We Fired Our Health Insurance Company

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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.

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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.

16 thoughts on “We Fired Our Health Insurance Company

  1. I love reading stories like yours! We have been a Samaritan member since Nov 2013 when we fired BCBS and never plan to go back to health insurance. Your research mirrored my own and I’m so glad to hear how well it has worked for your family. Thank you for sharing! I have linked to your story on my blog. Thanks.

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  2. Tonya

    We had the same experience with Samaritan Ministries. My husband had a blood clot 2 years after we signed up and everything was covered. It was a scary experience in the hospital for me but I made a call to Samaritan telling them we are about to check out of the hospital and I’m not sure how to do this…the first thing they said to me was….. can we pray with you first. I can not begin to tell you how much that helped me and what insurance company is going to do that. When I got to the billing department of the hospital I told them what Samaritan Ministries told me to say and in the blink of an eye the bill went from 12,000 to 6,000. We turned in the 6,000 to Samaritan Ministries and everything was paid for. We have no desire to ever leave Samaritan Ministries — no traditional insurance for us ever again. I love sending our monthly share to those that need it that month.

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  3. Im looking into Samaritans for our family. Right now i am working part time as an RN, but my check is only covering our insurance through my employer. I would like to be able to work only a few times a month, but my husband farms so my employer is the only insurance option we have. One big perk i have is that being a hospital employee,i automatically get a 50% discount on my out of pocket costs now. I need to check into how that works if im self pay?
    We currently pay about $650 a month and have a $1,000 deductible..BUT we too have had issues concerning this..im certain we have paid more than $1,000, but when i talk to the insurance company im told oh its applied to your deductible or to your out of pocket..sorry.
    My husband is ok with trying Samaritan. We have no issue paying for routine checkups etc, he is concerned about bigger things, like accidents (he does farm and is around heavy equipment a lot), surgeries, ER visits.. i think he feels there is a hidden loophole of sorts and that when we submit a need it will not be shareable.
    Im thinking we need to just take a leap of faith and try it;)

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  4. Im looking into Samaritans for our family. Im currently working part time as an RN, and my husband farms so my employer is our insurance option now.
    Id like to reduce my hours and would lose benefits. Right now my cost is $650 a month, plus a $1000deductible plus an out of pocket cost..which we can never get a straight answer about!?
    As a hospital employee i get 50% discount on anything done there so i feel fairly ok trying Samaritan.
    My husband is hesitant as he thinks there will be some type of hidden loophole and that an accident, ER visit, surgery whatever wouldnt be shareable and we would be stuck with an astronomical bill.
    I am curious as to whether you are part of the higher teir (save to share?) For needs greater than $250,000. I really hesitate to join that because the monthly cost will be much higher but am unsure.
    Thanks!

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    • I would encourage you to pursue it, and would be happy to dialogue with your husband if he wants to talk. This is such a different way of thinking compared to what we have always been used to. I had the same concerns he had at first, but I just can’t say enough good things about how our medical needs have been handled by Samaritan. In fact, today I will finish paying off a bill for my wife’s knee surgery from September, thanks to this great organization! When this is all said and done, we will have spent about $300 from start to finish.

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      • Thank you so much for your quick response! Im curious, when approaching drs offices about being self pay and asking for discounts, im not sure how to go about this without asking for a handout if that makes sense?
        I have a personal relationship with all our drs since i work with most of them. I know there will be lots of questions regarding why we would give up insurance, and it seems like when i had looked into it before, the drs offices acted like they had no idea what to do with self pay?

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  5. Excellent question…we had the same feelings, and sometimes still do when it is a new clinic/relationship. I usually come with a brochure from Samaritan to leave with them and direct them to the website for further questions. The easiest thing for most offices to understand is the phrase “major medical” (which this is not what Samaritan is, but they tend to understand the terminology of high deductible/major medical). I always use the words “we are cash pay patients” because they now how to code that way. I also usually say up front “we are not looking for a handout. We can pay, We will pay. And you will receive your money faster than you will receive it from an insurance company.” We did recently have 1 office that looked at me like I had 3 eyes, but continued to explain and got through to them. The bottom line was they could not imagine I was paying the full $100 for the visit instead of the $50 co-pay they were charging their other patients. But I can promise you hospitals know the phrase “cash pay.” We have been through 3 surgeries with Samaritan. Every single time, the hospital has brought us a document to sign with at least a 40% discount on the estimate of the surgery before the surgery happened.

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  6. Shane Pike

    Michael, I’d love to read a full update on what you think about the program now (and especially with the recent news that insurance rates are jumping dramatically).

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    • Hi Shane…it continues to be extraordinary for us. I typed a couple quick updates in the body of the post…I still stand by everything in it. Even before rates began the dramatic rise we are now seeing, my wife and I had already decided what we have with Samaritan is so good that we would decline insurance if it was offered through our job. Now that we see the news of at least 22% likely hikes, I can’t imagine doing anything different. We are “middle class” (although the government apparently considers that up to $250K annually and we are not half that). But we do make too much money for any significant subsidy. Choosing a government plan in our state could be financially devastating for us if we had to meet a family deductible. We did just go through a share increase. This only happens when Samaritan hits 3 months in a row where the need is greater than the shares that come in. When that happens the membership has an opportunity to vote on 2 different share increase proposal scenarios. The President of the company emailed a video message to all members explaining what what happening and why. I deeply appreciated their honesty and transparency, and the opportunity to have a voice in the process.

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    • The basic Samaritan program covers you up to 250k. If you opt for Save-to-Share, that will cover you up to 1 million. With STS, you agree to save up an additional 500 dollars per year. Then when Samaritan has a month when expenses are higher, they will call upon each STS participant to add some extra to their payment. For example, our family currently pays 495/monthly. Occasionally, we might be asked to pay a figure like 520 on a particular month. You wouldn’t be called upon to pay more than 500 cumulatively. When we have been asked, it usually has been an extra 15-30 dollars.

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