctor or hospital as needed
2. Pay your IUA — Pay your Initial Unshareable Amount (like a deductible) out-of-pocket
3. Submit bills — Send medical bills to your health sharing program (usually online portal)
4. Program reviews — The program verifies expenses are eligible per their guidelines
5. Sharing occurs — The community shares (pays) your eligible expenses, either:
   • Direct sharing: Other members send payments directly to you
   • Central pooling: Program pays providers from shared funds
6. You receive funds — Typically within 30-90 days (varies by program)

Timeline: Most programs share eligible bills within 30-90 days. Some are faster, some slower depending on their model.

IUA (Initial Unshareable Amount) is the amount you pay out-of-pocket before the community starts sharing your medical bills. It's similar to a deductible in traditional insurance.

Key differences from insurance deductibles:

• IUA is typically per incident, not annual
• If you have multiple unrelated medical needs in a year, you may pay the IUA multiple times
• Some programs offer annual IUA options similar to insurance

Learn more in our health sharing glossary.

Many health sharing programs are faith-based, but not all. The majority of established HCSMs have Christian foundations and may require:

• Signing a statement of faith
• Regular church attendance
• Lifestyle guidelines (no tobacco, alcohol restrictions, etc.)
• Agreement to biblical principles

However, several non-religious options exist:

• CrowdHealth — No religious requirement, modern tech platform
• Zion Health — Universal, non-denominational approach
• Sedera — Secular health sharing community
• Altrua HealthShare — Community-based, not faith-based

See our non-religious health sharing programs comparison.

If your bills are deemed ineligible, you are responsible for paying them yourself. This is one of the key differences between health sharing (voluntary) and insurance (legally required to pay).

Common reasons bills might not be shared:

• Related to a pre-existing condition during the waiting period
• Excluded services (preventive care, mental health, etc.)
• Lifestyle violations (tobacco use, substance abuse if prohibited)
• Experimental or elective procedures
• Bills submitted after the deadline
• Failure to follow program guidelines

What you can do:

• Understand guidelines — Read your program's sharing guidelines carefully before joining
• Pre-approval — Some programs offer pre-approval for major procedures
• Appeal process — Most programs have an appeal process for denied sharing requests
• Negotiate with providers — Many hospitals offer cash-pay discounts or payment plans

Track record matters: Established programs with decades of history (Medi-Share, CHM, Samaritan) have strong sharing track records. Check program reviews and member testimonials before joining.

Most health sharing programs do NOT cover preventive care. This includes:

• Annual checkups and physicals
• Routine lab work and screenings
• Vaccinations and immunizations
• Well-child visits
• Mammograms and colonoscopies (screening, not diagnostic)

Exceptions and workarounds:

• Medi-Share offers an optional preventive care add-on
• Some programs include limited wellness benefits (telehealth, discounts)
• You can pay out-of-pocket — Preventive care is often affordable without insurance ($100-300/year)
• Community health centers offer free or low-cost preventive care based on income

This is a key trade-off: Health sharing saves money on monthly costs but doesn't cover routine preventive care like traditional insurance.

Some health sharing programs cover maternity, but with waiting periods and requirements.

Important considerations:

• Most programs require 9-12 month waiting periods before pregnancy
• You must be a member before getting pregnant for coverage to apply
• Shared amounts vary — typically $15,000-25,000 for normal delivery
• Complications may be shared separately under medical guidelines

Planning pregnancy? Join a maternity-inclusive program at least 12 months before trying to conceive.

Monthly health sharing costs range from $60 to $600+ depending on household size, age, and coverage level.

What affects cost:

• IUA (deductible) — Lower IUA = higher monthly share
• Household size — More members = higher cost (but not proportionally)
• Age — Some programs charge more for older members
• Coverage level — More comprehensive sharing = higher cost

Compare costs: Use our comparison tool to see actual pricing from 10+ programs.

Yes, most health sharing programs allow you to cancel anytime with 30 days notice. There are no annual contracts or cancellation penalties.

Important things to know:

• You're typically responsible for paying your share through the end of the notice period (30 days)
• Any sharing requests submitted before cancellation may still be processed
• If you cancel and rejoin later, you may be treated as a new member (new waiting periods)
• Some programs require you to be a member for a minimum period (e.g., 3 months) before canceling

This flexibility is a major advantage over traditional insurance, which typically requires you to keep coverage through the end of the month or policy year.

Most programs share prescription costs related to shareable medical needs. However, the coverage differs significantly from insurance prescription drug plans:

What's typically shared:

• Prescriptions related to a shareable illness or injury
• Post-surgery medications
• Medications for new diagnoses (after waiting periods)
• Acute condition treatments

What's typically NOT shared:

• Maintenance medications for chronic conditions (during waiting periods)
• Preventive medications (birth control, etc.)
• Lifestyle drugs (ED medications, etc.)
• Over-the-counter medications

Cost-saving strategies:

• Use GoodRx or RxSaver — Often cheaper than insurance copays
• Generic alternatives — Ask for generic versions
• Pharmacy programs — Walmart $4 list, Costco, etc.
• Direct pharmacy negotiation — Cash prices can be surprisingly low

Yes, you can switch between health sharing programs, but be aware of the implications:

What happens when you switch:

• You'll be treated as a new member at the new program
• New waiting periods apply — Pre-existing condition clocks restart
• Time with your old program does not transfer
• Any pending sharing requests must be resolved with your old program

When switching makes sense:

• Your needs have changed (want better coverage, lower cost, etc.)
• You're unhappy with sharing speed or customer service
• You want different provider network access
• Religious/lifestyle requirements no longer align

Tip: If you're generally healthy and past pre-existing condition waiting periods, switching is relatively low-risk. If you have ongoing conditions, weigh the cost of new waiting periods carefully.

Choosing the right program depends on your priorities. Here's what to consider: