Health sharing accreditation keeps popping up in real conversations lately, and it’s not hard to see why.
Employer health insurance plans now run the average family almost $27,000 a year. The Kaiser Family Foundation’s 2025 employer survey puts the average family premium at $26,993, with workers supplying more than $6,850 themselves.
That’s before you hit a deductible, which now averages $1,886 for single plans.
It’s no surprise that more than 22.8 million people selected Marketplace plans for 2026 coverage, according to CMS. People are shopping.
Some land on health care sharing ministries. But once you move outside regulated insurance, the next question is simple: who checks the checker?
That’s where health sharing accreditation and the Health Share Accreditation Board enter the picture.
What Is the Health Share Accreditation Board?
The Health Share Accreditation Board exists because health sharing organizations don’t answer to state insurance commissioners.
If you buy a traditional health plan, the carrier has to meet reserve requirements, file rates, and follow state complaint rules. Health sharing organizations operate under a different legal structure.
That difference leaves a gray area for shoppers trying to compare options.
The board steps into that space with written standards that health sharing organizations must meet to earn accreditation.
Those standards cover governance, financial oversight, written sharing guidelines, and how clearly an organization explains what is and is not eligible for sharing.
It’s worth knowing that the HCSAB was founded with support from the Alliance of Health Care Sharing Ministries and has focused exclusively on faith-based organizations.
Every organization that has earned HCSAB accreditation — Medi-Share, Samaritan Ministries, and OneShare Health — is a Christian ministry. Non-faith-based health sharing organizations are not evaluated under this framework.
Health sharing accreditation matters because people aren’t questioning insurance out of curiosity; they’re questioning it because of cost.
When someone considers a healthshare plan, they’re usually trying to lower fixed monthly expenses. What they don’t want is uncertainty, replacing one problem with another.
Accreditation gives them something concrete to look at.
What Health Sharing Accreditation Actually Reviews
Most people assume health sharing accreditation means “financially safe.” That’s not what it measures.
It’s closer to an operational check.
The review looks at how the ministry is governed. Is there real board oversight? Are decision-makers accountable to written policies, or is everything discretionary?
Then there’s money handling. Member contributions need tracking. Sharing requests need documentation. Financial reporting can’t be informal if the organization wants accreditation.
The board also looks at how clearly the ministry explains its rules. An accredited health sharing ministry has to publish written sharing guidelines that outline eligibility, limits, and participation standards.
If there are caps or waiting periods, they must be stated clearly. The health care sharing ministry standards require direct disclosure that the ministry is not insurance. That distinction must be obvious.
Accreditation doesn’t change the voluntary nature of sharing. It confirms that processes exist and are written down.
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Who’s Actually Accredited — and Why Many Strong Plans Are Not
Very few health sharing organizations carry HCSAB accreditation.
There are more than a hundred federally recognized health sharing organizations in the U.S. Only a handful appear on the accredited list — and as noted above, all of them are faith-based Christian organizations.
Medi-Share and Samaritan Ministries have appeared on that list for several years. Samaritan has cited more than 250,000 members. Medi-Share reports sharing more than $9 billion in medical needs since 1993. Scale alone doesn’t guarantee anything. But it does show experience.
That said, the absence of HCSAB accreditation doesn’t mean a health sharing organization is lower quality or less trustworthy. A number of well-regarded plans simply fall outside the HCSAB’s scope.
The HCSAB was built around faith-based organizations and is backed by the Alliance of Health Care Sharing Ministries — a coalition that doesn’t include secular health sharing communities.
Plans like Sedera and Zion HealthShare, both of which are non-faith-based and open to members of any background, operate under a different model entirely. They’re not eligible for HCSAB accreditation the way a Christian ministry would be. That’s a structural difference, not a mark against their quality.
For those evaluating secular options, other transparency signals matter more: published financial reports, clear member guidelines, track records of paying sharing requests, and GuideStar or Candid nonprofit ratings.
Accreditation simply adds a layer of outside review in a space that otherwise runs largely on internal governance — and it applies only to one segment of that space.
Want to compare accredited and non-accredited healthshare plans side by side? Get a free comparison from our Personal Benefits Manager.
How to Use Health Sharing Accreditation in Your Decision
If a ministry has health sharing accreditation, that narrows the field. It doesn’t finish the job.
As you evaluate, pay attention to:
- Whether accreditation is current
- Pre-existing condition policies
- Annual or lifetime limits
- Prescription and maternity rules
- Financial summaries or audit availability
- How the ministry handles needs that exceed sharing limits
You’re not just comparing monthly share amounts.
You’re deciding how much uncertainty you’re comfortable carrying.
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Understanding Health Sharing Accreditation
Health sharing accreditation won’t eliminate risk, and it doesn’t convert a health sharing plan into insurance.
What it does is add outside review to one segment of an industry that isn’t regulated like traditional health plans. It’s worth keeping in mind that the HCSAB focuses exclusively on faith-based organizations — every plan it has accredited is a Christian ministry. Non-faith-based health sharing plans like Sedera and Zion HealthShare operate outside this framework entirely.
At a time when employer family plans average nearly $27,000 a year, and deductibles continue to rise, it makes sense that people are scrutinizing every option — faith-based and secular alike.
If you’re considering a healthshare plan, don’t stop at the monthly share amount. Read the guidelines. Review the limits. And know that accreditation is one useful signal among several, not the only one.
Frequently Asked Questions
Who runs health sharing accreditation?
The Health Share Accreditation Board handles it.
Health share organizations apply, and the board reviews how they operate. The goal is to give shoppers some outside perspective in a space that isn’t regulated like insurance.
Does HCSAB accreditation apply to all health sharing organizations?
No.
The HCSAB was established specifically for faith-based health care sharing ministries — nonprofit religious organizations structured as ministries. Secular health sharing organizations operate outside its current scope.
Does accreditation mean a plan is insurance?
No.
Even if a health share organization is accredited, it’s still not insurance. Members voluntarily share medical costs. There’s no legal guarantee the way there is with a regulated insurance policy.
What does the accreditation review actually look at?
Mostly how the organization runs day to day.
Governance, financial tracking, written sharing rules, and how clearly those rules are explained to members.
Why haven’t more organizations earned accreditation?
The HCSAB only launched in 2022 and the process is voluntary.
Many health sharing organizations have strong internal governance built over decades and haven’t yet prioritized an external review.
Also, the 80+ standard evaluation is a significant undertaking. The accredited list is growing — OneShare Health earned accreditation in December 2025 — but it remains a small portion of the total market.
Does accreditation guarantee bills will be shared?
No.
Accreditation checks whether the organization has structure and transparency. It doesn’t promise that every medical need will be paid.
How should someone use accreditation when comparing options?
Think of it as one data point.
It tells you the organization allowed an outside review. You still need to read the guidelines and understand the limits before making a decision.
Why HSA for America?
For over 20 years, HSA for America has helped individuals, families, and small businesses dramatically lower their healthcare costs — often by hundreds of dollars a month — without sacrificing the protection they need.
If you’d rather have someone who’s already done the homework walk you through your options, HSA for America is a good place to start.
Hi! I’m Misty Berryman, and I’m one of your Personal Benefits Managers. I like working with HSA for America because we’re creating solutions to healthcare problems. Our focus on money-saving alternatives like HSA plans and health sharing programs, and the variety of health share programs we offer, are what set us apart. Read more about me on my Bio page.
