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Retire With Confidence is the podcast designed to help you move beyond the fear of the complexity of finances so you can be financially free to achieve personal significance. Tune in with Josh Duncan each week to turn fear into fuel that drives you into Freedom & Significance.
Have you ever looked at your health insurance premiums and thought, there's gotta be a better way to do this? Maybe your monthly costs keep going up, your deductible feels impossible to meet, and you're wondering if there's an alternative that still protects your family without breaking the bank. If that sounds familiar, you've probably come across something called health sharing or health care sharing ministries. But what exactly are these? Are they a form of insurance?
Josh:Are they safe? And who should and should not consider joining one? That's exactly what we're going to unpack today. In this video, we'll talk about what health sharing programs are and how they actually work, how they compare to traditional health insurance, both the pros and the cons, when using a health share might make sense for your family, and when it probably doesn't. And finally, I'll share my own experience.
Josh:My family of five has been using health sharing for the past seven years, first with MediShare for six years, and more recently with Zion HealthShare for the last year. By the end, you'll have a clear understanding of whether a health share could be a fit for your situation or whether sticking with traditional health insurance is the wiser move. Let's start with the basics. What health sharing actually is. Health sharing programs, also called health care sharing ministries or medical cost sharing communities, are organizations where members share the cost of one another's medical expenses.
Josh:That's it in a nutshell. Unlike traditional health insurance where you pay a premium to an insurance company and they're contractually obligated to cover your claims, a health share is a voluntary arrangement among members who agree to help pay each other's medical bills. That's an important distinction. Health sharing programs are not insurance. There's no guarantee of payment.
Josh:You don't have a legal contract that says, if I get sick, the company must pay my claim. Instead, you're part of a community that agrees, often through faith based or community principles to share costs among members. Here's what that typically looks like in practice. You pay a monthly share amount similar to a premium based on your family size and the program structure. When you have a medical need, you submit the bills to the organization.
Josh:The organization reviews it against their guidelines. If expense qualifies, other members' monthly contributions are pooled or distributed to help pay for your need. Every program is a little different, but that's the general idea. Some of these organizations also negotiate discounts with providers, handle billing, and coordinate payments. So from your perspective, it can feel fairly similar to insurance, but with a few key differences that we'll soon get to.
Josh:So now that you know what health sharing is, let's compare it to traditional insurance so you can really see the differences both good and bad. Both systems aim to protect you financially from large medical expenses, but under the hood, they work very differently. Let's break it down into five main areas, cost, coverage, compliance, risk, and administration. First is cost. This is the number one reason people look into health sharing.
Josh:For many families, traditional insurance premiums have skyrocketed. A family plan on the ACA marketplace can easily run over $2,000 per month, especially with a lower deductible. Health sharing plans, by contrast, are often a fraction of that. For example, many families can find a health share plan for somewhere between 500 to $800 a month, sometimes less depending on the program and the unshared amount you select, which functions similarly to a deductible. In my own case for our family of five, we were paying significantly less with Medishare and now with Zion than we would have with a traditional policy.
Josh:But, and this is key, that lower cost comes with trade offs. Number two is coverage. Traditional health insurance is heavily regulated. Under the Affordable Care Act, insurance companies are required to cover certain essential health benefits like preventative care, maternity, mental health, and prescription drugs. Health sharing programs are not bound by those same rules.
Josh:Each program has its own set of eligibility guidelines and sharing limitations. Some examples. Many health shares don't cover routine preventative care or well visits. They may exclude preexisting conditions for a certain period of time, sometimes up to one or two years. Some have limits on maternity costs or mental health care.
Josh:Prescription coverage may be limited or require you to use a discount program like GoodRx. So before joining, you have to read the fine print carefully. You can assume that every medical expense you've had under insurance will automatically be shared in a health share. Number three is compliance and legal protection. Another major difference, health shares are not regulated as insurance.
Josh:That means there's no government oversight guaranteeing claim payments, no state insurance commissioner, solvency, no legal recourse if a share doesn't pay. You're relying on the organization's track record and integrity. Most of the major ones have been around for years and have good reputations, but it's still a risk you have to be comfortable with. During the Affordable Care Act years, members of qualifying health sharing ministries were exempt from the individual mandate penalty, the fee for not having insurance. Even though that penalty has since gone away, that is exemption was an important milestone, they gave these programs more legitimacy.
Josh:Still, they remain voluntary associations, not insurance companies. Number four is risk management. This is where the philosophical difference really comes through. In insurance, risk is pooled and transferred to the company. You pay your premium, and in exchange, they take on the financial risk of your medical costs.
