Faith-based health sharing ministries allow Christians to pool costs and cover each other's medical bills.
Health care sharing ministries (HCSMs) are nonprofit organizations in which members — generally people who share a Christian faith — voluntarily contribute monthly amounts that are pooled and used to pay qualifying medical bills for other members. This plain-English guide explains how these programs work, who can join, what they typically do and do not cover, the consumer protection considerations every potential member should understand, and the major active ministries
When a member has a covered medical need, the community shares in those costs. Members send contributions to a common fund, or in some programs directly to other members, and receive the same support when they have a medical need of their own. For people who are 65 or older and already on Medicare, a separate page covers the faith-based Medicare supplement programs that operate alongside government coverage.
- NOTE: Health care sharing ministries are not insurance. They are not regulated by state insurance departments and are not required to meet the consumer protection standards that apply to licensed health insurance plans. No HCSM guarantees that your medical bills will be paid. Before joining any health care sharing ministry, read the membership guidelines carefully and understand what is and is not eligible for sharing.
How health care sharing ministries differ from insurance
This distinction is not a technicality. It has direct, real consequences for members.
Health care sharing ministries are not insurance and are explicitly exempt from state insurance regulation and from the federal Affordable Care Act's coverage requirements. This means they are not required to cover the ten essential health benefits that ACA-compliant insurance must cover. They are not required to accept members with pre-existing conditions, are not required to cover mental health care, substance abuse treatment, or maternity care in the same way regulated plans are, and in most states are not required to pay claims on any particular timeline or at all.
When a member submits a medical bill for sharing, the ministry's membership guidelines determine whether that need is eligible. If it is not, the member is responsible for the bill. No government agency oversees whether the ministry pays what it says it will pay. No state guarantee fund covers members if the ministry becomes insolvent.
Some states require HCSMs to provide a written disclosure at enrollment that the program is not insurance and does not guarantee payment. Even without that requirement, every potential member should read and understand this before contributing a dollar.
Who can join
Most HCSMs restrict membership to practicing Christians who agree to a statement of faith and commit to lifestyle standards consistent with the ministry's beliefs. Common requirements include not using tobacco, limiting alcohol, and abstaining from illegal drugs. Some ministries verify lifestyle compliance through attestation; others may require a letter from a pastor or church leader. Applicants who do not meet these requirements are not eligible for membership.
Some ministries, including Liberty HealthShare, have opened membership to people with a broad range of faith backgrounds who share common health values, not exclusively Christians. Each ministry sets its own membership criteria.
There is no income requirement. HCSMs are available to people at any income level, unlike programs such as Medicaid that are income-restricted. They are open year-round — there is no enrollment period or qualifying life event required to join.
What health care sharing ministries typically cover and exclude
Coverage varies by ministry and program. What follows describes common patterns, not a universal standard. Membership guidelines for each ministry govern what is actually shareable.
Most HCSMs cover major medical expenses — hospitalizations, surgeries, emergency care, and diagnostic testing — after the member has paid an initial unshared amount (comparable to a deductible). Routine preventive care, such as annual physicals and screenings, is excluded by some programs and included by others, often with a cap. Prescription drugs are handled differently across ministries — some cover them, others do not.
Pre-existing conditions are commonly subject to a waiting period before becoming eligible for sharing, ranging from one to several years depending on the program and the condition. Some ministries exclude certain pre-existing conditions permanently.
Mental health care, substance abuse treatment, and abortion are excluded by most Christian HCSMs. Cosmetic procedures, experimental treatments, and injuries arising from illegal activity are also commonly excluded. Maternity care is covered by some programs and excluded or limited by others, often with requirements related to marital status.
Members are typically free to see any licensed provider — there is usually no provider network requirement — though some programs offer preferred networks for lower out-of-pocket costs.
The consumer protection warning every potential member needs
Sharing is voluntary. If the ministry's membership declines, faces financial difficulty, or changes its guidelines, there is no legal recourse for members whose bills are not shared. Unlike regulated insurance, there is no state insurance department to file a complaint with and no state guarantee fund to cover shortfalls.
This has not been a theoretical concern. Several HCSMs have had documented financial difficulties or closed with members holding large unpaid medical bills. The most significant was Aliera Healthcare, which marketed faith-based sharing plans through several names, was found by federal and state authorities to have retained the majority of member contributions rather than sharing them, and eventually declared bankruptcy. Members were left with millions in unpaid medical bills and no recourse through insurance regulation channels.
Liberty HealthShare, one of the larger ministries, settled with the Ohio attorney general's office in 2021 following an investigation into its financial practices under prior leadership. It has since reorganized under new management and operates under terms of that settlement.
None of this means that established, well-run ministries cannot provide real financial value to members who qualify and understand what they are joining. Many members of CHM, Samaritan Ministries, and Medi-Share report consistent and meaningful sharing of their medical bills over many years. The point is that the protections that exist in regulated insurance — guaranteed coverage, government oversight, legal remedy for denied claims — do not apply here, and potential members should make that decision with clear eyes.
