The Key Differences Between Medi-Share and Samaritan Ministries | My Loss is Your Gain

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There is a silver lining to the phone call that I received last Thursday.

The silver lining is that you, my readers, will now be able to learn the key differences between Medi-Share and Samaritan Ministries.

The phone message …

“Hi, Craig, this is xxxxxxxx with Christian Care Ministry.  Our records indicate that you moved to Montana and we do need to talk.  This is very, very important, so if you could give me a call back …”

After listening to the voicemail, I Googled “Medi-Share Montana”, and sure enough, Medi-Share is not legally able to operate in Montana.

I did call them back and was impressed by how kind, apologetic, and conscientious they were about the situation.  Apparently, when I updated my address online a few months ago, no one caught that I had a Montana address.  To their credit, they will be refunding me for the last two months worth of sharing.

With that one brief phone call, I joined the ranks of the uninsured.  Yes, only a few days after Obama and his crew made it illegal.

Since I’m blessed to have written about the topic of Christian medical sharing on this blog, I’d had a lot of people recommend Samaritan Ministries.  Changing insurance is about as fun as driving in a winter storm, so I wasn’t about to go out looking for other insurance when I was perfectly happy with what I had.  However, when I found myself and my family without insurance, the first thing I did was Google Samaritan Ministries, and I visited ehealthinsurance.com.

[Background: I'm working with a church, and I'm the only minister on staff.  As such, I'm treated as self-employed and required to track down my own health insurance just as any other self-employed individual.]

The results didn’t surprise me.  We could enroll in Samaritan Ministries for about $400 per month or we could get traditional health insurance for $800 per month with a $6,000 individual deductible or $15,000 family deductible.  The idea of paying $15,000 between premiums and deductibles before our insurance company would kick in any cash didn’t sit well with me, so I was definitely intrigued by Samaritan Ministries.

Now my mission was to identify …

The Key Differences Between Medi-Share and Samaritan Ministries

I spent a good part of the afternoon on Thursday trying to determine the major differences between Medi-Share and Samaritan Ministries. Below, you’ll see what jumped out at me as the major differences.  I’m sure the list isn’t inclusive, so if you see anything missing, please add a comment below.

How the monthly ‘payments’ are made.  

With Medi-Share, all payments are sent to Medi-Share, and then they sort through all the claims and make payments.  However, with Samaritan Ministries, you pay your monthly amount directly to another family.  That’s right. Every month, you get a name and address of another participant, and your money is sent directly to that individual.  It’s for this reason Samaritan Ministries can operate in Montana, but not Medi-Share.

My first thought – that’s crazy.  What if somebody doesn’t pay?

If someone doesn’t pay, you simply contact Samaritan Ministries, and they arrange for someone else to make a payment.

What if there isn’t enough money?

If there isn’t the money to cover your expenses, then the amount is prorated.  If, for example, they only have 90% of what they need for all the claims, everyone will only get 90% of their claim.  The next month, if they have enough, they’ll send the other 10% of the claim.  If they are short three months in a  row, there will be a vote to increase the share amount per household.

‘Limits’

Samaritan Ministries has a max payout of $250,000.  If a person wishes, they can enroll in a program called Save to Share where you’ll share people’s bills over $250,000 and they will help share yours as well.

Medi-Share doesn’t have any limits.

‘Payouts’

With Medi-Share, some medical organizations will directly bill Medi-Share and only send you a bill if there is anything left unpaid.

With Samaritan Ministries, you’ll need to cover the bill 100% out of pocket.  From there (once you get your bill), you’ll submit it. Payouts typically come about 3 months after you’ve received the bill.  This makes it important that you’ll be able to cash flow some of your expenses while you wait for the other member payments to arrive in the mail.  Again, the payments will come directly from other households so your checks will slowly come in over a period of a few weeks.

With Medi-Share, your out of pocket expenses depend on the annual household portions you select.

With Samaritan Ministries, you’ll be personally liable for any expense below $300.  Any expense above $300 will be eligible for sharing.

We typically operated with a high household portion ($3,750), so when I had my skin cancer surgery last year, I basically paid for the whole thing because the total cost came out around $3,500.  With Samaritan Ministries, I would have been eligible for sharing on that medical event.  As such, this could work out beneficially for us ????

Conclusion:

We were definitely happy enough with Medi-Share that I wouldn’t have ever considered changing to another sharing program.  However, our situation necessitated the change.  In six months or so, I’ll be sure to write a follow-up post explaining more of the differences I’m discovering and how we personally feel about the experience.

Anyone else with either Medi-Share or Samaritan Ministries and you want to chime in on the differences?

 

Comments

  1. Karen says

    Hi Craig,

    We also recently joined Samaritan Ministries after we were notified that our insurance through my husbands work would be increasing by more than 50%. Fortunately we had lots of time to compare and shop around. I have worked in healthcare for over 20 years the last 9 of them as a billing manager for a physicians office. One of the things that I liked about Samaritan in contrast to traditional insurance is the $300 per event rather than a yearly deductible (think car insurance) for many people with high deductible HSA qualified plans that have expenses in the last few months of the year this can be a real problem. Some traditional insurance will carry a deductible over if the care is for the same problem but the high deductible plans are not allowed to do this. We also looked at Medi-Share and I was really drawn to Samaritan since you send your payment directly to the person with a need and they have a plan in someone doesn’t pay you aren’t left out in the cold. One of the things that I considered a drawback with Medi-Share was their alignment with the insurance wrap networks. This does make Medi-Share seem somewhat easier to use but the drawback is the pre-negotiated rates. With both plans you are technically a private pay patient but by filing the claim the provider is agreeing to the discount with that network. If the provider offers a prompt pay discount this could actually be more than the network discount. For example in our office we offer a 20% prompt pay discount to patients that pay in full at the time of service (no claim to file and no mailing statements) and the network discount for Medi-Share is 5%-10%. With both plans if you have any pre-existing conditions I would ask lots of questions before changing but if you are going from being uninsured to medical sharing you just have to remember that for those problems you are still basically uninsured.

