ACA marketplace plans are insurance: guaranteed acceptance, required benefits, and help with premiums if your income qualifies. Health sharing is not insurance: it usually costs less each month, lets you see any provider and lets you join any time of year, but it phases in pre-existing conditions and doesn't guarantee a bill will be shared. Healthy people paying full price often save with health sharing; people with ongoing conditions or large subsidies are usually better off on the marketplace.
Side by side
| ACA marketplace plan | MightyWELL (copay + health sharing) | |
|---|---|---|
| What it is | Health insurance | Everyday benefits plus ShareWELL health sharing. Not insurance |
| Monthly cost | Full price unless you get a subsidy | $315–$1,042 depending on age, household and unshared amount |
| Everyday visits | Often paid toward a deductible first | Set copays for primary, specialist, urgent and virtual care |
| Preventive care | $0 ACA preventive care | $0 ACA preventive care (MEC plan) |
| Big bills | Deductible, then coinsurance up to an out-of-pocket maximum | Your unshared amount ($2,500 or $5,000), then eligible costs are shared |
| Pre-existing conditions | Accepted from day one | Waiting period, then phased in |
| Doctors | Plan network, sometimes with referrals | Any licensed provider, no referrals |
| When you can join | Open enrollment or a qualifying life event | Any month of the year |
| Guarantee | Contractual obligation to pay claims | Sharing is voluntary and not guaranteed |
Cost: compare what you would actually pay
Comparing premiums alone misleads people in both directions. Add up a year: twelve months of premium or contribution, plus what you'd pay out of pocket for the care you expect. On a high-deductible marketplace plan, a healthy year can still mean paying full price for every visit until the deductible is met. With a copay plan, a sick visit is a set copay from day one.
For a household that gets a large premium tax credit, the marketplace is often cheaper. For one that pays full price, the gap can be big. One MightyWELL member, Tracy S., went from a $970-a-month Blue Cross plan with a $5,000 deductible to $420 a month, and had two claims paid with nothing out of pocket. Current Concierge prices start at $315 for an individual (see every price).
Pre-existing conditions: the biggest difference
Marketplace plans can't decline you or charge you more for a condition. Health sharing can't promise that. In ShareWELL, a pre-existing condition starts with a waiting period of limited sharing, then graduated sharing up to $25,000, and after 24 continuous months it's eligible for sharing up to $125,000 a year under the guidelines. Conditions that begin after you join are eligible from day one.
If you have surgery planned, are already pregnant, or are in active treatment for something serious, choose insurance. The fit guide goes through this in more detail.
Doctors and networks
Many marketplace plans are HMOs or EPOs with narrow networks. MightyWELL members can see any licensed provider in the country without referrals. In-network providers through PHCS and Prime Health Services have pre-negotiated rates, so billing is simpler and cheaper, and out-of-network visits are still eligible. See the provider network.
Timing
Marketplace open enrollment starts November 1, and after it closes you generally need a qualifying life event to sign up. Health sharing has no enrollment window: you can get a price and join any month, which also makes it a practical option if you miss the deadline.
The risk you take on
Insurance is a contract; health sharing is a community. ShareWELL publishes its track record: about $2.1 million shared toward eligible medical needs and $2.3 million negotiated off members' bills since October 2024, with an average bill reduction of about 43%. That's real, but it isn't a guarantee, and every member should read the member guidelines before joining.
Common questions
Is health sharing cheaper than an ACA plan?
Usually, if you pay full price for the ACA plan. MightyWELL's Concierge bundle starts at $315 a month for an individual. If you qualify for a large premium tax credit, a marketplace plan may cost less, so compare both.
Can I keep my doctor with health sharing?
With MightyWELL, yes. Members can see any licensed provider nationwide without referrals. Partner networks offer the best rates but are not a restriction.
What happens if I get sick after joining?
New conditions that begin after your membership starts are eligible for sharing from day one, subject to your unshared amount and the member guidelines.
Can I switch from an ACA plan to health sharing mid-year?
Yes. You can join MightyWELL any month. Line up your start date before you cancel your current plan so you have no gap.
MightyWELL plans are not insurance. ShareWELL is a health care sharing community, not insurance, and sharing is not guaranteed. Prices are monthly estimates for the Concierge bundle; final pricing is confirmed at enrollment.
