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.

Psalms: Our (Re)New Workout

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Some books fill my mind. Others fill my heart.

This week, an excerpt from a MUST-READ for all believers.  N.T. Wright’s The Case for Psalms is eye-opening to the point of introducing the “more mature” Christ-follower, who thinks she’s tasted-and-seen-it-all, to the world of gourmet.

Psalms, dusted off, reinstated, is our renewed workout for transforming the mind, heart and body.  Wonder-full. psalms

For those who wonder if worship is happy-clappy praise all the time, this offers a broader picture. For those of us with concerns over worship devolving into self-focus, Wright explains clearly how this easily & quickly took root in Western culture.

The Psalms are the hymnbook collection of both Judaism and the early Church in private and corporate worship.  Our opportunity to be real and genuine before a loving, involved Creator.

Part of the strange work of the Psalms is to draw the terror and shame of all the ages together to a point where it becomes intense and unbearable, turning itself into a great scream of pain, the pain of Israel, the pain of Adam and Eve, the pain that shouts out, in the most paradoxical act of worship, to ask why God has abandoned it. And then of course the Psalms tell the story of strange vindication, of dramatic reversal, of wondrous rescue, comfort, and restoration.

Click HERE to find it on Amazon.

Resisting Consumer Worship

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consumer_churchIn biblical worship, the Church offers an alternative to a me-centered culture.  It is accepting God’s invitation to encounter Him on His terms, to be reoriented to life in His Kingdom and to taste glimpses of heaven.   Yet in an effort to appear “relevant,” it is easy to turn Christ-centered community into entertainment that attracts consumers who hopefully will sign on to the organization.  Some of my thoughts, and best bits from research this past week…

On Victoria Osteen

“Out of the heart, the mouth speaks.” The Osteen gospel fits hand-in-glove with me-centered American philosophy. But it is worse than heresy; it is trivialization of the One in whom we live and move and have our being. Encased in a facade of spirituality, it is gobbled up like a delicious appetizer by tens of thousands in our culture who do not realize their dish was basted in poison.

From Marva Dawn’s Reaching Out without Dumbing Down

“It is urgent that the Church recognize how easily we assume the self-centered mind-set of the culture that surrounds us and work more deliberately to reject it…This focus on the self is a curious inversion, for in losing God as subject we lost exactly what we need to find genuine self-identity.”

We exist encased in a giant cultural condom.

From Joey Earl Horsman’s article “Channel Too: The Postmodern Yawn,” The Other Side 29

“Modern technology and media have proved to be Valium for our leisure time. They have turned the U.S. into a nation of spectators, more eager to watch life that to participate in it.  We want our art, for instance, to provide distraction rather than require concentration, asking it for either escape of knee-jerk political messages.  We want shock or sleep. Period.  We live in the age of simulation.  For just as shopping malls simulate the great outdoors, replacing sun and trees with fluorescent lights and green plastic “plants,” we simulate danger with amusement park rides, friends or enemies with talk-radio hosts, rebellion with torn jeans and black boots, sex with lewd phone conversations, revolution with improved fabric softeners, and freedom with the newest panty liner. We simulate real life by eliminating risk and commitment, and end up mistaking what is real for what is only artificial. We exist, that is, encased in a giant cultural condom.”

From  C. Welton Gaddy’s The Gift of Worship

“Worship is a gift between lovers who keep on giving to each other.”

A Pastor’s/Worship Leader’s Essential Checklist before Sunday:

  • Center on God
  • Glorify Christ
  • Involve the people
  • Express praise
  • Communicate the truth of the Bible
  • Encourage faith
  • Promise redemption
  • Reflect the Incarnation
  • Build up the Church
  • Instill vision
  • Make an offering
  • Nurture communion
  • Evoke an “Amen”

From John Piper’s, Brothers, We are Not Professionals

“It boils down to this: we either make much of Him, or much of us.”

Superstition, the Liturgy of Social Media, Chicken Sexers & Judaism

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The best bits from this week: impacting excerpts that influence our worship and discipleship…

rabbits foot“If we participate in worship and simply hope that our being there will cause God to bless us, what we are doing in church really amounts to practicing something other than Christianity. We are practicing superstition, or hypocrisy— in which we sometimes even intentionally learn to say things to God that we do not mean. Spiritually speaking, the sin of hypocrisy is one of the most vexing antidotes to formation. In hypocrisy, our external actions are cut off from internal attitudes. We may even become well practiced at not meaning what we say or do.” (from James K. A. Smith, Imagining the Kingdom (Cultural Liturgies): How Worship Works)

