6 Key Differences Between Samaritan Ministries vs Medishare
It seems as if our “affordable” healthcare is becoming more and more “un-affordable.” Recently, our family’s monthly premium went from $480/month to $1596/month! Knock on wood, we have been a very healthy family up until this point. So I decided to research other options which led me to something called “health care sharing ministries”. The two main players that will be highlighted today are: Samaritan Ministries vs Medishare
What Is A Health Care Sharing Program Or Ministry?
Health care sharing ministries (HCSMs) are an organization that assists sharing of health care costs among individual members who have common ethical or religious beliefs.
They are NOT health insurance.
Specifically, members send in their monthly premium which are called “shares.” These shares are distributed to or on behalf of other members with medical expenses in accordance with program guidelines.
They are built upon the principle of people with similar beliefs and values coming together to share each other’s burdens, not unlike the risk-pooling nature of health insurance.
One reason they are becoming so popular is their cost to join. For only a few hundred dollars a month, families can become members versus traditional health insurance which for many of us is well over $1,000 per month.
Part of the reason that they’re much cheaper than traditional health insurance is that they may have limited coverage regarding certain health conditions.
Make sure you read what limitations each company has before making your decision.
Here’s an overview of how one of the major players, Medishare, works:
What is Samaritan Ministries for those who are hearing it for the first time?
Samaritan Ministries is health care for people of biblical faith. We’re a group of like minded believers who share one another’s medical expenses directly, person to person, household to household without using any insurance at all.
We’ve been doing this now at Samaritan for a little over 22 years and currently there are 65,000 families all across the country sharing in this way. That translates to about 210,000 individuals.
How does it work?
Every household joins and pays what we call a monthly share.
It’s a set amount, and currently the shares would be:
- $220 for one person
- $440 for a couple
- $495 for a family of any size
Every month we coordinate all of those people sharing those expenses. We let them know where to send their monthly share.
The unique feature here is that members are sharing directly with another member. (Key difference between Medishare and Samaritan)
As a Samaritan member, you don’t send my monthly share to the office. You have the opportunity to minister directly to a brother or sister in Christ by sending my monthly share directly to them.
The process is a very coordinated one. In other words, it’s not a haphazard, we’re going to cross our fingers and pass the hat and hope that enough people send.
We specifically allocate or direct the right amount of Samaritan members to send their monthly shares to somebody with a medical need.
Then, finally, the exciting thing is that in addition to sharing the financial need, we’re able to pray for one another and send cards and notes of encouragement. Community is really what makes this whole thing spin.
Let’s be clear, this isn’t insurance. This is a share program, correct?
That’s correct. There’s no contractual transfer of risk. This is a voluntary sharing situation.
It’s really crowdfunding for health care.
We’re becoming more accustomed to seeing more resources shared, whether it’s through Uber of sharing transportation, or Airbnb. This gets back to the Acts II church of God’s kids taking care of one another. You’re correct, it’s not insurance in any way.
As far as what the new administration will do, we’re hopeful that we’ll get away from regulations and mandates and taxes, because that’s not the way to reform health care. If we’re going to really reform it, then we need to have a biblical understanding of what free markets are and what personal responsibility is and generous charity of a free people, not a people coerced through taxes, which is distributed to others, which is really not charity at all. It’s unjust.
Samaritan Monthly Costs
Here’s a nice breakdown of Samaritan’s monthly costs from the Samaritan Ministries Review site:
Similar to a premium, the monthly share is the amount you send each month direct to another member to help cover their medical needs.
Members of the Classic Level Membership agree to share expenses incurred for medical treatments specified in the Membership Guidelines.
The amount of the monthly share is based on household size (see chart below), regardless of your medical history, age (unless individual 29 or younger), or other factors.
Effective Oct 2, 2017 Samaritan has two membership levels to choose from:
Members of both plans can choose to add Save to Share which is recommended for sharing of needs above $250,000.
|Individual Membership is < Age 29||$160|
|Two person family||$440|
|Widowed or Divorced with Children||$305|
|Three or more Person Family||$495|
|PERSONAL RESPONSIBILITY (level where a need can start being shared)||$300/incident (can be reduced to $0 with discounts)|
|MAX SHAREABLE AMOUNT (including maternity, 2 person or higher required)||$250,000/incident (Save to Share-increases this to unlimited)|
|Samaritan shares 100% of qualifying needs which go above $300 in total cost on the Classic Plan. Prorating rules apply.
