Pros and Cons (Positives vs Negatives)

As with everything, there are pros and cons to be considered. For someone newly looking at a healthcare sharing ministry, your list of pros and cons may be different than mine so this list is somewhat subjective. These are in no particular order.

(If this is your first visit to the site and want to learn more about Samaritan Ministries please use the menu at the right for lots of details about what I’ve researched and experienced while being a member) Enjoy!

 

MEMBERSHIP POSITIVES
(disclaimer: These are all topics which I consider positive, your viewpoint may differ)

  • Monthly share amount is probably a LOT cheaper than your insurance quote.
  • No messing with Obamacare website, no concern about identity theft from that website, no headaches with lost data, account issues, etc.
  • Membership is fully exempt from the ACA so you don’t pay any fines/taxes to the IRS
  • Your monthly share is sent directly to a member with a medical need (some would see this as a potential negative, I see this as a very big positive because of total transparency about where the money goes and what its needed for)
  • This is a non-profit ministry with very low overhead (1/12 of member shares go to the ministry which is 8.333% annual overhead– insurance companies can have as high as 15% overhead for admin costs)
  • The President of Samaritan makes a reasonable salary, not millions like insurance company CEOs
  • Samaritan will share expenses for alternative treatments (pre-approval required)
  • Samaritan will share reasonable travel expenses if the resulting treatment saves at least 30%
  • Your doctor (licensed medical) doesn’t have to ask permission from an insurance company to treat you. If he/she orders a treatment that meets the guidelines, Samaritan will share it.
  • Samaritan will never share in abortions
  • Monthly share amounts do not automatically increase every year. Members must vote and have majority agree to any share increase. This typically happens every 18-30 months. A vote is held if 3 months in a row have to be prorated.
  • The family rate (currently $495) is the same no matter how many children you choose to have.
  • You will receive prayers and cards in the mail, along with money, if you have a need. Health care with Samaritan goes far beyond money, it includes many spiritual benefits (members often keep the cards to bolster their spirits during recovery and beyond)
  • Samaritan staff will pray with you during your time of need
  • You can see any doctor you want, no need to worry about out-of-network extra expenses. This is a huge help when traveling, no need to check the network. Just go where you need to.
  • International medical bills are shared like any other. They must be converted to US dollars and submitted in English.
  • Being self-pay can often lead to even bigger discounts than you previously got with insurance
  • We don’t have to get the discounts on our own, Samaritan will assign an advisor to get bigger discounts if we are unable to, or just too uncomfortable. Read more here. Samaritan walks us through everything, submitting needs is very simple and fully supported.
  • The $300 personal responsibility amount can actually be reduced to ZERO if you get discounts (discounts applied directly to that $300 amount)
  • Referral credit when someone joins and lists you as their referrer
  • Needs which don’t meet the guidelines for sharing (like dental) can be shared as a Special Prayer Need. No insurance company helps you pay for needs which aren’t traditionally covered so this is a big bonus help.
  • No lifetime caps
  • No per incident caps (only if you are a Save to Share member, otherwise there is $250,000 incident cap if you only have the regular membership)
  • Member reviews are overwhelmingly positive and members are so happy with the ministry
  • Members actually look forward to getting their monthly newsletter and paying their share assignment. Have you ever said that about paying your health insurance premium?
  • Very large needs are shared as part of the Save to Share program. This means we don’t have to worry about a catastrophic need wiping us out, it can be fully shared by Samaritan (largest need submitted to date is $1.5 million, discounted to $700k and fully shared)
  • Samaritan shares needs for nontraditional treatments, such as a cancer drug that has been successful but isn’t fully FDA approved for that type of disease, or cancer treatments out of the country which may not be allowed in the US. (always consult with Samaritan in these cases)
  • Fellow members are all Christians leading Christian lifestyles to keep costs low.
  • Your are back in charge of your healthcare without an insurance “bean counter” deciding if your health and life are worth the expense (this one is priceless)
  • Your membership cannot be cancelled for having a lot of needs
  • Home births and VBACs have the $300 personal responsibility waived
  • You can join while pregnant and still get the pregnancy bills shared as a special prayer need
  • Pregnancy “coverage” with Samaritan is better than any insurance company I’ve seen, with the exception of military coverage
  • Needs are shared in a timely fashion
  • There is no co-insurance or high deductible to worry about (major awesome!)
  • No long waits to speak with someone at the main office. They have busy times, but the most I have waited is about 4 minutes vs 50 minutes with my old insurance. Typically someone answers right away.
  • Compared to insurance, you will likely end up paying far LESS out of pocket for any need you have. In fact, it’s entirely likely you’ll pay nothing in the end since discounts can often be obtained to eliminate your $300 responsibility
  • Your provider will likely be paid in full before insurance would have paid them without any of the headaches insurance can give (remember you pay them from the shares you receive, they are not paid directly by Samaritan)
  • You are not required to be on a government assistance program (medicaid, etc), even if you happen to qualify for it. Samaritan members believe in taking care of their own. If you are on medicaid/medicare, etc, they are required to pay their portion first, Samaritan will share the remainder.

