My Medi-Share Review of the Healthcare Sharing Program for Christians

Joining the Christian medical expense sharing community, Medi-Share, for around $300/month has been a fantastic financial move for my family.

Prior to joining this healthcare expense-sharing community as an alternative to traditional health insurance, I was paying a staggering $1,100/month for a health insurance plan through Humana!

This is a monthly savings of around $800/month!

Now, Medi-Share is NOT health insurance (nor is it charity), but it’s a great alternative to expensive healthcare coverage for some.

And, even without the Obamacare mandate, this alternative will continue to be a great option for my family and could be for yours, too.

What is Medi-Share?

Medi-Share is a healthcare sharing program where Christians share financial resources to pay for each other’s medical expenses. Since 1993, over $875 million has been shared and discounted among Medi-Share members. It’s a proven biblical model of healthcare–Christians helping Christians.

Medi-Share is a non-profit, medical expense sharing program for Christians. Members, quite literally, share in each other’s health expenses (hence the name).

Essentially, each month, everyone places their monthly share (like a premium) into one big pot (technically a credit union account,) and those with expenses use the money to pay their bills.

However, it’s not insurance. But for some, it can be a ideal replacement for health insurance and its high premiums.

Read on to learn more about how Medi-Share works, its advantages and disadvantages, as well as my personal experience so you can know what to expect if you think it’s a good option for your or your family.

How Does Medi-Share Work?

If you’re unfamiliar with Medi-Share, here are the basics of how their healthcare sharing ministry works.

Annual Household Portion

Members choose an annual household portion (AHP), which is similar to an annual deductible. The size of your portion determines how much you will have to pay out-of-pocket for covered medical expenses before the health share kicks in. You get to choose both the AHP and the monthly share from the provided chart.

The size of the AHP you choose will determine your monthly share.

Here’s what a sample chart might look like for a middle aged couple with at least one child living in Texas (pulled on September 21, 2021):

For my family of five, we chose a $10,000 AHP, which is high, but it means a lower monthly share.

In the case of an emergency, we could handle having to pay $10,000 out of pocket from our emergency fund, and we enjoy the savings the lower monthly share affords us.

If your family would struggle with such a high AHP, you should choose a lower AHP—just be prepared for higher monthly portions.

Provider Fee

As with traditional insurance, you will still pay a provider fee (like a co-pay) of $35 for doctor visits and $200 for emergency room care.

Routine well patient care—such as annual physicals—and dental and vision care are not covered by Medi-Share, so you need to be prepared for those expenses throughout the year.

Preferred Provider Organization (PPO)

Medi-Share is partnered with the preferred provider organization Private Healthcare Systems, Inc., or PHCS, and members are encouraged to seek care from providers within the PHCS network.

Though, you are free to choose treatment with an out-of-network doctor—but if you do, a penalty may be applied for going out of the network.

Doctor Visits

When you need medical care, you will hand over your Medi-Share card and pay your provider fee; then, the provider will bill Medi-Share the remainder.

After the medical bill is processed and discounted your doctor will bill you for the amount you owe.

Once the amount you pay meets your AHP for the year, your eligible medical bills will be approved for sharing.

Health Incentive

Families may take up to 3% off their monthly share amount by qualifying for the health incentive.

To qualify, all adult Medi-Share members in the household must meet certain health criteria, including:

• Blood pressure under 121/81
• Abdominal circumference of <38″ for men and <35″
• BMI between 17.5 and 25

You need to complete an online health form at the time of application (or upon re-review) in order to secure the discounted rate.

It was this health incentive which has helped spur me to lose some weight over the past couple of years—and it put money back in my pocket in addition to improving my health!

Medi-Share Coverage

Below is a quick breakdown of what Medi-share will and will not cover as of October 2021.

More details about Medi-Share coverage can be found in their guidelines. The member-approved guidelines detail the program requirements, qualifications, and what sharing is covered.

What Medi-Share Does Cover

Here a few of the medical expenses that are eligible for sharing with Medi-Share.

