Nourishing Stewardship

Ditching Health Insurance – Part One: The Basics

When I made the decision to quit my job earlier this year, one of the major questions was “what will we do for health insurance?”. Josh’s employer offered a plan to keep the government off its back, but the premiums were so high it basically negated one of our incomes entirely.

Instead of shopping the Maryland health market and trying to find a government sponsored health plan (shudder), I took some time to research health insurance alternatives. With plans for future businesses and continuing Josh’s education, the consideration of “some Christian health sharing thing” has never exactly been off the table. So we decided to look into some of the most well-known health sharing groups and pray specifically for the group we should join.

What is Christian Health Sharing?

To help you get a better understanding of what this whole Christian health sharing thing is about, here are some basics:

1. It’s not health insurance.

There aren’t Christians hiding out with some sneaky grandfathered BCBS plan that has super low premiums. Health sharing groups are voluntary health cooperatives that practice fund sharing to cover the health needs of members within the group. So while we have health coverage as a member family of a Christian health sharing group, we don’t have health insurance.

2. It enables members to choose whatever doctor/hospital/health care worker they want.

As members of a Christian health sharing group, families like ours have free rein to choose any provider they want. This includes any traditional doctor or hospital – we kept our family practice doctor without a hitch. But it also includes other alternative medicine providers, should you choose the path of herbalism, chiropracty, or other non-standard medical care.

Not only does this mean that choosing your standard providers: general practice, pediatrician, OBGYN, etc. but it also means choosing what care you want when we want it. If you choose to visit a specialist before going to your GP, you can.

3. It facilitates care choices independent of location.

Because health sharing families don’t have health insurance, we don’t have to concern ourselves with in-network and out-of-network providers. We have the freedom to choose providers in any other state or country that we might visit – no questions asked.

As our travels in future years take us between states for Josh’s education, nothing about our coverage will change. We could get treated at a practice in Maryland one week and at a hospital in Indiana the next and there wouldn’t be a single snag in getting our medical bills covered.

4. Sharing members pay out of pocket – and get reimbursed later.

Again, because health sharing coverage isn’t health insurance, there isn’t anything for doctors to submit to a central office for processing. Individual members are responsible for their own health care costs.

Once we have an “incident” in order (say someone gets a sickness and needs to see a few doctors, get some testing, and a procedure), we simply submit the information to our health sharing group and scan them the bills. We still pay a certain non-reimbursable amount out of pocket, but anything beyond this cost is passed along to other members, who send us money as part of their monthly shares.

Most members of health sharing groups have savings accounts or credit cards set aside to use for covering health costs. When the bills come, they simply pay through their account or card, and use the funds received later on to refill the account or pay off the credit card balance.

5. It’s legal.

One of the first questions I get asked when I tell people we’re part of a health sharing community is whether it’s actually legal to be uninsured. Since the ACA passed, technically every American is required to purchase health insurance to some degree or pay a penalty.

As I mentioned above, we are by every measure uninsured. However, many of the large Christian health sharing programs have been around for much longer than the ACA, so members of these groups are given a special exemption from the health insurance mandates.

This means when Josh and I fill out our 2017 taxes, we will mark the box that we’re uninsured but will pay nothing in penalties.

6. It doesn’t cover preventative care.

Most Christian health sharing groups do not cover preventative care. This includes well visits, testing, and vaccinations.

Under most traditional health insurance plans, preventative care costs are covered 100%. This is a huge perk, especially if you don’t get sick often.

But this isn’t how health insurance has always worked.

Once upon a time, health insurance was much like auto insurance: you paid your monthly share and received coverage when something major happened. When it comes to caring for our cars, we happily pay out of pocket for everyday cheap stuff like oil changes and go on about our business.

When health care is done correctly, this model works surprisingly well for providing a family’s health coverage.

7. It requires members to follow certain guidelines for living.

Christian health sharing groups work because they’re cooperative groups of people who share the same basic values. Most of the groups that I researched – including the one we ultimately chose – even require a signed document from your pastor before you’re allowed to join.

In addition to being plugged into a local church, you also have to sign an agreement that outlines some basic living principles to observe. These aren’t crazy or outrageous – though groups do differ.

For our membership, Josh and I had to agree that we won’t have sex with other people, we won’t smoke (except the occasional celebratory cigar), and we won’t drink to drunkenness. As you might imagine, these weren’t exactly challenging for us to sign off on.

