As a member of Samaritan you are considered self pay. Sometimes (usually) that means you get charged more than someone with regular insurance, which I find beyond frustrating, totally illogical and completely unfair. Fortunately members are able to ask for and receive discounts without too much trouble. But what if you meet with some resistance? What if you just don’t WANT to ask for a discount, either because you are afraid of a confrontation, or feel odd about it? Samaritan understands. It can be a new experience, especially if you haven’t ever negotiated for other purchases (like a car) or maybe just weren’t very good at it. (those car dealerships are tricky, but I think I’m getting better each time) 🙂
Fortunately, we are not on our own!! Samaritan contracts with the Karis Group to handle those negotiations for us and they are averaging about 45% off. If we are able to score a big reduction on our own, then great! Some people are getting 40-60% and more! But if not, don’t feel bad, Karis can help. If we submit a medical need to Samaritan (especially anything over $1000) we will be assigned an advisor who will work with the providers to get the bills lowered to something more reasonable. Being self pay as a Samaritan member doesn’t mean you’re on your own. It means we have an entire organization of people ready to pray with us, guide us, help us, advise us, and get bills lowered for us. Samaritan answers questions, gives reassurances, and walks with us through that entire medical need so we can get the bills paid, even if bills keep coming that we weren’t expecting.
Even when I had health insurance I was surprised at how many different bills we would get. Hospital, doctor, lab, radiologist, surgeon, visiting surgeon, the list went on. The bills didn’t always arrive at the same time. The volume of bills doesn’t change by being a Samaritan member, but the level of support for them goes way up. I no longer have to get so frustrated at how much something costs, fearing that I’d be stuck with a huge bill either from a giant deductible or an out-of-network surprise. Now I can peacefully ask for a discount, get the best I can, and turn it over to Samaritan. If they feel more deductions are attainable then Karis will try to get them. Either way, the remaining amounts will be submitted to Samaritan members and shares will start arriving, about 30-60 days later.
Over and over again I read reviews from Samaritan members about how SIMPLE the need process is. How SUPPORTIVE Samaritan and Karis staff are. How QUICKLY shares came in and bills were able to be paid. Reading those reviews is so reassuring.
If we have a medical need, the bills are unavoidable; insurance or not. Comparing the two, I’d MUCH rather have the support of Samaritan Ministries and its members than our old insurance company. Instead of cold rules and high out of pocket costs, I have traded it for warmth, support, caring, and prayer from an organization who just wants to be sure the bills are paid and that none of us are overcharged. Samaritan strives to follow the laws of Christ. Anytime you have that as your foundation you know you’re on solid ground.
We submitted our need to SMI and received notice from Karis Group that they would be negotiating our bills. About 2 and a half weeks later, we received a surprising email from Karis Group. We expected it to say that negotiations have completed and the provider has agreed to accept a certain amount. Instead, the email said that Karis has reviewed the bill and believes a certain price (about 34% of billed amount) to be fair. It instructs us to send a check for that amount (writing “payment in full” on the check), along with a letter to contact Karis Group if there are any questions, to the provider.
Really not what we expected. It gives us the sense that Karis did not negotiate with (or even contact?) the provider. Is this the norm? Curious as to what others have experienced.
Hi Robert. This is a new layer of bill management that Samaritan has rolled out for members. My understanding is that Karis is reviewing bills line by line for errors and inflated pricing (such as $1000 for a toothbrush billed as an “oral cleaning device”), identifying and correcting the issues they find. Their information is based on past billing experiences with facilities as well as a huge database of area benchmark pricing information (as well as a number of other resources). Obviously a big discount doesn’t do much good if the starting prices were too high to begin with, so Karis/Samaritan is working to level the playing field on our behalf. Without knowing specifics of your case, my advice is to follow their instructions and also to contact Karis to see if there’s more information regarding official negotiations; maybe this is just step one. If they cut the bill that much my guess is either that hospital was participating in some massive overbilling, or they did have a conversation about pricing directly to arrive at those numbers. Samaritan will not leave you high and dry and they will go to bat for us to made sure we are not overcharged. I don’t have any personal experience with this new feature as we haven’t had to submit a need in a long time, but I look forward to learning more about it.
