What Is a Healthcare Sharing Ministry?

For many Americans, buying health insurance can be complicated and expensive. If you buy coverage through your employer, you’ll usually have a choice of a few different policies, and your employer may help to subsidize your health insurance premiums. If you buy a health insurance plan on the individual market, your options will be determined by which insurance companies service the geographic area where you live—and getting coverage can be quite expensive.

People looking for an alternative to traditional health insurance may come across health sharing ministries. Joining health sharing ministries could allow you to replace or supplement traditional insurance coverage. However, before you decide to join one, you need to know exactly how these ministries work and what types of health coverage you can expect from them.

On this page:

• What Is a Healthcare Sharing Ministry?
• Healthcare Sharing Ministry vs. Health Insurance Company
• Are Healthcare Sharing Ministries Always Religious?
• Popular Healthcare Sharing Ministries
• Pros and Cons of a Healthcare Sharing Ministry

What Is a Healthcare Sharing Ministry?

A healthcare sharing ministry is a nonprofit organization that helps people share the cost of medical expenses across a larger risk pool.

People buy health insurance in order to share the risk of illness. Everyone pays in premiums, the insurance company collects those premiums, and the insurer pays out when you get sick and need to use your coverage. 

Healthcare sharing ministries work in a similar way by allowing people to pool money together so that there’s cash available if someone incurs costly medical bills. However, there’s no insurance company involved; the nonprofit healthcare sharing ministry facilitates the collection and distribution of funds.

Healthcare sharing ministries are not subject to the same rules applicable to traditional health insurance under the Affordable Care Act (ACA). When you get coverage through a health sharing ministry, the plan does not have to include coverage for 10 essential benefits the ACA requires standard insurers to cover. This includes preventative care, maternity care, and mental health counseling. The cost you’ll pay for coverage through a health sharing ministry may be lower than the costs of traditional insurance because of this.

However, if you purchase coverage through a healthcare sharing ministry, you do not have to buy traditional coverage—you are exempt from the ACA’s individual mandate that you buy insurance or pay a tax (and yes, this mandate is still in effect until 2019, although the Tax Cuts and Jobs Act eliminated the individual mandate after that).

Healthcare Sharing Ministry vs. Health Insurance Company

While healthcare sharing ministries can provide coverage for your medical expenses, they are not the same thing as a health insurance company. These ministries are not subject to the same regulations as insurance companies are, and the rules for the ministries can vary substantially by state.

The strict regulations applicable to health insurance companies are intended to make sure insurers keep their promises to policyholders and pay out when people face medical expenses. So you’re taking a bigger risk by buying coverage from a healthcare sharing ministry. However, some ministries have been around for a long time and have a proven track record of covering the medical costs of those who are covered, so you may not need to worry too much if you choose the right one.

Health-sharing ministries are often, but not always, religious in nature. To join a ministry that’s religious, you will likely need to prove you are a practicing follower of the religion. You may need to show which church you attend and even have a letter from a Christian or Mennonite minister. The policy may also require you to uphold certain religious beliefs or standards of behavior, such as not using drugs or engaging in sexual relations outside of wedlock—and so it may not cover you for certain types of care, such as abortion care or treatment for addiction.

In general, because healthcare sharing ministries aren’t subject to coverage requirements put in place by the Affordable Care Act, the coverage you get from a healthcare sharing ministry may not be as expansive as coverage from a traditional insurance company. There may be lifetime limits on how much your policy will pay out, for example, or you may not be able to get coverage for pre-existing conditions.

Are Healthcare Sharing Ministries Always Religious?

While many healthcare sharing ministries are religious, there are also others that are not based on belief in a particular faith. In fact, some secular healthcare sharing ministries were created as a way to help people escape the requirement to buy traditional coverage under the ACA’s individual mandate.

If you would prefer a healthcare sharing ministry that takes a more secular approach to medical cost sharing, you just need to shop around and understand the coverage rules.

