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 – Health Savings Accounts (Eligibility Rules): https://www.irs.gov/forms-pubs/about-publication-969
- U.S. Department of the Treasury / IRS, Regulatory guidance on medical care arrangements and HSA eligibility: https://www.federalregister.gov
Content history
Originally published: March 27, 2025
Last reviewed: January 27, 2026