Ellie Posted January 22, 2008 Share Posted January 22, 2008 Dh's new job does not include health coverage for me that is affordable so we're checking out all options. Quote Link to comment Share on other sites More sharing options...
Lady Katherine Posted January 22, 2008 Share Posted January 22, 2008 They are good, and I like many things about them. A few cautions, though.... They take a long time to pay. They are putting in a new system, and they say that should really speed things up, but it's not at peak efficiency yet. I have had to make MANY phone calls to doctors' offices promising that it really is in the works. Most doctors will take their card just like any insurance card. My son's endocrinologist, however, won't take it. There is a $250 deductible per illness per person per year, and they no longer have a maximum of three before they pay 100%. So if you have 10 illnesses/injuries, you pay $2500. (It used to be a max of $750.) The biggest disadvantage for us is that they will not pay for medical equipment (splints, syringes, glucometers, etc.) and they will not pay for "maintenence meds" after six months. That is fine for most families, but we've had a string of illnesses that have ended up being VERY expensive. The worst so far is that we have to pay for ALL of ds's insulin now, and will have to forever unless we somehow get on a group policy someday. I'm also concerned for myself, because if my doctors ever do find that MS they've suspected for nearly 2 years, the best treatment is a monthly injection that costs $1000 a shot. There's no way we could pay for that. If you're a normal, healthy family (not the poster family for autoimmune disorders like we are), it's a great alternative. Quote Link to comment Share on other sites More sharing options...
Lorna in the boonies Posted January 22, 2008 Share Posted January 22, 2008 We've been with Samaritan Ministries since 1997 and absolutely love them! They have covered broken bones and c-sections and overnight hospital stays and emergency room visits and outpatient surgeries (and probably more if I think about it long enough) -- we haven't had any trouble at all. Do you have any specific questions? Quote Link to comment Share on other sites More sharing options...
Jenn in Mo Posted January 22, 2008 Share Posted January 22, 2008 . Quote Link to comment Share on other sites More sharing options...
Ellie Posted January 22, 2008 Author Share Posted January 22, 2008 We've been with Samaritan Ministries since 1997 and absolutely love them! They have covered broken bones and c-sections and overnight hospital stays and emergency room visits and outpatient surgeries (and probably more if I think about it long enough) -- we haven't had any trouble at all. Do you have any specific questions? I don't know enough yet to ask questions, lol. Dh and I were wondering, though, how it goes at tax time. You turn in your claims to Samaritan Ministries, and members pay their shares to you, yes? (Not sure if I have the right terms yet). So, does the IRS considers these payments to be income? Does Samaritan Ministries shares come in more quickly than Medi-Share? Quote Link to comment Share on other sites More sharing options...
Ellie Posted January 22, 2008 Author Share Posted January 22, 2008 They are good, and I like many things about them. A few cautions, though.... They take a long time to pay. They are putting in a new system, and they say that should really speed things up, but it's not at peak efficiency yet. I have had to make MANY phone calls to doctors' offices promising that it really is in the works. Most doctors will take their card just like any insurance card. My son's endocrinologist, however, won't take it. There is a $250 deductible per illness per person per year, and they no longer have a maximum of three before they pay 100%. So if you have 10 illnesses/injuries, you pay $2500. (It used to be a max of $750.) The biggest disadvantage for us is that they will not pay for medical equipment (splints, syringes, glucometers, etc.) and they will not pay for "maintenence meds" after six months. That is fine for most families, but we've had a string of illnesses that have ended up being VERY expensive. The worst so far is that we have to pay for ALL of ds's insulin now, and will have to forever unless we somehow get on a group policy someday. I'm also concerned for myself, because if my doctors ever do find that MS they've suspected for nearly 2 years, the best treatment is a monthly injection that costs $1000 a shot. There's no way we could pay for that. If you're a normal, healthy family (not the poster family for autoimmune disorders like we are), it's a great alternative. Hmmm....what amounts to a $2500 deductable...OY! Slow in making payments...ack! Well, still thinking. Thanks for the comments :-) Quote Link to comment Share on other sites More sharing options...