Do I shape my image to appear like God, or allow God to shape me into His image? 

fb“Users [of social media] can severely underestimate the (de) formative power of cultural artifacts, approaching them with just a little bit too much confidence, assured that they are masters of the technology when it might be the technology that is slowly mastering them. Social media— despite the good uses to which it can be put— might be just this sort of disordering liturgy. Signing up for Twitter or Facebook is not a neutral decision to simply employ a “medium”: it is to insert oneself in an environment of practice that inculcates in us certain habits that then shape our orientation to the world— indeed, they make our worlds.” (from James K. A. Smith, Imagining the Kingdom (Cultural Liturgies): How Worship Works, 2013)

In speaking of ways the Church and Christian University should work hand-in-hand to nurture and disciple the next generation of believers to experience and act out the way of Christ as second nature…

chick“These perceptual skills can be astonishingly subtle. Many chicken farms employ professional chicken sexers. They look at newly hatched chicks and tell whether the chicks are male or female even though, to the untrained eye, the chicks all look the same. Experienced sexers can look at eight hundred to one thousand chicks an hour and determine their gender with 99 percent accuracy. How do they figure it out? They couldn’t tell you. There is just something different about the males and females, and they know it when they see it.” ( David Brooks, The Social Animal: The Hidden Sources of Love, Character, and Achievement, 2011)

Consistent, disciplined practice will help the heart catch up…

jew“Judaism stresses that if you begin with the right actions, you’ll come upon the right beliefs; Christianity works the other way around. In the Talmud, there is a passage that’s considered fundamental in Jewish education, ‘Let a man busy himself with observing the commandments and customs even if his heart is not in them, for eventually the hand will teach the heart’.” (Scott-Martin Kosofsky, The Book of Customs: A Complete Handbook for the Jewish Year, 2004)

Everyone Worships Something

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So…lots of reading these days on the topic of Worship. Which is probably a good thing, since that’s the area in which I’m called to lead and disciple others. As this unfolds, I’ll periodically post some the best bits. This one left me both convicted and breathless:

David Foster Wallace had this to say to a graduating class at Kenyon College in 2005:

In the day-to-day trenches of adult life, there is no such thing as atheism. There is no such thing as not worshipping. Everybody worships. The only choice we get is what to worship. And an outstanding reason for choosing some sort of god or spiritual-type thing to worship— be it JC or Allah, be it Yahweh or the Wiccan mother-goddess or the Four Noble Truths or some infrangible set of ethical principles— is that pretty much anything else you worship will eat you alive.

If you worship money and things— if they are where you tap real meaning in life— then you will never have enough. Never feel you have enough. It’s the truth.

Worship your own body and beauty and sexual allure and you will always feel ugly, and when time and age start showing, you will die a million deaths before they finally plant you. On one level, we all know this stuff already— it’s been codified as myths, proverbs, clichés, bromides, epigrams, parables: the skeleton of every great story. The trick is keeping the truth up front in daily consciousness.

Worship power— you will feel weak and afraid, and you will need ever more power over others to keep the fear at bay.

Worship your intellect, being seen as smart— you will end up feeling stupid, a fraud, always on the verge of being found out. The insidious thing about these forms of worship is not that they’re evil or sinful; it is that they are unconscious. They are default settings. They’re the kind of worship you just gradually slip into, day after day, getting more and more selective about what you see and how you measure value without ever being fully aware that that’s what you’re doing.

Quoted in…Smith, James K. A. (2013-02-15). Imagining the Kingdom (Cultural Liturgies): How Worship Works (Kindle Locations 4764-4766). Baker Publishing Group. Kindle Edition.

Life Between the Legos

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21 years ago, I met the woman who would become my wife.  Neither of us realized that the mutual respect and friendship we shared would cause us to “notice” one another 5 years later.  This wonderful friendship with Emily Cartwright allowed us to skip some awkwardness only because our history had already revealed some of the good, the bad and the ugly WAY before we tried to impress each other.  Saying “yes” to a covenant together was an embrace of acceptance, whatever already is and whatever may come.

We made that promise 15 years ago today. Best earthly decision of my life! But wow…it is God’s Providence and grace that He does not reveal everything coming.

Earlier this week, Emily posted a picture of me in her grandmother’s old recliner, reading, in the midst of a DELUGE of legos our childlegosren had dumped out in the floor.  That picture received more hits and comments than anything we’ve ever posted in our Facebook history! Funny as it was, it made me wonder exactly why?

