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Thinking of switching to Samaritan Ministries from insurance, thoughts?

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#1 Halcyon

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Posted 25 July 2012 - 11:28 AM

Dh had to go the er last week for two staples in his head (something fell on hm) amd we got te bill today and it is $1500. He was in the er for literally 45 minutes, no xrays, o iv, o monitoring, no scans. Our deductible is 7500 for our family, amd we pay 1300 a month for insurace. We just cant afford this anYmore. I was hospitalized last year and the bill came to 3500.

Dh is now reluctantly willing to explore alternatives, like health sharing plans. We are healthy wxcept i take anti depressants and birth control for hormal problems, and my guess is those would not be covered. We dont smoke or drink, we are fit and work out.

Thoughts?

Edited by Halcyon, 25 July 2012 - 12:02 PM.


#2 mims

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Posted 25 July 2012 - 11:44 AM

We've loved it. You are correct about preexisting conditions. They do also require regular church attendance (2 or 3 out of 4?). They tell you who to send your money to and what you can pray for. Just look at the details because there is so much per incident out of pocket etc.

#3 Halcyon

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Posted 25 July 2012 - 11:47 AM

Thanks. I attend church regularly, and it looks like the cost for oop precriptions are not that hig, so i could cover those myself.

#4 TranquilMind

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Posted 25 July 2012 - 11:56 AM

Dh had to go the er last week for two staples in his head (something fell on hm) amd we got te bill today and it is $1500. He was in the er for literally 45 minutes, no xrays, o iv, o monitoring, no scans. Our deductible is 7500 for our family, amd we pay 1300 a month for. Surace. We just cant afford this anYmore. I was hospitalized last year and the bill came to 3500.

Dh is now reluctantly willing to explore alternatives, like health sharing plans. We are healthy wxcept i take anti depressants and birth control for hormal problems, and my guess is those would not be covered. We dont smoke or drink, we are fit and work out.

Thoughts?


Yikes! What a ridiculous bill.

I just sold a mattress to a woman on Craigslist who happens to work as an administrator at a major local hospital. She said to me that when huge bills come, just call the hospital and tell them you can't pay it. They will ask what you can pay, and put you on a no-interest payment plan. They overcharge everyone, as they did you, in the hopes that some will pay the ridiculous prices in order to cover others who cannot. She said it is no problem at all and they expect this regularly.

Also, get a specific itemized bill. You may have been charged multiple times for the same thing.

#5 creekland

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Posted 25 July 2012 - 02:00 PM

We've been with Samaritans for a good number of years now (I don't know the specific number) and I absolutely love them.

Our latest claim is my youngest son's (16) diagnosis of epilepsy since April. They have covered everything from the ambulance ride (over $1000) and emergency room ($1900 - did you get the dr bill for yours yet? Ours was separate than the ER bill), and various family doctor, EEG, and neurology appts he's had since getting the diagnosis. On top of that, whenever we've called to talk about things, they always offer to pray. We had to pay $300. We've gotten nice notes from around the country. I'm working on thank you notes now (not required, but something I want to do).

What they don't cover will be his ongoing meds (though they do cover 2 months worth). They're about $55/month, so we'll still be paying less per month than when we had insurance ($355 normal Samaritan's cost + $55 meds is less than the $600 monthly we paid for insurance oodles of years ago). Plus, our policy would have only covered 80% of our bills after $1000 deductible. We'd be looking at having to pay a LOT more than $300 (equivalent of a deductible) if we still had insurance.

Oh, and his follow up visits and another EEG in Sept will also be covered without another $300 on our part.

I have nothing but praises for Samaritan's right now. It's our third need/claim over all these years and each time it's been superb. Plus, it saves us monthly AND I know the money I'm sending in (after the first three months) goes directly to another person in my current shoes. I prefer that to sending it to a for-profit company personally.

Did I mention we could choose any doctor too? We had to go off a list before (with our insurance policy). Not now.

I think all health care ought to consist of non-profit health sharing plans like Samaritans, but for different groups as everyone finds a fit.

Fortunately, with the new health care law, we can keep Samaritans. We don't need to change.

To each our own, but you asked, and I'm more than willing to share our current experience (between April and now). I'm 100% satisfied.

#6 womanintheshoe

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Posted 25 July 2012 - 02:06 PM

Question: Do you have to pay bills first then get reimbursed with Samaritan's? A friend tried to sell us on a plan that sounds similar to Samaritan's yet the deal was you paid your bill in full then got reimbursed. I'm trying to imagine paying a 300K NICU bill out-of-pocket then hoping others sent money to me... :001_huh:

#7 creekland

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Posted 25 July 2012 - 02:15 PM

Question: Do you have to pay bills first then get reimbursed with Samaritan's? A friend tried to sell us on a plan that sounds similar to Samaritan's yet the deal was you paid your bill in full then got reimbursed. I'm trying to imagine paying a 300K NICU bill out-of-pocket then hoping others sent money to me... :001_huh:


In our case, no, we didn't have to pay anything up front - not even an office visit fee. We explained what Samaritan's was to the financial people (who said they knew about such plans) and were totally ok waiting 3 months to be paid. They even gave us a self-insured discount in some cases. This includes two different hospitals, a handful of doctors, and a couple of companies who did things like read (or administer?) the CAT scan and EEG. Oh, and the ambulance. We have 7 different bills going out. All were fine with getting paid 3 months later.

