Recently my husband and I have been evaluating all our bills to try to cut back. Like so many other people, the economy has taken it’s toll on our finances, and we’re looking for ways to make our money stretch further.
The most recent area of our finances to come under fire is what we pay for health insurance. It’s getting time for my husband’s employer to renew insurance, and that usually means a raise in rates. Because he works for a small company, our insurance rates are through the roof. Last year the employees elected to forego prescription coverage, to keep the costs from going up a lot.* But as it is, insurance costs eat up about 1/3 of my husband’s paycheck. It’s not the fault of his employer at all, but it’s not working out so well for us.
Looking for Alternatives
Unfortunately there aren’t a lot of alternatives for us. We’ve tried to buy our own policy before, but because of pre-existing conditions, we can’t get coverage. And since I’m a freelancer, I don’t have an employer to turn to for insurance. And since I only freelance part time, I can’t qualify for self-employment insurance pools, like the ones available through Costco.
A Possible Solution: Samaritan Ministries International
One of the options we’re considering is Samaritan Ministries International. It’s not insurance. Rather, it’s a group of Christians who share medical expenses.
Basically, you pay a certain share per month. In our case, it would be under $300, which is less than half of what we pay now. Each month we would send that money to a family who has submitted medical expenses that need reimbursement. If we had a medical need, we’d submit our bill for reimbursement, and other families would send us money.
The $300 or so would only cover us up to $100,000, which isn’t much. So we’d probably opt to pay $400 more per year to be covered up to $1 million. Still, that comes out to less than $350 a month, still a big savings from what we’re paying now.
To become a member of Samaritan Ministries International, you have to be a Christian and be willing to live by some guidelines that are generally accepted by Christians (attend church regularly, don’t abuse drugs, etc.). None of the requirements would be a problem for our family.
Pre-existing conditions may not be covered, but again, this is not a problem for our family. The pre-existing conditions that prevented us from getting our own insurance coverage aren’t things that require any follow up care.
How Samaritan Ministries International Works
When you have a medical need, you contact Samaritan Ministries International. They send a packet out to you, so you can fill out the forms and submit your expenses. They also begin praying for you.
After you submit your expenses, they are processed and your need is published in the monthly newsletter, so others can pray for you. Specific members will be assigned your need and will send their monthly share to you, so you can pay your bills. There is a system of checks and balances, so if someone doesn’t send the money or a check bounces, another person will be assigned to send you the money to meet your need.
The Pros and Cons
As with anything, there are pros and cons to this insurance alternative.
Pros:
- It’s much less expensive than what we’re paying now.
- It’s better than going without insurance.
- I like the idea of people working together to take care of medical needs. No insurance. No government. People helping people.
- I also like the idea of a community of people praying for us when we’re sick.
Cons:
- Dealing with reimbursement, rather than direct payment from the insurance company could be difficult.
- Expenses under $300 aren’t covered; neither is preventive care.
What Will We Do?
The short answer is I don’t know. I’m definitely going to look into this further. We can’t afford our insurance now, and we’re expecting it to go up again. Our insurance right now isn’t great. We are covered for preventive care and have $20 copays for our regular doctor and $40 copays for specialists. But we have no dental or prescription coverage, and we really don’t go to the doctor frequently. I just called to get my daughter in for her 12 year vaccination boosters, and other than one bout of bronchitis, a flu shot, and a chicken pox booster, she hasn’t been seen since 2007. I don’t think any of us have.
This is a really tempting option for us. I’m going to have to think about it further. I’ll keep you posted on what we decide.
In the meanwhile, has anyone had any experience with Samaritan Ministries International? Care to share? What would you do in my shoes, knowing you could save $400 a month with this option?
*My husband works for a great company, and I want to make clear that I don’t blame them at all for our insurance situation. They really do the best they can. This is just the nature of the medical care/health insurance beast.
