Health Care Sharing -- Our Experience

3/14/15 update: Our first medical need with Samaritan Ministries
10/7/15 update: post-second medical need with Samaritan Ministries  
12/9/16: read my overview of Health Care Sharing's tremendous growth
4/3/18: our third medical need with Samaritan Ministries
6/3/18: What does Health Care Sharing with Samaritan Ministries cost?
2/19/19: Major Growth Continues in Health Care Sharing

As healthcare costs continue to skyrocket, families are struggling with the high price of health insurance. With the onset of ObamaCare, other issues with health insurance have come to the forefront as well, such as religious organizations being forced to cover abortion-related drugs in their insurance plans. Is there a different path than the health insurance industry? Is there another option that fits your family's moral values, doesn't support abortion, and is affordable?

Enter, Samaritan Ministries. 

My wife and I joined Samaritan Ministries at the end of 2012. Samaritan Ministries is a not-for-profit religious organization classified as a health-care sharing ministry, and is not considered to be traditional "health insurance". HCSMs are exempt from the individual mandate in ObamaCare.

Why do Health Care Sharing?

Growing up in a self-employed family, for much of my childhood my family was either uninsured or insured under catastrophic, doomsday plans that were of practically no benefit to us. The times when we did have insurance, we rarely used it (and by rarely, I mean rarely).

Let's fast forward some. My wife and I got married in September 2012, and researched numerous insurance options around that time period. I looked, and looked, and looked and looked. Finding something affordable and usable was practically impossible.

Ultimately, we opted out of the traditional insurance scene, and (as I mentioned previously) joined Samaritan Ministries.

Galatians 6:2 says "Bear ye one another's burdens, and so fulfil the law of Christ." It is out of this principle that Health-Care Sharing Ministries operate. Applying this principle to health-care expenses results in the Body of Christ operating as it did in the days of the Early Church -- encouraging fellow believers in difficult situations through prayer and sharing the load.

As followers of Jesus Christ, the Biblical focus of Samaritan Ministries appealed to us in a way that traditional health insurance did not. Additionally, HCSMs tend to be more affordable than the premiums and deductibles of insurance.

Who Can Join Samaritan Ministries?

To be a member of Samaritan Ministries, you must be a professing Christian, agree to the Samaritan Ministries Statement of Faith, be a regularly attending member of a church, agree to certain moral standards (dealing with alcohol, tobacco, and sexual activity), and have your pastor or church leader sign a testimonial form. You can view the Application Form here, and the Guidelines here.

How It Works

Members of Samaritan Ministries commit to sending a set "Share" each month (similar to an insurance premium) directly to fellow members with "Needs". Monthly "Shares" are not run through a central administration office, where funds could be diverted to office costs.

Here’s how the Needs Process works in a little more detail:

Samaritan Ministries publishes a monthly newsletter mailing that reports the total Shares and Needs and includes an individualized Share Notice for each member household. The Share Notice tells each household how to pray for a specific member with a Need and what his address is, so the Share can be sent to him. Typically less than 10 percent of the members have a Need in a given month and are receiving Shares.

When a member has a health care “Need” he receives health care treatment from a provider of his choice, collects the bills, and sends them to Samaritan Ministries. Samaritan Ministries verifies that the Need meets the Guidelines. Then, in the monthly newsletter mailing, Samaritan Ministries directs some members to send their Shares to the member with the Need. The member with the need receives the shares to pay his health care bills.

The following dollar figures are for Samaritan Classic, the more comprehensive and expensive plan offered by Samaritan Ministries. They recently launched Samaritan Classic, which has lower costs but higher thresholds for sharing. You can see the details on Basic here; since we use Classic I'll focus on that plan.

When a member has a medical need, the first $300 of the bill is the member's responsibility (similar to an insurance deductible). After the first $300, any other expense on up to $250,000 can be shared (click here for the Guidelines). Members can join SM's Save To Share program, which involves setting aside funds (ranging from $133 for singles, to $399 for a family) which may be needed from time to time for needs greater than $250,000. There is a $15-per-year administrative cost for S2S.