Samaritans will give you a membership card you can show people and they can call if they wish to verify anything. In our case they didn't need to call because they were already aware of how it works.

The reason it's a 3 month wait is because you first have to wait to get the bills, then submit them (we submitted in May), then ours were "published" in July. July is the month people send you their "shares" (ie checks) as per what level of membership they have. For a family, it's $355/month right now - it's less for singles, couples, and single parents. We started getting checks the end of the first week in July and only have 4 left to come in. I'll be sending out 18 thank you notes. ;) And I've already started paying the bills. No one even charged interest for the wait.

#8 Excelsior! Academy

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Posted 25 July 2012 - 02:18 PM

We have a friend that uses Samaritan and is very happy with it. There are other similar types of programs out there, so if Samaritan is not exactly what you are looking for you might look into one of those. The one I am thinking of right now is MediShare.

#9 Halcyon

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Posted 25 July 2012 - 02:33 PM

We have a friend that uses Samaritan and is very happy with it. There are other similar types of programs out there, so if Samaritan is not exactly what you are looking for you might look into one of those. The one I am thinking of right now is MediShare.


Thanks. Samaritan looks like it gets better reviews online, but i will be getting infor for both of them.

#10 Sevilla

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Posted 25 July 2012 - 05:02 PM

Does your ER not have a posted "self pay price"? Ours is $250 for those without insurance. I would call and try to negotiate the bill to the self-pay amount.

#11 G5052

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Posted 25 July 2012 - 05:27 PM

Even with good insurance, I've done that over and over. One out-of-network surgeon wrote off 50% of the bill. We still owed several thousand :001_smile:, but they put us on a no-interest payment plan and we got it paid off.

Just be sure to read all of the fine print very carefully. They've had to get tighter on the regulations of what they cover and don't cover, and I know two families locally who left that type of program and went with traditional insurance because of long-term expensive treatments, which unfortunately they really don't cover. There are some dollar limitations if you get sick after you enroll, otherwise they'd never make it. I have a family member whose bills before insurance sometimes go over $100,000/year, and obviously that type of person is not someone that they could keep on the program long-term or they'd go broke.

#12 HoppyTheToad

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Posted 25 July 2012 - 05:30 PM

We have Samaritan. It doesn't cover psychiatric services, if I remember correctly. So if you need your antidepressant changed and need a dr appt for it, I don't know if it would be covered.

You should also check out the statement of faith to see if you can sign it.

One thing I don't like are many of the articles in their newsletters. They keep giving space to people like Doug Philips (Vision Forum patriarchy nut), Republican political activists, etc. One article a few months ago was about how Christians should adopt more kids to keep all those "evil homosexuals" from adopting them. Nothing was mentioned about adopting because you want more kids. It was all from a dominionist/must have large families to outpopulate the "heathen" perspective. I found it disturbing. I generally just throw the newsletters away now.

#13 Halcyon

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Posted 25 July 2012 - 05:46 PM

Does your ER not have a posted "self pay price"? Ours is $250 for those without insurance. I would call and try to negotiate the bill to the self-pay amount.


I have not heard of this. Thing is, weHAVE insurance, but the deductible is very high.

#14 Halcyon

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Posted 25 July 2012 - 05:48 PM

We have Samaritan. It doesn't cover psychiatric services, if I remember correctly. So if you need your antidepressant changed and need a dr appt for it, I don't know if it would be covered.

You should also check out the statement of faith to see if you can sign it.

One thing I don't like are many of the articles in their newsletters. They keep giving space to people like Doug Philips (Vision Forum patriarchy nut), Republican political activists, etc. One article a few months ago was about how Christians should adopt more kids to keep all those "evil homosexuals" from adopting them. Nothing was mentioned about adopting because you want more kids. It was all from a dominionist/must have large families to outpopulate the "heathen" perspective. I found it disturbing. I generally just throw the newsletters away now.

That would bother me, but i would end up doing what you do.

#15 HomeOnTheRanch

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Posted 25 July 2012 - 06:09 PM

We had Medishare for a few years and the only thing we used it for was 2 normal pregnancies/deliveries. One thing that bothered me was that they called me during my pregnancy and started asking all sorts of question that I felt were none of their business. When I pressed them as to why they were asking the questions, they told me that they wanted to see if I qualified for govt. help. I didn't, and told them so, but it was unnerving to me that they were trying to pass expenses off to the government. If a person wants to sign up for govt. help, they will, but I was upset that I felt like I was being coerced into signing up.

Another thing that bothered me was that we ended up paying more than we were supposed to for a normal pregnancy per their guidelines. I added it all up, and they didn't pay more than the maximum, and I wasn't able to get a straight answer from Medishare. It wasn't *that* much more, so we just paid it.

