Living Loving Learning

Insurance or Assurance?

In Uncategorized on Monday, December 1, 2008 at 9:56 am

After having surgery in September for removing my gall bladder I can say I’m back to normal. I am self-employed so any work I missed while recuperating was easily rescheduled. What could not have been so easy were the many (can I say MANY) bills that came after surgery. Remember, I’m self-employed. No company health insurance. We as a family are on our own.

 

Total cost after sixteen or so bills later: $21,000+  !!  All that money just to get a stinking diseased GB out of me. I give God all the praise for watching over me.

 

Now, rather than us being stuck with paying $21,000, we are only responsible for $300!  And that’s with us being considered one of Oklahoma’s uninsured families.

 

We have been lead to a great organization that we joined many years ago. Samaritan Ministries was created as a way for individuals to help families that have medical needs by using a health share newsletter.  It is not insurance, but it is assurance. SM has gone back to doing business the way insurance companies used to when they were first created many years ago, helping people with medical needs.

 

As I write today, we have paid all the bills and have heard from over 65 families sending their “share”, notes of encouragement, and prayers for my well-being. We have just experienced the fulfilling of Malachi 3:10-12 in our lives. This, though, is not the best part. The best part is when we get to send our share to help someone else, people that really need help in these uncertain times.

 

Do you have insurance?

Is it 80% or 70% coverage for medical bills, after a deductible?

Do you have fears about medical emergencies and what happens afterwards?

Let me know of any experiences you have had with the systems you now have.

 

Next, I will share how to maneuver through your medical bills.

sulphur-springs-8-8-08-043

 

 

Dirk

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  1. Sounds like a great alternative to your typical insurance policies. I was trying to tell my mom about it several weeks ago since they both work for churches and the insurance isn’t always affordable!

    I love how you describe it as “getting to send your share to someone else when they need it.” I’ve never thought of it that way with OUR insurance! 🙂

  2. I’m so glad you found that company. I absolutely hate dealing with insurance companies. Do I have fears about insurance companies??? Absolutely! But, I know where my STRENGTH comes from. Do I want to learn more though? Definately! Keep it coming!

  3. So wise… so wise…

  4. Yes, we have insurance, but having insurance does not mean assurance.

    I’ve had between 14 and 18 surgeries in the last 13 months. I’ve also had a baby in that time too. I count only 14 surgeries the insurance counts 18. Anytime, they stick an IV in my arm or perform an invasive procedure the insurance docks it as “surgery”.

    The last time I added up all the medical bills in June the grand total was $230,000. I’ve since had many doctor visits, x-rays, cat scans, etc.

    The problem with insurance is it is subjective. Some person I’ve never met who has no medical experience or education has the ability to determine whether what I had done was “necessary”.

    Many times we have had to appeal decisions made by the insurance company to cover expenses that were suppose to be covered and they decided weren’t “necessary”. Also, the patient loses. The medical facility and the insurance company get into it over something not being filed correctly and I get to pay for the mistake. If it isn’t filed correctly the insurance doesn’t pay. We’ve come across this A LOT.

    I have spent hours and hours on the phone with the insurance company and hospital working things out. The hospital wants to receive ALL of the money owed within 90 days. If you can’t pay it in 90 days they will not work out a payment plan with you. And after 90 days they send it to collection. It doesn’t matter if I made payments each month. To get a lawyer is expensive. Again they win.

    In the last 13 months we have paid $18,000 and we still owe. It has depleted our savings and for the first time in our marriage we ended up putting ER visits and medications on a credit card because I needed the care and we didn’t have the money. It has been exhausting. It is the first time in our marriage we have owed money to anyone other than our mortgage and my student loan. Very frustrating.

    Our ER visits are $350. Doctor $35.00. Deductible for hospital and such is suppose to cap at $3500 per individual and $10,000 per family. However, this does not include the amount we have paid when a procedure was done and the insurance declared it not necessary.

    For example Cat scans are $4,000—-the insurance pays less than a $1,000. When the insurance wouldn’t pay the hospital billed us $4,000—-when we called and said we would pay the $1,000 billed to the insurance in cash that day if they would settle they did not agree. Greed. A nightmare.

    In my opinion insurance companies and hospitals are greedy and it is greed that drives them not the care for the person. I am not including the doctors and nurses who have cared for me but the institutions themselves are all for their pocket book and it doesn’t seem to matter who has to lose to make their profit.

    Some days I’m thankful for insurance, some days not. In addition our monthly cost for insurance as tripled in the last two years.

