Medi-Share

What Medi-Share is

Medi-Share is the flagship program of Christian Care Ministry, a 501(c)(3) nonprofit based in Melbourne, Florida. It is a healthcare sharing ministry — a structure recognized under federal law (and explicitly exempted from the ACA individual mandate while that mandate had teeth) in which members make monthly contributions that are then directed to other members’ eligible medical bills. There is no insurance pool, no actuarial reserve in the traditional sense, and no contractual promise that any given bill will be paid.

Operationally, it looks a lot like a PPO health plan. You pick an Annual Household Portion (the deductible-equivalent). You see doctors in the PHCS network. You present a Medi-Share ID card at the front desk. The provider bills Medi-Share, the ministry negotiates and processes the bill, and the eligible portion is shared from member contributions. The differences from insurance live in the fine print — eligibility, lifestyle requirements, what counts as shareable, and the absence of a legal guarantee.

Why 400,000 households choose Medi-Share over insurance

The single biggest practical difference between Medi-Share and a marketplace insurance plan is cost. For a healthy, non-smoking family of four, the monthly contribution is often 40–60% less than an unsubsidized ACA Silver plan in the same market. That gap is the entire reason most members are here. The savings come from three sources: no profit margin (the ministry is a nonprofit), no requirement to cover services the ministry doesn’t share (no birth control, no abortion, no most fertility), and a healthier-than-average risk pool selected by the lifestyle requirements.

The second-biggest difference is the cultural one. Members receive monthly notes telling them which family their share is being sent to, and members with eligible needs receive prayer cards from strangers across the country. For many evangelical households, that combination — meaningfully cheaper than insurance, plus a faith-aligned community — is the whole package. It is, in a real sense, the model that respects how a particular kind of Christian household already thinks about money, body, and church.

The healthcare sharing model: the differentiator vs. insurance

Healthcare sharing is structurally different from insurance in three ways that matter. First, there is no risk transfer in the legal sense — members are not buying a contract that says "we will pay your bills." They are contributing to a pool that the ministry then directs toward other members’ eligible needs. Second, the ministry retains discretion. The Member Guidelines document specifies what is shareable and what isn’t, and the ministry decides whether a given bill meets those guidelines. Third, healthshares are explicitly exempt from state insurance regulation in roughly 30 states and operate in a gray zone in the others — there is no state insurance commissioner overseeing claims disputes.

In practice, this means a Medi-Share member who follows the guidelines and has a clear-cut eligible bill usually has a smooth experience. A member with a complicated case — pre-existing conditions, mental health needs, edge-case diagnoses — has a more uncertain experience. The ministry publishes its sharing rate (typically reported as 100% of eligible bills shared in a given period) and members generally do receive sharing for eligible bills. The risk lives in that word "eligible" and in the absence of a legal backstop if you disagree with the ministry’s determination.

Christian-living commitments: the lifestyle covenant

Joining Medi-Share is not just opening an account. Applicants sign a Statement of Faith affirming broadly evangelical Protestant Christian beliefs and a Statement of Christian Lifestyle that commits to a specific set of behaviors. Tobacco and illegal drug use are out. Sex outside of heterosexual marriage is out. Excessive alcohol use is out. Members commit to attending a Christian church regularly. A pastor or church leader is asked to confirm the applicant’s church involvement.

These aren’t footnotes — they are how the system works. The lifestyle covenant is what produces the lower-cost pool (smoking and several other excluded behaviors are correlated with higher medical costs) and what gives the community its specifically Christian character. For households who already live this way, the covenant is invisible and inoffensive. For households who don’t, Medi-Share is not the right product, and the ministry is straightforward about that. Misrepresenting one’s lifestyle on the application can result in retroactive denial of bills already shared — meaning a member could be on the hook for bills the ministry previously paid.

Limitations and scope: what gets shared and what doesn’t

The Member Guidelines are publicly available and worth reading before signing up. Routine preventive care is shareable on most plans (some preventive services are bundled into the membership without an AHP applying). Hospitalization, surgery, emergency care, prescriptions related to an eligible event, and most major medical scenarios are shareable. Maternity is shareable for married couples when conception is after the membership effective date. Pre-existing conditions follow a phase-in: conditions can become eligible for limited sharing in year two, additional sharing in year three, and full sharing in year five, with some conditions permanently excluded if severe.

