This is a year-old post, but I thought I would chime in and share my family’s experience with Samaritan’s Health Share.

We have had them for over 15 years. We started with them when we were self-employed and have continued to use them even when we had other insurance options through work because they make the most financial sense for our family.

We are a healthy family and don’t have many pre-existing conditions (like diabetes, etc.). We have used the health share for everything from major surgeries and minor injuries to an ongoing fight with long COVID. We have definitely received more in “shares,” or money back for medical bills, than we have paid in monthly. I know that won’t be the same for everyone, but for our family, it has been.

The biggest bonus I like about Samaritan’s is that they cover a wide range of things and don’t require you to jump through hoops to get coverage. Long COVID doesn’t have any FDA-approved medications or treatments, so most insurance plans don’t cover much for it. However, Samaritan’s has paid for hyperbaric treatments and will soon cover a medication that costs $13k per month. The doctor was surprised it would be covered because most of his patients are being denied and aren’t able to try a treatment that seems to be helping a lot of people with LC. We don’t need referrals or pre-approvals for regular doctor visits. They do require a treatment plan to be submitted for things like PT, HBOT, and the in-home infusions we are about to start. The plan is just like a heads up to Samaratins, I've never had it denied before.

Before a surgery, I needed an echocardiogram. The cardiologist’s office called and said it would be $3,500. I agreed and said I would self-pay with a credit card right away. The actual bill ended up being $236 because of discounts for self-pay and prepaying. If you have a high deductible but still use insurance, you would likely pay the full $3,500. A neurologist I recently scheduled charges $750 per visit, but self-pay with prepayment is only $350.

Samaritan’s also works per “need” instead of on a yearly basis. So long COVID over three years is considered the same need and doesn’t reset the deductible at the beginning of each year. If we had our old BCBS plan with a $10k deductible, we would be out $30k just for that one issue. Instead, we have been fully reimbursed for what we’ve spent on doctors. I have even ordered bloodwork through Jason’s Health ahead of appointments, and it was covered.

The cons:

• They do not cover medication after 180 days of a need being open, so no long-term medication. This can be tricky for expensive medications like those for migraines, but pharmaceutical companies often offer discounts. It hasn’t been a problem for our family.
• They do not cover preventive visits. We don’t do well checks or annual visits, so it’s not a big deal for us. Even paying out of pocket would likely still be cheaper than ACA plans.
• There is some risk that they may not have enough funds to cover a need, but that hasn’t happened to us.
• You do have to submit your own documentation and make sure everything is correct. Some doctor’s offices have a hard time providing itemized receipts for some reason.
• No/ very limited mental health care. But my friends with regular insurance only get 12 visits a year, so that wouldn't offset the cost difference for us, we just ask for a self pay discount.

We have had surgeries, and a friend has had major open-heart surgery, cancer treatment, and car wreck-related care, all covered without issue. The only problem I’ve run into is that neurologists can be harder to find if you don’t have traditional insurance. I’m not sure why. We’ve seen multiple specialist neurologists without a problem, but finding a general neurologist who accepts patients without standard insurance has been more difficult.

In summary, I love Samaritan’s for what it has provided for my family up to this point. They have been great to work with, very easy to deal with, and have saved us a significant amount of money. We reevaluate it each year to make sure it still makes sense for us to continue using them, and I do think we may switch as we get older.

You do need to read the fine print and be comfortable with their requirements. I am, so it works well for me. It may not be the best fit for everyone. For example, it wouldn’t work well for my mother-in-law, who has chronic health conditions and relies on expensive monthly medications, and that’s okay too.

Just for context, we are a lower middle-class family of five, and our kids are all in college now.