Joe Bayly: Our Experiences with Scamaritan

[August]

On 9 January 2016 at 9:43 AM, EmainMacha said:

If I had to pay the equivalent of $1000 on top of my rent, childcare and commuting costs I'd barely have enough left for food! Do people's jobs pay it for them?

Also in the article it mentions that the hospital wouldn't perform the operation without knowing how the bill would be paid. Does that mean it wasn't life-saving surgery? Presumbly if the child needed the surgery to survive they would just do it? I do work in healthcare but not the US so I'm not sure how it works.

For us, the $650 is after work has paid roughly $1800 per month. The amount work pays has been about the same for last few jobs, our component is higher at this job, but is an expensive state and this HMO covers just about everything.

Of course, it is still not OK that we get insurance and someone else doesn't. It should be single payer with some deterrent costs for wealthy people.

[August]

1 hour ago, socalrules said:

I just don't understand paying for insurance that does not cover the everyday visits. For most people, they really just need preventative, cold, flu, broken foot type visits. I would rather be able to go to the doctor whenever I wanted than to have to stop and think if I am sick enough to warrant the money because my scam insurance only pays out if there is a catastrophe. 

For us all the preventative, vaccine, birth control visits per year would cost about the same as one months premium. It's the insurance company who benefits financially from these visits by keeping us all healthier.

[countressrascal]

1 hour ago, socalrules said:

I just don't understand paying for insurance that does not cover the everyday visits. For most people, they really just need preventative, cold, flu, broken foot type visits. I would rather be able to go to the doctor whenever I wanted than to have to stop and think if I am sick enough to warrant the money because my scam insurance only pays out if there is a catastrophe. 

They use EO to treat the symptoms and then show up when it doesn't get better or it keeps coming back. Best one I have seen lately is a patient with foot neuropathy being treated with EO however they had advanced type II diabetes undiagnosed because they had a christian medical share program and it would not cover the testing nor the medication, so just treat the neuropathy - diabetes be dammed. Shame of this is that the family could get free medical insurance under the state program but no. My head just hit the wall.

[pamplemousse]

On 1/9/2016 at 7:34 AM, Terrie said:

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.

Pro-life my foot. They only care about the baby until it is out of the womb. After that, if baby has problems, too bad. 

[desertvixen]

@socalrules - I am totally with you on wanting the preventative stuff covered.  Aside from the fact that it helps more people, for those of us who are healthy that's the real benefit.

There is also something to be said for simply taking your kid to the doctor/going yourself without playing games. 

[bea]

I was especially interested in the person who made the point that long-term chronic illnesses are not what Samaritan handles. So, I guess you just hope that you don't develop one, because Scamaritan sure as hell isn't going to pay for your care.

The blog sounds to me like they really really WANT Samaritan to be "the answer" and feel a certain amount of pressure to talk about it favorably, but reality is different than theory. Doctors and hospitals aren't just going to trust that you'll raise the cash for your surgery. Kids need checkups and they get sick and they need vaccines. Preventative care is hugely important and Samaritan doesn't cover it. I found it interesting that the "rah, rah, Samaritan" blog talked mostly about what it didn't cover and how hard it can be when you need medical care and are uninsured. They even mentioned that the bulk of some bills were paid by the evil evil government via Medicaid. It didn't really read as an endorsement of Samaritan, it read like a "looks like insurance/single payer is inevitable, now that we've given this alternative a try. "

Silly people believing they're entitled to healthcare. You sit there and die of easily-treated cancer because you smoked in your 20s, that'll teach you to be Godly. And you over there with T2 Diabetes, well, you must have brought that on yourself (T2 is partially lifestyle relared, but mostly genetic), suck it up.

Assholes.

[CrazyCatLady]

I work for the gov and am so lucky to have great insurance (medical and dental) that only costs me $172 a month to cover both of us.

I use my insurance almost exclusively for preventative care and don't understand why Scamaritan doesn't think preventing problems is worth paying for!

[chaotic life]

1 hour ago, socalrules said: I just don't understand paying for insurance that does not cover the everyday visits. For most people, they really just need preventative, cold, flu, broken foot type visits. I would rather be able to go to the doctor whenever I wanted than to have to stop and think if I am sick enough to warrant the money because my scam insurance only pays out if there is a catastrophe. 