We switched from Medishare to Samaritan ministries after the baby was born. We haven't had to use it yet, so I don't know anything else about it. My husband is a MD, so he handles a lot of stuff for us. The biggest thing we've had to deal with is a $200 x-ray bill for one of our sons, which was under the minimum required ($300?) to submit to Samaritan.

#16 creekland

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Posted 25 July 2012 - 06:30 PM

There are some dollar limitations if you get sick after you enroll, otherwise they'd never make it. I have a family member whose bills before insurance sometimes go over $100,000/year, and obviously that type of person is not someone that they could keep on the program long-term or they'd go broke.


This is a good point. The "regular" cost with Samaritans will cover up to $250,000, but they also offer an optional extra for $400/year (for families that's the cost - I'm not sure if it varies) to have expenses covered up to 1 million. We do opt for that and I consider it essential - esp for < $40/month. This amount is NOT paid monthly, but is only paid when they need it. It stays in your account until it's needed and builds up each year if not used (meaning if none of the $400 were used the first year you're supposed to have $800 available, if needed, the 2nd year). This can take discipline, but if you just set it aside each year, it's there - earning a measly interest if in an interest bearing account.

Each month there are some of these special needs ranging from the "usual" cancer and organ (heart/liver, etc) problems to premie babies with issues. One never knows what could happen. It's worth the peace of mind to know it's covered if it ever happens.

#17 Lisbeth

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Posted 25 July 2012 - 06:34 PM

Sorry to hear it. You are paying for others padded into your bill. Something I could get all on my soapbox abt, but instead I'll offer hugs...:grouphug:

#18 Sevilla

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Posted 25 July 2012 - 06:34 PM

I have not heard of this. Thing is, weHAVE insurance, but the deductible is very high.

Right - and did you get an EOB from the insurance company (i.e., you get the claim submitted) that showed the insurance discount?

This is why I would call and talk with someone and explain your situation that you are basically 'paying out of pocket uninsured' unless something drastic happens - and that you would like to pay the self-pay rates.

#19 creekland

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Posted 25 July 2012 - 06:36 PM

Oh, and we've had 3 claims over our years of membership, though this last one was the most costly. For the first, my oldest broke his collarbone ($1400). With insurance we'd have had to pay most of that bill since we had the $1000 deductible and were only covered at 80% thereafter. For the second hubby blacked out in our horse pasture. Chances are, one of the ponies ran into him, but he simply doesn't remember. A neighbor took him to the ER. I don't remember the total cost there, but it was also covered without question. We only paid the deductible each time (can't remember if that was still $300 or not back then).

We've had no problems with any of the three and never had to pay up front for anything.

Insurance over the years would have been far more costly for us - mostly in the monthly premiums, but also those three times when we would have needed it. Insurance did give us one free physical each year, but our doctor charges less then $150 for that (I'm thinking around $120 - we haven't had one since last Dec). Even paying for that out of pocket, we're still WAY ahead financially.

#20 creekland

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Posted 25 July 2012 - 06:38 PM

This is why I would call and talk with someone and explain your situation that you are basically 'paying out of pocket uninsured' unless something drastic happens - and that you would like to pay the self-pay rates.


For us, this sometimes knocks 10% off our bills. Yes, it's worth it to call - I agree with that - but it might not end up quite the savings you get.

#21 [email protected]

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Posted 25 July 2012 - 06:42 PM

We have had medi-share for about a year. So far we've been pleased. We chose it over private insurance because it covers maternity and over Samaritan (and a third option I can't remember right now) because it functions the most like insurance. When we go to the doctor or ER there are copays and we are dealt with just like a person who has "regular insurance". So far we've been to urgent care a few times, dh has been to the dermatologist and I just had my pre-natal visit. For some reason the doctor listed my visit as a well- woman exam so it wasn't covered. I have to call later this week to see if that can be changed. I will say even though I am a pretty conservative Christian it is still a little odd to me when I call customer service they want to pray with me:001_huh: I'm a pretty reserved person and wouldn't ask a stranger for prayer so I'm sure it's my issue.

They do also ask a lot of questions but I am okay with that because I knew it going in. We have a fairly high family share option to keep our monthly cost low so I will be taking advantage of the bill reduction services in the next few weeks and will let you know how that goes. I had to have stitches at urgent care last month & an ultrasound this week so I have bills adding up.

#22 cin

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Posted 25 July 2012 - 06:55 PM

We have Samaritan. It doesn't cover psychiatric services, if I remember correctly. So if you need your antidepressant changed and need a dr appt for it, I don't know if it would be covered.


Thank you for posting this. Saves me a TON of time researching it.

#23 eaglei

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Posted 25 July 2012 - 07:07 PM

Yikes! What a ridiculous bill.

I just sold a mattress to a woman on Craigslist who happens to work as an administrator at a major local hospital. She said to me that when huge bills come, just call the hospital and tell them you can't pay it. They will ask what you can pay, and put you on a no-interest payment plan. They overcharge everyone, as they did you, in the hopes that some will pay the ridiculous prices in order to cover others who cannot. She said it is no problem at all and they expect this regularly.