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For those of you that live in Oklahoma, you should check into OEPIC / Insure OKlahoma. It is real insurance based on your income and very, very reasonable. It is for students and self-employed individuals/families. I believe It doesn’t matter what you do, or if you are just working part-time. One lady started knitting and selling her items to church and family members, so she could qualify. You only have to pay $10 to see a doctor and then your RXs are $5/$10/$15. You get to pick your own doctors, it is real hospitaliztion coverage, and they cover pre-existing conditions. It will still be in force and effect in Oklahoma through 2014, even with the ObamaCare debacle. They will base your monthly premium on last year’s income. One caveat — if your employer offers you insurance, and you turn it down for whatever reason, you are not eligible for this plan.
Would the plan accept application from am small Christian School (about a dozen teachers and staff) as a group, or would each individual have to apply.
Thank you.
John, from my understanding this is available for a family, couple, or single person. The teachers and staff should each sign up this way. They will still get the best available price. I totally recommend Samaritan Ministries to every family because this is set up in a way that works, makes sense, and is very clear in their agreement. In fact, I would be way more skeptical of the massive (small print) agreement from most health insurance companies.. At least with Samaritan Ministries they actually want you to (require) you read everything before signing up.
Samaritan does have options for groups, please contact them for details. They are really great people to work with.
samaritanministries.org
If Samaritan does not allow preexisting conditions, then how did they get a waiver for ObamaCare, when ObamaCare states all policies and other insurance must allow preexisting conditions. I have preexisting conditions. Would the members reimburse me for issues arising out of one of my preexisting conditions?
Lee, Are you saying you should pay a few hundred dollars and immediately pay thousands of dollars for preexisting conditions? I don’t understand how that would work? But then again, I don’t understand how Obamacare could possibly work! Let me re-state… I am self-employed, and married. We have not had health insurance for many years now. After researching many health insurance companies, I have realized what a waste of money it would have been to pay the additional expenses factored into traditional health insurance in this day and age. Unfortunately, this forum is so full of mis-information about Samaritan. I have learned accurate information directly from Samaritan Ministries, and simply reading their agreement. This agreement is not too long, so take the time to read it when filling out your application. Also, I want to mention, that my wife and I spend about $75 per month on vitamins, supplements, and preventative “health care”. Just as brushing your teeth is preventative of gum disease, toothpaste will cost money. Does anyone actually expect their toothpaste to be covered? How we think about health care needs to change, as a nation. I think it begins with ministries like this one. God bless!
why won’t you answer his very reasonable question?
Samaritan Ministries is a healthcare sharing ministry, not an insurance company. Obamacare mandates apply to insurance companies. To be a qualifying ministry exempt from the ACA the ministry cannot turn down anyone with a pre-existing condition (they don’t, you are allowed to have it and still join and get other needs shared) and they cannot cancel membership if someone develops a condition or has a medical need (they never do, no matter how many bills you have). It doesn’t mean they have to share/reimburse for that particular pre-existing condition, but they do share/reimburse for all other needs. Samaritan considers most condition which have gone 12 months with no necessary treatment, no symptoms and is considered over by your doctor as no longer pre-existing anyway (diabetes and heart conditions are an exception). If you had a certain cancer in the past, and you’re “cured” for 7 years with no redevelopment, that is also no longer pre-existing as it has been explained to me. If you are still within that 7 year timeframe and develop a new unrelated cancer they will still share (cover) it right away. If you’re uncertain whether your particular health issue is truly pre-existing under Samaritan guidelines please call them directly. They’re very friendly. (888) 268-4377
But the key here is that the rules you are referring to only apply to insurance companies, which healthcare sharing ministries are not.
There are two other Christian ministries, and they have a stepup program for pre-existing conditions. Depending on the stage someone’s condition is in, they may either benefit with Samaritan because they’ve gone long enough with it being a non-issue to not even be pre-existing, or maybe better off with one of the other ministries under the step-up plan (if it’s actively being treated). Many issues that got people turned down for insurance plans in the past were actually just well managed former health issues which aren’t a problem anymore. In those cases a healthcare sharing ministry like Samaritan is a great solution as you don’t pay extra for having it, it is well managed, and depending on the length of time since it’s been an issue, the ministry may not even see it as such.
