Affordable Alternative, a plain-language guide for people weighing their options when marketplace premiums or COBRA costs no longer fit the budget.
ACA marketplace premiums are up sharply for 2026, some by more than 100 percent, after pandemic-era subsidies expired at the end of 2025 with no sign of returning. Millions of people without employer coverage are paying full price, or going without coverage at all.
Meanwhile, healthcare sharing, a nonprofit model where members contribute monthly to cover each other’s medical expenses, grew from about 160,000 participants in 2014 to an estimated 1.7 million today. The industry has existed for over 40 years, but has been relatively unknown.
This article is for anyone discovering and evaluating healthcare sharing as an alternative to ACA marketplace plans, COBRA health insurance, or even employer coverage. It covers how the model actually works, whether it holds up as a legitimate option, what it typically covers and doesn’t cover, and how to evaluate a specific organization before joining.
How Does Healthcare Sharing Work?
A healthcare sharing ministry (HCSM) is a nonprofit organization whose members contribute a set amount each month to share one another’s eligible medical expenses. These monthly contributions are held in an escrow account and used to cover all members’ eligible medical expenses, in contrast with traditional insurance premiums, which fund insurance companies’ contracts.
Similar to health insurance, when a member needs care, they present a membership ID card to a participating provider and pay a set consult fee. From there, the healthcare sharing organization reviews the provider’s bill, applies a threshold that functions similarly to a deductible, and sends those eligible amounts directly to the provider. The member then receives a statement showing what, if anything, is still owed.
Not every healthcare sharing organization or ministry runs billing the same way, but the strongest ones operate similarly to traditional insurance for everyone involved: the member, the doctor, and the hospital. For example, WeShare Health, a nonprofit healthcare sharing organization founded in 2018 to make healthcare simpler, more affordable, and more human, partners with the nation’s largest individual PPO network, giving members access to more than 1 million providers at pre-negotiated rates and the ability to fill prescriptions at over 68,000 CVS Caremark Pharmacies. Most of WeShare Health’s members are able to keep their preferred providers because their network is so extensive.
“I spent over two decades inside the insurance industry, giving me a direct view of where the system fails the people it is supposed to serve,” said Christopher Jin, Founder and CEO of WeShare Health. “Healthcare sharing exists because people need a safe, trusted, and transparent way to handle medical expenses, without the complexity and costs that price many people out of healthcare.”
Is Healthcare Sharing a Legitimate Alternative to ACA Insurance?
Yes, and it’s more established than most people assume. The category has served people for more than forty years, structurally and legally distinct from insurance, with roots that trace to Amish and Mennonite communities in the early 1900s pooling money to cover neighbors’ medical needs. That practice has since been formalized nationally. The U.S. Department of Health and Human Services now recognizes more than 100 such healthcare sharing organizations.
How Can Healthcare Sharing Ministries and Organizations be Evaluated?
When considering a healthcare sharing Ministry or Organization, members should do their due diligence and evaluate six areas:
- Nonprofit status, certification and governance: Confirm the organization is a registered nonprofit certified by the U.S. Department of Health and Human Services and ask how shared dollars are accounted for.
- Track record at scale: Determine how many members the organization has served and the total amount of medical expenses shared.
- Independent, verifiable reviews: Check ratings posted by actual users on reputable third-party sites, such as Google Reviews and TrustPilot.
- Contribution stability: Ask how often the organization increases monthly contributions, and choose an organization whose rates have remained similar or unchanged for long periods of time.
- Program fit: Ensure membership guidelines are published before enrollment, not after, and review them to determine the best option that fits your anticipated needs.
- Payment process: Determine who is responsible for handling provider billing and rate negotiation – the member or the healthcare sharing organization
“No one should have to argue with a billing office while they’re sick,” Jin said. “That’s why the WeShare Health team handles provider negotiations and advocates against unfair bills for our members.”
What Doesn't Healthcare Sharing Cover?
Commonly excluded categories include pre-existing conditions during a waiting period, elective or non-medically necessary cosmetic procedures, certain preventive care, and prescription drugs, though specifics vary by organization and largely mirror what traditional insurance itself often limits. Pre-existing conditions vary the most: many organizations exclude them entirely, while others, such as WeShare Health’s Premier program, offers no waiting periods for pre-existing conditions related to general medical or pharmacy sharing. Instead of assuming what’s included or not covered, those evaluating healthcare sharing options should request an organization’s guidelines document before enrolling, not after a bill arrives.
What Does Healthcare Sharing Membership Actually Cost Compared to ACA or COBRA?
The number that matters is total potential annual cost, not the monthly figure alone: deductibles, copays, prescriptions, and what a household would owe in a high-use year. Limiting sharing to necessary, eligible needs is part of what keeps monthly contributions lower and more stable than traditional premiums, which tend to rise every year. WeShare Health, for example, hasn’t raised its member contribution rates in more than five years, and some members report average annual savings of 30 to 60 percent compared to traditional insurance, though actual savings vary by plan, location, and household.
