Brynna My husband was blessed with a wonderful new job in December. We were told repeatedly that “those jobs” came with amazing insurance for our family, and coming from a previous employer that essentially cut all of his useful benefits, we were anxious to explore our options. However, upon comparing this “great” traditional insurance with our current healthcare sharing plan, I realized it was NOT “great”, it would cost us more, and what we’d get in return when we needed it was less. We were paying $235/month for healthcare sharing for our family of seven- this is the lowest tier of Christian Healthcare Ministries and it was the option that fit our family best during the season we are in. Recently we switched to the top tier for 6 of us, and are now at $422/month. The highest we have ever paid for the 7 of us is just around $500, and that usually includes a minimal $300-500 out of pocket (read: deductible) portion and after that, 100% is paid. We would have been paying over $500/month for JUST myself and the kids with the highly regarded insurance offered through my husbands job, and that includes a $3,000 deductible and 80/20% coverage. But this all brought me back to healthcare sharing and how I want to reiterate to people that these programs are WORTH it. Most of the time, the negative comments I read about them are rooted in misunderstanding or people trying to use the programs outside of the clearly defined guidelines. So I thought that I would break it down a bit and do my best at explaining what I know and what we’ve experienced!
I wrote this up in 2016 to help explain healthcare sharing to some acquaintances. Since that time, we’ve switched from Samaritan Ministries to Christian Healthcare Ministries, the reason being that CHM offered more monthly share membership options than Samaritan. However, having been with both, as well as having regularly explored the other healthcare sharing programs out there (including ones like Liberty Healthshare and Medi-Share), I will be honest in saying that I feel like if you regularly incur medical expenses, or if you just want the best, I do feel like Samaritan Ministries offers that. While we switched to fit the financial season of life that we were in AND we don’t regularly bring in medical bills of any kind so we weren’t restricted by any specific needs, I personally feel like Samaritan definitely gives you the best “bang for your buck.”
That said, let me break down Samaritan and the way that healthcare sharing works (for the most part- some of them differ in small ways). I choose Samaritan for a couple of reasons- one, I already had this written up from years ago. Ha! Two, because even though we switched, I have yet to submit any medical needs to CHM, but we used Samaritan for two incidents (an ER bill and the birth of our 5th baby), so I feel I’ve had far more experience with them. I should also note that they, too, now offer different “tiers” of membership.
We would be more than happy to talk more with you about this. Most healthcare sharing programs also offer a “thank you” credit for referring people to their ministry, so if you’re so inclined as to mention our name and member number (#445039) with Christian Healthcare Ministries, you have our gratitude! Or find someone else in your life who you know would be blessed by the referral credit and make sure to mention them.
October 2016 – For those who aren’t aware, we were planning our fourth homebirth with baby #5, but due to some complications ended up having a planned (very late in the game) cesarean. In the end, our bills quadrupled from $4000 for the homebirth to over $28,000 for the surgery and the hospital, even with the shortest stay allowed and minimal care. Amazingly, because we are members of Samaritan Ministries, the bills were all covered ENTIRELY. What a blessing to not have to stress over that huge increase in costs (especially since we had no time to prepare for the increase). It would have been a very different situation if we still had regular health insurance. But the most beautiful part of this is that we’ve received so many lovely notes and cards from others, praying for us and congratulating us. I have seen some people even receive handmade gifts (like baby blankets) with their share. It is more than just monthly bill, it is a chance to connect on a personal level with others while helping them with their medical bills at the same time. It is a truly Biblical model of what it means to bear one another’s burdens. (Galations 6:2) ***Here is where CHM differs from Samaritan. With CHM, you send your checks into a “pool”, where it is dispersed among members. I will say that the personal connection with people was one of my favorite things about Samaritan.
We have been members for several years now (after comparing multiple different healthcare sharing programs beforehand) and have submitted two needs- one child’s emergency room visit last winter and our maternity care/birth for our 5th baby this year. Any questions we’ve had have always been answered kindly and patiently by the staff at Samaritan, and they’ve helped us solve any issues that have come up. They pray for us on the phone, and they have even checked in with us. It has been an amazing experience after dealing with previous insurance companies, and we love being a part of something that blesses others so much. We have certainly been praising God for Samaritan over this past year!! ***We have found CHM to be just as helpful, just as encouraging, and just as prayerful.
We tend to get some questions about how it all works, so here is my attempt at explaining the process:
Samaritan Ministries isn’t like traditional insurance. Instead of paying a premium to the company (and an OUTRAGEOUS one at that!), you send a set monthly “share” directly to another person to cover their medical needs. Your money is ALWAYS going to someone who needs it! (which is great for long stretches where you aren’t incurring any medical bills, like us, because it doesn’t feel so frustrating to be “paying” for something you aren’t using) The kicker here is that if during any given month, there are fewer needs than expected, they lower the monthly share amount to reflect that! (on the flipside, however, if there are more needs than available shares, the needs are pro-rated, and if this occurs several months in a row, they offer all members a chance to vote on the solution, usually to continue as is, or to raise the monthly share amount- blame our broken system, not Samaritan!)
