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Joe Bayly: Our Experiences with Scamaritan


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Damn, I keep forgetting how expensive it is to have to pay for medical care out of pocket in the US!  As a Canadian I really don't think twice about taking the kids to the doctor.   We go if we need it.

But holy crap, Samaritan is expensive!  $405 a month!  For private health insurance that covers up to 80% of out of hospital medical expenses and dental/eye care and prescription meds and chiropractic and massages, we are paying about $150 a month, since neither of us are employed full time.  I have no idea how these families can afford Samariran at all. 

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24 minutes ago, treehugger said:

Damn, I keep forgetting how expensive it is to have to pay for medical care out of pocket in the US!  As a Canadian I really don't think twice about taking the kids to the doctor.   We go if we need it.

But holy crap, Samaritan is expensive!  $405 a month!  For private health insurance that covers up to 80% of out of hospital medical expenses and dental/eye care and prescription meds and chiropractic and massages, we are paying about $150 a month, since neither of us are employed full time.  I have no idea how these families can afford Samariran at all. 

Samaritan is often cheaper for these fundie superfamilies because of the number of dependents involved. That $405/month is for any family larger than 3 people, whereas a normal (self-paid) insurance policy would likely make you pay per person on the policy. If you had 12 dependents, that's a huge premium.

This is the worst part of SM to me:

Many families with a middle-class income and lots of children will pay little to nothing out of pocket for medical coverage under Obamacare once you take all of the credits and subsidies into account. For those of us within that demographic, Samaritan will cost more than an Obamacare plan. The place where this really comes home is with children's doctor visits. If you've been on government programs or had very good insurance, it's possible that you never think twice about taking your children in to see the doctor. On Samaritan, you will. Routine visits, which can easily cost between $100 and $250, are not shareable, and so you simply have to pay for them out of pocket. And, of course, children get sick all the time: ear aches, colds and coughs, etc. With Samaritan, you'll think twice about whether or not you really need to take your son or daughter in, or whether you'll wait another week to see if the cough goes away.

They actively encourage participants to choose the riskiest measures if they want their expenses covered, often involving children who have no voice in their medical care. It's the same with childbirth; most expenses under $350 are not shareable at all, but if you choose a homebirth or VBAC instead of that scheduled c-section, you can get 100% of expenses covered. They take the complete opposite road than most real insurance companies. One of the biggest benefits of Obamacare, I think, is the emphasis on getting preventive care and having it covered 100%. SM would rather have you wait until the little problems become big, expensive problems, then have their members try to reduce costs after the fact.

Yes, the prohibition of sharing unbiblical treatments and procedures saves money. So do the reasonable policies, such as "no tobacco." Undoubtedly limiting membership to Christians who are members in good standing in a local church, and requiring accountability to your church leaders, also keeps costs down.

We save money through discrimination! It's exactly like the story of the Good Samaritan, except it's the exact opposite.

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My insurance has mandatory preventative care.  If you dont get your (free) annual checkup you have to pay an additional $50.  Its completely nonsensical to encourage people to wait until small problems become large so they are "shareable."  It should mandate that you take care of yourself in the same way that they prohibit the other "risky" behaviors. 

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6 minutes ago, Buzzard said:

My insurance has mandatory preventative care.  If you dont get your (free) annual checkup you have to pay an additional $50.  Its completely nonsensical to encourage people to wait until small problems become large so they are "shareable."  It should mandate that you take care of yourself in the same way that they prohibit the other "risky" behaviors. 

Noted expert in everything Dr. Kim Coghlan disagrees!

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3 hours ago, slickcat79 said:

Samaritan is often cheaper for these fundie superfamilies because of the number of dependents involved. That $405/month is for any family larger than 3 people, whereas a normal (self-paid) insurance policy would likely make you pay per person on the policy. If you had 12 dependents, that's a huge premium.

You are right, I didn't think of that. We only have two kids.  That would make a difference. 

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There is nothing more unChristian and unBiblical than the Samaritan Health Plan.  Christians are not called to make judgements on other people's health.  The fact they will exclude so many people for smoking, obesity, etc makes a mockery of the command to do for the least of your brothers and sister.  The Samaritan never asked the guy beat up on the side of the road whether he smoked or drank, he just picked him up and nursed him back to health.  To even put the name "Samaritan" on that scam is blasphemy.

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31 minutes ago, AreteJo said:

There is nothing more unChristian and unBiblical than the Samaritan Health Plan.  Christians are not called to make judgements on other people's health.  The fact they will exclude so many people for smoking, obesity, etc makes a mockery of the command to do for the least of your brothers and sister.  The Samaritan never asked the guy beat up on the side of the road whether he smoked or drank, he just picked him up and nursed him back to health.  To even put the name "Samaritan" on that scam is blasphemy.