——— OR ———-
Members of the Basic Level Membership agree to share expenses incurred for medical treatments specified in the Membership Guidelines.
The amount of the monthly share is based on household size and age group determined by the age of the head of household (see chart below), regardless of your medical history or other factors.
This plan level allows for smaller monthly share amounts, with greater personal responsibility portion and a 90/10 split sharing as detailed below (similar to a 90/10 co-insurance level).
AGE GROUPS (oldest member age) Monthly Share
|PERSONAL RESPONSIBILITY/SHARING THRESHOLD (level where a need can start being shared)||$1500/incident|
|SHARING PERCENTAGE (amount shared by members)||90% of the amount that is shareable|
|CO-SHARE (amount paid by member on his/her own need)||10% (up to maximum co-share)|
|MAXIMUM CO-SHARE (MCS)||$13,500 (applies even if get Save to Share)|
|MAX SHAREABLE AMOUNT (non-maternity)||$236,500 ($250,000 minus the MCS) (Can still join Save to Share to get sharing above $250k)|
|MATERNITY MAX SHAREABLE AMOUNT (2 person or higher required)
||$5000 (more sharing is available if certain conditions are met.)|
What is Medi-Share?
Just like Samaritan, Medi-Share is NOT health insurance. It’s a healthcare sharing ministry membership program in which Christians share their financial resources to help pay for other members’ medical expenses.
Think of your local neighborhood. If one of your neighbors was in the hospital and couldn’t mow their yard, more than likely some of the neighbors would pitch in and help out with their yard work.
Medi-Share works in a similar fashion.
It is based on the biblical principles of Christians helping other Christians and applied to healthcare expenses.
Here’s a brief video:
Here is a breakdown from their site about how Medi-Share works:
Each month, your monthly share is matched with another’s eligible medical bills. Through a secure online portal, Christian Care Ministry publishes the bills eligible for sharing and coordinates the direct sharing of medical costs between members.
You will know each month whose bills your share is helping pay, and when you have eligible bills and your annual household portion (AHP) has been met, your fellow believers will be sharing those bills and praying for you as well.
How much does Medi-Share cost?
There are a few factors that go into play regarding what you’ll actually pay per month:
1. Age of the oldest applicant.
2. Number of people that will be participating either one, two, or a family of three or more.
Once you input the two factors above, you next have to decide on:
A. The Annual Household Portion (AHP) is the dollar amount a household pays toward their eligible medical bills during a 12-month period before any eligible bill may be shared among members.
Instead of having a set insurance deductible, each household chooses their Annual Household Portion.
Here’s an example for someone like myself (40’ish) married with two kids:
Monthly Payment Options – Medi-Share’s system is like choosing a health insurance deductible and monthly premium.
Annual Household Portion (AHP) – in the first column above, the AHP ranges from as little as $500 for young singles to as much as $10,000 per year for families.
Similar to your insurance deductible, after you reach your Annual Household Portion through eligible medical costs that you pay, Medi-Share then publishes the remaining amount of your eligible medical bills on the platform so other members can share in the cost.
Standard Monthly Share – in the second column above. This is similar to a monthly insurance premium. Comparable to health insurance, the higher your annual deductible or annual household portion, the lower your monthly share cost.
Here’s an example for a healthy 25 year old:
Medi-Share Program Options
|Annual Household Portion||Standard Monthly Share||*Healthy Monthly Share|
*Healthy Monthly Share – Medishare offers an option for healthy individuals called the Healthy Monthly Share. This is the reduced monthly share amount (up to 20%) for households who meet the Health Incentive standards, which are determined based on:
- Waist measurement
- BMI (Body Mass Index)
- Blood pressure
Click here to see how much your rates will be with Medi-Share.
Samaritan Ministries vs Medishare – Key Differences
Both Samaritan and Medishare are similar in cost. Medishare starts at $80/month vs $100/month for Samaritan.
Remember with Medishare, different plans have different deductibles (called an annual household portion), and the copay (called a provider payment) is always:
- $35 for doctor/hospital visits
- $135 for emergency room visits
With Samaritan, you pay a flat $300 per visit, and the rest (up to $250,000) is covered. This is like having no deductible and a $300 copay.
