Samaritan Ministries: How do you handle maternity bills?

Q. I was wondering how you handle your maternity bills with Samaritan Ministries. We just found out that we will be having our third blessing in Nov! We have been members with Samaritan since Oct 2011 & have never had to process a need. It seems like my doc & the hospital just don’t get what we’re doing & I think our bills are going to suffer for it (we have always paid our bills on time – early actually, so it saddens me that they bristle now that we are “self pay”).

We’ve been happy members of Samaritan Ministries for about 6 years, and I have received many different versions of this question, so when I answered her privately I asked if it would be ok for me to share the response here as well.  Of course she agreed.

A. I don’t use a hospital and doctor for pregnancy, but I can tell you how it works for me and how we have dealt with other doctor bills not related to labor/delivery.
My midwife has a total charge for prenatal/birth/postnatal services, with a significant discount if it is paid in full by 36 weeks.  She does charge separately for a few things, but for the sake of simplicity I asked her to put it all on one bill and she was happy to comply.
Normally, Samaritan members pay their bill if they are able or make payment arrangements as necessary.  It’s fine to explain that you are a member of a Christian medical sharing organization, but don’t expect special treatment.  As far as the provider is concerned, Samaritan members are uninsured, so they work together with us inside that framework.  Of course my midwives have been very understanding and I have been told that they usually gets their money much faster this way than when their customers have traditional health insurance!
I mentioned that normally we pay our bill up front or make arrangements to pay, but with our midwife it’s different.  Because she gives a discount for payment in advance, I contacted Samaritan Ministries and was able to share my need before the services were rendered.  This saved everyone money, which makes me happy.  It also made my midwife happy to have her payment in advance.
In any case, the first thing to do is request a Need Processing form from Samaritan.  This is just a single page where you list your bills and have your pastor/elder sign to verify that the need is genuine.  Having the form on hand allows you to list bills as they arrive.
Then I would suggest telling your providers a little about your situation.  Ask each individual provider if there is a discount for paying in advance for any portion of the bill (maybe your OB charges a set amount and will discount, for example).  Ask if there is a special cash price or self-insured price.  Talk to Samaritan about publishing a portion of your need in advance if it cuts the bill.
Otherwise, pay what you can when billed and make arrangements for the rest.  Keep track of your separate bills, and send in the Need Processing form when you think you’re done – or if you expect a lot of bills over time you can simply get the first batch in line, and submit more later.  :)
It may sound like a lot of fuss and bother, but it’s nothing like the old days when we had to submit our own claims to the insurance company.  Does anyone remember that?  I chose doctors and dentists based on whether they would do the insurance forms for me because it was such a hassle and follow-up was a nightmare!  This is nothing like dealing with an insurance company.  It really is easy, and requires just enough involvement to ensure that a member’s brain is engaged, so we don’t accidentally pay $960 for 57 bars of soap we didn’t use or get charged for an epidural that was never administered.
Once you send in your list of bills, just sit back and wait.  Here’s what happens next:
  1. You’ll receive an acknowledgment that it was received and processed, and they’ll tell you when your need(s) will be published.
  2. Then you’ll receive a checklist telling you exactly who is supposed to send you money and how much.
  3. Now you’ll start receiving checks in the mail directly from other members like yourself.  Most will arrive with cards and/or notes of prayer and encouragement.
  4. If you don’t receive everything by the date on the list, send the checklist back to Samaritan and any unreceived amounts will be assigned to other members the following month.
  5. Use the money to pay your providers, or reimburse yourself if you already paid out of your own pocket.
That’s all the followup that is required on your part.
Does that give you a better idea of how it should work for you?  As always, I strongly recommend calling the office and chatting with them.  They are always friendly, helpful and encouraging, and you can be sure you’re getting the right answers to your questions.

If you decide to join Samaritan Ministries, I would love for you to tell them that you heard about it from Kim Coghlan!

Comments

  1. Jessica says:

    I am self employed and have individual insurance as it is cheaper to do it that way then be on my husbands insurance. We are thinking seriously about joining samaritans ministry. We meet all the requirements ect. We also want to start trying to get pregnant soon. Is there a waiting period after we join before we can get pregnant?

    • Jessica,
      The complete guidelines are available for you to read on the Samaritan site, but I think this is how it works: There is no waiting period for pregnancy, but during the first 12 or 18 months your need will only be shared up to the amount that you have shared with other members. E.g., if you have been a member for 6 months when your baby is born, and your family membership meant that you shared about $400/month for those 6 months, then Samaritan members will pay up to $2,400 of the cost of your baby’s birth.
      Please take time to read the guidelines for yourself or just call. They are very helpful and friendly on the phone!

  2. Hi! Im really interested in joing SM, the only thing is Im a bit confused, can I join if im already pregnant? How would that work? Would it cover the whole cost of my mid wife even though I just joined? Im really tring to avoid getting state pregnancy incurance this time around again, but Its almost impossible for us to pay the mid wife complety out of pocket and medical doesnt pay for midwives anyway:(, any suggestions? Im 8 weeks pregnant. Thank you God bless!

