Samaritan Ministries

[desertflower]

Hello,

 

So, I was thinking of signing up.  I've read past threads and was wondering if Creekland and Ellie still uses SM? 

 

Still unclear about a few things.  For example, if I was in an accident and had to go to the ER, what does my dh say?  We have Samaritan Ministries and will be paying up front?  Or what if I was by myself and injured so badly that I couldn't talk and no one can find an insurance card in my wallet.  Will the doctors/nurses assume that I don't have insurance?  Put me aside and work on the next patient who does have insurance? 

 

I understand that SM is not an insurance company.  But is there a card or something that I show? 

 

Thanks for any information.

[creekland]

Yes, we are still members and absolutely no regrets as with any previous threads you came across.

 

We have a membership card we can provide to doctors/hospitals.

 

We rarely pay up front as most doctors/hospitals here LIKE that we're with health share and they don't have to deal with insurance.  They'll bill me, often with discounts already applied, and if the amount is more than I can pay that month (since we get reimbursed two months after submitting bills - submit in Sept, paid in Nov) then they are ok with me paying a small amount - like $10 - during that time period.

 

I do have to admit there has been one major exception to "being good to deal with."  Only one (that I've come across).  That's Johns Hopkins.  For whatever reason, their system is not set up for health share and they've been a bear to deal with over the past three years.  We worked through it and would get one department on board (ie, no problems at all now with radiation) only to find another department had issues (I'm sorry ma'am, no, we can't talk with other departments about it all.   :banghead: )  Every time we think we have everything "fixed" with them, they surprise us.  They also will often require a downpayment at time of service ranging from $75 - thousands, though the thousands was only in the beginning and was for an unusual type of radiation I was told insurance companies often deny payment on - SM paid without any questions at all - after submitting bills, of course.  Coming up with the thousands could have been impossible for many people, but again, insurance might have meant no options at all if they had refused to pay.  (JH told us they require insurance to pay up front too.)  Usually their downpayment is between $75 and $600.  

 

JH's latest surprise was their applying our downpayment directly to bills and never sending us copies of those bills.  I have no idea how that happens from any medical place, but I digress.  When we called them to get copies we were told they couldn't reissue bills that were already paid.  Reissue?  It's NOT reissue when we never received them in the first place!!!  I had to NOT pay a significant sized bill in order to get them to come up with something they could send us.  Did I mention frustrating?  I'm not used to not paying bills, but it's the only way it seems to prod them into helping.

 

But in the end, all is paid (to them) now and we'll finish getting reimbursed in Nov.

 

And in the end, SM has never been a problem.  Only JH has.  It has turned me off from JH - not SM - esp when multiple other places handle health share so easily and thank us for having it.  FTR, many people we've dealt with who work at JH tell me we have better "coverage" than they do... I find that kind of telling about insurance - or JH - or both.

 

NOTE:  This in no way disparages doctors, nurses, or even financial staff at JH.  They've been 100% super nice.  It's their system I despise and wish they would fix.

Edited October 4, 2016 by creekland

[emzhengjiu]

You might also consider Christian Healthcare Ministries as an alternative to compare.   Routine prescriptions aren't covered by CHM.  I don't know about SM.  My older daughter is on one of CHM's programs.  She's only had to use the sharing once - we're still in the process of sending receipts.  Unfortunately, we did have problems with the surgeon who didn't understand the program at all.  I paid the bill up front (no choice) and hope to get my money back soon from CHM.

[desertflower]

Yes, we are still members and absolutely no regrets as with any previous threads you came across.

 

We have a membership card we can provide to doctors/hospitals.

 

We rarely pay up front as most doctors/hospitals here LIKE that we're with health share and they don't have to deal with insurance.  They'll bill me, often with discounts already applied, and if the amount is more than I can pay that month (since we get reimbursed two months after submitting bills - submit in Sept, paid in Nov) then they are ok with me paying a small amount - like $10 - during that time period.

