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Everything You Need to Know About HealthShares

Fri, 14 Nov 2025 15:48:16 GMT

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.

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.

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.

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.

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 .

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.

In This Article

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.

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

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

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.

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 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 Simple Guide to Open Enrollment for Individuals and Families

Mon, 13 Oct 2025 21:24:34 GMT

Health coverage is one of those things we all know we need—but it can be confusing, expensive, and hard to navigate. Premiums go up, paperwork piles up, and sometimes it feels like you have no choice but to “just pick something.”

But here’s the good news: you actually have more options than you think. Whether you’re reviewing your current plan or exploring something new, understanding open enrollment can help you make a more confident, informed decision about your care.

What Is Open Enrollment — and Why Does It Matter?

Open enrollment is the time of year when individuals and families can review, renew, or change their healthcare coverage.

During this period, you can:

Enroll in a new health plan
Renew your current coverage
Switch carriers or plan types
Add or remove dependents
Update your household information to see if you qualify for tax credits or subsidies

For most insurance-based coverage, open enrollment is the only time of year you can make changes unless you experience a qualifying life event—like marriage, a new baby, or losing your job’s health benefits.

That’s why it’s important to pay attention to deadlines and know your options ahead of time.

Tip: If your healthcare is insurance-based, open enrollment applies. If it’s membership-based—like direct primary are (DPC) or a Planstin Membership—you have flexibility year-round.

Who Is Affected by Open Enrollment?

If your care is insurance-based, open enrollment likely applies. If it’s membership-based, you typically have year-round flexibility. The chart below shows what’s affected—and what isn’t. :

When Does Open Enrollment Happen?

Open enrollment windows vary by the type of plan that you have, but many align with the Marketplace timeline.

Marketplace plans: November 1st to January 15th (most states)

Employer plans: Dates vary by company

State marketplaces: Some states extend their windows. Always check your state site for details.

Membership-based programs: Join or cancel anytime of the year.

Why this matters: Knowing when your enrollment window opens helps you avoid coverage gaps, compare plans accurately, and make the most of your options.

What to Know Before You Enroll?

Open enrollment is your chance to pause—not panic. Instead of auto-renewing last year’s plan, take time to look at how you actually used care and what you paid overall. A few minutes of review can help you save money and frustration later.

Understand your timing and start date.
Marketplace coverage typically begins on the first day of the month after you enroll (for example, enroll by December 15 for a January 1 start). Employer plans may follow a different schedule. Membership-based options are usually active immediately after sign-up.

Count the real yearly cost.
Don’t stop at the monthly premium. Add up your deductible, copays, prescriptions, and any major expenses to get the true total cost . Then compare side by side to see what’s actually worth it.

Make sure it fits how you use care.
Think about last year: How often did you visit your doctor, urgent care, or specialist? Do you use telehealth or mental health services? Are prescriptions a big part of your budget? Your answers can guide which option fits best—virtual, in-office, or a membership that combines both.

Keep your doctors and medications simple.
If keeping a specific doctor or specialist is important, check their availability under your new plan. Review your regular medications for pricing, refills, and delivery options—especially if you use mail order or travel often.

Plan for big medical needs and flexibility.
Know your potential out-of-pocket limits for emergencies or hospital care. Ask how your plan handles major bills and whether benefits are available if life changes mid-year.

Tip: Compare traditional plans with membership-based options like direct primary care or healthcare memberships. Many families pair a DPC membership for everyday access with a sharing or safety-net program for larger needs.

What Happens if You Miss the Open Enrollment Deadline?

If open enrollment ends and you don’t qualify for a Special Enrollment Period , you may need to wait until next year to make changes.

You could qualify for a special window if you:

Got married or divorced
Had a baby or adopted a child
Moved to a new ZIP code or state
Lost or gained job-based coverage
Experienced another major life change

If you don’t qualify, you still have a few options:

Short-term health insurance: Temporary coverage to bridge a gap until next open enrollment.
Medicaid or CHIP: Available year-round for those who qualify based on income or family size.
Membership-based healthcare programs: These allow you to join anytime and provide immediate access to care and savings.

Planstin Membership is open year-round—offering everyday care, mental health support, prescription savings, and help with larger medical needs whenever you’re ready.

Why You Might Consider Nontraditional Healthcare Options this Year

Each year, premiums and deductibles continue to rise faster than wages, and many families are paying more while using less care. Traditional insurance often comes with narrow networks, complicated billing, and limited flexibility.

That’s why more individuals and families are looking for simpler, membership-based models that focus on access and affordability.

Membership-based options, like direct primary care (DPC) and healthshare memberships, offer:

Predictable monthly costs instead of surprise bills
Year-round enrollment (no waiting for open enrollment)
Personalized care with direct communication from your provider
Virtual and in-office access that fits your schedule
Transparency in pricing and benefits

Planstin Membership was designed for exactly this reason. It pairs direct primary care through Primestin Care with 24/7 virtual care, mental health support, prescription savings, and protection for larger medical needs, all in one simple membership you can join any time of year.

Click here to learn more about Planstin’s membership options >

Make Open Enrollment Work for You

Open enrollment doesn’t have to be stressful. Think of it as your annual check-in—your chance to make sure you’re getting real value from what you’re paying for.

Take time to compare your options, ask questions, and think about what kind of care actually fits your lifestyle.

And remember: traditional insurance isn’t the only path to affordable healthcare.

