Update: 12/2018: Our 5 Year experience with Samaritan Ministries can be found HERE. This post is extremely thorough with detailed needs and sharing experience.

Update 4/1/15: You can read about our most recent homebirth experience with Samaritan Ministries HERE.

Last year I wrote a post about Christian healthcare sharing ministries and had no idea that it would become my most popular post on Green Drink Diaries. Apparently more people are looking for alternatives to the federally mandated “Obamacare” than I originally thought!

Today I’m going to go back over some basics of Samaritan Ministries, the Christian healthcare sharing ministry we decided was best for us and also tell about our experience. Americans have only until February 15th, 2015 to make their decisions regarding federally-supplemented health insurance for 2015, so it’s perfect timing for research into other options as well.

For my full run-down on how Christian healthcare share ministries works a a whole concept, click HERE.

For my side-by-side comparison of the largest and most popular 3 Christian healthcare share ministries (Medi-Share, Christian Healthcare Ministries, and Samaritan Ministries) click HERE.

OK, now onto my review of Samaritan Ministries after one year of membership….

Our Samaritan Ministries One Year Update:

It has actually been about a year and three months since we joined SM, and I have not one complaint. The organization as a whole has experienced tremendous growth since the passing of the Affordable Care Act, and yet as a member I haven’t felt any of the growing pains.

Remember that the primary reason we joined was to be part of a group of people who believed in healthcare choice and freedom- such as the choice to use alternative medicine for cancer care.

We have been asked in almost every monthly newsletter to pray for the staff as they grow in numbers to accommodate the growing ministry. I love feeling included in the ministry and connected to other members by doing this. It is just SO DIFFERENT from insurance!

One issue that was surprising occurred earlier in the year when there were three months in a row of needs prorated by 80% because there were more needs than shares from members. (Remember that the “share” is the month each family agrees to send to another member, for instance my family of 4 sends $405 monthly to another member.) “Prorated by 80%” means that what usually is 100% paid for that month is only 80% paid because there just wasn’t enough funds to share that month. Your need will continued to be shared each month until enough money is gathered, but for that month in particular there isn’t enough.

After the third month, we were ASKED (not told) to vote on whether we thought monthly shares needed to be adjusted or raised. After a ballot was sent out and given a month to send back in, the members agreed that there needed to be a raise in our monthly share amounts to accommodate the rising care of health care costs.

The Samaritan Ministry share rates are now currently: (Updated 10/5/16)

Rates for those under 25 years old are less expensive- so check with SM if that is you.

Even though we, as a ministry decided that raising our monthly shares was the best solution to the rising costs of medical care and proration issues, there have been several months, including the last four in a row, that our share rates were reduced because of more shares than medical needs filed! This past month (January 2015) ours was $336.15, reduced $68.85 from our usual $405.

I chuckle at the idea of an insurance company ever REDUCING a premium. (:

FILING A NEED- TMJ Headaches:

This past summer I began having really bad headaches when I woke up in the morning. I never would have thought they could be TMJ related, but thankfully I quickly figured this out. I called SM to see if they covered issues arising from TMJ, and sure enough as long as if it was a medical issue (such as severe ongoing headaches or ear pain,) they covered it 100% (after my $300 personal responsibility which can be reduced if I ask for and receive any discounts from my doctor for being a self-pay patient.) We also prayed for healing over the phone, which I’m still not used to after a call to SM.

It only took one trip to the dentist to have my jaw and bite patterns examined to solve my issue. After $180 in discounts for being a self-pay patient, I only ended up paying $399 out of pocket. Since I received $130 in bill reductions from my dentist, I was able to file for the $99 that was over my personal responsibility of $300, plus the $130 in bill discounts that I asked for that came off of my $300 responsibility. So my total NEED that was published with other members was $229 ($130 + 99.)

Sure enough, it was super easy to fill out the NEED paperwork and after attaching all of my itemized bills, within 60 days I was sent a checklist of the members to expect checks from and received those checks promptly. I must also add that my checks both came with cards and one lady even sent a special book on healing prayer which really touched my heart. Again, SO DIFFERENT from insurance!

FILING A NEED- MATERNITY:

Update: 4/1/15 You can read about our homebirth experience with Samaritan Ministries HERE.

Shortly after my TMJ need was taken care of last summer, I began racking up more bills for my current pregnancy. My husband and I knew we wanted to look into having a home birth (for a variety of reasons I’ll discuss in a later post,) but so far we are eligible to file for my prenatal appointments and ultrasounds (one for conception dating and the other for the twenty-week anatomy scan.)