• Doctors visits
  • Medi-Share offers free telehealth access. Talk to virtual doctors at absolutely no cost to you via MDLIVE.
  • If you need to see a doctor in person, choose a physician that is a member of PHCS, Medi-Share’s preferred primary provider organization (PPO). You’ll pay a $35 provider fee that does not count towards your AHP. And you’ll also eligible for in-network discounts.
• Emergency room visits: Members must pay a $200 provider fee that does not count towards your AHP.
• Hospitalizations: Members must pay a $35 provider fee per hospital visit that does not count towards your AHP.
• Prescriptions: Up to 6 months of FDA-approved prescription drugs per eligible treatment.
• Maternity:
  • Sharing is limited to $125,000 for any single pregnancy event.
  • To be eligible, your AHP must be $3,000 or higher and you must have faithfully shared from the month of conception through the month of delivery.
• Well-child care: Sharing for routine well-child care is eligible until the child reaches the age of six.
• Professional Counseling Services: Free mental health counseling is available through a Medi-Shares preferred provider. Mental health calls are limited to 30 minutes but you are allowed unlimited visits.
• Physicals – Each member is allowed one physical per year for sharing. The physical includes sharing for two labs—a basic Lipid panel and Hemoglobin A1C.
• Adoption costs: For members who meet certain criteria, up to two adoption events can be shared per household.
• Senior assist: Seniors with Medicare Parts A and B can enjoy the benefits of healthcare sharing of medical bills that Medicare doesn’t pay, including copayments, deductibles, hospitalization and out of country urgent care.
• Disability expenses: Through their Manna program, Medi-Share is able to replace up to 80% of lost income for up to a year for Manna members.
• Final expenses: Up to $5,000 of funeral expenses are eligible for sharing.

What Medi-Share Does NOT Cover

Ok, so now let’s take a look at a few of the expenses that aren’t eligible for sharing with Medi-Share:

• Dental, vision, and hearing: While these expenses aren’t eligible for sharing, Medi-Share does give members savings cards that provide exclusive discounts.
  • Dental: Save 20% to 60% on most dental procedures.
  • Vision: Save up to 30% on eye exams, glasses, contact lenses, and LASIK surgery.
  • Hearing: Save 30% to 60% on hearing aids.
• Routine and preventive care: Including physicals, immunizations, vaccines, mammograms, some lab studies, and colonoscopies.
• Fertility/infertility care: Including birth control, infertility testing, and sterilization.
• Alternative care: Including vitamins, acupuncture, and experimental treatments.
• Some Counseling: Including dietary counseling, diabetic counseling, lactation counseling, or genetic counseling.
• Behavioral or mental care
• Cosmetic procedures
• Non-prescription drugs
• Hearing aids

Medical Expenses Eligible for Limited Sharing

The following expenses are eligible for sharing under certain situations, such as when ordered by a certified physician, when medically necessary, or when supported by current medical treatment standard of care.

• Ambulance (or other medical transport services)
• Cardiac rehabilitation (up to 36 sessions)
• Chiropractic care
• Durable Medical Equipment (DME)
• Genetic testing
• Home care (limited to 60 calendar days)
• Non-hospital admissions
• Outpatient speech therapy (up to 10 visits)
• Physical therapy (up to 20 visits)
• Prostheses
• Psychiatric or primary care evaluation
• Sleep apnea studies

Advantages of Medi-Share

Let’s explore some of the positives of this sharing program.

Escape the Market Altogether

Before Obamacare came along, I used to pay $300 a month for a $10,000 deductible health insurance policy.

I am self-employed and make a solid income. However, once the law was passed, my monthly premiums shot up to $1,100 a month!

With the future of American health insurance still being unclear, you may feel uncomfortable with a system that is being tinkered with in real-time and Medi-Share allows you to leave it all behind.

You Can Join Anytime

That’s right. You can apply for Medi-Share and join it anytime during the year.

With the implementation of Obamacare, you were forced to join within their open enrollment period, which runs from November 1 to December 15, unless you have a change in status (moving, having a baby, etc).

