Health insurance premiums keep climbing. Employer coverage now averages $9,325 a year for one person and $26,993 for a family, counting what employers and workers pay together (KFF, 2025). On the marketplace, benchmark premiums rose 26% for 2026, and enhanced subsidies expired at the end of 2025.
That's why more people are asking: what are health share plans, and could they work for me?
This guide covers everything you need to know about health sharing in 2026. Whether you're self-employed, between jobs, or just tired of traditional insurance, you'll learn exactly how health shares work, what they cost, and whether they're right for your situation.
What Is a Health Share Plan?
A health share plan is a cost-sharing arrangement where members pool money together to pay for each other's medical expenses.
Think of it like a medical expense co-op. Members contribute a monthly amount (similar to a premium), and when someone has eligible medical costs, the community shares the burden. You're not buying insurance. You're joining a group of people who've agreed to help cover each other's healthcare.
Most health care sharing ministries operate as 501(c)(3) nonprofits. They're not insurance companies, and they don't promise guaranteed coverage. About 30 states have laws exempting qualifying ministries from insurance regulation. What they do offer is a more affordable alternative to traditional health insurance, with more flexibility in how you spend your healthcare dollars.
How Health Sharing Actually Works
When you join a health share, you pay a monthly share amount. This is your contribution to the pool.
You also pick an amount you pay yourself before sharing starts, often called an Annual Household Portion (AHP) or Initial Unshareable Amount (IUA). It works like a deductible: with a $3,000 AHP, you pay the first $3,000 of eligible medical expenses (per year or per medical need, depending on the program) before the community starts sharing costs.
Here's an example: You join a health share with a $300 monthly share and a $2,500 AHP. You break your arm and the bill comes to $8,000. You pay the first $2,500, and the health share community covers the remaining $5,500.
Different organizations handle the mechanics differently. Some use digital platforms where you submit bills and get reimbursed. Others pay providers directly.
The key difference from insurance is this: health shares typically require you to pay providers upfront, then seek reimbursement. Traditional insurance usually pays providers directly through a network.
A Brief History of Health Sharing
Health care sharing ministries started in the 1980s, rooted in Christian communities.
The model was simple: church members would help each other with medical bills, following biblical principles of bearing one another's burdens. These organizations grew slowly for decades, serving a niche religious audience.
Then the Affordable Care Act changed everything. Its individual mandate exempted members of qualifying health care sharing ministries from the tax penalty for going uninsured, and membership grew fast.
By 2018, about 1 million Americans belonged to health care sharing ministries, up from fewer than 200,000 before 2010 (Commonwealth Fund). Colorado regulators counted more than 1.5 million members of sharing plans nationwide in 2023. Most belong to faith-based groups like Medi-Share, Samaritan Ministries, and Christian Healthcare Ministries.
The model has also expanded beyond religious communities. Non-religious options like Sedera (founded in 2014) and CrowdHealth serve people who want the cost savings and flexibility without a faith requirement.
Health Share vs Health Insurance: Key Differences
| Feature | Health Share Plans | Traditional Insurance |
|---|---|---|
| Legal status | Not insurance, not regulated by state insurance departments | Heavily regulated insurance products |
| Monthly cost | Roughly $115-$500 for one person, by program and age | 2026 benchmark silver plan: $625 for a 40-year-old before subsidies |
| Coverage guarantee | No legal obligation to pay claims | Guaranteed coverage per policy terms |
| Networks | Usually no network restrictions | Often limited to in-network providers |
| Pre-existing conditions | Often excluded or waiting periods | Must be covered (ACA requirement) |
| Preventive care | Varies, some plans share a preventive visit | Must cover recommended preventive care in network at no cost |
| Alternative medicine | Usually limited or excluded | Rarely covered |
| Annual/lifetime limits | Varies: some have none, others cap per illness, per incident or per year | No annual or lifetime dollar limits on essential benefits (ACA requirement) |
| ACA status | Not ACA coverage. No federal penalty since 2019, but some states have their own | Meets ACA requirements |
The biggest difference comes down to this: insurance is a legal contract with guaranteed benefits. Health sharing is a voluntary agreement with no legal obligation for the organization to pay your bills.
That sounds scary, but most established health shares have strong track records of paying eligible expenses. The trade-off is risk vs. reward. You accept more uncertainty in exchange for lower costs and more control.
What Health Shares Typically Cover (and Don't Cover)
Most health share organizations cover similar categories of medical expenses.