    I think insurance has become a “god” in this country. This is what tugs at my heart the most. Who do I trust? Do I trust the insurance to meet my medical needs or do I trust God? My husband and I are at a crossroads in our lives with this issue.

    This is was so long. Sorry 🙂

  5. Dirk…Would like to talk to you more about this next time I see you. 🙂

  6. Donna told me about this post.

    I have my two cents to add to our personal frustrations with insurance. However, I wanted to mention my sisters.
    My sister died in 1989 of Cystic Fibrosis. I had two brothers die of the same condition before I was born. My dad had a good job and good insurance. At that time the insurance paid every cent of hospitalization. They didn’t pay for medication or doctor visits. We were poor. Dirt poor. We didn’t have “floors”. We had earth for a long time. Not because my dad didn’t work two jobs but because my sisters medical bills were so high. In the 80’s my dad paid $500.00 a month just for her medication.

    As I mentioned above, my sister died almost 20 years ago. My dad continued to make payments on her medical bills 10 years after her death. Month after month he paid between $300.00 – $500.00 a month paying for medical care for a daughter he had buried. I graduated from high school before all the bills were paid. I was 9 when she died. I admire him for that. I’m not sure I would have had the integrity to do so.

    I said all that to say the whole insurance thing is not a new problem. It’s become worse. But it is not new.

    Donna didn’t add in everything in her comment. We’ve paid around $23,000. Our payments to the hospital, urologist, anesthesiologist, labs, and OB are roughly between $500 and 800 per month. This does not include doctor visits or medication. This also does not include my asthma care costs or any medical care for our children.

    My main issue is Donna still isn’t well. All that money and she still hurts. All that money and they still don’t know exactly what is wrong. I don’t think the answer is insurance or doctors. I think it is trusting in the Lord. We pray a lot. I also do not ever want to be ungrateful for the ways in which the Lord has provided. I do desire to be wise. I desire to discern his leading for our family.

    The ministry you mentioned above sounds interesting. Appealing.

  7. I have never heard of this insurance type before and will try to remember to look it up. I have been able to get “SoonerCare” with the help of DHS. I only get it because I do not work and get child support. Recently, my living situation is about to change and I have to work. I am worried about insurance because I have back problems and nerve damage and know without any money doctors will not see me. This gives me some hope and am happy that you were able to share it will all of us.

  8. Kim: You don’t see insurance helping others out because the insurance companies have turned from helping others in need to earning profits for their stockholders.
    Erin and Anna: thanks and I will try to help just by discussing.
    Donna and Jonathan: Prayer is what we all need to offer up for you and realize that God can meet your needs. I have witnessed this. But most of all we need to pray that Donna is healed completely.
    Theresa: Any time.
    Helena: Alternatives can always be found if they are sought after. However SM does not help with pre-existing conditions. That is why the sooner a family can sign up the better.

  9. I’ve never heard of any alternatives to insurance. We are self-employed as well and pay a lot to cover our family. My question is – Does the organization you are a part of cover prescriptions? My prescriptions would be enormous without insurance.

  10. WOW! That is fantastic. Look at God providing for you guys! 🙂

  11. it’s so good to hear that you’re in good health, and that He provided so plentifully!! my parents are both teachers, and i am still on their state insurance for the time being. it’s been sufficient, but my two phases of braces as a kid and my father’s diabetes and heart and eye surgeries have put a huge dent into that. last year i underwent several tests/scans/ultrasounds which amounted to almost $900. insurance paid a tiny fraction of this [and for that i am thankful for, of course!], and my deductable was gone by march. i was terrified at any other medical expense occuring before the end of this year! though i rejoiced at a clean bill of health, i could not help but feel overwhelmed by all the bills coming to my college mailbox, and the doctors were nowhere closer in to determining what was wrong. we made it through, though, and His hand was on the situation at all times.
    my parents are in their mid-60’s and will retire within the next year or two. me being on their insurance is an added financial burden, so my mom and i are investigatng all of the individual plans available for me to pursue. it can be a scary, murky set of waters to navigate, but i’m thankful for the wisdom i know He will provide. =)

  12. Hey, didn’t know you were going through all that…my pancreas has taken me to the hospital twice…but, hey they never took it out. ha.

    I am glad you are alright. And what a great thing with the medical bills. We are members of Medi-share and while they did pay $20,000 for my lithotripsy–your group seems to be more connected and caring. I have only ever received one card.
    I would like to know more about it…are there monthly share amounts?

    Also, I am curious…do you have to eat differently when you have no gall bladder? I know there are body parts we can function fine without. Really, it’s alarming how many. adnoids, tonsils, appendix, and now apparently the gall bladder.

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