How health share plans work
You pay a monthly amount, often called a share or fee. When a member has a medical bill that meets the ministry's guidelines, shared money helps pay it. Ministries can decline needs tied to behavior they consider unacceptable under their rules.
Tennessee's insurance department puts it plainly: these ministries are not insurance companies, help from other members is voluntary, and you stay responsible for your own medical bills whether or not the ministry pays.
The main risks
- No promise to pay: membership doesn't mean your bills will be reimbursed.
- No ACA protections: ministries don't have to cover pre-existing conditions or the essential health benefits Marketplace plans must cover.
- No independent appeal: if a bill is denied, you don't get the independent review right you'd have with individual health insurance.
- Little oversight: many states exempt ministries from insurance laws, so the state insurance department may not be able to help.
Some people have joined a sharing ministry believing they were buying insurance. Read the guidelines, not just the marketing, before you pay.
Health share plans vs Marketplace insurance
| Health share plan | Marketplace plan | |
|---|---|---|
| Is it insurance? | No | Yes |
| Pre-existing conditions | Can be excluded or limited | Must be covered; can't charge more for them |
| Required benefits | Set by the ministry's guidelines | 10 essential health benefits, including mental health, maternity and prescriptions |
| Payment of your bills | Voluntary, by other members | Paid under the policy's terms |
| Income-based savings | None from the Marketplace | May qualify for lower premiums based on income |
| Denied claims | No independent review right | Appeal rights, including independent review |
Questions to ask before you join
- What isn't shared? Ask for the full list of exclusions and waiting periods for pre-existing conditions.
- Are there limits per need, per year or per lifetime?
- How are needs submitted, and how long do payments usually take?
- Will doctors and hospitals bill me directly, and am I responsible if a need isn't shared?
- What happens to my bills if the ministry closes?
There's no longer a federal tax penalty for going without health coverage, so the decision comes down to the protection you need. If you have ongoing conditions, regular prescriptions or plan to have a baby, compare a Marketplace plan carefully first.
How Gabriel helps
Gabriel can help you compare health plans and switch, at no cost. Gabriel is not an insurer and doesn't sell sharing ministry memberships. Gabriel membership is not health insurance.
Common questions
Are health share plans insurance?
No. Health care sharing ministries are not insurance companies, and membership doesn't mean your medical bills will be paid.
Do health share plans cover pre-existing conditions?
They don't have to. Ministries aren't bound by the ACA's protections, so many limit or exclude pre-existing conditions. Marketplace plans must cover them.
Is there a penalty for using a health share plan instead of insurance?
There's no longer a federal tax penalty for not having health coverage.
Can I get Marketplace savings with a health share plan?
No. Income-based savings apply to Marketplace insurance premiums, and a sharing ministry isn't a Marketplace plan.
Who regulates health share plans?
Often no one in the way insurers are regulated. Many states exempt ministries from insurance laws, so check with your state insurance department.
Sources
- What are health care sharing ministries? What are the risks and benefits of signing up for one? Georgetown University Health Policy Institute, Navigator Resource Guide
- Healthcare Sharing Ministries Tennessee Department of Commerce and Insurance
- Coverage for pre-existing conditions HealthCare.gov
- What Marketplace health insurance plans cover HealthCare.gov
- Health coverage exemptions, forms and how to apply HealthCare.gov
This guide is general information, not medical advice. It does not replace a visit with a licensed clinician. Gabriel membership is not health insurance.