Sep
02
2011

How We Cover Our Medical Bills Every Time

Samaritan newsletter

We can't speak more highly of Samaritan Ministries, an alternative to traditional insurance.

Yesterday Micah underwent surgery for his finger he split open with the table saw on Tuesday. (See Surviving the Emergency Room.) We’re exiting emergency mode and entering healing mode. His hand will take 6-12 months to heal, and we’re so thankful for the treatment he received. Overall, the diagnosis looks good.

Now we get to focus on another pain: the medical bills.

Times like this require insurance. We all know the economic, bureaucratic, and political mess insurance has become in recent decades. It’s a hassle, and when an emergency hits, it’s a hassle that frustrates you. This article isn’t an attempt to unravel this mess, but to show a solution that has removed much of the hassle when dealing with the mess: Samaritan Ministries.

Samaritan is the cooperative insurance that we subscribe to. To some it appears too “out of the box” or radical, but when you think about its root function, it makes total sense. When you figure out how it works, you begin to understand its brilliance. You also wonder why more people don’t subscribe to it.

How Samaritan fits into the system

Ask yourself, What is the purpose of medical insurance? Fundamentally, medical insurance is a group of real people pooling their funds for the sake of medical emergencies. Those who pay in understand (or should understand) that they will likely pay in more than they retrieve. Insurance “assures” those who participate that their bills will be covered if they end up one of the medical emergencies.

If you thought of insurance differently, you’re not alone. Many people see insurance as a slush fund to pay for prescriptions and doctor visits. Or they see it as a savings account to draw from, making sure they get their piece of the fund, at least as much as they paid into. Others see insurance as something the government should manage, thinking of medical expenses as trivial, something that need not be paid personally, but a responsibility of society (that is, tax payers).

Samaritan isn’t a pool of funds, it is a pool of people, as we believe insurance was meant to be. Subscribers aren’t sent a monthly bill. Instead, subscribers are sent directions to pay a certain amount of money to other members. Essentially, Samaritan serves as an accountant to divvy up claims among its members. It is the responsibility of members to follow through with their payments.

There are administrative costs associated with this, but it comes directly from the yearly subscription for the newsletter. Unlike insurance companies that receive bazillions of dollars in revenue and distribute bazillions of dollars (minus their profits) in claims, Samaritan is able to clear most of this from its P&L. Technically, very little revenue comes in, and very few expenditures go out. It is a well managed accounting machine, and millions of dollars in medical bills go paid through the system every year.

How Samaritan returns humanity to the medical industry

One of the criticisms of the medical industry is how impersonal it is. And no wonder! Insurance companies view patients as numbers, little emotion is exhausted from a paper pusher who decides what illness is covered and what isn’t. Government insurance isn’t any better. Someone eventually pays for the medial service, and an hourly worker in some skyscraper is no different than a bureaucrat in Washington. Arguably worse.

Not so at Samaritan. Sure, they have their restrictions, but what insurance company doesn’t? With Samaritan, you are taken care of by real people who are in the same boat as you. They’re brothers and sisters in Christ who have your best interests at heart.

The monthly instructions come with a newsletter of prayer needs of other members. It’s a great pool of people, and we love to read through the concerns and blessings from month to month. When we have had to file claims, we receive handwritten get-well cards or congratulations to the birth of a new child along with the checks.

Of course, there is the risk that someone may take advantage of the Samaritan system. Two thoughts on that. First, folks who try to cheat Samaritan (bouncing checks, not sending them, or making false claims) are quickly weeded out. Remember, you’re dealing people-to-people, not bureaucracy-to-people, so efficiencies are much tighter. Second, we can count the number of checks that didn’t come through on one hand, that after thousands of dollars in claims over the years. Besides, claims are covered with several small checks, not one big one, so even if we were to get cheated, it wouldn’t be by much.

How Samaritan brings medical costs down

Doctors and hospitals face a brunt of criticism, too. If they weren’t so expensive, insurance companies wouldn’t charge such high premiums, and patients wouldn’t find themselves in such dire straights. While there is plenty of blame to go around, we find it difficult to hang much blame on doctors or hospitals. Their medical expenses are so high because of the insurance mess, not the other way around.