Josh:In a health share, risk remains shared among members. There's no guarantee the community will always have enough funds to cover every need. Most organizations manage this through systems of reserves, member caps, and eligibility rules. But, again, it's based on community commitment rather than legal obligation. That can feel uncomfortable for people who want a clear contractual guarantee, but others find comfort in the community aspect that their dollars are going to help real people, not corporate profits.
Josh:Just read some of the reviews members leave for health share providers and how thankful they are for the community. Number five is administration and experience. If you've ever dealt with traditional insurance billing, you know how complicated it can be. Networks, prior authorizations, surprise bills, and endless paperwork. Health sharing programs vary widely in this regard.
Josh:Some, like MediShare, have a fairly structured process and even offer provider networks to simplify billing. MediShare allows members to use any provider they like, but more paperwork is needed for out of network providers. Others like Zion HealthShare are more flexible and allow you to choose any doctor or hospital as long as the charges are reasonable and customary. That flexibility can be great, especially if you want freedom of provider choice. But it also means you're more involved in the in managing the process, submitting bills, following up, and making sure things get handled.
Josh:In my own experience, MediShare felt more like traditional insurance when using a network provider, but they were helpful when settling expenses for out of network providers. Zion has no network and, potentially, shareable expenses follow the same process, but every organization is different, so you'll want to ask plenty of questions about how the claims or needs process works. Okay. So we've covered how they compare. Let's talk about when it actually makes sense to consider using a health share and when it doesn't.
Josh:There's no one size fits all answer here, but there are a few circumstances where a health sharing program can be a smart and responsible choice. Let's go through the top four. First, you're generally healthy and want lower fixed costs. If you rarely go to the doctor, don't take expensive prescriptions, and mostly just want protection against big unexpected expenses like surgeries or hospitalizations, a health share can make a lot of sense. You'll likely pay far less each month, and you're effectively self insuring for smaller routine costs.
Josh:Think of it like having a very high deductible catastrophic plan, but through a community structure instead of an insurance company. Number two, you're comfortable managing your own health care. Health shares often require you to take a more active role in your care, choosing providers, asking for self pay discounts, submitting bills, and following up on reimbursements. If you're organized and willing to be your own advocate, that's not a big deal. But if you prefer a set and forget it model, it might feel like too much work.
Josh:For me personally, I actually like the transparency of seeing the cost directly. It helps me make a more informed decision as a consumer, but not everybody wants to do that. Number three, you don't qualify for health insurance subsidies. If your income is too high to qualify for Affordable Care Act subsidies, traditional insurance premiums can be brutal. In those cases, health sharing can provide a meaningful savings while still offering a safety net against major medical costs.
Josh:This is actually the situation for a lot of small business owners, self employed professionals, and families buying coverage on the open market. Number four, you align with the program's principles. Many health sharing ministries are faith based and include moral or lifestyle requirements. For example, they may exclude coverage for injuries related to alcohol or drug abuse, or require that members live according to certain beliefs. If you're comfortable with those values or if you choose a more secular option like Zion HealthShare, that can work well.
Josh:But if you don't share those beliefs or don't want someone reviewing your lifestyle, that's something to consider carefully. Now let's flip the coin. There are definitely situations where a health share might not be the right fit. Here are six scenarios where you should proceed with caution or stick with traditional insurance. First, if you have ongoing preexisting medical conditions.
Josh:Most health shares either don't cover preexisting conditions for a period of time or only share limited amounts until you've been a member for a while. If you or someone in your family has chronic health issues that require ongoing treatment or expensive medication, this could be a deal breaker. Traditional insurance is likely to be a safer and more predictable choice. Number two, you rely heavily on preventative or prescription coverage. Since health shares often don't cover routine preventative care prescriptions beyond a limited amount, you'll need to budget for those separately.
Josh:If your medical usage includes regular checkups, ongoing prescriptions, or mental health care, those out of pocket costs can add up, sometimes offsetting the monthly savings. Number three, you want legal guarantees and consumer protection. If peace of mind for you means knowing that a claim must be paid under contract law, then a health share may not feel secure enough. Again, health shares rely on community trust guidelines and not legal obligations. Most established programs have strong payment records, but it's still a different level of assurance than what you get with regulated insurance.
Josh:Number four, you're eligible for subsidized ACA plans. If your income qualifies for a subsidy on the health insurance marketplace, you might find that a traditional plan is just as affordable or even cheaper once the subsidy is applied. In that case, you get a regulatory protections and coverage requirements without paying extra. Number five, you want a one stop medical experience. If you prefer not to handle your own billing, negotiate rates, or submit documentation, traditional insurance will probably be more convenient.
