lionsimba
Junior Member
Posts: 85 
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Post by lionsimba on Oct 9, 2015 16:00:28 GMT
I got the dreaded letter that my family's current health plan (that I spent HOURS switching over to last year at this time) will no longer be available come January. I have to switch plans yet again. I'm tired of this. And I'm almost positive that a new plan will mean another big premium increase.
So I've heard about Medi-Share and SMI and they are intriguing. Does anyone here use one of these organizations? What I can read about them online looks promising but I'd really like to hear from people who are members to find out if they are truly happy and if the plans save them money.
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georgiapea
Drama Llama
Posts: 6,846
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Post by georgiapea on Oct 9, 2015 18:37:13 GMT
SMI is the most interesting form of health 'insurance' I've ever heard of. For those as uninformed as I was 5 minutes ago, you pay other people's health care costs. You have a set monthly payment, but it goes to the person the organization directs you to pay. I'm sure some people would not like that concept but to me it sounds great. Then if I have a medical situation the organization would direct other's to send money to cover my own bills.
I hope we have actual Peas who are part of this program because I'm just responding from my Google search.
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Post by AR Scrapper on Oct 9, 2015 18:51:19 GMT
We don't use it now, but we have used Samaritan Ministries previously. And yes Georgiapea you are correct. You pay your monthly "premium each month to the persons "need" you are directed to. It was always neat feeling like your "premium" was actually going towards something instead of simply throwing away your money each month just incase you needed insurance. SMI specifically isn't for everyone as you must be a member of a local church to join (you have to get a form filled out by your pastor to prove you attend church and I believe you have to agree to a statement of faith. But if you are a member of a local church and can agree to their statement of faith than its a great option for insurance. We never had to use the coverage while we had it (2 years), but several of my friends have. You negotiate a cash discount with your dr and then you submit all the bills in to SMI. It takes about 60 days I believe but then you get checks from members and often notes and cards of encouragement from them. Let me know if you have any other questions.
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lionsimba
Junior Member
Posts: 85
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Post by lionsimba on Oct 9, 2015 19:08:58 GMT
We don't use it now, but we have used Samaritan Ministries previously. And yes Georgiapea you are correct. You pay your monthly "premium each month to the persons "need" you are directed to. It was always neat feeling like your "premium" was actually going towards something instead of simply throwing away your money each month just incase you needed insurance. SMI specifically isn't for everyone as you must be a member of a local church to join (you have to get a form filled out by your pastor to prove you attend church and I believe you have to agree to a statement of faith. But if you are a member of a local church and can agree to their statement of faith than its a great option for insurance. We never had to use the coverage while we had it (2 years), but several of my friends have. You negotiate a cash discount with your dr and then you submit all the bills in to SMI. It takes about 60 days I believe but then you get checks from members and often notes and cards of encouragement from them. Let me know if you have any other questions. This is exactly how I understand it to work, and it seems awesome. We have been paying almost $1,000 / month for insurance for our family of 6, and with SMI it would cost us $405 / month. I'd love to know how easy / hard it is to handle the checks and bills. We don't go to the dr. all the time, but when we do I don't want it to be a hassle. Thanks so much for your insight! Out of curiosity, why do you no longer use SMI? |
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Post by rst on Oct 9, 2015 19:43:34 GMT
SMI sounds like a great option for situations where you have low liklihood of high expenses. I wonder how they would feel about our family, where my DS just racked up $100,000 with 9 days in the ICU, and my DH has $1000 clinic visits every 6 weeks?
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Peamac
Pearl Clutcher
Refupea # 418
Posts: 4,240
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Post by Peamac on Oct 9, 2015 19:49:33 GMT
We dropped Medishare and switched to Samaritan. Much less headache, better rates, and they cover more than Medishare does.
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Post by kellybelly77 on Oct 9, 2015 19:59:20 GMT
I have never used any sort of medi share program but I can tell you from a regulatory standpoint they are a nightmare. I worked in insurance regulation for years and we received so many complaints that they did not pay the bills like they were supposed to. But, because it wasn't insurance we didn't regulate them and could not help the citizens who came to our office for assistance. Never in a million years would I recommend one of these programs.