Want to see a doctor? No problem. With Medishare, they offer free virtual doctor visits via MD Live which is a 24/7 on-demand access to US Board Certified doctors via video chat.
For serious issues, you will have to pay a fee of around $35 at a doctor’s office.
Being a Medi-Share member has additional benefits including coverage for:
MediShare has a large provider network. But if you want to see an out of network doctor, you must pay a fee to do so.
For those using Samaritan, there is no network and you can see any doctor without penalty. You will have to self-pay which means doctor visits are going to cost more. Keep in mind that you will have to pay out of pocket until your bill reaches a certain limit.
- Samaritan Classic = $300/incident
- Samaritan Basic = $1500/incident
Bottom line Regarding Costs
For most of us that are paying an arm and a leg for healthcare, you can’t go wrong with either of these companies to save you and your family thousands of dollars a year.
Discounts For Being Healthy
At this time, Samaritan does not offer discounts for their healthy members. Medishare offers a 20$ Healthy Monthly Share discount.
Method of Payment
With Medishare, your payment runs through an account at America’s Christian Credit Union.
Samaritan users send their payments directly to members in need.
Who Sends The Bills
Patients send bills to Samaritan whereas the provider send bills to Medishare.
One of the top questions many have regarding sharing ministries is:
Is there a limit to sharing?
No limits when it comes to your bill being shared. This is one of the main reasons I chose Medishare over other companies. As of this writing, they do have a maternity limit of $125,000.
- Basic plan – max shareable limit of $236,500 and a $5000 2+ person maternity limit.
- Classic plan – max shareable limit of $250,000 and a $250,000 2+ person maternity.
For those members in need of a higher max shareable limit, then you will have to pay an extra yearly fee and a administrative fee (Save to Share program).
If you want a more in depth look into why I chose Medishare, click here.
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I have Christian Healthcare Ministries for my “Health Insurance.” It is another option like the two you mentioned. I have been pleased but I have not needed to use it yet for an event. I save about $15,000 a year in premiums over the insurance I would have had to buy. I’ve had it for about 4 years now. I have saved $60,000 in premiums so that should cover a lot of deductibles.
Dr. Cory S. Fawcett
Prescription for Financial Success
It seems like an awful risk to me. Having saved up millions to retire I would not risk that just to save $10,000 a year in my case. Logically it can only be cheaper if their plan is covering a lower risk pool of people but there just is no evidence that their patients are much lower risk than others. In fact I might expect their pool of people to be identical to the insurance pool, self employed and early retired people. Secondly they could be cheaper if they have lower overhead or by the fact they are not for profit. However Blue Cross and the other major carriers are barely breaking even with their plans so there is no fat in them. They do get to screen out pre-existing conditions, something that troubles me for a “Christian” organization to do. Where is the sharing of their burdens? I wonder if the medical sharing plans are kind of like an unintended pyramid scheme in that the rush of new people coming in who haven’t had time to file claims are covering the longer term participants who are filing claims. This can go on for awhile but eventually could implode. Ten thousand a year is not worth risking my entire life savings on.
@steveark Pre-existing conditions are “covered” under something called extra blessings. Members give extra each month to cover the needs of other members. Our household gives to this each and every month and I believe that since Medishare has been in existence, all pre-existing conditions have been covered by members giving an extra amount each month to cover the burdens of others. When you pay your bill they say something like “if each household gave $1.78 all extra blessings would be covered this month.” Who doesn’t want to give such a small amount to help someone else in need? I’ve had Medishare for 4 years and have been blown away by how great they’ve handled everything and we’ve had big events 3/4 years. They even called me after we lost our baby just to pray for me and ask how I was doing. It seems like everyone is skeptical, which I understand. But as someone who has had over a 150k in medical bills in the last four years, I would highly highly recommend Medishare.
@steveark if you are someone who has saved up millions to retire, you are in a different position than most people and likely can make health insurance decisions without factoring in price. For most people, we weigh the costs and benefits. That $10k of savings per year invested over 40 years is over $1M. Christian sharing ministries tend to be a good fit for many people who are in this position of weighing costs and benefits, including for my parents when I was growing up and for our family.