    • You can read the guidelines online, but I think if you are already pregnant when you join, they will pay as much as your own contributions. For example, if you pay a total of $2,400 to other members over the remaining 8 months of this pregnancy, I think Samaritan will share $2,400 of your midwife’s charges. If I’m right, it amounts to free membership for the rest of your pregnancy since you are out of pocket the same amount either way. Not a bad deal!

  3. Thanks for sharing about Samaritan Ministries. My husband and I are considering joining as we just got our new insurance premium for next year and it is going up another $58 a month! We already pay well over $700/mo for us & our 3 kids. I have been wanting to hear what other people say about Samaritan & this was really helpful, especially for maternity needs.

  4. Rose, With Samaritan you do not have to apply for any government aid. We have been with them for about 3 years and have had 2 or 3 claims. Each time we have been reimbursed and had all our bills paid with no Medicaid or any government assistance applied for. If you have questions, the staff at Samaritan is very friendly and will talk through everything with you and your husband. I don’t know the mission behind other heath care sharing, but I do know the hearts behind Samaritan. They truly believe in Christians sharing needs with other Christians. They carry this vision out not only in the business side, but also in their personal lives. (we are friends with many of the staff at Samaritan). It has been a blessing to our family.

  5. Rose Linhardt says:

    How long have you had Samaritan’s? We had Christiancare Medishare – which we thought was a Christian cost sharing program…however, when we had a claim…they insisted we first apply to a government program, I believe it was Medicare or aid. We were very frustrated since we knew we were qualified for it but didn’t believe it was the governments job to pay for our medical needs. Christiancare Nedishare said they believed it was being a good steward of their resources to use those funds first. we believed it was deceptive and why pay for it if teh government would pay either way. We switched to a regular insurance company with a huge deduction to just cover major jedical needs and pay everything else out of pocket. Have you heard or seen similar with Samaritan’s?

    • Hi Rose:

      We at Samaritan strongly discourage the use of government insurance programs like SCHIP and Medicaid. We think it’s the Church’s job to care for our own, not to force people to go to the government for help first. We do have members that choose to use those programs (we can’t force them not to, nor would we) but we never, ever encourage members that direction.

      James Lansberry
      Executive Vice President
      Samaritan Ministries International

    • Rose, we’ve been members for almost 7 years and have had our needs shared 4 times. We’ve never been asked or required to file for government assistance, though I’m sure we would qualify if we could do it in clear conscience. Like you, we don’t believe that paying our medical bills is a legitimate use of taxpayer funds.

  6. Thanks for sharing this post, Kim. We’ve been members of Samaritan for more than a year and have never had a claim. To this point in the pregnancy, we’ve just paid everything out of pocket, but obviously we will eventually turn everything in. Also, we just had a 911 call, ambulance ride and ER visit that we will probably need to work with Samaritan over.

  7. Hi,
    We have Samaritan, and I had a need. It was handled beautifully after the initial getting- used- to- keeping- up with my own medical information and being involved in the claim process. The money came in and my bills were paid in full!

  8. I’ve thought about Samaritan Ministries a bunch since I started reading your blog. Right now my husband and I are insured through our respective parents (Steven is in a volunteer position) but our son is uninsured. All the doctors he has seen so far have given us 10-25% discounts for paying up front. We do not know what we will be doing next year, but we will probably consider Samaritan. Thank you for all the great information, Kim. We will gladly let them know of your “referral” if we join.

  9. We also just had a baby with Samaritan. I got an estimate from the doctor’s office and hospital. Our doctor does not require a Medicaid application, but does require monthly payments paid off by the 8th month. The estimates were published about half way through the pregnancy. We also ended up having complications with the pregnancy ending with an emergency c-section for cord prolapse. In spite of that the hospital bill ended up being less than the estimate after the discount they gave us. The doctor’s bill is considerably more, and there were various other bills related to the several other complications. It was a little confusing, especially knowing what kind of payment plans to set up for all the other bills, but in the end I got it all taken care of! Our remaining bills will be pubished next month, and I’m looking forward to getting them all paid off and not having to think about it anymore. We are very thankful for Samaritan Ministries as my husband doesn’t have insurance through his job, and it would be ridiculously expensive to purchase ourselves. I tell couples getting married that Samaritan is worth having just for the purpose of maternity unless you have really killer insurance!

  10. Samantha says:

    Just a little ‘warning’:

    All the OB’s and hospitals around here (Arkansas) are now *requiring* that couples that are ‘self pay’ apply for Medicaid before they will EVEN DISCUSS payment arrangments. So even when a friend said she was a member of a ‘sharing’ community (not SM, but another) they told her they wouldn’t even talk to her about payment arrangments until she applied for Medicaid. She did, and was denied (they make a bit too much money). They then gave them an estimated bill and divided it by the number of months up to 8 months (at the time she was 4 months, so they wanted the doctor’s bill paid IN FULL, by 8 months. Again, I common practice here by nearly all doctors and hospitals). She ended up having to come up about $300 a month for 4 months just for the OB office.

    The hospital gave her an estimate but didn’t require the money til after the baby was born. She ended up with an emergency C section, so she had to come up with even more money for the OB AND the hospital.

