Medi-Share is a health care sharing ministry, not insurance, and what it “covers” works differently than a traditional plan. Members pay a monthly share amount that gets directed toward other members’ eligible medical bills. Eligible expenses include hospitalizations, surgeries, cancer treatment, organ transplants, prescription drugs (up to six months per condition), and FDA-approved testing and treatments. But eligibility depends on more than just the type of care you receive. It also depends on your lifestyle, your membership history, and whether you followed specific steps before seeking treatment.
How Eligible Expenses Are Defined
For a medical expense to qualify for sharing, it must involve a treatment or test approved by the FDA or the Centers for Medicare and Medicaid Services (CMS). The care must be provided by a qualified medical professional. Broadly, eligible categories include inpatient hospital stays, non-emergency surgeries, elective cardiac procedures, cancer diagnosis and treatment, organ and tissue transplants, and specialty medications.
Some of these categories, particularly hospitalizations, surgeries, transplants, and specialty medications, require pre-notification. That means you need to contact Medi-Share before the procedure or treatment occurs. If you skip this step, the expense may not be shared even if it would otherwise qualify.
Medi-Share is also not a pay-anything model. Members must meet their Annual Household Portion (AHP) first, which functions like a deductible. Current AHP options are $3,000, $6,000, $9,000, and $12,000 per household. You’re responsible for medical costs up to that amount each year before other members’ contributions kick in.
Lifestyle and Membership Requirements
This is where Medi-Share diverges most sharply from traditional insurance. Eligibility for sharing is tied to personal conduct. Members must maintain a verifiable Christian testimony, abstain from tobacco and illegal drugs, and limit sexual activity to a Biblical Christian marriage. If your medical need is connected to a lifestyle choice that falls outside these guidelines, the expense won’t be shared.
You also need to provide medical records from the 36 months before your membership start date. Medi-Share uses these to identify pre-existing conditions, which have their own set of rules.
Pre-existing Conditions
Medi-Share defines a pre-existing condition as anything for which you received medical advice, diagnosis, care, or treatment in the five years before your membership began. That’s a broad window, and it captures conditions many people consider resolved or minor.
Costs related to pre-existing conditions are not eligible for sharing during your first 36 months of membership. After that three-year period, eligibility may increase, but only if the condition hasn’t produced symptoms, required treatment, or needed medication during those 36 months. If the condition stayed dormant for the full period, you may become eligible for limited sharing in your fourth year and full sharing in your fifth year.
This is a significant consideration if you have any chronic health issues. A condition like high blood pressure that requires ongoing medication would likely not meet the “no treatment for 36 months” threshold, meaning sharing eligibility could remain limited well into your membership.
Maternity Sharing
Medi-Share does share maternity expenses, but the requirements are strict. You must be married, you must already be a member at the time of conception, and you must select an AHP of $3,000 or higher. If your AHP is set at the $1,000 or $1,750 level, maternity expenses are excluded entirely.
Pregnancies conceived before your membership effective date are not eligible, regardless of when the bills arrive. You’re also required to faithfully pay your monthly sharing contribution every month from conception through delivery. A gap in contributions during that window could disqualify the entire pregnancy from sharing.
Prescription Drug Sharing
Prescription medications are eligible for sharing, but with a clear limit: up to six months of FDA-approved prescriptions per eligible condition. This works well for short-term needs like antibiotics after surgery or a limited course of medication following a diagnosis. It does not function like the ongoing prescription coverage most people are used to from traditional insurance.
If you take maintenance medications for a chronic condition, such as daily blood pressure or cholesterol drugs, you’ll likely be paying for those out of pocket beyond that six-month window. This is one of the most commonly misunderstood aspects of the program.
What Medi-Share Typically Does Not Share
While the program shares many major medical expenses, several categories fall outside its guidelines:
- Pre-existing conditions during the first 36 months, and potentially longer if the condition remains active
- Maternity for unmarried members or those with an AHP below $3,000
- Long-term prescription drugs beyond six months per condition
- Expenses tied to tobacco use, illegal drug use, or sexual activity outside a Biblical marriage
- Treatments not approved by the FDA or CMS, including experimental or alternative therapies
- Care that wasn’t pre-notified when pre-notification was required
How This Compares to Insurance
The most important thing to understand is that Medi-Share is not insurance. There is no legal guarantee that your bills will be paid. Sharing is voluntary among members, and the program’s guidelines determine what qualifies. In practice, Medi-Share has operated consistently for decades and members do receive sharing for eligible needs, but the legal framework is fundamentally different from an insurance contract.
Traditional health insurance is required to cover certain categories by law, including preventive care, mental health services, maternity, and prescriptions without the lifestyle conditions Medi-Share imposes. Medi-Share’s monthly costs are often lower than marketplace premiums, which is a major draw, but the trade-off is narrower eligibility and more out-of-pocket responsibility for chronic conditions, long-term medications, and anything connected to your health history in the five years before joining.
If you’re generally healthy, don’t have pre-existing conditions, and align with the program’s lifestyle requirements, Medi-Share can meaningfully reduce your medical cost exposure for major events like hospitalizations, surgeries, and cancer treatment. If you manage ongoing conditions or take daily medications, the gaps in sharing may leave you covering substantial costs on your own.