Understanding Your Options

Health Sharing & Direct Primary Care

Pairing a Summit membership with a health sharing plan can be a smart way to keep everyday care personal and affordable while staying protected against large medical bills. Here's what health sharing is, how it works, and how to decide if it's right for you.

What is a health sharing plan?

Health sharing plans (also called health cost-sharing or medical cost-sharing programs) are not insurance. They are run by member organizations rather than insurance companies. Members contribute a set amount each month into a shared pool, and when a member has a large qualifying medical bill, the pool helps pay some or all of it.

Most health sharing organizations began as faith-based communities, and several still ask members to agree to a statement of shared values or ethical guidelines. There are also secular options. Each plan publishes its own guidelines describing exactly which medical expenses are eligible to be shared and which are not, so it's important to read those guidelines closely before joining.

How health sharing compares to insurance

Health sharing and traditional insurance can look similar on the surface, but they work very differently. This side-by-side can help you understand the trade-offs.

 Traditional InsuranceHealth Sharing
What it isA regulated insurance contract that guarantees payment of covered claimsA membership community that voluntarily shares eligible medical costs — not a guarantee of payment
Monthly costPremiumMonthly share (often lower than a comparable premium)
Your upfront costDeductiblePersonal responsibility / annual household portion
NetworksUsually tied to in-network providersTypically no networks — you can often use any provider, including cash-pay pricing
Pre-existing conditionsMust be covered under the ACAMay be limited, phased in, or excluded — varies by plan
RegulationRegulated as insuranceNot insurance; not regulated the same way

Key terms to know

Monthly shareThe set amount each member contributes into the shared pool every month — the health sharing equivalent of a premium.
Personal responsibilityAlso called the "annual household portion" or IUA (Initial Unshareable Amount). The amount you pay yourself before the community shares in a bill — similar to a deductible.
Eligible / shareable expensesThe medical costs the plan's guidelines allow to be shared. Anything outside those guidelines is your responsibility.
Pre-existing conditionsHealth conditions you already have when you join. Many plans limit or phase in sharing for these — check each plan's rules.

Weighing the trade-offs

Potential advantages

  • Often a lower monthly cost than comparable insurance premiums
  • Freedom to see the providers you choose, with no networks in most plans
  • Pairs naturally with cash-pay and Direct Primary Care pricing
  • Protection against large, unexpected medical bills
  • Community and shared-values model that many members value

Things to consider

  • It is not insurance — sharing of a bill is not legally guaranteed
  • Pre-existing conditions may be limited, delayed, or excluded
  • Not all expenses are eligible; you must follow plan guidelines
  • May not satisfy employer or other coverage requirements
  • You may pay providers first and be reimbursed by the community

How it pairs with Direct Primary Care

Health sharing is designed to help with large, unexpected medical costs — surgeries, hospital stays, and major events. It is generally not built for everyday primary care. That's exactly where a Summit Direct Care membership fits in.

Summit handles the everyday

Your membership covers unlimited primary care, urgent care, chronic condition management, and same/next-day access — with no per-visit copays.

Health sharing handles the big stuff

The sharing community helps with the large medical bills — hospitalizations, surgeries, and major events — that fall outside primary care.

Together, you may save

Many healthy households find that a Summit membership plus a health sharing plan costs less than traditional insurance while keeping care personal.

Who is it a good fit for?

Health sharing tends to work best for individuals and families who are relatively healthy, comfortable with a non-insurance model, and want lower monthly costs and the freedom to choose their providers. It may be less suitable if you have significant pre-existing conditions, expect major planned medical care, or need coverage that satisfies a specific employer or program requirement. Everyone's situation is different — the calculator below can help you compare the numbers for your household.

Compare the Cost of DPC + Your Best Coverage Match

Direct primary care works best when paired with the right coverage. Use our interactive calculator to read the four coverage pathways, enter your numbers, pick a pathway, and see your estimated annual savings.

Open the Cost Calculator →
1 · Read the four pathways 2 · Enter your numbers 3 · Pick a pathway $ · See your savings

Please note: Summit Direct Care does not endorse, recommend, or receive compensation from any of the organizations, plans, or resources listed on this page. This information is provided for educational purposes only and is not insurance, financial, tax, or legal advice. Health sharing plans are not insurance and do not guarantee payment of medical bills. Plan guidelines, eligibility, and pre-existing condition rules vary — please review each plan carefully and speak with your HR representative, a licensed advisor, or the organizations directly before making a decision.