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 the clear-eyed comparison of the six biggest plans — 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.

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.

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.

What a year actually costs — total spend, not just the monthly share

The monthly share is the number plans advertise, but it's the least useful figure for budgeting. Two members paying the same $400/month can have wildly different real costs depending on how much medical care they use, because the Annual Unshareable Amount (AUA) and per-incident "personal responsibility" come out of your pocket first. Add it up across a full year before comparing to insurance:

Those are rough planning ranges, not quotes. The first two rows are where healthsharing wins on cost. The third row is the whole reason this isn't insurance: when a share request is declined, there's no out-of-pocket maximum protecting you. That bottom row is the worst case you're choosing to accept in exchange for the lower monthly figure. Budget as if it can happen, because for a minority of members it does.

One more cost that's easy to miss: most plans charge a one-time enrollment or application fee (often $50–$200), and some bill an annual membership fee on top of the monthly share. Read the fee schedule, not just the headline rate.

The tax and HSA angle most people get wrong

Healthsharing changes your tax picture in two ways, and both surprise new members.

• Monthly shares are generally NOT tax-deductible as medical insurance. Because healthsharing isn't insurance, the IRS doesn't treat the monthly contribution like a deductible health-insurance premium for most filers. Self-employed people can't take the self-employed health-insurance deduction on it. Don't assume your accountant will catch this — flag it.
• You usually can't pair a healthsharing plan with an HSA. To contribute to a Health Savings Account, the IRS requires you to be covered by a qualified High-Deductible Health Plan and have no other disqualifying coverage. Healthsharing is not an HDHP, so being a member doesn't open the door to HSA contributions. If tax-advantaged saving for medical costs matters to you, run the numbers with our HSA tax savings calculator before you drop insurance — the HSA deduction can erase a chunk of the premium gap.

The medical-expense itemized deduction is a separate question: out-of-pocket bills you actually pay (the portion not shared) may count toward the deduction if your total medical costs clear the IRS threshold for the year and you itemize. That's the standard rule for any medical spending, not a healthsharing perk.

What to do when a bill arrives — the billing mechanics

Healthsharing flips the normal sequence. With insurance, the provider bills your insurer first. With most healthsharing plans, you're often treated as self-pay or uninsured at the point of care, then you submit the bill for sharing afterward. That matters more than it sounds.

• Tell the provider you're self-pay and ask for the cash price before treatment. Cash or prompt-pay rates are frequently lower than the billed "chargemaster" number, and many hospitals will quote one if you ask. This is the same playbook in our guide to negotiating a medical bill.
• Keep every itemized bill and receipt. Plans share off itemized bills, not summary statements. A missing line item can stall a share request for weeks.
• Submit fast and follow up. Most plans have a filing window measured in months. Missing it can void sharing for that bill entirely.
• Know your federal protections still apply at the hospital. Being on a healthsharing plan doesn't strip your billing rights. The No Surprises Act protections against certain surprise out-of-network bills are based on the care setting, and uninsured/self-pay patients are entitled to a good-faith estimate up front.

Regional and age variation in what you'll pay

Healthsharing shares are priced mostly on age and household size, and far less on ZIP code than insurance premiums are. That's a quiet advantage in high-cost insurance states. An ACA Silver premium for a 55-year-old can run two to three times what a 30-year-old pays, and it swings hard by region; healthsharing shares rise with age too, but the curve is usually flatter and the same nationwide for a given plan.

The flip side: because shares aren't tied to local provider contracts, your real-world cost depends on how good a cash payer you are in your own market. In a metro with competitive direct-primary-care clinics and transparent cash pricing, a healthsharing-plus-DPC setup can land well below insurance. In an area dominated by one hospital system with opaque pricing, the same plan can leave you negotiating large bills alone. Healthsharing rewards markets with price transparency and punishes markets without it.

Frequently asked questions

Can I see any doctor I want?

Generally yes — most healthsharing plans have no network, so any licensed provider is fair game. The trade-off is that there's no negotiated in-network rate protecting you, so you carry the responsibility of getting a fair cash price.

What happens if I have a baby?

Maternity is shared by most plans for married members, but nearly all impose a waiting period (commonly several months to roughly a year) if the pregnancy begins after you enroll. Enrolling while already pregnant usually means that pregnancy won't be shared. Check the exact waiting period in the Guidelines before timing a plan switch.

Will my prescriptions be covered?

Usually only partially. Most plans share medications tied to a specific shareable incident for a limited window, not ongoing maintenance drugs. Heavy prescription users often do better keeping insurance, or pairing a plan with a discount tool. A pharmacy discount card can blunt the cost of routine refills either way.

Can I switch from healthsharing back to ACA insurance later?

Yes, but only during ACA Open Enrollment or a Special Enrollment Period triggered by a qualifying life event. Dropping a healthsharing plan is generally not itself a qualifying event for ACA, so you could face a coverage gap if you leave at the wrong time. Plan the exit, don't improvise it.

Is healthsharing the same as a "Christian insurance plan"?

No. There's no such thing as Christian insurance. Most healthsharing ministries are faith-based cooperatives, but the religious framing doesn't make them insurance and doesn't add legal payment guarantees. Two of the six plans here (Sedera, Knew Health) drop the faith requirement entirely.

Questions to ask the plan before you sign

Get answers in writing, ideally over email so you have a record. A confident verbal "yes" on the phone is worth nothing if a share request is later denied.

• "Is [my specific condition] treated as pre-existing, and for how long?" Name the condition. Ask for the exact waiting period and any permanent exclusions.
• "What is the maximum amount shared per incident, and is there a lifetime cap?" Some plans cap per-incident sharing unless you buy an add-on like Brother's Keeper or Save to Share.
• "What is your published timeline for processing a share request?" Slow processing is the most common complaint. A plan that won't commit to a timeline is telling you something.
• "How are bills handled at the hospital — am I self-pay at the point of care?" This determines how you present yourself when scheduling and what cash price you can negotiate.
• "What's the appeals process if a bill isn't shared?" There's no state-insurance appeal right, so the plan's internal process is all you have. Understand it before you need it.

If you want to compare the full math against insurance, financing tools, and tax-advantaged accounts, browse the rest of our healthcare cost guides — the right answer usually comes from running your own numbers, not from a plan's brochure.

Bottom line

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.

LinkedIn · Profile

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.