Samaritan Ministries vs Liberty Healthshare

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Posted by admin | Posted in Other Ministries | Posted on 26-09-2014

Liberty Healthshare is a 4th healthcare sharing ministry, which is fairly small (and growing) and has now established themselves under Gospel Light Mennonite Church Medical Aide Plan, Inc which now makes them an eligible sharing ministry under the ACA.

If this page is your first glimpse of Samaritan and you are interested in more details about how Samaritan Ministries works, please read through the pages at the right as I go into a lot of detail about everything. If you have questions don’t hesitate to ask! 🙂

 updated 11/1/16 SAMARITAN LIBERTY SHARE LIBERTY PLUS LIBERTY COMPLETE
PERSONAL RESPONSIBILITY $300/incident (can be reduced to $0 with discounts) $500/pp annually with $1500 max (3 ppl in house)
MONTHLY COST
family of 4 $495 $395* $424* $449*
couple age 25 $360 $198 $227 $249
(see full cost structure here) see full cost structure here
 Liberty pricing is $50/mo cheaper for those under 30, and $25/mo higher for those over 65 (compared to amounts above)
WHEN BILL SHARING CAN START Immediately Immediately
ANNUAL FEES, APPLICATION FEES No annual fee, $200 application fee $125 1st year membership fee
$75 each following year membership fee
No apparent application fee
PROVIDER NETWORK NONE, see any doctors NONE, see any doctors
GUIDELINES OF COVERAGE Samaritan
Guidelines
Liberty Guidelines
 EXTRA SHARING PROGRAM  yes – Special Prayer Needs for non-publishable needs like dental, pre-existing, etc  No extra program
METHOD OF PAYMENT send direct to Members members send money to online sharebox accounts
AVAILABILITY all states all states
 PRE-EXISTING CONDITIONS 1. For most issues if the condition has been considered “cured” with no treatments or symptoms for 12 months, it’s no longer pre-existing.

2. For cancers and heart conditions the timeframe is 5 years

3. Type 1 diabetes is always considered pre-existing.

4. New, unrelated cancers are shared right away, even if you had a different cancer previously.

Deemed pre-existing if conditions have had symptoms/treatments or meds within the past 24 months.

No sharing year 1.
Months 13-24 (year 2) shared up to $25,000.
Months 25-36 (year 3) sharing of another $25k (total of $50k)

Starting month 37 no longer considered pre-existing. Per guidelines, Liberty may deny membership to those with active pre-existing issues.

REFERRAL PROGRAM $180 credit $100 Visa giftcard
 HOSPICE CARE  Fully shareable for 90 days with doctors order, extended in 90 day increments as long as doctor prescribes. Pays for 5 days in any 30 day period
WHO SENDS BILLS patient sends bills to Samaritan doctors send bills to Liberty electronically
COVERAGE LIMITS
  • $250,000/incident -regular membership
  •  Save to Share program is for everything above $250,000 with no limit.
  • No lifetime limits
  • Liberty Share: 70% of bills up to $125,000/incident
  • Liberty Plus: 100% of bills up to $125,000/incident
  • Liberty Complete: 100% of bills up to $1 million/incident

New guidelines state no more lifetime limits. Apr 2016.

 CATASTROPHIC COVERAGE  Save to Share program is for everything above $250,000 with no limit.  Guardians Group program is for everything above $125,000 up to $1 million. There are some limitations.
FAQ Samaritan FAQs Liberty FAQs
PRESCRIPTION DRUGS All drugs related to an incident/treatment and those as part of hospital treatments are shared plus four calendar months of maintenance drugs. Cancer meds are not subject to that limitation. 45 days before and after each related medical
incident
PHONE NUMBERS (888) 268-4377 (855) 585-4239
WEBSITE samaritanministries.org libertyhealthshare.org

 

Liberty Healthshare has 3 sharing plan options with the lower monthly cost plans giving fewer services/less “coverage”. They do list their guidelines online for all to read and I have linked to them. I noticed when reading that they have a very short list of things they cover and a very long list of things they don’t (this is starting to improve, they recently updated their guidelines mid Feb ’15), including some oddly specific exemptions like not sharing for hospital stays if you check in on a weekend and it’s not an emergency. Odd. Neither ministry covers dental officially, but Samaritan does allow dental to be listed in the Special Prayer Needs and Liberty doesn’t appear to have a program like that. I like that Liberty shares in annual exams and shares in routine mammograms and colonoscopies every other year until you’re 50, then yearly at age 50. Their guidelines indicate they are a lot more restrictive on the things they cover. There are now 36 (down from 62) listed things they don’t cover at all, and 17 things they only share in limited fashion. I think this is because they are pretty small and probably don’t have the share funds available to do as much as the other ministries can, although they have gotten bigger and are allowing for more sharing of needs within the last year. Liberty has a provisional membership status for anyone who applies and has health conditions they feel could be improved by lifestyle changes. From the few reviews I’ve read it sounds like that could include weight, bloodwork issues and so on. They want you to be healthy when joining. Liberty has a step up program for pre-existing conditions (anything having treatment in the past 24 months), no sharing in 1st year, then $25k 2nd year, $50k third year, 4th year not pre-existing any more. They require pre-notification for non emergency services and notification within 48 hrs for emergency situations. It sounds like they do have a membership card that you give to providers.

