So many friends—and friends of friends—have contacted us about our choice for health care that we decided it might be easier to write out our story. Hopefully our experience will assist you in making the wisest choice for your family. This will be lengthy but worth it. I promise.
Emily & I have been blessed by churches who provided a medical insurance plan for us. My salary has been structured so that the medical insurance payment was held out of my paycheck for the pre-tax benefit. But if I received a cost-of-living raise in January, it was undone in July because the existing policy would adjust upwards somewhere between 13-20% annually. Year after year, I was actually making less money.
About 7 years ago, we began noticing that BCBS paid for less and less while our copays kept increasing. When we questioned them, the answer was always that it was being applied to our deductible. There were multiple conversations with many agents to attempt to fully understand what our deductible truly was, because we never seemed to fully reach it. The bottom line was that our “family aggregate” deductible was several thousand dollars. This fact was hard to digest knowing that we were already paying close to $14,000 annually just to have insurance.
3 years ago, our monthly premium hit $1250. We began to realize that the Plank’s were on a completely unsustainable path, and we began investigating other options. Various Christian Health Sharing programs were being advertised on radio and in magazines. We decided it was time to make a change.
We were most attracted to Samaritan Ministries Health Sharing (www.samaritanministries.org). Their deal sounded too good to be true, so I spent an entire month researching them. Honestly, I tried to find a single negative thing about the organization and found nothing. I made several phone calls to the company, always spoke to a live person, got courteous answers and plenty of helpful info in the mail. I read every word…even the fine print. They even offered to give me phone numbers of people who have been long time customers so that we could question them about their experience. I took them up on their offer, and requested numbers of people in our area. I wanted to know if this was really working where we lived.
It would take too long to share their testimonies, but I was sold after the second conversation.
In February 2012, we fired BCBS and began a brand new thing with Samaritan Ministries. We paid an initial, one-time $200 administrative/membership fee. Our “family share” (not a premium), is currently $495 monthly. The home office tells us who to send the check directly to, and the medical reason, so that we can pray for the patient. In other words, we write our check to a different person or family every month.
For us, this meant that all those pre-tax dollars would now land in my paycheck as income earned. Our taxes increased; yet this paled in comparison to what we were literally throwing out the window. It also meant we needed to be wise savers to be prepared to cover some medical costs for which we were used to making copays.
One of my hesitations in making the transition was that we became responsible for the total cost of our doctor office visits and prescriptions. Before making the change, we spoke with all our doctors to tell them what we were going to do, and asked what we would be charged as “cash-pay” patients. None of our doctors knew. They had to go ask someone in their administrative office. Here is something amazing: the “cash pay” price for people without insurance was almost exactly the same as what our co-pays had been! Now that our doctors understand what we are part of, they are wonderful about sharing medicine samples that they have in stock and are careful to write prescriptions for generic medications.
We also went to our pharmacy in advance. I wrote down every single prescription we currently take AND had ever taken and inquired what the cash price would be. Most were affordable. We do have 1 that is expensive. But Samaritan pointed us toward www.rxdrugcard.com. We pay an annual $45 subscription to this. Our policy number stays on file at CVS and discounts most of our drugs to a similar level to what we were paying on insurance. A couple of prescriptions actually ended up costing less with this than we paid with insurance. We discovered that we had been paying a $35-40 copay, for example, for a $12 bottle of Amoxicillan. (If you don’t have children yet, brace yourself. It will always be in your refrigerator. Sam’s Club should sell it by the gallon.) Another option is mail order Canadian pharmacies like www.northwestpharmacy.com. There appears to be some debate about the legality of ordering medication from Canadian pharmacies. Until it’s clearer, this will be my civil disobedience. For the 1 prescription that is very expensive for us, I can purchase 3 months of it for what 1 month costs here. The generic is not yet allowed in the U.S. because of its patent.
(Editing our story now in 2016, we have continued to learn the drastic difference in drug prices if you are willing to shop around. Pharmacies use various wholesale providers to purchase the drugs we buy. A few months ago, my wife’s prescription was changed to a new drug. Although we asked for the generic, this particular drug was $273 for 1 month’s supply at CVS. We found the same drug at a local family-owned pharmacy for $27 monthly. We then compared all our prescription prices and moved our business to the small family pharmacy.)