They use EO to treat the symptoms and then show up when it doesn't get better or it keeps coming back. Best one I have seen lately is a patient with foot neuropathy being treated with EO however they had advanced type II diabetes undiagnosed because they had a christian medical share program and it would not cover the testing nor the medication, so just treat the neuropathy - diabetes be dammed. Shame of this is that the family could get free medical insurance under the state program but no. My head just hit the wall.

Sadly, I am guessing no one told them at least metformin and one other DM med are on the $4 plan at Walmart.

[bea]

You can also get older forms of insulin over the counter at Walmart. Even without insurance, and on a fixed income, people manage to keep their blood sugar under control with over the counter materials. It's a lot of work, though, and you need to know some inside secrets.

(This is me refraining from exploding about the US healthcare system and way it can turn people to begging on Facebook, asking strangers to please send them an expired bottle of insulin with half an inch of liquid in it to help them stay alive.)

I had not thought about the fact doctors will look at people without insurance, ask them to come up with a fair chunk of cash before doing surgery. It's logical, though. Doctors, and hospitals, need to be paid. And if someone is without insurance, their chances of being paid even the bare minimum just went down the tubes.

I wonder if there are any statements by doctors or hospitals when it comes to their attitude towards Samaritan? I can't imagine that they look on it all that favorably because it really doesn't cover very much, and doesn't cover any preventive care.

I'm sorry for being lazy and not going to look it up right now, but what does Samaritan do about your visits? Do they decide later if the ER visit is worth reimbursement or not? Or do they just not reimburse ER visits?

[Terrie]

Looked around at some reviews. Noticed that Samaritan fans keep noting the deductable is $300, while many insurance companies are in the thousands, so Samaritan is cheaper! Only the 300 is per visit, while the 3000 is per year. 

[Howl]

And sadly, because many of these people are bare-bones homeschooling, SAHD and not encouraging or preparing their Godly spawn for college, you have even fewer RNs, nurse practitioners, physician assistants, doctors, dentists and dental hygienists and other health care professionals from this demographic.  In other words, if you want to raise Godly spawn, you should prepare at least some of them to meed your damn health needs at the local level. 

[desertvixen]

1 hour ago, Howl said:

And sadly, because many of these people are bare-bones homeschooling, SAHD and not encouraging or preparing their Godly spawn for college, you have even fewer RNs, nurse practitioners, physician assistants, doctors, dentists and dental hygienists and other health care professionals from this demographic.  In other words, if you want to raise Godly spawn, you should prepare at least some of them to meed your damn health needs at the local level. 

But they are!  Look at all the girls getting casual midwife training and selling essential oils, and learning how to make black salve, and learning about the evils of all those horrible medications...

Oh wait, you meant real medical training.  There is legitimate midwife training and then there's what goes on in this world.

[bea]

Briefly, let me derail the conversation. My business involves essential oils. One of the biggest issues I run into is people treating essential oils like medication.

Only they don't treat it like medication in that they have respect for it, are careful with how much they take, and are concerned about side effects. No, because essential oils are "natural," these idiots assume they can take all of them internally, slap them on their skin hither and yon, use them on tampons (I wish I was kidding), use them on infants and children, and put whatever oil they like and whatever combinations they want into diffusers and breathe them in for 24 hours a day.

Essential oils are not supposed to be ingested, applied to skin without significant dilution, and usually not diffused without being very careful about what kind, how much, the dilution, and the ventilation of the room that the person is in. While there have been no confirmed deaths due to essential oils alone, people do end up in the hospital because of ingesting, applying, or breathing in essential oils - the wrong kind, or the wrong combination. There is a report that comes out every year about essential oil injuries, and the number is steadily climbing every year. People are getting their information about essential oils from sales representative, and believing that a sales representative would never lie to them. These sales representatives are trained in selling the most oil they possibly can, which means encouraging people to use up the oils as fast as they can, which means encouraging people to take them internally, use them undiluted on the skin, and do other dangerous things with these incredibly potent oils. These representatives also get no training in safety, or in the legalities of advising people to do stupid things with their products. Essential oils are regulated as perfumes in the United States. Either something is an essential oil, or it is not, there is no such thing as a "graded" essential oil, or an essential oil that is considered more or less pure than any other. The term "therapeutic grade" is actually a registered trademark for one of the multi level marketing companies, it has no actual meaning. None of these companies are selling anything new, or different than any other essential oil company.

