When was the last time this happened to you?
You get your ‘health insurance’ premium and instead this month it is LOWER than your regular payment because there were less insurance claims … so everyone’s bill is reduced that month to compensate.
N E V E R.
This month we just experienced this – with Samaritan Ministries which I must say clearly is NOT traditional medical insurance. Now, a reduction in a month’s payment is RARE… the last time this happened they said was March and October of 2008. But the fact that it can happen at all — is just plain fantastic.
So, if this isn’t traditional medical insurance … what is Samaritan Ministries then?
In layman’s terms is a very large membership group of people who agree to pay a set known amount each month and instead of going to an insurance company, that money goes directly to the family with a real submitted medical need. If you have a medical need, then you receive money from other members until your ‘need’ amount balance is paid. It is a very simple concept and yet, took my husband and I a number of years to investigate, ask for references, pray about… and get totally comfortable with – before jumping off our Blue Cross Blue Shield provider. Now I wish, we signed up years ago.
This was our situation – we are self-employed and have been for almost a decade. The bonus of that is…. paying for independent health insurance and paying a TON for it. Not only was it expensive each month – for us, family of just 4, was $1,400 a MONTH. Each year, it would rise a lot as well and not a little bit… about $75/month more… If you had a birthday – Happy Birthday – that month if you were in a new bracket – another massive increase. So say, every few years between hubby and I – there were two increase letters a year. I’ll tell you honestly – when I would get that envelope in our mailbox I would feel literally sick to my stomach waiting to see how much our new payment would be.
At $1,400 a month… then if you happen to actually use that insurance you have an individual or family deductible and also a 20% co-insurance to pay on all bills up to your out of pocket max — with BCBS. This is common with most health insurance providers. So you’re scraping to pay your monthly bill even without using your insurance.
We took the leap of faith this summer and joined Samaritan Ministries. We pay $405/month for our family of 4 now. Call that a $1,000.month savings! Now, we can start putting savings aside in a bank account to pay our out-of-pocket medical expenses, pay off debt etc.
HOW DOES IT WORK ?!
In a very simple description…. wellness visits, vaccines, visits that are under $300 are not shared – this is your personal responsibility. If you have a non-preventative visit that ends up being over $300 you can submit that to Samaritan Ministries as a “need” with simple paperwork – and your need will be divided up amongst other member families – put on their monthly ‘newsletter’ with your name, address and the reason for your need and they will send a check to you personally. If a person in your family has more than three $300+ publishable medical needs, the forth onwards that year will be publishable at 100%. Samaritan Ministries is administrative and they organize who gets what etc…. and make sure everyone is participating as expected. If a check bounces… you tell Samaritan Ministries, they ask another member to pay that share instead to you … and give a warning to the member who bounced the check. I believe if they do it again…. or not sure if it’s a 3x you’re out rule…. but if so – then they are no longer able to be a member. This program is way to precious to bounce a check… so undoubtedly I’m sure every member household tries VERY carefully to never ever ever bounce!
Publishable needs up to $250,000 are covered. If you wish to participate in an optional ‘Save to Share’ plan you can be covered for needs OVER $250,000. All you do is sign up for this optional program, which we certainly did, and you have to keep a certain amount ready in savings, I think it’s under $400, I year ‘just in case’ someone has a need over $250,000 and you’ll be told how much to send to that person from that ‘kitty’ so to speak. So far, we haven’t been asked for this but are ready if we need to. If we have a need over that amount, we would get taken care of in return.
WHAT IS NOT A PUBLISHABLE NEED?
You would need to read the documentation online at Samaritan Ministries for all fine details but simply things like needs resulting from:
- substance abuse (drugs, alcohol, smoking etc.)
- car accident caused by the driver being under the influence
- gender assignment changes
- issues resulting from risky sexual behavior/pregnancy outside of marriage
- certain driving off-legal roads on certain ATVs
- dental or optical – unless is a certain kind of medical need described
- cosmetic surgery
- pre-existing conditions
- and more… you’ll have to read it yourself if interested.
I’ll tell you this… our ‘fine print’ booklet from BCBS was WAY WAY WAY larger, more pages with smaller font and WAY harder to understand than the Samaritan Ministries Guideline Booklet. It’s written clearly and easily understandable – there are no gray areas. I appreciate the transparency of knowing what your responsibilities are.
HOW TO JOIN?
This is a Christian Ministry. On the membership form, your pastor (or perhaps a church Elder or another church staff member to whom you are personally responsible to – perhaps a Bible study leader etc…) from your church signs your form stating that yes – you are a member of that church and attend regularly.
The form is short, simple. You state that you do NOT drink alcohol, smoke, engage in sexual activity outside of marriage etc… (You won’t be covered on these things, nor accepted into the program if these are a part of your life.) You must list all pre-existing conditions. See booklet for details on that as these aren’t publishable. You send in your first month’s payment and a registration fee. For the first few months your monthly payment goes to Samaritan Ministries for administration. After that, you’re monthly needs are sent to a member directly in need. I think to keep the organization going 1 month payment a year might go to the Samaritan Ministries office for admin purposes.
