As I’ve written previously, my family has not had health insurance for about four years.  Instead, we are members of Samaritan Ministries, a Christian “health sharing ministry”.  A health sharing ministry is not health insurance, but it performs a similar function.  Once a month, we are given the name of another member or members who have recently had a medical need.  Instead of sending in an insurance premium to an insurance company, we send our monthly share (currently $495 per month for families with children) directly to that member.

Carry Each Other’s Burdens

It’s based on Galatians 6:2: “Carry each other’s burdens, and in this way you will fulfill the law of Christ.”  So in January, we might learn that a member in California had a heart attack, and we, along with other members, carry his burden by sending our $495 directly to him.  In February, we might learn that a couple in Texas recently had a baby.  So that month, we would send our share directly to that family.  We are also asked to pray for the person, and to include a personal note or card in addition to our check or online payment.  The money travels strictly from person to person, without passing through an intermediary.  (Once per year, we send our share directly to Samaritan, meaning that Samaritan’s administrative expenses are 1/12, or about 8%.  I suspect this is considerably lower than any insurance company.)  And as far as I can tell, there would be no way for a member to legally compel other members to pay.  It’s based upon Christian trust.  And since I’m a lawyer, I suppose I ought to be skeptical.  But I’ve learned that the system works, and that it works exceptionally well.

With Samaritan Ministries, we are responsible for minor medical bills.  If the total bill for a certain condition is under $300, then we simply explain to the doctor that we are cash customers.  In most cases, that means that we pay by check or credit card at the time of service.  Or, the provider will send us a bill and we simply pay.

For the past four years, all of our medical bills came in that category.  That’s a good thing, because it means that nobody in our family was sick enough to generate a medical bill of more than $300.  But the pessimist would look at the situation and point out that we weren’t getting anything out of our membership.

My First Medical “Need”

In a sense, the pessimist would have been right.  Since nobody in our household had been sick enough, we weren’t getting our money’s worth.  Well, our “bad” luck recently ended, and I got very sick to the point where I was hospitalized twice.  In other words, I was now “lucky” enough to be able to get my money’s worth.

I had essentially never been to a doctor as an adult.  But that all changed late last year.  I finally went to see a doctor, and she quickly referred me to a specialist.  As the specialist put it, “you’re a lot sicker than you think,” and I was hospitalized the same day.

I’ve now nearly recovered, but only after being hospitalized twice and incurring tens of thousands of dollars in medical bills.  Since Samaritan Ministries is not insurance, I am uninsured, and I was personally responsible for these tens of thousands of dollars in medical bills.

I had faith that we had made a good decision in going with Samaritan Ministries.  We did our homework, and I was confident that my medical bill would get paid and that I would stay out of bankruptcy court.  But I still had some doubts.  As another reviewer of Samaritan Ministries recently put it, “the lawyer in me had some questions.”

Even before I reported to the hospital, I informed Samaritan that I would have a “need” (they’re careful to avoid insurance terminology, so it’s not called a “claim”) in excess of $300.  My memory of that whole time is a blur, and I honestly forget whether I made the notification by phone or online.  But they quickly contacted me (again, I don’t remember if it was by phone or e-mail, since I’ve been in contact with the “need advocate” both ways).  He answered any questions and sent me the correct form and instructions.   The form itself was quite simple, and I was to send this along with my medical bills.  He also prayed for me.

I was first hospitalized in early December.  One great advantage of Samaritan is the fact that there’s no “network” to worry about.  You can go to any hospital or doctor you please, anywhere in the world.   I was able to chose which hospital I wanted, and my wife strongly recommended HealthEast St. Joseph’s Hospital in St. Paul,   This was an excellent choice.  I hope you never have to go to the hospital, but if you do, then St. Joe’s is the one you want to go to.  The hospital has a strong history as a faith-based institution, having been founded by the Roman Catholic Sisters of St. Joseph of Carondelet in 1853.  Everyone I encountered there, whether they were doctors, nurses, or support staff, treated me with extreme compassion.  Even the cleaning people gave the impression that they were important parts of a healing ministry, which, of course, they were.  Even though the hospital is now part of a secular healthcare institution, it is clear that the faith-based roots are respected and continued.

