Everything You Need to Know About HealthShares

If you’ve ever felt overwhelmed by the cost of health insurance, you’re not alone. Premiums, deductibles, and out-of-pocket expenses keep going up, leaving many families wondering if there’s another way. 

There is. It’s called a HealthShare, and it’s quickly becoming one of the most popular alternatives to traditional health insurance. 

A HealthShare is built on a simple idea: people helping people. Members contribute a set amount each month, and when someone has a medical need, those funds are shared to help cover their expenses. It’s a practical, community-based approach to managing healthcare costs. 

In this guide, we’ll explain what a HealthShare is, how it works, and why more Americans are choosing this affordable healthcare option. 

Why Are People Switching to HealthShares? 

More than 1.7 million Americans are now part of a medical cost-sharing program. That number continues to grow each year as families look for more affordable and flexible ways to manage healthcare. 

People are turning to HealthShares because: 

• They are more affordable. Monthly costs are often lower than traditional insurance premiums. 
• They are flexible. You can choose any doctor or hospital you prefer. 
• They are transparent. Guidelines are easy to understand and clearly outline what’s shareable. 
• They build community. Members know their money is helping real people, not funding an insurance company’s bottom line. 

For many, the appeal of a HealthShare is about more than saving money. It’s about taking back control of healthcare decisions and feeling supported by a community with shared values. 

What Is a Healthshare? 

A HealthShare, sometimes called a medical cost-sharing program, is a nonprofit community that helps members pay for medical expenses. 

Instead of paying premiums to an insurance company, members contribute a set monthly amount to a shared fund. That fund is used to help other members with eligible medical costs. You can think of it as a large community pool: everyone contributes, and when a member faces a qualifying medical need, funds are shared to help cover their expenses. 

How are HealthShares Managed? 

HealthShares are managed by nonprofit organizations that oversee how funds are distributed. These organizations create the member guidelines, and every member agrees to follow them when joining. The nonprofit then uses those guidelines to review requests and manage the shared funds in a consistent, fair way, without needing approval from each individual member.  

When Do HealthShares Step In to Help? 

HealthShares are designed to assist with major or unexpected medical events such as hospital stays, surgeries, or maternity care. Routine visits or preventive care may not always be included, depending on the program. 

HealthShares focus on larger medical needs because this approach keeps monthly costs affordable for members. By concentrating on significant or unexpected expenses, the community can share in the moments that would otherwise create major financial strain.   

How Does a HealthShare Work? 

HealthShares make it easy for members to get support when medical needs arise. Here’s how the process works in just a few simple steps: 

1. You pay a monthly contribution. 

Each month, members contribute a set amount to their HealthShare. Paying this monthly share secures your ability to request financial support for eligible medical needs. 

2. You visit your doctor or hospital. 

When you need care, you see your provider as a self-pay patient and pay directly at the time of service. 

3. You pay your member responsibility. 

Most HealthShares have a set amount that members pay before sharing begins. This is sometimes called an IUA (Initial Unshareable Amount). It’s similar to a deductible in traditional insurance. 

4. You submit a sharing request. 

After receiving care, you send your itemized medical bill to the HealthShare. The nonprofit reviews your request based on the member guidelines to see if it qualifies for sharing. 

5. The community shares the cost. 

If your need is eligible, the HealthShare “shares in” your request — meaning funds from the community pool help pay the rest of your medical expenses. 

Note: Some HealthShares encourage members to contact them as soon as they know they’ll need care. In certain situations, HealthShares may even help coordinate payment ahead of time if cost estimates are provided. Always check your specific HealthShare’s guidelines to understand their preferred process. 

Choosing your Monthly Amount 
Many HealthShares let you choose your monthly contribution. A higher monthly share usually means a lower personal responsibility when you receive care, and a lower share means a higher out-of-pocket amount. 

This flexibility is one of the reasons families appreciate HealthShares. It allows them to customize their membership based on what works best for their budget and lifestyle. 

HealthShare vs. Health Insurance: What’s the Difference? 

HealthShares and health insurance both help with medical costs, but they work very differently. 

HealthShares focus on helping members manage larger, unexpected medical expenses, while insurance covers a wider range of care but often at a higher cost. The right fit depends on your healthcare needs, budget, and comfort level. 

Why HealthShares Use Different Terms 

If you’re new to HealthShares, you may notice that some of the terms sound different from what you see in traditional insurance. Instead of premiums, deductibles, or claims, you’ll hear phrases like monthly share amount, member responsibility, and eligible need. 

