How I Found SMI

When the Obamacare rollout began, our insurance policy was cancelled and we were given 11 options by Blue Cross to replace it, none of them affordable. The suggested plan (Bronze) had a 37% higher premium and 350% higher deductible. It was horrible. The closest plan they offered to what we had was DOUBLE the premium. It would have been equivalent to more than two of our mortgage payments.

We could also go to the Exchange and look for a policy there, perhaps with subsidies. But we all know how the Obamacare website turned out. Broken, crashing, and a massive security risk. The government couldn’t pay me enough in subsidies to use that website and put my entire financial life at risk.

Thus began my search for something better.

I first posted to my facebook page about my dilemma and outrage. Fortunately a friend saw the post and suggested Samaritan Ministries. I’d never heard of it. But when he quoted his monthly cost as a member I did the quick math and realized we’d be saving almost $500 a month. I followed a link to their main site and started my research. This website is a culmination of everything I found, what I learned and how we came to the decision to officially cancel our Blue Cross health insurance policy and join Samaritan Ministries. I wish we had done it years earlier.

When we joined we listed my friend’s name as a referral. Full disclosure, Samaritan does have a nice referral program, giving a one time reduction in your monthly share for each household who joins because of you. It was nice to help him in this way because I am truly thankful he took the time to share Samaritan with us. In a similar way, we wanted to get the word out to others who may have been as panicked and frustrated as we were about our insurance options so this website was built. Referrals are a nice bonus (you can mention Heather Peters or the blog name), but we would share information about Samaritan regardless. We are also giving every month to members who have Special Prayer Needs and hope you will consider donating something, too.

Here’s how the math works for our family, updated for 2018:

Insurance Premium: $2158.54/month for bronze plan HSA. Medica is the only company offering any plans to Nebraska
Samaritan share: $495/month
SAMARITAN SAVES US: $1663.54/MONTH or $19962.48/YEAR
Insurance OOP max: $6650 per person, $13300 total with a $12,000 deductible
Our Responsibility with Samaritan: $300 per incident
SAMARITAN OOP SAVINGS: $13,300 (assumes we had 3 incidents per year and would have met our full deductible/OOP, and got full discounts)
Insurance Co-pay: I pay 100% until deductible is met on everything except the free physical
Samaritan co-pay: NONE
Insur Premium + Full Deductible: $37,902.48 (That number leaves me breathless). Almost $40,000 before insurance even helps?

 

Medica is our only choice for 2018 (Blue Cross dropped individual plans entirely) and the rates are out so I updated this comparison chart.  First of all, for my family of four they now 5 plans and every single one is over $2000 per month. The highest plan is the Gold level at an astonishing  $3055.87/month. *gasp* The spread between insurance and Samaritan grew tremendously this year. We will be saving over $1600 a month next year by sticking with Samaritan, and about $2500/mo in savings compared to the gold plan we had before the ACA started. Since it’s an HSA there is no co-insurance at all, so I’m stuck with 100% of the bills until the $6650 is reached each year. They still offer the free physical, but I’m not about to pay over $2000 a month for a free physical!

Consider this: if we had this insurance plan and had 2 people hit their deductibles next year, let’s say we each have a kidney stone, we would spend $25902.48 in premiums plus $12,000 in deductible costs before insurance would pay for anything. That is $37902.48 of insurance related expenses.  Almost $40 grand?!?!  (No wonder families have medical bankruptcies) Conversely, with Samaritan we would spend $5940 in shares and $600 in medical costs for 2 medical issues if we didn’t get discounts.  $37902.48 (insurance) vs $6540 (Samaritan w/o discounts). That’s a difference of $25422.48 and a savings of 83%!!! And even if we don’t have any medical needs in a year, we still save almost $20,000 in premiums alone.  I will happily pay for our physicals ($45 for the kids, about $170 for us) to save $20-$25,000. Imagine what we could do with an extra $20,000/yr. I’ll say it again. This comparison is nothing less than astonishing. Look at what the premiums have done from 2016-2018. In just two years it has doubled from a little over $1100 to around $2200. Now look at Samaritan’s share rate. Still $495 during that time.

 

Previous Math for 2017:

Insurance Premium: $1488.35/month for bronze plan HSA. It is the ONLY plan offered by Blue Cross on individual market
Samaritan share: $495/month
SAMARITAN SAVES US: $993.35/MONTH or $11,920.20/YEAR
Insurance OOP max: $6550 per person (2 person max)
Our Responsibility with Samaritan: $300 per incident
SAMARITAN OOP SAVINGS: $13,100 (assumes we had 3 incidents per year and would have met our full deductible/OOP, and got full discounts)
Insurance Co-pay: I pay 100% until deductible is met on everything except the free physical
Samaritan co-pay: NONE

 

Previous Math for 2016:

Insurance Premium: $1102.27/month for bronze plan
Samaritan share: $495/month
SAMARITAN SAVES US: $607.27/MONTH or $7297.24/YEAR
Insurance OOP max: $6850 per person (2 person max)
Our Responsibility with Samaritan: $300 per incident
SAMARITAN OOP SAVINGS: FROM $12,800 to $13,700 (assumes we had 3 incidents per year and would have met our full deductible/OOP, and got full discounts)
Insurance Co-pay: 50/50 (so they leave me with 50% up to $13,700 per year for the family)
Samaritan co-pay: NONE

 

As you can see, the spread between Samaritan’s cost and our Bronze insurance plan choice is getting wider. So the “premium” savings each year is getting bigger by staying with Samaritan. That will probably continue to happen for a while. It’s because insurance premiums are climbing faster and higher than Samaritan’s share’s increase. There’s a big difference between increasing yearly (insurance) and increasing every 1 1/2 – 2 1/2 yrs (Samaritan) and insurance rate hikes are usually bigger. The OOP max is still about the same if we have those 2 kidney stones, but the annual savings if we don’t have many or any needs is getting wider.

Also note: The gold plan they offered us for 2016 that most closely matches the plan we used to have before Obamacare began was $1683.95/mo for our family. While that was jaw droppingly expensive for us to consider last year, it’s amazing that the HSA bronze plan they offer us for 2017 has nearly caught up to it at almost $1500/mo. It’s out of control.