There are a few Christian Health care Sharing Ministries available which are ACA exempt if you are looking for an insurance alternative. The comparison between Samaritan Ministries and Christian Care Medishare was an easy one for us. Samaritan’s monthly cost structure is based on family types (couple, single, family unit). Medishare’s cost structure is based on which personal responsibility limit (AHP, annual household portion) you choose. Similar to a deductible/co-insurance combo the AHP is the amount of bills you are responsible for each year before Medishare starts paying. The levels are setup accordingly, and the higher your AHP, the lower your monthly cost.
If this page is your first glimpse of Samaritan and you are interested in more details about how Samaritan Ministries works, please read through the pages at the right as I go into a lot of detail about everything. If you have questions don’t hesitate to ask! 🙂
Samaritan has two membership levels. Classic plan (yellow chart) and the new Basic level (purple chart) which offers lower monthly costs in exchange for higher personal responsibility amounts during each medical event. Both are great options. My personal favorite is still Samaritan Classic in order to keep the potential bills lower (or zero). If the monthly share price is an issue then I recommend Samaritan Basic and there are many members using this new Basic plan.
COST AND BENEFIT COMPARISONS
|PERSONAL RESPONSIBILITY AMOUNT BEFORE SHARING STARTS||$400/incident||$1500/incident (can be reduced to $0 with discounts)||$3,000||$6,000||$9,000||$12,000|
| MONTHLY COST
|family of 4 (adults age 48)||$495||$350||$896||$652||$511||$351|
|couple age 28, no kids||$440||$200||$505||$371||$293||$206|
|(see full cost structure here)||(click for cost calculator)|
|SHARING PERCENTAGE||100% of shareable amount||90% of the amount that is shareable||100%|
|CO-SHARE||n/a||10% (up to maximum of $13,500)||n/a|
|MATERNITY SHARING||100% of shareable||max of $5000||included, but no maternity sharing on $1000 AHP plan|
|SAMARITAN (BOTH LEVELS)||MEDI-SHARE|
|MONTHLY COST REDUCED WHEN THERE ARE FEWER NEEDS||YES||NO|
|PERSONAL RESPONSIBILITY REDUCED WITH DISCOUNTS
||YES (on $1500 Basic PR amount, all the way to $0)||NO|
|DISCOUNTS FOR BEING HEALTHY||NONE||reduce medishare cost by up to 20%, requires submitting health data. Potential blood work or physical may be necessary depending on circumstances.|
|$1000 AHP available (no maternity) for those 18-29. Senior assist with $1250 AHP available for Seniors.|
|EXTRA FEES FOR CERTAIN CONDITIONS||NONE||some health conditions like high cholesterol, obesity, diabetes require an extra $80/month fee and mandatory health partner program|
|ANNUAL FEES, APPLICATION FEES||No annual fee, $200 application fee||$50 application fee, one time $120 member fee,
$5 ACCU setup fee (total of $175 up front)
|MISC FEES||NONE||$2/month ACCU credit union admin fee
$3/month Paper Statement Fee, waived if you choose E-statements
$75 fee to change AHP levels
|PROVIDER NETWORK||NONE, see any doctors||PHCS PPO network|
|GUIDELINES OF COVERAGE||Samaritan guidelines||click this link for Medishare guidelines|
|METHOD OF PAYMENT||send direct to Members||payment runs through account at America’s Christian Credit Union|
|AVAILABILITY||all states||Not available in Montana|
|PT and CHIROPRACTIC CARE||All inpatient PT sessions, plus 40 outpatient sessions per need. 40 per need is the combined total of all therapy, whether chiropractic, PT, OT, etc. Maintenance visits are not shared. Chiropractic xrays and 120 days supplements are shareable.||Chiropractic – 20 visits in 6 weeks, only if surgery is the only other option.
PT/OT – 20 visits per referral
|REFERRAL PROGRAM||$100 credit||$100 credit|
|WHO SENDS BILLS||patient sends bills to Samaritan||provider sends bills to Medishare|
Save to Share program for everything above $250,000.
No lifetime limits
|no lifetime or incident caps|
|PRE-EXISTING CONDITIONS||1. For most issues if the condition has been considered “cured” with no treatments or symptoms or meds for 12 months, it’s no longer pre-existing.
2. For cancers and heart conditions the timeframe is 5 years
3. Type 1 diabetes is always considered pre-existing.
4. New, unrelated cancers are shared right away, even if you had a different cancer previously.
|1. up to $100,000/yr if no signs/symptoms/treatments/meds for 36 months or if person has been faithfully sharing as a member for 36 mo.