SIMILARITIES

  • They both have similar statements of faith required, although Liberty’s statement is not as doctrinally Christian as Samaritan’s.
  • No tobacco use.
  • No s-e-x outside of marriage.
  • No coverage for abortion
  • Both will prorate needs if needs are bigger than available shares, both have policies for raising monthly shares if needs are prorated too often
  • No networks, allow you to see any doctor
  • Both have a membership card that you can present to providers
  • Both allow for sharing of some alternative treatments, usually with prior approval and not too expensive. Liberty just recently started this allowance mid Feb, Samaritan recently expanded their sharing for alternative treatments to be more encompassing.

 

MAJOR DIFFERENCES

  • Liberty does share for 1 wellness visit per year and shares routine mammogram and colonoscopies every 2 years until age 49, every year for age 50 and up.
  • I can’t find anything about any extra sharing plans (like Samaritan has Special Prayer Needs for those expenses like dental which don’t otherwise meet the guidelines)
  • Liberty has a discount program you can join which gives discounts at participating dentists, eye doctors, etc.
  • Liberty has a lot more services that they don’t share vs how many they will share
  • Liberty has a step up plan for pre-existing conditions, no longer pre-existing in year 4 of membership.
  • Liberty does allow for same sex couples/partners (married or not) to join but they must join under separate memberships not as a married couple. Liberty is the only HCSM I know which allows this.
  • Even the top sharing plan with Liberty has an incident cap of $1 million. Lifetime caps have been removed. Samaritan has no caps if you’re in the Save to Share program and no lifetime caps regardless.

REVIEWS

Liberty is a very small ministry with about 28,000 members as of Sept 2016 (according to a couple of member reviews). Initially there weren’t a lot of reviews out there, but I’m now able to find quite a few on google and social media. Unfortunately the more recent reviews are quite negative with a few positive ones in between.  I get the impression that Liberty has had trouble managing their growth and customer service is now lacking, and bill payment has been poor for several members.  The firm they use to get additional discounts, Claims Delegate Services, told a member that it could take a year to get billing settled. That is not a good sign, and hopefully it’s an isolated case.  I didn’t even consider them at first because being exempt from the ACA is critical to me, and they were not for sure exempt when we picked a ministry. After having confirmation they are exempt they were previously my 3rd choice for a ministry to join, but the negative reviews lately have put them in 4th position. I am concerned about their small size (of course they all had to start small), they cap incidents at $1 million which bothers me tremendously if we were to have a very expensive issue, but their lifetime caps have been removed as of Apr 2016. I wish they had an extra sharing program that the other 3 have.

This is from Liberty’s guidelines: “Medical expenses for a newborn arising from complications at the time of delivery that exceed $125,000, including congenital birth defects, are not eligible for sharing by members of GUARDIANS GROUP.” — Ok I find that concerning. So if you have a baby as a member with expensive complications/birth defects even the Guardians Group membership which is designed to cover bills going above the $125k limit still won’t share in the cost?  I am not planning on more children so this is less of a concern for me, but I would suggest anyone considering Liberty and wanting more children to ask about that.

Guardians Group level is what provides member sharing for incidents above $125k. However, it will not share expenses for congenital birth defects and organ transplants, and has waiting periods on a couple other issues. Please review their guidelines for more details.

Liberty’s website says that providers are reimbursed at Medicare’s rate plus 50-70% depending on if it’s inpatient or outpatient or physician charges. I am curious what happens if the provider doesn’t agree to that reimbursement rate, does the patient get balance billed? My area hospitals wouldn’t accept those payment levels, but I’m sure lots do. That is something you should ask Liberty if you are considering them. I am starting to see more negative reviews on review sites, but there are also positive ones. Some people have had trouble getting bills paid, even for their routine visits. I’m sure that’s not the case for everyone, and it may be just a timing delay. They do state they abide by Christian principals, but I think they are more loose about some of those definitions. I’ve read that Liberty Healthshare only require you to believe that government should be out of healthcare and share like-minded beliefs, and apparently couples in non traditional marriages are allowed to join, but only as single members on separate accounts.

I have not called Liberty to get information on their program, I am just reviewing what is available on their site and I update this page every few months. Overall I am cautious and skeptical about Liberty, but think they have good potential for the future. Their guidelines appear a little restrictive and confusing, but that does seem to be improving as they grow (I’ve been watching their guidelines for a couple of years).  I would pick their top plan, wouldn’t even consider the bottom two if I was choosing them.

Please review their website for any updates they have done on new sharing guidelines.