These terms reflect how HealthShares operate as nonprofit, community-based programs instead of insurance companies. While the language is different, the ideas are familiar. For example, a member responsibility works similarly to a deductible, and a monthly share amount functions a bit like a premium. The difference is that HealthShares focus on members helping members, not on policy contracts. 

HealthShare Terms Explained 

If you’re new to HealthShares, you may see a few words that are different from what you’re used to with insurance. Here are some of the most common terms and what they mean in simple, everyday language. 

The Pros of Joining a Healthshare 

There are several reasons individuals and families choose HealthShares as their healthcare solution. The main benefits are affordability, flexibility, and clarity. 

Affordability 

Monthly costs are often significantly lower than traditional insurance premiums, helping families manage healthcare costs without sacrificing peace of mind. 

Flexibility 

Most HealthShares allow you to visit any doctor or hospital you prefer. There are no provider networks to restrict where you can go for care.

Transparency 

Member guidelines clearly outline what medical events qualify for sharing. This makes it easy to understand how the program works before you need it. 

Community Connection 

You’re part of a group of people helping one another in times of need. 

Year-Round Enrollment 

There’s no open enrollment period, which means you can get started, or cancel, whenever it’s right for you. 

Month-to-Month Membership 

HealthShares work on a month-to-month basis with no long-term contracts. This offers flexibility, but it also means it’s important to keep your membership active. Missing a payment can interrupt sharing eligibility, including waiting periods for things like maternity or pre-existing conditions. 

For many families, these features make healthcare simpler, more predictable, and easier to afford. 

The Cons (and Risks) to Consider Before Joining 

While HealthShares offer flexibility and cost savings, it’s important to understand their limits before deciding if one is right for you. 

Not Insurance 
HealthShares are not regulated insurance plans, and there is no legal guarantee that every bill will be paid. Members agree to share costs according to the program’s guidelines rather than through a binding contract. 

Not ACA-Compliant 
HealthShares do not meet the Affordable Care Act’s definition of minimum essential coverage, so they do not qualify as traditional insurance for tax or regulatory purposes. 

Selective Sharing 
Each HealthShare sets its own rules for what expenses can be shared. Preventive care, pre-existing conditions, or routine services may not be included right away, or at all. 

Out-of-Pocket Costs 
Members are responsible for paying any medical expenses that fall outside of what the HealthShare considers shareable. 

HealthShares work best for people who are comfortable managing their care directly and want to be part of a transparent, community-based approach. 

Tip:  Many HealthShare members choose to pair their membership with a Direct Primary Care (DPC) program. With unlimited access to primary care for a flat monthly fee, DPCs make everyday healthcare simple and affordable. Combined with a HealthShare for larger medical needs, this can create a well-rounded healthcare solution for families. 

How to Know if a HealthShare Is Right for You 

HealthShares can be a great way for individuals and families to make healthcare more affordable and flexible. They work especially well for people who want a simple, straightforward way to handle unexpected medical costs. 

A HealthShare might be a good fit if you are: 

• Are self-employed or do not have access to employer-sponsored benefits. 
• Are generally healthy and want an affordable way to handle larger medical needs if they come up. 
• Prefer flexibility in choosing your doctors and hospitals. 
• Feel comfortable being a self-pay patient and submitting medical bills for review. 
• Want predictable monthly costs that are often lower than traditional insurance premiums. 

HealthShares are designed to give members peace of mind without the high costs or complexity of traditional insurance. If you value flexibility, affordability, and clarity in your healthcare, a HealthShare may be a viable option for you and your family. 

Real-World Example: How HealthShares Help Families 

“Zion Healthshare is truly a God send! It is the only "insurance" we carry. Its about 50% of the cost of traditional insurance. They have handled all of our needs with the utmost professionalism. My husband had an emergent issue with his heart and we were able to get a huge prepayment made to the hospital within days so that my husband's surgery could proceed quickly. They have been so kind, supportive and professional. Highly recommend!!!” 

— J. Loureiro 

FAQs About HealthShares 

A Simpler Path to Healthcare 

HealthShares are helping more individuals and families find a simpler, more affordable way to manage medical expenses. They offer flexibility, clarity, and peace of mind when unexpected healthcare needs arise. 

At Planstin Membership, we’re here to help you explore your options and find a solution that fits your family’s lifestyle and budget. Learn more at personal.planstin.com.