Most self-employed people should not rely on health sharing plans as their main coverage. Health sharing ministries are not insurance: they have no legal obligation to pay claims, can exclude pre-existing conditions, and are not regulated by Florida’s insurance office. They may fit a narrow group of healthy people with strong savings who don’t qualify for ACA subsidies.
If you’re self-employed in Florida and shopping for health coverage, you’ve probably come across health sharing plans — sometimes called health sharing ministries or healthcare sharing programs. They advertise lower monthly costs, no network restrictions, and a community-driven approach to covering medical bills. For someone staring down a full-price ACA premium with no employer picking up any of it, especially now that enhanced subsidies have expired, the pitch is understandably attractive. But before you sign up, it’s worth understanding exactly what these programs are, what they are not, and where they’ve left members in a very difficult spot.
What Health Sharing Plans Actually Are
Health sharing ministries are member-funded organizations — most of them faith-based — where members pool their monthly contributions to share each other’s eligible medical costs. When a member has a qualifying medical bill, they submit it to the organization, which distributes the cost across the membership.
The critical distinction: health sharing plans are not insurance. They are not regulated by the Florida Office of Insurance Regulation. They do not have to comply with ACA rules. They are not required to cover pre-existing conditions. And they have no legal obligation to pay your claims. That last point is the one that catches people off guard.
Major national programs include Liberty HealthShare, Sedera, Altrua HealthShare, and Solidago Health. Some require members to sign a statement of faith or agree to specific lifestyle guidelines — including abstaining from tobacco, alcohol, or illicit drugs — as a condition of membership. Violation of those guidelines can result in claim denial.
The Appeal: Why Self-Employed People Consider Them
The reasons health sharing plans attract self-employed individuals are real:
- Lower monthly costs: Monthly “share amounts” (the equivalent of premiums) are often lower than full-price, unsubsidized ACA premiums
- No network restrictions: You can typically see any provider willing to bill the organization, which appeals to people with established doctor relationships
- No enrollment windows: You can usually join at any time, unlike the ACA marketplace
- Faith-based community: For members aligned with a particular worldview, there’s an appeal in a values-based approach to healthcare
For a healthy 35-year-old freelancer with no chronic conditions, no dependents, and solid cash savings, those factors carry genuine weight.
The Risks You Need to Understand Before You Enroll
This is where the honest assessment gets uncomfortable — but it’s the part that matters most.
No Legal Obligation to Pay
Because these are not insurance contracts, the organization has no legal obligation to reimburse your medical bills. If the membership pool runs short, or if your claim is deemed ineligible, you are responsible for the full bill. Some programs have failed to pay millions of dollars in member claims. Others have gone bankrupt entirely, leaving members with unpaid hospital bills and no recourse.
Pre-Existing Condition Exclusions
Most health sharing plans exclude pre-existing conditions for an initial waiting period — typically one to three years. During that window, any medical cost related to a condition you had before joining is entirely your responsibility. Unlike ACA plans, which are legally prohibited from denying coverage based on health history, health sharing ministries have no such restriction.
Coverage Gaps
Even after the waiting period, many sharing plans do not cover — or severely limit — the following:
- Mental health and substance use disorder treatment
- Prescription drugs (especially ongoing medications)
- Contraception and reproductive health
- Preventive care that doesn’t result in a finding
- Experimental or alternative treatments
Benefit caps are also common — some plans cap annual or per-incident sharing amounts, and a serious illness or trauma injury can exceed them. ACA plans, by contrast, have no annual or lifetime caps on essential benefits and cap your in-network out-of-pocket costs at $10,600 (2026) or $12,000 (2027) for an individual.
Florida Offers No Consumer Protections
Florida does not regulate health sharing ministries. If a plan declines your claim, misrepresents its coverage, or shuts down with your money, the Florida Office of Insurance Regulation has no jurisdiction. Your complaint options are extremely limited compared to a licensed insurance carrier.
Real-World Outcomes
There have been well-documented cases of health sharing ministries denying large claims, retroactively reclassifying conditions as pre-existing, or simply becoming insolvent. Members facing serious illnesses have reported large claims going unpaid. Without the regulatory framework that applies to actual insurance carriers, members have little recourse beyond civil litigation — an option that is rarely cost-effective against a claim denial.
This doesn’t mean every health sharing ministry operates this way. Some members report positive experiences, particularly for straightforward, non-complex medical events. But the asymmetry of risk — you handle the premium equivalent, they handle whether to pay — is not comparable to a regulated insurance product.
When It Might Make Sense
There is a scenario where a health sharing plan functions reasonably well as part of a broader strategy:
- You are genuinely healthy with no significant medical history
- You have no dependents whose health history might trigger exclusions
- You have substantial cash reserves to cover gaps, denials, or deductible-equivalents
- You pair membership with a Direct Primary Care (DPC) membership, which provides primary care visits for a flat monthly fee, reducing day-to-day healthcare costs (see can self-employed people use direct primary care)
- You genuinely do not qualify for ACA subsidies (for 2027 coverage, income above roughly $63,840 single) and the unsubsidized premium is significantly higher
Even in this scenario, entering with clear eyes about the risks is essential. Read the membership guidelines, the sharing guidelines (not just the marketing brochure), and research the organization’s history of paying claims before you commit. Our overview of what a MediShare plan is and how it compares goes deeper.
The Honest Bottom Line for Most Floridians
For the majority of self-employed Floridians — especially those with any health history, prescription needs, mental health coverage requirements, or dependents — an ACA marketplace plan with premium tax credits is both safer and, when subsidies are factored in, often comparably priced. A subsidized plan comes with full ACA protections, a defined formulary, mental health parity, and guaranteed renewability. Subsidies apply from 100% to 400% FPL; see do self-employed people qualify for subsidies. Earn too much for help? Off-exchange ACA plans and a careful marketplace vs. private insurance comparison are worth a look.
The self-employed health insurance deduction also generally allows you to deduct 100% of your health insurance premiums, up to your net self-employment profit, — further closing the gap with any sharing plan’s apparent cost advantage.
Get a Real Comparison Before You Decide
Frequently Asked Questions
Is a health sharing plan the same as health insurance?
No. Health sharing ministries are not insurance. They are not regulated by the Florida Office of Insurance Regulation, do not have to follow ACA rules, can exclude pre-existing conditions, and have no legal obligation to pay your medical bills. Members share costs voluntarily under the organization’s guidelines.
Do health sharing plans cover pre-existing conditions?
Often not, at least at first. Many sharing ministries exclude or limit pre-existing conditions for a waiting period, commonly one to three years, and some limit them permanently. ACA-compliant plans, by contrast, cannot deny coverage, charge more, or exclude treatment because of your health history.
Can I switch from a health sharing plan to an ACA plan?
Yes, but timing matters. Leaving a health sharing ministry generally does not trigger a Special Enrollment Period, because sharing plans are not qualifying coverage. You can switch to an ACA plan during Open Enrollment, which for 2027 coverage runs November 1, 2026 through January 15, 2027, or sooner if you have another qualifying life event.
When might a health sharing plan make sense?
It may fit a narrow situation: a healthy person with no dependents, no significant medical history, and substantial savings who does not qualify for ACA subsidies and faces a much higher full-price premium. Even then, read the sharing guidelines closely and check the organization’s track record of paying claims.
Weighing a health sharing plan against an ACA Marketplace plan? Get an honest side-by-side comparison first. Talk with Michael McAllister, owner of Choice Health Insurance Brokers in DeLand and a licensed broker appointed with 200 carriers (NPN 18229135). Call or text 321-230-9536 or visit choice.healthcare to get started.