2. up to $500,000/yr if no signs/symptoms/treatments/meds for 60 months or if person has been faithfully sharing as a member for 60 mo.
3. Pre-existing conditions always maintain their pre-existing status.
4. No sharing for pre-existing until at least that 36 month mark is reached.
|FAQ||Samaritan FAQs||Medishare FAQs|
|PRESCRIPTION DRUGS||All drugs related to an incident/treatment and those as part of hospital treatments are shared plus four calendar months of maintenance drugs. Cancer drugs are not subject to this limitation.||Six months of drugs per incident. Exceptions may be made for cancer/transplant cases.|
|PHONE NUMBERS||(888) 268-4377||(800) 772-5623|
Samaritan’s Basic level plan is great for those who need a lower monthly cost and still want great protection against medical expenses. It does have a higher personal responsibility portion of $1500 per need before sharing kicks in and a 90%-10% co-share (so Samaritan members will share 90% of the need costs above the $1500 and the member pays 10% up a max of $13,500 the member would pay on any one need). This would be similar to a 90-10 co-insurance on an insurance plan. It also reduces maternity sharing to $5000 per pregnancy. My recommendation is to have your family on the classic level if you have the possibility of more children in your future. In the Basic Samaritan plan the $1500 can be reduced to nothing by getting discounts.
Medishare’s pricing structure is more complicated and a lot more like regular insurance.
Since Medishare operates more like insurance this is appealing for those who want to be more hands-off with their need payment.
Samaritan has no provider network so you can see any doctor without out-of-network penalties. Medishare’s PPO works just like insurance plans. Patient has a bigger share and bill for out-of-network.
Medishare has a nice step up plan for pre-existing conditions, with no sharing prior to being a member for 36 months unless the condition shows no signs/symptoms/treatments/meds for the immediate prior 36 months timeframe. So if you’ve gone 3 years with no treatment/issues and then join, it sounds like you can get sharing up to $100,000 on that condition right away. But please confirm with Medi-share that I’m reading their guidelines correctly. The limits of $100,000 and $500,000 once the 36 and 60 month marks have been reached are pretty generous I think, especially since you can reach those amounts simply by staying a member for that time frame. Samaritan’s policy is that if the condition has been considered “cured” with no treatments or symptoms for 12 months, it’s no longer pre-existing, so the wait time is shorter (12 mo vs 36 mo). For heart conditions and cancers the timeframe is 5 years, while type 1 diabetes is always considered pre-existing. With Samaritan, new, unrelated cancers are shared right away, even if you had a different cancer previously.
My analysis of all that is that Samaritan’s pre-existing program is better if you have something that is not going to show itself for 12 months (or 60 months if cancer/heart related) because it will no longer be pre-existing and get full sharing pretty quickly, but if you have something that keeps popping up then Medi-share’s would be better for you if you can hold on as a member with them for 36 months and cover those costs yourself during that time frame.
If you’re willing to have a very high AHP it is possible to have a super cheap monthly share payment with Medishare. Samaritan monthly shares are based on fewer factors.
- They both have similar statements of faith required.
- No tobacco use.
- No s-e-x outside of marriage.
- Must be a Christian and attend church regularly.
- Extra sharing plans available (not required) for members with non publishable bills. Samaritan’s is called Special Prayer Needs, Medishare calls it Extra Blessings.
- Routine care not published/shared on either one.
- No coverage for abortion
- Personal responsibility limits are higher with Medishare.
- Medishare’s monthly rates slide higher every year as you get older. Someone age 64 would have an individual monthly cost of $496 (couples rate is $1011 for $3000 AHP). Samaritan’s monthly rates only change in large age bands on the Basic plan and doesn’t change at all with Classic plan.
- Medishare has specific Senior plans starting at age 65, secondary to standard Medicare coverage.
- Medishare has a reduced rate for seniors on medicare, Samaritan does not.
- Samaritan’s Classic plan will reduce the personal responsibility portion (the amount the member owes for each need before sharing starts) dollar for dollar down to a potential of $0 owed when discounts are obtained,, Medi-share does not reduce a members AHP.
- Samaritan will reduce the monthly share during any months that have fewer needs, Medishare does not.
- Members have mentioned on blogs that Medishare also requires members to participate in Medicaid and get hardship financial assistance if they qualify. Samaritan does not. (I do not wish to be on Medicaid since I have a choice, even if we did qualify.) UPDATE — a statement direct from Medi-share on another blog states that they do not require it, but they will let you know if you qualify for medicaid and help you apply. If you choose to get medicaid then Medi-share will give a discount on your monthly share. I’m glad to know it’s not required, but it seems counter intuitive that they would want you to get back on a gov’t program.