We have a need that has been published with SMI. Our need has been flagged for review. What are the chances Karis will pick us up since the MRI charge is very high and Healthcare Bluebook shows a substantial lesser cost. We are not in a large city, with that being said the reading of the report does not go to a larger city. We are looking for advice.
Thank you!
All needs are reviewed for full details, but also there’s a Karis review if the total is over $1000 and it hasn’t been paid in full yet. Karis will go through their process to determine if they can get the charges lowered. They would likely evaluate prior contact history with the facility, the accepted costs for your procedures, any existing discounts, etc. If there is a big difference they will likely try to get the costs lowered. They have a pretty good success rate in getting an avg reduction of 45%. However, that means sometimes they get nothing discounted, sometimes they get almost all of it. It will entirely depend on the facility. You are in very good hands and don’t really have to worry about it at this point. Samaritan/Karis will get the discounts they can and then publish the remainder. Hopefully they get enough discounts to cover your $300 portion (and if it’s substantially different from the blue book then chances are good for that). While you are waiting go ahead and make tiny payments each month toward any bills, but don’t pay it off without speaking to Samaritan first unless you get word that the remainder has been published. I’m sure Samaritan and/or Karis will be in touch with you about it. I found the process to be very smooth for our need. God bless!
If I don’t opt for the Health Co-Op when I sign up, can I add it later? Also, I don’t see it as being part of the application, or did I miss it somewhere? I see the Save to Share option which I believe is different, correct?
Thanks!
Hi Jill. Yes, you can join the health co-op later if you wish. It is not on the general Samaritan application, you would contact The Health Co-op later when you wanted to add that portion. I confirmed it with Samaritan and they said it’s an easy process. Save to Share is different, that is Samaritan’s the catastrophic “add-on” option to get sharing of needs above $250,000. I strongly recommend it. 🙂 So you would join Samaritan and Save to Share now (if you wanted that add-on) and then join the Health Coop at their website later if you wanted. We submitted a need in December and our need is being shared this month. Checks are coming in and the process has been so simple. I cannot recommend Samaritan highly enough, it has just been an awesome experience for us! 🙂 God bless!
Thank you so much for your answer. I just found this page again, so was happy to see your answer to my question. I also thank you for sharing the process and adding some more clarification.
I’m really looking forward to joining Samaritan Ministries Health Care Sharing, as I will soon be losing the insurance provided through my husband’s employer.
Jill
Hi Heather –
You mentioned the advocacy of the Karis Group in negotiating costs for SMI. In my research, I encountered “The Health Co-op.” It appears to be a Karis “add-on” service to sharing ministries. They listed the price of SMI plus $83 a month for the Karis assistance. I’m trying to figure out what they are and if this is different from what Karis is already doing thru SMI. Is this a required add-on? A beneficial one? Sorting through health care options is so overwhelming. Your review site has been a tremendous help! Thanks so much for any insight you can offer.
Jen P – IL
Hi Jen. As part of our regular membership Samaritan contracts with Karis to provide bill reduction/negotiation services on any member bills they feel can be reduced, but bill negotiation is just one aspect of what Karis offers. Karis also has The Health Coop add-on service, which is not required for Samaritan members. The Health Coop offers additional services such as helping with finding low cost providers who have cash pay options, Christian counseling services, telemedicine, getting surgical cost comparisons, discount drugs, vision and dental, etc. Those services are available other places piecemeal, and some are available through Samaritan (drug discounts, telemedicine is coming soon, bill negotiation), but the health coop combined them all as part of their add on program. Some people can handle those things on their own. For those who don’t want to do leg work on their own about finding low cost providers, The Health Coop will do it for them. That is useful especially in places where there are lot of choices. In rural areas probably less useful (fewer options anyway), but if you were needing services in a bigger city and weren’t sure where to start, then it becomes useful again. I see them as useful for those who need help navigating the complexities and options of the medical world, and those who would rather someone else handle some of the details of service hunting. The question becomes whether that extra $83/month is worth it to gain the extra hand holding from a personal advisor and possible dental/vision discounts. I think they offer a great service for those who need/want it. It wasn’t something we found necessary for our family right now, but someday it might be. Never know. 🙂