Typically Covered:
- Accidents and injuries
- Emergency room visits
- Hospital stays and surgeries
- Doctor visits for new conditions
- Prescription medications (with restrictions)
- Maternity care (after waiting period)
- Cancer treatment
- Catastrophic illness
Often NOT Covered:
- Pre-existing conditions (at least initially)
- Routine preventive care (though some newer plans include this)
- Mental health and substance abuse treatment
- Cosmetic procedures
- Experimental treatments
- Medications for chronic conditions that existed before joining
Here's the gap: most health shares, like most insurance, don't cover the care people use to stay well.
Functional testing, peptide therapy, IV vitamin treatments and psychedelic-assisted therapy are almost always out of pocket. If you're interested in optimization and longevity medicine, that's the gap a wellness membership like Gabriel Care fills, alongside an insurance plan.
The Major Health Share Organizations in 2026
The health sharing landscape includes both established faith-based organizations and newer secular platforms.
Medi-Share (Christian Care Ministry) Sharing since 1993, with more than 350,000 members. Requires a Christian statement of faith. Medi-Share doesn't publish a rate table, but its own examples put a single member in their 30s at about $150 to $250 a month with a $12,000 AHP. Uses a national provider network for discounts and includes 24/7 telehealth.
Samaritan Ministries Old-school model where members send their monthly shares directly to other members. Strong Christian emphasis. 2026 monthly shares run $210 to $925 on the Classic program and $125 to $525 on Basic. Samaritan says bills are typically shared within 60 to 90 days. Appeals to people who want to see exactly where their money goes.
Christian Healthcare Ministries (CHM) One of the oldest (founded 1981). Simple structure and low costs: $115 (Bronze), $169 (Silver) or $299 (Gold) per unit per month in 2026, with a $125,000 limit per illness unless you add CHM Plus. Requires a Christian lifestyle commitment.
Liberty HealthShare Requires members to agree to a statement of shared Christian beliefs. Individual shares run from $87 to $362 a month (2026), with per-incident limits of $300,000 to $1 million depending on the program. Liberty settled an Ohio attorney general investigation in 2021 that brought in a new board and management, and a members' class action against Liberty and members of its founding family was still pending in 2025.
CrowdHealth Secular, for-profit platform that crowdfunds members' bills instead of pooling money. $60 a month per person plus capped monthly asks to fund other members' bills, about $142 a month in total on average for a single member under 55 (2026). You pay the first $500 of each health event. Best for healthy people who want catastrophic-focused coverage.
Sedera Non-religious option founded in 2014; members agree to an ethical-beliefs statement rather than a statement of faith. $210 to $336 a month for a single member aged 30 to 39 (2026), with IUA options from $500 to $5,000. No provider network. Its guidelines treat acupuncture, naturopathy and functional medicine as alternative and not shareable, and share chiropractic only for musculoskeletal injuries, up to $3,000 a year.
Zion HealthShare Welcomes members of all faiths with no statement of faith, though members attest that Zion considers itself accountable to a higher power. $175 to $260 a month for a single member aged 30 to 39 (2026). No annual or lifetime limit. Washington ordered it to stop selling there, and a state appeals court upheld that order in February 2026.
Each organization has different eligibility requirements, sharing rules, and coverage details. Some require lifestyle commitments (no tobacco, no excessive alcohol), others have faith requirements, and the newer secular options drop the faith requirement, though some, like CrowdHealth, have health-based eligibility rules.
Where Gabriel Care fits: Gabriel Care isn't a health share. It's a wellness membership that works alongside your health insurance. Your plan handles conventional medical care, and Gabriel Care covers the care insurance won't, including functional medicine, peptides, IV therapy, advanced lab testing, and cannabis medicine and psychedelic therapy where legal, through licensed providers. Memberships start at $249 a month, with a monthly wellness balance of up to $500 on Emerald, $750 on Sapphire, and $1,500 on Onyx. There's no faith requirement, and an AI health advisor is included.
Pros of Health Share Plans
Lower Monthly Costs This is the big one. Many people pay less each month than they would for unsubsidized insurance, which can add up to thousands of dollars a year. For self-employed people and small business owners, that's real money that can be reinvested in your business or health.
No Network Restrictions Most health shares let you see any provider. No need to check if someone is "in-network" or get referrals. You have the freedom to choose your doctors based on quality and fit, not insurance contracts.
Community Model Feels Different You're not paying a corporation. You're part of a group of real people helping each other. Some organizations even let you see member stories or connect with people you're helping. There's something psychologically satisfying about that.
Transparency Most health shares publish their guidelines clearly. You know what's covered, what's not, and how decisions get made. Try getting that level of clarity from a traditional insurance company.
