I've heard a few friends complain recently about the cost of their health insurance. Um, I HEAR YOU. Teachers in Texas hear you. There is exactly one affordable plan offered to public school teachers in Texas, and it is for ONE person who is willing to take high-deductible insurance, and vision and dental are extra. Add a spouse? The premium almost TRIPLES. Add children? Oh, it only doubles. Holy smokes.
So, for us, Jeff takes insurance, as his school covers the cost. My school covers the cost for me, but we also have Charlotte to cover--so for more than a year, the two ladies in our family have taken a different route.
We use Samaritan Ministries. It's not insurance, but it meets the criteria necessary to avoid a tax penalty, and it more than meets our needs! The ministry is well-established (over 30 years old) and well-tested (serves over 50,000 households across the globe).
Basically, it's a network of Christians who promise to live healthy lifestyles (sexually, spiritually, in daily habits, and in routine health), and who commit to helping each other cover healthcare bills. There's a clear explanation on the website of what needs qualify to share with the group and which don't, so there's no mystery or surprise involved. The FAQ section and video testimonials are very helpful as well!
First, we signed up and incurred nominal administrative charges. No biggie at all. The first few months, I sent a check to Samaritan Ministries to help cover costs there. Again, no biggie at all. Now, every month, I receive a newsletter along with a name and a need. I send a check for $360 to the person with the need, in addition to a note of encouragement and a promise to pray for them. When the next baby comes and we add him/her to our account (HEY SURPRISE THAT'S HAPPENING IN APRIL!), we'll go up to $405 per month, and stay there. That's as high as it goes, unless the group votes to raise costs, which is very rare.
When we have a qualifying need, we simply give Samaritan a quick call and let them know, and they send us the paperwork necessary to get the ball rolling. We are responsible for the first $300 of a need, but after that, the community will take care of us. They cover anything up to $250,000, and we actually opt into "Save to Share," a program that covers astronomical bills over $250,000, for a commitment of up to $266 a year--I just have to understand that I may be asked to pay some or all of that amount at any given time. However, I won't be asked for more than that $266 per year. Easy enough!
So, when I go to the doctor, I just tell them we're self-pay. We actually started paying LESS at several appointments than we did with insurance! A lot of doctor's offices offer a reduced price if you pay up front. Um, deal. I can do that.
For big bills that we'll submit as a need, we pay if we can, or we tell them we'll pay ASAP if we can't. We also beg for discounts, which is good practice anyway. We submit the need via the easy process outlined by the Samaritan staff, and receive what we need to keep up with the "shares" that will start coming in. Once members share their checks with us, we're able to take care of our bills or repay ourselves. Excess money, should that happen, is sent on to other folks with needs. It's beautiful, really.
That's the gist of how it works. The website does an AMAZING job of explaining it all, so check it out! Their customer service reps are ridiculously kind, patient, and helpful, so a phone call is a great option too!
Here's my list of pros and cons for Samaritan Ministries, based on the past 15 months or so.
1. Affordable on a monthly basis. I feel like anything under $500 is a WIN. And it's better than a high-deductible insurance plan, in my opinion. I'd rather pay up to $300 out-of-pocket for a bad case of strep throat than try to accumulate $4000 in bills over a year so everything else can be paid for.
2. Great choice for the "maternity minded." OH MY GOSH CHARLOTTE'S HOSPITAL BILLS, Y'ALL. We paid the doctors, the hospital (on my behalf), and the hospital (on Charlotte's behalf), plus random labs, pharmacies, and on-call doctors. It's fine--they all did their jobs and we appreciate them so much--but the bills added up SO FAST, and our deductible just went up when we added Charlee. SOOOO THIS IS GOING TO ROCK. I'm not sure if this baby is going to count as one need (one birth) or three (doctor, hospital/momma, hospital/baby), but either way, we're going to be coming in anywhere from 40% to 90% less than our bills two years ago. GLORY HALLELUJAH WHOOOOOOOOP!
3. Easy on the heart. Sending a check to a fellow believer in need is easy. Sending a check to an insurance company sucks. That's that.
4. It's great for single people and single parents. A single person will share $180 a month. A windowed or divorced person with children will share $250 a month. NO MATTER HOW MANY CHILDREN. These people are here to BLESS US, ya'll!
There are a few cons, of course.
1. Individual "needs" could add up. Those "up to $300" needs could get hefty. So could the dental/vision needs that aren't covered. That's something to consider.
2. A little more complex on the backside. I'm working with our doctor's office now to get the information I need to submit our need for this pregnancy. It's not been a walk in the park. But, for the money we're saving, I'd do it again in a heartbeat!
3. Have to meet criteria. Members have to promise to not drink heavily, not have extra-marital sex, attend church regularly, etc. This cuts some people out, which is tough. However, just thinking practically, several of these criteria are vital to keeping members healthy and keeping healthcare costs down. So, to me it's logical, even if it's not ideal to everyone.
So, that's the gist of it! We've been thrilled with our experience so far and have NO hesitations referring our friends! If you're interested, do your research, find out for yourself, and if it's a good fit, GO FOR IT and remember that we sent you there! ;)