Members cover the first $300 on three Needs per year; if they have any additional Needs, the entire amount is shared. Members are encouraged to negotiate for bill reductions; any bill reduction is applied to their $300 responsibility amount, making it possible to entirely eliminate that amount.

Personal example - I had an emergency appendectomy and hospitalization in June of 2015. My medical bills were in the neighborhood of $33,000. I was ultimately able to get a 35% discount for a final amount of around $22,000. Because of the discounts we obtained, the entire amount was shared with Samaritan members. The picture below shows the cards and notes we received from 55 families who helped pay my medical bills.

Cards and checks received from about 55 Samaritan Ministries families across the country

When we shared the medical bills from my wife's pregnancy and birth expenses, once again, every penny was shared due to the bill reductions we received (self-pay discounts of 40% in some instances).

Another example - my wife's second pregnancy and delivery had an initial cost of $53,878.34. Discounts we obtained brought that down to a final total of $20,383.06. That's a 62.17% discount on the full bill. We even got a 70% discount on the largest bill (bringing it down from $44,000 to a mere $13,000).

Cards and checks from 45 families in 22 states, as far away as Delta Junction, Alaska!

Here are some numbers from our experience with Samaritan Ministries since 2012:

• 5: total submitted medical needs
• $53,878: largest pre-discount medical need
• $118,000: total of medical bills
• $60,000: self-pay discounts
• $58,000: final post-discount bills
• 100%: largest percentage discount on any single bill ($9,692.73 bill)
• 73.21%: largest self-pay discount on any full medical need
• $31,000: largest dollar amount discount on any single bill (70% of the full bill)
• 50.7%: total percentage of discounts received
• 170: families who have shared our bills
• 30+: states we received shares from
• $0: our net out-of-pocket cost on submitted medical needs

On rare occasions, if there are more Needs than Shares, Needs are prorated. Explanation from SM's FAQ:

What happens if there are more medical needs than shares in a month?

Sometimes we can overlap needs from two months so that there is enough money for all the needs. However, if all needs cannot be met, we use a prorating method to evenly distribute the burden. For example, if there is only enough share money for 90 percent of the needs submitted for a particular month, only 90 percent of each need would be published in the newsletter for that month. If prorating occurs three months in a row without being reversed, the Board must propose a share increase to the members for a vote.

There is a flip side to "Needs-outnumbering-Shares", which I'll address in the cost section.

What Does It Cost?

Samaritan Ministries now has two different levels (Classic and Basic), illustrated below. Members agree to share the following amounts per month, depending on which program they sign up with:

click to view larger

Any changes to Share amounts is subject to a vote of the entire membership, and has to have 60% in order to pass. Since we joined in December 2012, the membership has only approved three increases (most recent was September 2019).

The flip side of "Needs-outnumbering-Shares" is that if Shares outnumber Needs (like they have for the past two months!), the share figure for the month is temporarily reduced. For example, in October 2014, the amount of dollars "shared" outnumbered the dollars in "needs", so there was a 10% reduction in October's Share amount. Instead of us sending $280 to a member in need, we sent $252. This also happened in November 2014 (5% reduction), May 2015 (5% reduction), November 2016 (5% reduction), and December 2016 (6% reduction).

More Information

Currently, there are over 69,000 families (about 225,000 individuals) participating in Samaritan Ministries. For more information about why they do, visit SamaritanMinistries.org. You can view videos, testimonials, Frequently Asked Questions, the Guidelines, the Application Form, and much more.

Members of Samaritan Ministries also have access to free medical advice from medical professionals, a 24/7 RN hotline, discount labs and prescriptions, as well as tools to help identify quality providers and fair prices for procedures. More information on that is here.

If you are interested in joining, I'd be more than happy to talk with you. You can call me at (918) 869-6000, or email me at JamisonFaught@MuskogeePolitico.com. When a member refers someone who then becomes a member, Samaritan Ministries gives the referring member a credit. Obviously, that's some incentive, but regardless of that, Samaritan Ministries is a great organization.