Samaritan frees us from network headaches

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Posted by admin | Posted in ACA-Obamacare, Samaritan Perks | Posted on 17-11-2014

http://www.hngn.com/articles/49331/20141113/wisconsin-woman-meghan-rothbauer-taken-to-wrong-hospital-gets-300k-bill.htm and http://www.cbsnews.com/news/wisconsin-woman-sent-to-out-of-network-hospital-faces-hundreds-of-thousands-in-bills/

The above articles are a perfect example of why the restrictive networks of ACA insurance plans are so troublesome and why the completely freeing avenue Samaritan Ministries takes is so beneficial. A young woman having a heart attack was taken by ambulance to the closest hospital to save her life. She survives after spending several days in the ICU (praise the Lord!) The resulting bill was $300,000 and her insurance wouldn’t pay that much because it was out-of-network. An in-network hospital was about a mile away, but ambulance drivers don’t have time or care to check your insurance, they are going to do what’s best to save your life at that moment. As they should. Even though she got some great discounts, the whole idea that it could still cost her $40,000 or more out of pocket is completely crazy when her in-network cost 1 1/2 miles away would have been $1500.

ACA insurance plans have very restrictive networks in order to try to keep premiums down. Unfortunately this is creating a massive burden for some patients who are unable to find close doctors who accept their polices. This woman’s example of being unconscious during a medical emergency and having no ability to tell anyone where to treat her shows just how damaging that can be. Why should the right network even be a concern during something as critical as a heart attack? Is your first thought supposed to be “which hospital is in my network?” Good grief, the very notion is ludicrous and it’s amazing we have allowed ourselves as a nation to consider that standard acceptable practice.

Samaritan Ministries doesn’t give you that restrictive headache. A Samaritan member in the same situation could have been taken to any hospital and the bills would have been shared. There would have been support, prayer, and financial healing while she recovers. Samaritan would have negotiated a reasonable discount just like she did, and then would have shared the entire remaining bill with its members, instead of leaving her with $40,000 to pay on her own. That is the difference a ministry membership can make. She would have had the same treatments, been taken to the same hospital by the same drivers, had her life saved, AND had her bills paid WITHOUT insurance and WITHOUT the nightmare insurance is putting her through (in fact her final out of pocket cost likely would have been $0, even better than her in-network $1500). Her story is an example of the extreme failure of today’s insurance system and the growing success of health care sharing ministries which provide solutions to these very situations. The above scenario is one we just don’t think about until it’s too late. It’s time we have that discussion in this country and demand better. Fortunately HCSM’s like Samaritan Ministries exist to provide us with that peace of mind in addition to low monthly costs, financial healing during a need and prayer support from its members. When you think about it, it’s very hard to beat.

One Year Later

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Posted by admin | Posted in Samaritan Newsletters, Samaritan Perks | Posted on 14-11-2014

Well, it’s been 1 year since we joined Samaritan Ministries. Our official start date is Nov 1.   I want to go over a few of the key points I’ve learned during that time.

** The support staff at Samaritan is so incredibly friendly and helpful. I have called them a few times to ask questions from my blog readers that I wasn’t fully confident in answering on my own. Every interaction has been so reassuring and comforting about how this ministry is being managed.

** I love the monthly newsletters and ministry updates. Insurance always kept me in a fog, I had no idea what was going on behind the scenes. Samaritan publishes their need/share totals each month, sends out helpful articles on a variety of topics, and allows me to share in the needs of other members through prayer and financial gifts.

** Being self pay and a member of a health care sharing ministry definitely puts a new perspective on health care. You do learn to ask for discounts if they aren’t offered, to ask for a sample of something (medications, even contact lenses). You start to ask around your community where the best/cheapest places to get immunizations and lab work are and look online for discount services as many cities have great resources available. (Since we live in a rural area we discovered that the monthly immunization clinic in our area for those without immunization coverage and the discounted lab work at the annual health fair were our best options). And you learn that while sometimes self pay get charged more, there are also tremendous savings available for self pay patients. So far we have come out way ahead on the financial side and I’m pretty sure we always will. Thinking about our old deductible vs the $300 responsibility amount with Samaritan makes me sigh with relief each time. Thinking of our low monthly share does that same thing. 🙂

** From Nov 2013 through Oct 2014 (12 monthly shares), we have saved $5484.50 vs what we would have paid to Blue Cross in health insurance premiums during the same time period. That includes a small share increase which began in July. Wow. Thank you God.