Lifestyle judgments aside, they even exclude things like known medical conditions in adopted children. Which is seriously wrong on so many levels. 

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4 hours ago, treehugger said:

Damn, I keep forgetting how expensive it is to have to pay for medical care out of pocket in the US!  As a Canadian I really don't think twice about taking the kids to the doctor.   We go if we need it.

But holy crap, Samaritan is expensive!  $405 a month!  For private health insurance that covers up to 80% of out of hospital medical expenses and dental/eye care and prescription meds and chiropractic and massages, we are paying about $150 a month, since neither of us are employed full time.  I have no idea how these families can afford Samariran at all. 

$400 is pretty inexpensive compared to what a lot of people are paying. We have a high deductible now with low monthly premium, but before switching we were paying more than$1000/month for me, dh and 3 dependents (the max we had to pay for). I've heard of others paying much more, dh works for a large corporation with excellent benefits.

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5 hours ago, treehugger said:

Damn, I keep forgetting how expensive it is to have to pay for medical care out of pocket in the US!  As a Canadian I really don't think twice about taking the kids to the doctor.   We go if we need it.

But holy crap, Samaritan is expensive!  $405 a month!  For private health insurance that covers up to 80% of out of hospital medical expenses and dental/eye care and prescription meds and chiropractic and massages, we are paying about $150 a month, since neither of us are employed full time.  I have no idea how these families can afford Samariran at all. 

We have insurance through my husband's job (we live in the U.S.) and we spend quite a bit more than $405 a month.

Yeah, insurance is expensive here and I am very envious of your insurance situation in Canada.  We thought we were heading in Canada's direction when Obama's insurance plan passed, but for some of us it got more expensive!

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I have personal experience with patients that participate in medical sharing programs, they all have unrealistic expectations of how much the bill is going to be discounted. Any provider, hospital and health care center that accepts Medicare or Medicaid can only discount the bill to that level, if you discount below that you can lose your accreditation. Period end of story. Health care clinic that I work at with my students (NP and PhD BSRN) the cash pay prices are already at Medicare/Medicaid rates so we do not discount at all, which is hard for these patients to accept. Regarding the Home Birth issue, at least in AZ NPMW (totally different from Jill the person has a BSRN then additional 2-3 yrs of training you need something more than a GED) would like to do home births and we did them until about 13 yrs ago however the medical malpractice carrier refused to cover us so we had to quit, in certain cases it is the best. Guidelines were stricter than they are now, I wish they would go back to the tougher guidelines then my life would be easier. I am going to be on call in the ER OB/GYN this weekend I will have at least three- five transfer, two of them will be VBAC and the patient will have been in labor for at least 48 hrs and they will have failure to progress and someone will be in trouble another emergency C-section will take place, father will pass out. One will be a first birth that does not progress or the fetus will flip at the last minute and refuses to go back. Other two will be postpartum issues. Then I will have a couple that show up who have not had any prenatal care and are in active labor. I am so much looking forward to the weekend. By the way if anyone wants a copy of the KJV and other bibles, we have about 100 of them that people either leave behind or send to us because we are all sinners and need to be saved, no we all have ADHD and want you and your fetus to live. Free to anyone they are going into the trash this weekend we are cleaning the lost and found this weekend, this is three months supply.

Off to call room-new residents should be fun.

 

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Quote

Americans simply assume that healthcare is a right

Well, it's a little hard to have life, liberty and the pursuit of happiness if you're dead.

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One of the problems I have encountered paying over $1000 a month for 2 adults and 1 dependent is the plan can cover all sorts of great stuff but where are the doctors and hospitals to do these tests and checkups? My city has over 100k people and forget preventative care, well checks for kids and yearly check ups for adults are schedule 6-9 months out. Our area has a lack of PCP and now specialists. I'm getting scared for emergency care now. Our only ER is bar bones, meaning they make sure you are stable and then you are out with no follow up help. My child had a seizure for the first time. The ER said he looks fine and told us to leave. Waiting lists for neurology are over a year since we have 1 neurologist for over 250k people and many are retired .We drove 650 miles for to see an adult neurologist for our child  after 6 weeks just to get some basic answers and we only got that appointment because of a snow cancellation.

 

I also was in total shock when the only 24 pharmacy for a 400 miles stretch decided to have normal hours. I do have incredible prescriptions coverage but there are no pharmacies open after 8pm or on holidays. I found this out the hard way on Dec 23rd at 9pm when I went to pick up antibiotics and found the next time I could pick up was Dec 26th at 9am! The sign in the window at the pharmacy says the next closest pharmacy open in your state is Provo Utah (which is 250 miles each way!) or out of state is North Las Vegas (125 miles each way).

 

Our city has decided to solve the problem by opening a for profit medical school next year. This makes NO sense. Our hospital is not a teaching hospital so students will have to find 3rd-4th year rotations out of state. Will they even find residency placements and what makes the city think these doctors will want to stay here? The doctor turn over rate is so high and the factors causing the turnover rate are not being addressed.

