From what I read about both: They are very private at how they operate. OTW I am not getting a straight answer as to how it works from either of them. So can somebody chart the pros and cons for both??
I can't answer anything about Medishare. We looked at them when we were signing up, but honestly? That was years ago, so I wouldn't trust my brain for one, and for two, things might have changed.
I can talk about Samaritans as we've been with them long enough to know and have experienced quite a bit.
First... they are a Christian health share organization designed for active Christians and exclusive to active (meaning attending some sort of church - no particular denomination) Christians. If someone decides to join, you need to sign (and initial) some statements regarding faith plus get your pastor or some sort of church leader to attest that you regularly attend services (3 of 4 Sundays on average). If anyone has issues with this, then Samaritan's is not the right solution for them. They do not ask any political or "gray area" questions.
If you're ok with that part, then here's how the health sharing works... it's all non-profit - no CEOs or high paid employees...
You send in an annual membership fee (currently $175 for families I THINK - we send ours in in Feb, so my brain could be off). It's less for singles, couples, and single parents, but I don't have a ballpark on those fees. This is the money the non-profit uses to pay the bills - keep the newsletter going, do all the paperwork, pay the electric, you name it.
When you sign up, you decide if you're going with the regular plan or the Save to Share plan - the regular allows claims up to $250,000. The Save to Share allows up to $1,000, 000. Your monthly share cost is the same, but some months you might pay extra for Save to Share - up to $400 annually - not monthly, however, if the $400 isn't used one year, it carries over to the next to be $800. If it is used then it's back to $400.
Then, each month, you will receive an envelope with the newsletter (read it or not - no big deal), monthly prayer guide (again, use it or not, but many of us Christians do pray for one another), and your assigned share. The first three months your share will go directly to Samaritans. There are two reasons for this. The first is to make sure you're reliable with payments. The second is additional "headquarters" $$ to be used where needed.
After the first three months you get assigned a person (or family) to send your check to. You get a short few lines describing what it is for (a baby, cancer, epilepsy, whatever) and any prayer request or praise for the family. You're to send your check directly to that person and they use 100% of the funds toward their medical bills. Your amount doesn't change monthly except when you're with Save to Share - then it can vary.
Most months, the amount coming in = the amount going out. As health care costs rise, there comes some months when bills can be pro-rated. I've seen it happen as low as 80% (the same we had covered when we were with insurance). When this happens it's noted and people have the OPTION to cover the extra by sending it directly to the person, donating the extra to a special Pro-rata fund at headquarters (this is tax deductible), or not covering it at all. Many who are able add the extra. Some who can't afford it simply can't. It's all ok. The Pro-rata funds are distributed among those with needs to try to cover everything. No promises are given, but it appears to generally work.
When needs are pro-rated 3 months in a row or 4 of 6, then a vote is taken among the members to increase the shares. We all know health care costs are rising. Votes haven't ever lost when we've been members, but they don't go up a ton either. We started paying $263/month and now are paying $355/month. This covers 5 of us and we've been members for 10 years or so.
On the "need" side, when something happens or you need something >$300 covered you call headquarters. They will listen and offer to pray - no apologies about being Christian! They will then send you simple paperwork to fill out. You collect bills from your providers - keep copies for yourself - and send the originals in to headquarters. Your original need form needs your pastor or church leader's signature (tries to prevent fraud). Later submissions for the same condition do not need this. (We just submitted more yesterday...)
IF the bills seem unreasonably high, they'll ask you to allow a group to take your side and talk with the provider about lowering costs. The group does this - not you - though you could too if you wanted to. We've had claims work both ways - with the group contacting the hospital (our second claim) and without (this last claim - the bills seemed in line with expectations).
Roughly 2 months after you submit your needs your claim will be published and you'll be on the receiving end of these checks. We're there now for my youngest son's epilepsy that he developed suddenly in April... You'll get a form telling you who to expect funds from and how much. You keep track (on a provided form) of when you get each check, the check #, how much it was for, and if there was a note included or not (you are supposed to send a note, but it's not required). All of our checks for July are due by Aug 6th. So far, we've received 14 of 18 and all but one had a note.
If you don't get a check in by the cut off date, headquarters will contact that person and see if there was a problem. We had that happen once - we sent a check, but it got lost somewhere. It hadn't been cashed, so we just wrote another one and there was no problem.
If you don't pay, you get dropped. You can contact headquarters if you're running into financial difficulty and they can put your membership on suspension for a little bit (no claims during that time), but if you simply opt not to pay, you'll be dropped. They do have a fund for people having financial difficulty too, but I don't honestly know how easy that is or how it works. Fortunately, we haven't needed it.
There are other little things too... they will mention special needs - things not covered - and people can voluntarily opt to send $$ to those. They can range from maternal needs when one wasn't a member long enough to be covered or dental or pre-existing issues. It's totally voluntary. When we had more $$ we sent to them each month. When money's been tight, we don't. There's absolutely no pressure.
And yes, certain things aren't covered at all. Abortion is one, but anything alcohol related (by the person) isn't either. Mental illnesses are not, but my son's epilepsy is. Pre-existing conditions are not.
Why are these things not covered? For one, it's Christian and some of those go against what members believe (abortion, drunkenness). For two, it's all sharing each other's health costs. If one doesn't pay when they are healthy, but only joins when/if they have a claim, there's no way it could be affordable. Everyone would do that...
It's not for everyone, but it absolutely is for us. I'm glad we found them. We've saved a TON over the years and I just like sending a check to a person, not a company. I like not covering abortions and I like not paying for some CEOs vacation home. I can choose any doctor I like (MD, I'm not sure about experimental or other - check guidelines).
I have a lot of pros and no cons. Others might have all cons and no pros.
Each family or person needs to decide for themselves.
Whew! I feel like I wrote a book! Gotta go now!!!