CHM and Medicare

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 inpatient hospital stays, care in a skilled nursing facility following a hospital stay, hospice care, and some home healthcare. Medicare Part B covers certain doctors’ services, medical equipment and preventive services. CHM’s Guidelines say that to receive full bill sharing, members must participate in Medicare Parts A and B. For more information on Medicare, visit the Medicare website, view the “Your Medicare Costs” menu and click the links for “Part A costs” and “Part B costs.”

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 a supplement and secondary to the payment made by your Advantage Plan.

The decision is yours whether to join additional Medicare programs. Medicare Prescription Drug Plans (Part D) may be helpful to CHM members who take multiple routine medications. Joining Part D may not be necessary if you have a Medicare Advantage Plan because some of them include prescriptions (check your plan to learn more). At the CHM Gold level, incident-related (related to the major medical test or procedure performed) prescription costs are eligible for sharing. However, it’s important to know that CHM does not share costs from routine, maintenance prescriptions at any membership level (Gold, Silver or Bronze).

The Medicare Helpful Contacts page provides more information about Medicare, including where to find local contact information and program details. The main Medicare page is found at medicare.gov.

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

As healthcare costs continue to rise, it’s wise to make sure you’ll be ready if a medical event occurs. Though Medicare 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 expenses. As a CHM member, you can be confident that CHM will share the remaining amount of your eligible bills.

Christian Healthcare Ministries 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. CHM requires members—of any age— to apply for financial assistance in order to reduce overall costs and keep membership affordable. When financial gift amounts are low, more believers can afford to join CHM.

CHM has evaluated adding a program specifically for members of Medicare age. However, we’ve found that using the Gold program as a Medicare supplement is more affordable than other Medicare supplements and works extremely well for Medicare-participating members. We highly recommend the Gold program as a supplement to Medicare.

CHM doesn’t have a program specific to Medicare-age members. Membership at the Gold level combined with Brother’s Keeper is the best option for members of all ages. The Gold program 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 $1,000 and $5,000 per incident, respectively).

Medicare or your Medicare Advantage Plan pays first. (CHM shares eligible medical bills after all other resources are used.) Then, instead of submitting itemized bills to CHM, submit your Medicare Summary Notice or your Medicare Advantage Plan Explanation of Benefits (EOB). The only exceptions—situations in which you’d need to send itemized bills—are prescriptions and any bills from non-Medicare participating providers. (If your healthcare provider doesn’t accept Medicare, you’ll have to file a CMS 1490S form with Medicare and send CHM your updated Medicare Summary Notice when you receive it.) For all medical incidents, send the CHM Needs Processing Forms. We also recommend watching our step-by-step video on how to submit medical expenses to CHM.

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.

Our goal is to help you prepare for unexpected events and to help you as best we can to be comfortable as you grow older. According to the CHM Guidelines, bills for nursing homes are ineligible for sharing. Long-term care insurance is a great option for people who desire nursing home benefits. More information about costs is available by contacting your local insurance agent. Medical transportation and traveling expenses are defined separately in the CHM Guidelines. At the Gold level, CHM cannot share bills incurred for medical transportation from the site of your emergency to a medical facility. However, bills for medical transportation are eligible for sharing at the Gold level if 1) you are transferred from one hospital to another hospital because the first facility cannot adequately care for you; 2) you’re transported to the nearest hospital able to provide the necessary treatment; and 3) you’re in a life-threatening situation. Medical transportation bills on the Silver and Bronze level are ineligible for sharing. Medical transportation costs from the site of your emergency to the hospital are not eligible for sharing. Likewise, travel expenses are not eligible for sharing.

CHM encourages members to get the medical care they need without delay. Therefore, you should seek treatment from any doctor or hospital as long as the treatment is within CHM Guidelines. The ministry doesn’t have a provider network from which you must choose.

Most healthcare providers accept payment from Medicare. If your healthcare provider doesn’t bill Medicare, you’ll have to file a CMS 1490S form with Medicare and send CHM your updated Medicare Summary Notice (MSN) when you receive it. For your benefit, please choose providers who accept Medicare whenever possible.

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 friends will earn you one free month when your friend submits their third monthly financial gift.

We encourage you to keep CHM as a Medicare supplement; however, if you decide to drop, you can discontinue your membership at any time. Please allow 30 days for the cancellation to take effect.