Lorna in the boonies Posted January 22, 2008 Share Posted January 22, 2008 Dh and I were wondering, though, how it goes at tax time. You turn in your claims to Samaritan Ministries, and members pay their shares to you, yes? (Not sure if I have the right terms yet). So, does the IRS considers these payments to be income? Does Samaritan Ministries shares come in more quickly than Medi-Share? I'm not a tax person, nor do I play one on TV, but we've been audited twice, both during years when we have had claims with Samaritan Ministries. We were told that they count as 'gifts' for tax purposes and that they are not considered income. We've never counted them as income and were open and aboveboard about that during our audits and neither of our auditors had a problem with it. (Our audits had nothing to do with Samaritan Ministries, by the way! Dh is a pastor, and for some reason pastors are audited far more than the Average Joe.) Samaritan Ministries does ask you to request a discount when you have the procedure done. If you don't succeed in getting one, then they have someone who will try on your behalf. Once the total owed is figured out, they add your name to the list of recipients for the next month. So if I have a procedure done in December and I am *extremely* prompt about getting my bills submitted to Samaritan, it is possible that I will have most of my money by January 15. If I lollygag a bit and don't get my bills in until January, then it will most likely be February 15 before I have a majority of the money (the money is supposed to reach the recipient by the 15th of each month). Technically, there is a copayment per incident of, umm, I think $400, with a maximum of $1200 per family, per year (this may have changed. It's been a few years since we've had a need published.). However, I have never had to pay it! The amount that has come in has always been enough to cover the copay. One time I even received something like $58 more than the total amount of my bill. (I called and asked what to do about that -- they said I could either send the extra in to the main office or pass the extra along to the next person I sent a monthly amount to.) Before we signed up with them, I called and asked a kajillion questions, my main one being, "What do you do if somebody doesn't send their share?" (The answer to that is that they give them 30 days. If they don't send it to you by then, they are dropped from the program and the money they did not send to you is assigned to somebody else the next month.) They were very friendly and helpful and were happy to answer all the questions I shot at them. Let me know if you have any other questions. We honestly could not be any happier with them! Quote Link to comment Share on other sites More sharing options...
G5052 Posted January 22, 2008 Share Posted January 22, 2008 They're really best for folks who are basically healthy with no chronic conditions and no pre-existing conditions. It's really a safety net for something unexpected, not a plan that covers ongoing things. For example, they'll cover cancer the first time, but some don't if it recurs. Or like Katherine experienced, if you have a chronic condition that requires frequent medical care and ongoing medications, it's going to end up being expensive for you, but of course not as bad as if you had nothing. We looked at all the plans like this three years ago when DH first considered retiring early, and frankly they probably wouldn't take us because of him, and if they had, a lot would not be covered. Quote Link to comment Share on other sites More sharing options...
Old Dominion Heather Posted January 22, 2008 Share Posted January 22, 2008 We looked into it, but they would not cover anything for my son's glaucoma or anything related to his vision. (He was born with cataracts and has had double lensectomies and has many ophthalmologist visits each year. Quote Link to comment Share on other sites More sharing options...
Sunny Posted January 22, 2008 Share Posted January 22, 2008 We've have them for YEARS. They are timely in getting out needs newletters and I've never had a problem with them. I have heard that Medi-share has been slower to pay. We've never been audited so I can't say anything about that, nor have we ever actually asked for payment. Which is another reason why we chose this, because it is so much cheaper than insurance and we rarely have any medical problems. Samaratin has had to increase the amounts a couple of times in the last couple of years because of increase in costs, but it is still really affordable. Quote Link to comment Share on other sites More sharing options...
Lorna in the boonies Posted January 22, 2008 Share Posted January 22, 2008 I just remembered something else I really like about Samaritan Ministries. We had a daughter who had a fatal birth defect and only lived for an hour. After her death, they published our loss in the newsletter and asked the members to remember us in prayer. We were inundated with sympathy cards -- I have a huge stack of cards we received from friends and family, but probably half the cards we received all total were from fellow subscribers at Samaritan Ministries. We even got letters months later from SM subscribers who just wanted to let us know that they hadn't forgotten us and were still praying for us. I know that speaks more for the members than for the program itself, but I was still very impressed. Quote Link to comment Share on other sites More sharing options...
HomeOnTheRanch Posted January 22, 2008 Share Posted January 22, 2008 I have Medi Share (the rest of the family has traditional insurance). I've never made a claim, so I don't have first-hand knowledge. I do know they paid for my MIL's pacemaker last year with no problems, but I've heard from at least 2 other families that aren't happy with them. They've had huge bills such as a week in ICU and it was at least a year since the incident and Medi Share was still putting off paying. They said they would...in a few months... I don't know the specifics, so I really don't know if it was all Medi Share dragging or some other factors. Quote Link to comment Share on other sites More sharing options...
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