You may be looking at this review during open enrollment but understand you can jump on Medishare anytime during the year. And you don’t need one of the special exemptions to make the move.

It’s Significantly Cheaper

Compared to unsubsidized health insurance under Obamacare, Medi-Share is a huge money saver.

My own family’s switch has shown very significant savings (see below for details).

Medi-Share is affordable compared to health insurance because they can be more discriminate in who they serve.

Direct Primary Care

Starting December 1, 2020, Medi-Share gives members access to Direct Primary Care (DPC) by allowing DPC fees to be submitted for sharing.

To be eligible, you must be under the new $12,000 AHP (see below for the new AHP program options). Only $1,800 of your DCP fees are qualified for sharing. 

DPC is a way to receive primary medical care for a fixed monthly or quarterly fee. The fee can range from $50-$100 per month and be applied to your AHP. Fees vary based on if you are single or have a family and your location.

Services provided under a DPC will depend on your provider and include office visits, vaccines, lab work, and annual physicals.

The focus of DPC is primary care and usually does not cover emergency or specialty medical services.

It’s a good fit to save money on routine primary care with the higher $12,000 AHP option.

Disadvantages of Medi-Share

However, there are some disadvantages to Medi-Share, too:

No Health Savings Account (HSA) Contributions

Since Medi-Share is not insurance, you can’t qualify for a health savings account, or HSA.

HSA’s as you know, require you to have a high-deductible health insurance plan. This was a major bummer for me. I was really enjoying the annual tax deduction from contributions to our HSA.

Now, Medi-Share is working with Congress on a bill which might allow HSAs to be used with sharing programs. I’m contacting my Representative to ask him to support this.

Also, don’t worry if you already have funds in an HSA. You can still use them for qualifying medical expenses.

We plan to use ours for expenses which aren’t covered by our particular Medi-Share plan.

No Tax Deductions

Health insurance premiums are tax-deductible. Medi-Share contributions are not.

That said, medical expenses are still deductible, subject to a threshold based on a percentage of your adjusted gross income, or AGI.

Have a business with a few employees? You may be able to deduct the cost of reimbursing them for their Medi-Share monthly share.

I did this myself by setting up a QSEHRA.

Medical Providers May Not Want to Bill Medi-Share

There have been a few anecdotal cases of doctors and hospitals refusing to bill Medi-Share, and instead, asking the patient to pay out-of-pocket. In some cases, this may stem from the fact the PHCS network Medi-Share uses is not the universal PHCS provider network.

It’s incumbent on Medi-Share Members to call PHCS directly to confirm the provider you want to see is covered under the Medi-Share PHCS system.

That said, the anecdotes of providers being unwilling to bill Medi-Share have still had happy endings. In particular, this mother’s cancer treatment was prepaid by Medi-Share at self-pay rates after the provider initially refused to accept the plan.

The health share ministry made sure to come through for her.

However, receiving a huge out-of-pocket bill from a provider can come as a shock to a family who has already paid their full portion.

Since you want to be focused on getting well rather than on finances, this bears keeping in mind.

Join Medi-Share Today.

Is Medi-Share Good?

Yes, Medi-Share is good. It works to meet the needs of my family’s medical expenses, but it’s important to understand how Medi-Share works to make that decision for yourself.

My tithe to the Church or individual giving through certain charities is how I take care of that.

Medi-Share is simply sharing among believers. To have the right to share, you have to be a believer and living an active Christian lifestyle.

1. No coverage for medical expenses related to unbiblical (i.e. not Christ-like) activities

Get injured in an accident where you were driving drunk? No coverage.

Get an STD from an extra-marital affair? No coverage.

Use tobacco? No coverage.

When you join Medi-Share, you agree to live your life according to biblical principles.

2. You must have a Christian faith and be attending church regularly

To participate in the program you’ll need to sign a form professing your faith and share your Church information.

3. Restrictions for maternity expenses

Expecting? Don’t expect to just jump on Medi-Share six months in and get full coverage.

You can have children on the plan, but to get full coverage you will have to be participating in the plan before you get pregnant.

Otherwise, coverage has limitations.