Whether you’re exploring new coverage or looking for a simpler, more personal approach to care, Planstin Membership is here to help.

Learn more or enroll anytime at personal.planstin.com.

How does Planstin Membership keep healthcare simple and affordable?

Mon, 13 Oct 2025 21:23:38 GMT

Every company claims to make healthcare more affordable — but how is what really matters.

Premiums are expected to rise again in 2026, and for most individuals and families, that feels discouraging. The traditional system wasn’t built around people; it was built around insurance companies. That’s why even small procedures can come with confusing bills and big costs.

At Planstin, we saw a better way forward. Instead of building another insurance plan, we created a membership-based option that connects proven solutions — Direct primary care (DPC) and Zion HealthShare — into one cohesive, affordable model.

It’s not too good to be true. It just works differently and smarter.

Who is Planstin?

Planstin is a third-party benefits administer that serves both businesses and individuals. Planstin Membership is the branch of Planstin that focuses on individuals and families — those who aren’t covered through an employer but still deserve dependable care.

Our goal is simple: make healthcare easier to understand and easier to use. We help you stay healthy, get care when you need it, and avoid financial surprises — without the confusion that usually comes with insurance.

Are you an employer? Learn how Planstin makes benefits easy >

Our Strategy: How We Actually Keep Costs Lower

All of Planstin’s personal memberships share the same foundation: a partnership between Direct primary care (DPC) and Zion HealthShare. Together, they cover both everyday and large medical needs and play clear roles:

DPC: Personalized, unlimited day-to-day care, including telehealth and mental health support.
Zion HealthShare: Help with preventive care, prescriptions, and large or unexpected medical costs like hospital stays, surgeries, or maternity needs.

This model works within the current healthcare system — using providers, labs, and pharmacies you already know — but removes the inefficiencies, markups, and administrative layers that drive up costs.

Together, DPC and HealthShare create a full, affordable alternative to traditional insurance. One that balances preventive, everyday care with reliable support for larger medical expenses.

How Healthshares Keep Costs Affordable

Zion HealthShares is different. It's a nonprofit organization built around community sharing rather than corporate profit. The goal isn’t to grow revenue — it’s to keep membership sustainable and fair.

HealthShares are able to keep costs lower because they avoid or reduce many expenses that drive up insurance premiums.

How HealthShares save:

No profit margins or shareholders
No state taxes on premiums or costly insurance mandates
No bloated administrative costs or claims bureaucracy
Fair-market pricing through care coordination and cash rates
Transparent member guidelines that clearly outline what’s included

This lean, community-based structure means more of each monthly contribution goes directly toward eligible medical needs, not company profits.

It’s easy to wonder why insurance premiums keep rising. While inflation and higher medical costs play a role, one major reason is simple: most insurance companies are for-profit businesses. When they want to increase revenue, premiums go up.

Press play to hear how insurance companies profit from rising premiums.

See the full documentary here.

Why Direct Primary Care Works (and Why It Feels Different)

For most people, visiting the doctor comes with waiting rooms, rushed appointments, and surprise bills. That’s because most traditional clinics rely on insurance billing to get paid. Every visit must be coded, submitted, approved, and processed — adding layers of paperwork, delays, and administrative costs that ultimately raise prices for patients.

Direct primary care (DPC) removes that friction. Instead of billing insurance, DPC clinics use a simple monthly membership that includes most preventive and everyday care.

How DPCs save:

No insurance billing, so overhead costs stay low
Fewer patients per doctor means longer visits and more personal care, leading to less costly visits later.
Predictable monthly pricing replaces copays and deductibles
Fair “cash pay” rates for labs, imaging, and prescriptions keep costs close to true market value

By cutting out the insurance middleman, DPCs make care more affordable, more accessible, and more personal.

Care Coordination: Real Support When You Need It

It is hard to know what care should cost or whether you are paying too much. That is why Planstin Membership includes care coordination.

Instead of calling around and guessing what is “fair,” our team does that work for you. We find quality providers, compare options, secure reasonable cash rates, and line up the details so you spend less time managing healthcare and more time getting it.

The result is fewer surprises, clearer pricing, and a faster path to care. Members regularly pay less than typical insurance rates for imaging, labs, and procedures because we shop options and agree on fair-market prices up front.

For example:

When Jane needed an MRI, she contacted care coordination. We found a provider, negotiated about 30% off, scheduled the appointment, and sent the details. She saved money and got results sooner without doing the legwork herself.

This kind of real-time support helps keep costs down and gives you peace of mind that someone is looking out for you.

How Planstin makes it easy - Simple Billing, One Membership

Healthcare can feel complicated. Our job is to keep yours manageable.

With Planstin Membership, you have one login, one monthly bill, and one team helping behind the scenes. We handle both your DPC and HealthShare billing so you don’t have to juggle multiple accounts or portals. Communication is straightforward, and pricing is clear — everything you need to know is outlined in your member guidelines.

It’s a simple, predictable system that helps you focus on your health instead of your paperwork.

Simple, Predictable, Proven

This approach is already trusted by thousands of families and growing communities across the country. We’re not replacing healthcare — we’re improving how it’s accessed and managed.

Our mission is to simplify healthcare by removing barriers, keeping costs transparent, and providing a reliable, affordable option for individuals and families.

Because when care is simple and affordable, people actually use it, and that’s when health really improves.