Release 2
2024 Program Updates — New member sharing guidelines
Starting September 1, 2024, we are updating sharing guidelines to require new members to wait certain periods of time before bills for some conditions and treatments can be shared. All new members can submit bills for acute illnesses and accidents, but will be limited in other types of bills they can submit.
We believe these changes are reasonable, and curtailed costs will help contain current and future Share increases for all members. (These new guidelines will not apply to members who already joined prior to September 1.)
Samaritan is implementing new member sharing guidelines that limit what new members may share.
The first three months:
Within the first three months of membership, the only bills a new member may share are for acute illness, injury, or accident.
The first twelve months:
Within the first twelve months of membership, bills for these conditions and treatments will not be shared:
- Allergy treatments
- Arthritis
- Auto-immune
- Back surgery
- Bone calcification
- Cataracts
- Glaucoma
- Hormone therapy
- Joint replacement
- Lipedema/Lymphedema
- Lyme disease
- Macular degeneration (AMD)
- Prosthetics
- Restricted airway conditions
- Varicose veins
The purpose of the three-month and twelve-month new member sharing guidelines is to better ensure that pre-existing conditions are not submitted for sharing.
Part of the reason Samaritan has always limited sharing on pre-existing conditions has been to help the entire membership maintain balance in the degree of burdens we can bear with one another. We occasionally have situations where new members submit Needs for pre-existing conditions. We have many measures in place to help us understand which conditions are considered pre-existing and thereby protect the entire membership. However, we have also recognized there’s more we could do to guide new members and help ensure pre-existing conditions are not submitted.
We are not saying a new member’s medical burden is less important or is not legitimate. We care very much for each new Samaritan member! We are saying only that we will begin sharing certain types of medical conditions for new members after three months or twelve months, depending on the medical condition.
No, you do not. The new member sharing guidelines apply only to those members who have a start date of September 1, 2024, or later.
The new member sharing guidelines apply to an individual who becomes a member on or after September 1, 2024. That means if you add your family member on or after this date, the new Guidelines will apply to that family member, even if your membership started earlier.
However, if your new family member is a newborn, whether from birth or adoption (congratulations!), that child will not be subject to these new member guidelines.
If you switch membership programs, you will not be subject to the new rules related to sharing a Need.