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5 Questions to Ask Before Joining a Health Sharing Plan
Last updated: February 2026 | All data verified from official plan guidelines
Health sharing can save you $3,000–$12,000 per year compared to ACA marketplace insurance. But it is not insurance, and joining the wrong plan can cost you more than it saves. KFF data shows unsubsidized premiums averaging $400–$600/mo for individuals — that gap is real, but only if you would have paid the full unsubsidized price. Before you sign up, ask these 5 questions to avoid costly surprises.
Each question below includes a plan-by-plan comparison so you can see exactly how the major ministries stack up on the issues that matter most.
Key Takeaways
- Pre-existing conditions: Most plans have 6-12 month waiting periods. Zion shares high blood pressure, high cholesterol, and type-2 diabetes from day 1; other conditions phase in.
- Coverage gaps: Prescriptions and mental health often excluded. Check your plan's sharing guidelines carefully.
- Total annual cost: Factor in IUA ($500-$10,500), co-share (10-20%), and uncovered expenses — not just monthly share.
- Faith requirements: Zion, Sedera, and CrowdHealth accept any faith. CHM and Medi-Share require Christian statements.
- Legal protection: Health sharing is NOT insurance. No state guarantees. Your only recourse is internal appeals.
Question 1: What Happens With My Pre-Existing Conditions?
This is the single most important question to ask, and the answer varies dramatically by plan. A pre-existing condition is any health issue you had before joining — diabetes, hypertension, asthma, anxiety, a previous surgery, even a past injury. Most health sharing plans impose a waiting period of 6 to 12 months during which expenses related to pre-existing conditions are partially or fully excluded.
During the waiting period, you pay 100% of those costs out of pocket, on top of your monthly contribution. For someone managing diabetes, that could mean $4,000–$8,000 in uncovered expenses during year one.
| Plan | Waiting Period | Year 1 Sharing | Full Eligibility |
|---|---|---|---|
| Zion HealthShare | 12 months (then phased in over 4 years) | Pre-existing conditions (anything diagnosed/treated before joining) are not shared in year 1. Phase-in: Year 2 up to $25,000/request; Year 3 up to $50,000/request; Year 4+ up to $125,000 per 12-month period (permanent cap). Exceptions: high blood pressure, high cholesterol, and diabetes (types 1 and 2) are shareable from day one — provided the member was not hospitalized for these conditions in the 12 months before joining and can manage them through medication or diet. Source: Zion Member Guidelines, January 1, 2026. | Year 2+ |
| CrowdHealth | 2 years ineligible | Years 1-2: not eligible for crowdfunding | Year 3+: up to $25K/year (per current published FAQ). Note: Prior schedules showed higher Year 3+ limits — verify directly with CrowdHealth before enrolling. | Varies |
| Medi-Share | 36 months | Pre-existing conditions are not shared for the first 36 months. After 36 consecutive months, shared up to $100,000/member/year; after 60 months, up to $500,000/member/year. | Month 7 |
| Sedera | 12-36 month phase-in | Not shared in the first 12 months; graduated annual caps in months 13-36; fully shareable after 36 months. A 36-month look-back defines a pre-existing condition. | Year 2+ |
| CHM (Christian Healthcare Ministries) | 12 months | A condition is no longer pre-existing after 12 months symptom/treatment-free; cancer requires 5 years cancer-free. | Year 2+ |
| Samaritan Ministries | 12 months | 50% first year. 5 years symptom-free for cancer, heart, and hereditary conditions; type-1 diabetes is permanently excluded. | Year 2+ |
| Knew Health | Phase-in | Not shared year 1; Year 2 up to $25,000; Year 3 up to $50,000; Year 4+ up to $125,000 per 12-month rolling period (permanent cap on pre-existing conditions). | Varies |
| HSA Secure | 12 months | Not shared months 1-12; up to $25,000/yr months 13-24; up to $50,000/yr months 25-35; up to $125,000/yr from month 36. | Year 2+ |
What to do:
Make a list of every health condition you currently have or have had treatment for in the past 3 years. Call the plan directly and ask: “Will these conditions be shareable from day one, and if not, what is the waiting period and sharing percentage during the wait?” If you have pre-existing conditions, Zion HealthShare (no waiting period) should be your starting point.
