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.