Nathan and Melanie interviewed about Samaritan Health

[genericJname]

I was skimming their website and it looks like there is a $250 K per illness limit. That would leave a lot of people screwed.

The maximum amount that will be shared among the members for each medical need (i.e illness or injury, see Section VI.A.4) is $250,000. The need has to meet the Guidelines before it can be shared. SMI members are also eligible to participate in another sharing ministry, Save to Share™ , where the rest of needs over $250,000 may be shared. (See Save to Share™ Guidelines.) There is no limit on the number of needs one person may have shared.

[YPestis]

And in Nathan and Melanie's case, it's a good thing her dad is a doctor. I'm sure that reduces costs considerably.

I got the impression her dad is a doctor of divinity or something religiously affiliated, not a medical doctor. Of course, if he was a medical doctor, he'd be very against the very idea of this charity health insurance, especially for his two granddaughters. Physicians are aware of the many things that could go wrong in a person's health, and I know of no physician that want to risk young children's health in such a way. Of course, Nathan and Melenie can always apply for medicaid if they are really desperate and Samaritan doesn't come through.....

What I'm curious about is how do they make sure members abide by the "healthy" living? I mean, are they going to check their credit cards to make sure no alcohol and cigarette purchases were made? What about someone who doesn't exercise but say they do?

So many of our health issues is the result of poor lifestyle choices, but it's not just those that smoke and drink. Eating processed foods, having a sedentary lifestyle, participating in "adventurous" sports. They can all cause a trip to the doctor. Futhermore, Isn't Nathan being extremely naive to assume that everyone pledges to maintain a healthy lifestyle is honest about it?

This "health insurance" is a system where people get medical bill assistance based on how "deserving" they are. If physicians and hospitals only took "deserving" patients, people would be appalled....why do so-called good Christians think this is "biblical"?

[WonderingInWA]

I think if Melanie's dad was a medical doctor, they'd have talked more about him on the blog when they were going through what they did with the baby that died. I guess that's an assumption on my part, but certainly he would have given them guidance, wouldn't he? They never talk much about her family, which is interesting (especially during the baby crisis). I can only hope they are close to them and just don't talk about it publicly.

[NurseNell]

I got the impression her dad is a doctor of divinity or something religiously affiliated, not a medical doctor.

I just learned in another thread he is a chiropractor, and I looked him up. Yep, that's what he is.

[doggie]

I just learned in another thread he is a chiropractor, and I looked him up. Yep, that's what he is.

well insurance does nto usualy cover back crackers,

[GeoBQn]

You have to post your need through the news letter so everyone gets to read about it. Then of course you have to depend on these nasty judgermental skinflint christians to send you their money. they send the money directly to you.

I bet those newsletters are like the reading equivalent of that old 1950's game show, "Queen for a Day."

Since Samaritan Health is only open to Christians, do they want other religions to form their own "health care sharing" plans?

I found these stipulations interesting:

Conditions Cured and 12 Months Symptom and Treatment Free

Needs that result from a condition that existed prior to membership (known or producing observable symptoms) are only publishable if the condition appears to be cured, and 12 months have passed without any symptoms (benign or deleterious), treatment, or medication (even if the cause of the symptoms is unknown or misdiagnosed). Tests or a doctor's statement may be required to verify the lapse of symptoms, treatment, and medication.

Exception: For genetic defects and hereditary diseases, the waiting period is five years and for any previous cases of cancer of the same type, seven years.

Please note: New needs are not considered as "resulting from a condition that existed before membership" unless the prior condition actually caused the new need. SMI may require that the member provide a written opinion from a physician that the current need was not caused by the prior condition. Even though a need may not be publishable because it resulted from a condition existing before membership, it may still qualify to be shared among our members as a Special Prayer Need. See Section V.A.

Exception for Diabetes and Heart Conditions

Needs resulting from heart conditions or diabetes that existed prior to a membership will not be published even though the member went 12 months without symptoms, treatment, or medication. Be aware that even though a condition may appear at one time to have been cured, there could be a subsequent relapse or complication which is a result of the original condition. If there is a question whether a member's need is the result of a previous heart condition or diabetes, a verification from a physician will be required to verify the lack of a connection.

Exception: High blood pressure will not be considered a "condition existing prior to membership" even if you have not gone 12 months symptom free, as long as you have not been hospitalized for high blood pressure in the past, and you are able to control the condition through medication or diet. Medication for treatment as a chronic condition will not be published.