When I showed up at the hospital, the lawyer in me was expecting that I would probably need to explain my “uninsured” status, and reassure someone that they would, indeed, get paid.  At the entrance, I was placed in a wheelchair, and I fully expected them to wheel me to the business office where I would have that conversation.  But I was wrong.  They instead wheeled me directly to my room, where the nurses began asking medical questions rather than billing questions.  It wasn’t until a couple of days later when someone from the business office showed up.  When I explained how Samaritan Ministries worked, she seemed quite satisfied, and put away the Medical Assistance application that she had brought with her.

Filing the “Need” with Samaritan

When I was discharged (the first time, since they sent me back a few weeks later), my wife stopped by the business office and asked for an itemized hospital bill.  It was for tens of thousands of dollars.  But since I was an “uninsured” patient, they immediately gave me a discount and subtracted about half!

I got home in mid-December, and a few days later, I mailed the bill to Samaritan, along with the other bills that I had received so far.  I did make a point to make sure it arrived before the end of the month, because Samaritan works on a monthly cycle.  I believe we wound up mailing them on Christmas Eve.  If it had been a few days later, I probably would have sent them Express Mail to make sure they arrived by the end of the month.  (It is possible to submit bills online, but I haven’t tried that process.  My thinking is that since most of my bills originate in paper form, it’s probably easier just to mail them, rather than needing to scan them first.)

When bills are submitted, they are reviewed.  This process seems to take about one to two weeks.  When approved, they are assigned to other members.  A bill that is submitted by the end of December will generally be shared starting on February 1.  So being a member does require a certain amount of organization and getting things sent in a timely fashion.  It is, however, not overly burdensome.  As new bills arrived, I placed them in a folder, and when I had gathered a few, I sent them to Samaritan.

Processing by Samaritan

Samaritan has a good online portal to track how needs are progressing.  At one point, the information displayed there made me a bit nervous, since that information is apparently delayed a few days from real time.  After Samaritan received my bills, the online portal initially said that they were undergoing review, and that the amount currently approved was zero.  This made perfect sense, since they hadn’t been reviewed yet.

A few days later, the status switched, and indicated that the review was complete.  And the amount approved was listed as . . . zero!

I correctly guessed that this was an online glitch of delayed reporting.  In fact, if I looked at another part of the online portal, the approved dollar amount was shown.  But I have to admit that the “zero” made the lawyer in me a bit nervous for a couple of days!

Lo and behold, a few days later, the full amount of my original bill was listed as being approved.  The bills from the initial hospitalization were submitted in late December and approved in early January.  And in late January, I was given a list of names of the other members who would be sending me their monthly shares starting on February 1.  I received the first share in late January.  Most of them arrived in the first two weeks of February, and they continued to trickle in until the end of the month.  A small sampling of some of them is shown in the illustration above.  Most members, it turns out, submit their shares via PayPal rather than by mailing a paper check.  The immediacy is nice, but there’s something to be said for getting a physical get well card in the mail.

As I mentioned, I was hospitalized a second time in early January.  This stay was actually longer and more expensive.  I submitted those bills in January, and the shares from other members started arriving on March 1.  More bills have trickled in, and some of them will be reimbursed in April or probably later.  But I’ll have the bulk of my medical bills paid in full by the end of March.

It takes a bit of organization, but even though I’m somewhat organizationally impaired, it isn’t particularly burdensome.  As money arrives, I immediately use it to pay my medical bills, most of which are now 31-60 days past due.  I usually make an online payment every day that I receive one or more PayPal payments from other members.  And when I receive paper checks, I deposit them, and then mail a payment for that amount within a day or two.  Even though my account is technically “past due” by a small amount of time, I haven’t received any collection calls.  I suspect the hospital (and all of the other providers) are getting paid much faster than they are for their insured patients.

100% Coverage!