Before joining any HCSM, it is worth checking the ministry's rating and complaint history with the BBB at https://www.bbb.org/ and reviewing the membership guidelines in full before submitting a first payment.
Major active Christian health care sharing ministries
The following ministries are among the largest and longest-operating in the United States. All are 501(c)(3) nonprofits. Each operates under its own membership guidelines, cost structure, and eligibility criteria. Monthly contribution amounts and program details change regularly — visit each ministry's website for current information rather than relying on any published figure.
Before joining a health care sharing ministry, consumers should compare costs with ACA Marketplace plans at https://www.healthcare.gov/. Depending on household income, premium tax credits may substantially reduce the cost of comprehensive insurance coverage.
Christian Healthcare Ministries (website: https://chministries.org/) is the longest-running health care sharing ministry in the country and operates in all 50 states. It offers Gold, Silver, and Bronze program tiers with different monthly contribution levels and member responsibility amounts before sharing begins. An optional Brothers Keeper add-on provides additional protection for catastrophic expenses. Members must be Christians and agree to CHM's statement of faith.
Samaritan Ministries (website: https://samaritanministries.org/) was founded in 1994 and currently serves more than 250,000 members. It offers two main programs — Samaritan Classic and Samaritan Basic — that differ in the initial unshared amount and the percentage of eligible bills shared after that threshold. Samaritan operates differently from most ministries: after a need is published, members are assigned to send their monthly share directly to the member with the need, rather than contributing to a central fund. Membership requires practicing Christians living according to biblical principles. An optional Save to Share program covers needs above the standard sharing limit.
Medi-Share (website: https://www.medishare.com/), administered by Christian Care Ministry, was founded in 1993 and describes itself as a Christ-centered community wellness program. It offers multiple membership tiers with varying annual household portions (comparable to a deductible) and monthly share amounts. Medi-Share uses a provider network and operates more similarly to a conventional insurance plan in its administration than some other HCSMs. Members must agree to a statement of faith and lifestyle standards.
Liberty HealthShare (website: https://www.libertyhealthshare.org/) was founded in 1995 and is based in Canton, Ohio. It offers several program tiers for individuals and families. It is somewhat more inclusive than other Christian ministries in its membership criteria, accepting members who commit to a set of Christian health values but not requiring affiliation with a specific denomination or church. Members with Medicare can join the Liberty Assist program, covered on the Medicare supplement page. Liberty HealthShare's prior leadership was the subject of a 2021 Ohio attorney general investigation and settlement; the ministry has since reorganized.
Altrua HealthShare (website:: https://altruahealthshare.org/) is a smaller, Austin-based Christian ministry that has operated since 1996. Membership requires a commitment to a clean and healthy lifestyle and abstention from tobacco and substance use for at least 12 months before joining.
Solidarity HealthShare (website: https://solidarityhealthshare.org/) is a Catholic and broadly Christian ministry that has operated since 2014. It is notably more inclusive in its coverage terms than most HCSMs, sharing costs for mental health care, some alternative treatments, and prescription medications — categories that many other ministries exclude or limit significantly. Solidarity offers three program tiers: Solidarity ONE, Solidarity SAVVY (designed for younger single members), and Solidarity SHIELD (catastrophic-only coverage). Importantly, Solidarity has no age limit — members who reach 65 and enroll in Medicare can remain in the community and receive a senior discount on their monthly contribution, with Solidarity sharing secondary to Medicare. This makes it one of the few ministries that does not require members to leave at 65.
UHSM (Unite Health Share Ministries, website https://www.uhsm.com/) was founded in 2018 and is based in Norfolk, Virginia. It operates in all 50 states and was notably the first HCSM to offer prescription drug coverage as part of its standard program. UHSM's flagship WeShare program provides access to the PHCS PPO network of more than one million providers nationwide, which means members have broad provider access more similar to a conventional insurance network than most other HCSMs. UHSM's programs are oriented primarily toward working-age adults and those approaching Medicare eligibility rather than seniors already on Medicare.
Zion HealthShare (website https://zionhealthshare.org/) was founded in 2019 and has grown to more than 75,000 members. Unlike most Christian HCSMs, Zion does not require any religious affiliation or statement of faith — membership is open to anyone who agrees to Zion's principles of membership and healthy lifestyle standards. This makes it an option for people who want the cost structure of a sharing community but do not meet the faith requirements of more religiously specific ministries. Zion membership is available only to individuals under age 65; members who reach that age are directed to transition to Medicare.
Impact Health Sharing (website https://www.impacthealthsharing.com/) was founded in 2020 and is based in Davie, Florida. It is one of the newer and faster-growing ministries in the space. Impact offers a senior membership for members 65 and older who are enrolled in Medicare Parts A and B, sharing the costs Medicare does not fully pay.
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