Also, get a specific itemized bill. You may have been charged multiple times for the same thing.


This surprised me - and yet it didn't. However, calling the hospital NEVER worked for us - not once - and even to just have lower payments, we were made to feel like criminals the couple times we were actually approved. Maybe it depends on the hospital . . .

As for Samaritan's - we just switched to them beginning this June. We are quite at peace with this decision.

We, too, checked into MediShare and ultimately rejected them (in favor of Samaritan's) for such reasons as: significantly higher share amounts; share amounts are raised EVERY year (the man I spoke with specifically told me this; Samaritan's rep said theirs is generally raised every 18-24 months but ONLY IF the membership [which now includes us] votes for it); the share is sent to a specific bank; you sign over "power" to MediShare to go into your account to use the share amounts to send to whomever. These are a few reasons. Ultimately, we were at peace with Samaritans.

Samaritans also gave us phone numbers of members we could phone. I called one family and asked LOTS of questions. Their experience meshed with all I had read, and heard from the Samaritan rep. (Husband had had a stroke - they paid NOT ONE PENNY - Samaritan covered it all - both from the regular monthly shares as well as the Save to Share program where, if you opt to do this, you set aside a certain amount each year [in your own home or bank account - you don't send it to Samaritan] that you may be asked to contribute.

I also like that they will post some non-covered items. With your monthly "bill" you are asked to contribute to a specific one - you don't have to - just if you want to. They also list other non-covered expenses that you can choose to help or not. The family I spoke with said they always help two or three of these needs each month.

One of the things we did when we were in the decision-making stage was to call our family doctor to see if he would accept payment in a share program. He will not. However, his receptionist suggested that, if we needed any testing done that could be done in-office, to request that he write up a referral for the hospital because they might accept this program. I phoned the hospital and, while they were not familiar with Samaritan, they WERE familiar with a very similar program that she said German Baptists have and that they definitely would accept this. She asked me for further information and said she was going to suggest to her supervisor that they send out letters to the doctors affiliated with their hospital urging them to consider accepting plans like these from their patients.

Anyway, we don't have any personal experience with Samaritan as far as having a medical need (THANK THE LORD!) - just posting to say we switched over . . .

#24 ColoNative

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Posted 25 July 2012 - 07:56 PM

We looked into Medi-Share, but ultimately felt the risk was too high. In the fine print, it says they are not insurance and not bound to cover anything...that's not comforting...how do you all deal with this who have signed up with them - or Samaritans?

I have a friend using Samaritans. She had a baby and had less than half her expenses paid...no reason given, just that that was all the people who wanted to contribute...:confused:

We had no maternity coverage with two of our babies - the doctor and hospital both gave us good discounts. I had the hospital send me an itemized statement - they had charged over $2000 for procedures I didn't have, and all of their charges were so outrageous. A can of dermoplast was charged at $80. I asked about it and she said, well, you're getting a 55% discount. So, I only paid $36 for a $3 can of dermoplast....I learned my lesson...I take everything with me now!

#25 creekland

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Posted 25 July 2012 - 08:10 PM

We looked into Medi-Share, but ultimately felt the risk was too high. In the fine print, it says they are not insurance and not bound to cover anything...that's not comforting...how do you all deal with this who have signed up with them - or Samaritans?


It hasn't been an issue here. I have, however, had a friend who had insurance and then found out certain procedures weren't covered - plus her dr choice was limited. My uncle has free med care - but it must be at a VA. The nearest VA is an hour away - not so great when one has an emergency. He's still dealing with trying to get some bills related to a recent stroke covered. They covered some due to it being a real emergency, but not all. I think every option (short of being a member of congress) has its issues.

I have a friend using Samaritans. She had a baby and had less than half her expenses paid...no reason given, just that that was all the people who wanted to contribute...:confused:

How long was she a member before becoming pregnant? That does affect how much you can claim. People who don't send in their shares are dropped from the program. I have a list of everyone who is supposed to send a check and exactly how much they are supposed to send. I need to note when the check arrived, the check #, how much it was for, and if they sent a note or not along with the check. By Aug 6th I'm supposed to have it all and send the form back. If any don't arrive, they then contact those people to make sure something wasn't overlooked or lost in the mail. We had this happen to us once - we sent a check, but it evidently got lost somewhere. No problem. We sent another one. Things can happen.

If something were to go wrong - someone didn't send one even at that point, then they are dropped from the program and the amount we missed would get republished - not in August, of course, as it would be too late for that, but Sept.

There are some nice checks and balances IMO. I have literally no fear of being left with huge bills, though I'll admit for the first claim we had I wondered how it would all work out. At this point in our current claim, 14 of 18 expected checks are already here and only one didn't also send a note of encouragement. Since many people pay their bills at the end of the month, I'm not terribly worried about the other 4, but there are "plans" if they don't come.