I had colon cancer almost 20 years ago. I am a single parent and last year had what I thought was considered preventative followup care, a colonoscopy and mammogram. My current BCBS insurance through my work did not cover these, since “something”(diverticulitis) was found, etc. And since my deductible is $2000, I was informed that I am responsible for the payment. I have been contacted by my doctor and even received a certified letter in the mail to inform me I needed a followup mammogram in 6 months. That was about the time that the amount I owed on the procedures was placed in collections. I pay over $7000 a year in premiums to the insurance company, almost as much as my house payment. How could I even consider having another procedure when the first one is not even paid? Besides the possibility that I might have difficulty in paying for my medications, someone tell me why I wouldn’t consider having membership in Samaritan. It is definitely something to consider.
I am self-employed, and married. We have not had health insurance for many years now. After researching many health insurance companies, I have realized what a waste of money it would have been to pay the additional expenses factored into traditional health insurance in this day and age. Unfortunately, this forum is so full of mis-information about Samaritan I have learned accurate information directly from Samaritan Ministries, and simply reading the agreement. This agreement is not too long, so take the time to read it when filling out your application. Also, I want to mention, that my wife and I spend about $75 per month on vitamins, supplements, and preventative “health care”. Just as brushing your teeth is preventative of gum disease, toothpaste will cost money. Does anyone actually expect their toothpaste to be covered? How we think about health care needs to change, as a nation. I think it begins with ministries like this one.
Just stumbled across this blog and the responses posted a year prior…. as a bookkeeper, accountant, and tax-preparer for Pastors and Christian families using Samaritan Ministries “Insurance”, I can tell you the system works very well. All items are paid as intended by the plan; by having a health savings account in place, other items would not be a concern. Let’s say your premium is $700/mo in a typical employer-offered insurance program. Take the $400mol difference, have it deposited in your health savings account, then YOU can choose your healthcare providers rather than go where your policy says you have to go. By the way, you’re not always billed the same by the physician if they know you are paying cash. Frequently you can see a savings in that area, as they are not dealing with insurance company red tape. Go for it!
It seems that everyone who has actual experience with SMI loves them and thinks they do great work and everyone who does not have experience with them is skeptical. I find it interesting in the 2 years since this thread has been going no one who has used SMI has had even 1 complaint! That is impressive!
Debbie,
In my own words, preventative is when you go in just for a checkup or a physical, not when you have a specific concern. When my husband had his heart checked out because it was racing, it turned out his heart was fine – but the cost of all his visits was published and paid for by Samaritan members. Even though each visit was less than $300, the *chain* of visits and follow-ups was considered a single incident because it had a single cause, so the need was publishable.
So in your example, any visits relating to the moles should be publishable as a single need, even if it turns out to be benign – unless the total cost is less than $300, of course.
You can send in bills one at a time if you want, but it’s easier to submit them all at once if you can cover or make arrangements for the cost in the interim.
A chronic condition discovered or diagnosed after joining would be publishable since, as you mentioned, it’s not preexisting. Even if you suspected it ahead of time, it seems to be more of an ethical issue than anything else. If you believe you had it before joining but it was never confirmed, I think it would up to you to decide whether you could submit needs for publication in good conscience.
About a preexisting pregnancy, you’ll have to check the membership guidelines. I know there is a clear and specific policy. I *think* the answer is that your need will be published up to the amount that you have contributed so far, i.e. if your monthly contributions as a member totaled $1,250 before the baby was born, you would be eligible to receive $1,250 toward the birth of your baby.