What is not shareable: birth control and most contraception, abortion (except in narrowly defined life-of-the-mother circumstances), most fertility treatments, gender-affirming care, non-emergency cosmetic procedures, injuries resulting from excluded behaviors (intoxicated driving, etc.), and many mental health services beyond acute crisis. Dental and vision are not part of the medical sharing program — Medi-Share sells separate add-on programs for those. This is the part of the product that gets the most attention in negative reviews. None of these limitations are hidden; all of them are spelled out in the guidelines; but applicants who don’t read them carefully are sometimes surprised at year two, and that surprise can be expensive.

Pricing

Where Medi-Share falls behind

No legal guarantee that any specific bill will be paid. This is the headline limitation and it cannot be waved away. Eligible bills are shared "as funds are available," and while the ministry has a strong track record of sharing eligible bills, "eligible" is the ministry’s call, not a contractual obligation. If you have a high-stakes diagnosis and the ministry decides the bill is tied to a pre-existing condition, your recourse is internal appeal — not state insurance commissioner, not court (in most jurisdictions).

Pre-existing conditions can produce nasty surprises. The phase-in schedule is real, but the determination of what counts as "tied to" a pre-existing condition can be aggressive in disputed cases. A member who developed a heart condition in year four may discover that the ministry traces it back to elevated cholesterol noted in their pre-membership records, and the bill is declined.

Mental health coverage is genuinely thin. Crisis stabilization can be eligible. Ongoing therapy, most psychiatric medication management, and intensive outpatient programs generally aren’t. For households where mental health care is a real and ongoing need, this is a meaningful gap.

No coverage for services the ministry doesn’t share on faith grounds. Birth control, sterilization, most fertility treatment, and abortion are out by design. This is not a defect of execution — it is the product, and Medi-Share is upfront about it. But it means households who want those services covered need to budget for them out of pocket or look elsewhere.

Regulatory environment varies by state. A handful of states have moved to tighten oversight of healthshare ministries, and some have considered requiring sharing organizations to disclose that they are not insurance more prominently. The legal terrain is evolving, and members in different states have meaningfully different practical recourse if something goes wrong.

Medi-Share vs. Samaritan Ministries vs. traditional insurance

Different strengths. Medi-Share runs a centralized operation — you pay one monthly share, the ministry routes funds, you present an ID card at a PPO doctor, and the back-end is invisible. Samaritan Ministries runs a decentralized peer-to-peer model — members send their monthly share directly to other named members each month, often with a personal note and prayer. Both are healthcare sharing ministries. Both share roughly similar categories of bills. The cultural feel is different: Medi-Share is closer to "Christian PPO" in member experience, while Samaritan leans further into the relational, hand-written, mutual-aid character of the original sharing model.

Medi-Share is broader (PHCS network, telehealth bundled, centralized billing). Samaritan is more relational (members write checks to other members by name, communities of need are publicized monthly). On cost, the two are roughly comparable for similar households, with monthly amounts varying by age and family size. On pre-existing conditions, both have phase-in structures; the specifics differ and are worth comparing line by line if you have a chronic condition.

Traditional insurance — whether ACA marketplace, employer group, or Medicare/Medicaid — is the very different category. Insurance is a regulated contract. The insurer is legally obligated to pay covered services. There is a state insurance commissioner you can appeal to. There is no Statement of Faith. Birth control, fertility, and mental health are typically covered. The price is higher, sometimes dramatically higher, especially for unsubsidized buyers. For households with serious chronic conditions, for households who want broad mental health and reproductive coverage, or for households who qualify for substantial ACA subsidies, traditional insurance is usually the better fit. For healthy evangelical households without group coverage and without subsidies, Medi-Share and similar healthshares are often meaningfully cheaper — with the trade-offs documented above.

Alternatives to Medi-Share