Samaritan members see this every time they end up in an emergency situation. With Micah’s saw accident, we were required to pay certain amounts. The ER required $150 down payment, and the rest of the bill will come later. The specialist’s clinic visits are free, but the operation will run an estimated $4,400. The hospital, too, will cost money for the operation. So, in the end, Micah’s wood-making project will cost somewhere around $10,000.

We, however, will probably pay about half that. We are constantly amazed at how much doctors and hospitals will slash their price when you tell them you are self-pay. Without hardly a bat of an eye, they drop 35 to 60 percent. We used to think it was because they had pity on us (oh, poor people with no insurance, let me help them!). Not true. By avoiding the insurance debacle, the professionals gain payment upfront and the medical service bypasses collections totally. A collection that oftentimes goes unpaid in the end. It is a wise business move: Ready to pay upfront? You bet we’ll drop the price.

We look at it this way: we actually pay the market price for medical service. If we had insurance, medicare or medicaid, we would pay the bloated price that the corporate and bureaucratic system demands. We feel better about it, too. The good people in the medical field are professionals, and we’re paying them for their good work.

Let’s go back to the humanity of Samaritan for a moment. Once the question of payment is out of the way (we’ll get to that next), both parties (us and the doctors) feel like the elephant is out of the room and we can all return to caring for the patient. The doctor can focus on Micah’s finger, we can focus on the various questions we have and decisions we need to make, and neither party needs to worry about much else. The doctor doesn’t need to worry about whether he’s going to get paid, and we don’t need to worry about whether we will be able to pay. We get to work, and everyone is happy about it. Except Micah, but he’s young and will heal.

How Samaritan truly “insures” us

We’re not wealthy people. Far from it! We live month-to-month like most Americans, trusting God as we work hard to provide for our growing family. Granted, it was tough handing over the credit card for the doctor’s receptionist to run $2,200 on it (half the “normal” cost). These initial bills will be a struggle to work out, but we have no doubt in Samaritan. Before Micah’s finger heals, we’ll have all our bills paid for. Here’s how it works.

The question the front-desk lady asks is, “What insurance do you have?” That’s really not the question. Instead, it is, “How will you be paying for this today?” Our answer, as is it is for every Samaritan member, is, “self-pay.” Doctors and hospitals then send you down an entirely different route than the insurance route. The insurance route is ladened with regulations that a full-time staff (what a heavy cost!) typically handles. Self-pay patients either whip out the checkbook or credit card. Sometimes payment plans can be set up. Whatever the self-pay process, the point is simple: you pay your own medical bill, save the receipts, and submit claims to Samaritan.

This is where most people fear Samaritan. That “self pay” option is difficult, and passing the bill onto an insurance company seems, on it’s surface, worth it. We challenge this thought in two ways. First, is it really worth the 35-60% up charge? That’s how much extra you’ll eventually pay just to kick the can down the road a couple months. Your credit card sure isn’t charging you that much. We cannot economically justify the insurance route.

Second, what if we didn’t have the $2,200? A finger operation is easy sailing compared to cancer or open-heart surgery. A final bill of $10,000 is something we could handle, our credit is that healthy. But what about $100,000? Would that be end-of-story? “Sorry, game over!” It might be with traditional insurance, but not with Samaritan Ministries.

Again: With insurance you’re dealing with corporate or government bureaucracy, with Samaritan you’re dealing with people. And they’re people in the people-caring business. Doctors and hospitals have slashed their prices for us not just for business reasons, but because they genuinely care for us, their patients. In fact, the lady we talked with at the doctor’s office (the one who swiped our credit card) let us know that there is a program at the hospital that waves fees based on income. We’ll be looking into that program later, but my bet is that the program is based on the same Hippocratic values that their hospital is built on: caring for the lives of others.