4. Restrictions for pre-existing conditions

Common sense dictates to make Medi-Share work, you can’t just have people jumping on the program after they discover a major medical need.

But Medi-Share members can receive up to $100,000 per year for pre-existing conditions once they’ve been faithfully sharing for at least 36 consecutive months.

And, they can receive up to $500,000 per year once they’ve been sharing for 60 consecutive months.

What Does Medi-Share Cost?

The cost of Medi-Share depends on your age, family size, marital status, the AHP you select, and the state you live in. 

I’m in my early 40’s with a wife and three kids. As a family, we pay ~$300 a month and have a $10,500 Annual Household Portion (i.e. our Medi-Share “deductible”).

For a lower deductible, like $3,000, then your monthly payment would be $928.

Here’s a chart based on my age and number of people on the plan:

We used to pay $1,100 a month with Humana.

So in just the first seven months of being with Medi-Share, we had already saved $4,388!

Here’s how that breaks down:

• With Obamacare, we would have paid a minimum of $7,700 ($1,100 x 7 months) in premiums.
• With Medi-Share, we’ve paid $1,960 ($280 x 7 months) in premiums.
• Copays are roughly the same under both plans.
• With Medi-Share we’ve paid roughly $70 each for five sick visits for the kids, and $475 each for the two well visits (six months and nine months) for our son. This totaled up to roughly $1,352.83. The well visits were a shock, but still not as shocking as an Obamacare premium.

Here’s a screenshot of our deductible (annual household portion) usage as of our first year with Medi-Share:

New Medi-Share AHP Levels

As of fall 2020, Medi-Share is offering new AHP levels. The updated AHP options are for new and existing members. However, current members must elect to change their AHP to a new level. There are now only four AHP program options.

• $3,000
• $6,000
• $9,000
• $12,000

You can review the potential pricing and program levels to compare your options using the Medi-Share calculator. 

Medi-Share Fees

There are other fees associated with becoming a Medi-Share member to consider in your budget. Here are some of the additional costs.

One-Time Fees

• $50 application fee
• $120 new member fee (paid with your first share payment)
• $2 administrative (set up new accounts) fee

Monthly Fees

If it’s determined that you’re at a higher risk for disease, you could be required to become a Health Partner, which is an additional cost of $99 per month.

Medi-Share Mobile App

Available on iOS and Android, the mobile app gives you access to your membership information anytime, anyplace.

It may not be the smoothest running app, but there are basic features that can come in handy.

With the Medi-Share app, you can:

• Search for providers
• Access your member cards
• Schedule telehealth appointments
• Visit and chat with telehealth doctors
• Connect and interact with community members
• Track medical bills
• Get customer support

Medi-Share vs. Traditional Health Insurance

Medi-Share operates closely to how traditional health insurance works but with some differences. Often healthcare sharing programs have similar features but just with different names to avoid confusion with traditional insurance. There are some key features of traditional insurance plans that Medi-Share does not have and vice versa. Here’s how Medi-Share compares to traditional health insurance. 

Medi-Share and Traditional Insurance Similarities

• PPO network – Both offer access to a network of providers to reduce care costs. Like traditional health plans, Medi-Share members pay more if they go out of the network for care.
• Deductibles – Just like traditional deductibles, Medi-Share AHP is what you will pay before you can share covered expenses.
• Monthly payments – With Medi-Share, you’ll pay a share amount, which is equivalent to a monthly premium for traditional health insurance.
• Visit fees – Copays—Medi-Share calls them provider fees—are paid when you visit the doctor.
• Telemedicine – Many traditional plans also offer virtual doctor visits at no cost, similar to telehealth with Medi-Share’s MDLive.

Medi-Share and Traditional Health Insurance Differences

• • Enrollment – There is no enrollment period for Medi-Share. You can join their healthcare sharing program anytime.
  • Biblical standards – Medi-Share members must live under Biblical standards, which is not a requirement under traditional health insurance.