Also, this would not meet the definition of insurance coverage for the IRS so you and your family would be paying the penalty. Which for 2016 is $695 per person ($347.50 per child) or 2.5% of your income, whichever is higher.
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lionsimba
Junior Member
Posts: 85
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Post by lionsimba on Oct 9, 2015 20:03:35 GMT
I have never used any sort of medi share program but I can tell you from a regulatory standpoint they are a nightmare. I worked in insurance regulation for years and we received so many complaints that they did not pay the bills like they were supposed to. But, because it wasn't insurance we didn't regulate them and could not help the citizens who came to our office for assistance. Never in a million years would I recommend one of these programs. Also, this would not meet the definition of insurance coverage for the IRS so you and your family would be paying the penalty. Which for 2016 is $695 per person ($347.50 per child) or 2.5% of your income, whichever is higher. According to everything I've read, they do comply with the law and members pay no penalties. It's on the front page of the website. |
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lionsimba
Junior Member
Posts: 85
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Post by lionsimba on Oct 9, 2015 20:07:25 GMT
We dropped Medishare and switched to Samaritan. Much less headache, better rates, and they cover more than Medishare does. Interesting. Can I ask what the size of your family is and how often you use it? Have you ever had any issues? Is it a hassle to submit needs? |
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Post by kellybelly77 on Oct 9, 2015 20:17:13 GMT
I have never used any sort of medi share program but I can tell you from a regulatory standpoint they are a nightmare. I worked in insurance regulation for years and we received so many complaints that they did not pay the bills like they were supposed to. But, because it wasn't insurance we didn't regulate them and could not help the citizens who came to our office for assistance. Never in a million years would I recommend one of these programs. Also, this would not meet the definition of insurance coverage for the IRS so you and your family would be paying the penalty. Which for 2016 is $695 per person ($347.50 per child) or 2.5% of your income, whichever is higher. According to everything I've read, they do comply with the law and members pay no penalties. It's on the front page of the website. I apologize, you are correct, I pulled up the exemption list for the individual mandate and religious ministries are exempt from the penalty.
However, they are not insurance so they are not subject to the laws that govern insurance companies. We had numerous problems and had to refer the people to our State's Attorney Generals office for assistance in getting claims paid. While I am sure there are some laws that govern them in my experience they are more trouble than they are worth.
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Deleted
Posts: 0
Aug 18, 2025 20:58:31 GMT
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Post by Deleted on Oct 9, 2015 20:19:05 GMT
I got the dreaded letter that my family's current health plan (that I spent HOURS switching over to last year at this time) will no longer be available come January. I have to switch plans yet again. I'm tired of this. And I'm almost positive that a new plan will mean another big premium increase. So I've heard about Medi-Share and SMI and they are intriguing. Does anyone here use one of these organizations? What I can read about them online looks promising but I'd really like to hear from people who are members to find out if they are truly happy and if the plans save them money. My family have been Samaritan members for 14 years. I gave birth to one son and survived a broken knee with surgery by using Samaritan--those are the big events...there have also been the usual small medical events along the way. Feel free to PM me. (My husband was featured in the Samaritan promotional video.) |
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lionsimba
Junior Member
Posts: 85
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Post by lionsimba on Oct 9, 2015 20:20:33 GMT
According to everything I've read, they do comply with the law and members pay no penalties. It's on the front page of the website. I apologize, you are correct, I pulled up the exemption list for the individual mandate and religious ministries are exempt from the penalty.
However, they are not insurance so they are not subject to the laws that govern insurance companies. We had numerous problems and had to refer the people to our State's Attorney Generals office for assistance in getting claims paid. While I am sure there are some laws that govern them in my experience they are more trouble than they are worth.