 

I do have to admit there has been one major exception to "being good to deal with."  Only one (that I've come across).  That's Johns Hopkins.  For whatever reason, their system is not set up for health share and they've been a bear to deal with over the past three years.  We worked through it and would get one department on board (ie, no problems at all now with radiation) only to find another department had issues (I'm sorry ma'am, no, we can't talk with other departments about it all.   :banghead: )  Every time we think we have everything "fixed" with them, they surprise us.  They also will often require a downpayment at time of service ranging from $75 - thousands, though the thousands was only in the beginning and was for an unusual type of radiation I was told insurance companies often deny payment on - SM paid without any questions at all - after submitting bills, of course.  Coming up with the thousands could have been impossible for many people, but again, insurance might have meant no options at all if they had refused to pay.  (JH told us they require insurance to pay up front too.)  Usually their downpayment is between $75 and $600.  

 

JH's latest surprise was their applying our downpayment directly to bills and never sending us copies of those bills.  I have no idea how that happens from any medical place, but I digress.  When we called them to get copies we were told they couldn't reissue bills that were already paid.  Reissue?  It's NOT reissue when we never received them in the first place!!!  I had to NOT pay a significant sized bill in order to get them to come up with something they could send us.  Did I mention frustrating?  I'm not used to not paying bills, but it's the only way it seems to prod them into helping.

 

But in the end, all is paid (to them) now and we'll finish getting reimbursed in Nov.

 

And in the end, SM has never been a problem.  Only JH has.  It has turned me off from JH - not SM - esp when multiple other places handle health share so easily and thank us for having it.  FTR, many people we've dealt with who work at JH tell me we have better "coverage" than they do... I find that kind of telling about insurance - or JH - or both.

 

NOTE:  This in no way disparages doctors, nurses, or even financial staff at JH.  They've been 100% super nice.  It's their system I despise and wish they would fix.

 

Thanks creekland. Can I pm you with another question that I don't want to express on this thread?

 

 

[desertflower]

Thanks emzhengjiu.  I looked up CHM, but their site wasn't working so I thought they went out of business.  I'm guessing I got the wrong site.  I read a couple of different places where they seem to compare CHM, SM and medi-share.  SM seemed to be the best fit for us so far.

 

 

[desertflower]

You might also consider Christian Healthcare Ministries as an alternative to compare.   Routine prescriptions aren't covered by CHM.  I don't know about SM.  My older daughter is on one of CHM's programs.  She's only had to use the sharing once - we're still in the process of sending receipts.  Unfortunately, we did have problems with the surgeon who didn't understand the program at all.  I paid the bill up front (no choice) and hope to get my money back soon from CHM.

 

Found the site.  Will look into it.  :)

[JumpyTheFrog]

We were members for seven years. You can also PM me with questions if you like.

[creekland]

Thanks creekland. Can I pm you with another question that I don't want to express on this thread?

 

 

 

Absolutely!  As can anyone reading...  

[BrittanyM]

We've been members with Samaritans for 4 years and they are awesome!

 

 

Sent from my iPhone using Tapatalk

[Liz CA]

I have considered it in the past but never followed through.

So if I accrued a charge of $5000 in June, I submit bills to SM and they'd pay around August?

Do they have any restrictions, e.g., minor things up to a certain dollar amount are not covered, diagnostic procedures - or major things in the hundreds of thousands?

Do you have to pay first and SM reimburses you?

 

[creekland]

So if I accrued a charge of $5000 in June, I submit bills to SM and they'd pay around August?

Do they have any restrictions, e.g., minor things up to a certain dollar amount are not covered, diagnostic procedures - or major things in the hundreds of thousands?

Do you have to pay first and SM reimburses you?

 

Submit i June, get reimbursed in August is correct.  Note though, that many doctor's offices and hospitals aren't so quick with billing.  It could take us up to 6 months to get a bill from JH whether I had already paid it or put a deposit toward it or not.  No other place has taken that long though.  Most are within 2 months.  Some are very quick.

 

Yes, there are restrictions.