Three companies, including doTERRA and Young Living, have been so overt about selling their essential oils as treatment for illnesses that they received formal letters of reprimand from the FDA. The reason? These companies were cleaning that essential oils could prevent you from getting Ebola.

The other issue is that doTERRA and Young Living mark their products up 300 to 500%. No, I did not mean 30 to 50%. And there is a complaint in front of a California judge at the moment, claiming that Young Living's new, ingestible supplements contain lead. They are terrible, terrible companies. The idea that some of these families are using essential oils in the place of actual medicine on their children turns my stomach. Sooner or later, one of these kids is going to get killed.

I will stop derailing the thread here, it's just something I feel really strongly about.

[slickcat79]

7 hours ago, Terrie said:

Looked around at some reviews. Noticed that Samaritan fans keep noting the deductable is $300, while many insurance companies are in the thousands, so Samaritan is cheaper! Only the 300 is per visit, while the 3000 is per year. 

It's not like a deductible at all, it's like a copay. You could (theoretically) have 10 $300 SM "deductibles" in a single month if something different happened to multiple members of the family. 

[bea]

I went to their web page and looked around at the information available. What a horrible, horrible idea. I'm not kidding, I'm serious, I can't understand why anyone would join this. You would get a better deal just staying on insured, and managing your own medical bills. At least that way, you're not on the hook for contributing to other people's medical bills. The biggest selling point for Samaritans seems to be that you can call up and talked with chaplain. Their coverage, so to speak, for mental health is especially egregious. Three 50 minute sessions with a Christian counselor. Has to be Christian. Can't be, say, a professional with a PhD who specializes in treatment of your problem . Or a psychiatrist. Anyway, a psychiatrist wouldn't do you much good anyway, since Samaritan doesn't cover medications. Plus, mental health issues are probably an indication that you're not praying hard enough. Or that you're not a good person. Or maybe, you're not even Christian.

I didn't see anything about HIPPA on the website. Does this mean that Samaritan is under no obligation to keep your medical problems in house? Can they start blabbering about your issues to all of their members?

[halcionne]

35 minutes ago, bea said:

I didn't see anything about HIPPA on the website. Does this mean that Samaritan is under no obligation to keep your medical problems in house? Can they start blabbering about your issues to all of their members?

Every other member of Scamaritan will know your business because that's how you get reimbursed--by stating your "need" in the newsletter everyone gets. Then you get to pray that other members feel moved to send you a check. Scamaritan isn't actually paying your claims, other members are paying you and you pay your bills. There's so much wrong with this, I can't even.

[Et Moi]

It really sounds like they're actively encouraging medical neglect by not covering routine visits and preventive care. 

[August]

18 hours ago, Terrie said:

Looked around at some reviews. Noticed that Samaritan fans keep noting the deductable is $300, while many insurance companies are in the thousands, so Samaritan is cheaper! Only the 300 is per visit, while the 3000 is per year. 

Or don't have deductibles at all.

Quick story: went to the doc yesterday, got prescription for antibiotics for potentially serious, but caught early infection. Stopped at CVS to fill it. Clerk too one look and blanched and asked if I wanted them to check my coverage before they dispensed it. Yes, and is Ok, I paid $8. Come home, look up the cost.

$1000-1500.

Fuck me. Seriously, just fuck me. 

 

With scamaritin, if someone is told to send their money to someone, can they decide that person isn't godly enough and refuse?

[August]

Aha! I knew there had to be a catch, there's no way that every single month ingoing exactly matches with outgoing. From comments on a blog post about 'prorating' - when you only get partly reimbursed because your bill was too big.