#26 cdrumm4448

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Posted 25 July 2012 - 08:20 PM

I researched Samaritan when Obamacare passed. We have employer provided insurance, but I'm very concerned DH's employer will find it more cost effective to pay the penalty for not insuring than to pay for the insurance. (The premium for our family of 4 is over $1,000 paid for by the employer. We pay $150 a month with a $2,400 deductible.) If this does happen we will use Samaritan Ministries. Cost wise it works out almost the same.

#27 Holly IN

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Posted 25 July 2012 - 08:40 PM

We are also concerned that when Obamacare passed that our employer (the same employer for both of us so we get the spousal benefit package and it helps tremedously!!). They are changing everything in October but have been assured that spousal benefit stays the same. So we will see....

I have been researching Mediashare and Samarition. I am very uneasy about both of them. I really prefer our insurance. sigh!! (Yes I know they support the democrat party and abortion but...)

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??

TIA
Holly

#28 creekland

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Posted 25 July 2012 - 09:18 PM

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??

TIA
Holly


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!!!

#29 eaglei

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Posted 26 July 2012 - 09:36 AM

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.


Creekland - You did a GREAT job explaining this!

I wanted to comment on the part that I copied out of your response, and also add more. We are new to Samaritan's - just joined as of June.

You are right - the annual membership fee is $175.00. According to the Guidelines booklet, this appears to be the fee regardless of family size (single, married, etc.)

However, the monthly share amount (what regular insurance companies call your premium) varies. The rates just went up in June (the month we joined)! For singles, it is currently $150; couples $300; single-parent family $215; two-parent family $355. For each member who is 65 or older, the amount is reduced by $30.

If you wish to join the Save to Share program, there is an annual administrative fee of $15. The YEARLY amount that is set aside is as follows: singles $133; couples $266; single-parent $266; two-parent $399. This is money you set aside at home; you do not send it in unless requested to - and then only the portion requested. According to the booklet, only a percentage is requested - 20% the first time; the second request would be for 50% of the balance. If you haven't been asked to use these set-aside funds one year, then you ADD this year's amount to last years and the percentage requested is different.

I also wanted to mention that, if you help with an unpublished need, they give you two options. One is to send the money directly to the family whose name they have selected for you. The other is to send it to Samaritan's who will forward it on to that family, or to the family you request, or, if those needs have been met, they will sent to another family in need - when you choose this option, it is tax-deductible (as charitable, I think).

Creekland - I really appreciate your positive testimony regarding your experiences with Samaritan's. I posted an inquiry thread about this when we were researching and several people had positive personal experiences - it is quite encouraging. We feel so at peace with this decision. Even though we still have one more month to send our share to the administration, we were absolutely glad to do so these past two months - it feels so good and so right. Also, we were glad to be able to help with an unpublished need. We are experiencing great financial hardship (our ds is a two-time cancer survivor plus there are underemployment issues, etc. - BTW, we only signed up as a couple as ds has a separate insurance policy that, given the cancer, we cannot/will not cancel; nonetheless, the savings for dh and I are phenomenal with Samaritan's). We are actually looking forward to sending our monthly share to a real live person with a real need and KNOWING that the money is going to that person and need and not to pad someone's pocket, pay for an abortion, etc.

This has gotten rather lengthy - sorry . . .

Edited by eaglei, 26 July 2012 - 09:39 AM.


#30 HoppyTheToad

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Posted 26 July 2012 - 09:56 AM

We've been members of Samaritan Ministries for about four years. Our first claim was for a home birth, which was paid without problems. Then last fall I had a claim for about $11,000. There were too many claims that month and needs were pro-rated at 80%. A few months later, I unexpectedly got a check for about 15% more, because people had sent in extra. So I wasn't paid the whole amount, but we did get most of it.

I like being able to use any doctor and not need an insurance company to approve off-label uses of drugs. An insurance companies probably would not have covered some of my treatments.

#31 KnitWit

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Posted 26 July 2012 - 10:06 AM

We joined Medi-Share several years ago and then dropped them after the SECOND claim that they denied and claimed was pre-existing. I cannot even remember the first, but the second was a bump that my dh had on his face. Neither he NOR I had noticed it until a man at church came up to him and said "You better get that checked out. I had a bump like that and it turned out to be melanoma." It was such a SMALL bump...but he went RIGHT in. It turned out to be melanoma for my dh as well and it was removed. Medi-Share claimed that due to the *depth*, it had to have been there for a long time and therefore would have pre-existed our membership. I honestly cannot remember how long we had been members at the time, this was several years ago. Anyway, they did not allow ANY of it to be paid. My dh even had his dermatologist write a letter to them because SHE was appalled and felt they were just trying to get out of it. Medi-Share rejected her statement. Dh was so frustrated that he just dropped them.

Part of our issue was the attitude. They made him feel like he was purposefully trying to cheat them. :001_huh:

#32 LMA

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Posted 26 July 2012 - 10:27 AM

Does your ER not have a posted "self pay price"? Ours is $250 for those without insurance. I would call and try to negotiate the bill to the self-pay amount.


If you have insurance, the amount you are billed is related to the contracted amounts of the insurance companies. It has to be processed through the insurance companies to count toward the deductible. If you do self-pay, it does not count toward the deductible.