Sharing groups work on the honor code: the sharing police aren’t going to come by your house and check up on whether you’re following their rules. But, if you do end up in a medical situation that’s induced by participation in an activity you’ve explicitly said you won’t participate in (ex. a car accident that you cause by driving drunk), those needs are simply unsharable and you’re responsible for the burden of the medical expenses. Kind of a no brainer.

8. It has members send shares directly to one another – not to a central office.

Probably the coolest part of participating in a Christian sharing group is that you send your monthly healthcare shares (“premiums”) directly to other members. This is how the whole coverage with no insurance thing works.

Each month, members send their health needs (aka bills) to the central office. The office then runs figures through an algorithm that matches needs with shares. Members whose shares correspond with the requested need receive notice of their monthly share recipient, write a card and a check, and send it off to that person.

This means that membership shares never go straight to the central office. Instead, you send money – all of your monthly share requirement – to member families who need the funds.

One month you’ll send a share to the parents of a child in Nebraska who fell and broke his leg. Then the next month you might send a share to a family who had a baby. Or an elderly member who had some testing to check for a respiratory condition.

9. Its members have got each other’s backs.

Some things aren’t shareable needs. This can involve medical procedures that are really expensive, but fall out of the umbrella that your sharing group has agreed to cover. Pre-existing conditions (including pregnancies that began before a family becomes a member) and dental procedures usually fall into this category.

But the beauty of working with other human beings, rather than a cold corporate conglomerate, is that members can go above and beyond the call of duty to serve one another. Often, members are encouraged to share “unsharable” needs . These needs are then published for other members to view. If a family feels led to chip in $20 or $100 in addition to their regular monthly share, they simply send that money to a family listed in the special needs section.

While there’s certainly no guarantee that these needs will be covered, there are many testimonies of families in need of serious help receiving everything that they need to cover their extra health expenses.

10. It doesn’t cover abortions.

A big concern for ethically minded Christians navigating the treacherous waters of institutionalized health care is what their money is actually paying for. For pro-lifers, abortion is a huge factor, and one that’s openly funded by corporate health insurance companies.

When you participate in a Christian health sharing group, you can rest assured that your money is never going to go to fund someone else’s abortion. That’s a promise you won’t get anywhere else.


Ok, that was a pretty intense overview of what Christian health sharing is all about. There are obviously a lot more details than what I’ve provided here, but I hope that this can help to answer some of your questions about Christian health sharing groups.

After nearly a year without health insurance, I can say with confidence that our family will never return to traditional health insurance. Sure, it’s awkward to deal with being different (we’re usually the only patients who don’t have insurance at any of the practices that we go to), but that’s a small price to pay for total freedom in selecting our care. Not to mention the value in putting our money where our mouths are and staunchly refusing to fund things we firmly don’t believe in.

It’s open enrollment season, so likely you’re working through some health care decisions of your own. If you’re fed up with the options you’ve got available to you through the standard system, you may want to give Christian health sharing a second thought.

In my next post, I’ll get into a cost comparison between what a family might expect to pay with a traditional health insurance plan versus what they might pay for comparable coverage through a Christian health sharing network.

I’ll also talk a little more specifically about the Christian health sharing group that we’ve chosen – Samaritan Ministries – and why we’re so happy with the care we receive as Samaritan members. While I’ve obviously got some glowing things to say about our health sharing group, the opinions I express in these posts are wholly my own and I am in no way being compensated for sharing my experience.

If you’ve got any specific questions about Christian health sharing, please reach out and I’ll help you find the best answers. Perhaps there are some other aspects of health sharing that you’d like to see addressed in another post – just leave a comment here and I’ll be in touch 🙂

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Gabrielle Rystedt
Gabrielle Rystedt
Gabrielle Rystedt is a writer by day and a writer by night (because writers never sleep), who spends time balancing client orders, a couple of books and her blog at Raising Rystedts. She’s a business school grad who’s dabbled in management, both at the project and company level. She loves coffee and crafting, and enjoys settling down with a good book. Though as mom to three kiddos in three years, she realistically spends most of her time reheating her coffee and typing away like a crazy person on a laptop keyboard while surrounded by (clean) cloth diapers and cheddar bunnies.

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