Thinking About Joining a Share Plan?
Seven things every potential health share plan member should know.
In the first installment of our series on share plans, we explored why healthcare ministry share plans, commonly called “share plans,” are poised to proliferate. Rising premiums for Affordable Care Act (ACA) compliant insurance have left millions of Americans searching for alternatives, and share plans are filling that gap. Before you sign up, it’s critical to understand what these plans are, and what they are not.
Share plans are not insurance
This is the most important point. Share plans operate outside the regulatory framework that governs health insurance. They are voluntary cost-sharing arrangements, not legally binding contracts. If your medical needs meet their guidelines and funds are available, they may help pay your bills. If not, you’re on your own.
What to look for before you join
If you’re considering a share plan, here are the key factors to evaluate:
Coverage guidelines
Every share plan has strict rules about what expenses are shareable. Many exclude:
Pre-existing conditions (sometimes for years)
Preventive care, mental health, and prescriptions
Maternity care unless certain conditions are met
Read the member handbook carefully. If you have chronic conditions or anticipate major medical needs, these exclusions could leave you exposed.
Caps and limits
Unlike regulated insurance, share plans often impose:
Annual or lifetime caps on what they will share
Per-incident limits (e.g., $125,000 per illness unless you buy an upgrade)
These limits matter if you face a serious illness or accident.
Waiting periods
Coverage for certain conditions may not start immediately. Pre-existing conditions and maternity care often have waiting periods of 6–12 months or longer.
Monthly costs vs. out-of-pocket
Share plans typically cost 50–70% less than ACA-compliant insurance, but you’ll have:
A Member Responsibility Amount (MRA), similar to a deductible, before sharing kicks in
Responsibility for negotiating discounts and paying providers upfront in many cases
Provider flexibility
Most share plans don’t use networks, which means you can see any doctor, but you may need to pay cash and submit bills for reimbursement. Some plans offer Preferred Provider Organization (PPO) access or bill negotiation services, which can be a big advantage.
Transparency and financial stability
Because these plans are unregulated, you need to do your homework:
Check if the organization publishes audited financials
Look for a strong track record of paying eligible needs
Larger, established organizations tend to be more reliable than newer or smaller ones
Lifestyle and faith requirements
Many share plans require members to adhere to certain lifestyle standards, such as abstaining from tobacco or illegal drugs, and some require a statement of faith. If you prefer a secular option, you can find those, too. The religious affiliation is slowly falling by the wayside as these plans become less about religious exemption and more about an unregulated alternative.
Understand the risks
Joining a share plan is a calculated risk. There is no legal guarantee of payment, no appeals process, and no state oversight. If funds run short or your need doesn’t meet the guidelines, you could be left paying the bill yourself.
The bottom line
Share plans can make sense for healthy individuals who want lower monthly costs and accept the risk of limited coverage. They are not ideal for anyone with chronic conditions or high-cost medical needs. Before you join, read the fine print, understand the exclusions, and weigh the risks against the savings.
If you’d like to learn more about health share plans, read, “The Rise of Share Plans.”