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 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. The CHM Guidelines state that Medicare-eligible members must have Parts A and B to receive full sharing eligibility. For more information, visit medicare.gov, view the “Your Medicare Costs” menu and click the links for “Part A costs” and “Part B costs.” 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 Medicare Parts A and B.

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 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.

• 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 (there is a $40 annual fee per membership in Brother’s Keeper)
• 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!

CHM has evaluated adding a program specifically for Medicare-eligible members. However, the Gold program ($172 per person, per month) is comparable to the cost of Medicare supplements and works very well for Medicare-participating members.

CHM doesn’t have a program specific to Medicare-eligible 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 $2,500 and $5,000 per incident, respectively).

1. Medicare Parts A and B pay their portion of your qualifying medical charges and send you a Medicare Summary Notice. Please note: If you're a Medicare-eligible member but choose to go to a provider who does not accept Medicare, CHM can only share 20 percent of your eligible medical charges. For your benefit, please choose healthcare providers who accept Medicare.

2. You submit your Medicare Summary Notice—along with CHM’s sharing request packet—to the ministry.

a. If your provider gives you an additional discount, write in the discount amount and the adjusted total owed on your MSN before sending it to CHM.

b. Gold members only: Please send itemized bills for prescriptions only.

3. CHM processes your eligible charges and sends you a check to share the balance Medicare doesn’t pay (20 percent).

4. You pay your provider(s) directly for any balance due.

Adding Brother’s Keeper to your Gold program means that there’s no limit to the dollar amount of bills eligible for sharing. Learn more about Brother’s Keeper costs on our programs page.

Silver and Bronze, though good programs, can only share surgery bills or medical bills incurred in a hospital. Therefore, there’s no reason to offer them to CHM members on Medicare.

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. For all medical incidents, send the CHM sharing request packet. 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.

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 Medicare-eligible members who choose to go to a non-participating Medicare provider, can only receive assistance with sharing for the amount that Medicare would not have paid (20 percent). 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.