Samaritan Update

As long-time readers will know, almost two years ago we left the world of conventional health insurance for the comparatively unknown entity of Christian healthcare cost-sharing via Samaritan Ministries.  While it’s a decision we have been excited about, it is one that has caused some concern on the part of the good folks trying to look after us in terms of my compensation and benefits.

Samaritan requires members to sign a covenant attesting to faith in essentially the Apostles’ Creed.  In other words, you must be a Christian to participate.  As a professing Christian, you are expected to live a lifestyle in keeping with Biblical precepts, and so not all claims are covered.  If you get high on cocaine and then get into a car accident, they aren’t going to pay your medical bills.  There are a variety of other things that they don’t cover as well, however being relatively healthy, we’ve stuck to our guns and said that this is what we wish to keep doing until there is a compelling reason not to.  The decision has always primarily one of theology and philosophy.  We like helping actual people with their actual needs, rather than paying money to a for-profit company that provides services we disagree with.

Now we’re going to get to test Samaritan out and see if it is as good in a pinch as it appears to be.  Last spring our oldest son blacked out after getting out of a hot tub.  He fell forward, landing on his face on the cool decking.  He killed both of his front two upper teeth and actually broke one of them.  It took several months and several thousand dollars for the necessary root canals and a very nice patch job on the broken tooth.  His mouth looks good again and he’s very happy with it.

Of course, all of this had to be paid up front.  Not simply because we don’t have conventional health insurance, but because the particular orthodontist we were directed to doesn’t accept it.  Or, more accurately, she doesn’t trust it, but doesn’t mind if we trust it.  So payment is due up front and in full at the time of service, and her office will provide the necessary paperwork to file with an insurance company for the patient to try and get reimbursed.

She’s a smart orthodontist in my opinion.

Samaritan doesn’t cover orthodontic work, so we knew that our son’s procedures wouldn’t be covered normally, but that we might receive some help through an additional fund and group of members who covenant to help out with non-covered member needs.  We’re part of that group and so each month we pay a little extra that is directed for this purpose.  There was no guarantee we’d receive help, but there was a chance, and on that basis I called Samaritan last week.

I was pleased to be speaking with a human being within less than five minutes.  After confirming our membership number and information, I explained what had happened.  To my surprise and delight, the customer service representative immediately corrected me – while elective orthodontics aren’t a covered expense, dental work required as the result of an accident can be covered.  He quickly reviewed the pertinent details to set up a claim.  He indicated we’d receive the paperwork necessary to file a claim within the next week.  He reminded me that the first $300 of a claim must be covered by us – it won’t be included in the need amount shared with Samaritan’s members, which of course is fine with us.  He then reminded me that, if we had received any discounts on the services (for paying cash, etc.), that these were counted towards that first $300 dollar for dollar.  In fact, our dentist had given us a discount on his services, and because of this, Samaritan considers that part of our up front $300 responsibility, meaning that more of what we actually paid out will be reported as a need.

Before we concluded our 10-minute talk, he prayed for our family and our son.  We received the paperwork on time.  Three sheets of paper to be filled out – one of which is just verifying our contact information.  We will send this back with the bills showing payment and the particular services we received, and if all our ducks are in a row, we’ll begin receiving checks from other members of Samaritan in October.

These bills are still our responsibility – there is no guarantee that any or all of our expense will be covered.  But the expectation is that most of it will.  There are tens of thousands of households across the country that are part of Samaritan, providing a pre-determined monthly share amount to a particular Samaritan member with an approved medical need.  Samaritan grew rapidly and impressively with the advent of Obamacare, with many Christians like us unhappy at being forced to pay for treatments and prescriptions related to birth control and abortion.

If there are ever more needs in a month than membership shares to cover them, then all needs are paid on a pro-rated basis.  In other words, if there were one million dollars in needs in a given month, but only nine hundred thousand dollars in shares to go around, then all of the needs for that month would be shared at 90%.  In months where there are more shares than needs, it is possible for Samaritan to go back and pay more towards needs in a previous month that weren’t met fully.  The organization is non-profit.  In the event that three months in a row there are more needs than shares, than an increase in the monthly shares amount is voted on by the membership.  This has happened at least once in the last two years, and our monthly share amount for a family of five has increased by roughly $25 as a result.

We’re obviously very excited about all of this, and look forward to seeing the organization in action from the receiving end rather than just the sharing end.  As I’ve said from the beginning, this arrangement isn’t for everyone, and you need to carefully evaluate what they do and don’t cover and make sure that you are comfortable with their approach to things.  But so far it has suited our needs and preferences very well.  I’ll keep you posted as to how things develop.  Check the website link above if you’re curious, or feel free to e-mail me and I’ll explain what I can.

I don’t get compensated to blog about Samaritan, though if you join up as a result of reading my blog and mention me as a reference, we get one of our monthly shares waived, so feel free to claim me as a reference if you join!

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4 Responses to “Samaritan Update”

  1. Sarah Devendorf Says:

    Fifteen years we have been Samaritan members. Through the birth of a child that involved six weeks in the hospital and an emergency knee surgery. You will not be disappointed. (My husband is even in the promo video.) :)

  2. Gina Says:

    Unfortunately, I have had a recent and first time need that was shared. I have been so amazed and blessed to receive so many wonderful notes and checks from members from all around the country. SM truly works and I have never felt so happy about writing a check each month to help other members with their medical needs. I am so thankful to have found this medical sharing ministry.

    • mrpaulnelson Says:

      I’m sorry that you had a need, but glad to hear how Samaritan was there to help you through it. Before I joined, I searched online to see if there were detractors from this type of program, or Samaritan in particular. All I could find were warnings about how it wasn’t the same as insurance. Frankly, that’s part of why I chose it! We’re waiting on an itemized bill from one of our providers and then we’ll be sending all of our supporting documentation off. I look forward to posting what happens in the next two months!

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