    Blessings,
    Karen

    • says

      Karen,
      Thanks for the information. I found it especially helpful hearing about why you decided to join Samaritan Ministries. I found your discussion about pre-negotiate rates very interesting.

  2. John says

    Greetings!

    My family have been members with Samaritan Ministries for over 10 years, and we’re very happy with our experience.

    There are a few areas I would say this comparison is a bit off on the Samaritan Ministries end of things, but one major issue is under the “payouts” section. Very few of the bills we’ve submitted to Samaritan Ministries have been payed before submission. We’ve typically submitted needs and had them shared before paying the bills.

    While this comparison is helpful, it doesn’t replace going to source documents or the individual ministries themselves for clarity on the facts.

    Best Regards!

    • says

      John,
      Thanks for helping bring some clarity to the subject. The reason I wrote the post is that sometimes listening to information in ‘plain English’ is easier than the legalese you read on some websites. But certainly verifying anything you read online is highly recommended.
      If I understand correctly (please correct me if this isn’t right) with Samaritan Ministries you need to submit your claim only after you get your bill from the doctor or medical institution. At that point it may take a month or two until you receive all the payments. If that isn’t correct please let me know how it works.
      Thanks.

  3. Todd Fuller says

    Craig thanks for sharing, and keeping us informed. I will pray that change works out for you.

    Yeah, when we signed up for Medi-Share 2.0 four years ago, we had heard about it no longer being offered in Montana. I could be way off on this, so don’t quote me, but I think that I heard at that time, 10+ years prior, a pastor had signed up for Medi-Share, been approved for membership, then almost immediately had a heart attack. From what I heard, I believe the pastor did not disclose a pre-existing heart condition which should have been done on the application and so his heart attack was not make eligible for sharing; the pastor fought it, including getting MS thrown out of Montana- this was my understanding which could be wrong.

    …. It sounds like there are pros and cons to Samaritan’s just like there are with Medi-Share (more pros then cons in my opinion). One concern I have with Samaritan’s is if you had a major medical event, like being in a car wreck, or contracted a bug that kept you in the hospital for 30+ days.

    The concern here is that a 30 day hospital won’t cost any hospital more than a quarter of a million. But, there are many hospitals who will charge this and some well in excess of this to attempt to recoup the money lost from 2 out of 3 patients; those on some sort of government program, where the government tells the hospital how much they will pay – which can be either almost not enough, or, far from enough… In any of these events, the hospital will shift the costs to the shrinking pool of patients on “self-pay” or “insurance/private health plans.” With no contracted network blunting some of these costs/filtering for those on “self-pay”, then it might become “easier” for the hospital to charge a much higher bill initially, because there is no network holding contracted rates with the hospitals.

    Yes, most hospitals offer some sort of “self pay discount” but this discount comes off a full retail price (of some Greek thing called the ‘chargemaster’), leaving it up to the patient to figure out how “accurate” the charge really is.

    Maybe some Samaritans folks can chime in that have experienced five or six digit bills and how they were handled.

    • John says

      The $250,000 upper limit is within the basic sharing that Samaritan Ministries practices. Save to Share helps out with needs that exceed that amount, potentially up into the millions.

      Samaritan Ministries also pays a group to negotiate billings, also.

      Lord bless.

    • says

      Todd,
      I hear what your saying. The $250,000 limit caused the biggest hesitancy on our part. Based on my research there are advocate groups that will help negotiate hospital charges if that was absolutely necessary. This would be a way to ensure that we’re not overcharged just because it’s self pay.
      In our case we did opt for the extra sharing portion of Samaritan Ministries so we should be eligible for claims over $250,000.

      • Todd Fuller says

        Ok Craig and John sounds good. I had a work colleague who her and her family moved from insurance to Samaritan’s early this year, before they moved to Georgia.

  4. John says

    Craig,

    Yes, you do actually have to have the bill and submit it to Samaritan Ministries in order to share the need.

    Lord bless!

  5. Belinda says

    Just curious, is anyone familiar with Christian Healthcare Ministries? How would you say they compare with the other two groups?

  6. Larry Ritter says

    I would also be interested in reading comments comparing Christian Health Ministries with Samaritan Ministries. Thank you.

  7. Debbie says

    Hello,
    We are a family of 7 and have not had insurance for 2 years. My husband is self-employed and the cost was just exorbitant, even though we are a very healthy family. We tend to favor natural health practices and rarely are our kids sick other than the routine, occasional colds, viruses, etc.
    However, I guess I still get nervous knowing that something could happen and we have nothing in place to help with the cost.
    I am happy to have found your blog as I am trying to work on better budgeting and money saving practices for our family.
    Thank you for reviewing the Samaritan Health Care. We have decided to go with that, as it seems to make more sense than a high-deductible health insurance plan that wouldn’t cover much anyways.
    Thanks and God bless,
    Debbie

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