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Health sharing explained (not insurance)

How health care sharing ministries work, how they differ from insurance, and the notice Tennessee law requires.

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Health sharing is not insurance. Health care sharing ministries are not insurance companies, are not regulated as insurance in Tennessee (Tenn. Code Ann. § 56-7-116), are not ACA Marketplace plans, and do not qualify for premium tax credits. Tennessee notice (Tenn. Code Ann. § 48-51-201): "Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payments for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills."

What health sharing is

A health care sharing ministry is a group of members with shared religious or ethical beliefs who agree to help pay each other's eligible medical bills. Members make a monthly contribution, often called a share amount, and the organization's guidelines decide which bills are eligible for sharing.

Tennessee law says a sharing ministry is not engaged in the business of insurance (Tenn. Code Ann. § 56-7-116) and requires the notice above (Tenn. Code Ann. § 48-51-201).

How it differs from an ACA plan

ACA Marketplace health insuranceHealth sharing (not insurance)
Is it insurance?Yes, regulated insuranceNo
Guaranteed payment of covered claims?Yes, under the policyNo. Sharing is voluntary
Pre-existing conditionsCovered; can't be deniedOften limited or excluded for a period
Premium tax creditsAvailable if eligibleNot available
Essential health benefits required?YesNo; guidelines decide what is shared
Who regulates it in TennesseeDept. of Commerce & InsuranceNot regulated as insurance

Who considers it, and the risks

People who don't qualify for a tax credit and find full-price premiums hard to afford sometimes look at sharing. Before joining, read the guidelines closely: what isn't shared, limits on pre-existing conditions, per-incident amounts you pay first, and what happens if bills go unshared. You remain responsible for your own medical bills. If you have ongoing health needs, an ACA plan is usually the safer choice.

Chuck will explain how both options work so you can decide. He won't describe sharing as insurance.

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Health sharing is not insurance. Health care sharing ministries are not insurance companies, are not regulated as insurance in Tennessee (Tenn. Code Ann. § 56-7-116), are not ACA Marketplace plans, and do not qualify for premium tax credits. Tennessee notice (Tenn. Code Ann. § 48-51-201): "Notice: The organization facilitating the sharing of medical expenses is not an insurance company, and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. As such, participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive any payments for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills."

Common questions

Is health sharing insurance?
No. Tennessee law says health care sharing ministries are not engaged in the business of insurance, and they must tell members that participation should never be considered insurance.
Can I use a premium tax credit for health sharing?
No. Premium tax credits only apply to Marketplace health insurance plans.
Talk it through with a licensed Tennessee agent. Free, no-pressure help comparing your options, by video or phone.
Book a free video or phone consultation

Sources

  1. Tennessee Pub. Ch. 526 (2024), House Amendment 0125 to HB1163, amending Tenn. Code Ann. § 48-51-201 and adding § 56-7-116. https://www.capitol.tn.gov/Bills/113/Amend/HA0125.pdf
  2. Tennessee Department of Commerce & Insurance, Health Care Sharing Ministries. https://www.tn.gov/commerce/insurance/consumer-resources/healthcare-sharing-ministries.html
  3. HealthCare.gov glossary, Premium tax credit. https://www.healthcare.gov/glossary/premium-tax-credit/

Checked October 24, 2026.