Samaritan Basic Features
Sharing Medical Needs
Medical bills related to the same condition will be shared as one need.
$1,500 Initial Unshareable Amount
Sharing starts once a need exceeds this threshold. The initial unshareable amount (IUA) can be reduced or eliminated dollar-for-dollar by discounts received.
90% Sharing Percentage
The amount shareable for a need above the initial unshareable amount. There is a maximum cumulative co-share of $13,500.
A Two-person membership, or its equivalent, is required for maternity sharing. Maternity needs have a $5,000 sharing limit. The maximum 10% co-share amount of $13,500 applies to prevent medical bills from becoming a burden.
Limit Per Need up to $236,500
The maximum amount that can be shared for a need. Save to Share™ is an optional program for sharing catastrophic needs exceeding $236,500.
You might be wondering about...
- Shareable Bills
Samaritan members share medical needs that begin after membership. A need encompasses all the medical bills related to the same condition and is shared at 90%* after the $1,500 IUA is met. For information about what types of needs are shared, see Section VIII of the Guidelines.
*except in months where proration occurs
- Pre-Existing Conditions
Needs that result from a condition that existed prior to membership are only shareable if the condition has been symptom, treatment, and medication-free for 12 consecutive months. Some pre-existing conditions, such as cancer, heart conditions, and hereditary diseases, have a five-year period before they are eligible for sharing. See Section VII of the Guidelines for more details.
- Routine Care
Routine care (dental, vision, yearly wellness checks, colonoscopies, etc.) is generally not shared by Samaritan members. If a shareable condition is discovered because of a routine visit, those related medical expenses can be shared. See Section VIII of the Guidelines for more information.
- Prescription Care
Prescriptions for shareable medical needs can be shared for up to a 120-day supply. Prescriptions for chronic, ongoing conditions are not shareable past this limit. See Section VIII of the Guidelines for more information.
- Maternity Care
Maternity needs are shareable in Samaritan Basic provided there are at least two family members in the same membership program at least 300 days before the estimated due date. A maternity need will be shared at 90% after the IUA has been met and has an initial shareable amount of $5,000. If the maternity need exceeds the initial shareable amount, additional sharing can occur once the $13,500 co-share has been reached. Families where only one person is eligible for membership can request to pay the equivalent of a Two‑Person share amount each month to be eligible for maternity care sharing as a One‑Person membership. See Section IX of the Guidelines for more information.
Members enrolled in Save to Share can have maternity needs shared beyond the $236,500 maximum shareable amount.
- Save to Share™ for Catastrophic Needs
When a catastrophic need occurs, you can be there for others, and they’ll be there for you through an optional program called Save to Share™.
Save to Share is designed to help Samaritan Classic and Samaritan Basic members with qualified needs that exceed the maximum limit per need. Participating members set aside a designated amount each year and send a portion of that savings, along with their monthly share, to a member with a catastrophic need. Depending on membership size, families set aside $133, $266, or $399 each year, and pay an annual $15 administrative fee. See Save to Share Participation for details.
Samaritan Basic has a $236,500 maximum limit per medical need.
As you work toward making your decision, we encourage you to review the Guidelines for Health Care Sharing.