Samaritan Ministries: A Fact-Based Review

How Samaritan Ministries works

Samaritan Ministries International, based in Peoria, Illinois, is a 501(c)(3). Its October 2026 guidelines describe members sending monthly shares directly to other members with needs, with no provider network. Members must be professing Christians who affirm its Statement of Faith, attend church at least three of four weeks, and follow lifestyle standards, with a church leader confirming each year. The initial unshareable amount is $1,000 (Classic) or $2,000 (Basic), with per-need maximums of $500,000 and $497,500. Pre-existing conditions become shareable after 12 months without symptoms, treatment, or medication, five years for certain conditions, and pre-existing Type 1 diabetes is never shared. The guidelines say: “Health care sharing is not insurance.”

Size

Samaritan reported 349,396 members nationally for 2024 in Colorado’s data collection, which the state didn’t verify, and ProPublica’s nonprofit records show revenue of about $73.4 million for its fiscal year ending June 2025.

Why it isn’t insurance

A health care sharing ministry, or health share, is not insurance. Members pay a monthly amount that the organization uses to help pay other members’ eligible medical bills under its own guidelines, but no one is legally obligated to pay your bills. NAIC says sharing ministries “can’t guarantee the payment of claims,” don’t have to follow ACA protections, and aren’t supervised by insurance regulators. Illinois’s insurance department lists them under “other coverage that is not insurance” and notes the ministry “is not legally obligated to pay.”

Federal tax law defines a health care sharing ministry for the old individual-mandate exemption: a 501(c)(3) organization whose members share religious or ethical beliefs, that keeps members after they develop a condition, that has shared expenses continuously since December 31, 1999, and that has an annual independent audit, as summarized in a 2020 Treasury proposed rule.

Because health shares aren’t insurance, ACA consumer protections don’t apply. Michigan’s insurance department notes that most insurance policies must cover pre-existing conditions and essential health benefits, and sharing ministries don’t have to. California’s attorney general adds that they’re exempt from the ten essential health benefits and the out-of-pocket limits, and Maine’s marketplace warns they “can refuse to pay for your medical expenses.” Many ministries limit pre-existing conditions or use waiting periods, and some cap sharing per illness or per year.

Health share vs. ACA insurance

Sources: NAIC (2022), Michigan DIFS (2024), California Attorney General (2026), IRS. Summary only; each ministry’s guidelines control.

How sharing works

Each ministry publishes guidelines that act as the rules of membership. Common features include a monthly share amount; an amount you pay yourself before sharing starts, called an initial unshareable amount, annual household portion, or similar name; limits per need or per illness; waiting periods or limits for pre-existing conditions and maternity; and lifestyle or faith requirements. Many have no provider network, so members are treated as self-pay patients and may negotiate bills. Guidelines can change, so read the current version before joining.

State laws and required notices

Most states treat health shares outside insurance law. NAIC counted 30 states that explicitly exempt sharing ministries from insurance regulation as of November 2022, and West Virginia’s legislature passed an exemption in 2024. Exempting states usually require a written notice. Arizona’s, for example, begins: “The organization facilitating the sharing of medical expenses is not an insurance company and the ministry’s guidelines and plan of operation are not an insurance policy,” and ends by telling members they are “always personally responsible for the payment of your own medical bills.”

• Texas adds that complaints may be reported to the Texas attorney general.
• Florida requires an annual independent audit and says a qualifying ministry doesn’t market through agents licensed by the state, and its notice says the organization isn’t subject to the Florida Insurance Code’s consumer protections.
• North Carolina covers “health care sharing organizations” whose members share similar interests, not necessarily religious ones.
• Michigan’s notice says the assistance “is not insurance” and that the document “is not a contract of insurance or a promise to pay.”
• Washington uses the federal definition, including the 1999 rule, and fines organizations that don’t meet it as unauthorized insurers.

Tax credits and taxes

Health shares aren’t sold through HealthCare.gov or state marketplaces, and the IRS says premium tax credits are available only for coverage bought through the Marketplace, so share amounts can’t be paid with those credits. Treasury proposed in 2020 to treat sharing-ministry membership as a deductible medical expense, but we didn’t find a final rule, so check with a tax professional before deducting share amounts. Federal bills introduced in 2025, including H.R. 2062 on deductibility and H.R. 3103 on transparency, hadn’t passed as of October 2026.

Switching to insurance later

Leaving a health share doesn’t by itself open a Special Enrollment Period for marketplace coverage. CMS guidance says the loss-of-coverage SEP doesn’t apply when the lost coverage wasn’t minimum essential coverage, and sharing-ministry membership isn’t. Other life events, such as moving, marriage, having a baby, or losing job-based coverage, can still qualify. Otherwise, the time to switch is Open Enrollment: November 1, 2026 to January 15, 2027 on HealthCare.gov, with some state marketplaces setting their own dates.