Horror stories of the insurance system are a dime-a-dozen. It’s a great irony on how inhumane such a human-centered institution can be. In the end, we ask you: which would you trust more? The insurance company, or your doctor? The government agency, or your own decisions? We go with the latter choices, and Samaritan empowers those choices.

How to apply

Samaritan is designed for dedicated Christian laymen, especially the self-employed and ministry leaders, profiles that we fall into perfectly. If that describes you, definitely look into this. But even if not, Samaritan insures thousands of other likeminded Christians nationwide. See their website for complete information (www.samaritanministries.org). And be sure to mention that Chris & Wendy Jeub recommended you!*

Micah's a trooper, pictured here right before wheeling down the hall to surgery.

*Full disclosure: We receive a discount on our monthly instructions when someone signs up from our referral. However, this article was not solicited in any way by Samaritan and is not an advertisement. We honestly believe in their ministry and want to spread its good will.

About Chris & Wendy Jeub

The Jeub Family live in Monument, Colorado. They encourage couples to love God and love one another, building an atmosphere of love in their homes.

  • http://www.trooppetrie.blogspot.com trooppetrie

    Praying for a quick healing. My husband is in the military so this post does not help me but I know of a couple of friends, this sounds like a great idea, thank you so much for sharing

  • Peggy

    What about life, dental, vision, and disability insurance? I think I remember you mentioning you pay monthly for Samaritan and send extra to individuals when they really need it, is that correct? Is the monthly payment to Samaritan a set amount or is what you can afford? We both would love to be self-employed but insurance and benefits are what is stopping us. I tried looking into individual insurance through Blue Cross Blue Shield but it’s all so confusing! I’d like to know more about your experiences with Samaritan and what things they cover. Thanks!

    • http://www.jeubfamily.com Chris Jeub

      You’ll find answers to these questions at http://www.samaritanministries.com. Real quick:
      1. Just medical (not the others).
      2. Monthly fixed amount.
      3. A LOT of self-employed families go with Samaritan, and we’re one of them.
      4. I’m thinking of posting all the numbers from this emergency experience, to give a real-world view of how it all works. More to come!

      • Peggy

        So what do you do for the rest? Are there other programs like Samaritan for dental and vision? And what about life insurance? Thank you!

        • http://www.jeubfamily.com Chris Jeub

          We don’t insure dental or vision. We have a couple life insurance policies, but we pay for that. (Doesn’t everybody?)

  • Anonymous

    We have just been accepted.  The helping deciding factors were:  Your recommendation, Dr. Voddie Baucham’s Recommendation and Doug Phillips recommendation. 

    • http://www.jeubfamily.com Chris Jeub

      Very cool! A lot of Christian leaders are backing Samaritan. It’s a wonderful organization that brings people together.

  • MamaTLC

    This is only good for those
    who do not have pre-existing conditions or a medically fragile person in
    the family. I am glad this works for your family but our family is
    ineligible.

  • Twi

    That “free” specialist clinic is being paid for by someone else.

  • Anonymous

    I think you are forgetting that the doctors/hospitals/etc don’t get 100% of what they charge the insurance company because of the rates they have agreed to with the insurance companies.  Case in point, my daughter’s ER and 4 day hospital stay came to $12,000 before insurance was billed.  After the insurance was billed and paid their part and we paid our part the hospital only got $4500 of that $12,000.  When I saw that it definitely gave me a pause!  

    I’m glad Samaritan has worked out for you but for families with medically fragile children it would be like having no insurance whatsoever.

  • http://www.facebook.com/people/Tiara-Smith/100000386126152 Tiara Smith

    There is so much over-doctoring that goes on with insurance.My son fell and we went to have his arm checked to see if it was broken,It wasn’t,yet they still wanted us to come back for a follow-up visit.And that is only one example.we have many more.
    we pay so much for ins. anyway…and on top of that,they want a hefty co-pay for specialists.It’s ridiculous.