WHY DID WE CHOOSE SMI – THERE ARE OTHER CHRISTIAN MEDICAL SHARING PROGRAMS?
We looked at two other Christian Medical Sharing organizations before choosing Samaritan Ministries.
Here are the reasons why we choose Samaritan Ministries:
- We had direct personal positive experience referrals from friends who were with Samaritan Ministries and did experience full pay-out on their medical needs. Some are no longer with Samaritan Ministries only because their spouse changed jobs and they were sort of forced to all go on that plan. They stated they wished frankly they could STAY with Samaritan Ministries…. and would re-sign up in a heartbeat if their situations changed.
- Online comparison websites and opinions — very few had anything negative to say about Samaritan Ministries. There was a few ‘hmmm??’ concerning comments on a few other organizations that put a red flag up for me – but not with Samaritan Ministries.
- We liked the transparency of the organization – the money trail. Money to admin goes to admin. Money to members goes right to members in need. If all the money went to a head office… whose to say they don’t pocket it and open a Swiss bank account. 😉 Not that is likely to happen…. but when you’re researching it’s good to be paranoid to a degree and make discerning choices. When you give up responsibility for bill payments that are between X and the provider… communication can get muddy. We’d rather know that our bills are paid directly ourselves and have a receipt of that.
- Multi-levels of accountability
- Our favorite part has been hand making cards for the recipients to go with the check. When you’re ill or recovering from surgery and so on… there is nothing like a hand written note and knowing that the sender is specifically praying for you !
- Members have voting rights
- The monthly newsletter is great! You’ll get a ‘This Month at Samaritan” and a”Christian HealthCare Newsletter” as a part of your monthly packet and the articles are relevant, interesting (new medical treatments, natural medicine, missionary stories about members etc.) and you’ll read testimonies from other members who have been blessed during very difficult life circumstances – enough to bring you to tears of joy!
- You get a “Monthly Prayer Guide” for each day of the month there is a person’s name along with their medical need to specifically pray for. There is power in prayer and to have thousands of people praying for YOU is uplifting and encouraging to say the least.
- No network, you can choose any medical provider you wish. With the new government medical plans, more doctors are going private and encouraging cash patients.
- As with anyone paying cash and avoiding complex insurance paperwork…. you get negotiate large discounts off of your bills thus helping all members ending up paying less out for a given medical need.
- No medical exam to register.
- If you have a need that is say, pre-existing, and not publishable you can still have a chance for other members to make a personal decision to send an offering to you out of the goodness of their hearts – this happens… and families have been blessed with unexpected funds! This is called a “Special Prayer Need”. These are included on your newsletter and it is up to you whether to contribute to help another family in addition to your designated monthly share payment.
- Exempt from the 2014 Federal Tax imposed on ‘non-insured Health Reform Act.’ Samaritan Ministries is in contact with the IRS who are currently developing a form for Samaritan Ministries to use for their 2014 taxes. (There are a couple other Christian Medical Sharing organizations who are also exempt. Not ALL are exempt. There are rules, grandfathering, subject to 3rd-party auditing of the organizations required etc.)
- You’ll want to save some money aside for the unexpected. If a normal Dr visit costs $200 that could hurt at the time if not prepared for that in savings. It might feel worse that paying a $30 office co-pay BUT… you’re way ahead still since you didn’t pay a $1,400/month payment that month like we would have…..
- You might want to ask your Dr if they will accept cash. Most will happily, but is good to ask first!
- For a large procedure, you’ll want to put a down payment on that in good faith with the billing department. Explain that you’re a member of Samaritan Ministries, how that works, and get on a payment plan.With traditional insurance you do that… pay your deductible… than arrange for payments when the bills start coming in – which they will !
- It can take a few months for all member checks to be received. Getting on a payment plan with your medical provider for hospital, in-patient etc. type services that get pricey will be important. From personal experience with billing departments, they are happy if you’re in communication with them and have a plan in place.
- Ask your tax expert, but monthly shares are not tax-exempt. Extra donations are… but not the monthly share.
Feel free to contact us if you have any questions at all, we’re happy to help. If I have helped your family with this review, if you would be so kind to include my member number #60441 on your form as a referral that would be truly appreciated. Samaritan Ministries is based on word of mouth and they do offer a small token credit off a member’s monthly payment if they have shared information about Samaritan Ministries with a new registering member.
We are still relatively new members and will keep adding more updates to our experience with Samaritan Ministries as we go!
UPDATE: December 2014 – for the third month in a row our monthly share was reduced by 8% !! because there was more share money than needs again. God’s provision is something to be so thankful for !
UPDATE: January 2015 – 4th month in a row our monthly share was reduced by 17%!! I know this can’t last… but so thankful while it does.