No problem, I'm just learning about all of this as I go so I'm trying to find out all the good and bad and that is definitely something I checked out. So what types of claims were typically denied? I know these organizations only post positive experiences online so I want to be prepared for the reality of how they work. My family is blessed to have no major health issues aside from my daughter's food allergies and EoE, but you never know what will happen in the future. |
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lionsimba
Junior Member
Posts: 85
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Post by lionsimba on Oct 9, 2015 20:21:46 GMT
I got the dreaded letter that my family's current health plan (that I spent HOURS switching over to last year at this time) will no longer be available come January. I have to switch plans yet again. I'm tired of this. And I'm almost positive that a new plan will mean another big premium increase. So I've heard about Medi-Share and SMI and they are intriguing. Does anyone here use one of these organizations? What I can read about them online looks promising but I'd really like to hear from people who are members to find out if they are truly happy and if the plans save them money. My family have been Samaritan members for 14 years. I gave birth to one son and survived a broken knee with surgery by using Samaritan--those are the big events...there have also been the usual small medical events along the way. Feel free to PM me. (My husband was featured in the Samaritan promotional video.) Awesome! I'm going to send you a pm. Thanks!  |
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Deleted
Posts: 0
Aug 18, 2025 20:58:31 GMT
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Post by Deleted on Oct 9, 2015 20:22:24 GMT
I have never used any sort of medi share program but I can tell you from a regulatory standpoint they are a nightmare. I worked in insurance regulation for years and we received so many complaints that they did not pay the bills like they were supposed to. But, because it wasn't insurance we didn't regulate them and could not help the citizens who came to our office for assistance. Never in a million years would I recommend one of these programs. Also, this would not meet the definition of insurance coverage for the IRS so you and your family would be paying the penalty. Which for 2016 is $695 per person ($347.50 per child) or 2.5% of your income, whichever is higher. That is not correct information. The ACA law was written with a clause that allows med-needs sharing families to be exempt from the penalties. |
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Post by AR Scrapper on Oct 9, 2015 21:31:04 GMT
We don't use it now, but we have used Samaritan Ministries previously. And yes Georgiapea you are correct. You pay your monthly "premium each month to the persons "need" you are directed to. It was always neat feeling like your "premium" was actually going towards something instead of simply throwing away your money each month just incase you needed insurance. SMI specifically isn't for everyone as you must be a member of a local church to join (you have to get a form filled out by your pastor to prove you attend church and I believe you have to agree to a statement of faith. But if you are a member of a local church and can agree to their statement of faith than its a great option for insurance. We never had to use the coverage while we had it (2 years), but several of my friends have. You negotiate a cash discount with your dr and then you submit all the bills in to SMI. It takes about 60 days I believe but then you get checks from members and often notes and cards of encouragement from them. Let me know if you have any other questions. This is exactly how I understand it to work, and it seems awesome. We have been paying almost $1,000 / month for insurance for our family of 6, and with SMI it would cost us $405 / month. I'd love to know how easy / hard it is to handle the checks and bills. We don't go to the dr. all the time, but when we do I don't want it to be a hassle. Thanks so much for your insight! Out of curiosity, why do you no longer use SMI? We don't use it anymore because we moved and have great insurance through my husbands work currently, but I wouldn't hesitate to use them again in the future if our situation ever changed. |
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Post by kellybelly77 on Oct 9, 2015 22:25:14 GMT
I have never used any sort of medi share program but I can tell you from a regulatory standpoint they are a nightmare. I worked in insurance regulation for years and we received so many complaints that they did not pay the bills like they were supposed to. But, because it wasn't insurance we didn't regulate them and could not help the citizens who came to our office for assistance. Never in a million years would I recommend one of these programs. Also, this would not meet the definition of insurance coverage for the IRS so you and your family would be paying the penalty. Which for 2016 is $695 per person ($347.50 per child) or 2.5% of your income, whichever is higher. That is not correct information. The ACA law was written with a clause that allows med-needs sharing families to be exempt from the penalties. Please see my correction several posts below my original. |
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Post by kellybelly77 on Oct 9, 2015 22:35:11 GMT
I apologize, you are correct, I pulled up the exemption list for the individual mandate and religious ministries are exempt from the penalty.
However, they are not insurance so they are not subject to the laws that govern insurance companies. We had numerous problems and had to refer the people to our State's Attorney Generals office for assistance in getting claims paid. While I am sure there are some laws that govern them in my experience they are more trouble than they are worth.