Just a reminder – I don’t work for Samaritan and I can’t speak for them, so please check my answers against the member guidelines or call them directly. I’m just a very satisfied member who loves to encourage others to join. :)
How is it determined whether or not the care is “preventative”? For example, if my husband is concerned about some moles and wants to have them looked at, at what point does SMI begin to cover? None if they turn out to be benign? Or would it cover the testing to see if they are okay? And, do we send in all of the bills for one medical “event”? What about a chronic condition that is diagnosed after joining (making it not preexisting”?
Lastly, I guess this is a silly question, but I’m already pregnant…I suppose I couldn’t get an out-of-hospital birth covered this time around?
If you need care and are pregnant there are lots of agencies and hospitals that provide free help to deliver a healthy baby. Many of these programs are Christian/Catholic and offer this help regardless of where you are in your faith walk. As for how it works at SM I suggest calling Samaritan Ministries or emailing them directly
Lynnae,
Thanks for keeping up this discussion page. The first comment is April 6, 2010. Surely, you made your choice by now. How is your choice working out for you?
Thanks, Dave
Ps. If you don’t wish to post your reply, feel free to email me back direct.
Jenn, I’m glad it’s working for you!
Husband and I have SMI. Essentially, it covers emergencies and childbirth. We love it. We’re aware that preventative care is an out-of-pocket expense and budget accordingly. His parents have been using Samaritan for decades. It’s certainly not for everyone but it is working for us.
Any suggestions or help for people with no insurance but have a diagnose of 2 ruptured disk in lower back?
My family has been a part of Samaritan’s Ministry for years. From tonsils and adenoid surgery ( 7 yr old daughter), my husband having kidney stones and the loss of two babies ( both stillborn).. SM paid ALL OF OUR BILLS! It has been a blessing beyond words. Just think of it as family helping family. We pay $320 a month for a family of five. When our medical bills are paid.. payment comes from other brothers and sisters in Christ.. along with words of love and encouragement and prayer. There was a comment posted about that the effect that “prayer doesn’t pay bills”.. and I would disagree with that! We go to the doctor if we don’t feel well and attend local health fairs each year for blood screenings, and other free or low cost screenings to stay on top of our health and have a baseline of numbers. I think it’s easy for people to be skeptical of something that is faith based. Again.. I really don’t have words to adequately express how wonderful Samaritan’s Ministy is.. and the blessing it has been in our lives. Just last night we were in the ER with our daughter as we feared a ruptured appendix. I had no worries of how the bills would be paid.. as SM has always been there for us. To God be the glory!
My mother and father-in-law have this insurance plan for them and their 4 kids that are still at home. It’s great! My mother-in-law was diagnosed with colon cancer in 06′ and Samaritans ministries paid over 95% percent of the cost! They have been happy with them over the years and are considering using them to provide a health care option to their employees. Its a wonderful company.
We have been with Samaritan Ministries for 4 years and think it is wonderful. As a self employed family we started looking for something when the conventional insurance was costing us more than our mortgage and it covered very little and had a high deductible plus a 80/20 on surgery. We’ve had 3 needs covered since joining and aside from the first $300 all the bills were totally covered by the shares sent to us. It was wonderful. I don’t know about you but we’ve paid for years just to pay off our share of 20% on a couple surgeries. I would not hesitate to recommend Samaritan. Another plus is they have a patient advocate who will help you deal with the hospital and all other vendors. They are a great organization.
I have read all these blogs and all I can share is that my son and his wife have had this through thier church for years and they have 2 girls and one on the way and this paid all thier home births too. They really like it. All this comes down to is that the middle man “BCBC and others” are just cutting the checks, and they keep a lot of the money to do it. At least this way, more of the money stays in the fund for people to use, and guess what…..they don’t have a special group figuring out how to get out of denying the claims! Yes, we all need help. I have been self employed for 15 years and had to always pay these crazy premiums. I just turned 51 and I am very healthy, I really pay attention to my heath, exercise, eat right and take vitamins, etc….always take the natural road first, and still have to pay the higher premiums. You just have to make a decision that is right for you and your family…You will always hear good and bad about everything you ask about…..