- Medishare requires submitting health data for joining (height/weight/blood pressure, BMI, waist size, etc) including potentially needing to submit blood work, and or data from a physical depending on circumstances, Samaritan does not.
- Samaritan has an optional program for incidents that go above $250,000. Medishare doesn’t require an additional program.
- Medishare has a PPO network just like insurance does, including office visit and ER copays. It functions the most like insurance. Samaritan has no networks, you can choose whichever doctor you want without penalty.
- Samaritan has you send shares direct to other members, Medishare members send their money to personal credit union accounts for distribution
- Medishare has prenegotiated rates with providers due to the PPO network, Samaritan does not. This means Samaritan members are able to ask for even bigger discounts, Medishare discounts are already fixed.
- Medishare has a $100,000 sharing limit for motorcycle accidents.
- Medishare receives the bills direct from the provider, Samaritan members receive the bills themselves and send those on to Samaritan to be shared.
- Medishare has no payment for alternative treatments (like alternative cancer treatments), Samaritan will pay for alternative treatments if they are preapproved by Samaritan and the cost isn’t excessively higher than a standard treatment.
When I was reviewing these programs, I couldn’t find a negative review for Samaritan members. In fact they were gushing their love for it. However, I found several complaints about Medishare. Some of them were older, but there was even a lawsuit against them which is why they aren’t allowed to operate in Montana. Medi-share had reports of taking longer to pay the bills, Samaritan members very much enjoy process of sending their shares direct to other members. Overall, the reviews I found showed that Samaritan members had a much happier experience than those on Medishare. I’m sure there are very happy Medishare members, though. People who choose Medishare are drawn to its similarities to regular insurance. It’s familiar. In a similar fashion, it appears to offer familiar headaches with many “claims” being denied, and some payment delays. The process of pooling member shares for distribution by the main office has gotten Medishare into trouble with a few states for operating too much like insurance but without being subject to state insurance regulations. Samaritan doesn’t have those headaches with the states because of the method members have for sending shares direct to each other. Medishare does have a fairly attractive pre-existing policy, although pre-existing conditions never fall out of that status. The annual limits are generous though, once you reach the 3 year mark of being either clear of issues or 3 years of membership.
We found that Samaritan Ministries was cheaper, easier to join, easier to understand, offered more personal sharing with members thanks to the direct sending of cards and shares, and the overwhelming positive reviews from other members spoke highly to us. We didn’t want to have a very high personal responsibility (deductible) and with Samaritan Classic plan it’s only $400 per incident (higher $1500 on Basic plan). With Medishare (for a similar price/month) our AHP responsibility would now be $5500 before Medishare would pay anything. That’s pretty high for us. With Samaritan that responsibility is $400 per incident, and that can actually be reduced to nothing based on discounts we get. Using that comparison it makes Samaritan a considerably better deal “dollar wise” vs Medishare. Especially since Samaritan $400 amount (or $1500 on Basic) can be reduced to $0 by getting discounts and Medishare’s AHP is fixed, no reductions. Financially we are on the hook for a lot more with Medishare.
OUR NEED EXPERIENCE
We experienced a surgical need while Samaritan members and found it to be a very simple, straightforward, rewarding experience (as much as any medical event can be). The big question is always, “will it work?” and I can honestly say, without any hesitation, YES IT DOES. We had 100% of the costs of my husband’s surgery shared by Samaritan members and all of it was received 2 1/2 months after the surgery was performed. That is faster than any insurance payout we’ve had in the past, and the Samaritan staff was wonderful, as were the medical staff upon hearing that we are self pay and learning we are ministry members. You can read more about it in my blog posts (links at right), but overall the process demonstrated that need sharing is simple, the staff were supportive and we loved the cards and prayers from members, and we had the entire cost shared (we got an immediate 50% discount for being cash pay). The doctor was thrilled to be dealing only with his patient, and we received the best care from our preferred surgeon. This is how health care should be. Without question. If you are looking for something that better fits your family please give Samaritan a look. I think you’ll be thrilled with what you find. 🙂
UPDATE: We experienced a second need this year and I’m happy to report that it was also 100% shared within 2 months of submitting the paperwork. It was fast, easy to submit the bills online, and we received lovely notes from members along with the checks to pay the bills. We absolutely love being Samaritan members.