Health Insurance for Pastors: Finding Affordable Coverage & Avoiding Medical Debt
Health insurance is something many pastors know they need but often struggle to afford. Medical costs can be overwhelming, and without proper coverage, a single health crisis can create financial hardship. For pastors, particularly those in smaller congregations or bi-vocational roles, navigating health insurance options can feel like a daunting task.
This post is part of our ongoing series on insurance for pastors, where we’re breaking down essential coverage types to help you protect your family and finances. If you missed the introduction, you can check it out here: The Pastor’s Guide to Insurance. Today, we’re starting with one of the most pressing concerns—health insurance.
The good news? You have options. Whether you're looking for traditional health coverage, exploring alternatives, or simply trying to understand what’s available, this guide will help you find solutions that fit your needs and budget.
Employer-Sponsored Health Insurance
If your church provides group health insurance, this is often the most cost-effective option. Many denominational networks also offer group plans that can provide affordable coverage. If employer-sponsored insurance is available, review the plan to understand what’s covered and whether dependents can be added.
ACA Marketplace Plans
For pastors without employer-provided insurance, the Affordable Care Act (ACA) Marketplace is a strong option. Many qualify for income-based subsidies that significantly reduce monthly premiums. These plans guarantee coverage regardless of pre-existing conditions and provide access to essential health benefits. You can explore options at Healthcare.gov and use their subsidy calculator to estimate costs. Open enrollment occurs annually, but special enrollment periods are available for major life events like job changes, marriage, or having a child.
Health Sharing Ministries
Health sharing ministries offer an alternative to traditional insurance. These faith-based organizations operate on a cost-sharing model, where members contribute toward each other’s medical expenses. They are often more affordable but come with limitations, such as exclusions for pre-existing conditions and specific faith-based participation requirements. Popular options include Medi-Share, Samaritan Ministries, and Christian Healthcare Ministries. Before choosing a health sharing ministry, carefully review the guidelines to ensure it aligns with your healthcare needs.
Medicaid & CHIP
For pastors with lower incomes, Medicaid and the Children’s Health Insurance Program (CHIP) provide free or low-cost healthcare coverage. Eligibility varies by state, and even if you don’t qualify for Medicaid, your children may be eligible for CHIP. To check eligibility, visit Medicaid.gov.
Private Insurance & High-Deductible Health Plans
Private insurance plans may be an option for pastors who don’t qualify for ACA subsidies or prefer alternative coverage. High-deductible health plans (HDHPs) are often paired with a Health Savings Account (HSA), which provides significant tax advantages.
An HSA allows you to contribute pre-tax dollars for medical expenses, offering three key benefits:
Contributions reduce taxable income.
Funds grow tax-free.
Withdrawals for qualified medical expenses are also tax-free.
This triple tax advantage makes HSAs one of the most effective tools for managing healthcare costs. For a deeper dive into how HSAs can benefit pastors, check out this article: Are You Paying Too Much in Taxes?
Maximizing Your Health Coverage
Choosing a plan is just the first step. To get the most from your coverage, consider the following:
Use preventative care services included in most plans at no extra cost. Routine checkups and screenings can help catch health issues early.
If you have an HSA, contribute to it consistently to build a tax-advantaged fund for future medical expenses.
Track out-of-pocket medical expenses. If they exceed a certain percentage of your income, you may be eligible for tax deductions.
Choosing the Best Plan for Your Needs
There’s no one-size-fits-all solution when it comes to health insurance. The best plan depends on your budget, healthcare needs, and available options through your church or network. Some pastors prioritize affordability and opt for a health sharing ministry, while others prefer the security of traditional coverage.
The key is ensuring you have some level of protection in place. Delaying coverage increases financial risk, so take the time to compare plans and choose the best option for your situation.
What’s Next?
This is the first installment in our series on insurance for pastors. Next, we’ll cover life insurance—how much you need, term vs. whole life, and affordable ways to protect your family’s future.
What’s been your biggest challenge in finding health insurance? Join the conversation on LinkedIn.
