SMI Chalk Talk: How does Medicare work with Samaritan membership?

Samaritan staff

How does Medicare work with Samaritan membership?

The first and best resource for Medicare information is Medicare.

You can be enrolled in Medicare and continue to be a Samaritan Ministries member. The need-sharing process will remain the same, but any third party that is legally responsible to pay your medical bills must meet their responsibility before we will share your need, per our Guidelines. Therefore, if you do enroll in Medicare, you must first submit your bill to Medicare before seeking assistance from your fellow SMI members.

The expenses that are eligible to be shared with Samaritan members remain the same, so routine tests and long-term prescriptions are not shared. All expenses must be submitted as a part of a qualifying medical need.

I was told I had to get Medicare Part A, Part B, and a “Medicare Supplement.” Does Samaritan Ministries count as a “Medicare Supplement” or offer one?

Samaritan Ministries is a health care sharing ministry and does not fall into the category of a “Medicare Supplement.” However, you are not required to get any supplement or any part of Medicare, and Samaritan Ministries has been meeting the medical needs of those over 65 for as long as we have existed.

What if I don’t sign up for Medicare now, but decide I want to later?

There are penalties for signing up later than a window of time that occurs when you turn 65. According to the Medicare.gov website, “If you don’t sign up for Part B when you’re first eligible or if you drop ‘Part B and then get it later, you may have to pay a late enrollment penalty for as long as you have Medicare.” [1]

Please consult a representative of the Social Security Administration for details.

Do you recommend signing up for Part A & B, just Part A, or something else?

Samaritan Ministries does not make any official recommendations regarding government programs. Some members opt out of Medicare altogether, some sign up for A & B, and many opt for only A.

How would Medicare supplement insurance apply to a member at Samaritan Ministries?

Medicare supplement insurance is for expenses not covered by Medicare, and the policies vary. Be sure to examine them carefully.

Some supplemental plans offer help with routine care and prescriptions that Samaritan Ministries does not share.

It is common for doctors to order some routine tests when a patient reaches 65, assuming that these will be covered by insurance. Frequently, these same tests would not be shareable by Samaritan Ministries because they are not related to treating a current medical condition. However, a routine test is shareable when a condition that needs further testing or treatment is discovered in that initial exam.

Some factors to consider: 

  • Most Americans who have worked during their lifetime are eligible for Part A without additional cost (beyond the Medicare tax taken from their paychecks over the years).
  • Part B will cover some expenses that are not shared through Samaritan, but it significantly reduces the amount of your Social Security check. Consult Social Security Administration personnel for details on your cost and coverage.
  • There have been reports that members have been signed up for A & B automatically, and then were not able to opt out of Part B. Make sure you find out far in advance how to opt out of Part B if that is what you want to do.
  • The cost and content of supplemental plans vary widely, from free (in some locales) to much more than the cost of a Samaritan share. As a member, you will need to evaluate what is available to you to determine what will best meet your needs and be cost-effective.

[1] “Part B Enrollment Penalty,” Medicare.gov: The Official U.S. Government Site for Medicare, www.medicare.gov/your-medicare-costs/part-b-costs/penalty/part-b-late-enrollment-penalty.html, Accessed 3 October 2014.

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