Health sharing ministries have been around since the 1980s, but they've exploded in popularity over the past decade as traditional insurance costs have climbed. For churches and pastors, they're often the first option that comes up — and for good reason. But they're not right for everyone.
This guide gives you a straight look at how the three largest health sharing ministries — Medi-Share, Christian Healthcare Ministries (CHM), and Samaritan Ministries — actually work, what they cost, what they don't cover, and how they compare to traditional group insurance for churches.
Health sharing ministries are not insurance. They are membership organizations where members voluntarily share each other's medical costs. They are not regulated by state insurance departments, do not guarantee payment, and do not constitute minimum essential coverage under the ACA (for employees — though individuals are exempt from the ACA individual mandate penalty).
How Health Sharing Ministries Work
The basic model is simple: members pay a monthly "share" (not a premium — the word matters legally). When a member has a qualifying medical need, they submit it to the ministry. The ministry then directs other members' shares to cover that need — either directly or by publishing it in a directory.
Members typically have an "Initial Unshareable Amount" (IUA) or "Personal Responsibility" — essentially a deductible. Medical bills above that amount are eligible for sharing by other members.
The key difference from insurance: no contract guarantees payment. The ministry's obligation is moral and relational, not legal. In practice, established ministries like CHM (founded 1981) and Samaritan (founded 1994) have strong track records, but it's worth understanding the structural difference.
The Big Three: Side-by-Side
Medi-Share (run by Christian Care Ministry) is the largest health sharing ministry in the U.S. It has a traditional insurance-like structure — members use a network of providers, bills go through the ministry's system, and your share amount is predictable month-to-month. Members must be practicing Christians.
CHM is the oldest health sharing ministry in the U.S. Its Gold Plan is particularly compelling for larger families — flat $255/person with a family maximum of $765/month. The CHM+ add-on ($32/person, up to 3) gives unlimited coverage per medical event. Members pay bills first, then submit for sharing.
Samaritan operates differently from Medi-Share and CHM — members send their monthly share directly to a specific fellow member who has a need, creating a very literal expression of community. The ministry shares 100% of eligible expenses in the Classic plan above the IUA. Strong community feel; some members describe it as one of their most meaningful church connections.
Which is right for your church?
Our comparison tool helps you see real plans and costs based on your church's size and location — including health sharing ministries and group plans.
🙏 Compare My Options →Traditional Group Insurance: What It Offers
Traditional group health insurance — whether through a commercial carrier or a denomination-specific plan — remains the gold standard for coverage breadth and legal certainty. Here's what you get that you don't get with health sharing ministries:
- Guaranteed issue: No one can be denied coverage or charged more for pre-existing conditions
- Regulated coverage: State insurance commissioners oversee claims, disputes, and financial reserves
- ACA-qualified: Satisfies employer mandate if your church has 50+ FTEs
- Mental health parity: Required by law to cover behavioral health equally to physical health
- Preventive care: 100% covered (ACA plans)
The catch: cost. A group health plan for a pastor plus family can run $1,200–$2,000/month in employer contributions — before the employee's share. For small churches operating on tight budgets, this is often simply not feasible.
Denomination-Specific Plans
Several major denominations offer group plans with better pricing than commercial carriers — and with Christian plan design:
- GuideStone (Southern Baptist Convention): One of the largest church benefit boards in the U.S. Covers SBC churches and other evangelical ministries.
- Servant Solutions (Wesleyan): Group health, life, and disability for Wesleyan-affiliated churches and ministries.
- Concordia Plans (Lutheran LCMS): Comprehensive benefits for LCMS congregations.
- Church Mutual: Not denomination-specific — insures churches across traditions with group benefits programs.
If your church is affiliated with a denomination, check whether they offer a benefits plan before going to the open market.
The Real Cost Comparison
| Plan Type | Monthly Cost (Individual) | Monthly Cost (Family) | Out-of-Pocket Max | Pre-Existing |
|---|---|---|---|---|
| Medi-Share (mid-tier AHP) | ~$200–$350 | ~$500–$900 | $3,000–$6,000/yr | ⚠ Excluded initially |
| CHM Gold + CHM+ | $255 + $32 = $287 | Max $765 + $96 = $861 | $1,250/event | ⚠ 2–5 yr wait |
| Samaritan Classic | ~$300–$450 | ~$700–$1,100 | $1,000/event (IUA) | ⚠ Exclusions apply |
| ACA Silver (with subsidy) | $0–$250 (after credits) | $0–$600 (after credits) | ~$4,500–$9,000/yr | ✓ Always covered |
| Commercial Group Plan | $600–$900/mo (employer pays most) | $1,200–$2,000 total | $3,000–$8,700/yr | ✓ Always covered |
When to Choose Health Sharing Ministries
The pastor/staff are generally healthy (no significant ongoing conditions). The church values faith alignment in how healthcare is handled. Budget is tight and premiums above $400/person/month aren't sustainable. The ACA employer mandate doesn't apply (fewer than 50 FTEs). Members are comfortable with the spiritual/community accountability aspects.
When to Choose Traditional Insurance
Staff have significant pre-existing conditions (diabetes, heart disease, cancer history). Mental health coverage is a priority for staff and families. The church has 50+ FTEs and must satisfy the ACA employer mandate. Staff depend on specific specialists or medications not easily obtained without network coverage. Legal certainty of coverage is more important than cost savings.
The Honest Answer
Health sharing ministries are a legitimate, proven option for many pastors and church staff — but they're not a one-size-fits-all solution. For healthy families in smaller churches with limited budgets, ministries like CHM and Samaritan have served hundreds of thousands of members well over decades. For families with serious ongoing health needs, the pre-existing condition exclusions and lack of guaranteed payment make traditional insurance a safer choice.
The best path is to compare both options side-by-side using your specific situation — age, family size, health history, church size, and location all affect what makes financial sense.
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