"Health care, premiums, co-pays, deductibles, benefits, in network, out of network, co-insurance"....this was all foreign language to me a few years ago. I honestly didn't give a lot of thought into health insurance and how it worked. But boy have my eyes been open to it within the last year. Why? Because there have been so many changes to health care and it's making a huge impact, or should I say indent, in peoples wallets. I'm still bitter over a $575 stool sample for my daughter...which I had to pay completely out of pocket. The hospital was "in network" but the lab they use is "out of network". This, along with some other situations, was a huge wake up call to me...I needed to do my homework and get a clue on how insurance worked.
I was very naïve about how insurance worked and the reality is I never took the time to read through the information or do my research. But as time went on, I did start to get smarter with the "game" I had to play for me and my families health coverage. I learned the importance of making phone calls and asking the right questions. Phyllis and I were on a first name basis!! She was the gal I spoke to with our insurance company whenever I had questions....and I had a lot!!
I shared a few weeks ago about my husband starting a new job, which meant a new health insurance plan. I was beyond excited to FINALLY have better insurance...but was I ever in for a shock when I realized what our new insurance entailed. I honestly had no idea how GOOD of insurance we actually had in comparison to the new plan. All those times I had put down our insurance, griped and complained to others....I would take it all back if we could have that plan again.
When we realized having health coverage through my husband's new employer meant a $1200/ monthly premium deducted from his paycheck and a $3500 per person/$7000 per family annual deductible...I wasn't naïve anymore....I knew exactly what this meant for our family. It meant NO insurance coverage UNLESS we had some catastrophic situation. It meant paying out thousands upon thousands of dollars to a large corporation...for company bonuses, large executive desks, nice leather chairs and fancy cars. All my money going into a big massive pot. I just felt sick inside thinking this was our only option.
But thankfully I put my ability to research to good use, I started talking to people, asking questions and searching out alternative options, which led me to a Christian health share ministry....
Their slogan caught my attention: "Sick of Insurance? Come join us". Heck yes I was sick of insurance!
Samaritan Ministries is a Biblical, non-insurance approach to health care needs. With the verse Galatians 6:2 as their example, “Bear one another’s burdens and so fulfill the law of Christ.”
So how exactly does this non-insurance program work? Here is an explanation from their website:
Each member commits to sending a set “Share” amount each month. These “Shares” are sent directly through the mail from one household to another, to the members with “Needs”. Samaritan Ministries uses a database that randomly matches Shares to Needs, so that the Sharing is coordinated and Shares go to the appropriate members with Needs.
Here’s how the Need 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.
With more than 24,000 member households participating in the ministry, there is about $6.5 million available each month to meet health care needs. How exciting to know my money is going directly to families in need...I will be writing my monthly check with a huge smile!!
Membership Type Monthly Share
Single-Parent Family $230
Two-Parent Family $370
|A few additional things to know:|
· 11 months out of the year you pay your monthly "share" amount, which in our case is $370, to a different family each month who has medical needs. In addition to sending a check, you can include a card with verses, prayers, or words of encouragement.
· The remaining month (your renewal month) you send your "share" amount to the home office to help with administrative fees/costs. (When you first join you send your share to the home office your first 2-3 months of being a member and then the 11/1 plan goes into effect).
· There is a one time, $200 membership fee, which also helps at the administrative level.
· Medical expenses must be greater than $300 to be considered a "burden" that are publishable.
· You must have your pastor or a person you are accountable to, sign the form, acknowledging that you attend church regularly and abstain from things that are not honoring to the Lord.
· Any discounts, write-offs, deductions that you are able to receive due to being non-insured and paying out of pocket all get applied toward your first $300 responsibility. For example, you have a visit to the ER which results in a $1200 bill. You negotiate with the hospital and they give you a $200 discount. That $200 gets applied toward your $300 you have to pay out of pocket. Now you only have to pay $100 out of pocket and the remaining $900 is eligible for other members to help pay.
· If you have 4 or more eligible medical expenses in a year, then even the first $300 is able to be covered by other members.
· There are some obvious things that are not eligible for sharing: abortions, cosmetic surgeries like a breast reduction or implants, as well as preexisting diseases or illnesses.
· When you have a medical need, you are given a check-off list of those you should be receiving a check from. This is how they keep track and keep everyone accountable to their monthly "share". So if you are not doing your part of giving, you will not get to be on the receiving end when you have medical expenses.
· There is a $250,000 per incident, per person maximum unless you choose to participate in the Save to Share program. In that case you set aside a specific dollar amount per year, for a family that is $399. When others who are apart of this program have medical expenses that surpass the $250,000 limit you are called upon to help them out and vice versa if you are in need.
You can learn more on their website or by requesting an information packet! www.samaritanministries.org
They offer a great referral system so if you do your research and discover Samaritans Ministries to be a good fit for your family... I would be so appreciative if you would let them know Andrea Webb sent you!!
No matter what your family chooses for health care, make sure you know and understand how it works. What is your monthly premium? What is your individual/family deductible amount? Typically you must pay the entire deductible BEFORE your insurance will pay anything out towards medical expenses. Make sure you know who is "in network" for doctors, clinics, and labs...otherwise you will be paying out a whole lot more. Don't be afraid to call your insurance company and ask questions, in advance, if possible. Don't ever assume!
I look forward to sharing more along the way about our experiences with Samaritan Ministries!!