Popular Healthcare Sharing Ministries

If you’re looking for a healthcare sharing ministry, popular options include:

• Medishare: This is a Christian healthcare ministry made up of members who share eligible medical bills. Members must agree to live by principles taught in the Bible. Premiums are based on the number of people seeking coverage, ages of policyholders, and the “annual household portion” of expenses you pay (which is the equivalent of a deductible). For example, the standard monthly share for one 35-year-old would cost $342 with a $1,750 annual household portion.
• Altrua Healthshare: This healthcare sharing ministry offers copper, bronze, silver, and gold coverage with monthly contributions starting as low as $100 for a copper plan and going up to $265 for gold coverage. Members must agree to share a clean and healthy lifestyle and to share the same faith. Members must not use tobacco or illicit drugs, consume alcohol to excess, engage in extramarital sexual relations, commit physical abuse, or have abortions.
• Liberty Healthshare: There are three program options with Liberty: Liberty Complete, Liberty Plus, and Liberty Share. Premiums vary depending upon whether you are under 30, 30 to 64, or 65 and over. For example, Liberty Complete allows you to share up to $1 million in medical bills and costs $249 for a single person under 30, $349 for a couple, and $479 for a family under 30. Members must practice “longstanding Christian principles” in sharing healthcare costs.
• Samaritan Ministries: Members must attend a Christian church at least three out of every four weeks and must agree to live by Bible-based principles, including abstaining from extramarital sex. There are different membership options including Samaritan Classic and Samaritan Basic, which is less expensive but provides less comprehensive coverage. Premiums for Samaritan Classic would total around $220 monthly for a single person age 30 to 44.

Pros and Cons of a Healthcare Sharing Ministry

It’s important to consider the advantages and disadvantages of joining a healthcare sharing ministry instead of, or in addition to, buying more traditional insurance coverage.

Pros of a Healthcare Sharing Ministry

Advantages of a healthcare sharing ministry include:

• Affordable insurance coverage: Policies may cost much less than the insurance you could obtain through your employer or through the individual insurance market. If you can’t afford traditional insurance coverage, joining a healthcare sharing ministry is usually far better than having no coverage at all.
• Avoiding the Obamacare individual mandate: Through 2019, you can still be penalized if you do not buy Obamacare-compliant insurance. However, you are exempt from this penalty if you’re a member of a qualifying healthcare sharing ministry. Becoming a ministry member may be cheaper than paying the penalty, depending upon your situation.
• The ability to be part of a charitable organization: Healthcare sharing ministries are about people helping people. Often with Christian healthcare ministries, people send letters or pray for you when you are ill and need to share the costs of a healthcare need.
• Buying coverage that reflects your beliefs: Some people don’t want to give money to insurance companies that cover things that are against their beliefs, such as abortion. They can join a healthcare sharing ministry that excludes this type of coverage.

Cons of a Healthcare Sharing Ministry

There are also some disadvantages of joining a healthcare sharing ministry, particularly as a replacement to more traditional insurance coverage. This includes:

• A lack of coverage for pre-existing conditions: While the ACA requires all traditional insurance policies to cover pre-existing conditions, this is not the case with healthcare sharing ministries. If you had a medical condition before you get covered, you may not be able to get any help paying for treatments for it, or you may be denied coverage entirely.
• More limits and restrictions: You may need to adhere to certain lifestyle requirements in order to be eligible to join a healthcare sharing ministry.
• No guarantee of comprehensive coverage: Healthcare sharing ministries are not required to provide all of the essential benefits traditional policies must cover under the ACA. And the policies may have lifetime limits, which the ACA prohibited on traditional insurance policies. So, if you have very high medical bills, these policies may not be good for you.

Healthcare Sharing Ministries Are a Good Option Under the Right Circumstances

If you are looking for affordable health insurance coverage and you can’t find it with a traditional insurer—or you don’t want traditional insurance—healthcare sharing ministries are a good alternative. Just make sure you can find a ministry that you can join based on your faith and lifestyle choices, and ensure the health coverage is comprehensive enough to meet your needs.