 

POTENTIAL NEGATIVES
(disclaimer: I don’t really see many true “cons” to this, these are just points that should be considered and may or may not be a concern to you)

  • Money to pay the bills will likely arrive about 3 months after you suffer the need, about 2 months if you have instant medical bills (not likely). Because of this you will need to be able to cash flow a small monthly payment to your providers. This may or may not include using a credit card depending on your available cash and the size of the bill.
  • Some pre-existing conditions are never shared (type 1 diabetes) Other pre-existing conditions require an amount of time in “cured” status before being shared (cancers and heart issues 5 years, most others just 12 months)
  • Members are actively part of the bill receiving and payment process. Most people aren’t used to that as insurance transactions happen behind our back. It takes some getting used to having those large bills come to your house. This could also mean requesting more detailed copies of bills a couple of times if the hospital likes to consolidate (hide) charges. A large need will have a lot of bills to manage (of course it would with insurance, too). Keeping a list or spreadsheet of bills of you have received and submitted will help keep your organized.
  • Most clinics/hospitals have self pay customers, but insurance is far more common. Depending on how often they see cash patients their memory on how to handle self pay processes could be “fuzzy”. I suggest calling your area clinics/hospitals to get familiar with their process and standard cash pay discounts before joining a ministry.
  • Regular checkups/routine care appointments are not shared. This would include a colonoscopy if you aren’t having symptoms and just are getting one because you turned 50. You should be able to get a colonoscopy for about $2100, and can be budgeted for. (If you are having symptoms and a colonoscopy is ordered, or if you have a routine colonoscopy and they happen to find something (cancer or noncancerous polyp) then it IS fully shared)
  • Immunizations are not shared, but can usually be done for free or very cheap at your local immunization clinic
  • If you decide to get back on regular insurance it can only be done during open enrollment (Nov-Jan usually), or any time you have a qualifying event (birth, new job, etc). However, the question of insurability is no longer an issue because of Obamacare rules. The uninsured cannot be denied coverage (in fact I would think we’d be treated like royalty)… I should point out our family never intends to go back on health insurance. Samaritan rocks!
  • General dental needs are not shared except as Special Prayer Needs. You will need to cash flow dental checkups, braces (braces are often submitted as special prayer needs), etc or get a dental plan.
  • If you have a need you will get cards and money in the mail. Most would say, “Great!”, but it can be a LOT of cards and money in the mail. A $25,000 need after discounts would be at minimum 50 cards assuming everyone sent $495 (which they won’t as several smaller checks will also be assigned). A $150,000 need could have over 300 cards coming to your house. Some people may find that to be a burden. I personally think it would be a lot of fun to read all those cards, mark off the checklist, and deposit checks. Not to mention the satisfaction of paying those medical bills off so soon. You could have hundreds of households all praying for your healing. The power of that is so humbling.
  • Maintenance drugs are not shared (4 months of drugs for each incident are shared). Depending on the cost of your regular medications that may or may not be an issue (goodrx and other discount sites can offer very big savings, though, sometimes costing even less than your insurance copays)
  • Needs can be prorated if there are more needs than share money available that month (usually to 80%). Prorated needs have all be met in full so far (one way or another), it just may take an extra couple of months for that remaining 20% or so.
  • You are technically uninsured. But a great quote I found from another member says that Samaritan is “Assurance” not “Insurance”. So TRUE! Samaritan provides assurance that our needs will be covered. It’s not a contract with a for-profit company who’s primary goal is profit at your expense, it’s a promise from a group of Christians who’s sole purpose is to support you in your time of need and get your medical bills paid. Wrap yourself up in that thought. No fighting over contract details and denials. Just people of faith praying for you, sending you money and all in the name of God. When you think about it, this assurance puts your medical needs on an even more solid financial footing than corporate insurance does.