    • http://www.jeubfamily.com Chris Jeub

      Good point, Tiara. This has much to do with medical malpractice suits, and that blame can hang on both incompetent doctors and sue-happy patients’ necks. Their actions inadvertently effect the rest of us.
      NOTE: Another reason to prefer Samaritan. Once that self-pay option is taken, we all get down to focusing on the injured patient. Arguably, it’s where we should have started, but with Samaritan, we’re quickly there.

      • Anonymous

        Honestly I think the doctors rarely know how you are paying unless you ask them “I’m self-pay can I get a discount?”.  Its’ not like my children get worse care cause their doctor is thinking that we are with Aetna and his/her staff will have to submit a claim versus not thinking that because he/she see’s self-pay on the form.  The only place I could see it making a difference is when a doctor is prescribing medication but if you are self-pay you are probably going to be asking the doctor if there is a cheaper alternative anyway.  Our prescription plan is not very good but when it comes to prescribing medication if the doctor looks/comments/etc on our insurance I always make it very clear that I want the best medication for myself/child/etc – not the cheapest.  If there is a cheaper alternative with the same effectiveness great but if not I will pay the difference.  Otherwise I am tying the doctors hands together and not letting him/her treat the condition to the best of his/her ability.  Than again we go over 7.5% of our income in medical expenses every year so I know we will be able to claim the expense and I buy discounted gift cards for Walgreens/Walmart/Sam’s Club so I can save an extra 2-5% off prescriptions. 

  • http://www.fromourfrontporch.net Sherri

    Thanks so much for sharing a real-time experience of how this works! My husband & I are very seriously considering switching from traditional insurance to Samaritan’s. 

    I would love to hear your thoughts on this though… We currently have medical debt (payment plan arrangements) from our last child’s birth (in Oct. of ’10) & are just beginning to pay down a surgery from Mar. of this year. We were kinda thinking it would be a good idea to keep the traditional insurance until we’ve got the debts (yes, the CO-PAYS have indebted us… ugh…) paid off… but at the same time, it looks like our monthly “portion” w/Samaritan’s may actually be LESS then our current premium??? Do you have any advice about a situation like that?

    Thanks again!

  • Pingback: What kind of health insurance do you carry?()

  • Jcgertner

    Hello! I just wanted to add an AMEN to this post.  We are part of the Samaritan program & this month the Jeub family sent their monthly share to us! Thank you Jeubs!  Our need covered the birth of our 6th child, Brandon. 

    We have been blessed by Samaritan Ministries for several years now & through several different needs. I highly recommend this for families desiring to use their money to bless others of like faith & practice!
    The Gertner Family

    • http://www.jeubfamily.com Chris Jeub

      Very cool! This is a wonderful community.

  • Missy

    I don’t quite understand your statements about the 35-6@sherribarth:disqus 
    % “upcharge”, and the fact that doctors slash their fees when you are “self pay”.  When I was hospitalized last fall with pnuenomia on a high risk ward, my hospital bill alone was $30,000 for 3 days (including the ER visit which resulted in the admission).  Do you know how much my insurance paid?  About $2,000.  Do you know how much I paid?  Nothing.  So while the billed rate (what you call the upcharge) IS high, insurance companies are paying far, far less than you do as self-payers.

    Sorry, I’ll keep my insurance.  DH spent 27 years in the Army earning it, and I am thankful for it everyday.

  • julie

    In Canada, we avoid the insurance night mare. Everyone gets the medical attention they need reguardless of ability to pay. I have nine kids, had 3 c sections, a preemie at 31 weeks , a diabetic type 1 daughter, some thyroid, asthma and all we pay is parking here.Which some people have the nerve to complain about. Its like roads maintnance, schools medical care is covered by taxpayers, and we don’t pay excessive taxes. We have a great system here and I hope that you guys can have something similar to Canada we have had our system for years and it has not bankrupted our country. My husband works with inner city addictions recovery ministry without healthcare we would be destitute. I can’t imagine having the stress of medical bills. I would love to move to Florida for warmer weather but I could never live in the US because my 9 year old is diabetic and wouldn’t get the healthcare she needs. All the other first world countries have free health care, England, Astralia, Holland Canada ect . The US needs to catchup