What Is Christian Health Insurance (Health Sharing Ministry)?

Let’s clear something up right away: “Christian health insurance” isn’t actually insurance. That’s not just a technicality—it’s the whole ballgame.

What people call Christian health insurance is usually a health care sharing ministry, or HCSM. These are faith-based organizations where members pool money to help cover each other’s medical bills. You pay a monthly “share” (they don’t call it a premium), and when you have a medical expense, you submit it to the ministry. If it meets their guidelines, other members’ contributions help pay for it.

The keyword there is “help.” There’s no legal guarantee your bills will be paid. None. These ministries are set up as religious nonprofits—many are 501(c)(3) charities—which means they’re not bound by insurance regulations. They’re not required to pay claims. They’re not overseen by state insurance commissioners. When you join, you’re not buying a policy with legal protections. You’re joining a voluntary community that shares medical costs based on faith and mutual support.

For some people, that works beautifully. For others, it’s been a financial disaster.

How Health Sharing or Christian Health Insurance Actually Works

The mechanics for Christian health insurance vary by ministry, but here’s the general idea:

You sign up and agree to pay a monthly share—let’s say $300 for an individual or $500 for a family. That money goes into a pool managed by the ministry. When you have a medical expense that qualifies as “shareable” under their guidelines (more on that in a second), you submit the bill.

Some ministries work like a central clearinghouse. Your bill goes in, they process it, and if it’s approved, they send payment to your provider or reimburse you. Others operate more peer-to-peer. Samaritan Ministries, for example, actually sends you the names and addresses of other members who are sending checks to help with your bill. You get letters of encouragement along with the money. It’s genuinely touching if you’re into that kind of community connection.

But here’s where it gets tricky: not all medical expenses are “shareable.” Most ministries won’t cover pre-existing conditions for the first year or more. Many exclude mental health treatment, substance abuse care, fertility treatments, or anything related to pregnancy outside of marriage. Some won’t share costs for injuries that happened while you were doing something they consider risky or immoral—like getting hurt while intoxicated.

And then there are “personal responsibility amounts”—basically a deductible, though they don’t call it that. You might be responsible for the first $1,000 or $5,000 of any medical need before the ministry starts sharing.

The Major Players

There are several large Christian health sharing ministries operating in the U.S.:

Samaritan Ministries is one of the originals and takes a very transparent, member-to-member approach. You choose your own doctors (no network restrictions), and you can literally see who’s sending you money when you have a need. It feels very community-oriented.

Medi-Share, run by Christian Care Ministry, is one of the largest. They operate more like traditional insurance with networks, pre-negotiated rates, and a more structured approach. It’s less “here’s a check from someone in Ohio” and more “we’ll process your claim.”

Christian Healthcare Ministries has multiple program levels—Bronze, Silver, and Gold—that cover different amounts. They’re straightforward about what they will and won’t share.

Liberty HealthShare and Altrua HealthShare are others you’ll see advertised. Each has slightly different rules, sharing amounts, and eligibility requirements.

Unite Health Share Ministries operates out of Virginia and, like the others, excludes certain services based on its ethical guidelines.

The landscape shifts pretty regularly. Some ministries have faced financial troubles or lawsuits. Others have been around for decades with solid track records. That variability is part of what makes this risky.

Why People Actually Choose Health Sharing

Let’s be honest about the appeal, because it’s not just about faith—though that’s a big part of it for many people.

The cost is often significantly lower. A family paying $1,200/month for marketplace insurance with a $5,000 deductible might find a health sharing ministry charging $500/month. That’s $8,400 a year in savings. For a family living paycheck to paycheck, that difference is massive.

The faith community aspect matters to a lot of members. There’s something meaningful about knowing your monthly contribution is going directly to help another Christian family with medical bills. It feels more personal than paying premiums to a faceless insurance corporation. Some people receive encouraging notes or prayers along with their shared funds. For believers who value that kind of community, it’s genuinely comforting.

You often get more freedom in choosing providers. Many ministries don’t restrict you to narrow networks. You can see any doctor, go to any hospital, and they’ll share eligible costs. After years of dealing with insurance networks and out-of-network surprise bills, that flexibility sounds pretty appealing.