No problem, I'm just learning about all of this as I go so I'm trying to find out all the good and bad and that is definitely something I checked out. So what types of claims were typically denied? I know these organizations only post positive experiences online so I want to be prepared for the reality of how they work. My family is blessed to have no major health issues aside from my daughter's food allergies and EoE, but you never know what will happen in the future. Specifically, I don't remember, it's been a few years since I worked in that role. But mostly what I remember is that the claims were too large or that the members were expecting money that never came. Also, since they are not insurance there is no close regulatory oversight and no financial oversight to ensure solvency like you have with regular insurance companies. At the Kansas Insurance Dept there is a whole division of people that look at financials to ensure companies are solvent and there are measures in place to protect consumers if the company is not to ensure that claims are paid regardless. In medi shares you are basically at the whim of others to make sure your medical bills get paid. I understand that they may work for some people but I personally would never take the risk for my family. But I realize that not everyone has the same circumstances and may not have access to group health insurance. I guess its a "YMMV" situation. Was your plan that was cancelled a Marketplace plan? I looked at plans for my family and just for myself last year just to see what was out there and I found several for my family that were around $600 per month. My employer charges more than that for family coverage for a high ded plan! |
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Peamac
Pearl Clutcher
Refupea # 418
Posts: 4,240
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Post by Peamac on Oct 9, 2015 23:55:22 GMT
We dropped Medishare and switched to Samaritan. Much less headache, better rates, and they cover more than Medishare does. Interesting. Can I ask what the size of your family is and how often you use it? Have you ever had any issues? Is it a hassle to submit needs? - When we first got Medishare, I think we had 18yo dd, 16 yo dd, DH, and I on it. DD#1 was away at college. We never had to submit needs for anything. When we did have to go to a dr. (pre-college checkup, allergist), I told the doctors that we were self-pay and they were careful not to order extra tests (they also gave us a few free samples). I think we also got a discount b/c we paid right away. Every year the oldest person in the household has to get height, weight, blood pressure, cholesterol, HbA1c tested and it all has to be within a certain range or you will be charged $80-90 more a month. No matter what we did with diet, exercise, supplements, etc. DH's bp and cholesterol were always a tad too high, even though he was in good health. He always got so stressed when he had to get the tests done, it only made his numbers worse. This past summer we switched to Samaritan- they don't require the yearly tests, they actually cover more medical issues than Medishare, and DD#1 (who is now 23 yo) is still able to be on our plan. When we first joined Medishare, they allowed adult unmarried kids in school to still be on the parents' plan (up to age 24 or 25), but they recently changed that. DD#1 is in grad school full-time, works very part-time, and if she had her own policy with Medishare, we'd have to pay over $100 a month. And our family plan payment wouldn't go down, even though we'd only be mom, dad, one child. Plus they raised the prices on our family plan last year. With Samaritan, DD#1 can be on our plan till age 25yo I think. By that time she'll be out of grad school and probably married, so then it will be just DH and I (DD#2 is getting married in the spring). Then our payments will go down b/c we'll be a 2 person family. We do have to write and mail a check each month instead of paying online (like we did with Medishare), but with Medishare there were a few months where the payment wasn't received or credited properly and we had to call the company. With Medishare you have to use their credit union to make the online payments. Also with Samaritan, you can pay a little extra each month for more catastrophic coverage, if it becomes necessary. I'm thinking that when both DDs are off our policy, we might do that. DH turned 50 yo this year, and I'm 48. We have friends who've had Samaritan for over 20 years and they really like it. They have 5 kids, all active in sports and they still use it. They had a week-long hospital stay for one of their newborns and Samaritan covered it all with no problems, I believe. Hope that helps a bit- we've never had to submit needs to either one, but just reading the info from Samaritan, it seems a lot easier than with Medishare. ETA- our family share is $405/month. I forget what it would be if we stayed with Medishare. I know it would be more b/c of DD#1 needing her own plan. |
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Deleted
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Aug 18, 2025 20:58:31 GMT
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Post by Deleted on Oct 10, 2015 1:15:58 GMT
A couple other things I forgot to mention, lionsimba.
A rate increase is voted on by the membership. It spelled out in a process. You will never be surprised that a rate hike has arbitrarily been sprung on you. I don't remember specifically but it's been a couple of years I think since the last rate increase.
