Tuesday, October 6, 2015

Unhappy with your health insurance?

Due to the popularity and interest this attracted on Facebook, I'm taking a break from my regularly scheduled programming (i.e., re-posting my Millenials column...) to add a few details about the health care cost-sharing program we joined last January, in time for anyone to drop their health insurance during the open enrollment month of October.*

Unhappy with your health insurance? A year ago, so were we: we paid thousands and thousands of dollars for the birth of our child, on top of high monthly premiums. We dropped our health insurance and joined Samaritan Ministries, a cost-sharing program. We pay our monthly share to an actual person with a medical need- one month everyone even paid less because there were more shares than needs! We just finished receiving the money for the upcoming birth of our second child (which we will pay to the midwife and hospital); this time, we will pay $0 and have a much lower monthly payment.

Here’s how the need sharing process works in a nutshell:
Each member commits to sending a set “Share” amount each month. These “Shares” are sent directly through the mail from one household to another, to the members with “Needs”. Samaritan Ministries uses a database that randomly matches Shares to Needs, so that the Sharing is coordinated and Shares go to the appropriate members with Needs.

A few basic facts:
- Routine medical care is not "publishable," meaning that other members are not required to send money; we pay out-of-pocket for pediatrician visits, vaccines, etc.
- Anything under $300 is also not "publishable." However, a publishable need encompasses all related expenses to a specific medical condition.  For example, ultrasounds, labs, midwife/doctor visits, hospital costs, etc are all part of a maternity need. Even if one of these things is under $300, it is bundled with the others to count and is then published. 
- Pre-existing conditions are covered in a limited manner; certain things are publishable after some time; maternity care is publishable up to the amount you've contributed by the birth of the child
- Anything not "publishable" can be put in the newsletter as "special need." Each month, Samaritan suggests members send $20 to a specific special need, and distribute this suggestion such that the need would be almost entirely covered if every did so. It is not, however, required to do so.
- It is faith-based. All similar but not faith-based programs were shut down by "Obamacare." None meet the required criteria for health insurance; this still exists because of a religious exemption.
- There is not an age requirement
- Sometimes people send you thank you cards for helping them with their medical need!
- Members have the responsibility to collect and send bills as well as negotiate an uninsured/cash price with the health care provider.  So far, we have had no trouble getting prices reduced for paying in cash, but there is a service to help members do this if the provider won't negotiate with the member
- The other members who send you money know why they are sending it to you - this means they send prayers and sweet notes. It also means they know you are having a baby/had a kidney stone/have cancer (whatever your need is). With the transparency, some privacy is lost. This does not bother me but it is worth stating.

 I'm mostly making this PSA because I hate to see people robbed blind by insurance companies- there is another way!- but if you join please put us down as a referral. It costs you nothing but saves us money. Email me for more details, and check out their website:http://samaritanministries.org/

*You may be able to drop more quickly; we were not in a position to do so as it was tied to my husband's job-  I found out after the fact that the birth of a child makes someone eligible to drop insurance without finishing out the year.

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