 

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I don't get it.  The guy says he recommends Scamaritan but the whole article reads like a laundry list of why you shouldn't join.  Also, WTF is up with the thing where they have to negotiate a better price for all services from their health provider?  That's awful.  Doctors are professionals, they've had a heck of a lot of training and a heck of a lot of expenses, and I'm not going to haggle with them about if they're worth $65 or $100.  That's why I have insurance.  Is it possible that some doctors lower the price for these people just to get them to shut up and go away?  Also, does this guy understand that not all medical practitioners are Christian?  Because yes, I have a heck of a lot more faith in the US government and courts than I do in the word of a 1,000 'good Christians'.  It's a matter of 'you'll have to show up in court and may face penalties' as opposed to 'this invisible deity in the sky will smite you!'.

Of course, I'm biased, because I live in the Boston area where we have amazing health care for rich and poor alike.  And I literally just found out 2 weeks ago that not all hospitals were teaching hospitals, because every hospital that I've ever been to is one, and when someone says they're a resident, you ask what med school, not what community.

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And he points out the 2 families that used Medicaid to pay their bills, so..... apparently its ungodly to have the government pay for your healthcare until you need them to pay for your healthcare.

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24 minutes ago, anachronistic said:

I don't get it.  The guy says he recommends Scamaritan but the whole article reads like a laundry list of why you shouldn't join.  Also, WTF is up with the thing where they have to negotiate a better price for all services from their health provider?  That's awful.  Doctors are professionals, they've had a heck of a lot of training and a heck of a lot of expenses, and I'm not going to haggle with them about if they're worth $65 or $100.  That's why I have insurance.  Is it possible that some doctors lower the price for these people just to get them to shut up and go away?  Also, does this guy understand that not all medical practitioners are Christian?  Because yes, I have a heck of a lot more faith in the US government and courts than I do in the word of a 1,000 'good Christians'.  It's a matter of 'you'll have to show up in court and may face penalties' as opposed to 'this invisible deity in the sky will smite you!'.

Of course, I'm biased, because I live in the Boston area where we have amazing health care for rich and poor alike.  And I literally just found out 2 weeks ago that not all hospitals were teaching hospitals, because every hospital that I've ever been to is one, and when someone says they're a resident, you ask what med school, not what community.

Most Dr's have a cash price. They have to charge twice as much because of insurance, and the fact formulas they use to determine how much a dr gets paid. The Dr's have negotiated rates with the ins companies, all different of course. With a high deductible plan it sometimes works out better to pay out of pocket for things if its early in the year. For a visit I had with my primary care md I paid$145 for the cash price, they billed price was$360. Most places I've gone much prefer to get a cash laundry than deal with an insurance company, and the cash price is significant, often as much as 75% less.

Some types of visits we can then file with our insurance to apply towards our deductible. But some things you cannot. 

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Here is the biggest secret in the medical community- always ask for the medicare rate it is the lowest.

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40 minutes ago, desertvixen said:

I also love that joining Samaritan is based on "principals"..

5 out of 4 public school principals agree. :pb_rollseyes:

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There was a period of time where I didn't have insurance, didn't qualify for state insurance, and couldn't afford private insurance.  In theory I thought Scamaritan sounded great.  I went to my pastor to get the paper signed saying I was a member in good standing.  He refused.  He worked in the medical field, he was a nurse.  He told me about the medicaid thing, and helped me find a job with insurance.  It said a lot to me when a pastor said, "UMM NO!" 

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It seems like such an unchristian attitude too that they will only pay for medical care if the person has been living up to their standards. Did they miss the entire point of the parable of the good Samaritan?

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31 minutes ago, Rachel333 said:

It seems like such an unchristian attitude too that they will only pay for medical care if the person has been living up to their standards. Did they miss the entire point of the parable of the good Samaritan?

Not to mention that they will flat out deny coverage to anyone with an ongoing medical issue. I think it was in the comments of one of Erika Shupe's posts about Scamaritan where a few women mentioned that they were denied coverage due to their children's issues (one was autism, can't remember the other). So you can pretty much only get covered if you're already in perfect health AND you're an upstanding Christian. How convenient. :|

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Honestly, that article highlights both what a scam Scamaritan is and how fucked-up the U.S. health care system is. It scares the crap out of me.

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10 hours ago, slickcat79 said:

Lifestyle judgments aside, they even exclude things like known medical conditions in adopted children. Which is seriously wrong on so many levels. 

What. The. Fuck.

They really should be renamed Asshole Ministries. Even the most bureaucratic, inflexible insurance companies aren't that heartless.

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Even the article mentioned that the cost of the baby's ongoing issues would not have been covered by Scamaritan. So much for pro-life.

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