• Preventative care – Traditional plans are required with Obamacare to cover ten essential health benefits (EHB) at no cost. Preventative and wellness services is one of the EHBs. Medi-Share has the $35 provider fee for preventive care appointments. Sharing is not available for immunizations and lab work that might typically fall under a wellness checkup.

• Pre-existing conditions – Medi-share covers some pre-existing medical conditions, but it may have limits on sharing eligibility. Medical conditions diagnosed before joining Medi-Share are eligible for sharing if you haven’t had symptoms or treatment in the last three years. If you require treatment for the pre-existing condition later, there may be limits to your sharable amount. Traditional health insurance does not allow you to be denied coverage or charged additional costs for preexisting conditions.

• Health Partner – Medi-Share charges an additional $99 per month if you are deemed to be at higher risk for health problems. Under Obamacare, your health and medical history cannot increase your monthly premium.
• Tax deduction – Under traditional health insurance, monthly premiums are tax-deductible. Medi-Share’s monthly sharing contributions are not deductible. However, that could change in 2022 if the Certain Medical Care Arrangements passes. But for now, remember, you can deduct medical expenses based on a percentage of your AGI.
• HSA – Since it is not insurance, you cannot qualify for an HSA with Medi-Share. The good news is, funds already in an HSA, you can still be used for qualifying expenses.

Enroll in Medi-Share.

Medi-Share vs. Short-Term Health Insurance

Short-term health insurance is a temporary solution to meet your health care needs.

It provides you with insurance coverage when you are between health insurance or when you need insurance, but are outside the enrollment period. 

Medi-Share and Short-Term Insurance Similarities

• Temporary health insurance is similar to Medi-Share because neither falls under the standards for Obamacare.
• Neither Medi-Share nor temporary insurance has to meet the requirements of minimal essential coverage.
• They both also have higher deductibles or AHP.
• Enrollment in both Medi-Share and short-term health insurance is available all year.

Medi-Share and Short-Term Insurance Differences

• Short-term insurance typically only lasts 1 to 12 months, while Medi-Share does not end.
• Temporary health insurance usually only covers preventative, urgent, and emergency care and not maternity coverage or mental health. Medi-Share does cover pregnancy and offers free mental health counseling through telehealth.
• Term health insurance does not cover pre-existing conditions but Medi-Share does with some limitations.

Medi-Share vs. Concierge Plans

Concierge healthcare or concierge medicine is similar (but different) to DPC in that you pay a monthly fee for medical care.

But concierge plans can accept insurance payments and Medicare where DPC does not. 

Direct Primary Care focuses on saving money while concierge medicine costs more but provides more personalized medical care and premium services like longer office visits and shorter wait times. Because concierge medicine accepts insurance, they will submit claims to Medi-Share.

Is Medi-Share Right for You?

There’s a lot on the line when it comes to your family’s medical needs.

Take plenty of time to evaluate all of the pros and cons of the program and don’t forget to consider your long-term plans.

1. Are you having more children?
2. Will you be getting married soon?
3. Are you about to retire and qualify for Medicare?

All these things and more make a difference.

Medi-Share makes sense for my family because:

• We are self-employed Christians and don’t mind being obligated to the coverage restrictions related to lifestyle.
• Our income will likely exclude us from being subsidized in the Obamacare health insurance marketplace; Medi-Share gives us considerable monetary savings.
• We don’t have pre-existing conditions and we don’t plan on having any more children (i.e. we don’t have maternity care needs).

How to Join Medi-Share

It takes a while to go through the application process so leave yourself plenty of time.

Here are the major steps:

1. Click this link.
2. Use the Share Calculator to pick the best AHP for you.
3. Apply.
4. Complete the medical forms and testimony of faith.
5. Complete the power of attorney for the share account (set up with a credit union).
6. Make your first share payment.

The Bottom Line

While Medi-Share isn’t insurance, it could be a great way to save on healthcare costs this year.

If you qualify for subsidized health insurance, your monthly payments may already be affordable.

But if you’ve been paying for unsubsidized health insurance, Medi-Share could save you a ton of money.

Are you a Medi-Share member? If so, please share your experiences in the comments!