Christian Healthcare Ministries (CHM) is a health cost-sharing ministry where members make monthly contributions that are pooled to pay each other’s medical bills. It is not health insurance. Instead, it operates as a nonprofit organization rooted in Christian beliefs, where participants voluntarily share one another’s eligible healthcare costs. CHM is one of the largest organizations of its kind in the United States, but the distinction between what it offers and what traditional insurance guarantees is significant and worth understanding before you join.
How Cost Sharing Works
The basic idea is straightforward: members pay a monthly amount (called a “gift” or contribution), and that money goes toward covering other members’ qualifying medical expenses. When you have a medical bill, you submit it to CHM, and the organization coordinates payments from the shared pool. In practice, this looks a lot like insurance. Your monthly payment functions like a premium. You pay a set amount out of pocket before bills become eligible for sharing, similar to a deductible (CHM calls this your “Personal Responsibility”). You may also need to use network providers and pay a percentage of costs yourself, much like co-insurance.
But there is a critical legal difference: CHM makes no guarantee that any bill will be paid. Unlike an insurance company, which is contractually obligated to cover claims that meet your policy terms, a health care sharing ministry can decline to share costs even when a bill meets its own guidelines. Most states do not regulate sharing ministries as insurance issuers, which means CHM does not have to meet the financial reserve requirements that ensure an insurer can actually pay its claims.
Monthly Costs and Program Tiers
CHM offers three main tiers, with costs listed per “unit” (an individual or a couple/family):
- Gold: $299 per month per unit
- Silver: $169 per month per unit
- Bronze: $115 per month per unit
There are also two add-on programs. CHM Plus costs $42 per unit per month and provides additional sharing for large medical events. SeniorShare, designed for members on Medicare, runs $119 per unit per month. The Gold tier offers the broadest sharing, including a structured phase-in for pre-existing conditions, while Bronze covers less and is geared toward younger, healthier members who mainly want catastrophic protection. Your Personal Responsibility amount (the out-of-pocket portion you pay before sharing kicks in) varies by tier but has remained unchanged in recent updates.
What CHM Does Not Cover
Because CHM is exempt from the Affordable Care Act’s consumer protections, it does not have to cover what the ACA defines as essential health benefits. In practice, this means several major categories of care are excluded or sharply limited:
- Mental health and substance use treatment: Generally not eligible for sharing.
- Prescription drugs: Coverage is limited compared to a standard insurance plan.
- Preventive services: Routine screenings, vaccinations, and wellness visits that insurance must cover at no cost are not guaranteed under CHM.
- Maternity care: Sharing is available only under specific conditions (see below).
- Pre-existing conditions: Covered on a phased schedule with dollar caps for the first three years of membership.
This list matters because these are some of the most common and expensive reasons people need healthcare. If you rely on ongoing mental health care, take daily medications, or are managing a chronic condition, the gaps in sharing could leave you responsible for substantial costs.
Pre-existing Condition Limits
CHM Gold members can receive sharing for pre-existing conditions, but the amounts are capped during the first three years of membership. In year one, bills for a pre-existing condition are eligible for sharing up to $15,000. In year two, an additional $10,000 becomes available, bringing the two-year total to $25,000. In year three, another $25,000 is added, for a three-year cumulative cap of $50,000. After your third year, the condition is no longer considered pre-existing and is treated like any other eligible medical need.
If your bills exceed those schedule limits during the first three years, the excess may be posted to CHM Give, a separate voluntary giving program where other members can choose to contribute. There is no guarantee those additional costs will be covered. For someone with a serious chronic illness, a $15,000 cap in the first year could fall far short of actual costs, particularly for conditions requiring surgery, ongoing specialist care, or expensive medications.
Maternity Sharing Requirements
Maternity care is available through CHM, but with conditions that differ significantly from standard insurance. You must be a member before conception for the pregnancy to be eligible for sharing. CHM offers a $500 reduction to your maternity Personal Responsibility if you notify their Maternity Care Team within the first 16 weeks of pregnancy. The key takeaway: if you’re considering CHM and planning a pregnancy, timing your membership matters. Getting pregnant before enrolling, or shortly after, could mean those costs fall entirely on you.
Membership Eligibility Requirements
CHM requires members to affirm Christian beliefs and follow specific lifestyle standards. You must attend church regularly. You must agree to abstain from behaviors the ministry considers incompatible with its faith guidelines, including what it terms “sexual immorality” and drug abuse. These are not just sign-up requirements. If CHM determines that a medical need resulted from a lifestyle choice that violates its guidelines, it can decline to share those costs. This is a meaningful difference from insurance, where your personal behavior generally cannot be used as a reason to deny a claim.
How CHM Compares to Health Insurance
The appeal of CHM is clear: monthly costs are often lower than insurance premiums, especially for healthy individuals or families who don’t qualify for ACA subsidies. For a young, healthy person who rarely needs medical care and wants protection against a major accident or unexpected hospitalization, the savings can be significant. The faith-based community aspect also matters to many members who want their healthcare dollars aligned with their values.
The risks are equally clear. CHM is not regulated as insurance in most states, which means there is no state insurance commissioner to appeal to if a claim is denied. There are no guaranteed benefits. Coverage for mental health, prescriptions, and preventive care is limited or absent. Pre-existing conditions face dollar caps for three years. And your eligibility for sharing can be affected by lifestyle decisions that a traditional insurer could never consider.
If you’re comparing CHM to marketplace insurance, check whether you qualify for ACA premium subsidies first. Many people overestimate the cost of marketplace plans because they haven’t checked their subsidy eligibility. For those who don’t qualify for subsidies and are in good health, CHM can work as a lower-cost alternative, but it requires accepting a level of financial risk that insurance is specifically designed to eliminate.