Quote

My husband and I have also been on Samaritan for about 3 years now. About 4 months after we joined we found our we were expecting a surprise baby. My most complicated birth to date and $44,000 later, we had our little bundle of joy. Unfortunately, we experience the same situation with the split being 80/20. We were able to MIRACULOUSLY negotiate our bills down to almost $19,000 by paying upfront. (We also delivered at Ohio State University hospital so they were able to write some of the bills off as teaching because of my unique situation with a single artery umbilical cord). We ended up having to front a little more than $4,000 because of the pro-ration and never got anything from the pro-rata fund. I was very disappointed but I know that was a risk I was taking and after being completely uninsured for 5 years, I was glad to not be fronting the ENTIRE bill. God always provides at the right time.
Then, 7 months later, we were back at the hospital with said baby boy because he contacted meningitis. I was much more careful with my bills this time and instead of sending them all in at once, I sent them in as soon as I got them. This helped tremendously as there was only 1 month (out of 3) that were prorated and it was for my smallest of the submissions (we only had to cover $200). Another $17,000 of bills and lot of prayers that were lifted up for our now, very healthy, and almost 2 year old. 

 

Also, read the paperwork in the image at lissaanglin.com/blog/2012/4/11/a-newbies-review-of-samaritan-ministries-christian-healthcar.html

[Emme]

10 hours ago, halcionne said:

Every other member of Scamaritan will know your business because that's how you get reimbursed--by stating your "need" in the newsletter everyone gets. Then you get to pray that other members feel moved to send you a check. Scamaritan isn't actually paying your claims, other members are paying you and you pay your bills. There's so much wrong with this, I can't even.

Yes, someone published their birth in Scamaritan and posted the newsletter to their blog. it was like "Joe was seen for a prostate exam this week" "Bob went to the doctor for their cystic acne" it was weird. Everyone knows your business. I love how they're like "Obama Care is bad but adoption is good but if you adopt a kid that needs anything you're on your own so Obama Care... but it's bad. " That's absurd. 

[Soulhuntress]

11 hours ago, bea said:

 

I went to their web page and looked around at the information available. What a horrible, horrible idea. I'm not kidding, I'm serious, I can't understand why anyone would join this. You would get a better deal just staying on insured, and managing your own medical bills. At least that way, you're not on the hook for contributing to other people's medical bills. The biggest selling point for Samaritans seems to be that you can call up and talked with chaplain. Their coverage, so to speak, for mental health is especially egregious. Three 50 minute sessions with a Christian counselor. Has to be Christian. Can't be, say, a professional with a PhD who specializes in treatment of your problem . Or a psychiatrist. Anyway, a psychiatrist wouldn't do you much good anyway, since Samaritan doesn't cover medications. Plus, mental health issues are probably an indication that you're not praying hard enough. Or that you're not a good person. Or maybe, you're not even Christian.

I didn't see anything about HIPPA on the website. Does this mean that Samaritan is under no obligation to keep your medical problems in house? Can they start blabbering about your issues to all of their members?

The most expensive part for any chronic condition is the maintenance meds.  The copay for any insurance is a fraction of the cash price.  Even with 340b pricing there is a significant out of pocket cost. 

[chaotic life]

I had forgotten about the cheaper insulins that don't require a script! We get our insulin for our clinic free from the pharmaceutical companies for a low income grant and sell it to our patients for a $5 administration fee. But I have a type 1 I need to remind about the old insulins!

US hospitals are required to provide life saving care without clarifying payment. A lot of things would be necessary without being life saving per se. If it's not life saving, then yes they want payment.

[Terrie]

I had to go into Urgent Care last night. After 6 days of a cough and cold, I suddenly spiked a fever of 102. Meds cost me... $3.18. No paperwork or negotiating required.

[desertvixen]

Also, with the whole "personal check" deal, I wonder what recourse you have if the person who's assigned your need sends you a bouncy check. 

[August]

5 hours ago, Emme said:

Yes, someone published their birth in Scamaritan and posted the newsletter to their blog. it was like "Joe was seen for a prostate exam this week" "Bob went to the doctor for their cystic acne" it was weird. Everyone knows your business. I love how they're like "Obama Care is bad but adoption is good but if you adopt a kid that needs anything you're on your own so Obama Care... but it's bad. " That's absurd. 

And of course socialised health care is bad because it would lead to the government knowing your private business (and of course, it doesn't, at all). Exactly how is it modest for a newsletter to publich that I went to the doctor for menstrual cramps? Or vaginismus? Or erectile dysfunction? Or prostatitis?