Maybe I’m totally off-base, but my hope is that a snapshot of focused-study-amidst-disaster gave people hope. Here’s the deal…that picture really is a metaphor of our life, our marriage, our family.  Throughout our journey, oceans of joy and chaos have always pressed in: insane schedules and quiet evenings, picnics at the lake and temper tantrums, honest hugs and slow forgiveness, broken washing machines and new cars, intimate moments and major disagreements, vomit on the carpet and a sparking clean house, too much debt and a-little-extra this month, words spoken that brought life and words that did major damage. And with each passing year, more situations we could never have imagined emerge.

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I worry sometimes in ministry, by being on stage, that a subtle message is being communicated to the congregation:  These are the people who’ve got it all together!  Imitate them!  Perhaps this is magnified by the power of image management via social media. The truth is, we do not have it all together!  Although, I’d say she is more together than I am. (Good thing I married a Clinical Counselor! For a shameless plug on what Emily is doing, click HERE or on the Restore logo.) But what we DO have is a covenant with The LORD not only to follow Him but to make that journey of discipleship publicly and in community. Please forgive me for the times I have let any of you see only the successes. We are very blessed in our marriage and family, but we share those joys in a sea of things we are still striving to figure out.

Our journey with Christ reveals this: frequently when God creates beauty from ashes, the mess isn’t completely erased. Rather, He forms something so beautiful and redeemed that our focal point shifts towards a glorious miracle against a background of debris.

Every kingdom person is moving toward a future reality when all is restored, every lego will be in place, and all will be as it was intended. In the meantime, celebrate every victory right in the middle of the mess.  That single discipline will build unimaginable strength.

Your family is your small group. So is your marriage.

 

Family Investment Strategies

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Intended for Father’s Day weekend, these thoughts are a bit behind schedule!

This past Spring, Emily & I co-led and participated in our first ever Financial Peace University…which was CRAZY helpful in getting our minds wrapped around goals for our marriage and family.  The line we heard repeated more than anything else was this:

Live like no one else now so that you can live like no one else later!

Translation:  be willing to make sacrifices early on for a later pay off.  Choose homemade cards, board games and Family Dollar instead of bling, cruises and Neiman Mark-up. The savings and investments made early move a person into the realm of enjoying things without debt later.  And for the believer, moves him/her into the reality of eventually being able to bless specific ministries in extraordinary ways.

A fun way to teach this to our kids is sharing FPU’s investment calculator.  (Click HERE to preview and play around with it). I wish I had a picture of my oldest child’s face with this scenario:  $2000 invested at age 18, with NO more money paid in, at a 10% average rate of return by age 68 = $243,781!  But take the exact same scenario and have $100 per month drafted from your checking account.  In the same time span, the yield is $1.7 million!

It goes to show that a little, invested early, and continued over time reaps a great harvest.  This is a great principle for parents!  And I hope, an encouragement as well.  Many parents I know are working very long hours to provide for their families in this difficult economy. Many more are trying the accomplish the task which ought to be shared by a spouse all by herself.  As discouragement takes hold, it is easy to feel like one has skipped  today’s or this month’s payment, or maybe even has made some big withdrawals.

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Houston…we may have a problem!

But be encouraged, and know that every small kindness with the intent to nurture and reflect the Father’s love adds value that is compounding. Even if gone unappreciated in the moment, every

  • note in a lunch box
  • book read at bedtime
  • backyard ball game played
  • recital attended
  • music lesson, practice, rehearsal driven to (in your minivan with 248,000 miles)
  • prayer prayed over him, his folded clothes, made up bed
  • homework sheet assisted
  • “funeral” for yet another pet that kicked it
  • hug
  • wrestling match in the floor when you “let” him win
  • surprise “just because” little gift
  • lovingly confrontive conversation rather than letting it go unspoken
  • time spent doing something she loves (but you might hate)
  • “I love you” spoken
  • time you spent answering the questions you never saw coming, but by the grace of God were able to answer truthfully and without freaking out…

all these things compound the interest. These and more add to the vocation of biblical parenting:  to nurture our children towards being a gift for God’s world.  It’s biblical because it images the Heavenly Father upon them.  It’s obedience because you recognize your child as a divinely entrusted gift. It’s spiritual formation for the parent because as a father or mother, you make the investment not only for your joy but especially for others to savor.

This becomes the heart-cry of the believing parent: that the LORD may shape my son/daughter and use this life so that others may know and be in eternity with Him.

Hang in there moms and dads.  Even if today’s deposit is only a dime, it may be greater progress than you realize.  In God’s hands, He can turn the investment made in your child into an endowment instead of a Social Security check.

And for the record, this is why I’m late this week:

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 Your family is your small group.