** We discovered that our occasional prescription drug needs really didn’t change much in cost. A couple went up in price, a couple went down compared to our old copays. I was initially wondering how that drug part would work out, but between free samples, generic pricing and discounts from goodrx.com it has been a refreshing piece of cake to do medications outside of insurance. And the pharmacies really don’t care if I use a coupon vs an insurance card.

** Having a small savings account dedicated to potential health expenses is a must unless you have a huge cushion in your checking account. It’s a fact of life, health care costs money. I don’t feel like I’m being unfairly asked to pay for something at the time of service and I’m amazed that I used to just walk into a clinic and pay nothing as if they owed me something (while they waited for my insurance to reimburse them a small pittance). I have respect for the services being provided and if they have no timely money coming in how they those clinics cover their own expenses? Paying on the spot is fair and reasonable, I just ask to pay a fair and reasonable price. 🙂

** I used to think it was a badge of honor and success in life to say, “we have health insurance.” Now I couldn’t be prouder to tell people that we DON’T have health insurance. I admit I love to see the slight shock in their eyes and then I explain about Samaritan. The reactions have been so awesome. People want to know how it works, what it has been like for us, would it be good for them. The conversation gets the wheels turning in them about the existence of another option.

** I have started to pay more attention to health care stories in the news. Most of the time when I hear about insurance costs and nightmares I’m thinking, “so glad that can’t happen to me, we have Samaritan.”  and “So glad we can see any doctor we want, I would never want an insurance company telling me or my doctor what to do.” I don’t think I realized how stifled I was until I got away from it. My insurance is gone and I definitely DON’T miss it. I’m sure my doctor doesn’t miss my insurance either since he is now allowed to think for himself!

** Knowing that I can submit our bigger dental bills to Samaritan as a Special Prayer Need is just awesome. I’ve never had dental insurance before, and while we haven’t needed to submit anything yet, knowing that’s an avenue for a potential huge bill for braces or a big root canal is so comforting. Even some help is better than nothing. In fact, the entire concept of Special Prayer Needs is such a joy. Blue Cross would leave us with such huge left over amounts to pay, all the while touting how much they had saved us (sorry, I no longer believe that Blue Cross). But if we had a need that didn’t qualify with Samaritan they give us an option for further help with the SPN. How awesome! Blue Cross didn’t care, Samaritan really and truly does! No company does that except a health care sharing ministry.

When I was researching Samaritan a little over a year ago, I distinctly remember telling my husband that we probably wouldn’t join just because it was so different than what we were used to. He said, “you don’t think so, huh?”… with this playful tone in his voice as if he knew we would join and it would be great. I kept asking him if he had doubts or was scared of trying something new. He continually told me it felt right, it was centered in Christ and all the information we had learned was so positive. However, I wasn’t sure I could break out of that comfortable old shoe and take that next step. But the unfairness and overwhelmingly crushing expenses of health insurance today was just too irritating and too much of a burden. And I felt a calling, a pull toward Samaritan membership that I just couldn’t ignore, almost like it was something I could reach out and touch. I needed it. I am so analytical and I just couldn’t find any review, or what-if scenario that scared me. All of that was reason enough to join. While I did need to take a step of faith to join, the intense feeling of THIS IS SO RIGHT that I got every time I thought about it was more than I could ignore. God was clearly putting this on my heart. Now I wouldn’t have it any other way.

 

Special Prayer Needs Ease Members’ Extra Burdens

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Posted by admin | Posted in Samaritan Perks | Posted on 10-11-2014

I love this post on the Samaritan Ministries blog about a member (Brenda) who had an outstanding surgery bill which was largely met by those members’ contributing to her Special Prayer Need. Samaritan is the only health care sharing ministry I know that lets you submit big bills from before membership to be considered for extra giving. Samaritan also appears to be the only ministry which allows big dental bills to be shared as SPN’s. The ability to get assistance for these burdensome needs which otherwise don’t qualify for regular sharing is a big reason we love Samaritan. Our insurance company barely gave us financial help on regular bills, much less anything outside the scope of the policy. Samaritan actually gives members an avenue to get additional assistance for those non-publishable needs, it is the grace of God in action.

Every little bit helps and that’s why we love giving to Special Prayer Needs each month. Those gifts of generosity mean so much to those receiving it, even if you can only give $5… that $5, your card and your prayer can mean the world to someone suffering with that burden.  If you want you can also send your SPN donation direct to Samaritan, designated to whomever you wish, and then that donation becomes tax deductible.

You can read about Brenda’s story here: http://samaritanministries.org/members-burden-quickly-lifted-special-prayer-need/