Question 2: What Is NOT Covered (and How Much Will That Cost Me)?
Health sharing plans are not required to cover the ACA's 10 essential health benefits. Common exclusions include prescription drugs, mental health services, telehealth, dental, and vision. If you use any of these services regularly, the exclusion can add thousands to your annual costs.
| Service | Zion | CHM | Medi-Share | Sedera | CrowdHealth |
|---|---|---|---|---|---|
| Prescriptions | Yes | No | No | Yes | Yes |
| Mental Health | Yes | No | No | Yes | Yes |
| Telehealth | Yes | No | Yes | Yes | Yes |
| Dental | No | No | No | No | No |
| Vision | No | No | No | No | No |
What to do:
Add up what you currently spend on prescriptions, therapy, dental, and vision each year. If the plan does not cover those services, add that cost to your monthly contribution to get the real annual price. Read our prescription coverage guide and hidden costs article for detailed breakdowns.
Question 3: What Is the Total Annual Cost, Not Just Monthly?
The advertised monthly contribution is only one part of your total cost. To get the real number, you need to factor in the IUA (deductible equivalent), co-shares, uncovered services, and pre-existing condition gaps. Here is a realistic annual cost breakdown for an individual with moderate health needs (2 medical events, 1 ongoing prescription):
| Cost Component | Zion | CHM | Medi-Share | CrowdHealth |
|---|---|---|---|---|
| Monthly x 12 | $2,220 | $1,380 | $2,724 | $1,680 |
| IUA (2 events, $500 each) | $1,000 | $600 | $1,000 | $1,000 |
| Rx ($150/mo, not shared) | $0 | $1,800 | $1,800 | $0 |
| Co-share (10–20%) | $1,400 | $2,880 | $2,800 | $0 |
| Total Annual | $4,620 | $6,660 | $8,324 | $2,680 |
Notice that CHM's $115/month advertised cost becomes $6,660/year when hidden costs are included — more than double what the monthly rate alone suggests. The cheapest monthly cost does not always mean the cheapest total cost. CrowdHealth looks cheapest in this scenario, but remember: crowdfunding is not guaranteed, and pre-existing conditions are not covered for the first year.
What to do:
Build your own annual cost estimate: (monthly contribution x 12) + (IUA x expected medical events) + (uncovered prescriptions) + (co-share on expected bills). Compare this to unsubsidized ACA marketplace rates in your area using HealthCare.gov.
Question 4: Do I Need to Be Religious to Join?
Health sharing started as a faith-based movement, and several of the largest plans still require a specific religious commitment. This ranges from a simple checkbox to mandatory church attendance verification. If you are not religious, your options are limited but viable.
| Plan | Faith Requirement | Church Attendance | What It Means |
|---|---|---|---|
| Zion HealthShare | None | No | Open to all, no religious component |
| Sedera | None | No | Explicitly secular |
| CrowdHealth | None | No | Secular crowdfunding platform |
| Medi-Share | Christian (light) | No | Statement of faith checkbox during enrollment |
| CHM | Christian (strict) | Yes | Detailed statement of faith + pastor attestation |
| Samaritan Ministries | Christian (strict) | Yes | Regular church attendance verified |
What to do:
If you are not religious or are not a practicing Christian, stick with Zion HealthShare, Sedera, or CrowdHealth. Do not sign a statement of faith you do not genuinely agree with — plans can deny claims if they discover you misrepresented your faith commitment. Read our full non-religious options guide.
Question 5: What Legal Protections Do I Have?
This is where health sharing differs most from insurance, and it is the question people ask least. The answer may change your decision.
Health sharing ministries are not insurance companies. They are exempt from ACA requirements under Section 1402(d) and are not regulated by state departments of insurance. The NAIC has explicitly warned consumers that health sharing is not insurance and that members have no guarantee of payment. This means:
- No contractual guarantee of payment. Health sharing is voluntary. The ministry is not legally obligated to pay your medical bills. Every plan's guidelines include language like: “This is not insurance. Sharing is voluntary and not guaranteed.”
- No state insurance commissioner oversight. If a claim is denied, you cannot file a complaint with your state insurance department. Your recourse is limited to the plan's internal appeals process.
- No out-of-pocket maximum. ACA insurance caps your annual out-of-pocket at $9,200 (individual) or $18,400 (family) in 2026. Health sharing has no such cap. Your IUA resets per incident, and co-shares apply to every eligible expense.