There’s an ethical alignment. If you have strong religious beliefs about certain medical procedures—abortion, gender transition care, certain end-of-life decisions—you might appreciate that your money isn’t going toward covering those services for others. Your contributions align with your values.

Some people genuinely believe in the model. They see health sharing as a more biblical approach to community care—believers supporting each other in times of need rather than relying on secular insurance companies. For them, it’s not just about saving money; it’s about living out their faith practically.

The Serious Risks You Need to Understand

Now for the uncomfortable part. Health sharing ministries or a Christian health insurance can work out fine if nothing goes seriously wrong. But when things go sideways, they can go very, very sideways.

There’s no legal obligation to pay your bills.

If the ministry decides your medical need doesn’t meet their guidelines, or if they simply don’t have enough money in the pool that month, your bills might not get paid. You can’t sue them like you could sue an insurance company for wrongful denial. You signed up for a voluntary sharing arrangement, not a contract guaranteeing payment.

I’ve read stories about people who joined a ministry, got diagnosed with cancer six months later, submitted $200,000 in bills, and had the ministry share maybe $75,000 of it. The rest? The member is stuck with it. Hospitals start collection processes. Credit gets destroyed. It’s devastating.

Pre-existing conditions are usually a nightmare.

Most ministries won’t share costs for pre-existing conditions at all for the first year, and even after that, coverage is limited. If you have diabetes, heart disease, or any ongoing condition when you join, you’re basically on your own for managing it. That’s very different from ACA-compliant insurance, which has to cover pre-existing conditions from day one.

Coverage gaps are real and significant.

Mental health treatment? Often not covered. Substance abuse treatment? Nope. Fertility treatments? No. Preventive care like annual checkups and routine screenings? Sometimes partially covered, sometimes not at all. These aren’t just minor exclusions—for many people, these are essential services.

The ministries can change the rules.

Because they’re not regulated like insurance, they can modify what’s shareable, increase your monthly amount, or even shut down entirely. Liberty HealthShare, one of the bigger ministries, ran into serious financial problems in recent years and stopped paying medical bills for months. Members were left hanging with unpaid claims and mounting medical debt.

You’re essentially self-insuring for catastrophic events.

Let’s say you’re in a serious car accident and rack up $500,000 in medical bills. Your ministry has a $1 million annual sharing limit (some do, some don’t). But what if the ministry just doesn’t have the funds? What if they decide your accident happened while you were violating some lifestyle clause you forgot about? You could be personally liable for hundreds of thousands of dollars.

What Those “Lifestyle Requirements” Actually Mean

Here’s something people don’t always realize until they’re deep in the fine print: most health sharing ministries require you to live according to certain religious and lifestyle standards.

You typically need to sign a statement of faith affirming Christian beliefs. That’s expected. But many also have conduct requirements. No tobacco use. No illegal drug use. Some require regular church attendance. Some ask about your alcohol consumption. A few even ask whether you’re married if you’re living with a partner.

Why does this matter? Because if you violate these requirements, your medical needs might not be shareable. Got injured while drinking? Might not be covered. Developed lung cancer after years of smoking, you didn’t disclose? They might deny sharing.

I’m not saying these requirements are unreasonable for a faith-based organization. But you need to know they exist and that you’re expected to maintain them. It’s not just “pay your monthly share and you’re covered.” There are ongoing obligations.

Christian Health Insurance: The Regulatory Black Hole

Here’s the thing that makes consumer advocates nervous: health sharing ministries operate in a regulatory gray zone.

Under federal law, they’re not considered insurance, so they don’t have to comply with the Affordable Care Act. That means no essential health benefits requirement. No out-of-pocket maximums. Furthermore, there is no requirement to cover pre-existing conditions. No guarantee of coverage for preventive care.

Most states exempt health sharing ministries from insurance regulation, treating them as religious organizations instead. That means the state insurance commissioner—the person who would normally investigate complaints about denied claims or unfair practices—has no authority over them.

If you have a dispute with a health sharing ministry, your options are limited. You can’t file a complaint with your state’s insurance regulator. You probably can’t sue for bad faith denial because it’s not insurance. Your main recourse is… appealing to the ministry itself and hoping they’re reasonable.

Some states are starting to crack down and require more oversight, but it’s inconsistent. The industry mostly regulates itself through the Alliance of Health Care Sharing Ministries, but that’s a trade group, not a government watchdog.

