Healthsharing plans 2026: Medi-Share, Sedera, Liberty, CHM — what they actually cost and the not-insurance caveats.

Healthsharing ministries are not insurance. They're voluntary cooperatives where members pool monthly "shares" to help with each other's qualifying medical bills. Done right, they cost 30-60% less than ACA marketplace plans for healthy families. Done wrong, a denied "share request" leaves you with the full bill. Here's how the six biggest plans stack up — cost, what's covered, what isn't, and the gotchas that don't show up in the brochure.

The "not insurance" caveat — read this first

Every healthsharing plan in the US is explicitly NOT insurance. This means:

• No guarantee of payment. The plan can decline to "share" any individual medical bill for any reason, including reasons not listed in their published guidelines. There is no legal contract entitling you to reimbursement.
• Not regulated by state insurance departments. No solvency requirements, no claims-payment deadlines, no rate review, no appeals process under state insurance law.
• Not ACA-compliant. Healthsharing membership does NOT count as "minimum essential coverage" under the ACA. The federal individual mandate penalty is currently $0, but some states (CA, MA, NJ, RI, VT, DC) have their own mandates with penalties; healthsharing may not satisfy them.
• Pre-existing condition rules vary wildly. Most plans exclude pre-existing conditions for 1-5 years, or permanently. ACA marketplace plans cannot exclude pre-existing conditions at all.
• No subsidies. Healthsharing isn't eligible for ACA premium tax credits, even if your income would qualify on the marketplace.

For healthy individuals and families with predictable medical use, healthsharing can dramatically cut costs. For anyone with chronic conditions, a planned surgery, or wanting guaranteed coverage of mental health and prescription drugs, ACA marketplace insurance is the safer choice. The savings are real; the risks are also real.

How a bill actually gets shared

The mechanics differ from insurance in ways that matter at the hospital registration desk. With most of these plans, you are technically a self-pay patient. The standard advice from the ministries themselves: present as self-pay, ask for the cash price, then submit the itemized bill for sharing. Some plans smooth this over — Medi-Share issues member ID cards and many providers bill it much like they would an insurer. Samaritan sits at the other extreme: members collect their own bills, the ministry assigns the need, and checks arrive from fellow members with prayer notes attached.

The typical sequence runs like this:

1. You receive treatment and request itemized, self-pay billing.
2. You (or the provider, where supported) submit the bill to the plan.
3. Processors check the bill against the published guidelines and your unshared amount for that need.
4. A negotiation team often works the bill down first. Self-pay discounts of 20-50% off billed charges are common, and several ministries credit the discount you secure yourself toward your unshared amount.
5. Eligible amounts are reimbursed to you or paid to the provider.

Turnaround is the friction point. Well-run plans process needs in roughly one to two months; backlogged ones have taken far longer, which is exactly the failure pattern behind Liberty HealthShare's legal trouble. While a bill sits in processing it remains in your name, and a hospital billing office can send it to collections. Asking for a hold or an interest-free payment plan while sharing is pending is a routine and necessary move, not an admission that the plan failed.

The six major plans at a glance

Monthly costs are illustrative ranges for a family of four at typical age + plan-tier combinations; actual shares depend on the program, "Annual Unshareable Amount" (AUA) tier chosen, ages, and membership add-ons. Compare to ACA marketplace family premiums of $1,400–$2,200/month for similar households (before subsidies).

Medi-Share (Christian Care Ministry)

The largest healthsharing plan by membership. Operated by Christian Care Ministry in Melbourne, FL.

• AHP / AUA options: $1,750 / $3,000 / $5,250 / $8,400 / $10,500 Annual Household Portion before sharing begins.
• Pre-existing conditions: generally excluded for the first 12–36 months; permanently excluded for some conditions per the Guidelines.
• Maternity: included for married members with documented marriage; 6-month waiting period if pregnancy started after enrollment.
• Mental health: very limited — only catastrophic / acute psychiatric admissions in some cases.
• Prescription drugs: not directly shared; members get a discount card.
• Provider network: any licensed provider; Medi-Share negotiates with providers post-procedure.
• Religious requirement: signed Statement of Faith; no smoking, drug abuse, or sex outside of marriage.

Christian Healthcare Ministries (CHM)

The oldest healthsharing ministry (since 1981) and the most bare-bones. Three tiers: Gold, Silver, Bronze, with different sharing ceilings and AUAs.

