Friday, December 27, 2013

Samaritan Ministries: Anyone Here A Member?

Samaritan Ministries is a cost-sharing alternative health insurance.  I've read about them in the past, and I recently ran into a contractor at work who is a member and speaks highly of them.  The strategy is:

1. Pay up-front for medical bills.
2. Send bills above $300 to Samaritan.
3. They randomly pick other members to send their monthly membership fee to you.  If you have $1650 in medical bills, ten individual members will send you $165.

The costs are quite low ($165 per month for a single person, $315 for a married couple) because:

1. Pay up-front and get a discount from medical providers.  (This is often quite impressive.)

2. They have certain requirements for membership: regular church attendance; adherence to a pretty basic definition of Christian beliefs; no drug abuse, no tobacco, Biblical marriage (one man, one woman, and fidelity).  This knocks out a tremendous number of medical high-risk people.

Are any of my readers members?  I am intrigued by the possibility for when I retire, both because of cost, and because it conforms to a Biblical model of Christian living that I would prefer anyway.  I would love to hear both good and bad for an article that I am writing.

Oh yes: somehow, membership in such a cost-sharing ministry exempts from the Unaffordable Care Act requirement that you buy insurance.

UPDATE: Unfortunately, there are two categories of pre-existing conditions that are not ever covered: diabetes and heart disease.  Cancer is covered after seven years symptom-free.  Since my major concern is heart disease, I can either buy conventional health insurance, or put the $300 a month aside that I would save over conventional health insurance into an HSA, and figure that my horse valve will probably last until I am eligible for Medicare at age 65.  But even if that happened just before I turned 65, it would only be $25,200 plus interest that I would have saved up -- not anywhere near enough to cover a serious heart problem.

This is probably still a good strategy for Christians who do not yet have cancer, heart disease, or diabetes.

8 comments:

Unknown said...

Members of health sharing organizations which which existed before some cut-off date (checks - 12/31/1989) are exempt from the Obamacare requirement. The other two exempt organizations are Christian Healthcare Ministries and Medi-Share.

I've heard some criticism but generally good things about all three, but that's about all I know (I was looking into the subject just on the hypothetical that the ACA kills both my health care plan and my husband's.) I did find a blog about self pay health care which might have more information and certainly has information which is useful for people doing medical payment sharing programs.

Heather P said...

to be exempt, ministries must be in existence and continually active since 12-31-99.

We are members of Samaritan Ministries, the largest of the 3 Christian ministries which are fully exempt. we love it. we haven't had to submit a need ourselves yet, but friends of ours have, and everything was paid in full. with the ACA going full steam Jan 1, membership at Samaritan has increased tremendously. This method of getting medical bills covered without fighting an insurance company is really coming into its own. I love that we can choose any doctor, any hospital, even alternative treatments are allowed (preapproval required for those) by Samaritan. The staff are friendly, the president makes a reasonable salary, expenses are low.
I love it so much I have an entire website dedicated to it and compares Samaritan to the other two. Feel free to ask questions of myself or the main office. They are really great to talk with.
Heather
Samaritan Ministries review blog and website.

rfb said...

Heather P, et al

How does this system work in the vent of significant high-end procedures such as transplant surgery or the huge bills that follow something like a heart attack?

Thank you

asdf said...

You say biblical marriage is a requirement. That sounds like you can't be single. Or do you just mean, if you are married it must be one man one woman?

asdf said...

And what happens with pre existing conditions?

Anonymous said...

My family joined Samaritan Ministries (via The Health Co-Op) a year ago. We could not be happier. It is an amazing experience to send a check each month to someone who has had a medical event of some type. Sometimes we receive thank you cards back from the member we sent our check to (the ministry directs each member as to whom they send their "share" each month).

It is a humbling experience to be on the receiving end of this process (we just had our first need submitted).

Heather P said...

Sorry I didn't answer sooner, I didn't see these questions.

1. Yes, singles can join. Biblical marriage means between a man and woman.

2. The regular membership covers needs up to $250,000, which is 99%+ of them. They have a separate program called Save to Share to cover needs above $250k. Save to Share is not expensive, and you don't send the money to Samaritan. You are asked to keep a certain amount in savings and you might get called in to send some of it to someone with a larger medical need. It's possible you won't have to spend any of it, or maybe just some. We're on the family plan at $370/mo for regular members, plus we put $399 in savings to cover a year of savetoshare needs. Singles and couples are asked to put in less. Their largest need paid is $1.5 million, negotiated down to $700k, all paid.

3. Diabetes and heart disease are always considered pre-existing. Cancers are shared after 7 years without symptoms. Other pre-existings are shared after 12 months without symptoms.

4. We are asked to cover the first $300 of each need. If we get discounts, those are applied to the $300 so it's possible to have that requirement reduced to zero. The $300 only applies to 3 needs per year, after that the requirement is null.

What is not covered are preventative care and routine checkups. Samaritan operates under the guidelines of Galatians 6:2 Carry each other’s burdens, and in this way you will fulfill the law of Christ. The responsibility for the 1st $300 of each need and our own checkups follows with Galatians 6:5 for each one should carry his own load. As a result the costs are kept way down and members are not overly burdened. Compared to our former insurance plan (and certainly compared to ACA plans) we will actually pay less out of pocket throughout the year and in the event of a need.

YoYoMama said...

I am a member of Samaritan Ministries. While you can submit most health needs to the ministry, my family unfortunately has incurred needs that aren't covered. You need to be aware of what you are getting into.

Mental health is not covered. My son had a major mental health incident 1-1/2 ago. He is serviced by the county health system as he requires ongoing medication. ANY ongoing medication will not be covered by Samaritan, and mental health is NOT covered at all.

Health conditions covered by "sinful behavior" is not covered. While many may view this as an advantage, keeping the cost down, this can have an unfortunate consequence, especially if you are a parent of teens, who are notorious for engaging in risky behavior. It happens even to Christian parents, who raised their kids in Christian homes.

Since joining Samaritan, both of my teenage girls have gone through a rebellious phase. One daughter needed drug treatment (not covered), another daughter is currently pregnant and giving the baby up for adoption (again, NOT covered). We are leaning on Medicaid and the adoptive parents to help with expenses.

So, at especially painful times in my life, with all three of my children suffering, NOTHING they have gone through (or brought on themselves) is covered by Samaritan. This has been both expensive and discouraging.

My advice to anyone considering Samaritan or Medi-Share with teenagers is: buyer beware. Although we sat down with our teens and said - the consequences of these behaviors are NOT covered - teens are teens. They are impulsive and often stupid, even when raised in a Christian home.

One would hope for compassion in these instances, but trust me, Samaritan and Medi-Share will stick with the guidelines, which offers no leeway. Parents, you will pay the price for this. Just a warning.