What controls are in place to keep the directors of SMI from taking off to Brazil, or somewhere, with the kitty?
Commercial insurance companies have layers on layers of controls and still an occasional embezzlement hits one.
Remember, there isn’t any treasure in the US Treasury (same for state treasuries). It was all gone long ago. And government is what sets the basic rules for security of insurance.
There have to be people watching the people who handle the funds. And people watching the watchers.
If the Amish bishop took off with the kitty, the courts probably wouldn’t deal with it as they do their “insurance” (actually a kind of social insurance) within their church.
bob.trent@bobmail.info
The Amish system is different. There is no “kitty” with SMI. All the shares (reimbursed expenses) are sent directly from one member to another. The only money sent directly to the organization is the first three months shares when you initially sign up, and then an annual membership fee of $175. It is not only effectively, but actually, members helping other members when member A sends a check to member B.
Good morning. My 65th arrives Nov 6, and I have already signed up for Medicare, although I’m still faced with buying supplemental insurance. My question concerns my purchase of a supplement. But my larger concern today is coverage for my wife, Carol. She turned 63 on Friday the 26th. I am retiring from God’s World Publications, effective this week, and so our group coverage is ending. We have been considering SMI for Carol for the next two years. However, a friend has told us that we must buy insurance for Carol immediately, before our group coverage ends. Otherwise, she will be considered uninsured, and the cost will skyrocket. When I mentioned SMI, our friend said that it may not be recognized as an “insurance” company, so when we try to buy supplemental insurance for her two years from now, she will be considered uninsured and the cost will be outrageous. Could you please let us know if this is really the case. Thank you.
Sincerely,
Norm Bomer
Asheville, NC
I JUST LOST MY HEALTH CARE AND AM SCARED. I ALSO HAVE LOTS OF PRE-EXISTING CONDITIONS. I TAKE 13 DIFFERENT KINDS OF MEDICINE, LIKE ANTIVERT FOR MENIERES DX, SINGULAIR AND XYZOL FOR ALLERGYS,AMBIEN FOR INSOMNIA,AMITIZA FOR IBS,PREMARIN FOR MY HYST. NEXIUM FOR MY GERD. I ALSO HAVE 2 MDI LIKE PREVENTAL AND DULERA FOR ASTHMA.MY NEW MEDICATION IS FOR LOW IRON, ITS CALLED INTEGRA PLUS. HOW CAN I GET COVERAGE WITH ALL THIS?
Some of those conditions can be treated nutritionally & with lifestyle changes. My son used to be anemic … we changed his diet and his iron levels returned to normal… Also, Melatonin (an herbal supplement) is great for insomnia… as well as the obvious – no caffeine after 2pm… take a walk after dinner … create a “bedtime routine” for yourself & turn OFF the TV (if you have one in your bedroom).
MELATONIN DOES NOT WORK FOR EVERYONE. I JUST DO NOT HAVE INSOMNIA BUT NIGHTMARES AS WELL FROM A TRAGGATY WHEN I WAS 16YRS OLD THAT I DEAL WITH PTSD FROM. I AM ALSO LOW IN IRON BUT MY BODY DOES NOT DIGEST FOOD THE SAME AS NORMAL PEOPLE SO I AM STUCK WITH ALTURNITIVES. I HEARD GREAT THINGS ABOUT THIS SAMARITAN THING BUT NOW THAT I HAVE BEEN READING ALL OF THIS STUFF THERE IS NO WAY YOU WOULD WANT TO HELP ME OUT! I HAVE TRIED EVERYTHING FOR ALL OF THE CUNDITIONS I HAVE AND GOD KEEPS TELLING ME TO BE PATANT THAT THERE IS A REASON WHY HE HAS ME DOING THING THIS WAY!
My husband is a retiree and has $$$ deposited into a medical reimbursement account by his former employer as a retirement benefit. Would we be able to claim the monthly amount to that account. This is the only way we would be able to make a $350 monthly payment, by taking it out of that reimbursement account?