An Affordable Alternative to Health Insurance
If you’re distressed about the rising costs of health insurance or confused by the complexities of the Affordable Care Act, you will be happy to know that there is an alternative form of health care.
Samaritan Ministries is a “Biblical, non-insurance approach to health care needs”.
Our family has been members of Samaritan Ministries for several years now, and we have been very happy with our experience.
First, let me say that one of the reasons Samaritan Ministries works well for us is that we try to keep doctor's visits to an absolute minimum. We use it for larger medical bills only. If you have ongoing medical needs which require frequent doctor's visits you may need to look for a different option.
How it works:
When you have a medical need, you state to your provider that you are “self-pay”. You negotiate with the provider for any discounts they can offer. If you need help doing this, members of Samaritan Ministries can request free help from the Karis Group.
You then submit your need to Samaritan Ministries and send them all of the bills that you received. After they review the bills and confirm that the need submitted is in accordance with their guidelines, they assign members to send their shares to you the next month. You will receive a checklist with the names of each family who will be sending a check and mark them off as each check comes in. At the end of the month you send the checklist back to Samaritan Ministries so they can confirm that the other members are paying their monthly share.
You pay the first $300 of each particular need that you share, and everything above that will be sent to you by the other members. If you have negotiated discounts with your providers, that will count toward the $300, lowering your personal out-of-pocket costs.
Pros:
It’s affordable. Our share for the entire family is $405 per month. That number remains the same regardless of how many children we have. Singles, couples without children, and single-parent families pay even less. Before we became members of Samaritan Ministries, we paid a similar amount for insurance, but that policy did not cover our children, had a high deductible, and did not cover any maternity needs.
It’s personal. When I call to submit a need, I am met with an “I’m sorry. I hope you get well soon.” When other members send their checks to us, we also receive an encouraging note.
It works. Whenever I discuss Samaritan Ministries with others, I often hear concerns that it’s too scary to trust the other members to send their checks to you. We have shared multiple needs and have never been shorted. I mentioned the checklist earlier which Samaritan Ministries uses to make sure the other members are sending their shares. If for some reason someone on your list does not send their share, that amount will be reassigned in the following month to another member. Also, I like that when I send my monthly share, I am sending it directly to another member. I know that the full amount is going directly to that person’s need. If the shares were funneled through the Samaritan Ministries office, I would have to wonder if the money was really being used for needs or if they were using part of it for their own profits. Sending the money from member to member keeps the testimony of the ministry above board.
I have freedom to choose my providers. Rather than having to choose from approved health care providers as I would with an insurance company, I am free to choose my own providers. I love being able to go where I know I will receive the best care and not have to worry about being denied coverage by insurance.
Cons:
As much as we appreciate Samaritan Ministries, there are some not-so-perfect things about it. I’ll share them here in hopes of helping you make the most informed decision about your health care coverage.
Prorating. This happens when the amount of needs submitted exceeds the amount of share money available. This has happened with one of the needs we have shared, and we received 80% of the amount of our bills rather than the full amount. 80% is still great, but when money is tight and your bill is large, it can be very disappointing to find out that the bills had to be prorated. However, if there is extra share money available the following month, the surplus will be used to help with the prorated needs. My husband just got a letter notifying him that there was some money in the pro rata fund which would be dispersed to those whose needs were prorated earlier this year.
Out of pocket costs. Since members pay the first $300 of each need they have, routine checkups and single doctor visits will be paid for out of your own pocket. That can be a drawback if you are used to frequent doctor visits that were paid for by insurance. Most optical, auditory, and dental needs are not shareable either.
Additional information:
Members of Samaritan Ministries are exempt from the individual mandate to buy health insurance. The new healthcare laws contain a provision that members of health care sharing ministries are not subject to the insurance requirement.
While most needs are shareable, there are some medical conditions that are not covered or have limited coverage. The member guidelines clearly explain which needs can and cannot be shared. Additionally, if Samaritan Ministries determines your medical need cannot be shared according to their guidelines, they may publish your medical need as a “Special Prayer Need,” where members can help you pray for God’s provision and where they are encouraged to give a small amount above their normal share to help with your need. Many times needs that cannot be shared are still met in full through the generosity of other members.
To be a member of Samaritan Ministries, you must be a professing Christian who attends church regularly. You must agree to abstain from sinful practices such as drug abuse and sexual immorality and you must be accountable to a pastor or other church leader for the needs you submit.
The maximum amount that will be shared among the members for each medical need is $250,000. Members are also eligible to participate the Save to Share ministry, where the rest of needs over $250,000 may be shared.
There are no lifetime or yearly maximum amounts eligible for sharing and there is no limit on the number of needs that an individual member or household may have.
If you want to know more, you can find FAQ’s, member testimonials, and application information on the Samaritan Ministries website. And if you decide that this is the right option for your family, I would love for you to mention our family as a referral (John and MaryEllen Bream).
If you have any additional questions you can leave them here and I'll do my best to answer them.
(Are you part of a health care sharing ministry other than Samaritan Ministries? Email me at imperfecthomemaker@gmail.com if you're willing to share about your experience in a short written interview. I would love to give the readers here a comparison of the different services available.)