• Personal Responsibility: $1,000 (Gold), $2,500 (Silver), $5,000 (Bronze) per illness incident before sharing begins.
• Sharing ceiling: Gold shares up to $125,000 per incident; Brother's Keeper add-on extends to unlimited (additional $40–$60/month).
• Pre-existing conditions: 3-year graduated sharing (25% / 50% / 100% in years 4, 5, 6+).
• Maternity: included for married couples; no waiting period for Gold members.
• Mental health: not shared.
• Prescription drugs: shared only for the specific illness incident, post-discharge for 120 days.
• Religious requirement: Christian profession of faith.

Liberty HealthShare

The most controversial plan. Several lawsuits in 2020–2022 over delayed and denied sharing; the organization restructured but member-reported frustration with payment delays continues. Compare against alternatives carefully if you go with Liberty.

• Programs: Liberty Complete, Liberty Plus, Liberty Essential. Annual Unshared Amount ranges $500–$2,250.
• Pre-existing conditions: 1 / 2 / 3 / 5-year waiting periods depending on condition.
• Maternity: included after 10-month waiting period.
• Mental health: limited; some plans include outpatient counseling caps.
• Prescription drugs: shared for chronic conditions up to annual cap.
• Religious requirement: broad — "statement of belief" includes non-Christian theistic principles + ethical lifestyle.

Sedera

The fastest-growing non-religious option. Member-owned cooperative structure with no required faith statement. Heavy on direct-primary-care (DPC) integration.

• Initial Unshareable Amount: $500 / $1,500 / $2,500 / $5,000 / $10,000 per medical need.
• Pre-existing conditions: 36-month graduated waiting period (25% / 50% / 75% / 100% in years 1–4).
• Maternity: included for married members; 10-month waiting if pregnancy starts after enrollment.
• Mental health: shared for diagnosed conditions per published guidelines, including inpatient.
• Prescription drugs: shared for ongoing chronic conditions after the IUA per incident.
• Religious requirement: none — just an ethics statement (no smoking, drug abuse, etc.).
• DPC pairing: Sedera markets bundled with direct-primary-care memberships (~$60–$100/month additional); the combo replaces traditional primary care + insurance for many users.

Samaritan Ministries

The third-oldest plan, founded 1994. Distinctive model: members send monthly shares directly to other members in need, not pooled centrally. Lower overhead, more grassroots feel.

• Personal Responsibility: $400 per incident (Classic); $300 per incident (Basic).
• Sharing ceiling: $250,000 / $300,000 per incident; Save to Share add-on extends to unlimited.
• Pre-existing conditions: 1 / 2 / 5-year waiting periods, with limits.
• Maternity: included for married couples.
• Mental health: not shared.
• Religious requirement: Christian profession of faith.

Knew Health

Smaller, newer plan focused on holistic + wellness coverage. Non-religious. Distinctive in covering some alternative medicine (acupuncture, chiropractic) more generously than other plans.

• Initial Unshareable Amount: $500–$5,000 per incident.
• Pre-existing conditions: 2-year graduated waiting period.
• Maternity: included after 10-month waiting period; midwife and home-birth specifically supported.
• Mental health: included for diagnosed conditions.
• Religious requirement: none.
• Distinctive: wellness-focused — chiropractic, acupuncture, naturopathic care eligible for sharing.

Which one fits which person?

• Practicing Christian + healthy + family: CHM Gold or Medi-Share. CHM Gold + Brother's Keeper is often the cheapest path to comparable-to-insurance protection.
• Non-religious + healthy + want best plan: Sedera, especially paired with a Direct Primary Care membership.
• Non-religious + interested in alternative medicine: Knew Health.
• Christian + grassroots-feel: Samaritan Ministries.
• Liberty HealthShare: compare carefully against alternatives given the recent payment-delay history. Many members are satisfied; many are not. Read recent Reddit / Better Business Bureau threads before joining.

When healthsharing is wrong for you

• Chronic conditions (diabetes, autoimmune, cancer history, complex mental health): pre-existing exclusions will leave you exposed. Stick with ACA marketplace, which can't exclude.
• Planned major procedure in the next year: pre-existing waiting periods often catch this. Insurance is the safer bet.
• Heavy prescription drug user: most healthsharing plans share Rx only for acute conditions or with low caps. ACA + GoodRx works better.
• Mental health is a current need: limited or no sharing in most plans. ACA marketplace mental-health parity is meaningful here.
• Live in a state with its own insurance mandate (CA, MA, NJ, RI, VT, DC): healthsharing may not satisfy state requirements; check before joining.
• You'd qualify for ACA subsidies: ACA premium tax credits often beat healthsharing's monthly cost for low-to-mid-income households.