- State mandate penalties. In California, Massachusetts, New Jersey, Rhode Island, Vermont, and Washington D.C., health sharing does not satisfy state insurance mandates. You may owe a state tax penalty of $695–$2,000+ depending on the state.
- Not tax-deductible. Health sharing contributions cannot be deducted as health insurance premiums for self-employed individuals or itemized deductions. By contrast, IRS Publication 969 explains how HSA-compatible plans (like HSA Secure or Zion with a MEC add-on) can still deliver meaningful tax savings even though the sharing contributions themselves are not deductible.
In practice, established ministries have reliably shared billions in medical expenses over decades. CHM has operated since 1981, Medi-Share since 1993. No major ministry has failed to share eligible expenses. But the legal risk is real, and you should understand it before joining.
What to do:
If guaranteed coverage is important to you, an ACA marketplace plan is actual regulated insurance with pre-existing conditions covered from day one and full state regulatory protections. If you choose health sharing, maintain an emergency fund of $5,000–$10,000 to cover potential gaps.
Your Pre-Joining Checklist
Before signing up for any health sharing plan, go through this checklist:
- 1. List every pre-existing condition and verify the waiting period for each with the plan
- 2. Add up annual costs for uncovered services (prescriptions, mental health, dental, vision)
- 3. Calculate total annual cost: (monthly x 12) + (IUA x expected events) + (co-shares) + (uncovered services)
- 4. Compare total cost to ACA marketplace rates at HealthCare.gov (check if you qualify for subsidies)
- 5. Confirm the faith requirement works for you (or choose a secular plan)
- 6. Read the full sharing guidelines document (not just the marketing materials)
- 7. Check if your state has an individual mandate (CA, MA, NJ, RI, DC, VT) and understand the penalty
- 8. Build an emergency fund of $5,000–$10,000 before canceling existing insurance
- 9. Verify your current doctors are in-network (if the plan uses a PPO network like Medi-Share's PHCS and First Health PPO; plans like Zion have no network, so any licensed provider works)
- 10. Understand the claims processing timeline and plan for potential out-of-pocket cash flow gaps
The Bottom Line
Health sharing can save you thousands per year, but only if you choose the right plan for your situation. The 5 questions above will help you avoid the most common and costly mistakes: joining a plan with a long pre-existing waiting period, underestimating hidden costs, signing a faith statement you do not agree with, or assuming health sharing provides the same legal protections as insurance.
For most people without strong faith preferences and with any pre-existing conditions, Zion HealthShare offers the best combination of coverage, pricing, and accessibility at $114–$320/month, sharing BP, cholesterol, and type-2 diabetes from day 1 (other conditions phase in) with no faith requirement.
Not sure where to start? Take our free 2-minute quiz to get a personalized recommendation based on your health needs, budget, and preferences. Or compare all plans side-by-side to see the full picture.
Frequently Asked Questions
What happens to my pre-existing conditions in health sharing?
Most health sharing plans have a 6-12 month waiting period for pre-existing conditions. During this time, you pay 100% of related costs out of pocket. Zion HealthShare is the notable exception with no waiting period. See our pre-existing conditions guide for plan-by-plan details.
What is NOT covered by health sharing plans?
Common exclusions include prescriptions (CHM, Medi-Share), mental health (CHM, Medi-Share), preventive care at some plans, and pre-existing conditions during waiting periods. Coverage varies significantly by plan. Use our comparison table to see what each plan covers.
What is the total annual cost of health sharing?
Total annual cost = (Monthly share × 12) + IUA + Co-share (10-20%) + uncovered expenses. For a $5,000 medical year, expect $3,000-$7,000 total depending on the plan. Use our scenario calculator to model your specific situation.
Do I need to be religious to join health sharing?
No. Zion HealthShare, Sedera, and CrowdHealth accept members of any faith or no faith. CHM, Medi-Share, and Samaritan require Christian faith statements and church attendance. Read our non-religious options guide.
What legal protections do health sharing members have?
Health sharing is NOT insurance and is not regulated by state insurance departments. Members have no legal guarantee of payment. Your only recourse is the plan's internal appeals process or small claims court. See our health sharing vs insurance comparison for details on legal differences.
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