Health Care Sharing -- Our Experience



As healthcare costs continue to skyrocket, families are struggling with the high price of health insurance. With the onset of ObamaCare, other issues with health insurance have come to the forefront as well, such as religious organizations being forced to cover abortion-related drugs in their insurance plans. Is there a different path than the health insurance industry? Is there another option that fits your family's moral values, doesn't support abortion, and is affordable?

Enter, Samaritan Ministries. 

My wife and I joined Samaritan Ministries at the end of 2012. Samaritan Ministries is a not-for-profit religious organization classified as a health-care sharing ministry, and is not considered to be traditional "health insurance". HCSMs are exempt from the individual mandate in ObamaCare.

Why do Health Care Sharing?

Growing up in a self-employed family, for much of my childhood my family was either uninsured or insured under catastrophic, doomsday plans that were of practically no benefit to us. The times when we did have insurance, we rarely used it (and by rarely, I mean rarely).

Let's fast forward some. My wife and I got married in September 2012, and researched numerous insurance options around that time period. I looked, and looked, and looked and looked. Finding something affordable and usable was practically impossible.

Ultimately, we opted out of the traditional insurance scene, and (as I mentioned previously) joined Samaritan Ministries.

Galatians 6:2 says "Bear ye one another's burdens, and so fulfil the law of Christ." It is out of this principle that Health-Care Sharing Ministries operate. Applying this principle to health-care expenses results in the Body of Christ operating as it did in the days of the Early Church -- encouraging fellow believers in difficult situations through prayer and sharing the load.

As followers of Jesus Christ, the Biblical focus of Samaritan Ministries appealed to us in a way that traditional health insurance did not. Additionally, HCSMs tend to be more affordable than the premiums and deductibles of insurance.

Who Can Join Samaritan Ministries?

To be a member of Samaritan Ministries, you must be a professing Christian, agree to the Samaritan Ministries Statement of Faith, be a regularly attending member of a church, agree to certain moral standards (dealing with alcohol, tobacco, and sexual activity), and have your pastor or church leader sign a testimonial form. You can view the Application Form here, and the Guidelines here.

How It Works

Members of Samaritan Ministries commit to sending a set "Share" each month (similar to an insurance premium) directly to fellow members with "Needs". Monthly "Shares" are not run through a central administration office, where funds could be diverted to office costs.

Here’s how the Needs Process works in a little more detail:
Samaritan Ministries publishes a monthly newsletter mailing that reports the total Shares and Needs and includes an individualized Share Notice for each member household. The Share Notice tells each household how to pray for a specific member with a Need and what his address is, so the Share can be sent to him. Typically less than 10 percent of the members have a Need in a given month and are receiving Shares.

When a member has a health care “Need” he receives health care treatment from a provider of his choice, collects the bills, and sends them to Samaritan Ministries. Samaritan Ministries verifies that the Need meets the Guidelines. Then, in the monthly newsletter mailing, Samaritan Ministries directs some members to send their Shares to the member with the Need. The member with the need receives the shares to pay his health care bills.
When a member has a medical need, the first $300 of the bill is the member's responsibility (similar to an insurance deductible). After the first $300, any other expense on up to $250,000 can be shared (click here for the Guidelines). Members can join SM's Save To Share program, which involves setting aside funds (ranging from $133 for singles, to $399 for a family) which may be needed from time to time for needs greater than $250,000. There is a $15-per-year administrative cost for S2S.

Members cover the first $300 on three Needs per year; if they have any additional Needs, the entire amount is shared. Members are encouraged to negotiate for bill reductions; any bill reduction is applied to their $300 responsibility amount, making it possible to entirely eliminate that amount.

Personal example - I had an emergency appendectomy and hospitalization in June of 2015. My medical bills were in the neighborhood of $33,000. I was ultimately able to get a 35% discount for a final amount of around $22,000. Because of the discounts we obtained, the entire amount was shared with Samaritan members. The picture below shows the cards and notes we received from 55 families who helped pay my medical bills.

Cards and checks received from about 55 Samaritan Ministries families across the country

When we shared the medical bills from my wife's pregnancy and birth expenses, once again, every penny was shared due to the bill reductions we received (self-pay discounts of 40% in some instances).

On rare occasions, if there are more Needs than Shares, Needs are prorated. Explanation from SM's FAQ:
What happens if there are more medical needs than shares in a month?
Sometimes we can overlap needs from two months so that there is enough money for all the needs. However, if all needs cannot be met, we use a prorating method to evenly distribute the burden. For example, if there is only enough share money for 90 percent of the needs submitted for a particular month, only 90 percent of each need would be published in the newsletter for that month. If prorating occurs three months in a row without being reversed, the Board must propose a share increase to the members for a vote.
There is a flip side to "Needs-outnumbering-Shares", which I'll address in the cost section.

What Does It Cost?

Members of Samaritan Ministries agree to share the following amounts per month, based on household size:
  • 1 person family - $220
  • 2 person family - $440
  • 3+ person family - $495
  • Single parent family - $305
When one or both of the heads of household are under 26 years old, there is a discount:
  • 1 person family - $180 ($40 discount)
  • 2 person family - $360 ($80 discount)
  • 3+ person family - $445 ($50 discount)
  • Single parent family - $255 ($50 discount)
Any changes to Share amounts is subject to a vote of the entire membership, and has to have 60% in order to pass. Since we joined in December 2012, the membership has only approved two increases (most recent was August 2016).

The flip side of "Needs-outnumbering-Shares" is that if Shares outnumber Needs (like they have for the past two months!), the share figure for the month is temporarily reduced. For example, in October 2014, the amount of dollars "shared" outnumbered the dollars in "needs", so there was a 10% reduction in October's Share amount. Instead of us sending $280 to a member in need, we sent $252. This also happened in November 2014 (5% reduction), May 2015 (5% reduction), November 2016 (5% reduction), and December 2016 (6% reduction).

More Information

Currently, there are over 69,000 families (about 225,000 individuals) participating in Samaritan Ministries. For more information about why they do, visit SamaritanMinistries.org. You can view videos, testimonials, Frequently Asked Questions, the Guidelines, the Application Form, and much more.

Members of Samaritan Ministries also have access to free medical advice from medical professionals, a 24/7 RN hotline, discount labs and prescriptions, as well as tools to help identify quality providers and fair prices for procedures. More information on that is here.

If you are interested in joining, I'd be more than happy to talk with you. You can call me at (918) 869-6000, or email me at JamisonFaught@MuskogeePolitico.com. When a member refers someone who then becomes a member, Samaritan Ministries gives the referring member a credit. Obviously, that's some incentive, but regardless of that, Samaritan Ministries is a great organization.

1 comments:

Cody with SMI said...

Hello Jamison! Thanks for linking to our website and putting all our information on your blog for your readership to see. I've been a member of Samaritan Ministries International for over two years, and now have the blessing of working for SMI. For 20 years God has used this ministry to demonstrate how He can provide for our medical needs through His people's prayers, encouragement, and monthly shares. And recently I’ve been on the receiving end as I had to have a tumor and a third of my lung removed! If I may, I’d like to offer a slight correction to your thorough description of SMI: To participate in the Save 2 Share (S2S) program, there is no extra $15 monthly fee. That $15 is an annual administrative fee. In addition to the annual fee, members of S2S agree to set aside an extra annual amount in their personal finances based on their household membership, a portion of which they may be called upon from time to time to send to another participating member of S2S whose medical bills are above $250,000. For a complete description of how S2S works, your readers can view the program in our guidelines, which you thoughtfully linked to several times in your write-up. Thanks again, Jamison. And may our Heavenly Father bless you and yours.