Taxes, HSAs, and healthsharing

Two tax points trip people up. First, monthly shares are generally not deductible the way health insurance premiums can be (for the self-employed, for example), because the IRS doesn't classify healthsharing as insurance. The IRS proposed regulations in 2020 that would have treated ministry shares as qualifying medical expenses; those rules were never finalized, so the conservative reading still stands — treat shares as a personal expense unless your tax professional says otherwise.

Second, joining a healthsharing plan does not make you HSA-eligible. Contributing to an HSA requires enrollment in a qualified high-deductible health plan, and a ministry membership isn't one, no matter how high its unshared amount looks. If you leave an HDHP for healthsharing, you keep your existing HSA balance and can still spend it tax-free on qualified medical expenses; you just can't add new money. For households that prize the HSA triple tax break, that's a real cost of switching that never shows up in a monthly-price comparison.

How to actually evaluate a plan

1. Read the Guidelines / Membership Agreement in full. Not the brochure. The actual document that defines what is and isn't shared. Each plan publishes one; downloading and reading it before joining is the single most important step.
2. Check recent reviews on Reddit (r/healthinsurance, r/Christianity for Christian plans), Better Business Bureau, and the plan's own membership forum if accessible.
3. Run the math against ACA. Get a marketplace quote at healthcare.gov for your family at your income level (including subsidies). Compare 3-year worst-case (you hit OOP max in years 1-3) and best-case (you stay healthy) under both options.
4. Ask the plan about your specific conditions. Get the answer in writing before joining. "Will my Type-2 diabetes be eligible for sharing?" should have a documented answer, not a verbal yes.
5. Have an emergency fund: with healthsharing, your worst case is paying a full medical bill out-of-pocket. A 6-month emergency fund covering at least the AUA plus 1–2 typical major expenses is sensible.

Common questions

Can I join mid-year? Yes. Healthsharing plans enroll year-round; there is no open-enrollment window. That cuts both ways. Leaving an ACA plan for a ministry is easy any month of the year, but getting back onto the marketplace usually means waiting for open enrollment in the fall, because voluntarily dropping a healthsharing plan is not a qualifying life event that opens a special enrollment period.

Is preventive care included? Mostly no. Annual physicals, screenings, and vaccines are typically your own expense, or capped at a small annual allowance depending on the plan. This is a big part of why pairing a plan with a direct-primary-care membership is popular: DPC handles the routine layer, sharing handles the big bills.

What happens above the sharing ceiling? The remainder is yours unless you bought the add-on (Brother's Keeper at CHM, Save to Share at Samaritan). A long cancer course can run past a per-incident ceiling, and that scenario is exactly what these riders exist for. Skipping one to save a few dollars a month is a false economy.

Can a plan drop me? Yes. Membership is conditional on the lifestyle agreement you signed, and plans can terminate members who violate it. Termination also ends sharing for bills still in processing, which is a meaningfully worse position than an insurer rescinding a policy, since no state regulator stands behind you.

Will providers accept it? Any provider will treat you, because from their side you're a self-pay patient. The variable is the billing office: some will bill the ministry directly or wait for sharing to arrive, others want payment up front and leave you to chase reimbursement.

A cheaper bet, not a guarantee

Healthsharing plans cut typical family healthcare costs by 30-60% compared to ACA marketplace plans, which is real money. They work well for healthy families with stable employment and predictable medical use. They work poorly — sometimes catastrophically — for people with chronic conditions, planned procedures, or anyone who needs guaranteed coverage. The "not insurance" caveat isn't a footnote; it's the central trade-off. Read the Guidelines, compare against ACA with subsidies, and have an emergency fund. For those it fits, healthsharing is one of the best deals in US healthcare. For those it doesn't, ACA marketplace remains the right choice.

Shirley Chia — Researcher & Editor

Editor of HealthCostHub. Researches healthcare pricing, financing, healthsharing, and insurance plan rules.

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Reference information only — not financial, legal, or insurance advice. Healthsharing plans are NOT insurance and the protection they offer is voluntary, not legally guaranteed. Plan guidelines change; verify current terms with the plan directly before enrolling. Last updated June 2026.