Health Sharing vs. Health Insurance: A Cost Comparison

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Comparing a monthly insurance premium to a monthly health share contribution only tells part of the story. What matters is total cost — what you pay monthly plus what you’d owe out of pocket if something happens. Here’s that comparison worked out with 2026 numbers.

The 2026 ACA Baseline

For 2026, unsubsidized health insurance costs for a 40 year old look like this nationally:

Metal Tier	Average Monthly Premium	Average Deductible	Avg Copay	Average Out of Pocket Maximum
Bronze	~$456	~$7,500	40%	~$9,000
Silver	~$611	~$5,500	30%	~$7,500
Gold	~700 - $900	~$1,500	$20	~$4,500 - $8,000

These are national averages. Your actual numbers depend heavily on your state and age. If you qualify for a subsidy via the ACA Marketplace based on your income, your real cost could be dramatically lower. This comparison focuses on unsubsidized costs which apply once you’re above 400% of the federal poverty level, a subsidy cliff that returned for 2026.

The Health Share Baseline

For comparison, we use MPB Health’s Secure HSA health share plan for the same 40 year old as its coverage is comparable to an ACA plan.

Monthly Contribution	IUA (similar to deductible)	Copay	Out of Pocket Maximum
$266	$5,000	None	$15,000
$289	$2,500	None	$7,500
$359	$1,250	None	$3,750

An IUA functions like a deductible but applies per medical incident rather than annually. You’re capped at paying an IUA at most three times in a rolling 12-month period which therefore serves as an out of pocket maximum. MPB Health plans, along with most health shares, do not require coinsurance once you pass your IUA (deductible). See our plans, pricing & comparisons guide for the full explanation of how IUAs work.

Scenario 1: Healthy Individual, No Major Claims

If you don’t require much medical care in a given year, the comparison mostly comes down to monthly premiums:

• ACA Bronze Plan: ~$456/month × 12 = ~$5,472/year
• Secure HSA w/ Comparable $5,000 IUA: $266/month × 12 = $3,192/year

For a healthy individual who mostly avoids major medical events, health sharing’s lower baseline contribution comes out significantly ahead in a given year.

Scenario 2: Individual With One Major Medical Event

This is where the deductible and IUA structures begin to matter. Let’s assume a $15,000 medical event happens — an ER visit, a procedure, a short hospitalization.

• ACA Bronze Plan: ~$5,472/year in premiums, plus a ~$7,500 deductible and $1,500 in coinsurance before hitting the max out of pocket. Total: ~$14,472 for the year the event occurs.
• ACA Silver Plan: ~$7,332/year in premiums, plus the ~$5,500 deductible and $2,000 in coinsurance before hitting the max out of pocket. Total: ~$14,832 for the year the event occurs.
• Secure HSA w/ $5,000 IUA: $3,192/year in contributions, plus a single $5,000 IUA payment. Total: $8,192 for the year the event occurs.

The gap widens considerably with a medical event given the Secure HSA plan’s lower IUA (deductible) and no co-insurance requirement. It’s also interesting to note that while the Silver plan has lower costs for the medical incident than the Bronze plan, the yearly cost is slightly higher due to the increased premiums.

Scenario 3: Family of Four, Moderate Usage

Premiums for traditional insurance family plans are simply the sum of the premiums for each individual (i.e there is no family discount). This is true up through your third child. Adding children starting with the 4th doesn’t increase your premium. Presumably the thought being if you have 4 or more children, you deserve a break! Family plans introduce a family deductible which is generally twice an individual’s deductible. Once you hit the family deductible, medical needs for any family member are covered (minus any coninsurance requirements). Out of pocket maximums for a family plan are also double that of an individual plan.

In contrast, MPB Health’s Secure HSA plan, gives you a premium discount for each additional member added with pricing staying the same once you have added two children (i.e. the 3rd onwards is free). IUAs are still charged per incident and are still capped at 3 per 12 month period for the family regardless of the family member with the medical need(s).

For a health family of four, you’re again looking at just the premium differences when comparing ACA plans to a health share:

• ACA Bronze Family Plan: ~5,472/yr. × 4 = ~$23,888/year
• Secure HSA Family Plan: $598/month × 12 = $7,176/year

Secure HSA’s discounted family plan rate makes a huge difference when compared to the Bronze plan’s 4x rate.

For scenarios where you have 1 or more medical needs, Secure HSA’s IUAs (deductibles) and out of pocket maximums are lower than their respective Bronze, Silver, and Gold ACA plans. So you will come out ahead financially in virtually any scenario (similar to Scenario 2 provided above).

What Changes This Math

A few factors can shift this comparison significantly:

• ACA subsidies: If your household income qualifies for premium tax credits, a subsidized ACA plan can end up cheaper than health sharing. But it depends on the size of the subsidy. Be sure to get a quote.
• Pre-existing conditions: If you have an ongoing condition, ACA plans will cover it immediately while health share plans apply waiting periods and phased caps. See our waiting periods and pre-existing conditions guide for how that could change your costs.
• Taxes: If you are self employed, insurance premiums are often tax deductible whereas health share contributions generally aren’t. See is health sharing tax-deductible for the details. While this favors traditional health insurance plans, the savings generally aren’t enough to tip the scales. But it’s worth calculating in.

Note: Using a Health Savings Account (HSA) can save you quite a bit on taxes. Since you can establish an HSA with both traditional insurance and health sharing plans, it’s a wash in our comparisons above but see our MEC + HSA eligibility guide for details on how HSAs work with health share plans.

How to Run Your Own Numbers

Rather than relying on national averages, the most accurate comparison uses actual numbers:

1. Check your ACA subsidy eligibility at Healthcare.gov or your state marketplace — this alone can have a huge impact
2. Get a standard health insurance quote either via the marketplace or directly with health insureres in your area
3. Verify your MPB Health price using our plan comparison tool or get a quote from your preferred health share provider
4. Estimate your realistic annual medical usage — this will give you an idea how much to expect to pay with whatever plan you choose

Bottom Line

For an unsubsidized household, a health sharing plan’s total cost — monthly contribution plus IUA exposure — tends to come out significantly lower than unsubsidized ACA insurance in 2026, both in a typical healthy year and in a year with major medical events. This is due to lower premiums, especially with family plans, and lower deductible (IUA) and max out of pocket caps. That gap narrows or reverses for households eligible for ACA subsidies or in situations where coverage for pre-existing conditions matter more than the monthly cost difference.