No Federal Penalty The federal penalty for going without insurance has been $0 since 2019, so joining a health share doesn't trigger one. California, Massachusetts, New Jersey, Rhode Island and Washington, D.C. still have their own penalties. Most exempt members of qualifying sharing ministries (generally ones sharing since 1999), and Massachusetts applies its own test, so secular programs may not qualify. Check your state.
Better Alignment with Your Values Whether that's faith-based values, health freedom, or just not wanting to feed the insurance-pharma complex, health shares let you opt into a different system.
Cons of Health Share Plans
Not Legally Insurance The health share has no legal obligation to pay your bills. If the organization has financial problems or changes its guidelines, you could be stuck. This is the single biggest risk.
Pre-Existing Conditions Are Tricky Most health shares won't cover pre-existing conditions, at least not immediately. Some have waiting periods of 12-36 months. If you have a chronic condition requiring ongoing treatment, a health share might not work for you.
You Often Pay Upfront and Get Reimbursed Unlike insurance where the provider bills the insurance company, many health shares require you to pay the provider first, then submit for reimbursement. This means you need enough liquidity to float medical expenses temporarily.
Less Regulation Means Less Protection About 30 states exempt qualifying sharing ministries from insurance regulation, and regulators elsewhere have acted against some sharing plans. If something goes wrong, you have fewer legal protections and avenues for appeal. You're relying on the organization's integrity and financial stability.
Some Exclusions Feel Arbitrary Lifestyle requirements (no smoking, no excessive drinking, sometimes even body weight requirements) can exclude people who need affordable care the most. Faith-based organizations might not share costs for certain procedures based on religious beliefs.
No Preventive Care Mandate Traditional insurance must cover annual checkups, vaccines, and screenings at no cost. Health shares often don't, or they count toward your AHP. If you rely heavily on preventive care, you might not save as much as you think.
Variable Payment Speed Some health shares reimburse quickly, others can take 60-90 days. If you need fast reimbursement to manage cash flow, this can be stressful.
Risk of Changes Health shares can change their sharing guidelines with more flexibility than insurance companies can change policy terms. What's covered today might not be covered next year.
Who Health Sharing Is Best For
Health shares work really well for certain people and situations.
Self-employed and freelancers who don't have access to employer plans and want to cut their healthcare spending in half. You're already comfortable with managing irregular income, so the uncertainty trade-off makes sense.
Healthy individuals and families who rarely use the healthcare system but want catastrophic protection. If you're not managing chronic conditions and mainly need coverage in case something bad happens, health shares are a strong option.
Early retirees who need coverage between leaving their job and Medicare eligibility at 65. Health shares can bridge that gap at a fraction of the cost of COBRA or marketplace plans.
People with high-deductible insurance fatigue who are tired of paying $600/month for a plan with an $8,000 deductible that rarely pays for anything beyond preventive care. A health share lets you take on similar risk for way less money.
Faith-based communities who want their healthcare dollars aligned with their values. If mutual aid within a religious framework appeals to you, faith-based health shares are built for that.
Health shares are NOT ideal for people with chronic conditions requiring ongoing expensive treatment, people who can't float upfront costs, or anyone who needs the security of guaranteed coverage. If the idea of your claims being evaluated case-by-case causes major anxiety, stick with traditional insurance.
How to Choose the Right Health Share Plan
Start by getting clear on your actual healthcare usage and risk tolerance.
Step 1: Assess Your Health and Usage Patterns Look at the last 2-3 years. How often do you see doctors? Do you have ongoing prescriptions? Are you generally healthy or managing chronic issues? Be honest. If you're in poor health with high utilization, health sharing might cost you more than insurance once you factor in exclusions.
Step 2: Calculate Your Real Costs Take the monthly share amount plus your Annual Household Portion, and divide the AHP by 12 to get your true monthly cost. Compare that to insurance premiums plus your annual out-of-pocket spending. Don't just look at the monthly number.
Step 3: Check Coverage for What You Actually Use If you see a functional medicine doctor quarterly, get IV therapy monthly, or take peptides, know that most health shares won't cover that care. A wellness membership alongside an insurance plan is built for it. If you're healthy and just need catastrophic coverage, focus on low monthly shares with higher AHPs.
Step 4: Evaluate Financial Stability Research how long the organization has been around. Look for published financials (nonprofits must file Form 990). Check reviews and complaints. Ask about their reserves and what happens if they have more claims than expected.
Step 5: Understand the Fine Print Read the sharing guidelines carefully. What's excluded? What are the lifestyle requirements? How do they define "eligible" expenses? What's the process for pre-approval on major procedures?