One thing to note about Samaritan Ministries is that the $300 personal responsibility is waived if you chose home birth with a midwife as your birthing choice. I will go into much more detail once I actually file my need and after the baby is born in February. Until then, you can learn more from the SM Guidelines below. I highlighted the sections in blue that are particularly exciting for women who prefer unmedicated childbirth.

Taken from the Samaritan Ministries Guidelines:

In general, maternity needs include bills for prenatal care, delivery, postnatal care and miscarriage, and are treated like any other medical expense. There are specific Guidelines for types of maternity needs that are publishable (Section A) and the initial unpublished amount (Section B).

A. Maternity Needs that are Publishable

1. General Rule—Publishable maternity needs include bills for prenatal care, delivery, postnatal care, miscarriage, and congenital conditions.
Publishable services include those of doulas (up to $500), midwives, doctors, and/or nurse practitioners. There are special criteria for publishing needs of the child from genetic defects and hereditary diseases. See Section VIII.A.
2. Separate Needs—Bills for all pregnancy and birth-related complications of the mother will be published as a part of the maternity need. (Note from Cortney: meaning if you choose a hospital birth, you are only accountable to a one-time $300 responsibility.)Routine postnatal care of the child, including no more than one routine outpatient doctor visit, will be part of the mother’s maternity need.Any pre-birth need of the child or a post-birth need of the child beyond routine natal care will be considered a need separate from the mother’s maternity need. When there are complications (anything beyond routine natal care) from, or as a part of, a multi-child pregnancy, the expenses for each child will be considered a separate need. Exception: If a multi-child pregnancy is the result of the use of fertility drugs, in vitro fertilization, or other artificial means, all pregnancy and birth related complications of the children will be treated as one need.

3. Adopted Child—Medical expenses of the birth mother and an adopted child, for which the adopting parents are liable and which are publishable the same as other maternity needs, less any credit amount to which the member is entitled under the federal adoption income tax credit due solely to those medical expenses. However, any physical condition which the adopted child has prior to the adopting parents being legally responsible for the child’s expenses, or prior to his effective date within his parents’ membership, will be considered a “condition that existed before membership” under Section VII.

4. Early Publication—If a maternity care provider will reduce the normal charges if a member prepays some or all of the bill, we
will consider publishing the maternity need prior to the birth. The member must request an estimate and submit it with the Need
Processing Form. If the resulting bills are less than the pre-paid amount, the member must contact Member Services who will advise
where to send the surplus.
B. Initial Unpublishable Amount/Proration

1. Like any other need, only the portion of a maternity need that exceeds $300 will be eligible for publication. See VI.A.1 and 2.

2. Home Births—Home births have the initial unpublishable $300 waived and are not subject to prorating (see VI.D) because they
reduce overall maternity costs.

3. The initial unpublishable $300 is waived for a vaginal birth after cesarean (VBAC).
C. Limits on Maternity Needs for Pregnancies Beginning Prior to Membership

1. General Rule—If a member became pregnant prior to her membership, the amount that she is eligible to have published for her maternity needs from the pregnancy will be equal to the total amount the member has sent in monthly shares from the beginning
of her membership or from when added to an existing membership. The same amount will also be available for the child’s maternity
needs, which is limited to extra costs related to a premature birth. If a member terminates the membership or allows it to lapse for any reason, and later rejoins, the amount available for maternity needs will be calculated from the date of the most recent start of her membership.

2. Expenses Prior to Membership—Any maternity expenses that are incurred while the mother is not a member are not publishable
except as a Special Prayer Need.

3. Routine Maternity Expenses After Membership—All routine pre- and postnatal care of both the mother and child incurred on or after the effective date of membership will be publishable as part of the mother’s maternity need limit.

4. Complications and Conditions Through Birth—Any complication of the mother or baby which is treated, discovered, or produces
symptoms through birth, will be considered a condition that was evident prior to membership and the bills will not be publishable except as a Special Prayer Need, until the applicable waiting period has occurred. See VIII.A for genetic defects and hereditary diseases and VII.A and B for all other conditions.

5. Complications and Conditions After Birth —Any complication of the mother which first produces symptoms and is first discovered
after birth will be considered part of the mother’s publishable maternity need. Any complication to or defects in the child which first produces symptoms and is first discovered after birth, will be a regular need of the child’s if the child is a member at birth. See
Section II.D. However, all needs of a child related to a premature birth will be treated as a maternity need separate from the mother and subject to the special maternity publishing limit. See paragraph 6 below.

6. Premature Births—The publishable amount limit for the mother’s need is doubled for a baby born prematurely requiring extraordinary care. The premature baby’s maternity need publishing limit is not doubled.