When Health Sharing Might Make Sense

I’m not going to tell you that health sharing ministries or a Christian health insurance is always a terrible idea. For the right person in the right situation, they can work.

You’re young, healthy, and mostly need catastrophic coverage. You rarely go to the doctor, you don’t take any medications, and you mainly want protection against a major accident or unexpected illness. You’re comfortable with the risk that if something does happen, the sharing might not fully cover it.

You deeply value the faith community aspect. Being part of a Christian cost-sharing community genuinely aligns with your beliefs about how healthcare should work. You see it as a ministry, not just a financial transaction.

You have significant savings to cover potential gaps. If a medical need isn’t fully shared, you’ve got $20,000-$30,000 sitting in the bank to cover the difference. You’re not going to end up in financial ruin if things don’t work out.

You’re using it as a bridge, not a permanent solution. Maybe you’re between jobs for a few months, or you’re retiring early and need coverage until Medicare kicks in at 65. You’re not planning to rely on this for years.

You’ve thoroughly researched the specific ministry. You’ve read their guidelines cover to cover. Also, you’ve checked complaint histories. You’ve talked to current members. You know exactly what you’re getting into.

Christian Health Insurance: When You Should Absolutely Look Elsewhere

You have chronic health conditions. If you need regular care, ongoing medications, or specialist visits, health sharing is probably not the right fit. The pre-existing condition exclusions and coverage limitations will cost you more in the long run than just paying for real insurance.

You need guaranteed coverage. If the thought of a $100,000 medical bill not being paid keeps you up at night, you need actual insurance with legal protections and state oversight.

You’re pregnant or planning to be. Maternity care through health sharing ministries is often complicated. Some require you to be married. Also, some have waiting periods. Some share only a portion of the costs. If you’re having a baby, marketplace insurance with maternity as an essential health benefit is a much safer bet.

You need mental health treatment or substance abuse care. Most ministries exclude these entirely or offer very limited sharing. If you’re dealing with depression, anxiety, addiction, or any other mental health condition, you need insurance that covers treatment.

You can’t afford to be wrong about this. If an unexpected medical bill of even $5,000 would financially devastate you, don’t gamble on health sharing. Get real insurance, even if it costs more monthly. The risk isn’t worth it.

Questions You Must Ask Before Joining a Christian Health Insurance

If you’re seriously considering a health sharing ministry or Christian health insurance, here’s what you need to pin down before you commit:

What exactly is “shareable” and what isn’t? Get the specific list of excluded conditions and treatments. Ask about pre-existing conditions, mental health, maternity, prescriptions, and preventive care.

What are the personal responsibility amounts? How much do you pay out of pocket before sharing kicks in? Is it per incident or annual?

Is there an annual sharing maximum? Some ministries cap how much they’ll share per member per year. If you hit that cap, you’re on your own for the rest.

What’s the track record on paying bills? Ask how long it typically takes to process sharing requests. Look up complaints online. Check if they’ve ever suspended sharing or faced financial problems.

What are the lifestyle requirements? Get clear on what you’re agreeing to. Church attendance? No alcohol? No tobacco? What happens if you slip up?

How stable is the ministry financially? How many members do they have? Are they growing or shrinking? Have they changed their sharing amounts recently?

What happens if the ministry shuts down? Do you get any refund of your contributions? What happens to pending medical needs?

Conclusion

Health sharing ministries are not insurance, and that distinction matters enormously. They can be cheaper, they offer a faith-based community approach, and for some people in low-risk situations, they work out fine.

Christian health insurance comes with real, significant risks: no guarantee of payment, limited regulatory protection, coverage exclusions that could leave you with massive bills, and financial instability among some ministries.

Before you join, ask yourself: Can I afford the worst-case scenario? If the ministry doesn’t share my bills, will I be financially ruined? If the answer is yes—if you can’t absorb that risk—then you need actual insurance, not a sharing ministry.

For most people, especially those with ongoing health needs, families with children, or anyone without significant savings, traditional insurance through an employer or the ACA marketplace is the safer choice. It costs more, but you get legal protections, guaranteed coverage, and regulatory oversight.

Health sharing can work as a supplement or a short-term bridge. But as your only healthcare coverage? Think very, very carefully about whether you can afford to take that leap of faith.