Also noted the following things under their list of things that can and can't be covered:

Sexually Transmitted Diseases (STDs) - HIV, AIDS, or other STDs contracted innocently (e.g. blood transfusions or medical procedures) will be published. We do not publish for sexually transmitted diseases, including the HIV virus and/or AIDS, when contracted sexually outside of marriage, or through irresponsible behavior such as sharing hypodermic needles for legal or illegal drugs. It is the member's responsibility to demonstrate that the disease was contracted innocently.

Organ Transplants - Routine (not experimental) organ transplants are publishable, and are subject to the limitations for conditions that existed prior to membership

Speech Therapy - Needs for treatment of speech problems related to an illness or accident (e.g. stroke) are publishable, but developmental related speech therapy will not be publishable.

ADD, ADHD, and SPD - Psychotropic medication, to treat chemical imbalances not demonstrable by lab tests, for Attention Deficit Disorder, Attention Deficit Hyperactivity Disorder, Sensory Processing Disorder,and similar disorders are not publishable.

Infertility Expenses - Bills for prescriptions, tests, treatment, in vitro fertilization, or other procedures related to infertility are not publishable. However, medical expenses for an embryo adoption and implantation will be eligible for sharing as a Special Prayer Need.

Mental Illness - Expenses from treating mental illness are not publishable, including bills for mental, emotional, spiritual, psychological or psychiatric tests, or treatment.

[Zoom]

I checked out Samaritan Ministries when Kim at LiaS posted about it and I was left feeling super ill. The following three make me extra mad:

ADD, ADHD, and SPD - Psychotropic medication, to treat chemical imbalances not demonstrable by lab tests, for Attention Deficit Disorder, Attention Deficit Hyperactivity Disorder, Sensory Processing Disorder,and similar disorders are not publishable.

Infertility Expenses - Bills for prescriptions, tests, treatment, in vitro fertilization, or other procedures related to infertility are not publishable. However, medical expenses for an embryo adoption and implantation will be eligible for sharing as a Special Prayer Need.

Mental Illness - Expenses from treating mental illness are not publishable, including bills for mental, emotional, spiritual, psychological or psychiatric tests, or treatment.

They just continue to highlight a long standing prejudice against mental illness in the fundy culture. Many psychiatric illnesses are not treatable and the individual can go on functioning in society simply by taking one little pill per day (ask me how I know). But we won't fund it because rather than it being a chemical imbalance we think it is satan. SERIOUSLY. And we won't help kids with ADHD, ADD and SPD because they are just not disciplined correctly (read if they are properly treated through medication and/or therapy we can no longer justify hitting them with plumbing lines and complain about how our kids have heart issues). GRRRRRRRRRRRRRR

The middle one left me scratching my head. Don't prevent children, all children are blessings but don't do anything to help you actually have babies or find out why you can't have babies. But all babies are blessings. Pick one. Stick with it.

[Clementine]

Samaritan health insurance sounds extremely risky. But since they are convinced that "God will provide", I guess that they could skip health insurance all together.

I can't believe it doesn't cover mental illness. I bet half the fundie ladies suffer from depression and would benefit from medication.

[fundiefan]

Of course they don't cover mental illness. There is no such thing; it's an imaginary ailment invented by lazy people who hate god. Pray more and you will be fine. It is your fault if you are suffering. You need to get right with god and then he will get right with you.

Look at Teri Maxwell. I mean, she suffered for years. They even rejected god so much in their confusion that they tried to take over his job and prevent more kids. When they finally god right with god, Steve got a reversal, they had more babies, Teri gave up Pepsi and they are now full off happy, joyous, depression free love for god and are being rewarded. And, doesn't everyone want to be as happy as Teri? Doesn't everyone want to let god work in their hearts the way he has worked in Steve & Teri's heart? They are such a shining example of god's love and ability to cure you, if you only have enough faith. With Steve & Teri as role models, you're set for life. So, ultimately, Samaritan really makes complete sense for Nathan & Melanie.

eta to put words where they belong instead of skipping them altogether.

[formergothardite]

Their name always makes me laugh because the whole point of the Good Samaritan was to help people who are not like yourself and the whole mission of this "ministry" is to encourage people to only help people who are just like themselves.

[Buzzard]

Of course they don't cover mental illness. There is no such thing; it's an imaginary ailment invented by lazy people who hate god. Pray more and you will be fine. It is your fault if you are suffering. You need to get right with god and then he will get right with you.