“People come to us assuming affordable means settling for less,” said Christopher Jin, founder and CEO of WeShare Health. “It doesn’t have to. Lower cost and real access to quality care aren’t mutually exclusive. That’s the whole premise WeShare Health was built on.”
Frequently Asked Questions About Healthcare Sharing as an Alternative to ACA and COBRA
Question: What is healthcare sharing, and how is it different from health insurance?
Answer: Healthcare sharing is a nonprofit, faith-based model where members make a monthly contribution used to help cover all members’ eligible medical expenses, rather than paying a premium to an insurance company. It isn’t insurance: there’s no contract guaranteeing a specific bill gets paid, and requests are reviewed against an organization’s published guidelines rather than an underwritten policy. Contributions are typically 30 to 60 percent lower than comparable traditional coverage. Members still have access to a provider network and pay a set fee at the time of care, similar in structure to a copay.
Question: Is this kind of membership program legal and legitimate in the United States?
Answer: Yes. These organizations operate as legitimate nonprofits, structurally and legally distinct from insurance companies, and the category has served members for more than 40 years. Its roots trace back to Amish and Mennonite communities in the early 1900s, a practice that has since been formalized nationally and recognized by the U.S. Department of Health and Human Services.
Question: My ACA plan premium went up again this year, and I can’t afford it. What are the alternatives?
Answer: There are a variety of alternatives to explore when ACA plan premiums become unaffordable. If this happens to you, consider these options:
- Lower-tier marketplace plans. Bronze or catastrophic coverage carries a lower premium in exchange for higher out-of-pocket costs.
- Looking outside the marketplace. Short-term medical or private individual plans are priced differently but don’t carry ACA protections.
- Healthcare sharing memberships, where a monthly contribution replaces a premium. Some WeShare Health individual members report average annual savings of over $5,000 a year and more for families compared to traditional insurance; actual savings vary by plan, location, and household.
Question: How much does healthcare sharing cost compared to ACA or COBRA?
Answer: Monthly contributions typically run 30 to 60 percent below comparable traditional insurance, and well below COBRA, which requires paying both the employer’s and employee’s share of a former premium plus an administrative fee. WeShare Health advises members that the number that matters most is the total potential annual cost, not the monthly figure alone: deductibles, copays, prescriptions, and what a household would owe in a high-use year. Actual savings vary by organization, program, location, and household health needs.
Question: Can I switch from my ACA plan to a health sharing ministry mid-year or do I have to wait?
Answer: Yes. Healthcare sharing organizations enroll members year-round, with no open enrollment window and no COBRA-style election deadline, because membership isn’t bound by ACA regulatory calendars. Applications approved by an organization’s monthly cutoff typically take effect on the first of the following month. Members can also typically cancel anytime without a lock-in period, though it’s worth confirming the effective date and cancellation notice in writing before ending existing coverage.
Question: What services does this type of healthcare sharing typically include and exclude?
Answer: Healthcare sharing programs commonly help with eligible medical needs such as physician visits, diagnostic services, hospital care, surgery, maternity care and certain preventive services. Exclusions and limitations vary by organization but may include elective or non-medically necessary cosmetic procedures, experimental treatments, certain prescription drugs and services that fall outside the program’s published guidelines.
One important difference is how much a member must pay before sharing begins. WeShare Premier offers a $0 option for eligible medical services, meaning members do not have to first pay a deductible-like amount before sharing begins. Some visit fees may still apply, and prescriptions follow separate program rules.
Pre-existing conditions are another area where healthcare sharing programs differ. Some organizations exclude them entirely or require members to wait before related medical needs can be shared. WeShare Health Premier shares eligible pre-existing conditions, without a separate annual limit specifically for those conditions. Eligibility is determined during enrollment, so applicants should fully disclose their medical history and review the current guidelines before joining.
Question: Is there an option for people with pre-existing conditions?
Answer: Pre-existing-condition policies vary widely: some healthcare sharing organizations exclude them entirely, while others offer a path to sharing. WeShare Health’s Premier program allows eligible pre-existing conditions to be shared without a waiting period or annual limit.
Question: Who handles medical bills and provider negotiations for healthcare sharing programs?
Answer: This varies by organization. Some health sharing ministries expect members to negotiate cash-pay rates with providers directly and submit their own documentation for reimbursement. WeShare Health handles provider billing and rate negotiation on the member’s behalf, so the member isn’t the one debating with a billing office while dealing with a medical issue. This is worth asking before enrolling; these details matter when members are recovering from an already stressful time of illness.
About WeShare Health
WeShare Health is a nonprofit healthcare sharing organization built to make health care simpler, more affordable, and more human. Members contribute monthly to share one another’s eligible medical expenses, and WeShare Health partners with organizations including Noom, BetterHelp, and Amwell to help keep members healthy before they ever need to file a share request. Founded in 2018, WeShare Health has served more than 100,000 members nationwide and shared more than $50 million in medical expenses. Members access a national network of more than 1.2 million physicians at 30 to 60 percent less than comparable traditional insurance. WeShare Health is rated 4.6 out of 5 on Google Reviews and is certified as a Great Place To Work®. For more information, visit www.wesharehealth.org.