We were with Samaritan for about 6 months when our youngest son developed a golf-ball-sized bump on his chest. It was discovered that he had a benign cyst which would require surgery to remove. This would be our test to see how well the Health Sharing deal worked.
We called Samaritan and spoke to a live person, who coached us through the process of submitting receipts for reimbursement. He explained that we would be responsible for the first $300, but that everything over that would be published for the Health Sharing organization, and that we would receive the reimbursements following that. Then, he prayed for our son with us over the phone.
Samaritan members are responsible for negotiating the medical payments. This was unnerving to me at first; but I soon realized this is exactly what insurance companies do with hospitals and doctor offices. Samaritan also provided a simple 10 point document designed to help us navigate this.
On the day of our sons’ surgery BEFORE he was even taken back, a hospital worker brought us the cash pay triplicate agreement form to sign. If we could pay the full bill within 30 days, they would discount it 40%. If we could pay in full in 1 payment within the year, they would still discount 30%. We learned quickly that hospitals have the largest negotiating room in billing. The hospital is basically billing a rental charge for the use of their facility, surgical suite and equipment for the surgeon to use.
We received a second bill from the surgeon’s office for the work of the surgery and his pre-op assessment. They discounted us 30%. A third bill came from the anesthesiologist. They discounted 0%. A small fourth bill came from pathology to confirm the cyst was benign. Also discounted 20%.
At the end of the day, the total which would have been billed to an insurance company was nearly $9000. We negotiated the total cost to approximately $5200. We submitted all the bills to Samaritan in July—the original totals and what we had negotiated. We were published to the Health Sharing Group in September. In October, we received personal checks from 26 individuals from across the country, in “get well/praying for you” cards, totaling $5200. Samaritan counted our $300 responsibility into the cost of what we negotiated, so we were reimbursed the entire cost of the surgery!
1 additional fact about Samaritan, members agree to refrain from tobacco use, to completely abstain or use alcohol in moderation, and to the biblical mandate of sex within monogamous, heterosexual marriage only. We all agree to attend church at least 3 times per month. We sign a covenant agreeing to this lifestyle, and it is also signed by our pastor affirming that the information we are providing is truthful. It is the belief of Samaritan Ministries’ members that living in the way of Christ affects every level of our souls, including our physical well-being. Living healthy lives as a group holds health costs down for all.
We have learned through our experience that there is a MUCH BETTER WAY to handle health care. There are bills that I groan over when I write the monthly check. But I can say with complete integrity it brings me joy to send my share to a specific individual or family and pray for them each month.
We have since been through an additional small surgery. We had the same experience as before. It amazes me how quickly and easily the billing can be taken care of, for so much less money than we were paying. It makes me wonder if the entire for-profit medical insurance industry is consumed with greed and dishonesty.
Members of approved Health Sharing Ministries meet the federal mandate for having health insurance and are exempt from the tax penalty. For more information, click here: https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/.
When government health insurance became available this year (2014), we went to the healthcare.gov website and filled in our information to see what would be offered if we went that direction. In Alabama, we have 5 opportunities ranging from $700 to $1250, ALL with BCBS and all with massive deductible levels. No thank you.
In October 2014, we received a notification from Samaritan that they had fewer needs to publish this month, and that there had been plenty of funds to cover all needs through November, AND that they were lowering our payment for this month as a result. (Since the original posting of this blog, this happened AGAIN in November and December of 2014!)
Are you kidding me!? Who does that!?
If you are with traditional health insurance, do you believe your company would lower your monthly payment if they “took in too much money” this month?
Above all, I am thrilled to see believers coming together to accomplish the biblical mandate to “bear one another’s burdens” (Gal. 6:2). When we joined, there were 17,000 households in Samaritan Ministries. As of today, that has increased to 61,000 households! I would encourage you to investigate this for yourself at http://samaritanministries.org. If you have any questions, please post them to this blog site so that the conversation will continue to provide necessary info and FAQ’s to others.