When you have medical bills, you submit them to Samaritan, and they divide it up among other members to be “shared” the following month, and then you receive checks in the mail that will total (or surpass) your costs. It is the responsibility of the members to pay the first $300 of the bills (consider this the “deductible”) UNLESS you are able to get that amount or more in provider discounts, or in certain cases like homebirth, where they acknowledge the costs are already far less than a hospital birth and so they account for that by waiving the $300. There are guidelines as to what is shareable (“covered”) and what is not, and they do have certain restrictions on “pre-exisiting” conditions, but overall it is still a much better alternative to traditional insurance in many ways. (You can still submit bills for non-shareable needs, and they are sent in the monthly newsletter as “Special Prayer Needs” where members can send to them if able/desired. I once read that if everyone sent an extra $20 each month to a special prayer need, almost every single bill submitted to Samaritan would be covered, “shareable” or not!)
When you get your medical bills (or in advance, if you have the advantage of working that way), request any and every discount you can manage (and Samaritan has people that help you with this, should you need it). Because every discount you can get will reduce YOUR out of pocket portion (your $300 “deductible” in this case) dollar for dollar. If my bill is $500, and I owe $300 as my responsibility before Samaritan will pay the remaining $200, BUT I am able to get $150 in self-pay discounts, then I actually only owe $50 out of pocket and Samaritan covers the rest! ***Share reduction via provider discounts is also consistent with CHM. This is one way that being proactive in your healthcare and provider choices pays off big time. CHM has a program similar to Special Prayer Needs, as well.
For catastrophic expenses, Samaritan offers “Save to Share”, where you can contribute extra amounts each month that provide you with higher “coverage” should you need it. With CHM, we participate in their similar program, called “Brother’s Keeper.” Regular membership provides “coverage” of up to $250,000 per incident. However, with Brother’s Keeper we pay an extra $150 (for our family of 7, I can’t recall the cost broken down into units) per quarter, and that increases our catastrophic amount by $100,000 per year up to unlimited (depending on the level of membership you choose). We did not participate in this program when we were with Samaritan, so I don’t have personal experience with it, just CHM’s.
Remember that some illnesses/incidents are not shareable (read: covered) by healthcare sharing ministries. For example, pre-existing conditions are not sharable UNLESS you’ve had no signs or symptoms for one year (five years for cancer). Also, maternity sharing is generally limited to certain membership levels (Gold for CHM) or after a specific period of membership. So again, not necessarily a downside to healthcare sharing, but rather, requiring proactive measures to be taken.
So, some key differences to recognize, regardless of the healthcare sharing ministry you choose:
- Healthcare Sharing is not traditional insurance. You are considered “uninsured” by definition, and you are “self-pay” when you receive medical care. And sometimes this causes confusion and uncertainty on the part of the provider. These days people don’t understand why someone would choose to opt out of traditional insurance, especially within our pharmaceutically controlled country. But we have options and like my family has, you may find that healthcare sharing is a MUCH better one than what any traditional insurance can offer.
- You are required to be an active participant in your health. Routine well visits, immunizations, etc are generally not shareable (read: “covered”) by healthcare sharing as those are part of your responsibility for keeping yourself health, but they’re also almost always under the out of pocket portion (read: “deductible”) anyway. Prescriptions are also generally not shareable unless they are part of a specific incident. But discount programs like GoodRx are your best friend!
- You have to familiarize yourself with the difference in terms. For example, these are similar but not necessarily the same as what you’ve always known with traditional insurance: Monthly share = Premium. Out of Pocket Portion = Deductible. Need = Medical Bill (but healthcare sharing is per incident)
- You are on a different timeline with healthcare sharing. Not that traditional insurance is fast, by default…but healthcare sharing generally has a three month turnaround- month one is submission of your bills, two is administrative work, and three disperses your checks to you. This is another area where being proactive pays off. The more estimated bills you can get for planned procedures, or the more detailed bills and information you can get your hands on after care, the faster you can get the ball rolling.
I hope this helps break down healthcare sharing and what can be a rather confusing transition from the understanding of traditional medical insurance. Let me tell you, it’s SUCH a blessing and I’ve never been anything but pleasantly surprised with these programs. They ARE different, and they DO require a good understanding of the process in order to be utilized successfully. But the benefits are so very worth the change in mindset and the effort it takes to learn to ropes.
