Think Differently

From the beginning of our lives we are often trained to have health insurance. I was always told, “never go a minute without health insurance, you don’t know what might happen.” Ok, that’s sound advice. Be covered. However, times are changing and “being covered” doesn’t have to mean health insurance policies anymore. Over the last 30 years the concept of a healthcare sharing ministry has become more popular as people realize that health insurance often leaves them stuck facing huge bills on their own, even after insurance has paid. That’s not coverage, it’s guaranteed poverty for many people facing medical issues. There is a better way.

Healthcare Sharing Ministries offer a different way of thinking. Back in the 40s, employers were restricted from offering wage increases during the war, so they often compensated by offering employer paid health insurance plans. A new way of thinking was born. Employer based health coverage. At first people paid out of pocket for the simple office visits, only having insurance for hospital stays. Over time this morphed into what we have today where insurance plans cover nearly everything. The drawback is that as more and more was included in the coverage options, the monthly costs went up and the leftover portion for us to pay on bigger needs also went up. Way up. People became less incentivized to take care of themselves because going to the doctor costs a small $10-$15 copay, and insurance paid the rest. Why bother taking better care of my health? Someone else pays the bill. But after the cheap annual checkup co-pay, they got slammed with huge deductibles, co-insurance and surprises that weren’t covered. Oops. All on top of the ever climbing monthly premium.

The problems have now reached a peak where the premiums are so big, covering so much (now all pre-existing conditions are covered no matter what), that millions have a hard time affording the premium. Sure it’s great to have everything covered, but it all comes at a cost. And the costs are far too high for millions. Granted, there’s a lot more to it than that, rising healthcare costs are a runaway train and insurance plans are only part of the cost issue.

In order to reduce costs, many insurance policies have established networks of providers who give them better rates. This can often mean that your preferred doctor isn’t in the approved list and you will pay far more to see him, because insurance outright tells you that out-of-network providers are covered at a worse level. More out of your pocket. For some people that can mean avoiding a top cancer specialist or hospital because they can’t afford what their insurance plan will stick them with. Even when traveling, you may end up at an out of network hospital, easy to do when you are unfamiliar with the area. I don’t know about you, but if I need a doctor while traveling the last thing I want to research is whether that doctor is in-network or out-of-network. I just want to be treated and healed. Costs go up and your security blanket of insurance leaves you hanging. Nice.

Compare that to Healthcare Sharing with Samaritan Ministries.

  • There are no provider networks, you can see any licensed medical doctor you want at any facility.
  • You don’t have to ask permission from insurance to get treated. If you need it, your doctor orders it, you get treated. Period.
  • Insurance pretty much never pays for alternative treatments, Samaritan will share those needs (preapproval required, must not be too expensive)
  • You tell the provider you are self-pay and often get a large reduction in the bill for saving them the trouble of dealing with insurance.
  • There’s no worry that your visit will be miscoded and fought to be paid.

Samaritan Sides with You and Your Doctor

Insurance companies have a lot of fine print rules. For instance, your doctor may want to prescribe a drug treatment which is FDA approved for cancer A, but he knows it’s also effective for cancer B (which is the one you have, for example, and it’s not approved for cancer B yet). In order to do that your doctor must first check with your insurance company for approval, and is often rejected. It happened to a friend of mine and when I heard about it I vowed to find a way to remove that God like power from insurance companies over my family’s health. Despite all your doctor’s medical knowledge, the insurance company feels they know better. Wouldn’t that irritate you? It could also kill you if you can’t afford the treatment you need and the cost is denied by insurance. It means that if you go ahead with that treatment you’re entirely on your own. No payment help. So you have to choose between what your doctor wants and what your non-medically educated insurance company wants for you. Who would you rather trust? Samaritan Ministries handles those cases differently. Samaritan sides with you and your doctor. If your doctor is prescribing it, then you should be able to get it and have the costs published. Samaritan doesn’t put up the roadblocks that insurance does. As long as it meets the guidelines for sharing (not one of the stated non-shareable events) it will be published.  In fact, Samaritan will even go so far as to publish reasonable travel expenses IF substantial costs savings for the treatment will result. I’ve NEVER heard of insurance paying for my hotel, meals and transportation. I’m floored that Samaritan would even consider it. This means if you are willing to fly to Mexico and save a fortune on your treatment, there’s a good chance Samaritan will pick up the travel tab (ask them first, as conditions must be met). The point is that Samaritan offers logical solutions to health care costs, in ways that insurance companies are just completely blind to and heartless about.

