Quick answer
No. A health care sharing ministry is a religious nonprofit whose members share each other’s medical bills. It isn’t insurance, it isn’t regulated by state insurance departments, and it doesn’t have to follow ACA rules. That means it can limit sharing for pre-existing conditions, cap what it pays and leave out services, and there’s no legal guarantee your bills will be paid. Some people choose one because the monthly cost can be lower than unsubsidized insurance.
Key takeaways
- At least 1.7 million people in the U.S. use health care sharing ministries.
- They don’t have to cover pre-existing conditions or essential health benefits, and they can set yearly or lifetime limits.
- The ministries themselves say they don’t guarantee payment.
- Membership doesn’t count as health coverage under the ACA, so you can’t use a premium tax credit, and leaving a ministry doesn’t open a special enrollment period.
- Many people who choose a ministry because of cost could get a Marketplace plan for little or nothing after tax credits.
On this page
How sharing ministries work
Members pay a monthly amount, often called a share. When you have a medical bill, you submit it to the ministry, and if it’s eligible under the ministry’s guidelines, other members’ shares help pay it. Most ministries require you to cover a set amount yourself first, usually called an unshared amount or annual household portion.
Members also agree to a statement of faith and lifestyle rules. Common ones include regular church attendance, no tobacco or illegal drugs, and sex only within marriage.
What the law says
Federal law defines a health care sharing ministry as a tax-exempt nonprofit whose members share common ethical or religious beliefs and share medical expenses. To qualify, it must let members keep their membership after they get sick, must have been sharing expenses continuously since at least December 31, 1999, and must have an independent audit every year.
Because they aren’t insurance, sharing ministries don’t have to:
- Accept or share costs for pre-existing conditions
- Cover the ACA’s essential health benefits, like maternity care or mental health care
- Cap your out-of-pocket costs
- Skip yearly or lifetime limits on what they share
Members were exempt from the old federal penalty for not having insurance, but sharing ministry membership doesn’t count as minimum essential coverage.
What some ministries share and don’t
Every ministry sets its own guidelines. Here’s how three of them describe key limits:
| Ministry | Pre-existing conditions | Other limits |
|---|---|---|
| Samaritan Ministries | Shared once the condition appears cured and 12 months pass with no symptoms, treatment or medication; 5 years for some conditions | Needs under $1,000 (Classic) or $2,000 (Basic) aren’t shared; up to $500,000 per non-maternity need |
| Liberty HealthShare | In most programs, not shared in year one if there were signs or treatment in the past 36 months; up to $50,000 in years two and three | Annual unshared amount set by membership type |
| Christian Healthcare Ministries | No longer counted as pre-existing after one year with no symptoms or treatment; 5 years after being declared cancer-free | $125,000 lifetime limit per illness in its base program |
Liberty’s guidelines put it plainly: the program doesn’t guarantee or promise that your medical bills will be paid. Medi-Share and Samaritan say the same in their own words.
Risks to weigh
- No guarantee. If a ministry decides a bill isn’t eligible, or doesn’t have enough money, you owe it. You can’t appeal to a state insurance department the way you can with insurance.
- Pre-existing conditions. If you have an ongoing health problem, it may not be shared for a year or more. ACA plans have to cover it from day one. See getting health insurance with pre-existing conditions.
- You’re billed as self-pay. Doctors and hospitals bill you directly. You may be able to negotiate cash discounts, but you don’t get an insurer’s negotiated rates.
- Getting out can be hard. Leaving a ministry isn’t a qualifying life event, so if you get sick and want real insurance, you may have to wait for open enrollment. See what is the open enrollment period.
- Guidelines can change. Ministries can change what they share and how much.
Some states watch sharing ministries more closely. Colorado, for example, requires them to file annual reports with its Division of Insurance.
Taxes and state mandates
Your monthly share generally isn’t deductible as a medical expense or as health insurance. A 2020 federal proposal would have allowed it, but it was never finalized. One ministry notes that Missouri and Indiana let residents deduct contributions on state taxes. See is health insurance tax deductible.
A few places have their own penalty for going without insurance: California, Massachusetts, New Jersey, Rhode Island and Washington, D.C. New Jersey offers an exemption for sharing ministry members. If you live in one of the others, check the state’s exemption rules before you rely on a ministry.
Compare before you join
If cost is the main reason you’re looking at a ministry, price a Marketplace plan first. With the premium tax credit, 34% of people who signed up for 2026 picked a plan costing $10 a month or less, and a bronze plan is often free after the credit. Unlike a ministry, an ACA plan has to cover pre-existing conditions and caps your yearly costs. See how to lower your Marketplace premium and what is a subsidy in health insurance.
If you earn too much for a tax credit, other options include a bronze plan, a catastrophic plan if you’re under 30 or qualify for a hardship exemption, or a plan through a spouse’s job. See catastrophic health insurance and health insurance for the self-employed.
Before you decide, see what a real insurance plan would cost you. Compare quotes by ZIP code.
Frequently asked questions
Is a health care sharing ministry the same as health insurance?
No. It’s a voluntary arrangement among members with no legal obligation to pay your bills, and it isn’t regulated as insurance.
Do health care sharing ministries cover pre-existing conditions?
Often only after a waiting period, and sometimes with a dollar limit. Rules vary by ministry, so read the guidelines closely.
Can I get a premium tax credit with a sharing ministry?
No. Premium tax credits only apply to Marketplace health insurance plans.
Can I switch from a sharing ministry to a regular plan any time?
No. Leaving a ministry doesn’t give you a special enrollment period, so you’ll usually have to wait for open enrollment unless you have another qualifying life event.
Sources
- healthinsurance.org: Health care sharing ministry
- eCFR: 26 CFR 1.5000A-3, definition of a health care sharing ministry
- Colorado Division of Insurance: Health care sharing plans or arrangements
- New Jersey Treasury: Health insurance mandate exemptions
- Samaritan Ministries: Guidelines
- Liberty HealthShare: Sharing Guidelines (PDF)
This article is general information, not insurance, legal or tax advice. It isn’t affiliated with any sharing ministry. Last reviewed September 2026.