Regulatory actions

• Washington: the insurance commissioner fined Unite Health Share Ministries $300,000 in 2024 after a complaint that it paid $5,000 of a nearly $200,000 bill, fined ClearShare Health companies $275,000 in 2025, and fined OneShare Health $150,000 in 2021, finding each didn’t meet the sharing-ministry definition.
• New Mexico: regulators fined Liberty HealthShare’s legal entity $2.51 million in 2023; members’ challenge reached the U.S. Supreme Court, where the Solicitor General recommended against further review in May 2026.
• California: the attorney general reached a $1.3 million settlement with Sedera companies in 2025 and a $2.1 million settlement with Alliance for Shared Health in 2023, and renewed a consumer alert in July 2026 warning that some plans use “gold,” “silver,” and “bronze” labels like insurance.
• Colorado: a 2022 law requires annual reporting; a court denied the sharing ministries’ alliance a preliminary injunction against it in January 2025.

What the data shows

Colorado is one of the few states that collects data. Its report on 2024, published in October 2025, found 20 reporting organizations with 1,428,111 members nationally and 57,358 in Colorado. They collected about $91.7 million from Colorado members and paid or shared about $87.4 million, denied 13.23% of share requests, and listed pre-existing exclusions or limits including cancer, diabetes, asthma, hypertension, HIV/AIDS, and multiple sclerosis. The Division says it didn’t independently verify most of the data.

Mandates and exemptions

The federal penalty for not having coverage has been $0 since 2019, according to the IRS, so the federal sharing-ministry exemption matters mainly in states with their own mandates. California, New Jersey, Rhode Island, and the District of Columbia each allow an exemption for members of a qualifying sharing ministry; California and New Jersey require that the ministry has shared expenses continuously since 1999. Massachusetts’s 2025 Schedule HC offers a religious exemption but no exemption specific to sharing ministries. In each case membership is an exemption, not coverage: it isn’t minimum essential coverage.

Checking a plan and insurer

• Ask for the current sharing guidelines and read the limits, exclusions, and waiting periods.
• Find out how much you pay before sharing starts, and the maximum shared per need or per year.
• Ask how pre-existing conditions, maternity, prescriptions, and mental health are handled.
• Check the organization’s required state notice and whether it meets your state’s definition.
• Search your state insurance department and attorney general for actions against it.
• Compare against an ACA plan with any premium tax credit you qualify for.
• Remember the next marketplace enrollment window if you change your mind.

What an independent agency does

An independent insurance agency is licensed to sell policies from several insurance companies. Instead of quoting one company's products, an independent agent can compare options from the insurers the agency represents, explain the differences in coverage, and help you re-shop at renewal. The insurance company, not the agent, makes underwriting and claim decisions.

Blake Insurance Group is an independent agency. We work with clients by phone, email, and online in states where we are licensed, and we will tell you which insurers we can quote for your situation.

How we work

Blake Insurance Group serves clients by phone, email, and online in states where we are licensed. The insurers and plans we can offer depend on our appointments and your location; a company named on this page may not be available through us.

How to verify an insurer or agency

Before buying through any website or app, confirm who is selling you the policy and who will issue it:

1. Find the licensed agency or insurer named in the site's footer, terms, or license page.
2. Look up the agency or producer on your state insurance department's license search, or through the National Insurance Producer Registry (NIPR).
3. Look up the insurer on your state insurance department's company search to confirm it is authorized in your state.
4. Save the insurer's name and policy number once issued, since that is who handles claims.

A legitimate service will make this information easy to find. Be cautious if you cannot identify the licensed entity.

Sources

We checked the facts on this page against the sources below in October 2026. Plans, prices, and rules change, so confirm current terms before you buy.

• Samaritan Ministries: Guidelines (October 2026)
• ProPublica Nonprofit Explorer: Samaritan Ministries International
• Colorado Division of Insurance: Health care sharing plans and arrangements in Colorado, 2024 data (Oct. 2025)
• NAIC: Not all products are health insurance (Nov. 2022)
• Michigan DIFS: Health care sharing ministries are not health insurance (Jan. 2024)
• California Attorney General: Renewed consumer alert on health care sharing ministries (Jul. 2026)
• IRS: Individual shared responsibility provision
• IRS: Eligibility for the premium tax credit (Nov. 2025)
• CMS: Loss of minimum essential coverage SEP refresher (Apr. 2020)
• Arizona Revised Statutes §20-122
• 26 U.S.C. 5000A (health care sharing ministry definition)
• Federal Register: Treasury/IRS proposed rule on HCSM and direct primary care (Jun. 10, 2020)

What to have ready to compare options

These details help an agent quote accurately.

1. Current coverage. Any plan or sharing membership you have now and when it ends.
2. Household. Who needs coverage and their dates of birth.
3. Income. Your expected 2027 household income, to check premium tax credits.
4. Doctors and prescriptions. Providers and medications you want to keep.
5. Health needs. Ongoing conditions or planned care, such as a pregnancy.

Samaritan Ministries: A Fact-Based Review FAQs

Related guides

• Health insurance agency
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• Medicare insurance agency

Your next step

Ask about your options, and a licensed agent will explain how a health share compares with health insurance available to us.