Josh:Health shares can require more personal involvement, and while that gives you more control, it's not for everyone. And number six, you have affordable coverage through your employer. If your employer offers health insurance at an affordable rate, this might be the best financial decision. Plus, your premiums are deducted before taxes and therefore lowers your taxable income. Not all employers offer health insurance guarantees at a low rate, but it's a good idea to review the coverage being offered and evaluate it if it's the best path for your family.
Josh:I wanna take a moment to share my personal experience, what it's really been like for my family to live with health sharing for the past seven years. When my wife and I first started exploring health sharing, it was due to moving from corporate employment to self employment. Our corporate health insurance premiums were already high, and this gave us an opportunity to research another option. Plus, we were paying a small fortune for a plan with a deductible so high we never met, even with three young children. We're a family of five, generally healthy, with occasional medical needs, but nothing chronic, and we wanted an alternative that made sense financially, but still gave us peace of mind.
Josh:That's when we discovered MediShare. We joined MediShare and stayed for about six years. Overall, the experience was positive. We saved a significant amount of money compared to traditional insurance, several thousand dollars per year, and the process worked well for larger expenses. We even had a $20,000 hospital bill for an out of network facility.
Josh:MediShare stepped in and helped negotiate and cover all expenses above our insurable amount or annual household portion in MetaShare terms. MetaShare handled things professionally, and even though there were some administrative hoops to jump through, it wasn't unmanageable. MetaShares agreed about asking their members each year for feedback on the plans and what types of care they would like covered. Where I feel this approach backfired is that members kept piling on requests for covered care. Obviously, the more care covered, the higher the premiums.
Josh:In my opinion, MediShare has priced themselves too close to ACA plans. After several years, we decided to look for something that offered a bit more flexibility and a simpler structure. About a year ago, we switched to Zion HealthShare. One of the things that attracted us was the simplicity of membership. The cost is based on the oldest member's age, the members covered, and the initial unshareable amount or IUA.
Josh:Their guidelines are straightforward and similar to MediShare with the exception of a statement of faith, which Zion does not require. The process has been smooth, and we appreciate how transparent they are with pricing and need sharing updates. Zion also allows members to use any licensed provider, which makes it easier to choose doctors and hospitals without worrying about network restrictions. This is beneficial to my family because we live in an area where it can be difficult to schedule an appointment with a provider. You still need to read the guidelines carefully, and there's always that element of trust involved.
Josh:But after seven years of living with this system, I can confidently say that it's been a viable, responsible alternative for our family. Also, we have used prescription discount programs like GoodRx and save thousands of dollars on premiums and prescription costs. Every pharmacy in our area knows the prescription discount programs to help you get the best price. For us, the cost savings, transparency, and community aspects have outweighed the trade offs. But I also recognize that this approach isn't right for everyone, especially if you have ongoing medical needs or prefer the certainty of regulated insurance.
Josh:With that real world perspective in mind, let's wrap up with some key takeaways. One, health sharing is not insurance. It's a voluntary community model. There's no contractual guarantee of payment, so it requires a certain level of trust and alignment with the organization's principles. Number two, the savings can be significant.
Josh:Many families pay half or less of what they would for traditional insurance, but that lower cost comes with reduced coverage and more personal responsibility. Number three, read the guidelines carefully. Every program is different. Before you join, understand what's shareable, what's excluded, how preexisting conditions are handled, and what your out of pocket exposure could be. Number four, health sharing works best for the healthy and independent.
Josh:If you're in good health, don't qualify for subsidies, and are comfortable managing your own care, it can be an excellent alternative. If you have complex medical needs, it's probably not the right fit. Number five, do your homework and compare options. Programs like Medi Share, Samaritan Ministries, Christian Healthcare Ministries, Sedara, New Health, and Zion HealthShare each have unique rules and cultures. Look at the fine print, talk to current members, and make sure it aligns with both your financial goals and your personal values.
Josh:At the end of the day, there's no best system for everyone. Health sharing is not a silver bullet. But for the right family, it can be a smart, cost effective, and community centered alternative to traditional health insurance. For my family, it's been a practice practical solution for seven years now, helping us control costs while still providing peace of mind against major medical events. But it's not something to jump into lightly.
Josh:You need to understand the rules, accept the risk, and be willing to take a more hands on approach to your health care. If you're considering it, start by reviewing your own situation. Are you healthy and comfortable managing your care? Do you value community based support? And are you okay with some uncertainty in exchange for lower costs?
Josh:If the answer is yes, it's worth a closer look. If not, traditional insurance may still be your best bet. I hope this helped you understand how health sharing works and how it compares to traditional insurance from both a financial and a practical perspective. I'm Josh Duncan, partner at F5 Financial Planning. If you would like to learn more about how we help our clients achieve financial freedom for personal significance, please visit our website at www.f5fp.com.
Josh:Thanks for watching, and I'll see you in the next video.