Look at Teri Maxwell. I mean, she suffered for years. They even rejected god so much in their confusion that they tried to take over his job and prevent more kids. When they finally god right with god, Steve got a reversal, they had more babies, Teri gave up Pepsi and they are now full off happy, joyous, depression free love for god and are being rewarded. And, doesn't everyone want to be as happy as Teri? Doesn't everyone want to let god work in their hearts the way he has worked in Steve & Teri's heart? They are such a shining example of god's love and ability to cure you, if you only have enough faith. With Steve & Teri as role models, you're set for life. So, ultimately, Samaritan really makes complete sense for Nathan & Melanie.

eta to put words where they belong instead of skipping them altogether.

So sweet little 16 year old **** is walking back from bible study with her chaperone brother when they're jumped by an evil heathen, beaten and she's raped. No psychological treatment allowed.

**** serves our country and suffers PTSD from his experiences.... not covered.

What judgmental assholes. The whole thing is just a giant "community" that almost takes the place of facebook. I can bet that it I felt the need to post a horrible story on facebook and ask for donations for treatment I'd come up with enough.

[treemom]

Somehow i am not surprised they participate in Scamaritan Ministries.

[lilwriter85]

I was skimming their website and it looks like there is a $250 K per illness limit. That would leave a lot of people screwed.

Yup, people would be screwed with that limit, if serious injuries or illnesses occurred.

[Justme]

So sweet little 16 year old **** is walking back from bible study with her chaperone brother when they're jumped by an evil heathen, beaten and she's raped. No psychological treatment allowed.

**** serves our country and suffers PTSD from his experiences.... not covered.

What judgmental assholes. The whole thing is just a giant "community" that almost takes the place of facebook. I can bet that it I felt the need to post a horrible story on facebook and ask for donations for treatment I'd come up with enough.

Oh she becomes pregnant. She's not covered because she had sex outside of marriage.

[Buzzard]

Oh she becomes pregnant. She's not covered because she had sex outside of marriage.

AND she gets an STD and has to "prove" that it came from the rape and not from a random roll in the hay. Awesomness!

[YPestis]

I always thought of Nathan and Melenie as the less crazy members of the family. Signing up for this "insurance" contradicts that assumption. I'm glad they got their $200k in medical bills covered. But how long will this last? Melenie had problems with every pregnancy. She isn't planning birth control. She could easily lend up in the hospital again. How long before members get sick of paying off her fees? What happens to Steve's heralded "debt free" lifestyle if they get hill with snowballing medical expenses? Someday, I feel they will find themselves taken off their smug pedestal. All it takes is one really bad medical crisis.

Another thought occurred to me, what happens if Melenie delivers a premature child that requires years of developmental therapy? Good Samaritan doesn't cover that. Nathan is self-employed and will need to find insurance that covers a child with a pre-existing condition. I wonder if they will be good parents and fight to get her real coverage....or bury their heads in the sand and pretend she'll improve with prayer....

[Guest Anonymous]

pretend she'll improve with prayer....

As long as it's a 'she' it won't matter. She'll only need a chorepak and she'll be good.

[Someonetocall]

This annoys the hell out of me. How on earth does he know what that diabetic person has been doing? I have a friend who I have known since being at school. When she was 9 she became diabetic. Since then she has been hospitalised many times with her diabetes, and not because of anything she has done. Her diabetes is unstable and no matter how hard she tries she cannot control it. She will get it sorted with her insulin and for a few days it will be fine, then everythign goes tits up and she is back at square one again. It is nothing to do with what or how she eats, or how much she exercises - she is not overweight, she just has unstable diabetes which around 1% of people with type 1 diabetes have. If Nathan saw her in hospital he would presume that she was irresponsible and wasn't sticking to her diet. Diabetes cannot always be managed properly, sometimes it is brittle diabetes and then nothing you do will make a difference.

This is why I can not fathom living South of the 49th. My brother has diabetes and he is able to manage it and not stress because he knows he will always have the help he needs.

Your friend sounds like a candidate for an islet cell transplant. People with brittle control are some of the first getting it, as I understand it, because their health is the most at risk.

[genericJname]

I just googled that last year, Washington gave them a cease and desist order, but later that year, the governor signed a law that exempted health sharing groups.

I wonder if there is a case to be made for being a HIPPA violation. It sounds like, in order to get a claim paid, you are required to publicly share your private health details so everyone can pray about it**. That sounds like coercion for a patient to give up the right to privacy.