You are correct that the risk pool is lower. The principle is actually very similar to individual health insurance. On a group basis, insurance companies are willing to take on pre-existing conditions and spread the risk across the group. On an individual level, ACA plans are required to take on this risk (and are priced higher accordingly) while term medical plans are not required to take on this risk (and are priced lower accordingly).
I understand your concern around a Christian organization not taking on pre-existing conditions but consider the alternative when offering an individual sharing plan. If pre-ex is covered, many people will wait to join the program until they have the medical event. This risk would drive up rates and often ends in a death spiral of only the unhealthy staying in the program. Christian sharing ministries are acting in line with general insurance principles- insurance is for unforeseen future events not what has happened currently.
We carried Christian healthcare for quite a while and the only downside I found is that it did not cover doctor visits or any type of lab or other testing that needed to be done. Is your organization different than that, because I continued to pay approximately the same amount every month as what you are stating and didn’t ever really see where it did anything for us, when basically we, by the grace of God , have not had to use it for in hospital visits yet.
L.H., good feedback. Christian sharing ministries generally follow the principle of sharing in unforeseen and expensive medical costs to prevent bankruptcy. An analogy we use regularly is if you car insurance covered your tire rotations, oil changes, and brakes it would be very expensive. The principle is the same here. Many people take the savings each month and use it to pay for the Dr visits and lab or other testing and still have significant savings v. traditional insurance.
I have found that Samaritan Ministries does pay for testing ordered by a doctor due to a specific need to try to diagnose symptoms. They do not pay for routine testing. However, they often send information on how to have certain routine tests performed at reduced rates at annual or bi-annual testing sites near you. This may have been temporarily halted due to covid. I don’t recall getting a recent mailing with the testing site and date information.
Also Beware that if you want to leave SMI, you have to jump through a bunch of bu·reau·crat·ic hoops to leave. When I got insurance through work and one of my daughters did the same, it was easy. But when my wife became eleigible for medicare and I was left with just one daughter on the plan, Then paperwork hit the fan 1) my wife had to sign a special form to disenroll (previously I just made a phone call. 2). Then they said the form did not come in time so I got charged another $500 for a month of “services” that I won’t use because she is already covered with medicare. 3) My daughter had to “reenroll” on her own (Why?, makes no sense to me. She was already enrolled) but because she lives away from home at college and we had to get her local pastor to fill out his part of the form we missed another ar·bi·trar·y “deadline”. Now we have to pay a “new enrollee” fee of an extra $200. In addition to this, be aware that if you are able to “share” an need, not everyone pays in a timely manner. My wife fell and broke her arm requiring surgery. Total shareable needs were about $50,000. We did not have that kind of money and had to pay up front so we opend a credit card just for that purpose. The accident was in August and everything was not settled until April of the next year. Meanwhile we had to pay interest charges on the credit card. My daughter had a car accident in 2017 and to date, we still have not gotten $3000 we paid out. We are told that the time has lapsed for any bills to be submitted so here is another situation we had to go out of pocket. With a salary of $32000 a year as a christian school teacher, this has been a promise that is far from as good as it was portrayed.
Which company did you use?
For anyone in Henry’s position (big bill due and waiting to be reimbursed by shares) there should be interest-free financing available through your hospital or doctor’s group. There are even interest-free credit cards specifically for medical services, such as CareCredit.
I’m sorry your experience wasn’t good.
My husband has had 2-3 hospital stays due to heart issues where he had stents. We didn’t pay much up front and I paid the rest of the bills when the money came in from shares. We received all our money in a timely manner. Three months max. His health issues totaled close to $200,00 over time.
I had 2 scheduled back surgeries and I did have to pay up front money but it was paid off in about 3 months also. I did use credit cards that had sign on bonuses. That can be a lot of work but we received quite a bit in airline miles and points. My surgeries and subsequent care has totaled a little over $200,00.
It’s a lot of foot work and not always easy but I have really enjoyed having choices and not needing approvals.
I hope your future experience with Samaritan is better.
I am with SM and struggling to get them to share. One reason or another the want more information and rejections. When I finally get it shared I am gone. I am on Medicare and they only owe for alternative treatment.
Hi, I’m wondering if you can use an HSA or HRA for either of these medical sharing services?
Unfortunately they are not at this time.