Also since it's not at all tied to employment, there's no worry about what happens if you change jobs, lose your position, decide to move to another state, etc.
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Post by katieanna on Oct 10, 2015 4:37:07 GMT
I got the dreaded letter that my family's current health plan (that I spent HOURS switching over to last year at this time) will no longer be available come January. I have to switch plans yet again. I'm tired of this. And I'm almost positive that a new plan will mean another big premium increase. Yep, I just got a letter this week from my ins co informing me of the same thing, just like last year. Last year's new plan meant a premium increase w/less benefits and I bet the new one will mean the same thing. I'm not familiar w/the Samaritan plan but will check into it. Thanks for posting! |
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lionsimba
Junior Member
Posts: 85
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Post by lionsimba on Oct 10, 2015 12:24:27 GMT
Interesting. Can I ask what the size of your family is and how often you use it? Have you ever had any issues? Is it a hassle to submit needs? - When we first got Medishare, I think we had 18yo dd, 16 yo dd, DH, and I on it. DD#1 was away at college. We never had to submit needs for anything. When we did have to go to a dr. (pre-college checkup, allergist), I told the doctors that we were self-pay and they were careful not to order extra tests (they also gave us a few free samples). I think we also got a discount b/c we paid right away. Every year the oldest person in the household has to get height, weight, blood pressure, cholesterol, HbA1c tested and it all has to be within a certain range or you will be charged $80-90 more a month. No matter what we did with diet, exercise, supplements, etc. DH's bp and cholesterol were always a tad too high, even though he was in good health. He always got so stressed when he had to get the tests done, it only made his numbers worse. This past summer we switched to Samaritan- they don't require the yearly tests, they actually cover more medical issues than Medishare, and DD#1 (who is now 23 yo) is still able to be on our plan. When we first joined Medishare, they allowed adult unmarried kids in school to still be on the parents' plan (up to age 24 or 25), but they recently changed that. DD#1 is in grad school full-time, works very part-time, and if she had her own policy with Medishare, we'd have to pay over $100 a month. And our family plan payment wouldn't go down, even though we'd only be mom, dad, one child. Plus they raised the prices on our family plan last year. With Samaritan, DD#1 can be on our plan till age 25yo I think. By that time she'll be out of grad school and probably married, so then it will be just DH and I (DD#2 is getting married in the spring). Then our payments will go down b/c we'll be a 2 person family. We do have to write and mail a check each month instead of paying online (like we did with Medishare), but with Medishare there were a few months where the payment wasn't received or credited properly and we had to call the company. With Medishare you have to use their credit union to make the online payments. Also with Samaritan, you can pay a little extra each month for more catastrophic coverage, if it becomes necessary. I'm thinking that when both DDs are off our policy, we might do that. DH turned 50 yo this year, and I'm 48. We have friends who've had Samaritan for over 20 years and they really like it. They have 5 kids, all active in sports and they still use it. They had a week-long hospital stay for one of their newborns and Samaritan covered it all with no problems, I believe. Hope that helps a bit- we've never had to submit needs to either one, but just reading the info from Samaritan, it seems a lot easier than with Medishare. ETA- our family share is $405/month. I forget what it would be if we stayed with Medishare. I know it would be more b/c of DD#1 needing her own plan. Thank you so much for this information! I didn't realize college aged children would still be covered, so that's great to hear. |
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Post by ingrid6 on Oct 17, 2015 15:34:54 GMT
lionsimba We have been with Samaritans for about 2 years. We originally switched because at renewal time with Harvard Pilgram our rate increased from $1200.00 per month to $3300 per month with a $5000 per person deductible. Our per month share with Samaritan is $405.00. It covers dh &I, 3 of our college aged kids and our 18 year old daughter. I've opened a separate checking account and take the $800 difference that we were paying and put it in that account to use for small medical expenses that aren't publishable. (prescriptions and routine office visits etc) We have several friends that have been with Samaritan for 10plus years. 2 of the friends have had major medical expenses and all were covered. Samaritans has been a great option for our family. Feel free to pm me if you have any questions
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