**From my years as a christian, "sharing prayer needs" is pretty much slang for gossip.

[Guest Anonymous]

**From my years as a christian, "sharing prayer needs" is pretty much slang for gossip.

Yes! :P

I expect that many of the members of the Maxwells' former church enjoy sharing 'prayer news' about them.... :)

[Justme]

I'd have to imagine since the Maxwell's are "high profile" in the fundie world, there medical expenses/needs are going to go to the top of the "needs" list. Samaritan need all the "good" publicity it can get. Since they don't guarentee payment, I'd imagine many poor fundies have received little or no money to pay their "claims".

Paying for routine medical care can be very expensive. My childs pedi charges around $200 for a visit. She's older now, so we have our yearly physicals. When she was young, we could have 5-6 extra visits per year for ear infections, strep checks, etc. Multiple that times 6-8-18 kids. Then add glasses/eye checks, dental visits, etc. All the things insurance normally covers. This will most likely prevent most visits. Which could make a simple illness/problem turn into a very serious one when medical help is received. PERSONAL RESPONSIBILITY, HEY NATHAN?!?!

And let's not forget the male penis. It should be examined at least once a year to assure it fires at maximum capacity. ;) It is afterall, an IDOL! :dance:

[chaotic life]

When my parents got divorced, my father lost his health insurance at 59 years old. After desperately searching for options, I suggested he look into Samaritan Health. The program is modeled after Anabaptist cost shares which are pretty liberal in what they cover.

What my father discovered was that Samaritan Health won't cover anything of what he needed. He needed coverage for high blood pressure, instead he found low cost prescriptions. He needs coverage for maintenance issues, and they won't cover it at all.

The biggest issue he needed covered for is actually quite insulting. At age 28, my father was a missionary in Guatemala. He contracted a nasty GI infection that left him puking for nearly 3 months straight. That puking caused him to develop a hiatal hernia and ultimately he got Barrett's esophagus, which is a pre-cancerous condition. He's supposed to get anual scopes and biopsies to make sure he doesn't develop cancer.

Samaritan Health completely disqualifies the condition as pre-existing. They also have caps even on major medical. He opted to skip Samaritan, get everything done he could before the divorce was final and is now waiting for medicare to kick in and praying nothing comes up before then.

[treemom]

I just googled that last year, Washington gave them a cease and desist order, but later that year, the governor signed a law that exempted health sharing groups.

I wonder if there is a case to be made for being a HIPPA violation. It sounds like, in order to get a claim paid, you are required to publicly share your private health details so everyone can pray about it**. That sounds like coercion for a patient to give up the right to privacy.

**From my years as a christian, "sharing prayer needs" is pretty much slang for gossip.

Health sharing groups are not subject to HIPPA

[treemom]

When my parents got divorced, my father lost his health insurance at 59 years old. After desperately searching for options, I suggested he look into Samaritan Health. The program is modeled after Anabaptist cost shares which are pretty liberal in what they cover.

What my father discovered was that Samaritan Health won't cover anything of what he needed. He needed coverage for high blood pressure, instead he found low cost prescriptions. He needs coverage for maintenance issues, and they won't cover it at all.

The biggest issue he needed covered for is actually quite insulting. At age 28, my father was a missionary in Guatemala. He contracted a nasty GI infection that left him puking for nearly 3 months straight. That puking caused him to develop a hiatal hernia and ultimately he got Barrett's esophagus, which is a pre-cancerous condition. He's supposed to get anual scopes and biopsies to make sure he doesn't develop cancer.

Samaritan Health completely disqualifies the condition as pre-existing. They also have caps even on major medical. He opted to skip Samaritan, get everything done he could before the divorce was final and is now waiting for medicare to kick in and praying nothing comes up before then.

Well let me spell out the reasons Scamaritan would not have accepted your father.

1. Getting divorced. Really? Clearly a good Christian wouldn't do that.

2. His insurance was provided by his wife, that imply his wife worked. What sort of man would allow a woman to usurp the domain and men and work. She was taking away jobs from other men.

3. He probably wasn't the right kind of missionary in Guatemala.

[MrsYoungie]

I read this but I can't believe anyone thinks this is an acceptable alternative to regular insurance or Universal health care. You have to reveal your medical problems to a bunch of random strangers to judge whether you have "sinned" or not to end up in your sorry condition? They can decide that you aren't the "right" kind of person to deserve their judgmental coverage?

I'm dumbfounded.

Total agreeance with the person who pointed out the irony of the name. The founders of this must have totally missed the point of the Good Samaritan story. Wonder what they think it really means?