Medicare and CHM's SeniorShare™ program

Medicare is the federal health insurance program primarily for people age 65 or older. Some younger individuals with disabilities and people with kidney failure may also qualify. Medicare offers varying levels of participation, including Parts A, B, C and D.

Medicare Part A includes facility charges from inpatient hospital stays, limited care in a skilled nursing facility, limited hospice care and some home healthcare. Medicare Part B covers certain doctors’ services (including charges incurred in the hospital), some medical equipment and preventive services. Medicare-eligible members must have Parts A and B (or a Medicare Advantage Plan) to receive full sharing eligibility. Please note: CHM staff are not experts in what Medicare does and doesn’t cover. Please visit medicare.gov to make sure you understand exactly what’s covered by your Medicare plan.

Also known as Medicare part C, a Medicare Advantage Plan is a type of Medicare health plan offered by a private company. By contracting with Medicare, this type of plan provides individuals with all Part A and B benefits.

CHM is still secondary to the payment made by your Advantage Plan.

The decision to join Medicare part D is yours to make; be aware that you will be penalized if you don’t get Part D coverage in a timely manner. Medicare Prescription Drug Plans (Part D) may be helpful to CHM members who take multiple routine medications. Part D may not be necessary if you have a Medicare Advantage Plan because some of them include Part D (check your plan to learn more). At the CHM Gold level, incident-related prescription costs are eligible for sharing. However, it’s important to keep in mind that CHM does not share costs from routine, maintenance prescriptions at any membership level (Gold, Silver or Bronze).

The Medicare Helpful Contacts page is for individuals seeking more information about Medicare, including where to find local contact information and program details.

Yes, there are thousands of members who participate in both Medicare and CHM.

As healthcare costs increase, it’s wise to be ready if a medical event occurs. Though Medicare Parts A and B (or a Medicare Advantage Plan) likely will cover the majority of your healthcare costs, it’s not uncommon for senior citizens to find themselves with large dollar amounts of unpaid medical bills. As a CHM member, you can be confident that the ministry will share the remaining amount of your eligible bills according to the ministry’s Guidelines.

CHM is always secondary to other payment sources, which means financial provision through all other sources must be used before CHM members can share your medical bills.

• Qualifying Gold members participate in CHM SeniorShare™ at a reduced gift amount of $107
• Your monthly financial gift never increases because of your age or medical conditions
• One free month for each new family you bring to CHM
• No application or annual fee
• No physical required
• The joy that comes from knowing that each financial gift goes to help a fellow Christian in need—and knowing that other Christians are faithfully standing by to help you!

Participating in the Gold level's CHM SeniorShare™ program combined with Brother’s Keeper is the best option. CHM SeniorShare™ offers the highest level of cost support and helps with medical bills incurred from inpatient or outpatient hospital incidents and surgery; medical testing; physical therapy and home healthcare (up to 45 visits per illness); incident-related doctor’s office visits; and incident-related prescriptions. CHM shares up to $125,000 per illness for any of the health issues mentioned above. Adding Brother’s Keeper to your Gold program means that there’s no limit to the dollar amount of bills eligible for sharing through CHM. Silver and Bronze, though good programs, can only share medical bills incurred in a hospital (the Personal Responsibility amounts for Silver and Bronze are $2,500 and $5,000 per incident, respectively).

1. Members eligible for Medicare—for example, those
   qualifying for Social Security disability—and members 65 or older must have Medicare Part A and Part B (or a Medicare Advantage Plan) to be considered Medicare-participating members who can receive full sharing eligibility.
2. Otherwise, CHM shares up to 20 percent of the total eligible medical expenses that were incurred during months in which members were 65 or older but did not participate in Medicare (regardless of the reason), and the balance becomes the member’s responsibility.
3. Likewise, CHM shares up to 20 percent of eligible medical expenses when Medicare-participating
   members receive treatment from a non-participating Medicare provider.
4. Expenses incurred by members who choose to travel outside of the country for the purpose of undergoing testing or treatment are ineligible for sharing.

Medicare-age members should follow these important steps:

1. Submit the complete Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) for incident-related medical expenses.
2. Submit itemized bills only for expenses incurred for medical services or prescriptions from non-Medicare participating providers.
3. Complete the Sharing Request Form, Medical Release Information Form, and Letter of Explanation.
4. Do not submit the Medical Bill Worksheet. Instead, please note directly on your MSN or EOB which charges belong to your submitted incidents and indicate additional discounts applied.

As always, medical bill discounts are applied to your Personal Responsibility amount, an advantage that often brings your out-of-pocket costs to $0. The same is true with Medicare or Medicare Advantage Plans. The amount that either plan pays toward your eligible medical bills applies to your CHM Personal Responsibility. The CHM staff will make any adjustments needed and will send you the correct amount of funds when your bills are shared.

According to the CHM Guidelines, bills for nursing homes are ineligible for sharing. Long-term care insurance is a great option for people who may need nursing home benefits. More information about costs is available by contacting your insurance agent.

Medical transportation and traveling expenses are defined separately in the CHM Guidelines. At the Gold level, bills for medical transportation are eligible for sharing when that medical transport was:

• necessary to preserve the member's life, limb or eyesight, and
• the transport was either from the site of the emergency to the closest medical facility, or between medical facilities because the sending facility lacked the capability of providing the appropriate level of care.

Medical transportation bills on the Silver and Bronze level are not eligible for sharing.

Travel expenses are not eligible for sharing.

Circumstances are similar regardless of your location. Bills will be shared if they meet CHM’s Guidelines.

Though CHM doesn’t have a provider network, please note that CHM shares up to 20 percent of eligible medical expenses when Medicare-participating members receive treatment from a non-participating Medicare provider. For your benefit, please choose providers who accept Medicare.

A great advantage of being a CHM member is that you can receive a free month of membership for each new membership you bring into CHM. Members who participate in Medicare are included. Referring a friend will earn you one free month when your friend submits their third monthly financial gift.