 

Nothing totaling $300 or less is covered.  That visit for the sniffles?  Not likely to be covered.  Ditto for anything small.  Nothing maintenance is covered either (annual check ups, mammograms, maintenance MRIs, prescriptions - except cancer drugs - or EEGs are all things we - personally - pay for).  Prescription drugs that go with submitted needs are covered for the first 6 months - no limit to cancer drugs.  Whether this makes Samaritans worth it or not for any individual will depend upon their needs.  We (personally) save roughly $6000 per year in cheaper cost (if nothing were needed).  We save more when we have needs that would only be covered at 80% or have co-pays with insurance.  The 6K is also based upon what insurance would have cost for my family back when ACA took over.  I've no idea how much our insurance would be now.  If higher, then we would save more.  So far for us, we haven't even come close to having insurance be cheaper, but if one were to need expensive prescription drugs or maintenance issues, that variable could change for others.

 

Also not covered are things like abortion, many mental health issues (some are - check Guidelines), pre-existing conditions until a certain time period of no issues from it have been met (check Guidelines again), anything incurred due to being drunk or under the influence of drugs or alcohol, and similar thing. It is important to read Guidelines carefully and compare it to individual family needs.  The mental health/drug use one used to concern me - until I had two similar aged friends at school have problems with their offspring.  Insurance hardly covered anything either... we could easily pay for what their insurance covered and still have it all be cheaper.

 

Issues that are covered are covered at 100% with no deductible or network required - even small bills (less than $300) are covered if part of an overall issue greater than it.  Vision and dental are not covered - unless they too are medical issues (like my vision issue was - that eye doctor visit was covered because it found a medical cause).

 

Limits?  With the regular plan the upper limit is $250,000 per issue (I think).  If one opts for Save to Share (as we do), the cost is modestly more (up to $400 per year I think) and unlimited dollar amount coverage.  I've seen multiple cancers, organ transplants, premie babies, etc, all covered.  I think it's wise to go with Save to Share, but everyone makes their own decisions.

 

Whether one has to pay first or not depends upon the doctor/hospital.  As I reported, most of mine wait for me to get paid first.  I like it that way.  I tend to offer to pay up front if we can afford it and sometimes they take me up on it, but usually they tell me I don't need to, they'll send a bill.

 

Since we've been with SM for over a decade, we've had to teach our doctors (and JH) about them.  Everyone except the JH system has told us they like SM.  It saves them time and paperwork - no preapprovals, no networks - no hassle - most give us a reduced rate (similar to insurance) regardless of whether we are submitting the bill or not.  Individuals at JH have told us the same, but they can't change their system unfortunately. 

[Guest]

You might also consider Christian Healthcare Ministries as an alternative to compare. Routine prescriptions aren't covered by CHM. I don't know about SM. My older daughter is on one of CHM's programs. She's only had to use the sharing once - we're still in the process of sending receipts. Unfortunately, we did have problems with the surgeon who didn't understand the program at all. I paid the bill up front (no choice) and hope to get my money back soon from CHM.

That's very common - most providers expect cash pay patients to pay in full at the time of service, which is what the cost sharing ministries are. Some will provide payment plans and such, but even with discounts they usually expect the entire agreed upon amount in a lump sum unless they allow partial bill pay.

 

I've only had a few providers who are willing to wait for me to be reimbursed first for the cost of the bill. It's no biggie to hold the costs on a card for a few months before the pay comes in, which is what tends to end up happening with bigger bills.

[JoJosMom]

If you are shopping Christian healthcare ministries, Liberty HealthShare is another option.

[busymama7]

We just joined liberty health share. We haven't had to use it yet. But here are a few district differences:

 

All routine care is covered at 100%. Yearly check up, lab work, mammograms (limited to specific age and frequency) etc

$1500 per family per membership year deductible and then everything is covered at 100%. Including midwives and naturopaths and chiropractors etc

Prescription drugs are not covered if they are taken routinely such as my thyroid medication. If it is related to an incident (like pain pills for an injury or antibiotics) they are covered once deductible is met.

[desertflower]

Thanks.  I never heard of Liberty Healthshare.  Only CHM, SM and medi-share. 

 

If there are any others like this, please let me know.  :)

 

Will definitely look into Liberty Healthshare.