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If you’ve only ever known traditional health insurance, you might be surprised to learn there’s another option for handling medical expenses — one that often costs about half as much and gives you more control over your healthcare choices.
That option is a health share.
Both health shares and health insurance help with medical expenses, but the way they do it is completely different.
And those differences can make a huge impact on both your experience and your wallet.
The Motive: Profit vs. Purpose
The first big difference comes down to motive — where your money actually goes.
With health insurance, your monthly premiums go into a large corporate system.
A portion of that money is used for medical claims, but a significant chunk also goes toward administrative overhead, marketing, executive salaries, and even lobbying efforts.
It’s a massive for-profit industry built to manage financial risk — and to maximize profits.
With a health share, your monthly contribution goes toward helping other members with eligible medical needs.
These are nonprofit organizations, so there’s no incentive to deny care or protect profit margins.
They’re focused on people, not shareholders.
Regulation and Legal Guarantees
This is where a lot of confusion comes in.
You’ll often hear critics say that health shares have “no legal guarantees.”
And that’s technically true — because health shares are not insurance.
Insurance companies are regulated by state insurance commissioners and can make legal guarantees.
Health shares operate under state contract law, not insurance law, which means they can’t legally guarantee the payment of medical bills — even if they fully intend to.
But that doesn’t mean they won’t share in those expenses.
Instead of relying on legal guarantees, health shares follow written Member Guidelines that clearly explain what types of medical needs are eligible for sharing and how the process works.
If your medical need meets those guidelines, the organization facilitates payment — either directly to your provider or as reimbursement to you.
And for many families, this structure has proven to be dependable when it matters most.
The Paperwork: EOBs vs. Guidelines
If you’ve ever had health insurance, you’re probably familiar with the Explanation of Benefits (EOB) — a long, often confusing statement showing what your plan did (or didn’t) pay.
With a health share, instead of an EOB, you’ll have Member Guidelines.
These documents outline what’s shareable and what’s not — and are typically much more straightforward than the fine print of an insurance policy.
Both systems have paperwork, but health shares tend to make it simpler to understand what you’re responsible for and what the community will help with.
The Monthly Cost and How Payments Work
Here’s one of the biggest differences most people notice first: cost.
With health insurance, you pay a monthly premium — and still have deductibles, co-pays, and coinsurance before your plan starts helping with medical bills.
With a health share, members make a monthly contribution (sometimes called a monthly share).
When a medical need arises, members pay a Member Responsibility Amount — though each health share calls it something different.
You might see it listed as:
- Initial Unshareable Amount (IUA)
- Annual Household Portion (AHP)
- Qualifying Amount
- Member Responsibility Amount (MRA)
They all mean the same thing: it’s the amount you pay toward your own medical bills before the community shares the rest.
Some health shares apply that amount per medical event, while others allow smaller needs to accumulate toward it.
A few even include a cap — so after a set number of medical events, you don’t have to pay another member responsibility amount that year.
And if your program includes preventive care, things like checkups or screenings can often be shared right away — without first meeting your member responsibility amount.
Claims vs. Needs
Here’s another simple distinction.
With insurance, you file a claim.
With a health share, you submit a need (or “sharing request”).
It’s the same idea — you’re asking for help with medical expenses.
But instead of relying on insurance codes or network restrictions, your request is reviewed based on the member guidelines.
That means more transparency and fewer surprises.
Pre-Existing Conditions
This is one of the most important differences to understand.
Most health insurance plans must accept and pay for pre-existing conditions immediately.
Health shares work differently.
Pre-existing needs aren’t shareable in the first year, with partial sharing becoming available in later years of membership.
That’s actually one of the main reasons health shares can keep their monthly costs so much lower.
Most members join a health share because they’re generally healthy — they’re not looking for coverage for ongoing treatments, but for protection against unexpected medical events.
When a community is made up mostly of healthy members, there are naturally fewer large medical needs to share — and that helps everyone keep costs down.
Big Picture Recap
| Health Insurance | Health Share | |
|---|---|---|
| Structure | For-profit business | Non-profit community |
| Regulation | Governed by insurance law | Governed by contract law |
| Payments | Premiums, deductibles, co-pays, and coinsurance | Monthly contribution + member responsibility amount |
| Guarantees | Legal guarantees (but denials and appeals are common) | No legal guarantees, but clear guidelines and strong sharing records |
| Process | File a “claim” | Submit a “need” or “sharing request” |
| Pre-Existing Conditions | Covered immediately | Limited or phased-in sharing |
What’s Next: How a Health Share ACTUALLY Works
Now that you understand the key differences between health shares and health insurance, the next question is: What actually happens when you use a health share?
Most people understand the concept, but they’re unsure what to expect when they go to the doctor or face a major medical bill. That’s exactly what I cover in my next post and video.
Click here to read or watch: How Health Shares Actually Work – Step by Step
In that post, I walk you through what happens — from preventive visits and small medical needs to hospital stays — so you can see how it all comes together in real life.
Health shares are not insurance and do not offer insurance coverage. Membership in a health share does not guarantee the payment or reimbursement of medical expenses. Each organization operates under its own membership guidelines, which determine what expenses may be eligible for sharing. This publication is for informational purposes only and is not provided by an insurance company. For state-specific notices and full program details, please visit the respective health share’s official website.
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