The lawyer in me was worried that I might not get reimbursed for all of my medical bills.  But I needn’t have worried.  I’ll essentially be “covered” for 100% of my medical expenses.  There is that $300 “deductible,” that I would ordinarily need to pay myself.  But I don’t even have to pay that, because if I obtain a discount (which I did from most providers, including that discount of tens of thousands of dollars from the hospital), that is first subtracted from my “deductible.”  Since I’ve had discounts far in excess of $300, I don’t have to worry about this.

Really, my only out-of-pocket expense will be for prescriptions.  Samaritan pays them for up to 120 days, but I will have a couple that will extend past that point.  But thanks to the price comparison tools made available by Samaritan, these expenses will be very low.  (See my post on prescription drug prices to see some of the huge discounts available on otherwise expensive drugs.)

Better than Insurance

If I had insurance rather than Samaritan, it’s very unlikely that I would be as pleased as I am.  First of all, there would probably have been a very large deductible or co-pay.  When we were shopping for insurance four years ago, for example, the only policy that was even close to being affordable had a $10,000 deductible.  By contrast, my “deductible” for this illness started out at $300, but even that immediately vanished when I obtained a discount on a bill.

The Power of Prayer

Also, the knowledge that other Samaritan members were praying for me is very significant.  Almost all of the shares that I received from other members contained a  personal note (either electronic or paper).  In addition to sending me money, they were sending me encouragement and prayer.  I could feel all of those prayers from dozens of people (including the staff at Samaritan who made a point to pray for me personally).  I truly feel like a member of a community, rather than simply a customer of an insurance company.

Another reviewer put it this way, which applies to me as well, even though her son had a medical need even more serious than mine:  “This kind of thing makes me go weak in the knees, begging God for healing, wisdom, guidance and provision. God has answered powerfully and part of that answer has been Samaritan Ministries.”    I’m not sure I know exactly what the Apostle Paul meant when he said to “pray continually” or “pray without ceasing” (1 Thes. 5:17), but this experience has given me more understanding. The knowledge that dozens of other members are actively praying for me is truly humbling, and I have no doubt that it contributed to my healing.

No “Networks” to Worry About

Another critical factor is that with Samaritan, I don’t need to worry about whether my doctor or hospital is a part of some “plan” or “network.”  I can go to any doctor I want, anywhere in the world, with the assurance that the bill will be paid.  This allows me to chose a quality provider, such as the hospital I went to.  It also allows me to shop around for price.  For example, when I needed a CT scan, my cost was $392, because I was able to ask for the price and offer to pay at the time of service.  I suspect that for most people, the cost would have been much closer to $1000, and if they had a high deductible health plan, they would have been stuck with most of the cost, with no opportunity to shop around.  According to this website, a CT scan can cost as much as $5000.  For routine services such as this, it really pays to shop around, and Samaritan Ministries allows you to do exactly that.

My Recommendation

Samaritan Ministries is not for everyone.  For one thing, it is a Christian organization, and members must profess the Christian faith (in quite general terms, which would be acceptable to most Christians of almost any denomination.)  The governing law requires that health sharing ministry members share common religious or ethical beliefs.  Most such organizations are Christian, although United Refuah appears to be a similar organization for Jewish persons.   I hope there are similar organizations for those of other faiths.  Another consideration is that conditions that existed prior to becoming a member generally are not shareable.  (However, there are some exceptions.)

For most members of Christian churches, I believe that Samaritan Ministries is an excellent option.  In my experience, it is vastly superior to insurance.  And as I discussed previously, the cost is considerably less.  I’m quite confident that there is no medical insurance policy in America that would provide 100% coverage for a family for only $495 per month.  But that’s what Samaritan does.  It’s not insurance.  It’s what insurance was originally intended to be, and it’s what the early church was.  I strongly recommend that you consider it.

If you do decide to join Samaritan Ministries, I would appreciate if you would consider indicating on your application that I referred you. (Or, of course, if someone else recommended Samaritan, mention their name instead.) The application asks how you learned about Samaritan. If my information proved helpful, I would appreciate if you would include my name, Richard Clem. If you do, I will receive a credit.

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