Step 6: Test Customer Service Call or message with questions before you join. How responsive are they? Can they clearly explain how reimbursement works? Do they feel like a real organization or a sketchy operation?
Step 7: Consider the Community Do you want a faith-based model or secular? Do you care about alternative medicine coverage? Does the organization's philosophy and member base align with your values?
Step 8: Have a Backup Plan Keep enough savings to cover your AHP plus at least $5,000-$10,000 in case something isn't shared. Know what you'll do if a major expense gets denied. Some people keep health shares for day-to-day stuff and buy a cheap catastrophic insurance policy as a safety net.
The right health share depends entirely on your situation. There's no universal best choice, only the best choice for your health profile, financial situation, and risk tolerance.
Frequently Asked Questions
Are health share plans legal? Yes, to join. Health care sharing ministries aren't insurance, and about 30 states have laws exempting qualifying ministries from insurance regulation. Regulators have acted against arrangements that operated like unlicensed insurance: Aliera and Trinity HealthShare ended in bankruptcy after state actions, and Washington ordered Zion HealthShare to stop selling there. Check an organization's record before you join. The federal penalty for going without insurance has been $0 since 2019.
Will my doctor accept a health share plan? Most health shares don't have provider networks, so any doctor will "accept" you as a patient. However, you'll typically pay the doctor directly and seek reimbursement from the health share, rather than the doctor billing the health share like they would bill insurance.
What happens if the health share doesn't pay my claim? If an expense is deemed ineligible, you're responsible for the full cost. Health shares have appeals processes, but they're not legally obligated to pay. This is the primary risk of health sharing. Always get pre-approval for major procedures when possible.
Can I switch from insurance to a health share anytime? Yes. You're not locked into insurance outside of open enrollment if you want to leave. Going the other direction (health share to insurance) is trickier. You can only buy insurance during open enrollment or after a qualifying life event, and leaving a health share doesn't count as one. Plan your transition carefully.
Do health shares cover pre-existing conditions? Most don't, at least not immediately. Some have waiting periods of 12-36 months before they'll share costs related to pre-existing conditions. A few newer organizations are experimenting with limited coverage after shorter waiting periods. If you have a pre-existing condition, read the guidelines very carefully.
How do health shares handle prescriptions? It varies widely. Some reimburse prescriptions at a percentage after your AHP is met. Others offer discount pharmacy programs. Many exclude maintenance medications for chronic conditions. Some newer health shares partner with telehealth services that include basic prescriptions.
Are health share payments tax-deductible? Generally no, including for the self-employed. Health share payments aren't insurance premiums, so they don't qualify for the self-employed health insurance deduction, and IRS Publication 502 doesn't list them as medical expenses. The IRS proposed making them deductible in 2020 but never finalized it, and bills to change the law haven't passed. Consult a tax professional for your specific situation.
What's the catch? The catch is uncertainty. You're trading guaranteed coverage for lower cost and more flexibility. If you're healthy and financially stable, that trade makes sense. If you need guaranteed access to expensive ongoing care, it doesn't. There's no free lunch, just different risk profiles.
The Bottom Line
Health share plans represent a fundamentally different approach to managing medical expenses.
They're not insurance. They're communities of people who've decided to share healthcare costs directly, cutting out the insurance middleman and saving thousands in the process.
For the right person, in the right situation, health shares offer enormous value. Lower costs, more freedom, coverage for alternative medicine, and alignment with personal values.
For the wrong person, they're a gamble that could leave you stuck with bills a traditional insurance plan would have covered.
The key is honest self-assessment. If you're healthy, financially stable, don't have major pre-existing conditions, and comfortable with some uncertainty, health shares deserve serious consideration. If you need guaranteed coverage and ongoing expensive care, stick with traditional insurance.
The health sharing space is evolving rapidly. What started as a religious alternative to insurance is becoming a legitimate option for anyone who wants to take more control of their healthcare spending. New platforms are launching, coverage is expanding, and the model is proving it can work at scale.
A Different Option: Insurance Plus Gabriel Care
Gabriel Care is built for people who take their health seriously, and it isn't a health share.
It's a wellness membership that works alongside your health insurance. You keep an ACA or other health plan for conventional and catastrophic care, with its protections for pre-existing conditions and no annual or lifetime dollar limits. Gabriel Care covers what that plan ignores: functional medicine, advanced testing, peptides, IV therapy and more, from a monthly wellness balance of up to $500 on Emerald, $750 on Sapphire, or $1,500 on Onyx.
No faith requirements. No lifestyle restrictions. Memberships start at $249 a month.
See everything Gabriel Care covers at gabrielcare.co/coverage-list
Last updated: September 2026