OUR NEED EXPERIENCE

We experienced a surgical need while Samaritan members and found it to be a very simple, straightforward, rewarding experience (as much as any medical event can be). The big question is always, “will it work?” and I can honestly say, without any hesitation, YES IT DOES. We had 100% of the costs of my husband’s surgery shared by Samaritan members and all of it was received 2 1/2 months after the surgery was performed. That is faster than any insurance payout we’ve had in the past, and the Samaritan staff was wonderful, as were the medical staff upon hearing that we are self pay and learning we are ministry members. You can read more about it in my blog posts (links at right), but overall the process demonstrated that need sharing is simple, the staff were supportive and we loved the cards and prayers from members, and we had the entire cost shared (we got an immediate 50% discount for being cash pay). The doctor was thrilled to be dealing only with his patient, and we received the best care from our preferred surgeon. This is how health care should be. Without question. If you are looking for something that better fits your family please give Samaritan a look. I think you’ll be thrilled with what you find. 🙂

If you’d like more information you can click here to request an information packet direct
from Samaritan or signup online.

samaritan image

Consider these 10 points before running to the doctor

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Posted by admin | Posted in Self Pay Resources | Posted on 13-09-2014

I believe in the American health care system, but I also believe that people are placing too much faith in it and expecting quick fixes for conditions we could better prevent or handle on our own. Good judgement is required, and modern medicine can do a lot, but it should never replace our need to properly manage our own health.

I will point you to a great article written by an MD, who admits that if everyone followed her advice she would lose money. But she felt American’s need to know these things. We would all be better off with a little more common sense, good judgement and taking better care of our own bodies instead of expecting that modern medicine will just “fix” us so there’s no need to be responsible.

You can read her article here: http://www.mindbodygreen.com/0-13606/10-reasons-to-think-twice-before-going-to-the-doctor-advice-from-an-md.html

As a self pay patient, and a Samaritan member, her points ring true to me. Here’s my opinion on each point.

1. Eat better, feel better, be healthier. Pretty logical.

2. Hospitals can be dangerous, but I don’t think we should be in fear of them. However, don’t treat them like a Hilton either. We shouldn’t want to stay in one longer than absolutely necessary; both because of cost and exposure to everything going on in one. I know of people who like hospital’s so much they are constantly looking for any reason to be in one. They just become a burden on the system and end up broke financially and emotionally.

3. She says annual physicals are too frequent, and while I agree that yearly is probably a bit much, I do think they are important as we age and more can start going wrong, and also if the patient has family history of issues, then closer attention should be paid to those. For many people she’s right, checking in with your every few years is usually fine. The point is, be in charge of yourself, you don’t have to go all the time just because the gov’t says, or some guideline says you should. Do what is right for YOU, based on your health and your family history.

4. A healthy gut is critical for healthy living. Agree 100 percent.

5. Reduce stress! Yup, I still need help with that.

6. Sugar is addictive and causes a multitude of problems. Agreed. I need to get off that one, too. Boy do I love sugar.

7. Exercise. Not my favorite, but definitely necessary. Gee, she’s really hitting home with these points.

8. Thriving doesn’t come from your doctor, it comes from living well. The doctor isn’t there to live your life for you.

9. Find a passion in your life and do it. I agree, those who are lucky enough to be passionate about their daily work tend to live longer, be happier and live healthier. This isn’t easy to find, and not always possible, but we should strive for it as much as possible.

10. Medical care is expensive. Um, YUP! And it’s just continuing to get out of control. So why spend more on it than we need to? I agree that we should be proactive with our health and do as much on our own so that we don’t have to over pay. There are people who have gone decades without needing medical care simply by taking care of themselves. It’s not a rule that everyone needs to see the doctor all the time. The doctor shouldn’t be a crutch. He’s there to help us when we fall, not carry us our whole lives. We should stand on our own two feet, take care of ourselves the best we can, and walk with Jesus.

 

 

So thankful we don’t have to deal with networks!

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Posted by admin | Posted in Samaritan Perks | Posted on 06-09-2014

http://www.ketv.com/news/blue-cross-blue-shield-insurance-carriers-face-questions-come-midnight/27816944

Blue Cross Blue Shield of Nebraska and CHI Health, formerly Alegent Health, were unable to come to an agreement about pricing last week, so all CHI affiliated hospitals (about 15) and over 1000 providers just became “out of network” for Blue Cross members. That means costs just went way up for those patients because insurance policies usually have patients owing about double when they go out-of-network. Nebraska is pretty rural outside of Omaha and Lincoln, and there aren’t a ton of hospital choices without traveling large distances. If your doctor is part of this mess then do you decide to change docs (a very personal decision) and possibly drive a lot more or pay more for services?

As a member of Samaritan Ministries I am again reminded how happy I am to have no worries about provider networks. Samaritan lets me see any licensed doctor I want with no hassle about whether they’re in or out of network. That is a great relief when traveling, and now also when these kinds of negotiations fail.

I have such sympathy for Blue Cross members and hope these companies are able to get things straightened out soon, for the sake of their customers. Blue Cross is a huge provider in this area, this problem affects a lot of people I know.