CHM has two options for the sharing of pre-existing conditions: scheduled sharing and CHM Give (formerly known as Prayer Page). Here’s what you need to know about CHM and medical bill sharing for pre-existing conditions:
How CHM defines a pre-existing condition
A pre-existing condition is any medical condition for which you experience signs, symptoms, testing, or treatment before joining CHM, regardless of whether you’ve received a diagnosis (routine and/or maintenance medications are considered treatment).
For example, if you have a stent that was inserted for a heart condition before joining CHM, the stent is considered treatment and your heart condition
is pre-existing.
A condition is no longer considered pre-existing if
- you have experienced one year without signs, symptoms, or treatment;
- you’re not on a maintenance medication regimen for that condition; and
- it’s documented by your official medical records.
In contrast, cancer is no longer pre-existing if, after your doctor has pronounced you cancer-free or cured, you have gone five years without any signs, symptoms, testing, or treatment (other than routine follow-up appointments).
Active vs. maintained
We distinguish between two types of pre-existing conditions: active and maintained.
A condition is considered active—and medical bills are ineligible for sharing—if you have experienced any signs or symptoms either before or at the time of joining CHM (regardless of whether or not you’ve received a diagnosis) and/or your condition actively needs treatment other than with maintenance (routine) medications.
If there is any question about whether you’re in an active incident, CHM will request your official medical records.
Your pre-existing illness is considered maintained if
- you have gone at least 90 days without testing or treatment;
- your medical provider states that no further testing or treatment is needed; and
- your medical records show that you are cured or on a maintenance treatment regimen.
Medical expenses for conditions meeting these criteria may be considered for sharing according to CHM Guidelines as described below.
Scheduled sharing
CHM Gold members can receive assistance with medical bills for maintained pre-existing conditions according to the following schedule:
- In the first year of membership, bills incurred for a pre-existing condition are eligible for sharing up to $15,000.
- In the first two years of membership, bills incurred for a pre-existing condition are eligible for sharing up to $25,000 ($15,000 during the first year plus $10,000 during the second year).
- In the first three years of membership, bills incurred for a pre-existing condition are eligible for sharing up to $50,000 ($15,000 during the first year plus $10,000 during the second year plus $25,000 during the third year).
- After the third year of membership, the condition is no longer considered pre-existing.
Eligible medical expenses incurred during the first three years of membership that exceed the schedule limits for CHM Gold members will be considered for sharing on CHM Give.
CHM Give
CHM Give—which is published in CHM’s monthly Heartfelt Magazine—enables sharing for CHM Silver or CHM Bronze members with eligible maintained pre-existing conditions. Also, if you are a CHM Gold member with a maintained pre-existing condition and your medical bills exceed the scheduled sharing limits, the excess amount may be eligible to appear on CHM Give. Members on CHM Give provide CHM with permission to include their names, addresses, a summary of their condition, and current donation amounts.
All CHM members are invited and encouraged to give to medical bills listed on CHM Give (above regular monthly contributions) as they feel led. CHM Give donations sent to the CHM office qualify as tax-deductible charitable giving. One hundred percent of this extra giving goes to share CHM Give bills. Members listed on CHM Give receive donations each month proportionate to their total of eligible medical expenses until their bills are shared in full, so long as they remain CHM members.
This portion of our ministry is an amazing testimony to the power of the Holy Spirit to change people’s hearts.
Frequently asked questions
Any medical bills considered for the ministry’s pre-existing condition options must follow all other Guidelines for sharing eligibility. Also important is the distinction between active and maintained pre-existing conditions.
A condition is considered active and medical bills cannot be shared if, at the time you join CHM, you have experienced any signs or symptoms either before or after joining CHM (regardless of whether or not you’ve received a diagnosis), and your conditions actively need treatment (other than with maintenance [routine] medications).
If you have gone at least 90 days without testing or treatment and your doctor states you are cured, or on a maintenance treatment regimen, medical bills for any new incident (flare-up) related to the pre-existing illness are eligible for scheduled sharing (CHM Gold members) or CHM Give (CHM Gold, CHM Silver, or CHM Bronze members).
Here’s an example of the difference between an active and maintained pre-existing condition: Suppose that Joe X, a CHM Gold member, had a heart attack in October and joined CHM two months later (December). During that time he had surgery and a few follow-up appointments with his cardiologist, one of which took place after Joe joined the ministry.
According to CHM’s definition of a medical incident, Joe is in the middle of an active pre-existing incident because he hasn’t been declared cured, put on maintenance medication, or gone 90 days without treatment of his condition.
In February, Joe had an appointment with his cardiologist, at which time his doctor said he didn’t need to be seen again for six months. Joe’s treatment plan specified that aspirin is the only medication he needs to take regularly. However, Joe suffered a second heart attack in June. Medical bills related to the second attack are eligible for sharing through CHM’s options for pre-existing condition because it’s a new medical incident—he has taken only routine medication, and it has been over 90 days since he last received treatment (doctor’s office visit in February).
If you had any signs or symptoms before you joined the ministry—even if you haven’t had testing or treatment—your condition is considered pre-existing and will be evaluated according to whether it’s active or maintained (see the previous question for an explanation). Please note that CHM cannot share any bills incurred prior to joining the ministry.
If you change to a lower program, eligible medical bills for your maintained pre-existing conditions will be shared at the lower program, regardless of when your medical bills were submitted or incurred.
If you change to a higher program, medical bills for any current conditions will be shared at the lower program for the lifetime of your membership. Exception: If you’re switching to CHM Gold, a current condition eventually may be considered for sharing at CHM Gold once you are pronounced cured and one year free of signs, symptoms, and treatment (including medications). This applies regardless of whether medical bills have been previously submitted for sharing. Medical records may be requested.
New illnesses with signs, symptoms, testing, and treatment beginning after the higher program start date will be considered for sharing at the higher program.
If you’re a CHM Silver or CHM Bronze member, your eligible medical bills for your maintained pre-existing conditions will be shared through CHM Give (see below). CHM Gold members can be shared through the sharing schedule or via CHM Give if they exceed sharing schedule limits. Please see above for information about CHM Give and sharing schedule.
If a member joins CHM while she is pregnant, bills for that pregnancy cannot be shared through any of the CHM sharing programs, including the sharing schedule or CHM Give. Members must have a due date for delivery at least 300 days after joining CHM Gold for maternity bills to be eligible for sharing. Additionally, any complications for an ineligible pregnancy cannot be shared through CHM.