Alternative Treatments

What if you find out about an alternative, nontraditional treatment which has been successful? There’s really no way Insurance would ever pay for that. Insurance covers mainstream medicine only. However, Samaritan does share those, as long as the alternative treatment isn’t more expensive than traditional treatments (alternative treatments must be pre-approved by Samaritan first to be sure the cost isn’t exorbitant and they also consider factors such as the likelihood of preventing future costly treatments, being less invasive, is comparable to traditional options, etc ). This includes alternative treatments outside the USA, as long as you run it by them first they generally end up fully sharing that need (costs for these can be quite a bit cheaper).

When I was researching options I found a statement from someone saying that they had been “brainwashed” into thinking that traditional insurance was the only way. She’s right. It’s so common place that people are afraid of giving it up and going with something else. But there’s no reason to be afraid. I would never advocate being completely unprotected, but that’s why Samaritan is so great. We get away from the mess and complication of traditional insurance and we still get our medical bills paid. In fact, so much more of the bills are paid we are often left with nothing (or very very little) to pay out of our own pocket. Instead of taking years to pay off a maternity bill it’s all paid by the time the baby is 3-4 months old. Which way would you prefer?

We had traditional insurance when our kids were born. For each delivery our out of pocket expense ran close to $1500 (admittedly good, we had a good employer policy). If we had been with Samaritan our out of pocket cost would have been no more than $300, but more likely zero. Yes ZERO. Zero because based on what the hospital charged, and the discounts they gave insurance, and knowing their self pay discount policy of matching insurance discounts, our $300 responsibility with Samaritan would have been reduced to nothing and every single bill would have been paid in full from member shares we would have received. Obviously I’d rather pay ZERO than $1500. Wow.

Samaritan has one of the best maternity guidelines available. Their guidelines state that if you deliver with a midwife at home, those births are also fully shared. Many insurance plans won’t pay for home births or midwives. Samaritan recognizes the benefits of those births and will not only share in full (up to the $250k, more for Save to Share members), they also immediately wipe your $300 personal responsibility amount. Incredible! You pay nothing out of pocket! And yes they also publish expenses related to hospital births. 🙂 Maternity is also a need you can submit in advance. Many clinics and midwives have package deals and big discounts for early pay. You can share these bills even before the baby is born. Amazingly wonderful!!

Maternity need sharing if you’re already pregnant

What if you join Samaritan and you’re already pregnant? Many people do. If you were with a traditional insurance plan they wouldn’t offer any assistance. But Samaritan will publish those expenses as a Special Prayer Need so that others can voluntarily help you with those bills even though it happened prior to membership. And with self pay discounts offered by many hospitals the net cost could end up being less than what insurance deductibles and copays would have left you with.

Paying for Checkups Ourselves

Samaritan members’ personal responsibility of $300 means that regular doctor checks are often entirely out of pocket for us. Routine checkups like physicals and mammograms are not publishable. For some this is a shock to get used to. We are used to the insurance method of paying for all preventative care for us. But think about it, we are still paying for it, we just do it through really high premiums. For us, we are saving $993.35/month (as of January 2017) in monthly premiums by being with Samaritan. That’s $11,920.20 we won’t spend. Are we going to have $11920 in annual checkups? No. An office visit for a full physical is often $200 or less. Mammograms where we live are about $300. Well baby checkups are less than $100, and if the doctor knows you’re self-pay he can charge even less than regular rate before the bill even gets to billing. By saving so much every year in lower premium costs we will have the money in savings to pay out of pocket for those couple of checkups per year. Because of this we don’t feel a need to run to the doctor for every little sniffle. We take better care of ourselves so we hopefully won’t have a lot of doctor visits. We are thinking and doing medical care they way it was intended and started 60 years ago. We pay for the small things, Samaritan makes sure the bigger things are published. It’s logical, it’s proactive, it’s us managing our own care and getting what we need. We only have to rely on shares from others when a big need happens. Compared to many deductibles now ($6350 was the deductible for our new Obamacare insurance plan), the $300 that Samaritan asks us to cover is practically nothing. I cannot believe the difference.

In the end, my family is just as “covered” by being members of Samaritan, in fact, more so. We can get health care without worrying how much of a bill we’ll be stuck with. We know that many members across the country will be praying for us. The peace of mind we get by knowing this is priceless.