I have never seen a hospital with posted prices. Around here, you have to speak with a financial officer to figure out the amount charged.

#33 I.Dup.

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Posted 26 July 2012 - 10:36 AM

Does the $355 per month get divvied up for the families you wish to help? Or are the "published needs" that people help with on top of the $355/month?

Dh gets good insurance through his work that doesn't cost us nearly $355/month but this does seem like a good program.

#34 Susan C.

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Posted 26 July 2012 - 10:40 AM

I have not heard of this. Thing is, weHAVE insurance, but the deductible is very high.


You can still negotiate with some hospitals! I always tell doctors that I have a high deductible and ask for a cash price. One hospital even told us to apply for charity for the balance, and that was with insurance.

We applied to Samaritan years ago..... and were turned down for something I even got a letter from my doctor stating it was not valid.

AND Samaritan is not insurance. So if you ever go back to an insurance policy, you will have a wait for coverage because of preexisting conditions, meaning you will pay for insurance and preexisting conditions for one year (sometimes forever) before you will get coverage. Also, the deductible at Samaritan is PER incident.

Medishare is another company like Samaritan.

#35 creekland

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Posted 26 July 2012 - 12:21 PM

We are actually looking forward to sending our monthly share to a real live person with a real need and KNOWING that the money is going to that person and need and not to pad someone's pocket, pay for an abortion, etc.


I'll admit, this is my favorite part of the program, followed by the huge savings over for-profit insurance. I'd stick with Samaritans even if money were no issue just because I prefer paying a person/family each month. I'd probably stick with it even if it were to become more expensive, but I can't see that really happening. Things are a lot less expensive once profit is removed.

Thanks for clarifying things where my brain was fuzzy (exact amounts, etc).

Does the $355 per month get divvied up for the families you wish to help? Or are the "published needs" that people help with on top of the $355/month?


You do not get to pick who your monthly share goes to - those are assigned to be certain everyone is covered. Headquarters assigns the needs. We could be helping people in an hour down the road or people on the other side of the world (missionaries - needs for them are collected stateside - so you don't have to send money to other countries literally).

Any special needs are just listed monthly. Those are 100% optional and you can pick who you want to send any extra to - or not at all. Special needs are for things not covered.

I just pulled out my list for July. There are 10 special needs listed each month. This month:

4 were for pre-existing conditions such as a hernia and heart problems
3 were for maternity needs when the member hadn't been a member long enough to have full needs published
3 were for major dental needs - dental is not covered normally unless it stems from an accident

When we have extra $$ each month, we choose one or two to send $$ to for these. When times are tough we don't. We've never been harassed (or praised) either way. This is all optional. What is not optional is sending your agreed to monthly share each month. There are people counting on that.

#36 creekland

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Posted 26 July 2012 - 12:36 PM

AND Samaritan is not insurance. So if you ever go back to an insurance policy, you will have a wait for coverage because of preexisting conditions, meaning you will pay for insurance and preexisting conditions for one year (sometimes forever) before you will get coverage.


If I've read things carefully, Obamacare will change this in the not too distant future.

However, the same is also true for joining Samaritans. If you join when you are healthy, things are covered (or with a little wait for things like maternity needs). If you wait until something happens, things are not covered. If you drop the program, then opt to rejoin, it's like starting over.

Whether choosing insurance or health sharing, it's important to do so early - not wait until you have needs.

Also, the deductible at Samaritan is PER incident.


Good point. Yes, the deductible is per incident, though follow ups from the same thing do not get a second deductible (like my son's epilepsy appts from April/May and then Sept are all the same incident). Each incident is $300. When we were on insurance our deductible was $1000, so we could have 3 incidents per year and still be doing better. We've been fortunate and only have had 3 over several years, so we're doing much better. If you think you're going to have multiple incidents often, it's worth comparing.

Then also remember to compare how much is covered after the deductible. With our insurance policy it was 80% up to $10,000 out of pocket. With Samaritans it's generally 100%, but could go lower during times right before votes to increase shares. I don't recall it ever going lower than 80% - and then there can be families like ours who opt to pay the higher amount - but it's not guaranteed.

Everyone should be aware of all of these things and compare their own options based on their family and plans, etc. I've just been relating what ours were back when we switched. I suspect our insurance would be a bit higher now, but that's just a guess.

Back in the old days we were paying $600 month for the insurance to cover our whole family (and that included one free physical a year). Now we're paying $355/month + $175/year and pay for our own physicals. WE come out much better with all the above (deductible, coverage) factored in too. That may, or may not, be true for others.

#37 creekland

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Posted 26 July 2012 - 12:40 PM

AND Samaritan is not insurance.


Meant to reply to this one too... Yes, Samaritan's is NOT insurance. It's not for profit and it depends upon like minded people covering each others needs as agreed upon in the guidelines. It's based upon trust - with some checks and balances as I described from our experiences.