    She was really upset by it and ended up tying her tubes b/c they were so upset by how the hospitals and dr’s offices treated them b/c they were self pay. :(

    This is how *every single doctor’s office* here in our area (within about 2 hours drive) runs their OB practice now. The bill paid in full by 8 months or no service, and a MANDATORY payment every month or they won’t make you an appt.

    My husband is thankful for our insurance, at least that way we only have to come up with our co pay every visit and can pay off the rest later. sigh.

    • Hi Samantha:

      Could you tell me what area you live in? If there’s practices like that going on we’re unaware of it and would gladly work with the providers for our members’ sake. We think the Church can do a great job of taking care of one another and openly discourage our members from seeking Medicaid help.

      You can reply here or email me off board.

      James Lansberry
      James (dot) Lansberry (at) SamaritanMinistries (dot) org

      Executive Vice President
      Samaritan Ministries International

  11. Excellent explanation, Kim. My midwife also discounts for pre-payment and Samaritan makes it so easy! We have had to deal with hospitals and regular doctors since we have been members. Just this past Monday I had to go see my OB since we suspected i may have preeclampsia. When we told him we were self-pay, they discounted our bill if we paid right then. When we have had to use the ER/urgent care, we also tell them we are self pay and they note that on our records. When we get the bill we check to see if it has been discounted. If not I will call the billing office and explain our situation and approx. when they should receive payment. This also lets them know that we are thinking about the bill. The people at Samaritan are wonderful. They will talk you through everything and help in any way they can. We gave up the insurance offered by my husband’s employer because we believe that health care sharing and Samaritan is the way to go. We have been blessed by every need we have had to share and it is a blessing to send money to another family each month.

  12. We’ve had Samaritan since last June, and love it so far. It is less for me and our son (Hubby chews tobacco, so he’s excluded.) that it was for just me to have insurance. We had miscarriage last fall and I was amazed by the outpouring of love and support by both the employees and other members. I remember telling my husband one evening that when I called, they prayed with me. You won’t find that with an insurance company!

    We are now expecting again (yay! 10 weeks), and I’ve already been able to get the need process started. My midwife is giving a big enough discount for being a cash-paying-patient, that in the end, we won’t net any out-of-pocket expenses. That is a HUGE difference from the birth of our son. Even though we had a “really good” insurance plan, we are still making payments on over $6000 in “coinsurance” aka what your insurance sticks you with. And he’s almost two.

    Praise God for Samaritan Ministries!

  13. I’m happy to share my experience with our birth and SM if you want to e-mail me (heather@pagesbyheather (dot) com. We had pre-shared for our midwife, but on the last day we ended up with a footling breech/emergency c-section. We’ve shared the lion’s share of that bill now and are currently getting checks this month. There are just two small bills that will publish next month or May. I feel like I’ve gotten a good education on submitting in the last 8 months or so!

    I know that it seems like a lot and people don’t understand at first, but you are a cash patient and they’ll get more money faster than they do with insurance! Don’t feel bad at all. And don’t forget discounts. We got 40% off from EVERYONE (NICU docs, pathologists, OB, hospital, lab, etc) other than midwife and even she refunded a bunch after the emergency c-section (after sitting with me in recovery as our son was in the NICU…wonderful lady!) The billing people are confused at first as typically they would put you on the state dole or such of you are self-pay, but I think they are shocked, amazed and totally impressed at how SM works in the end.

    And I love SM because with insurance I cried at some point with both my other children (due to frustration) and with SM I cried at one point because I was telling him that my boy didn’t breath for 5 minutes and was in the NICU and everything was okay but telling him made me cry and he just listened and CARED. And when the baby screamed/cried through some of our conversation he said that “Baby cries are a happy sound…that is a joyful noise!” Not like insurance at all…in the best way possible!

  14. I heard a question like this come up on Dave Ramsy’s talk show the other day. If your thinking of using a hospital shop around. Talk to the finance department about the fact your not insured (self pay) and you want the very best price, be willing to pay in advance. He quoted birthing as low as 3k in some places. Cause lets face it I know under my insurance plan Hospital’s only get paid about 10% of their “submitted bills” actual costs are inflated so the hospital do not run in the red. Can’t say as I’ve done it myself since my 2 are adopted… but food for thought.

  15. we have insurance through my husbands work but we are really paying for a discount plan and we can’t cover our kids through it due to the crazy high cost. Our children are on the state program. We hate that but haven’t had any other options. We have read about Samaritan Ministries in the past but really wondered how it worked. I don’t know anyone in real life that is involved in it. It does sound simple though. This has helped a lot. I will be sharing this with my husband maybe we can make that change. I think we would pay the same amount for the family plan that we pay right now for the ‘discount plan’ for only the 2 of us.

  16. Thanks, Kim! This is perfect timing to read this post. We joined in Feb, but I am due in May with #3. I know SM won’t cover everything, but I was so glad to read this and have a better idea of what we will need when we do process a claim.

  17. Thanks for the explanation, Kim. We currently go with regular (?) health insurance, but we’ve been curious about organizations like Samaritan’s Ministries.

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