Christian Healthcare Ministries is not insurance. It is a health care sharing ministry — a nonprofit membership organization where members contribute monthly amounts and those funds are used to share other members’ eligible medical bills. CHM is one of the oldest and largest organizations of its kind in the United States, and it has operated since 1981. Members join as a way to handle medical costs outside the traditional insurance system, usually for religious reasons.
That distinction matters more than most marketing language suggests. Health care sharing ministries are not regulated as insurance in most states. They are not required to cover the same benefits, they can set limits on what they share, and they do not carry the same legal obligations to pay claims that licensed insurers do. Whether CHM is the right fit depends on what a person needs from their health coverage and how much financial risk they can absorb.
What Is Christian Healthcare Ministries and How Does It Work?
CHM is a nonprofit health care sharing ministry based in Barberton, Ohio. Members pay a monthly contribution — CHM calls it a “share” — and that money goes into a pool used to pay eligible medical bills submitted by other members.
The structure is closer to a cooperative than to an insurance company. There is no underwriting, no pre-existing condition exclusion in the traditional insurance sense, and no network of contracted doctors. Members pay providers directly and then submit bills to CHM for sharing, subject to the program’s rules.
CHM offers several membership levels, which it calls Gold, Silver, and Bronze programs, along with a “Brother’s Keeper” add-on for catastrophic costs. Each level has different monthly contribution amounts and different per-incident sharing limits. The specific dollar figures change periodically, so anyone considering membership should check CHM’s current published guidelines rather than rely on older numbers.
A few features distinguish CHM from typical insurance:
- Members choose their own doctors and hospitals. There is no provider network.
- Bills are shared up to a per-incident maximum. Costs above that limit are generally the member’s responsibility unless they have enrolled in the additional catastrophic program.
- CHM states that it shares eligible bills regardless of whether the member has other insurance, which means it can function as a supplement rather than a replacement.
- Membership requires a statement of Christian faith and regular church attendance.
Is Christian Healthcare Ministries Insurance Under the Law?
No. Under federal law and the laws of most states, health care sharing ministries are not insurance. This is a legal classification, not a marketing distinction.
The Affordable Care Act included a specific provision for health care sharing ministries. Members of a ministry that has been in continuous existence since December 31, 1999, are treated as having minimum essential coverage for purposes of the individual mandate. That provision mattered more when the federal penalty for being uninsured was still in effect. The federal penalty was reduced to zero starting in 2019, though a few states have their own individual mandate requirements with different rules.
The legal status also means ministries operate outside state insurance departments. They are not required to maintain the reserves that insurers must hold, and they are not backed by state guaranty associations that protect policyholders if an insurer fails. Disputes over whether a bill should be shared are generally handled through the ministry’s internal process, not through state insurance regulators.
This is the single most important thing to understand: the word “sharing” is doing real work here. Members are not policyholders with contractual coverage rights in the way an insurance policyholder is.
How Does CHM Compare to Traditional Health Insurance?
The differences go well beyond monthly cost. The table below summarizes the main structural contrasts.
| Feature | Christian Healthcare Ministries | Traditional Health Insurance |
|---|---|---|
| Legal status | Health care sharing ministry, not insurance | Regulated insurance product |
| State regulation | Generally not regulated as insurance | Regulated by state insurance departments |
| Guaranteed payment | No legal obligation to share a bill | Contractual obligation to pay covered claims |
| Provider network | None — members see any provider | Usually a defined network |
| Pre-existing conditions | Generally shareable, subject to program rules | Must be covered under ACA-compliant plans |
| Preventive care | Limited sharing, varies by program | Required to be covered at no cost under ACA-compliant plans |
| Backstop if the organization fails | None | State guaranty association |
One point that often gets lost: ACA-compliant plans are required to cover a set of essential health benefits, including preventive care, maternity care, mental health services, and prescription drugs. Health care sharing ministries are not bound by those requirements. CHM’s programs share some of these costs and not others, and the details are set by the ministry, not by law.
What Does CHM Actually Share and What Does It Not?
CHM publishes guidelines describing which medical expenses are eligible for sharing. The general categories include hospital stays, surgery, physician visits, and certain other medical costs, up to the per-incident limit for the member’s program level.
What is not shared is just as important. CHM’s guidelines have historically excluded or limited sharing for things like routine preventive care, some prescription medications, and certain conditions or treatments. The specifics change, and they vary by program level. Anyone evaluating CHM should read the current guidelines directly rather than rely on secondhand summaries.
There is also a practical wrinkle that surprises new members. Because there is no network, providers bill the member at whatever rate they charge. Insurance companies negotiate discounted rates with in-network providers; CHM does not. Some providers offer cash or self-pay discounts, but the member has to ask. In practice, the amount a member owes a hospital can be higher than what an insurer would have paid for the same service, even after sharing.
Who Is Christian Healthcare Ministries a Good Fit For?
CHM tends to appeal to people who are generally healthy, want to avoid traditional insurance for religious or philosophical reasons, and can handle the financial uncertainty that comes with a sharing arrangement.
It is a less comfortable fit for people with significant ongoing medical needs, people who want the legal protections of regulated insurance, or anyone who would struggle to cover costs above the per-incident sharing limit. It is also worth being clear about one thing: CHM is not a substitute for Medicaid or for coverage through an employer or the ACA marketplace in terms of guaranteed benefits. It is a different kind of arrangement entirely.
Some members use CHM alongside a traditional high-deductible plan or a catastrophic policy. Others use it as their only health cost arrangement. Both are common, and both carry trade-offs that depend on individual circumstances.
What Are the Risks of Relying on a Health Care Sharing Ministry?
The main risk is financial. If a medical bill exceeds what the ministry shares, the member is responsible for the difference. If the ministry’s sharing pool is strained, sharing may be prorated or delayed. These are not hypothetical concerns — they are structural features of how sharing ministries work.
There is also the question of what happens if the organization itself runs into trouble. Because ministries are not backed by state guaranty associations, members do not have the same backstop that policyholders of a failed insurer would have.
None of this means CHM is unreliable. It has operated for decades and has a long track record. But the arrangement is genuinely different from insurance, and the difference is not just terminology. Anyone considering it should read the current member guidelines carefully, understand the per-incident limits, and think honestly about whether they can absorb costs that fall outside what is shared.
Frequently Asked Questions
Is Christian Healthcare Ministries insurance?
No, CHM is a health care sharing ministry, not an insurance company. It is not regulated as insurance in most states and does not carry the same legal obligation to pay claims that a licensed insurer does.
Is CHM considered minimum essential coverage under the ACA?
Yes, members of qualifying health care sharing ministries are treated as having minimum essential coverage under the Affordable Care Act. The federal individual mandate penalty was reduced to zero starting in 2019, though a few states have their own requirements.
Does Christian Healthcare Ministries cover pre-existing conditions?
CHM generally shares eligible bills related to pre-existing conditions, subject to its program rules and per-incident limits. The specifics vary by membership level, so members should check current guidelines.
Can I use CHM instead of health insurance?
Some members use CHM as their only health cost arrangement, but it is not a legal substitute for insurance in the sense of guaranteed benefits. It lacks the benefit requirements and regulatory protections that apply to ACA-compliant plans.