It is, however, allowed under the new Obamacare law (you won't need to buy separate insurance or pay a fine). There are many of us who are thankful for that. ;)

#38 OnTheBrink

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Posted 26 July 2012 - 12:43 PM

Dh had to go the er last week for two staples in his head (something fell on hm) amd we got te bill today and it is $1500. He was in the er for literally 45 minutes, no xrays, o iv, o monitoring, no scans. Our deductible is 7500 for our family, amd we pay 1300 a month for insurace. We just cant afford this anYmore. I was hospitalized last year and the bill came to 3500.

Dh is now reluctantly willing to explore alternatives, like health sharing plans. We are healthy wxcept i take anti depressants and birth control for hormal problems, and my guess is those would not be covered. We dont smoke or drink, we are fit and work out.

Thoughts?


Definitely call the hospital's patient financial services and talk to them about paying the bill. At the very least, you can work out a payment plan that'll work for you. And, they always have other options, too. So, don't feel like you have to pay the bill all in one payment.

There are folks at my church who use Samaritan's Purse and are happy with it. I know no details about it, though.

#39 Sevilla

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Posted 26 July 2012 - 03:31 PM

If you have insurance, the amount you are billed is related to the contracted amounts of the insurance companies. It has to be processed through the insurance companies to count toward the deductible. If you do self-pay, it does not count toward the deductible.

I have never seen a hospital with posted prices. Around here, you have to speak with a financial officer to figure out the amount charged.

I think that I live in an area high in uninsured people who use the ER as regular medical care, hence the posted 'this is what you'll have to pay if you have no insurance' price posted.

#40 FairProspects

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Posted 26 July 2012 - 03:39 PM

However, the same is also true for joining Samaritans. If you join when you are healthy, things are covered (or with a little wait for things like maternity needs). If you wait until something happens, things are not covered. If you drop the program, then opt to rejoin, it's like starting over.

Whether choosing insurance or health sharing, it's important to do so early - not wait until you have needs.


Yes, but some of us have had health "needs" from birth through no fault of our own. I resent the fact that according to Samaritan Ministries I do not EVER get the opportunity to participate in their version of Christian medical sharing and prayer because of something I had no control over (which Christ knew about, no less). In failing to address these types of situations at all, there is a subtle implication of the prosperity gospel at work here IMO.

#41 creekland

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Posted 26 July 2012 - 03:44 PM

Yes, but some of us have had health "needs" from birth through no fault of our own. I resent the fact that according to Samaritan Ministries I do not EVER get the opportunity to participate in their version of Christian medical sharing and prayer because of something I had no control over (which Christ knew about, no less). In failing to address these types of situations at all, there is a subtle implication of the prosperity gospel at work here IMO.


It definitely is not a program that works for everyone... but to be fair neither does insurance. :grouphug:

#42 FairProspects

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Posted 26 July 2012 - 03:49 PM

It definitely is not a program that works for everyone... but to be fair neither does insurance. :grouphug:


True, but insurance does not claim to be Christian and compassionate, so it rankles less. But thanks for the hugs!

#43 eaglei

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Posted 26 July 2012 - 04:10 PM

Also, the deductible at Samaritan is PER incident.


We're just new to Samaritan's Ministry, but this is something I asked about - and asked again and again. My understanding of the answer is that it is a $300 deductible per person for the first three incidents per year. So if you have a fourth incident the same year, there is no $300 deductible for you to first pay. However, publishable needs must be more than $300. So anything under $300 you wouldn't be submitting for payment anyway.


It is, however, allowed under the new Obamacare law (you won't need to buy separate insurance or pay a fine). There are many of us who are thankful for that. ;)


YES! We are thankful for this, too!

Yes, but some of us have had health "needs" from birth through no fault of our own. I resent the fact that according to Samaritan Ministries I do not EVER get the opportunity to participate in their version of Christian medical sharing and prayer because of something I had no control over (which Christ knew about, no less). In failing to address these types of situations at all, there is a subtle implication of the prosperity gospel at work here IMO.


In reading the guidelines and asking countless questions, it does appear that no preexisting is covered, even if it is from birth. However, they will cover things not related to that condition.

My ds is a two-time cancer survivor with a separate traditional policy that we have not canceled. Only dh and I switched to Samaritan. Under Samaritan guidelines, ds can get a policy and they will cover any condition not related to the specific cancer he had. Since he had it twice, he has to be 7 or 10 years (don't remember which) in remission before they would consider covering cancer. So there are some preexisting that they will cover after you have been free of that condition for so much time.

I "understand" your frustration with the program since your condition is from birth - it's not a perfect system . . .

It definitely is not a program that works for everyone... but to be fair neither does insurance. :grouphug:


Well said.

#44 creekland

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Posted 26 July 2012 - 04:14 PM

True, but insurance does not claim to be Christian and compassionate, so it rankles less. But thanks for the hugs!


Being Christian and compassionate doesn't mean members have unlimited funds to be able to do everything they wished they could...

On a different note, from birth issues for kids of parents who belong are covered. We've had a couple of those we've helped pay for over the years.

#45 FairProspects

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Posted 26 July 2012 - 04:29 PM

Being Christian and compassionate doesn't mean members have unlimited funds to be able to do everything they wished they could...

