Last reviewed June 2026

Can I contribute to an HSA if I belong to a health care sharing ministry?

Short answer: Generally no. Membership in a health care sharing ministry is usually treated as disqualifying other coverage for HSA purposes and does not qualify as an HSA-eligible health plan.

Health care sharing ministries (HCSMs) are arrangements where members share medical costs among themselves. While these organizations are not health insurance, they can still affect HSA eligibility.

To contribute to an HSA, you must be enrolled in an HSA-qualified high-deductible health plan and have no other disqualifying health coverage. A health care sharing ministry does not meet the definition of an HSA-qualified HDHP.

In addition, IRS guidance has historically treated participation in a health care sharing ministry as other health coverage that disqualifies an individual from making HSA contributions, even though the arrangement is not regulated as insurance.

Unlike Direct Primary Care arrangements, recent federal law changes addressing HSA eligibility did not change the treatment of health care sharing ministries. As of 2026, there is no specific IRS guidance allowing HSA contributions while participating in a health care sharing ministry.

If participation in a health care sharing ministry makes you ineligible to contribute, you may still keep your HSA and use existing funds for qualified medical expenses.

Sources

IRS Publication 969, Qualifying for an HSA Contributionirs.gov/publications/p969
  • Internal Revenue Code §223(c)(1) (HSA eligibility and “other coverage”); IRS Publication 969.
  • Topic: HSAs