Are Health Share Plans Tax Deductible or HSA Eligible in Idaho?

Why Health Share Plans Aren’t Tax-Deductible (Most of the Time)

Health Shares Are NOT Insurance

Under IRS rules, Health Share plans are classified as:

• Health Care Sharing Ministries (HCSMs) or
• Non-religious medical cost-sharing organizations

Neither category is counted as insurance under the Internal Revenue Code.

This distinction matters because:

• Health insurance premiums can be deductible under certain circumstances
• Health Share monthly payments cannot be treated as premiums

This applies whether you’re:

• A Boise family
• A business owner
• A self-employed professional
• Filing as an S-Corp
• Filing as a sole proprietor

There is no direct federal deduction for Health Share payments.

The One Exception (Rare, but Important)

There’s a small, often misunderstood nuance:

If you itemize medical expenses, some IRS interpretations allow Health Share payments to be included in “medical expenses” for Schedule A.

However:

• You must exceed the 7.5% AGI medical expense threshold
• Most Boise families don’t hit that unless they’ve had a major medical year
• This is not treated as a premium deduction — it’s just part of total medical spend

Chris always tells families:

“You only get this benefit if you’re already itemizing AND you had a very heavy medical year.” For 99% of Idaho households, it does not provide meaningful tax savings.

Are Health Share Plans HSA-Compatible?

Short answer: Almost never. Here’s why.

HSAs Require an HSA-Qualified High Deductible Health Plan (HDHP)

For a plan to qualify for HSA contributions, it must legally be:

• A High Deductible Health Plan (HDHP)
• Issued by a licensed insurer
• Meeting specific minimum deductible limits
• Meeting specific maximum out-of-pocket limits
• Covering preventive services a certain way

Health Share plans do not meet any of these requirements.

• They’re not HDHPs.
•  They’re not insurance.
•  They don’t follow ACA preventive care rules.
•  They don’t have actuarial compliance.

So they simply cannot unlock HSA contributions on their own.

Can You Have an HSA While on a Health Share Plan? Yes — But With Rules

This is where things get interesting. You CAN keep an existing HSA account open

Even if you enroll in a Health Share, you can still:

• Keep your HSA bank account
• Spend funds already in it
• Use existing funds for eligible medical expenses
• Let it continue to grow tax-deferred

But you CANNOT contribute new money. Unless you also carry an HSA-qualified insurance plan at the same time.

Hybrid Strategy — Health Share + Catastrophic HDHP

Some Idaho families try this combined approach:

• Enroll in a low-cost HDHP just to qualify for HSA contributions
• Use a Health Share for actual medical sharing and large needs

This strategy:

Pros

• Allows continued HSA contributions
• Provides both catastrophic insurance AND sharing
• May create customized coverage

Cons

• You pay both HDHP premiums and Health Share monthly shares
• HDHP may offer very little coverage before the deductible
• Must meet ACA standards for the HDHP
• Complex and can be expensive

Chris only recommends this hybrid setup for:

• High-income Boise households wanting to shelter money in an HSA
• People with large HSA balances wanting to preserve tax advantages
• Households with a CPA guiding the decision carefully

Another Strategy — Health Share + Direct Primary Care (DPC)

This is a growing trend across Idaho, especially:

• Boise
• Meridian
• Eagle
• Nampa
• Caldwell

Families combine:

• Health Share for catastrophic protection
• DPC membership for unlimited primary care visits

Here’s the catch:

DPC payments are not HSA-qualified expenses when you're not enrolled in an HDHP. This matters if tax optimization is part of your plan.

Summary — HSA Compatibility

H2: Are Health Share Plans Tax-Deductible for the Self-Employed?

This is a big question for:

• Realtors
• Contractors
• Insurance agents
• Small business owners
• Gig workers
• S-Corp owners
• LLC/sole proprietors

Unfortunately:

The self-employed health insurance deduction applies only to insurance premiums — not Health Share contributions. So for Boise business owners, Health Shares:

• Reduce monthly cost significantly
• But do not offer the same tax deduction as traditional plans

This is one of the key tradeoffs Chris explains to business owners.

Idaho-Specific Tax Considerations

Idaho does not currently provide additional state-level tax incentives for Health Share contributions.

• No extra deductions.
• No special credits.
• No preferential treatment.

This may change in the future, but as of 2025, Health Shares offer no Idaho tax advantage.

When Tax Benefits Might NOT Matter

Chris sees this scenario constantly in Boise:

A family is paying:

• $1,600/month for an ACA plan (too much income for subsidies)

They switch to a Health Share costing:

• $650–$900/month

Even though Health Share payments aren’t deductible, the family saves:

• $700–$1,000 per month
• $8,400–$12,000 per year

Those savings can overshadow the lost tax deduction entirely.

This is why Chris always emphasizes: “Don’t let the tax tail wag the coverage dog.”

The real decision should prioritize:

• Health needs
• Risk tolerance
• Budget
• Comfort with guidelines

Savings for healthy families often far exceed the value of a tax deduction.

Who Typically Benefits From Health Shares (Tax Aside)?

Based on decades advising Idaho families, Chris sees Health Shares as strongest for:

• Healthy adults
• Self-employed people with high ACA premiums
• Families without subsidies
• Early retirees before Medicare
• People who rarely use the doctor
• Faith-based households

Their motivation is monthly savings, not tax optimization.

Boise-Focused FAQs

• Are Health Share contributions tax-deductible?
• No — not as premiums. In rare cases, only as part of medical itemization.
• Can I contribute to an HSA if I’m in a Health Share?
• Not unless you ALSO carry an HSA-qualified HDHP.
• Can Boise employers reimburse Health Share payments?
• Generally no — rules restrict employers from reimbursing non-insurance products through most formal plans.
• Is it legal to use Health Shares in Idaho?
• Yes. Idaho recognizes Health Care Sharing Ministries.
• Can Health Shares work with St. Luke’s or St. Al’s?
• Yes. Providers treat members as self-pay.

H2: Should You Use a Health Share If You Need Tax Benefits?

If tax benefits are essential — for example:

• You’re maximizing HSA contributions
• You itemize medical deductions
• You rely on the self-employed health insurance deduction

—then traditional insurance or an HDHP may be better. But if cost is your top concern, Health Shares often create the largest net savings even without tax deductions. This is why Chris customizes recommendations based on each household’s:

• Income
• Tax situation
• Health needs
• Risk tolerance
• No two families are the same.

Talk to a Boise Health Advisor Who Understands Both Health Shares & Tax Implications

Although Chris isn’t a CPA, he regularly coordinates with Boise tax professionals to help families understand:

• What’s deductible
• What’s HSA-compatible
• Which strategies are allowed
• How Health Shares compare with ACA plans financially

Families trust Chris because he combines real Idaho pricing, local provider knowledge, and decades of experience reviewing Health Share guidelines.



📞 Call Chris Antrim Insurance: 208-991-7540

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 📍 Serving Boise, Meridian, Eagle, Nampa, Caldwell & all of Idaho