On a different note, from birth issues for kids of parents who belong are covered. We've had a couple of those we've helped pay for over the years.


Oh, I get it. But on some level it is still about money and I wish they would be more upfront about this, even though it is a non-profit. The word "ministries" is somewhat loaded in the Christian sphere and in many instances means "charity" for the least of these and this program is really more cost-sharing for members. If I was denied "membership" to a club I tend to shrug it off as not fitting their qualifications, when I'm denied by a "ministry", the psychological toll is different.

I get more frustrated when I hear people say this style system should be THE solution to the health care crisis (which I don't hear people saying in this particular thread), because it completely leaves out a certain segment of the population through no fault of their own.

Edited by FairProspects, 26 July 2012 - 04:42 PM.


#46 [email protected]

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Posted 26 July 2012 - 04:30 PM

Today I got the bill from dh's dermotologist visit in May. He played the $35 co-pay when he saw the doctor and since we haven't met the family share (deductible) I have been expecting the bill. What I didn't know/expect was that medi-share negotiates the bill down for you before you get it. I knew they helped you get a discount but I figured it was something I had to initiate.

I tried to take a picture but I guess it's not possible to link from the iPad.

The bill said:
Office Visit $148
credits - $35 patient payment (the co-pay)
$20 medi-share adjustment
Balance due: $83.24

It looks like we received about a 20% discount. If I remember when the urgent care bills from my stitches come in I'll post those details?

#47 creekland

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Posted 26 July 2012 - 05:47 PM

I get more frustrated when I hear people say this style system should be THE solution to the health care crisis (which I don't hear people saying in this particular thread), because it completely leaves out a certain segment of the population through no fault of their own.


In MY ideal world, programs like these would be the main style system and everyone would pick a group they aligned with. It need not be based upon faith, of course, it could be motorcyclists, homeschoolers, lovers of Days of Our Lives, or anything as long as there were a large enough group to make it work. Each group would decide upon their own exclusions (like abortion). Everyone would belong somewhere and all "basic" bills (not purposely excluded by choice of the group you wanted to join) would be covered.

Then, I'd have a program every group would pay into to cover the really deep needs - say - about that $250,000 mark. This would include anything pre-existing, but not controversial "basics" which could be covered by joining a different group. Anyway, each group would pay according to their membership, so it'd be passed on through membership fees accordingly.

That way EVERYONE would share in helping those who truly need it and groups would share their own basic/everyday needs as per their preferences (a group could choose to cover hangnails if they wished, but their cost would likely increase).

Too poor to pay for a group? If it were verified (yeah, I know) then those could also fall into separate cases - within their group if temporary (layoff, etc) or with the deep needs fund if more permanent (disability).

So yes, I'm an advocate of what you suggest, but I also think it could work - and work far better than for-profit insurance. No one would be without assistance with healthcare.

But no one gave me control of the world (or our country or whatever) and ideal worlds don't exist on this planet.

#48 creekland

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Posted 30 September 2012 - 05:07 AM

Just thought I'd bring this back up to post a "final results" for our latest with my youngest's epilepsy...

EVERY. SINGLE. THING. was covered and paid for. This includes the original ambulance ride and ER visit + doctor and tests, the follow up with the family doctor, the specialist, the EEG, 2 months worth of prescription meds (the rest will be ours), a follow up visit with the specialist, and a follow up EEG.

We had no lists of doctors to choose from. We had no co-pays. (There was the $300 "deductible.") We had no percentage to pay (as we did when we had insurance). There wasn't anything not covered nor was there any hassle. All of our checks are in and there's no gap.

I'm extremely happy with the way things turned out financially and extremely glad we chose to go with Samaritans so many years ago. It has saved us a ton of $$ over the years and enabled us to help other people instead of lining CEO wallets and/or stock portfolios.

It's not a program for everyone, but it's certainly perfect for us.

#49 Chris in VA

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Posted 30 September 2012 - 06:46 AM

Not to be snarky, but just pray your child never has the need for rehab. Addiction is seen as a lifestyle choice, not a disease, and nothing for it is covered. We fit every single requirement of Samaritan, but couldn't join. I'm glad it works for some, but I sure wish they'd be compassionate to the children of the members.

#50 creekland

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Posted 30 September 2012 - 10:49 AM

Not to be snarky, but just pray your child never has the need for rehab. Addiction is seen as a lifestyle choice, not a disease, and nothing for it is covered. We fit every single requirement of Samaritan, but couldn't join. I'm glad it works for some, but I sure wish they'd be compassionate to the children of the members.


Close friends of mine are going through this now with their college aged son. Their insurance is covering next to nothing leaving them with thousands of dollars in loans. They get their insurance through their work, so at least they haven't been paying for it (their workplace has), but it sure hasn't saved them much.

Another friend was just informed that he will need to pay hundreds of dollars monthly (almost $600) just for one ongoing treatment his son needs and he is supposedly covered by insurance through his employer.

Insurance is not the be all, end all, either.

For some of us who need to pay out of pocket, Samaritans is a great option IME.


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